A method for calculation of true coincidence summing correction factors for extended sources.

In gamma-ray spectrometry, true coincidence summing correction factors for an extended sample can be calculated from full-energy-peak and total efficiencies as if the sample were a point source, if the so-called linear-to-square- (LS) curve, introduced by Blaauw and Gelsema, is known and properly applied. A method is described for obtaining the efficiencies and the corresponding LS-curve for an arbitrary cylindrical sample from calibration measurements in a reference geometry. The approach is aimed at the analysis of samples measured on p-type HPGe detectors in environmental gamma-ray spectrometry and was successfully verified against experimental data.     

Treatment of left-sided extension of AV node: A valuable integration of advance imaging modalities and cryoablation

We present a case of successful cryoablation of the left extension of the atrioventricular (AV) node for treatment of a recurrent atrioventricular nodal reentry tachycardia without the use of fluoroscopy. Three-dimensional electroanatomic mapping system and intracardiac echocardiography were used to navigate catheters in the heart and position them according to anatomical landmarks. Due to the nature of cryoablation lesion formation, lesions were able to be applied safely in right atrium, as well as in left atrium, without damaging AV node or bundle of His.     

Multiple interaction sites of galnon trigger its biological effects

Galnon was first reported as a low molecular weight non-peptide agonist at galanin receptors [Saar et al. (2002) Proc. Natl. Acad. Sci. USA 99, 7136-7141]. Following its systemic administration, this synthetic ligand affected a range of important physiological processes including appetite, seizures and pain. Physiological activity of galnon could not be explained solely by the activation of the three known galanin receptors, GalR1, GalR2 and GalR3. Consequently, it was possible that galnon generates its manifold effects by interacting with other signaling pathway components, in addition to via GalR1-3. In this report, we establish that galnon: (i) can penetrate across the plasma membrane of cells, (ii) can activate intracellular G-proteins directly independent of receptor activation thereby triggering downstream signaling, (iii) demonstrates selectivity for different G-proteins, and (iiii) is a ligand to other G-protein coupled receptors (GPCRs) in addition to via GalR1-3. We conclude that galnon has multiple sites of interaction within the GPCR signaling cascade which mediate its physiological effects.     

GPs facing reluctant and demanding patients: analysing ethical justifications

BACKGROUND: Several studies have explored the physicians' preferred actions when facing a reluctant or a demanding patient, but only a few studies have explored the physicians' justifying reasons. OBJECTIVE: The aim of this study was to assess how GPs would act and how they would justify their choice. METHOD: A postal questionnaire with questions about preferred actions and justifying reasons was sent to a random sample of GPs in Slovenia (n = 160) and Sweden (n = 200) using four vignettes: (i). a healthy patient reluctant to quit smoking; (ii). a healthy patient demanding an X-ray; (iii). a pulmonary cancer patient reluctant to quit smoking; and (iv). a pulmonary cancer patient demanding immunotherapy. RESULTS: The majority of GPs would bring up the question about smoking with the patients reluctant to quit. They justified their choice by referring to promotion of medical benefit and to protection from harm. Swedish GPs were less inclined to bring up smoking than were their Slovenian colleagues. Those who would not bring up the question referred to respect for self-determination and an enhanced relationship as their justifying reasons. With reference to the demanding patients, a minority of GPs would grant the healthy patient's request for an X-ray that was not medically motivated. The answers were similar with respect to the seriously ill patient requesting non-medically motivated immunotherapy. Slovenian GPs were much more inclined to grant the request than were their Swedish colleagues. Enhancing the relationship and respect for self-determination were the most important reasons for granting the demands. When the demands were denied, the GPs mostly referred to promotion of fair distribution of resources. CONCLUSION: Many of the GPs considered their patients' right to self-determination less important than other values, e.g. the obligation to promote medical benefit, to protect from harm, to distribute public resources fairly and to enhance the patient-physician relationship.     

Abdominal actinomycosis presenting as a small-bowel obstruction

A 48-year-old female, presented as a case of acute abdomen with a small-bowel obstruction and a palpable hypogastric mass, was urgently operated. Laparotomy revealed a tumor mass of unknown origin that included a loop of the small bowel by compressing it. Resection of the tumor including a portion of the large and small bowel was performed, and pathohistological examination revealed actinomycosis. The cause of abdominal actinomycosis in this patient could be the implantation of an intrauterine device nine years prior to the operation.