A new direct anatomic two-incision approach for total hip replacement without the use of fluoroscopy is described. The anterior incision is the distal one third of a Smith-Peterson approach and the ...posterior incision is the proximal one third of the Moore approach. It has been used on 142 unselected consecutive.
The six string quartets dedicated to his friend Joseph Haydn represent a turning point in Mozart's compositional development. In addition to providing a full synopsis of each quartet this book ...examines the music in relation to Mozart's earlier quartets, considers the genesis of the six 'Haydn' quartets through close examination of the autograph revisions and looks at contemporary eighteenth-century analytical models. John Irving also charts the reception of the quartets, drawing upon a broad range of sources: Mozart's letters and diary entries, early newspaper reports, harmony/compositional textbooks, contemporary criticism and early biographies.
We explored the relationships among different tintinnid populations on micro-, meso-, and basin-scales from three regions across the Pacific Ocean, including the Costa Rica Dome (CRD) in the Eastern ...Pacific Ocean, the Celebes Sea (CS), and the Tokara Strait (TS) in the Western Pacific Ocean. We quantified the species occurrence, vertical and biogeographic distribution patterns, and morphological parameters of tintinnid assemblages. A total of 46 tintinnid species were observed, with more than half (63.0%) in common among the three areas, accounting for 97.1% of the total abundances. The numerically abundant forms remained more or less the same set of species in the three areas. However, community structure analyses, in terms of species, lorica oral diameter (LOD) size classes, and genera, revealed clear distinctions among different regions, as well as among different water depths. A Lagrangian simulation of passive dispersal in ocean currents across the Pacific Ocean, supported the hypothesis that greater similarity between tintinnid populations in the CS and TS (relative to CRD), was related to ocean circulation linkages between the populations. A latitudinal decline of tintinnid species richness was observed, mainly as a result of a decline of redundant species and warm-water species in colder areas. These data provide information unique insight into population variability of microzooplankton communities on micro- to meso- and even large scales in the world oceans.
Grasses have a segmental morphology. Compared to leaf development, data on root development at the phytomer level are scarce. Leaf appearance interval was recorded over time to allow inference about ...the age of segmental sites that later form roots. Hydroponically grown Lolium perenne cv. Aberdart tillers were studied in both spring and autumn in increasing and decreasing day length conditions, respectively, and dissected to define the development status of roots of known age on successive phytomers basipetally on the tiller axis. Over a 90-day observation period spring and autumn tillers produced 10.4 and 18.1 root bearing phytomers (Pr), respectively. Four stages of root development were identified: (0) main axis elongation (~0–10 days), (1) primary branching (~10–18 days), (2) secondary branching (~18–25 days), and (3) tertiary and quaternary branching without further increase in root dry weight. The individual spring roots achieved significantly greater dry weight (35%) than autumn roots, and a mechanism for seasonal shift in substrate supply to roots is proposed. Our data define a root turnover pattern likely also occurring in field swards and provide insight for modelling the turnover of grass root systems for developing nutrient efficient or stress tolerant ryegrass swards.
Exaggerated hypoxic pulmonary vasoconstriction is a key factor in the development of high altitude pulmonary edema (HAPE). Due to its effectiveness as a pulmonary vasodilator, sildenafil has been ...proposed as a prophylactic agent against HAPE. By conducting a parallel-group double blind, randomized, placebo-controlled trial, we investigated the effect of chronic sildenafil administration on pulmonary artery systolic pressure (PASP) and symptoms of acute mountain sickness (AMS) during acclimatization to high altitude. Sixty-two healthy lowland volunteers (36 male; median age 21 years, range 18 to 31) on the Apex 2 research expedition were flown to La Paz, Bolivia (3650 m), and after 4-5 days acclimatization ascended over 90 min to 5200 m. The treatment group (n=20) received 50 mg sildenafil citrate three times daily. PASP was recorded by echocardiography at sea level and within 6 h, 3 days, and 1 week at 5200 m. AMS was assessed daily using the Lake Louise Consensus symptom score. On intention-to-treat analysis, there was no significant difference in PASP at 5200 m between sildenafil and placebo groups. Median AMS score on Day 2 at 5200 m was significantly higher in the sildenafil group (placebo 4.0, sildenafil 6.5; p=0.004) but there was no difference in prevalence of AMS between groups. Sildenafil administration did not affect PASP in healthy lowland subjects at 5200 m but AMS was significantly more severe on Day 2 at 5200 m with sildenafil. Our data do not support routine prophylactic use of sildenafil to reduce PASP at high altitude in healthy subjects with no history of HAPE. TRIALS REGISTRATION NUMBER: NCT00627965.
