Femorofemoral crossover grafts for claudication: A safe and reliable procedure

Objective:To evaluate the role of femorofemoral crossover grafts in patients with disabling claudication.Design:Retrospective study.Setting:University hospital.Materials:Two hundred and eleven patients with iliac artery disease undergoing femorofemoral crossover grafts for disabling claudication.Chief outcome measures:Perioperative mortality, follow-up cumulative graft patency, limb loss, survival, graft infection and false aneurysm formation were evaluated to determine the immediate and long-term outcome of the procedure.Main results:Primary and secondary graft patency at 5 years was 72% and 89% respectively. There were no perioperative deaths (zero 30 day mortality). Dacron was used in 66 patients (31%) and PTFE in 145 (69%). There were no differences in patency between the two graft materials but eight Dacron grafts (12.1%) were removed because of complications (false aneurysm or infection) compared to four PTFE grafts (2.7%)(p < 0.001 Chi-square). Five patients (2%) have undergone a major lower limb amputation. Forty-one patients (19%) have required subsequent inflow procedures which represents a cumulative need for inflow of 5% per year.Conclusions:Femorofemoral crossover grafts are a safe and reliable procedure in patients with disabling claudication caused by unilateral iliac artery disease

The <i>ENHANCED MAGNAPORTHE RESISTANCE 1</i> locus affects Ramularia leaf spot development in barley

Ramularia leaf spot (RLS) is a newly-important disease of barley which is caused when the fungus Ramularia collo-cygni enters necrotrophic development during colonisation of the host. Mutant alleles at the barley MILDEW LOCUS O, mlo, locus confer broad spectrum durable resistance against the powdery mildew fungus, Blumeria graminis f. sp. hordei, but can enhance susceptibility to pathogens with necrotrophic development stages such as R. collo-cygni. Given the importance of mlo in spring barley breeding programmes, identifying loci that mitigate the effect of mlo-mediated susceptibility on necrotrophic disease development is an important target. Mutation of the ENHANCED MAGNAPORTHE 1 (emr1) locus which can affect mlo-associated disease susceptibility, leads to a reduction in RLS symptoms on barley leaves but does not reduce R. collo-cygni accumulation. The effect of emr1 on the transition of R. collo-cygni from endophyte to necrotroph may relate to changes in reactive oxygen species in mutant plants which show reduced sensitivity to chloroplastic superoxide induced cell death and has lower relative chlorophyll content compared to mlo plants.</p

In situ gas treatment technology demonstration test plan

This document defines the objectives and requirements associated with undertaking a field demonstration of an in situ gas treatment appoach to remediation chromate-contaminated soil. The major tasks presented in this plan include the design and development of the surface gas treatment system, performance of permitting activities, and completion of site preparation and field testing activities

First-principles study of stability and vibrational properties of tetragonal PbTiO_3

A first-principles study of the vibrational modes of PbTiO_3 in the ferroelectric tetragonal phase has been performed at all the main symmetry points of the Brillouin zone (BZ). The calculations use the local-density approximation and ultrasoft pseudopotentials with a plane-wave basis, and reproduce well the available experimental information on the modes at the Gamma point, including the LO-TO splittings. The work was motivated in part by a previously reported transition to an orthorhombic phase at low temperatures [(J. Kobayashi, Y. Uesu, and Y. Sakemi, Phys. Rev. B {\bf 28}, 3866 (1983)]. We show that a linear coupling of orthorhombic strain to one of the modes at Gamma plays a role in the discussion of the possibility of this phase transition. However, no mechanical instabilities (soft modes) are found, either at Gamma or at any of the other high-symmetry points of the BZ.Comment: 8 pages, two-column style with 3 postscript figures embedded. Uses REVTEX and epsf macros. Also available at http://www.physics.rutgers.edu/~dhv/preprints/index.html#ag_pbt

Systematic uncertainties in the precise determination of the strangeness magnetic moment of the nucleon

Systematic uncertainties in the recent precise determination of the strangeness magnetic moment of the nucleon are identified and quantified. In summary, G_M^s = -0.046 \pm 0.019 \mu_N.Comment: Invited presentation at PAVI '04, International Workshop on Parity Violation and Hadronic Structure, Laboratoire de Physique Subatomique et de Cosmologie, Grenoble, France, June 8-11, 2004. 7 pages, 16 figure

Reducing αENaC expression in the kidney connecting tubule induces pseudohypoaldosteronism type 1 symptoms during K+ loading.

