Respiratory distress in a one-month-old child suffering brachial plexus palsy.

This paper describes a one-month-old girl presenting with respiratory and growth failure due to diaphragmatic paralysis associated with left brachial plexus palsy after forceps delivery. Despite continuous positive pressure ventilation and nasogastric feeding, the situation did not improve and a laparoscopic diaphragmatic plication had to be performed. When dealing with a child born with brachial plexus palsy, one must think of this possible association and if necessary proceed to the complementary radiological examinations. The treatment must avoid complications like feeding difficulties and failure to thrive, respiratory infections or atelectasis. It includes intensive support and a good evaluation of the prognosis of the lesion to decide the best moment for a surgical therapy.

Rehabilitation of orbital cavity after total orbital exenteration using oculofacial prostheses anchored by osseointegrated dental implants posed as a one-step surgical procedure

BACKGROUND: Total orbital exenteration is a radical surgical procedure, which typically involves the removal of the entire contents of the orbit including the periorbita, leaving the patient with a deep orbital deformity and results in devastating cosmetic, functional, and psychological consequences requiring difficult and challenging procedures for oculoplastic surgeons. Oculofacial prostheses retained by endosseous dental implants present an attractive and viable alternative when aesthetic and functional demands are beyond the capacity of local reconstructive efforts. PATIENTS AND METHODS: A 72-year-old woman presenting a malignant melanoma of the right eyelids and a 77-year-old man presenting a sebaceous carcinoma of the left upper eyelid underwent a total exenteration followed by positioning of endosseous implants (Straumann system Dental implants) as an integrated one-step combined surgical procedure. The oculofacial prosthesis was placed after epithelialization of the orbital cavity. RESULTS: The implants were perfectly osseointegrated without any complications, providing sufficient retention of the prostheses. A satisfactory aesthetic outcome has been achieved for both patients. CONCLUSIONS: Oculofacial prostheses anchored by osseointegrated dental implants placed as one-step surgical procedure ensure an adequate aesthetic result as well as a considerably decreased rehabilitation time and present a satisfactory solution when reconstruction is not a suitable option.

Two-kidney, one clip and one-kidney, one clip hypertension in mice.

The mouse remains the animal of choice in transgenic experiments, creating a need for methods of evaluating the physiology of genetically modified animals. We have established and characterized two murine models of renovascular hypertension known as the two-kidney, one clip and one-kidney, one clip models. The appropriate size of the clip lumen needed to induce high blood pressure was determined to be 0.12 mm. Clips with a lumen of 0.11 mm induced a high percentage of renal infarction, and clips with a 0.13-mm opening did not produce hypertension. Four weeks after clipping, two-kidney, one clip hypertensive mice exhibited blood pressure approximately 20 mm Hg higher than their sham-operated controls. After a similar period, this increase reached almost 35 mm Hg in the one-kidney, one clip model. Depending on the model, mice develop either renin-dependent or renin-independent hypertension. Both models are characterized by the development of cardiovascular hypertrophy.

Energy relaxation in nonlinear one-dimensional lattices

We study energy relaxation in thermalized one-dimensional nonlinear arrays of the Fermi-Pasta-Ulam type. The ends of the thermalized systems are placed in contact with a zero-temperature reservoir via damping forces. Harmonic arrays relax by sequential phonon decay into the cold reservoir, the lower-frequency modes relaxing first. The relaxation pathway for purely anharmonic arrays involves the degradation of higher-energy nonlinear modes into lower-energy ones. The lowest-energy modes are absorbed by the cold reservoir, but a small amount of energy is persistently left behind in the array in the form of almost stationary low-frequency localized modes. Arrays with interactions that contain both a harmonic and an anharmonic contribution exhibit behavior that involves the interplay of phonon modes and breather modes. At long times relaxation is extremely slow due to the spontaneous appearance and persistence of energetic high-frequency stationary breathers. Breather behavior is further ascertained by explicitly injecting a localized excitation into the thermalized arrays and observing the relaxation behavior.