Despite a large volume of evidence supporting the use of dual antiplatelet therapy in patients with acute coronary syndrome, there remains major uncertainty regarding the optimal duration of therapy. ...Clinical trials have varied markedly in the duration of therapy, both across and within trials. Recent systematic reviews and meta-analyses suggest that shorter durations of dual antiplatelet therapy are superior because the avoidance of atherothrombotic events is counterbalanced by the greater risks of excess major bleeding with apparent increases in all-cause mortality with longer durations. These findings did not show significant heterogeneity according to whether patients had stable or unstable coronary heart disease. Moreover, the potential hazards and benefits may differ when applied to the general broad population of patients encountered in everyday clinical practice who have markedly higher bleeding and atherothrombotic event rates. Clinicians lack definitive information regarding the duration of therapy in patients with acute coronary syndrome and risk scores do not appear to be sufficiently robust to address these concerns. We believe that there is a pressing need to undertake a broad inclusive safety trial of shorter durations of therapy in real world populations of patients with acute coronary syndrome. The clinical evidence would further inform future research into strategies for personalised medicine.
The human telomerase reverse transcriptase (hTERT) promoter is known to selectively drive transgene expression in many human cancer cells expressing hTERT, the catalytic component of the telomerase ...ribonucleoprotein complex. We have created a conditionally replicative adenovirus where the viral E1A gene, which is required for viral replication, is under the control of the hTERT promoter (AdhTERTp-E1A). In vitro studies with AdhTERTp-E1A virus on a variety of normal and tumor cell lines have shown that viral genome replication and productive infection is primarily restricted to telomerase-positive tumor cells. Lytic replication was not observed in normal primary fibroblast and epithelial cell lines tested. In vivo administration of the virus into nude mice bearing human liver or prostate tumor xenografts produced significant tumor reduction and, in some cases, resulted in complete tumor regression. AdhTERTp-E1A virus did not actively express E1A in normal mouse liver, in contrast to a control oncolytic vector in which the CMV promoter (AdCMVp-E1A) was driving the E1A gene. In addition, AdhTERTp-E1A virus produced no apparent toxicity to the liver in systemically injected mice. The hTERT promoter-driven oncolytic virus also produced significantly less toxicity to freshly cultured human hepatocytes. These studies demonstrate that an oncolytic virus driven by the telomerase promoter can be used to effectively kill a wide variety of cancer cell types and has the potential to treat primary and metastatic cancer of diverse origins.
Despite the importance of roots in determining plant performance, the factors controlling their development and longevity remain poorly understood. Grass morphology is based on repeating units called ...phytomers, with each capable of producing one leaf, one daughter tiller, and one or more roots. We developed a phytomer-based understanding of root birth, growth and senescence in Lolium perenne, using a modeling approach to explore seasonal effects on root turnover dynamics, and to explore cultivar differences in these processes. Similar to leaves, roots exhibit a clear progression from initiation, growing for approximately seven phyllochrons, with growth rates strongly influenced by environmental conditions. In spring, the phyllochron decreased over the experiment, while it increased in autumn. In spring, C availability exceeding maintenance respiratory requirements allowed root growth at each phytomer position, with a 70/30 split between maintenance and growth. Under C-deficient conditions in autumn, this split was approximately 80/20, with growth limited to younger phytomer positions, while older roots were more susceptible to starvation-induced senescence due to their high C requirements for maintenance respiration.
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