Jaundice in Early Infancy: The Surgical Aspects

A CAJM article on jaundice in early childhood.In this paper those conditions which cause jaundice in early infancy and are of direct interest to the surgeon are considered. While the treatment of this group is essentially surgical, an accurate diagnosis can only he made after a careful consideration of all aspects of the case in order to exclude the commoner causes of jaundice in early infancy and in particular to differentiate between the two principal causes of obstructive jaundice in young infants

Ruptured cervical aneurysm with Neurofibromatosis

A case is presented of spontaneous rupture of an aneurysm of a lateral branch of the right thyrocervical trunk in a patient suffering from diffuse neurofibromatosis. The operative findings are reported.S. Afr. Med. J., 48, 945 (1974)

Route information from a central route planner

We present a discussion of a problem posed by researchers of the comapny Ericsson, namely, to estimate the fraction of road users in a road network that must participate in a central route planning scheme such that travel time predictions improve significantly. The aim of this work is to derive a measure of travel time performance depending on the number of road users who are participating in the central route planner. The approach is mainly of a statistical nature

Diabetogenic drugs in the vervet monkey

Alloxan and streptozotocin were used to cause beta cell lysis in vervet monkeys used as recipient models for pancreatic allografts. Tests were performed on these animals to evaluate the effect of the drugs on carbohydrate metabolism. Streptozotocin is preferred as the drug of choice in creating a non-pancreatectomised hyperglycaemic recipient for pancreatic allografting.S. Afr. Med. J., 48, 273 (1974)

A limited and customized follow-up seems justified after endovascular abdominal aneurysm repair in octogenarians

ObjectiveThe objective of this study was to determine whether long-term follow-up after endovascular aneurysm repair (EVAR) is justified in octogenarians.MethodsBetween September 1996 and October 2011, all patients, including octogenarians, treated for an abdominal aortic aneurysm (AAA) by EVAR were included in a prospective database. Patients older than 80 years and with a nonruptured infrarenal aneurysm treated electively or urgently were included in the study (study group [SG]). Patients with ruptured aneurysms and patients who died during surgery or within the first postoperative month were excluded from further analysis. The control group (CG) consisted of patients younger than 80 years, matched for gender and AAA diameter. All patients were evaluated 4 to 8 weeks after EVAR and then annually thereafter. Follow-up data were complemented by review of the computerized hospital registry and charts and by contact of the patient's general practitioner or referring hospital. Primary outcomes were stent- or aneurysm-related complications and interventions. Secondary outcomes were additional surgical complications and patient survival.ResultsA total number of 193 patients (SG, n = 97; CG, n = 96) were included for analysis. Median age was 80 years, and 88.6% were male. Median follow-up time was 33.6 months (interquartile range [IQR], 12.9-68.3). Stent- and procedure-related postoperative complications were comparable between groups (SG, 41.2%; CG, 39.6%; P = .82). Median time to complication was 2.3 months (IQR, 0.2-19.4) in the SG compared with 18.1 months (IQR, 6.8-50.5) in the CG. The 2-year complication-free survival rates were 58% (SG) and 60% (CG). Interventions were performed significantly less frequently in octogenarians (SG, 8.2%; CG, 19.8%; P < .05). Median time to intervention was 11.1 months (IQR, 2.0-31.0) in the SG compared with 54.3 months (IQR, 15.0-93.2) in the CG. The 2-year intervention-free survival rates were 90% (SG) and 92% (CG). During follow-up, 98 patients died (SG, n = 54; CG, n = 44); median time to death was 31.8 months (IQR, 13.3-66.0) in the SG compared with 44.4 months (IQR, 15.0-77.7) in the CG. One aneurysm-related death occurred in the CG. The 2- and 5-year survival rates were 71% and 32% for the SG compared with 77% and 66% for the CG (P < .05).ConclusionsBecause of the low incidence of secondary procedures and AAA-related deaths in octogenarians, long-term and frequent follow-up after EVAR seems questionable. An adapted and shortened follow-up seems warranted in this patient group

Near-intrinsic energy resolution for 30-662 keV gamma rays in a high pressure xenon electroluminescent TPC

We present the design, data and results from the NEXT prototype for Double Beta and Dark Matter (NEXT-DBDM) detector, a high-pressure gaseous natural xenon electroluminescent time projection chamber (TPC) that was built at the Lawrence Berkeley National Laboratory. It is a prototype of the planned NEXT-100 136Xe neutrino-less double beta decay (0νββ) experiment with the main objectives of demonstrating near-intrinsic energy resolution at energies up to 662 keV and of optimizing the NEXT-100 detector design and operating parameters. Energy resolutions of ∼1% FWHM for 662 keV gamma rays were obtained at 10 and 15 atm and ∼5% FWHM for 30 keV fluorescence xenon X-rays. These results demonstrate that 0.5% FWHM resolutions for the 2,459 keV hypothetical neutrino-less double beta decay peak are realizable. This energy resolution is a factor 7 to 20 better than that of the current leading 0νββ experiments using liquid xenon and thus represents a significant advancement. We present also first results from a track imaging system consisting of 64 silicon photo-multipliers recently installed in NEXT-DBDM that, along with the excellent energy resolution, demonstrates the key functionalities required for the NEXT-100 0νββ search

Ionization and scintillation of nuclear recoils in gaseous xenon

Abstract Ionization and scintillation produced by nuclear recoils in gaseous xenon at approximately 14 bar have been simultaneously observed in an electroluminescent time projection chamber. Neutrons from radioisotope &#945;-Be neutron sources were used to induce xenon nuclear recoils, and the observed recoil spectra were compared to a detailed Monte Carlo employing estimated ionization and scintillation yields for nuclear recoils. The ability to discriminate between electronic and nuclear recoils using the ratio of ionization to primary scintillation is demonstrated. These results encourage further investigation on the use of xenon in the gas phase as a detector medium in dark matter direct detection experiments.This work was supported by the following agencies and institutions: the Director, Office of Science, Office of Basic Energy Sciences, of the U.S. Department of Energy, and the National Energy Research Scientific Computing Center (NERSC), supported by the Office of Science of the U.S. Department of Energy, both under Contract no. DE-AC02-05CH11231; the European Research Council under the Advanced Grant 339787-NEXT; the Ministerio de Economia y Competitividad of Spain under Grants CONSOLIDER-Ingenio 2010 C5D2008-0037 (CUP), FPA2009-13697-004-04, FPA2009-13697-C04-01, FIS2012-37947-C04-01, FIS2012-37947-C04-02, FIS2012-37947-C04-03, and FIS2012-37947-C04-04; and the Portuguese FCT and FEDER through the program COMPETE, Projects PTDC/FIS/103860/2008 and PTDC/FIS/112272/2009. J. Renner acknowledges the support of a Department of Energy National Nuclear Security Administration Stewardship Science Graduate Fellowship, grant number DE-FC52-08NA28752.Renner, J.; Gehman, VM.; Goldschmidt, A.; Matis, HS.; Miller, T.; Nakajima, Y.; Nygren, D.... (2015). Ionization and scintillation of nuclear recoils in gaseous xenon. Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment. 793:62-74. https://doi.org/10.1016/j.nima.2015.04.057S627479

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

Identification of regulatory variants associated with genetic susceptibility to meningococcal disease.

Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes