Urinary Sphincter Based on Electronics and Artificial Muscles

Objectives: The AMS 800 is the current artifi cial urinary sphincter (AUS) forincontinence due to intrinsic sphincter defi ciency. Despite good clinical results,technical failures inherent to the hydraulic mechanism or urethral ischemicinjury contribute to revisions up to 60%. We are developing an electronic AUS,called ARTUS to overcome the rigors of AMS. The objective of this study wasto evaluate the technical effi cacy and tissue tolerance of the ARTUS systemin an animal model.Methods: The ARTUS is composed by three parts: thecontractile unit, a series of rings and an integrated microprocessor. The contractileunit is made of Nitinol fi bers. The rings are placed around the urethrato control the fl ow of urine by squeezing the urethra. They work in a sequentialalternative mode and are controlled by a microprocessor. In the fi rst phase athree-rings device was used while in the second phase a two-rings ARTUS wasused. The device was implanted in 14 sheep divided in two groups of six andeight animals for study purpose. The fi rst group aimed at bladder leak pointpressure (BLPP) measurement and validation of the animal model; the secondgroup aimed at verifying midterm tissue tolerance by explants at twelve weeks.General animal tolerance was also evaluated.Results: The ARTUS systemimplantation was uneventful. When the system was activated, the BLPP wasmeasured at 1.038 ± 0.044 bar (mean ± SD). Urethral tissue analysis did notshow signifi cant morphological changes. No infection and no sign of discomfortwere noted in animals at 12 weeks.Conclusions: The ARTUS proved to beeffective in continence achievement in this study. Histological results supportour idea that a sequential alternative mode can avoid urethral atrophy andischemia. Further technical developments are needed to verify long-termoutcome and permit human use.

INTERVALO HÍDRICO ÓTIMO EM SOLO CONSTRUÍDO APÓS MINERAÇÃO DE CARVÃO EM DIFERENTES LIMITES CRÍTICOS DE RESISTÊNCIA À PENETRAÇÃO E UMIDADE

Na quantificação do intervalo hídrico ótimo (IHO), são utilizados diferentes limites críticos de resistência à penetração (RP) e umidade na capacidade de campo (θCC). Para solos agrícolas, esses valores estão sendo documentados na literatura. Entretanto, para solos construídos após mineração de carvão, constata-se grande lacuna de informações. O objetivo deste trabalho foi quantificar a faixa de variação do intervalo hídrico ótimo de um solo construído sob diferentes plantas de cobertura na área de mineração de carvão de Candiota, sul do Brasil, considerando diferentes limites críticos de umidade do solo na capacidade de campo e de resistência à penetração. Foram avaliadas no experimento, em blocos casualizados com quatro repetições, as seguintes plantas de cobertura: Hemártria (Hemarthria altissima (Poir.) Stapf & C. E. Hubbard), tratamento 1 (T1); Pensacola (Paspalum notatum Flüggé), tratamento 2 (T2); Grama Tifton (Cynodon dactilon (L.) Pers.), tratamento 3 (T3); Controle (Urochloa brizantha (Hochst.) Stapf), tratamento 4 (T4); e sem plantas de cobertura, tratamento 5 (T5). Para determinar o IHO, foram utilizados diferentes valores críticos de θCC referentes às tensões de 0,006; 0,01; e 0,033 MPa e RP de 1,5; 2,0; 2,5; e 3,0 MPa, mantendo-se sempre constante a umidade do solo no ponto de murcha permanente (θPMP) como sendo igual ao valor retido na tensão de 1,5 MPa e a umidade do solo em que a porosidade de aeração (PA) é de 10 %. A faixa de variação do IHO foi maior no solo construído cultivado com Urochloa brizantha; e a menor com Pensacola, independentemente dos limites críticos de θCC e de RP. Os limites críticos de θCC e de RP utilizados na definição do IHO originaram diferentes valores de densidade critica (Dsc) para o solo construído sob diferentes plantas de cobertura. Os menores e maiores valores de Dsc foram obtidos quando utilizados como limites críticos na definição do IHO, o θCC = 0,033 MPa e a RP = 3 MPa. O solo construído cultivado com Urochloa brizantha e Hemártria apresentou valor de Ds muito próximo ao de Dsc.

