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Eutectic NiAl-(Cr,Mo) composites are promising high temperature materials due to their high melting point, excellent oxidation behavior and low density. To enhance the strength, hardness and fracture toughness, high cooling rates are beneficial to obtain a fine cellular-lamellar microstructure. This can be provided by the additive process of selective electron beam melting. The very high temperature gradient achieved in this process leads to the formation of the finest microstructure that has ever been reported for NiAl-(Cr,Mo) in-situ composites. A very high hardness and fracture toughening mechanisms were observed. This represents a feasibility study towards additive manufacturing of eutectic NiAl-(Cr,Mo) in-situ composites by selective electron beam melting.

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False-positive serological reactions (FPSR) due to infections with Yersinia enterocolitica serotype Oratio9 (YeOratio9) are a problem in tests for brucellosis. In the present study, FPSR in classical and novel tests for brucellosis following experimental infections of pigs with YeOratio9 were compared with responses of B. suis biovar 2-inoculated pigs. FPSR were limited to 2-9 weeks post-YeOratio9 inoculation, while B. suis-infected pigs were test-positive throughout the 21-week period of investigation. Although YeOratio9-inoculated pigs exhibited FPSR in Brucella tests for a limited period of time, the serological responses in a YeOratio9-purified O-antigen indirect ELISA did not decrease accordingly. Analysis of available cross-sectional serum samples from pig herds naturally infected with YeOratio9 or B. suis biovar 2 confirmed that the observed difference in the duration of the serological responses between the two infections could be used to discriminate between herds infected with B. suis biovar 2 and YeOratio9.

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Narcolepsy is a disabling neurological sleep disorder characterized by excessive daytime sleepiness and abnormal REM sleep manifestations. Recently, the role of cytokines and growth hormone in the regulation of sleep and narcolepsy has been considered, and data suggest that proinflammatory cytokines may be involved in sleep and narcoleptic symptoms. Serum and clinical data were obtained from the Stanford Center for Narcolepsy Research for 39 Narcoleptics (22 Females, 17 Males, age 39+/-14.9) and 40 controls (13 Females, 27 Males, age 46+/-17.9). Plasma levels of TNF-alpha, IL-6, and human growth hormone (hGH) were measured by ELISA. TNF-alpha and IL-6 were significantly increased in narcoleptic subjects compared to controls (p=.001). Interestingly, hGH was significantly increased in narcoleptic subjects (p <.0001). There was also a significant difference in the epworth sleepiness scale (ESS) (17.7+/-4.6 vs. 5.5+/-3.2, p <.0001). These data indicate that narcoleptics, relative to controls, had higher serum levels of TNF-alpha, IL-6, and hGH. These data suggest that the dysregulation of sleep observed in narcoleptics correlates with the immune and endocrine dysregulation seen in these subjects, and the observed changes may in fact contribute to the higher likelihood of disturbed sleep and/or increased incidence of infection. Additional work is required to fully characterize connections between cytokines and narcoleptic symptomatology.

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In this study, the authors investigated the physiologic effects of the altered body composition that results from surgical removal of large amounts of subcutaneous adipose tissue. Fourteen women with body mass indexes of greater than > 27 kg/m2 underwent measurements of fasting plasma insulin, triglycerides, cholesterol, body composition by dual-energy x-ray absorptiometry (DXA), resting energy expenditure, and blood pressure before and after undergoing large-volume ultrasound-assisted liposuction. There were no significant intraoperative complications. Body weight had decreased by 5.1 kg (p < 0.0001) by 6 weeks after liposuction, with an additional 1.3-kg weight loss (p < 0.05) observed between 6 weeks and 4 months after surgery, for a total weight loss of 6.5 kg (p < 0.00006). Body mass index decreased from (mean +/- SEM) 28.8 +/- 2.3 to 26.8 +/- 1.5 kg/m2 (p < 0.0001). This change in body weight was primarily the result of decreases in body fat mass: as assessed by DXA, lean body mass did not change (43.8 +/- 3.1 kg to 43.4 +/- 3.6 kg, p = 0.80), whereas DXA total body fat mass decreased from 35.7 +/- 6.3 to 30.1 +/- 6.5 kg (p < 0.0001). There were significant decreases in fasting plasma insulin levels (14.9 +/- 6.5 mIU/ml before liposuction versus 7.2 +/- 3.2 mIU/ml 4 months after liposuction, p < 0.007), and systolic blood pressure (132.1 +/- 7.2 versus 120.5 +/- 7.8 mmHg, p < 0.0002). Total cholesterol, high-density lipoprotein cholesterol, plasma triglycerides, and resting energy expenditure values were not significantly altered after liposuction. In conclusion, over a 4-month period, large-volume liposuction decreased weight, body fat mass, systolic blood pressure, and fasting insulin levels without detrimental effects on lean body mass, bone mass, resting energy expenditure, or lipid profiles. Should these improvements be maintained over time, liposuction may prove to be a valuable tool for reducing the comorbid conditions associated with obesity.

