Peculiar septic responses in traumatic tetraplegic patients

Patients with a high level tetraplegia from a spinal injury have only been able to survive the critical initial period since the development of modern resuscitation techniques including artificial respiration. However, their lives are still threatened by many complications, such as decubitis ulcers, infections and respiratory failure. We describe four young tetraplegic patients who developed an unusual sepsis pattern several years after the injury. The sepsis was accompanied by hypothermia, leukopenia and mental deterioration. This peculiar 'silent' sepsis may also occur in elderly people who are not paralysed. The question arises, therefore, if the chronic spinal cord injured patient may become 'prematurely aged'.     

An exploration of street drinking in Drumchapel, Scotland

This paper describes the results of a survey undertaken to contribute to a health needs assessment of persistent street drinkers in Drumchapel, Greater Glasgow. Street drinkers, members of the public and local service providers [including agency professionals (community workers; health workers; social workers) and others (e.g. shopkeepers)] were interviewed. Street drinkers were generally male, single, unemployed and living in their own (rented) accommodation. Not being homeless, they gave volitional reasons for drinking in the street, centred on social aspects and the cost of drinking in traditional establishments/public houses. Half the group said they did not do all their drinking on the street, suggesting alternatives may be possible. Uptake of food offered to respondents being interviewed was low, and self-reported diet was poor in vitamins and unvaried. Awareness of services was low in the street drinking group, with friends/family remaining the most common source of support. Public concern was mainly with the visibility of the group and the negative impact this was perceived to have on the community; however, service providers focused on health risks associated with street drinking. Consensus on the need for some accommodation/centre for drinkers with access to services was established across all groups.     

A dual-route account for access to grammatical gender: evidence from functional MRI

Research investigating the neural correlates of grammatical gender processing has provided contradictory evidence with respect to activation in the left inferior frontal gyrus (IFG). A possible account for these discrepancies is a dual-route model proposing explicit vs implicit access to the gender information. In this event-related fMRI experiment, we investigated this issue by taking into account different processing strategies reported by the subjects. The participants performed two tasks, a gender judgement of German nouns and a non-lexical baseline task (spacing of consonant letter strings). Depending on the reported strategy (silent production of the definite determiner or direct access to the gender information), different patterns of activation in the left IFG were observed. Direct access to gender information yielded activation in the inferior tip of BA 44, whereas the verbalisation strategy elicited activation in the superior portion of BA 44, BA 45/47, and the fronto-median wall. These results speak in favour of a dual-route account for modelling the access to grammatical gender information during language comprehension.     

13C abundances of nutrients and the effect of variations in 13C isotopic abundances of test meals formulated for 13CO2 breath tests

Unlike 14CO2 breath tests, 13CO2 breath tests are performed in the presence of a large background of naturally occurring isotope. Because the exact abundance of 13CO2 in breath can be changed by variations in diet, a study of the 13C abundance of dietary constituents and their effects on breath 13CO2 has been undertaken. Dietary constituents have been combusted to CO2 and the relative abundance of 13C analyzed by mass spectrometry. Breath CO2 was collected and isotopically analyzed after the ingestion of several dietary constituents and test meals. The 13CO2 abundance of breath CO2 was shown to change in response to the 13C abundance of the substrate being oxidized. Conversely, a test meal that closely approximates the 13C abundance of fasting breath CO2 from North Americans was shown not to alter the 13CO2 abundance in breath. Investigation of the breath 13CO2 response to individual 13C-labeled dietary constituents demonstrated that amino acids produced the earliest 13CO2 response followed in order by medium chain triglycerides, carbohydrates, and long chain triglycerides. Because of the variation in 13C abundances in nature, the 13C abundance of any unlabeled substrate ingested during a 13CO2 breath test must be considered in order to eliminate artifacts that may reduce the sensitivity of the breath test or produce erroneous results. Methods for correcting breath tests for changes in background 13CO2 abundance are also discussed.     

Assessment of clonal relationships in ipsilateral and bilateral multiple breast carcinomas by comparative genomic hybridisation and hierarchical clustering analysis

The issue of whether multiple, ipsilateral or bilateral, breast carcinomas represent multiple primary tumours or dissemination of a single carcinomatous process has been difficult to resolve, especially for individual patients. We have addressed the problem by comparative genomic hybridisation analysis of 26 tumours from 12 breast cancer patients with multiple ipsilateral and/or bilateral carcinoma lesions. Genomic imbalances were detected in 25 of the 26 (96%) tumours. Using the genomic imbalances detected in these 26 lesions as well as those previously found by us in an independent series of 35 unifocal breast carcinomas, we compared a probabilistic model for likelihood of independence with unsupervised hierarchical clustering methodologies to determine the clonal relatedness of multiple tumours in breast cancer patients. We conclude that CGH analysis of multiple breast carcinomas followed by unsupervised hierarchical clustering of the genomic imbalances is more reliable than previous criteria to determine the tumours' clonal relationship in individual patients, that most ipsilateral breast carcinomas arise through intramammary spreading of a single breast cancer, and that most patients with bilateral breast carcinomas have two different diseases.