pH Sensitive surfactants from lysine: assessment of their cytotoxicity and environmental behavior

The toxicity and environmental behavior of new pH-sensitive surfactants from lysine are presented. Three different chemical structures are studied: surfactants with one amino acid and one alkyl chain, surfactants with two amino acids on the polar head and one alkyl chain, and gemini surfactants. The pH sensitivity of these compounds can be tuned by modifying their chemical structures. Cytotoxicity has been evaluated using erythrocytes and fibroblast cells. The toxic effects against these cells depend on the hydrophobicity of the molecules as well as their cationic charge density. The effect of hydrophobicity and cationic charge density on toxicity is different for each type of cells. For erythrocytes, the toxicity increases as hydrophobicity and charge density increases. Nevertheless, for fibroblasts cationic charge density affects cytotoxicity in the opposite way: the higher charge density, the lower the toxicity. The effect of the pH on hemolysis has been evaluated in detail. The aquatic toxicity was established using Daphnia magna. All surfactants yielded EC50 values considerably higher than that reported for cationic surfactants based on quaternary ammonium groups. Finally, their biodegradability was evaluated using the CO2 headspace test (ISO 14593). These lysine derivatives showed high levels of biodegradation under aerobic conditions and can be classified as"readily biodegradable compounds".

Dosimetry of 90Y-ibritumomab tiuxetan as consolidation of first remission in advanced-stage follicular lymphoma: results from the international phase 3 first-line indolent trial.

The objective of this analysis was to assess the radiation exposure associated with (90)Y-ibritumomab tiuxetan when used as consolidation therapy in adults with low or minimal tumor burden after first-line therapy of advanced follicular lymphoma (FL). METHODS: The patients who were enrolled in the phase 3 first-line indolent trial were 18 y or older, with CD20(+) grade 1 or 2 stage III or IV FL, and a partial response, complete response, or unconfirmed complete response to first-line chemotherapy. The patients were allocated randomly to receive a single infusion of unlabeled rituximab 250 mg/m(2) on day -7 and consolidation on day 0 with a single dose of (90)Y-ibritumomab tiuxetan, 14.8 MBq/kg, immediately after unlabeled rituximab, 250 mg/m(2), or no further treatment. On day -7, a subset of patients received an injection of 185 MBq of (111)In-ibritumomab tiuxetan immediately after unlabeled rituximab, 250 mg/m(2), for central dosimetry analysis. Correlations were assessed between organ radiation absorbed dose and toxicity, body weight, body mass index, and progression-free survival. RESULTS: Central dosimetry evaluations were available from 57 of 70 patients. Median radiation absorbed doses were 100 cGy (range, 28-327 cGy) for the red marrow and 72 cGy (range, 46-106 cGy) for the whole body. Radiation absorbed doses did not differ significantly between patients who had a partial response or complete response to initial therapy. Progression-free survival correlated significantly with the whole-body (r = 0.4401; P = 0.0006) and bone marrow (r = 0.2976; P = 0.0246) radiation dose. Body weight was significantly negatively correlated with whole-body radiation dose (r = -0.4971; P < 0.0001). Neither the whole-body radiation dose nor the bone marrow radiation dose correlated with hematologic toxicity. CONCLUSION: In patients with low or minimal residual tumor burden after first-line chemotherapy of advanced FL, whole-body and bone marrow exposure after (90)Y-ibritumomab tiuxetan consolidation showed a significant positive correlation with progression-free survival, whereas dosimetric data could not predict hematologic toxicity.

Effect of n-3 fatty acids on cerebral markers and the inflammatory response in sepsis

