The Fontan operation in infants less than 2 years of age

AbstractYoung age remains a reported risk factor for a successful Fontan operation despite improved survival rates. Since March 1978, the Fontan operation has been performed in 47 patients. To avoid a primary or secondary polliative shunt, an early Fontan procedure (Group 1: mean age 1.5 ± 0.5 years, range 0.6 to 2) has been performed in 17 children with the outcome similar to that of the remaining 30 older patients (Group 2: mean age 7.5 ± 5 years, range 2.4 to 23 years). Preoperatively both groups had acceptable hemodynamic status for a successful Fontan result.Operative variables including cardiopulmonary bypass time, aortic cross-clamp time and core temperature were similar between groups and did not affect mortality. The postoperative mortality rate including early surgical (0% vs. 13%, respectively), late (18% vs. 12%) and total (18% vs. 23%) was similar between Groups 1 and 2 (p > 0.05). Immediate postoperative arrhythmias were more frequent in Group 1 (71% vs. 25%, p < 0.01) with no related mortality, while late arrhythmias occurred with equal frequency (29% vs. 39%, p > 0.05). Group 1 infants required a longer hospital stay (22 ± 9 vs. 14 ± 5 days, p < 0.01).Thus, young age is not a risk factor for successful outcome of the Fontan operation in patients with acceptable preoperative hemodynamic status. An early Fontan operation may also avoid prolonged palliative procedures and their potential deleterious effects

The Challenges of Pluralism: Locating Religion in a World of Diversity

This is a postprint (author's final draft) version of an article published in the journal Social Compass in 2010. The final version of this article may be found at http://dx.doi.org/10.1177/0037768610362406 (login may be required). The version made available in OpenBU was supplied by the author.The author argues that religious pluralism is the normal state of affairs. Religion itself is multi-dimensional, and the several dimensions of religious and spiritual experience can be combined in myriad ways across individual lives. Preliminary findings from new research are presented, detailing modes of spiritual discourse that include mystery, majesty, meaning, moral compassion, and social connection. These dimensions find expression across multiple social institutions. In addition, religion is multi-traditional and organized by plural producers of the goods and services and events that embody and transform religious tradition. Finally, it is argued that religious pluralism must be studied in terms of the structures of power and privilege that allow some religious ideas to be given free voice, but limit the practice of other religious rituals or the gathering of dissident religious communities

CD4 inhibits helper T cell activation at lower affinity threshold for full-length T cell receptors than single chain signaling constructs

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Triple negative breast cancers express receptors for LHRH and are potential therapeutic targets for cytotoxic LHRH-analogs, AEZS 108 and AEZS 125

Background Triple negative breast cancer (TNBC) is a distinct subtype of breast cancer burdened with a dismal prognosis due to the lack of effective therapeutic agents. Receptors for LHRH (luteinizing hormone-releasing hormone) can be successfully targeted with AEZS-108 [AN-152], an analog of LHRH conjugated to doxorubicin. Our study evaluates the presence of this target LHRH receptor in human specimens of TNBC and investigates the efficacy and toxicity of AEZS-108 in vivo. We also studied in vitro activity of AEZS-125, a new LHRH analog conjugated with the highly potent natural compound, Disorazol Z. Methods 69 human surgical specimens of TNBC were investigated for LHRH-R expression by immunohistochemistry. Expression of LHRH-R in two TNBC cell lines was evaluated by real time RT-PCR. Cytotoxicity of AEZS-125 was evaluated by Cell Titer Blue cytoxicity assay. LHRH- receptor expression was silenced with an siRNA in both cell lines. For the in vivo experiments an athymic nude mice model xenotransplanted with the cell lines, MDA-MB-231 and HCC 1806, was used. The animals were randomised to three groups receiving solvent only (d 1, 7, 14, i.v.) for control, AEZS-108 (d 1, 7, 14, i.v.) or doxorubicin at an equimolar dose (d 1, 7, 14, i.v.). Results In human clinical specimens of TNBC, expression of the LHRH-receptor was present in 49% (n = 69). HCC 1806 and MDA-MB-231 TNBC cells expressed mRNA for the LHRH-receptor. Silencing of the LHRH-receptor significantly decreased the cytotoxic effect of AEZS-108. MDA-MB-231 and HCC 1806 tumors xenografted into nude mice were significantly inhibited by treatment with AEZS-108; doxorubicin at equimolar doses was ineffective. As compared to AEZS 108, the Disorazol Z – LHRH conjugate, AEZS-125, demonstrated an increased cytotoxicity in vitro in HCC 1806 and MDA-MB-231 TNBC; this was diminished by receptor blockade with synthetic LHRH agonist (triptorelin) pretreatment. Conclusion The current study confirms that LHRH-receptors are expressed by a significant proportion of TNBC and can be successfully used as homing sites for cytotoxic analogs of LHRH, such as AEZS-108 and AEZS-125