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Previous work has shown that morphine suppresses the pulmonary immune response to infection and reduces pulmonary inflammation. No published studies have addressed the impact of morphine on lymphocyte function in the lungs without infection. This study addressed this question by assessing the impact of acute morphine treatment on proliferation, cytokine production, and natural killer (NK) cell activity in resident pulmonary lymphocytes from healthy rats. Male Lewis rats received either a single 15 mg/kg morphine sulfate or vehicle injection 1 h prior to sacrifice. Lungs were minced and passed through wire mesh following collagenase digestion. The resulting cell preparations were pooled (2 rats/pool) to yield sufficient cell numbers for the functional assays, and a portion of these suspensions were separated using a density gradient. Crude and purified cell suspensions were used in assays of NK cell activity and mitogen-induced proliferation and cytokine production. Morphine significantly suppressed lymphocyte proliferation and cytokine production in whole cell suspensions, but not in purified cultures. NK activity was enhanced by morphine treatment in purified treated cultures. Studies of nitrate/nitrite levels in crude and purified cultures suggest that macrophage-derived nitric oxide may be a mechanism of the suppression observed in whole cell suspensions following morphine treatment. These data are consistent with previous work showing that morphine suppresses mitogenic responsiveness and NK activity in the spleen and peripheral blood, and may do so through a macrophage-derived nitric oxide mechanism.

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BACKGROUND: Many patients who present for plastic surgery take weight loss drugs that can interact with anesthetics or have other adverse effects. OBJECTIVE: We examine the implications that pharmacotherapy for weight loss might have for plastic surgery. METHODS: The mechanisms of action, drug interactions, and possible adverse effects of sibutramine (Meridia) and orlistat (Xenical), the two medications that have been approved for weight loss by the US Food and Drug Administration, are reviewed. Similarly, the effects of both over-the-counter weight loss medications containing ephedrine and caffeine and serotonin re-uptake inhibitors that are used to augment weight loss are examined. We also report on the status of pharmacologic research on weight reduction agents under development, including leptin, neuropeptide Y, and uncoupling protein UCP-5. RESULTS AND CONCLUSIONS: The best way to avoid any untoward effects of weight loss medications in combination with surgery is to determine whether patients are taking such medications, counsel them concerning possible complications, and insist on discontinuation of pharmacotherapy for weight loss beginning 2 weeks before surgery.

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BACKGROUND: Large-volume lipoplasty changes body composition during a single surgical intervention by selectively decreasing subcutaneous adipose tissue. Positive health benefits, previously reported for a cohort of 14 women at 4 months after surgery, include significant decreases in weight, systolic blood pressure, and fasting insulin levels. OBJECTIVE: In the present study, we sought to determine whether the benefits of altering body composition by large-volume liposuction observed at 4 months are sustained over longer periods of time. METHODS: Subjects were seen for an additional follow-up visit approximately 1 year (range 10 to 21 months) after surgery. Fasting insulin levels were measured in the 8 patients who had preoperative fasting insulin levels higher than 12 muU/mL. Weight, systolic and diastolic blood pressure, heart rate, and body circumferences were measured in all 14 subjects. RESULTS: Compared with data obtained before surgery and 4 months after surgery, results at 10 to 21 months after lipoplasty showed that the improvements in body weight, systolic blood pressure, and fasting insulin levels observed 4 months after the procedure had been maintained. CONCLUSIONS: Should these results be confirmed in larger studies, lipoplasty may prove to be a valuable tool for reducing some of the co-morbid conditions associated with obesity. (Aesthetic Surg J 2001;21:527-531.).

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Proper patient selection, diligent fluid management, and attention to body temperature are important safety considerations in large-volume lipoplasty (LVL). Complications related to fluid overload, lidocaine toxicity, coagulopathies, and lengthy combined surgical procedures are preventable and not directly linked to LVL technique. Benefits as well as morbidity and mortality from LVL can be weighed against risk factors such as obesity, a prediabetic condition, and/or adverse effects of weight-loss medications. The author describes how she incorporates safeguards into her LVL procedures. (Aesthetic Surg J 2001;21:545-548.).

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Milk and faeces samples from cows with clinical symptoms of paratuberculosis were examined for the presence of Mycobacterium avium subsp. paratuberculosis (M. paratuberculosis) by culture and PCR. M. paratuberculosis was cultivated in variable numbers from faeces or intestinal mucosa in eight of 11 animals. In milk from five cows (all faeces culture positive), we cultivated a few colonies of M. paratuberculosis (<100 CFU per ml). Milk samples from two cows were PCR positive (both animals were faeces culture positive, and one cow was milk culture positive). One cow was culture negative on intestinal mucosa, but culture positive in milk, and two cows were negative in culture and PCR from both faeces and milk. In conclusion, the presence of M. paratuberculosis could be detected in raw milk by PCR, but cultivation of milk was more sensitive.