Introduction ICM+ software encapsulates our 20 years' experience in brain monitoring. It collects data from a variety of bedside monitors and produces time trends of parameters defi ned using confi gurable mathematical formulae. To date it is being used in nearly 40 clinical research centres worldwide. We present its application for continuous monitoring of cerebral autoregulation using near-infrared spectroscopy (NIRS). Methods Data from multiple bedside monitors are processed by ICM+ in real time using a large selection of signal processing methods. These include various time and frequency domain analysis functions as well as fully customisable digital fi lters. The fi nal results are displayed in a variety of ways including simple time trends, as well as time window based histograms, cross histograms, correlations, and so forth. All this allows complex information from bedside monitors to be summarized in a concise fashion and presented to medical and nursing staff in a simple way that alerts them to the development of various pathological processes. Results One hundred and fi fty patients monitored continuously with NIRS, arterial blood pressure (ABP) and intracranial pressure (ICP), where available, were included in this study. There were 40 severely headinjured adult patients, 27 SAH patients (NCCU, Cambridge); 60 patients undergoing cardiopulmonary bypass (John Hopkins Hospital, Baltimore) and 23 patients with sepsis (University Hospital, Basel). In addition, MCA fl ow velocity (FV) was monitored intermittently using transcranial Doppler. FV-derived and ICP-derived pressure reactivity indices (PRx, Mx), as well as NIRS-derived reactivity indices (Cox, Tox, Thx) were calculated and showed signifi cant correlation with each other in all cohorts. Errorbar charts showing reactivity index PRx versus CPP (optimal CPP chart) as well as similar curves for NIRS indices versus CPP and ABP were also demonstrated. Conclusions ICM+ software is proving to be a very useful tool for enhancing the battery of available means for monitoring cerebral vasoreactivity and potentially facilitating autoregulation guided therapy. Complexity of data analysis is also hidden inside loadable profi les, thus allowing investigators to take full advantage of validated protocols including advanced processing formulas.

Association between foot growth and musculoskeletal loading in children with Prader-Willi syndrome before and during growth hormone treatment

OBJECTIVE: To explore how foot growth relates to musculoskeletal loading in children with Prader-Willi syndrome (PWS). STUDY DESIGN: In 37 children with PWS, foot length (FL) before and after 6 years of growth hormone therapy (GHT) was retrospectively evaluated with parental and sibling's FL, height, and factors reflecting musculoskeletal loading, such as weight for height (WfH), lean body mass (LBM; dual energy X-ray absorptiometry, deuterium labeled water), physical activity (accellerometry), and walk age. Because of the typically biphasic evolution of body mass and the late walk age in PWS, 2 age groups were separated (group 1, >2.5 years; group 2, < or =2.5 years). RESULTS: Children with PWS normalized height, but not FL after 6 years of GHT. Parental FL correlation with PWS's FL was lower than with sibling's FL. In group 1, FL positively correlated with WfH, LBM, and physical activity. In group 2, FL negatively correlated with age at onset of independent ambulation. Foot catch-up growth with GHT was slower in group 2 compared with group 1. CONCLUSION: In PWS, FL is positively associated with musculoskeletal loading. Small feet in children with PWS before and during long-term GHT may be more than just another dysmorphic feature, but may possibly reflect decreased musculoskeletal loading influencing foot growth and genetic and endocrine factors.

Radioimmunotherapy combined with maintenance anti-CD20 antibody may trigger long-term protective T cell immunity in follicular lymphoma patients.

Growing evidence suggests that the patient's immune response may play a major role in the long-term efficacy of antibody therapies of follicular lymphoma (FL). Particular long-lasting recurrence free survivals have been observed after first line, single agent rituximab or after radioimmunotherapy (RIT). Rituximab maintenance, furthermore, has a major efficacy in prolonging recurrence free survival after chemotherapy. On the other hand, RIT as a single step treatment showed a remarkable capacity to induce complete and partial remissions when applied in recurrence and as initial treatment of FL or given for consolidation. These clinical results strongly suggest that RIT combined with rituximab maintenance could stabilize the high percentages of patients with CR and PR induced by RIT. While the precise mechanisms of the long-term efficacy of these 2 treatments are not elucidated, different observations suggest that the patient's T cell immune response could be decisive. With this review, we discuss the potential role of the patient's immune system under rituximab and RIT and argue that the T cell immunity might be particularly promoted when combining the 2 antibody treatments in the early therapy of FL.

