Colour M-mode velocity propagation: a glance at intra-ventricular pressure gradients and early diastolic ventricular performance.

The physiology of early-diastolic filling comprises ventricular performance and fluid dynamical principles. Elastic recoil and myocardial relaxation rate determine left ventricular early diastolic performance. The integrity of left ventricular synchrony and geometry is essential to maintain the effect of their timely action on early diastolic left ventricular filling.

Daylong triglyceridaemia in healthy Mediterranean and northern European subjects.

Background: A Mediterranean eating pattern and diet enriched in monounsaturated fatty acids may result in a favourable daylong lipid profile.

Methods: 19 Spanish males (aged 32 +/- 8 years) and 28 females (34 +/- 8 years) were matched to Dutch subjects on the basis of fasting capillary triglycerides (TGc), gender and age. TGc were self-measured at six fixed time points over three days.

Variability in dilatation of the fetal renal pelvis during a bladder filling cycle.

Objective: To investigate the variation in the dimensions of the fetal renal pelvis in relation to the degree of bladder filling in fetuses with mild pyelectasis.

Methods: Eighteen third-trimester pregnant women with mild uni- or bilateral fetal pyelectasis, defined as an anteroposterior (A-P) diameter of the renal pelvis between 5 and 10 mm, were recruited for the study. The women were examined for 2-3 h by ultrasound.

Circulatory volume expansion therapy for aneurysmal subarachnoid haemorrhage.

Background: Secondary ischaemia is a frequent complication after aneurysmal subarachnoid haemorrhage (SAH), and responsible for a substantial proportion of patients with poor outcome after SAH. The cause of secondary ischaemia is unknown, but hypovolaemia and fluid restriction are important risk factors. Therefore, volume expansion therapy (hypervolaemia) is frequently used in patients with SAH to prevent or treat secondary ischaemia.

Evaluation of copolymers of polyethylene oxide and polybutylene terephthalate (polyactive): mechanical behaviour.

Polyether-polyester segmented block copolymers (Polyactive) on the basis of polybutylene terephthalate (PBT) and polyethylene oxide (PEO) were mechanically tested. Tensile strength and modulus of elasticity in compressive and tensile deformation were recorded according to ASTM standards. These tests were done in vitro under dry and wet conditions, and after 3, 9 and 25 wk subcutaneous implantation of these materials in goats.

Release of tobramycin from tobramycin-containing bone cement in bone and serum of rabbits.

Tobramycin release from tobramycin-containing bone cement was studied in vivo in a rabbit model. After insertion of cement into the right femur, tobramycin concentration as a function of time for up to 28 days was measured in serum and bone of rabbits. Tobramycin release in the femoral cortex adjacent to the cement was found to exceed the minimal inhibitory concentration for Staphylococcus aureus Wood 46.

Highly purified lipoteichoic acid from Staphylococcus aureus induces procoagulant activity and tissue factor expression in human monocytes but is a weak inducer in whole blood: comparison with peptidoglycan.

Lipoteichoic acid from Staphylococcus aureus was a potent inducer of procoagulant activity in isolated mononuclear cells but not in whole blood. In contrast, staphylococcal peptidoglycan showed equal levels of potency in isolated mononuclear cells and whole blood, suggesting that peptidoglycan is an important inducer of procoagulant activity in severe sepsis involving gram-positive bacteria.

Insulin-like growth factor-I: clinical studies.

Insulin-like growth factor-I (IGF-I) has endocrine, autocrine and paracrine properties. Receptors for IGF-I are present on virtually all cell types but are located mainly on cells of mesenchymal origin, such as fibroblasts, chondrocytes and osteoblasts. Growth hormone (GH)-dependent and GH-independent actions of IGF-I have been implicated in normal and abnormal bone growth, diabetes mellitus, malnutrition, cancer, thyroid disease and hematological diseases.

Scintigraphic assessment of early and late parotid gland function after radiotherapy for head-and-neck cancer: a prospective study of dose-volume response relationships.

Purpose: To investigate the value of scintigraphy as an indirect measurement of parotid function after radiotherapy (RT).

Methods And Materials: Ninety-six patients with primary or postoperative RT for various malignancies in the head-and-neck region were prospectively evaluated. Parotid gland scintigraphy was performed before RT and 6 weeks and 1 year after RT.

A double-blind placebo-controlled study of controlled release fluvoxamine for the treatment of generalized social anxiety disorder.

This was a randomized double-blind placebo-controlled multicenter study to assess the efficacy, safety, and tolerability of fluvoxamine in a controlled release (CR) formulation for treatment of generalized social anxiety disorder (GSAD). A total of 300 subjects with GSAD were randomly assigned to receive either fluvoxamine CR (N = 149) or placebo (N = 151) for 12 weeks. Mean changes from baseline to end point in Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression Severity of Illness Scale (CGI-S), Sheehan Disability Scale (SDS), as well as the mean end point scores in Clinical Global Impression Improvement Scale (CGI-I) and Patient Global Impression of Improvement Scale (PGI) were compared between the fluvoxamine CR and placebo treatment groups.

Toxin-gene profile heterogeneity among endemic invasive European group A streptococcal isolates.

