Semicircular canal orientation in the adult resting rabbit

Photographs of rabbits in the alert resting position were used to record head position. Semicircular canals were surgically exposed and points measured along each canal were used to compute the best-fit plane using a least-squares method. Computations of mean best-fit planes showed that the horizontal canals were not carried horizontally in the rabbit. The anteromedial edges were superior by 16 degrees. The anterior canals were vertically oriented and made an angle of 43 degrees to the sagittal plane. The posterior canal was tipped in the anterior direction slightly and also made an acute angle (26 degrees) with the frontal plane. Rabbit semicircular canals deviated significantly from orthogonality. The range was 86 degrees (anterior canals) to 133 degrees (posterior canals). Thus, there were no co-planar canals. Such semicircular canal geometry has implications for the neural circuitry controlling posture in the rabbit.     

Real-time measurement of indoor particulate matter originating from environmental tobacco smoke: a pilot study

Short-term measurement of suspended particulate matter has been recently made possible since the release of laser-operating portable instruments. Data of a pilot study of field evaluation of environmental tobacco smoke (ETS) with a portable instrument are reported. We analysed the concentrations of total suspended particle (TSP) and of the fine particles PM10, PM7, PM2.5 and PM1 released indoor from a single cigarette, and their levels inside smoking- and non-smoking-areas of a restaurant. The results indicate that ETS creates high level indoor particulate pollution, with concentrations of PM10 exceeding air quality standards. This kind of field evaluation could allow a more careful assessing of short-term exposure to ETS and its relevance to public health.     

Mario Gozzano: the work of an EEG pioneer.

The study of the early history of electroencephalography can yield fascinating insights and surprises. A revisit to the work of Mario Gozzano (1898-1986) has proved to be particularly stimulating. His EEG study of 1935 is a classic and should be resurrected from the graveyard of history. Gozzano was an eminent clinical neurologist-epileptologist and chairman of the neurological-psychiatric university departments in Cagliari, Pisa, Bologna and, from 1951 to his retirement, in Rome. He quickly recognized the significance of EEG and produced his major experimental EEG work in the wake of a stay at the Berlin-Buch Brain Institute. His prolonged corticograms of various regions in the rabbit demonstrated striking differences between various cortical areas. Topical cortical strychnine produced spikes (a barely known phenomenon at that time) and the evolution from interictal to ictal spiking. Spikes induced by visual stimuli may be regarded as precursors of evoked potentials. While Hans Berger was a holist ("the brain working as a whole"), Gozzano (influenced by Vogt and Kornmueller) provided EEG support for the localizationists.     

Dysfunctional uterine bleeding in adolescence

This paper assesses the basic steps of management and treatment of dysfunctional uterine bleeding (DUB) - the irregular bleeding arising from anovulation. After menarche, the hypothalamic-pituitary-ovarian axis can take several years to mature resulting in anovulatory and therefore irregular cycles. During an anovulatory cycle, the corpus luteum fails to form, causing failure of normal cyclical progesterone secretion. This results in continuous unopposed production of estradiol, stimulating overgrowth of the endometrium. Without progesterone, the endometrium grows thicker and thicker eventually outgrowing its blood supply, leading to necrosis. The end result is very heavy bleeding.     

Randomized trial of 8-week versus 12-week VNCOP-B plus G-CSF regimens as front-line treatment in elderly aggressive non-Hodgkin's lymphoma patients.

BACKGROUND: Among the third-generation chemotherapy regimens specifically adapted in the last decade for elderly aggressive non-Hodgkin's lymphoma (NHL) patients, we designed an 8-week cyclophosphamide, mitoxantrone, vincristine, etoposide, bleomycin and prednisone (VNCOP-B) plus granulocyte colony-stimulating factor (G-CSF) regimen which, in a national multicenter trial, induced good complete response (CR) and relapse-free survival rates with only moderate toxic effects. Here we report a prospective, multicenter, randomized trial comparing the efficacy and toxicity of 8- and 12-week regimens of VNCOP-B plus G-CSF. PATIENTS AND METHODS: From February 1996 to June 2001, 306 consecutive previously untreated stage II-IV aggressive NHL patients > or =60 years of age were enrolled from 12 Italian cooperative institutions. Of the 297 evaluable patients, 149 and 148 received 8- and 12-week regimens, respectively, of VNCOP-B. RESULTS: The CR rates were 63% and 56% in the 8- and 12-week groups; at a median of 32 months (range 3-62 months), relapse-free survival rates were 59% and 55%, respectively. Hematological and non-hematological toxicities were similar in both treatment groups. CONCLUSIONS: Our data show that extending induction treatment with the VNCOP-B plus G-CSF regimen from 8 to 12 weeks does not raise the CR rate or provide a more durable remission.     

