[MRI-based diagnosis of an acute bilateral compartment syndrome]

The acute compartment syndrome describes a posttraumatic or inflammatory edema, which leads to a painful constraint of muscular movement and paresthesia. An increase in pressure in the anatomical compartment is postulated. The main symptoms include local swelling, sensory loss, local muscle weakness as well as late livid discoloration. Therapy of choice is an early fasciotomy with decompression to avoid serious complications like muscle necrosis. Here we report a 22 year old patient who postoperatively suffered from a bilateral paresis of the foot jack. Further examinations by electromyography and magnetic resonance imaging (MRI) led to the diagnosis of an acute bilateral compartment syndrome.

Variability in outcome and resource use in intensive care units

OBJECTIVE: To examine variability in outcome and resource use between ICUs. Secondary aims: to assess whether outcome and resource use are related to ICU structure and process, to explore factors associated with efficient resource use. DESIGN AND SETTING: Cohort study, based on the SAPS 3 database in 275 ICUs worldwide. PATIENTS: 16,560 adults. MEASUREMENTS AND RESULTS: Outcome was defined by standardized mortality rate (SMR). Standardized resource use (SRU) was calculated based on length of stay in the ICU, adjusted for severity of acute illness. Each unit was assigned to one of four groups: "most efficient" (SMR and SRU < median); "least efficient" (SMR, SRU > median); "overachieving" (low SMR, high SRU), "underachieving" (high SMR, low SRU). Univariate analysis and stepwise logistic regression were used to test for factors separating "most" from "least efficient" units. Overall median SMR was 1.00 (IQR 0.77-1.28) and SRU 1.07 (0.76-1.58). There were 91 "most efficient", 91 "least efficient", 47 "overachieving", and 46 "underachieving" ICUs. Number of physicians, of full-time specialists, and of nurses per bed, clinical rounds, availability of physicians, presence of emergency department, and geographical region were significant in univariate analysis. In multivariate analysis only interprofessional rounds, emergency department, and geographical region entered the model as significant. CONCLUSIONS: Despite considerable variability in outcome and resource use only few factors of ICU structure and process were associated with efficient use of ICU. This suggests that other confounding factors play an important role.

Dynamics and kinematics of eruptive activity at Fuego volcano, Guatemala 2005-2009

Volcanoes are the surficial expressions of complex pathways that vent magma and gasses generated deep in the Earth. Geophysical data record at least the partial history of magma and gas movement in the conduit and venting to the atmosphere. This work focuses on developing a more comprehensive understanding of explosive degassing at Fuego volcano, Guatemala through observations and analysis of geophysical data collected in 2005 – 2009. A pattern of eruptive activity was observed during 2005 – 2007 and quantified with seismic and infrasound, satellite thermal and gas measurements, and lava flow lengths. Eruptive styles are related to variable magma flux and accumulation of gas. Explosive degassing was recorded on broadband seismic and infrasound sensors in 2008 and 2009. Explosion energy partitioning between the ground and the atmosphere shows an increase in acoustic energy from 2008 to 2009, indicating a shift toward increased gas pressure in the conduit. Very-long-period (VLP) seismic signals are associated with the strongest explosions recorded in 2009 and waveform modeling in the 10 – 30 s band produces a best-fit source location 300 m west and 300 m below the summit crater. The calculated moment tensor indicates a volumetric source, which is modeled as a dike feeding a SW-dipping (35°) sill. The sill is the dominant component and its projection to the surface nearly intersects the summit crater. The deformation history of the sill is interpreted as: 1) an initial inflation due to pressurization, followed by 2) a rapid deflation as overpressure is explosively release, and finally 3) a reinflation as fresh magma flows into the sill and degasses. Tilt signals are derived from the horizontal components of the seismometer and show repetitive inflation deflation cycles with a 20 minute period coincident with strong explosions. These cycles represent the pressurization of the shallow conduit and explosive venting of overpressure that develops beneath a partially crystallized plug of magma. The energy released during the strong explosions has allowed for imaging of Fuego’s shallow conduit, which appears to have migrated west of the summit crater. In summary, Fuego is becoming more gas charged and its summit centered vent is shifting to the west - serious hazard consequences are likely.

Climatological study of transport to the PICO-NARE site using atmospheric backward trajectories

This study developed a transport climatology to the PICO-NARE station, in the central North Atlantic Ocean, using a 40-year set of atmospheric back trajectories. The trajectory set was subjected to a cluster analysis in order to group trajectories into six flow patterns, or clusters. An air flow probability analysis was conducted in conjunction with the cluster analysis in order to determine the source regions for flow to the site. Seasonal differences in the flow patterns were found, which included enhanced westerly flow in the winter, decreased westerly flow in the summer, and spring and fall having moderate westerly flow. The North Atlantic Oscillation had a significant impact on the winter and fall seasons and less significant impacts during spring and summer. The results of the climatology can be used in conjunction with measurements of ozone, CO, NOx, and NOy, which are currently being measured at the site, to develop a long-term, seasonal climatology of transport of pollutants to the central North Atlantic.

Steady state free precession magnetization transfer imaging

The formerly proposed concept for magnetization transfer imaging (MTI) using balanced steady-state free precession (SSFP) image acquisitions is in this work extended to nonbalanced protocols. This allows SSFP-based MTI of targets with high susceptibility variation (such as the musculoskeletal system), or at ultra-high magnetic fields (where balanced SSFP suffers from considerable off-resonance related image degradations). In the first part, SSFP-based MTI in human brain is analyzed based on magnetization transfer ratio (MTR) histograms. High correlations are observed among all different SSFP MTI protocols and thereby ensure proper conceptual extension to nonbalanced SSFP. The second part demonstrates SSFP-based MTI allowing fast acquisition of high resolution volumetric MTR data from human brain and cartilage at low (1.5T) to ultra-high (7.0T) magnetic fields.

A Study of the Action of Various Energizers in the Carburization of Steel

The object of casehardening is to produce articles of steel having a tough or ductile interior and a hard sur­face. Quenching produces a surface somewhat harder than the interior, but in order to obtain a high surface hard­ness, the percentage of alloying elements in the steel must be raised to such an extent that the core or central por­tion becomes hard and brittle also.

The stem-loop binding protein stimulates histone translation at an early step in the initiation pathway

Metazoan replication-dependent histone mRNAs do not have a poly(A) tail but end instead in a conserved stem-loop structure. Efficient translation of these mRNAs is dependent on the stem-loop binding protein (SLBP). Here we explore the mechanism by which SLBP stimulates translation in vertebrate cells, using the tethered function assay and analyzing protein-protein interactions. We show for the first time that translational stimulation by SLBP increases during oocyte maturation and that SLBP stimulates translation at the level of initiation. We demonstrate that SLBP can interact directly with subunit h of eIF3 and with Paip1; however, neither of these interactions is sufficient to mediate its effects on translation. We find that Xenopus SLBP1 functions primarily at an early stage in the cap-dependent initiation pathway, targeting small ribosomal subunit recruitment. Analysis of IRES-driven translation in Xenopus oocytes suggests that SLBP activity requires eIF4E. We propose a model in which a novel factor contacts eIF4E bound to the 5' cap and SLBP bound to the 3' end simultaneously, mediating formation of an alternative end-to-end complex.