Endotoxemia and human liver transplantation

Ninety liver transplantations were performed in 81 patients. Plasma endotoxin was measured preoperatively, at the end of the anhepatic phase, and on postoperative days 1, 3, and 7. The presence of high endotoxin levels preoperatively and at the end of the anhepatic period was associated with graft failure and a high mortality. Patients with primary nonfunction of their transplants typically had severe endotoxemia. Endotoxemia could be a cause rather than an effect of perioperative complications and graft loss

The clinical significance of the arterial ketone body ratio as an early indicator of graft viabilityin human liver transplantation

Arterial ketone body ratio (AKBR) was measured sequentially in 84 liver transplantations (OLTx). These transplantation procedures were classified into 3 groups with respect to graft survival and patient condition at the end of the first month (Group A, the grafts survived longer than 1 month with satisfactory patient condition; Group B, the grafts survived longer than 1 month but the patients were ICU-bound; Group C, the grafts were lost and the patients died or underwent re-OLTx). In Group A, the AKBR was elevated to above 1.0 by the second postoperative day. In Group B, the AKBR was elevated to above 0.7 but stayed below 1.0 during this period. In Group C, the AKBR remained below 0.7 longer than 2 days after operation. Although conventional liver function tests showed significant increases in Groups B and C as compared with Group A, they were less specific in predicting ultimate graft survival. © 1991 by Williams & Wilkins

Re-entry adjustment of cross cultural workers

Copyright © 2005 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND: Re-entry adjustment affects Australian cross cultural workers returning home; and for many, loss and grief issues arise. General practitioners are often the first point of contact in the health care system and are well placed to deal with these issues. OBJECTIVE: This article examines strategies that GPs can use to support the Australian cross cultural worker on re-entry, and focuses on recognition of re-entry adjustment, the role of loss and grief issues, and the importance of dealing with these issues. DISCUSSION: Australian cross cultural workers are valued members of their communities. However, their loss and grief issues associated with re-entry adjustment on return are often unrecognised and may lead to significant morbidity. Acknowledgment of their disenfranchised grief and appropriate therapy may be part of the role of their GP. Further research is needed to equip GPs to manage this important group in the Australian community.Susan Selby, Alison Jones, Sheila Clark, Teresa Burgess and Justin Beilb

Etoposide and adriamycin containing combination chemotherapy (HOPE-Bleo) for relapsed Hodgkin's disease.

Forty-four patients with relapsed or resistant Hodgkin's disease were treated with adriamycin 40 mg m-2 i.v. on day 1, vincristine 1.4 mg m-2 i.v. on days 1 and 8, prednisolone 40 mg m-2 orally daily for 8 days, etoposide 200 mg m-2 orally daily for 4 days according to the nadir white cell count, and bleomycin 10 mg m-2 i.v. days 1 and 8 (HOPE-Bleo). Median age was 27 (range 12-71). When stage was considered according to all sites currently or previously involved by Hodgkin's disease (cumulative stage) 26 patients (59%) had stage IV, 13 (29%) stage III and five (11%) stage II disease; 33 (75%) had B symptoms. All patients had received previous chemotherapy and 18 (41%) had received two or more regimens. Twenty-six patients (59%) achieved CR and 10 (23%) PR; the median duration of CR was 22 months and median survival for all patients was 48 months. Eight patients remain in continuous CR; none of these had received extensive previous chemotherapy. Among the 19 patients who had relapsed from CR achieved by a single previous chemotherapy regimen, six (32%) achieved long CR on HOPE-Bleo. The regimen was generally well tolerated but the principal toxicity was myelosuppression. There were two toxic deaths, one due to neutropenic sepsis and the other due to acute peritonitis. The HOPE-Bleo regimen is an effective treatment for relapsed or resistant Hodgkin's disease, with a low probability of carcinogenesis and infertility. These factors suggest that HOPE-Bleo deserves further evaluation as primary treatment for Hodgkin's disease and very careful selection of relapsed patients for high dose salvage chemotherapy with bone marrow transplants must be exercised

Coexistence Curve of Perfluoromethylcyclohexane-Isopropyl Alcohol

The coexistence curve of the binary fluid mixture perfluoromethylcyclohexane-isopropyl alcohol was determined by precisely measuring the refractive index both above and below its upper critical consolute point. Sixty-seven two-phase data points were obtained over a wide range of reduced temperatures, 10(exp -5) less than t less than 2.5 x 10(exp -1), to determine the location of the critical point: critical temperature=89.901 C, and critical composition = 62.2% by volume perfluoromethylcyclohexane. These data were analyzed to determine the critical exponent 8 close to the critical point, the amplitude B, and the anomaly in the diameter. The volume-fraction coexistence curve is found to be as symmetric as any composition like variable. Correction to scaling is investigated as well as the need for a crossover theory. A model is proposed that describes the asymptotic approach to zero of the effective exponent Beta, which allows an estimation of the temperature regime free of crossover effects