Cardiovascular mortality in non-insulin-dependent diabetes mellitus. A controlled study among 683 diabetics and 683 age- and sex-matched normal subjects

Although non-insulin-dependent diabetes mellitus (NIDDM) is considered a major cause of death, the role of some independent risk factors in diabetic patients is under debate. In fact the prognosis of NIDDM diabetes varies considerably in relation to the individual risk pattern, and the different studies are not directly comparable because of differences in size, age and geography of the samples, and type of statistical analysis. The aim of the study is to identify the independent predictors of mortality in a cohort of subjects with NIDDM, and to verify whether the relative risk (RR) of cardiovascular mortality is different in comparison to that of coeval non-diabetic subjects from a general population. The study includes 683 patients with NIDDM from the Northern Italian town of Pordenone, followed up for 6 years and age- and sex-matched to 683 non-diabetic subjects from a Northern Italian general population. When the two cohorts were compared, NIDDM turned out to be a strong risk factor for cardiovascular mortality (RR: 2.67). Age, coronary artery disease (RR: 1.78), arterial hypertension (RR: 1.39), macro- (RR: 2.97) and microalbuminuria (RR: 2.01) were independent predictors of cardiovascular mortality in the diabetics. In conclusion, survival of diabetic patients is worse than that of non-diabetic coeval subjects. Only few items are able to predict cardiovascular mortality in the diabetics, namely age, hypertension, CAD, macro- and microalbuminuria.     

Reproducibility of the six-minute walking test in chronic heart failure patients

The six-minute walking test (WT) is used in trials and clinical practice as an easy tool to evaluate the functional capacity of chronic heart failure (CHF) patients. As WT measurements are highly variable both between and within individuals, this study aims at assessing the contribution of the different sources of variation and estimating the reproducibility of the test. A statistical model describing WT measurements as a function of fixed and random effects is proposed and its parameters estimated. We considered 202 stable CHF patients who performed two baseline WTs separated by a 30 minute rest; 49 of them repeated the two tests 3 months later (follow-up control). They had no changes in therapy or major clinical events. Another 31 subjects performed two baseline tests separated by 24 hours. Collected data were analysed using a mixed model methodology. There was no significant difference between measurements taken 30 minutes and 24 hours apart (p = 0.99). A trend effect of 17 (1.4) m (mean (SE)) was consistently found between duplicate tests (p < 0.001). REML estimates of variance components were: 5189 (674) for subject differences in the error-free value; 1280 (304) for subject differences in spontaneous clinical evolution between baseline and follow-up control, and 266 (23) for the within-subject error. Hence, the standard error of measurement was 16.3 m, namely 4 per cent of the average WT performance (403 m) in this sample. The intraclass correlation coefficient was 0.96. We conclude that WT measurements are characterized by good intrasubject reproducibility and excellent reliability. When follow-up studies > or = 3 months are performed, unpredictable changes in individual walking performance due to spontaneous clinical evolution are to be expected. Their clinical significance, however, is not known.     

Treatment of pure stage one ovarian dysgerminoma in young women. Report of a case and review of the literature

The authors report a case of stage 1 ovarian dysgerminoma (OD) in a young woman aged 23 who subsequently underwent conservative surgery. A review of the literature shows that in 80% of cases this neoplasia is present at stage 1A and 85% of patients are under 30, with a 5-year survival rate of 95%. OD treatment should therefore be personalized and, although it continues to be controversial, most authors agree that in young women in whom the disease is limited to one ovary, without lymph node metastases, treatment can be restricted to monolateral adnexectomy, thus assuring the patient's future fertility.     

Evaluation of the mechanical properties of human liver and kidney through aspiration experiments.

A proper mechanical characterization of soft biological tissues of the human body has a strong impact on several medical applications such as surgical planning, virtual reality simulators, trauma research, and for diagnostic purposes. Adequate experimental data are needed to describe quantitatively the mechanical behaviour of those organs. We present a technique for the acquisition of such data from soft tissues and its post processing, based on a continuum mechanics approach, to determine some parameters of the tissue's mechanical properties. A small tube is applied to the target organ and a weak vacuum is generated inside the tube according to a predefined pressure history. A video camera grabs images of the deformation profile of the aspirated tissue, and a pressure sensor measures the correspondent vacuum level. The images are processed and used to inform the fitting of uniaxial and continuum mechanics models. Whilst the aspiration test device is suitable for in vivo applications, under sterile conditions during open surgery, we hereby present first results obtained by testing cadaveric tissues.