Exaggerated pulmonary hypertension during mild exercise in chronic mountain sickness.

BACKGROUND: Chronic mountain sickness (CMS) is an important public health problem and is characterized by exaggerated hypoxemia, erythrocytosis, and pulmonary hypertension. While pulmonary hypertension is a leading cause of morbidity and mortality in patients with CMS, it is relatively mild and its underlying mechanisms are not known. We speculated that during mild exercise associated with daily activities, pulmonary hypertension in CMS is much more pronounced. METHODS: We estimated pulmonary artery pressure by using echocardiography at rest and during mild bicycle exercise at 50 W in 30 male patients with CMS and 32 age-matched, healthy control subjects who were born and living at an altitude of 3,600 m. RESULTS: The modest, albeit significant difference of the systolic right-ventricular-to-right-atrial pressure gradient between patients with CMS and controls at rest (30.3 +/- 8.0 vs 25.4 +/- 4.5 mm Hg, P 5 .002) became more than three times larger during mild bicycle exercise (56.4 +/- 19.0 vs 39.8 +/- 8.0 mm Hg, P < .001). CONCLUSIONS: Measurements of pulmonary artery pressure at rest greatly underestimate pulmonary artery pressure during daily activity in patients with CMS. The marked pulmonary hypertension during mild exercise associated with daily activity may explain why this problem is a leading cause of morbidity and mortality in patients with CMS.

Discours de M. Littré prononcé à l'Académie française, le... 5 juin 1873. Discours de M. de Champagny,... en réponse au discours prononcé par M. Littré pour sa réception à l'Académie française...

Collection : Institut ; 1873, 59

Randomized double-blind controlled Phase I/IIa trial to assess the efficacy of malaria vaccine PfCS102 to protect against challenge with P. falciparum.

The aim of this Phase I/IIa double-blind controlled trial was to test the efficacy of the sporozoite-based malaria vaccine PfCS 282-383 (PfCS102) to protect against Plasmodium falciparum parasitaemia. 16 volunteers were randomized to receive twice 30 μg of PfCS102 formulated in Montanide ISA 720 or ISA 720 alone (control). Two weeks after 2nd immunization, volunteers were challenged using 5 infected mosquitoes. All vaccinees developed antibodies against PfCS102 versus none control. 8/8 vaccinees and 6/6 controls challenged developed malaria parasitaemia. The duration from infection to onset of patent parasitaemia was similar in both groups (214 h in vaccinees and 216 in controls). PfCS102 is safe and immunogenic but provides no protection against artificial challenge in its current formulation.

Coarse Aggregate Gradations for P.C. Concrete, MLR-94-8, 1995

The effect of coarse aggregate gradation and cement content on strength of concrete was studied. Concrete made of Iowa Department of Transportation Standard Mix C-3 and Aggregate Gradation No. 3 were selected as reference. C-3 proportions were used for mixes #1 and #2. C-3 mix with 10% reduction of the cement content was used for mix #3. C-3 mix with 20% reduction of the cement content was used for mix #4. On the other hand, mix #1 used coarse aggregate of Gradation No. 3, while mixes #2, #3, and #4 used coarse aggregate mix of 65% concrete stone and 35% 3/8 in. chips. It was found that strengths of portland cement concrete decrease with decreasing cement factor. On the other hand, 35% of chip replacement for coarse aggregate increases strengths of concrete. By replacing 35% of coarse aggregate with chips, one could reduce cement factor 10% and achieve equivalent strengths.

Performance of Various Thicknesses of P.C. Concrete Secondary Pavement, HR-9, 1979

In 1951 Greene County and the Iowa Highway Research Board paved County Road E-33 from Iowa Highway No. 17 (now Iowa 4) to Farlin with various thicknesses [ranging from 4.5 in. (11.4 cm) to 6 in. (15.2 cm)] of portland cement concrete pavement. The project, designated HR-9, was divided into ten research sections. This formed pavement was placed on the existing grade. Eight of the sections were non-reinforced except for centerline tie bars and no contraction joints were used. Mesh reinforcing and contraction joints spaced at 29 ft 7 in. (9.02 m) intervals were used in two 4.5-in. (11.4-cm) thick sections. The concrete in one of the sections was air entrained. Signs denoting the design and limits of the research sections were placed along the roadway. The pavement has performed well over its 28-year life, carrying a light volume of traffic safely while requiring no major maintenance. The 4.5-in. (11.4-cm) thick mesh-reinforced pavement with contraction joints has exhibited the best overall performance.

Durability of P.C. Concrete as Affected by Aggregate Size, Curing and Proportions, R-214, 1968

The durability of concrete is a most important aspect in pavement life. Deterioration of the interstate portland cement concrete pavement has prompted various studies of factors which may contribute to the durability. Studies of cores taken from deteriorated areas indicated that the larger particles of coarse aggregate may contribute greatly to the problem. This indication was mainly due to the analysis of the cracking pattern which showed that most of the cracks passed through the larger aggregates and the larger aggregate particles were more cracked than the smaller particles. The purpose of this project is to determine if the size of the coarse aggregate has a bearing on the durability of freeze and thaw beams. A secondary purpose of this project is to determine what effect the method of curing and proportions have on the durability of freeze and thaw beams.

Pathogenesis of adult-onset Still's disease: new insights from the juvenile counterpart.

Adult-onset Still's disease (AOSD) is a rare inflammatory disease characterized by the classical triad of daily fever, arthritis, and typical salmon-colored rash. Recent accumulation of knowledge, mostly arising from hereditary autoinflammatory diseases and from the systemic-onset juvenile idiopathic arthritis (sJIA), has given raise to new hypotheses on the pathophysiology of AOSD. In this review, we first discuss on the continuum between AOSD and sJIA. Then, we summarize current hypotheses on the underlying pathogenesis: (1) an infectious hypothesis; (2) an autoinflammatory hypothesis; (3) a lymphohistiocytic hypothesis; and (4) a hyperferritinemic hypothesis. Finally, we present the recent data suggesting that patients with AOSD fall into two distinct subgroups with different courses, one with prominent systemic features and one with chronic arthritis.