Genetic inactivation of the epithelial Na(+) channel α-subunit (αENaC) in the renal collecting duct (CD) does not interfere with Na(+) and K(+) homeostasis in mice. However, inactivation in the CD and a part of the connecting tubule (CNT) induces autosomal recessive pseudohypoaldosteronism type 1 (PHA-1) symptoms in subjects already on a standard diet. In the present study, we further examined the importance of αENaC in the CNT. Knockout mice with αENaC deleted primarily in a part of the CNT (CNT-KO) were generated using Scnn1a(lox/lox) mice and Atp6v1b1::Cre mice. With a standard diet, plasma Na(+) concentration ([Na(+)]) and [K(+)], and urine Na(+) and K(+) output were unaffected. Seven days of Na(+) restriction (0.01% Na(+)) led to a higher urine Na(+) output only on days 3-5, and after 7 days plasma [Na(+)] and [K(+)] were unaffected. In contrast, the CNT-KO mice were highly susceptible to a 2-day 5% K(+) diet and showed lower food intake and relative body weight, lower plasma [Na(+)], higher fractional excretion (FE) of Na(+), higher plasma [K(+)], and lower FE of K(+). The higher FE of Na(+) coincided with lower abundance and phosphorylation of the Na(+)-Cl(-) cotransporter. In conclusion, reducing ENaC expression in the CNT induces clear PHA-1 symptoms during high dietary K(+) loading

An Update of the Mayo Clinic Cohort of Patients with Adult Primary Central Nervous System Vasculitis

Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with cerebral amyloid angiopathy. The annual incidence rate of PCNSV was estimated at 2.4 cases per 1,000,000 person-years. PCNSV appears to consist of several subsets defined by the size of the vessels involved, the clinical characteristics at presentation, MRI findings, and histopathological patterns on biopsy. Early recognition and treatment may reduce poor outcomes

Comparison of seismic sources for imaging geologic structures on the Oak Ridge Reservation, Tennessee

In this study, five non-invasive swept sources, three non-invasive impulsive sources and one invasive impulsive source were compared. Previous shallow seismic source tests (Miller and others, 1986, 1992, 1994) have established that site characteristics should be considered in determining the optimal source. These studies evaluated a number of invasive sources along with a few non-invasive impulsive sources. Several sources (particularly the high frequency vibrators) that were included in the ORR test were not available or not practical during previous tests, cited above. This study differs from previous source comparisons in that it (1) includes many swept sources, (2) is designed for a greater target depth, (3) was conducted in a very different geologic environment, and (4) generated a larger and more diverse data set (including high fold CMP sections and walkaway vertical seismic profiles) for each source. The test site is centered around test injection well HF-2, between the southern end of Waste Area Grouping 5 (WAG 5) and the High Flux Isotope Reactor (HFIR)

Jet disc coupling in black hole binaries

In the last decade multi-wavelength observations have demonstrated the importance of jets in the energy output of accreting black hole binaries. The observed correlations between the presence of a jet and the state of the accretion flow provide important information on the coupling between accretion and ejection processes. After a brief review of the properties of black hole binaries, I illustrate the connection between accretion and ejection through two particularly interesting examples. First, an INTEGRAL observation of Cygnus X-1 during a 'mini-' state transition reveals disc jet coupling on time scales of orders of hours. Second, the black hole XTEJ1118+480 shows complex correlations between the X-ray and optical emission. Those correlations are interpreted in terms of coupling between disc and jet on time scales of seconds or less. Those observations are discussed in the framework of current models.Comment: Invited talk at the Fifth Stromlo Symposium: Disks, Winds & Jets - from Planets to Quasars. Accepted for publication in Astrophysics & Space Scienc