EsPal: One-stop shopping for Spanish word properties

This article introduces EsPal: a Web-accessible repository containing a comprehensive set of properties of Spanish words. EsPal is based on an extensible set of data sources, beginning with a 300 million token written database and a 460 million token subtitle database. Properties available include word frequency, orthographic structure and neighborhoods, phonological structure and neighborhoods, and subjective ratings such as imageability. Subword structure properties are also available in terms of bigrams and trigrams, bi-phones, and bi-syllables. Lemma and part-of-speech information and their corresponding frequencies are also indexed. The website enables users to either upload a set of words to receive their properties, or to receive a set of words matching constraints on the properties. The properties themselves are easily extensible and will be added over time as they become available. It is freely available from the following website: http://www.bcbl.eu/databases/espal

Thoracoscopic segmentectomy: one vessel may hide a second one.

We report the case of an asymptomatic neonate prenatally diagnosed with a left basal pulmonary sequestration. The preoperative chest computed tomography with contrast showed 2 aberrant arteries arising from the distal thoracic aorta and supplying the intralobar left inferior lung malformation. Strategy and treatment by thoracoscopic segmentectomy are presented.

Autonomous Measurements of Bridge Pier and Abutment Scour using Motion-Sensing Radio Transmitters, TR-595, 2010

Two portable Radio Frequency IDentification (RFID) systems (made by Texas Instruments and HiTAG) were developed and tested for bridge scour monitoring by the Department of Civil and Environmental Engineering at the University of Iowa (UI). Both systems consist of three similar components: 1) a passive cylindrical transponder of 2.2 cm in length (derived from transmitter/responder); 2) a low frequency reader (~134.2 kHz frequency); and 3) an antenna (of rectangular or hexagonal loop). The Texas Instruments system can only read one smart particle per time, while the HiTAG system was successfully modified here at UI by adding the anti-collision feature. The HiTAG system was equipped with four antennas and could simultaneously detect 1,000s of smart particles located in a close proximity. A computer code was written in C++ at the UI for the HiTAG system to allow simultaneous, multiple readouts of smart particles under different flow conditions. The code is written for the Windows XP operational system which has a user-friendly windows interface that provides detailed information regarding the smart particle that includes: identification number, location (orientation in x,y,z), and the instance the particle was detected.. These systems were examined within the context of this innovative research in order to identify the best suited RFID system for performing autonomous bridge scour monitoring. A comprehensive laboratory study that included 142 experimental runs and limited field testing was performed to test the code and determine the performance of each system in terms of transponder orientation, transponder housing material, maximum antenna-transponder detection distance, minimum inter-particle distance and antenna sweep angle. The two RFID systems capabilities to predict scour depth were also examined using pier models. The findings can be summarized as follows: 1) The first system (Texas Instruments) read one smart particle per time, and its effective read range was about 3ft (~1m). The second system (HiTAG) had similar detection ranges but permitted the addition of an anti-collision system to facilitate the simultaneous identification of multiple smart particles (transponders placed into marbles). Therefore, it was sought that the HiTAG system, with the anti-collision feature (or a system with similar features), would be preferable when compared to a single-read-out system for bridge scour monitoring, as the former could provide repetitive readings at multiple locations, which could help in predicting the scour-hole bathymetry along with maximum scour depth. 2) The HiTAG system provided reliable measures of the scour depth (z-direction) and the locations of the smart particles on the x-y plane within a distance of about 3ft (~1m) from the 4 antennas. A Multiplexer HTM4-I allowed the simultaneous use of four antennas for the HiTAG system. The four Hexagonal Loop antennas permitted the complete identification of the smart particles in an x, y, z orthogonal system as function of time. The HiTAG system can be also used to measure the rate of sediment movement (in kg/s or tones/hr). 3) The maximum detection distance of the antenna did not change significantly for the buried particles compared to the particles tested in the air. Thus, the low frequency RFID systems (~134.2 kHz) are appropriate for monitoring bridge scour because their waves can penetrate water and sand bodies without significant loss of their signal strength. 4) The pier model experiments in a flume with first RFID system showed that the system was able to successfully predict the maximum scour depth when the system was used with a single particle in the vicinity of pier model where scour-hole was expected. The pier model experiments with the second RFID system, performed in a sandbox, showed that system was able to successfully predict the maximum scour depth when two scour balls were used in the vicinity of the pier model where scour-hole was developed. 5) The preliminary field experiments with the second RFID system, at the Raccoon River, IA near the Railroad Bridge (located upstream of 360th street Bridge, near Booneville), showed that the RFID technology is transferable to the field. A practical method would be developed for facilitating the placement of the smart particles within the river bed. This method needs to be straightforward for the Department of Transportation (DOT) and county road working crews so it can be easily implemented at different locations. 6) Since the inception of this project, further research showed that there is significant progress in RFID technology. This includes the availability of waterproof RFID systems with passive or active transponders of detection ranges up to 60 ft (~20 m) within the water–sediment column. These systems do have anti-collision and can facilitate up to 8 powerful antennas which can significantly increase the detection range. Such systems need to be further considered and modified for performing automatic bridge scour monitoring. The knowledge gained from the two systems, including the software, needs to be adapted to the new systems.