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The authors present case reports demonstrating the trilevel utility of the inferiorly based rectus abdominis musculocutaneous flap in the closure of complex wounds involving the pelvis, groin, and femur that had failed previously or were not amenable to traditional closure techniques. The use of the rectus abdominis flap was especially advantageous for achieving infection eradication and large dead space closure. Additionally they present the emerging technique of power color Doppler imaging as a valuable tool in preoperative flap planning. This technique is particularly useful in evaluating the candidacy for rectus abdominis musculocutaneous flap placement of patients with a prior history of abdominal surgeries, trauma, infection, irradiation, or other conditions that might compromise the patency of the deep inferior epigastric vessels.

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In the present study restriction fragment length polymorphism analyses with the recently described insertion sequence IS1245 as a probe was performed with clinical Mycobacterium avium complex strains cultured in Denmark during a 2-year period. The overall aim of the study was to disclose potential routes of transmission of these microorganisms. As a first step, the genetic diversity among isolates from AIDS patients and non-human immunodeficiency virus (HIV)-infected patients was described. In addition, a number of isolates from nonhuman sources cultured during the same period were analyzed and compared to the human isolates. A total of 203 isolates from AIDS patients (n = 90), non-HIV-infected patients (n = 91), and nonhuman sources (n = 22) were analyzed. The presence of IS1245 was restricted to Mycobacterium avium subsp. avium isolates. The majority of human isolates had large numbers of IS1245 copies, while nonhuman isolates could be divided into a high-copy-number group and a low-copy-number group. Groups of identical strains were found to be geographically widespread, comprising strains from AIDS patients as well as strains from non-HIV-infected patients. Samples of peat (to be used as potting soil) and veterinary samples were found to contain viable M. avium isolates belonging to genotypes also found in humans.

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A monoclonal antibody raised against a 40 kDa protein present in certain M. avium strains (IS901/IS902 positive) was used for developing a blocking ELISA. Sera from experimentally infected sheep were evaluated by indirect ELISA, AGID and blocking ELISA. The blocking assay proved to be highly specific for differentiation of sheep infected with different subspecies of M. avium.

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Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alteration in dermal histology and mechanical properties of skin following treatment with 25% and 50% trichloroacetic acid, Baker's phenol solution, and dermabrasion. Yucatan minipigs served as the animal model. The skin was analyzed at five intervals over 6 months after treatment using histologic, quantitative, and mechanical analysis (hematoxylin and eosin, elastic tissue, and Sirius red stains, computerized digital morphometry, and a tensiometer). At 6 months we found no change in the quality, structure, or arrangement of elastic fibers in skin treated with a single application of 25% and 50% trichloroacetic acid or dermabrasion when compared with untreated skin. Skin treated with Baker's phenol solution showed a marked morphologic change in the elastic fibers. The fibers within the regenerated zone of dermis were sparse, wispy, and immature at 6 months after treatment. Preliminary tensiometric analysis of phenol-treated skin at 6 months indicated that the skin was stiffer and weaker. This study questions the possibility of long-term change to the skin by the deep penetration of caustic chemicals to remove wrinkles and rejuvenate the skin.

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The aim of the present study was to characterize all strains of the Mycobacterium avium complex isolated in Denmark in 1993. A total of 141 M. avium complex strains (86 from man, 38 from animals, and 17 from peat) were analysed by serotyping, ELISA specific for a 40 kDa protein, and IS901-specific PCR. Serotype analysis showed that the most frequent serotypes among human strains were serotype 4 (27%) and serotype 6 (19%), which differs from an earlier survey where serotype 1 was most prevalent. The most frequent serotypes in animals were serotype 2 (53%) and serotype 6 (13%), whereas the most prevalent serotypes among strains isolated from peat were serotype 4 (29%) and serotype 9 (18%). There was a concurrent appearance of IS901 and p40 in all strains. Only M. avium complex strains isolated from animals, and belonging to serotype 1 or serotype 2, contained the IS901/p40 markers. The different distribution of serotypes of M. avium complex strains in animals and man, and the presence of IS901/p40 exclusively in animal strains, suggests that transmission of M. avium from animals to man is not of significance in Denmark.

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The pathogenicity of 13 strains of Bacillus licheniformis was studied in immunodepressed mice. The strains had been isolated from cases of bovine abortions (n = 5), bovine feedstuffs (n = 3), soil (n = 1), and grain products (n = 2). The origin of two strains was unknown. Groups of 10 mice were inoculated intravenously with B. licheniformis bacteria at doses from < 10(6) to 10(10) colony-forming units. Following 7 days of infection, the animals were euthanized and examined bacteriologically, histologically, and immunohistochemically using a PAP technique based on primary polyclonal rabbit anti-B. licheniformis antibodies. B. licheniformis bacteria were reisolated from the liver, spleen or kidneys of mice in all groups. Inflammatory lesions were present in mice of all immunodepressed groups, but only brain and pulmonic lesions were definitely attributed to B. licheniformis infection, as strong immunostaining was found within these lesions. It is concluded that all strains of B. licheniformis examined were pathogenic for immunodepressed mice, and that spontaneous infections may be established by bacterial strains to which susceptible individuals are accidentally exposed.

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