Optimum and standard beam widths for numerical modeling of interface scattering problems

Author Posting. © Acoustical Society of America, 2000. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 107 (2000): 1095-1102, doi:10.1121/1.428399.Gaussian beams provide a useful insonifying field for surface or interface scattering problems such as encountered in electromagnetics, acoustics and seismology. Gaussian beams have these advantages: (i) They give a finite size for the scattering region on the interface. (ii) The incident energy is restricted to a small range of grazing angles. (iii) They do not have side lobes. (iv) They have a convenient mathematical expression. The major disadvantages are: (i) Insonification of an interface is nonuniform. The scattered field will depend on the location of the scatterers within the beam. (ii) The beams spread, so that propagation becomes an integral component of the scattering problem. A standard beam parameterization is proposed which keeps propagation effects uniform among various models so that the effects of scattering only can be compared. In continuous wave problems, for a given angle of incidence and incident amplitude threshold, there will be an optimum Gaussian beam which keeps the insonified area as small as possible. For numerical solutions of pulse beams, these standard parameters provide an estimate of the smallest truncated domain necessary for a physically meaningful result.This work was carried out under Office of Naval Research Grant Nos. N00014-90-I-1493, N00014-96-1-0460, and N00014-95-1-0506 and under a Mellon Independent Study Award from Woods Hole Oceanographic Institution

Fluoroquinolones and the Risk for Methicillin-resistant Staphylococcus aureus in Hospitalized Patients1

To determine whether fluoroquinolone exposure is a risk factor for the isolation of Staphylococcus aureus and whether the effect is different for methicillin-resistant S. aureus (MRSA) versus methicillin-susceptible S. aureus (MSSA), we studied two case groups. The first case group included 222 patients with nosocomially acquired MRSA. The second case group included 163 patients with nosocomially acquired MSSA. A total of 343 patients admitted concurrently served as controls. Outcome measures were the adjusted odds ratio (OR) for isolation of MRSA and MSSA after fluoroquinolone exposure. Exposure to both levofloxacin (OR 5.4; p < 0.0001) and ciprofloxacin (OR 2.2; p < 0.003) was associated with isolation of MRSA but not MSSA. After adjustment for multiple variables, both drugs remained risk factors for MRSA (levofloxacin OR 3.4; p < 0.0001; ciprofloxacin OR 2.5; p = 0.005) but not MSSA. Exposure to levofloxacin or ciprofloxacin is a significant risk factor for the isolation of MRSA, but not MSSA

Gravitational Radiation from the Coalescence of Binary Neutron Stars: Effects Due to the Equation of State, Spin, and Mass Ratio

We calculate the gravitational radiation produced by the coalescence of inspiraling binary neutron stars in the Newtonian regime using 3-dimensional numerical simulations. The stars are modeled as polytropes and start out in the point-mass regime at wide separation. The hydrodynamic integration is performed using smooth particle hydrodynamics (SPH) with Newtonian gravity, and the gravitational radiation is calculated using the quadrupole approximation. We have run a number of simulations varying the neutron star radii, equations of state, spins, and mass ratio. The resulting gravitational waveforms and spectra are rich in information about the hydrodynamics of coalescence, and show characteristic dependence on GM/Rc^2, the equation of state, and the mass ratio.Comment: 39 pages, uses Latex 2.09. To be published in the Dec. 15, 1996 issue of Physical Review D. 16 Figures (bitmapped). Originals available in compressed Postscript format at ftp://zonker.drexel.edu/papers/PAPER2