Molecular investigation of lymph nodes in colon cancer patients using one-step nucleic acid amplification (OSNA): a new road to better staging?

BACKGROUND: A new diagnostic system, called one-step nucleic acid amplification (OSNA), has recently been designed to detect cytokeratin 19 mRNA as a surrogate for lymph node metastases. The objective of this prospective investigation was to compare the performance of OSNA with both standard hematoxylin and eosin (H&E) analysis and intensive histopathology in the detection of colon cancer lymph node metastases. METHODS: In total, 313 lymph nodes from 22 consecutive patients with stage I, II, and III colon cancer were assessed. Half of each lymph node was analyzed initially by H&E followed by an intensive histologic workup (5 levels of H&E and immunohistochemistry analyses, the gold standard for the assessment of sensitivity/specificity of OSNA), and the other half was analyzed using OSNA. RESULTS: OSNA was more sensitive in detecting small lymph node tumor infiltrates compared with H&E (11 results were OSNA positive/H&E negative). Compared with intensive histopathology, OSNA had 94.5% sensitivity, 97.6% specificity, and a concordance rate of 97.1%. OSNA resulted in an upstaging of 2 of 13 patients (15.3%) with lymph node-negative colon cancer after standard H&E examination. CONCLUSIONS: OSNA appeared to be a powerful and promising molecular tool for the detection of lymph node metastases in patients with colon cancer. OSNA had similar performance in the detection of lymph node metastases compared with intensive histopathologic investigations and appeared to be superior to standard histology with H&E. Most important, the authors concluded that OSNA may lead to a potential upstaging of >15% of patients with colon cancer.

Atrial arrhythmias in adult patients with right- versus left-sided congenital heart disease anomalies.

Atrial arrhythmias (AAs) are a common complication in adult patients with congenital heart disease. We sought to compare the lifetime prevalence of AAs in patients with right- versus left-sided congenital cardiac lesions and their effect on the prognosis. A congenital heart disease diagnosis was assigned using the International Disease Classification, Ninth Revision, diagnostic codes in the administrative databases of Quebec, from 1983 to 2005. Patients with AAs were those diagnosed with an International Disease Classification, Ninth Revision, code for atrial fibrillation or intra-atrial reentry tachycardia. To ensure that the diagnosis of AA was new, a washout period of 5 years after entry into the database was used, a period during which the patient could not have received an International Disease Classification, Ninth Revision, code for AA. The cumulative lifetime risk of AA was estimated using the Practical Incidence Estimators method. The hazard ratios (HRs) for mortality, morbidity, and cardiac interventions were compared between those with right- and left-sided lesions after adjustment for age, gender, disease severity, and cardiac risk factors. In a population of 71,467 patients, 7,756 adults developed AAs (isolated right-sided, 2,229; isolated left-sided, 1,725). The lifetime risk of developing AAs was significantly greater in patients with right- sided than in patients with left-sided lesions (61.0% vs 55.4%, p <0.001). The HR for mortality and the development of stroke or heart failure was similar in both groups (HR 0.96, 95% confidence interval [CI] 0.86 to 1.09; HR 0.94, 95% CI 0.80 to 1.09; and HR 1.10, 95% CI 0.98 to 1.23, respectively). However, the rates of cardiac catheterization (HR 0.63, 95% CI 0.55 to 0.72), cardiac surgery (HR 0.40, 95% CI 0.36 to 0.45), and arrhythmia surgery (HR 0.77, 95% CI 0.6 to 0.98) were significantly less for patients with right-sided lesions. In conclusion, patients with right-sided lesions had a greater lifetime burden of AAs. However, their morbidity and mortality were no less than those with left-sided lesions, although the rate of intervention was substantially different.