Vasopressine lors d'infarctus myocardique aigu: implications cliniques [Vasopressin in acute myocardial infarct: clinical implications]

Since current data on vasopressin (AVP) secretion during the early phase of myocardial infarction is not extensive, plasma AVP was measured in 26 patients with acute myocardial infarction. Twelve had an increased AVP concentration (23.2 +/- 7.0 pg/ml; mean +/- SEM) whereas 14 had an AVP level less than 3 pg/ml (1.96 +/- 0.14 pg/ml). The patients with AVP greater than 3 pg/ml had higher heart rate and plasma osmolality than those with AVP less than 3 pg/ml. Blood pressure values were the same in both groups of patients. There was no difference in peak CPK and iso CPK activities between the two groups. Seven patients with AVP greater than 3 pg/ml died within the next few days, while only 1 patient with AVP less than pg/ml died. It thus appears that increased AVP concentration during acute myocardial infarction is associated with a poor prognosis. Whether it is a cause or a consequence of an unfavourable course of myocardial infarction remains to be determined.

Tres argumentos para di/versificar as identidades de xénero: Arden, Pronomes e Lob*s

O noso propósito é presentar o proxecto máis ambicioso de poesía gai e lesbiana galega escrito, en paralelo, por Ana Romaní e Antón Lopo. A súa esculca poética representa unha interesante proposta de experimentación formal, na que se renova a concepción da poesía ó levala e adaptala a outros soportes, sen perder por iso a intensidade e a emoción lírica. Ademais ofrece dúas reflexións diferentes e complementarias sobre as identidades homosexuais, nas que se subliña o dereito a saír da sombra, a reivindicación do goce sexual (a arder e a ser lob*), e a definirse por posición e non pola imposición das convencións xenéricas (a rebeiión contra os pronomes).

Ursinia nana (Anthemideae, Asteraceae), and adventive from South Africa which is becoming naturalized in the Iberian Peninsula. Observations about its reproductive biology and fruit dispersal mechanism.

The presence of Ursinia nana, an Anthemideae of South-African origin which has been introduced into the NE Iberian Peninsula, is reported for the fi rst time in Europe. The data offered cover its precise location, morphology, chromosome number, ecology and a population census, as well as its life cycle, fl oral structure, reproductive biology and fruit dispersal mechanisms. Of special note are the clear predominance of autogamy (geitonogamy) over xenogamy as a reproductive system and the large number of fruits produced with high and immediate germinative capacity. These characteristics permit rapid colonization by the introduced species, which can become invasive. However, fruit predation by the ant Messor barbarus points to a natural mechanism that helps regulate population growth and makes biological control possible. Finally its possibilities of expansion in the colonized area and of naturalization in the NE Iberian Peninsula are assessed.

Taxonomia del grupo Anthyllis henoniana Coss. (Leguminosae): A. lugabcana, nom. nov.

Con motivo de la síntesis de Anthyllis para Flora iberica ha sido necesario revisar la nomenclatura y la taxonomía del agregado de Anthyllis henoniana, en el que se han incluido las Anthyllis sufruticosas inermes con glomérulos pauciflorus (4-7 flores), hojas subdísticas y folíolos pulvinulados. En este grupo se han reunido dos especies (A. henoniana Coss. y A. subsimplex Pomel) descritas de las estepas desérticas argelinas, junto a otra (A. sericea Lag.) descrita de los matorrales pedregosocalcáreos de Albacete. Los tres nombres han recibido diversos tratamientos taxonómicos, desde ser considerados como coespecíficos (JAFRI & ELGADI, Fl. Lybia 86:114.1980), hasta como tres entidades específicas independientes [BATTANDIER in BATTANDIER & TRABUT, Fl. Algérie (Dicot.) 1:250. 1889), o como dos especies distintas (GREUTER and al., Med-Checklist4:6-7.1989].

A proposito de la dispersion de Verbascum boerhavii L. var. bicolor (Bad.) Arcang. en Catalunya

A propósito de la dispersión de Verbascum boerhavii var. bicolor (Bad.) Arcang. en Catalunya. Verbascum boerhavii L. var. bicolor (Bad.) Arcang., Comp. Fl. Ital. 505 (1882). = V. bicolor Bad., Osserv., 3 (1824) = V. boerhavii L. fma. bicolor (Bad.) Murb., Lunds. Univ. Arssk, 29 (2): 159 (1933). = V. maiale DC. var. bicolor (Bad.) Rouy, Fl. Fr. 9:9 (1909).