Seasonal Ice Cycle at the Mars Phoenix Landing Site: 2. Postlanding CRISM and Ground Observations

The combination of ground observations from the Mars Phoenix Lander and orbital data from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) provided a detailed view of the formation of late summer surface water ice at the landing site and surrounding regions. CRISM observations of the landing site during and immediately after Phoenix operations were analyzed to track the seasonal and diurnal ice cycles during the late spring to late summer, and a nonlinear mixing model was used to estimate grain sizes and relative abundances of water ice and dust. The surface around the Phoenix landing site was ice-free from late spring through midsummer, although transient patches of mobile ices were observed in an 85 m diameter crater to the northeast of the landing site. At the ∼10 km diameter Heimdal Crater, located ∼10 km east of the landing site, permanent patches of water ice were observed to brighten during the late spring and darken during the summer, possibly as fine-grained water ice that was cold trapped onto the ice during late spring sintered into larger grains or finally sublimated, exposing larger-grained ice. CRISM spectra first show evidence of widespread ice during the night at solar longitude (Ls) ∼ 109°, ∼9 sols before Phoenix’s Surface Stereo Imager detected it. CRISM spectra first show evidence of afternoon surface ice and water ice clouds after Ls ∼ 155°, after Phoenix operations ended

Seasonal Ice Cycle at the Mars Phoenix Landing Site: 2. Postlanding CRISM and Ground Observations

The combination of ground observations from the Mars Phoenix Lander and orbital data from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) provided a detailed view of the formation of late summer surface water ice at the landing site and surrounding regions. CRISM observations of the landing site during and immediately after Phoenix operations were analyzed to track the seasonal and diurnal ice cycles during the late spring to late summer, and a nonlinear mixing model was used to estimate grain sizes and relative abundances of water ice and dust. The surface around the Phoenix landing site was ice-free from late spring through midsummer, although transient patches of mobile ices were observed in an 85 m diameter crater to the northeast of the landing site. At the ∼10 km diameter Heimdal Crater, located ∼10 km east of the landing site, permanent patches of water ice were observed to brighten during the late spring and darken during the summer, possibly as fine-grained water ice that was cold trapped onto the ice during late spring sintered into larger grains or finally sublimated, exposing larger-grained ice. CRISM spectra first show evidence of widespread ice during the night at solar longitude (Ls) ∼ 109°, ∼9 sols before Phoenix’s Surface Stereo Imager detected it. CRISM spectra first show evidence of afternoon surface ice and water ice clouds after Ls ∼ 155°, after Phoenix operations ended

Lifetime Socioeconomic Position and Twins' Health: An Analysis of 308 Pairs of United States Women Twins

BACKGROUND: Important controversies exist about the extent to which people's health status as adults is shaped by their living conditions in early life compared to adulthood. These debates have important policy implications, and one obstacle to resolving them is the relative lack of sufficient high-quality data on childhood and adult socioeconomic position and adult health status. We accordingly compared the health status among monozygotic and dizygotic women twin pairs who lived together through childhood (until at least age 14) and subsequently were discordant or concordant on adult socioeconomic position. This comparison permitted us to ascertain the additional impact of adult experiences on adult health in a population matched on early life experiences. METHODS AND FINDINGS: Our study employed data from a cross-sectional survey and physical examinations of twins in a population-based twin registry, the Kaiser Permanente Women Twins Study Examination II, conducted in 1989 to 1990 in Oakland, California, United States. The study population was composed of 308 women twin pairs (58% monozygotic, 42% dizygotic); data were obtained on childhood and adult socioeconomic position and on blood pressure, cholesterol, post-load glucose, body mass index, waist-to-hip ratio, physical activity, and self-rated health. Health outcomes among adult women twin pairs who lived together through childhood varied by their subsequent adult occupational class. Cardiovascular factors overall differed more among monozygotic twin pairs that were discordant compared to concordant on occupational class. Moreover, among the monozygotic twins discordant on adult occupational class, the working class twin fared worse and, compared to her professional twin, on average had significantly higher systolic blood pressure (mean matched difference = 4.54 mm Hg; 95% confidence interval [CI], 0.10–8.97), diastolic blood pressure (mean matched difference = 3.80 mm Hg; 95% CI, 0.44–7.17), and low-density lipoprotein cholesterol (mean matched difference = 7.82 mg/dl; 95% CI, 1.07–14.57). By contrast, no such differences were evident for analyses based on educational attainment, which does not capture post-education socioeconomic position. CONCLUSION: These results provide novel evidence that lifetime socioeconomic position influences adult health and highlight the utility of studying social plus biological aspects of twinship