Retroperitoneoscopic partial adrenalectomy for large adrenocortical oncocytoma

A young woman had mild hypertension, and on evaluation, a large tumor arising from the right adrenal gland was found. The tumor was hormonally inactive. Retroperitoneoscopic partial adrenalectomy was carried out. The histopathology report described adrenocortical oncocytoma.     

Secondary reconstruction of below knee amputation stump with free anterolateral thigh flap

Below knee stump preservation reduces ambulatory energy expenditure and improves the quality of life. Reconstruction of soft tissue loss around the stump is a challenging task. Below knee stump reconstruction demands stable skin with sufficient soft tissue to allow weigh bearing. Microsurgical tissue transfer is increasingly being used as a salvage option. Anterolateral thigh flap with additional vastus lateralis muscle provides extra cushioning effect. We report two cases of amputation below knee successfully salvaged. The anterolteral flap with abundant tissue and stable skin offers a reliable option for cover. Two patients with below knee amputation were reconstructed secondarily. After 6 to 20 months of follow -up, stumps showed no signs of pressure effects. Patients are able to bear 50-70 hours of weight per week.     

Modulation of prolactin release by a 25 kD peptide of human seminal plasma

Prolactin-regulating factor (PRF) of molecular size of 25 kD has been isolated from human seminal plasma. This 25 kD factor inhibits circulating PRL levels in intact adult male rats to the extent of about 48% at dose level of 10 micrograms. Furthermore, in vitro incubation of pituitary demonstrated that PRF inhibits the release of PRL in the medium. PRF also interferes with the binding of I125 PRL to its receptors in liver, prostate, and spermatozoa. However, I125 PRF itself does not bind to these receptors. PRF seems to modulate PRL release as well as its binding to receptors. A sensitive, specific RIA was developed for PRF. Using the RIA, levels of PRF in seminal plasma were measured. PRF levels were low in vasectomized subjects as compared with controls. A negative correlation was noted with seminal plasma PRF levels and sperm count.     

Hierarchical CdMoO4 nanowire–graphene composite for photocatalytic hydrogen generation under natural sunlight

Herein, a facile in situ solvothermal technique for the synthesis of a CdMoO₄/graphene composite photocatalyst is reported. Graphene oxide (GO) was synthesised by an improved Hummers'' method and was further used for the in situ synthesis of graphene via GO reduction and the formation of a CdMoO₄ nanowire/graphene composite. The structural phase formation of tetragonal CdMoO₄ was confirmed from X-ray diffraction measurements. The small nanoparticle assembled nanowires, prismatic microsphere morphology and crystalline nature of the synthesized material were investigated using field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM). Due to its unique morphology and stability, the CdMoO₄/graphene composite was used as a photocatalyst for H₂O splitting. In comparison to pristine CdMoO₄, the CdMoO₄/graphene composite showed the best hydrogen evolution rate, i.e. 3624 μmole h⁻¹ g⁻¹, with an apparent quantum yield of 30.5%. The CdMoO₄/graphene composite has a higher photocatalytic activity due to the inhibition of charge carrier recombination. H₂ production measurements showed that the ternary semiconductor/graphene composite has enhanced photocatalytic activity for H₂ generation.

Herein, a facile in situ solvothermal technique for the synthesis of a CdMoO₄/graphene composite photocatalyst for hydrogen generation under natural solar light.     

Managing Patients With Heart Failure: A Qualitative Study of Multidisciplinary Teams With Specialist Heart Failure Nurses

PURPOSE

The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams that include specialist heart failure nurses when caring for the management of heart failure patients.

METHODS

We used a qualitative in-depth interview study nested in a broader ethnographic study of unplanned admissions in heart failure patients (HoldFAST). We interviewed 24 clinicians across primary, secondary, and community care in 3 locations in the Midlands, South Central, and South West of England.

RESULTS

Within a framework of the role and contribution of the heart failure specialist nurse, our study identified 2 thematic areas that the clinicians agreed still represent particular challenges when working with heart failure patients. The first was communication with patients, in particular explaining the diagnosis and helping patients to understand the condition. The participants recognized that such communication was most effective when they had a long-term relationship with patients and families and that the specialist nurse played an important part in achieving this relationship. The second was communication within the team. Multidisciplinary input was especially needed because of the complexity of many patients and issues around medications, and the participants believed the specialist nurse may facilitate team communication.

CONCLUSIONS

The study highlights the role of specialist heart failure nurses in delivering education tailored to patients and facilitating better liaison among all clinicians, particularly when dealing with the management of comorbidities and drug regimens. The way in which specialist nurses were able to be caseworkers for their patients was perceived as a method of ensuring coordination and continuity of care.     

A case of longitudinally extensive transverse myelitis (LETM): neuromyelitis optica

Neuromyelitis optica (NMO), characterised by longitudinally extensive transverse myelitis (LETM), was previously thought to be a variant of multiple sclerosis. Transverse myelitis may be a manifestation of autoimmune connective tissue diseases and NMO is now recognised to be a humorally mediated autoimmune disease. We present a case of NMO associated with non-organ-specific autoantibodies and the absence of the characteristic NMO-IgG antibody. Our case provides an opportunity to review the diagnostic criteria of NMO and its distinction from other autoimmune and demyelinating conditions. We report successful treatment with plasmapheresis and rituximab in NMO-IgG-negative relapsing disease.     

Structural,mechanical, dielectric properties and magnetic interactions in Dy3+-substituted Co–Cu–Zn nanoferrites

Sol–gel-synthesized Co–Cu–Zn ferrite nanoparticles diluted with Dy³⁺ ions were investigated in terms of their structural, morphological, elastic, magnetic and dielectric properties. X-ray diffraction patterns showed the formation of a single-phase cubic spinel structure. As the concentration of Dy³⁺ ions was increased, the lattice length gradually increased from 8.340 to 8.545 Å, obeying Vegard''s law. The Williamson–Hall (W–H) method was employed to observe the change in the lattice strain. Crystallite size obtained from W–H plots followed a pattern similar to that observed using the Scherrer equation. The cation distribution suggested a strong preference of Dy³⁺ ions for the octahedral B site while Cu²⁺ and Fe³⁺ ions were distributed over both A and B sites. The microstructures of the samples were visualized using transmission electron microscopy. Mechanical properties such as stiffness constant, longitudinal and transverse wave velocities, Young''s modulus, bulk modulus, rigidity modulus, Poisson''s ratio and Debye temperature were investigated by acquiring infrared spectra recorded in the range of 300 to 800 cm⁻¹. Replacement of Fe³⁺ ions with the strongly magnetic Dy³⁺ ions increased the saturation magnetization and coercivity. Dielectric constant increased with Dy³⁺ substitution but decreased with applied frequency.

Improvement in various properties of Co–Cu–Zn ferrite upon Dy substitution.