We determined the toxin-gene profiles of 239 endemic, invasive group A streptococcal (GAS) isolates that circulated, within a 5-year period, in European university hospitals. Profiling was performed by use of multiplex polymerase chain reaction that screened for 9 streptococcal pyrogenic exotoxins (speA, speB, speC, speF, speG, speH, speJ, ssa, and smeZ). Analysis revealed that invasive GAS isolates do not share a common toxin-gene profile.

Site-specific manifestations of invasive group a streptococcal disease: type distribution and corresponding patterns of virulence determinants.

As part of a national surveillance program on invasive group A streptococci (GAS), isolates that caused specific manifestations of invasive GAS disease in The Netherlands were collected between 1992 and 1996. These site-specific GAS infections involved meningitis, arthritis, necrotizing fasciitis, and puerperal sepsis. An evaluation was performed to determine whether GAS virulence factors correlate with these different disease manifestations.

The angiogenic factor bFGF impairs leukocyte adhesion and rolling under flow conditions.

Recirculation of leukocytes is mediated by the intricately regulated expression of adhesion molecules on both the vessel wall and leukocyte membranes. In the present paper it is demonstrated that tumor angiogenesis factors impair leukocyte rolling and adhesion under flow conditions. Three lines of evidence presented in this paper support this finding; (i) treatment of cultured endothelial cells (EC) with the angiogenic factor basic fibroblast growth factor (bFGF) results in decreased ICAM-1 expression and decreased numbers of adhering leukocytes under flow conditions.

Transmission profile of hepatitis B virus infection in the Batam region, Indonesia. Evidence for a predominantly horizontal transmission profile.

The aim of this study was to describe the distribution of hepatitis B virus markers among the autochthonous and immigrant multicultural populations of Riau province, Indonesia, in order to define the groups at risk and their infrastructure. This investigation was part of a large hepatitis B vaccination study. A total of 9701 healthy individuals, aged 5 years or older and living in the urbanised area of Batam, near Singapore, and on the surrounding islands were included.

Geriatric medicine in the European Union: future scenarios.

The differences in training and services in geriatric medicine between European Union member countries raise some questions: what is a geriatrician, what is geriatric medicine, what will be the future development of the specialty and how does it interact with other medical specialties? To find answers to these questions, a questionnaire was sent to a selected group of 122 geriatricians. The response rate was 60%. A description has been given of what is a geriatrician and what is geriatric medicine.

Biliary pronucleating proteins and apolipoprotein E in cholesterol and pigment stone patients.

Background/aims: Although cholesterol gallstone patients exhibit higher biliary cholesterol saturation than pigment stone patients, underlying mechanisms that affect stone type are unknown. We hypothesized that pronucleating proteins, hydrophobic bile salts or apolipoprotein E genotype affect stone type. We therefore compared these putative factors in cholesterol and pigment stone patients.

Repetitive phosphorus-32 peritoneal instillations in a patient with malignant ascites.

During the last decade, intraperitoneal injection of phosphorus-32 chromic phosphate (P-32 CP) has been used principally for its initial intended purpose, the palliative management of malignant ascites. The authors describe a patient with a stage IIIB well-differentiated extraovarian peritoneal serous papillary adenocarcinoma. As a palliative treatment for malignant ascites, P-32 CP was instilled intraabdominally eight times.

Is granuloma annulare related to intermediate uveitis with retinal vasculitis?

Aim: To report on eight patients with severe idiopathic intermediate uveitis (IU) and granuloma annulare (GA), a self limiting cutaneous condition of unknown aetiology.

Methods: Retrospective case series. Clinical ophthalmic and dermatological data were studied and fluorescein angiography and skin biopsies were reviewed.

Long-term clinical outcome after stent implantation in coronary arteries.

The long-term clinical outcome after planned and unplanned stent implantation was assessed in a single-center, observational study in 178 patients who underwent coronary stent implantation between November 1986 and July 1994. Main outcome measures were survival and event-free survival at 5 years (Kaplan-Meier method). Independent predictors for event-free survival were determined by using multivariate logistic regression analysis.

Calcium antagonists for aneurysmal subarachnoid haemorrhage.

Background: Secondary ischaemia is a frequent cause of poor outcome in patients with subarachnoid haemorrhage. Its pathogenesis has not been elucidated yet, but may be related to vasospasm. Experimental studies have indicated that calcium antagonists can prevent or reverse vasospasm.

External fixation with standard AO-plates: technique, indications, and results in 31 cases.

The standard AO-plate was used as an external fixator in 31 patients with an infected nonunion or open fracture mainly of the upper extremity. With the use of this technique, good stability can be achieved with an inexpensive and relatively simple construction. The low profile of the frame is an advantage for the patient.

Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison.

Objective: To study the long-term recurrence rate and other complications after conventional and laparoscopic inguinal hernia repair.

Summary Background Data: Reliable long-term follow-up of patients with inguinal hernias treated by laparoscopic repair techniques is lacking.

Methods: The authors performed a randomized, multicenter trial in which 487 patients with inguinal hernia were treated by totally extraperitoneal laparoscopic repair and 507 patients were treated by conventional anterior hernia repair.

Transmission of nosocomial pathogens.

Prevention of the spread of antibiotic-resistant micro-organisms is one of the challenges for mankind in the new millennium, according to a recent report from the World Health Organization. In our Western world resistance problems occur mainly in intensive care units (ICUs). However, the observed numbers of infections are only the tip of the iceberg of patients colonised with multiple-resistant pathogens.