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Este estudo teve como objetivo avaliar o efeito de diferentes intervalos entre pastejos sobre as características produtivas de trevo-persa e azevém, consorciados e manejados sob lotação rotacionada, nos anos de 2009 e 2010. Os tratamentos consistiram em quatro intervalos entre pastejos (tempo para o surgimento de 2,5; 3,5; 4,5 e 5,5 folhas em plantas de trevo-persa), em delineamento de blocos completos ao acaso, com seis repetições. As variáveis analisadas foram: índice de área foliar, área foliar, altura do pasto e de plantas, comprimento de perfilhos/ramificações, taxa de acúmulo de matéria seca e produção de matéria seca. O índice de área foliar do dossel e do trevo-persa foi maior no intervalo de 5,5 folhas nos anos de 2009 e 2010. No ano de 2009, maiores valores de área foliar foram obtidos nos intervalos de 3,5 e 4,5 folhas e não se observou efeito dos intervalos entre pastejos sobre essa variável em 2010. Maiores intervalos entre pastejos proporcionaram maior altura do pasto e de plantas e também maior comprimento de perfilhos e ramificações. A produção de matéria seca do trevo-persa foi maior em 2010, ao passo que, para azevém, maior produção foi encontrada em 2009. A produção de matéria seca total foi maior no intervalo de 5,5 folhas. A taxa de acúmulo de matéria seca foi maior no intervalo de 5,5 folhas em 2009 e no intervalo de 2,5 folhas em 2010. As características produtivas da consorciação trevo-persa e azevém anual são modificadas pelos intervalos entre pastejos. Recomendam-se intervalos de até 3,5 folhas surgidas, em consorciação de trevo-persa e azevém anual, os quais proporcionam menor alongamento de caules associado à menor presença de material morto, o que, provavelmente, melhora a qualidade da forragem colhida.

The aim of this trial was to study the effect of different grazing intervals on productive characteristics of persian clover and ryegrass, in consortium and managed under rotational stocking during the years 2009 and 2010. Treatments were composed of four grazing intervals (time to onset of 2.5; 3.5; 4.5 and 5.5 leaves in persian clover plants) allocated in completely randomized blocks, with six replications. Leaf area index (LAI), leaf area, pasture and plants height, length of tillers/branches, rate of dry matter accumulation and dry matter yield were evaluated. The leaf area index of the canopy and the persian clover was higher in the interval of 5.5 leaves in years 2009 and 2010. In 2009, higher values of leaf area were obtained in intervals of 3.5 and 4.5 leaves and there no was effect of grazing intervals on this variable in 2010. Higher grazing intervals provided greater pasture height and plant height and also greater tiller and branch length. The dry matter production of persian clover was higher in 2010, while for ryegrass highest yields were found in 2009. Total dry matter yield was higher in the interval of 5.5 leaves. The rate of dry matter accumulation was higher in the interval of 5.5 leaves in 2009 and in the interval of 2.5 leaves in 2010. The productive characteristics of a of mixture persian clover and ryegrass are modified by the grazing intervals. It is recommended intervals up to 3.5 of appeared leaves with a mixture of persian clover and ryegrass, which provides lower elongation of stems associated with a lower presence of dead material, which probably improves the quality of the harvested forage.

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The cingulate gyri in 37 subjects with and without early dementia of the Alzheimer type (DAT) were studied by using MRI at 1.0 mm3 isotropic resolution. Groups were segregated into young controls (n = 10), age-matched normal controls (n = 10), very mild DAT (n = 8), and mild DAT (n = 9). By using automated Bayesian segmentation of the cortex and gray matter/white matter (GM/WM) isosurface generation, tissue compartments were labeled into gray, white, and cerebrospinal fluid as a function of distance from the GM/WM isosurface. Cortical mantle distance maps are generated profiling the GM volume and cortical mantle distribution as a function of distance from the cortical surface. Probabilistic tests based on generalizations of Wilcoxon-Mann-Whitney tests were applied to quantify cortical mantle distribution changes with normal and abnormal aging. We find no significant change between young controls and healthy aging as measured by the GM volume and cortical mantle distribution as a function of distance in both anterior and posterior regions of the cingulate. Significant progression of GM loss is seen in the very mild DAT and mild DAT groups in all areas of the cingulate. Posterior regions show both GM volume loss as well as significant cortical mantle distribution decrease with the onset of mild DAT. The "shape of the cortical mantle" as measured by the cortical mantle distance profiles manifests a pronounced increase in variability with mild DAT.

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We describe a case of metastasizing congenital adrenocortical carcinoma and a follow-up of 3 1/2 yr. Treatment with surgery and mitotane was associated with multiple complications. The patient was in remission at 3 1/2 yr. Because of the rarity of this condition, we discuss step-by-step problems encountered during management.

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Aplasia cutis congenita, a congenital condition characterized by the absence of all skin layers, occurs mostly on the scalp, but may also involve the trunk and extremities. Conservative treatment using silver sulfadiazine with daily dressing change has been recommended to avoid donor site morbidity and operative risks to the neonate who may have other congenital defects. Others have proposed early surgical intervention to prevent problems associated with delayed wound healing. In this case of a newborn, the authors used an alternative therapy to avoid delayed wound healing and multiple surgical interventions. During one operative procedure, a 130-cm2 lesion on the trunk was covered with allogeneic dermis and cultured epithelial autografts (CEAs). After 2.5 weeks and with three additional applications of CEAs at bedside, 90% of the wound had healed. At 27 months, the grafted area was smooth, and pliable with normal skin texture.

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Stimulus response latency is the delay between stimulus onset and the evoked modulation in neural activity. A common technique to estimate latencies involves binning the spike arrival times to form a peri-stimulus histogram. This histogram is smoothed using a fixed bandwidth. The estimated latency is the first time following stimulus onset in which the smoothed histogram exceeds the midpoint between the minimum and maximum of the smoothed histogram. We demonstrate that the choice of smoothing bandwidth is critical to the accuracy of this latency estimation technique. We suggest a bootstrap resampling technique for bandwidth selection which results in a robust latency estimate.

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Stimulus response latency is the delay in the onset of stimulus-evoked neuronal activity. We develop maximum likelihood and least squares estimators of stimulus response latency and present a comparison of the performance of these methods with estimators commonly used in the neuroscience literature. The formal statistical change-point estimation problem is nontrivial due to the inclusion of a 'nuisance parameter', the end of stationarity in the stimulus-evoked activity. Our results suggest that the automation of the estimation of stimulus response latency will benefit from the use of the maximum likelihood estimator.

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We report the development of spastic diplegia in infants during the course of interferon Alfa-2a (IFN) therapy for potentially life-endangering hemangiomas. Five infants who displayed diplegia were selected from a group of 26 infants treated with IFN. Diplegia persisted in three infants, and in the remaining two significant recovery occurred after IFN was discontinued. Magnetic resonance imaging showed no significant brain or spinal abnormalities except minor to moderate delayed myelination in two patients. Myelination was normal on subsequent radiographic examination in all five patients. We conclude that IFN can adversely affect the immature central nervous system and produce spastic diplegia, which is potentially reversible. We recommend careful clinical assessment of neurodevelopmental status during IFN therapy.

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Microcalcification clusters are often an important indicator for the detection of malignancy in mammograms. In many cases, microcalcifications are the only indication of a malignancy. However, the detection of microcalcifications can be a difficult process. They are small and can be embedded in dense tissue. This paper presents a method for automatically detecting microcalcifications. We utilize a high-boost filter to suppress background clutter enabling segmentation even in very dense breast tissue. We then use a threshholding and region growing technique to extract candidate microcalcifications. Likely microcalcifications are then identified by a linear classifier. We apply this method to images selected from the LLNL/UCSF Digital Mammogram Library, and produce a receiver operating characteristic (ROC) curves to detail the trade-off between probability of detection and false alarms. Finally, we exam the ability to properly select a threshold to achieve a desired probability of detection based upon a training set. This is a US government work. There are no restrictions on its use.

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Trichobezoars can occur in young women who have a history of trichotillomania, trichophagia, gastric dysmotility, and psychiatric dysfunction. A 6-year-old anorexic girl presented with a fixed right-upper-quadrant abdominal mass. Exploratory celiotomy for a duodenal trichobezoar led to removal of the large foreign body, via a duodenotomy, and prompted a Ladd procedure, in which the duodenum was moved from beneath the compressing superior mesenteric artery to relieve underlying duodenal narrowing.

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We report a case of a 13-year-old girl who presented with acute abdominal pain secondary to a sigmoid colon perforation. History, physical examination, and laboratory and radiographic studies were all suggestive, though not diagnostic, of an abdominal catastrophe. Her father died at the age of 30 from complications of bowel perforations and a vascular aneurysm. The unusual operative findings in our patient, together with her father's medical history, lead to the underlying diagnosis of Ehlers-Danlos syndrome. Knowledge of this family history at the time of presentation could have aided in diagnosis. Clinical manifestations and etiology of Ehlers-Danlos syndrome are discussed.

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As a first step in determining the efficacy of using computers to assist in diagnosis of medical images, an investigation has been conducted which utilizes the patterns, or textures, in the images. To be of value, any computer scheme must be able to recognize and differentiate the various patterns. An obvious example of this in mammography is the recognition of tumorous tissue and non-malignant abnormal tissue from normal parenchymal tissue. We have developed a pattern recognition technique which uses features derived from the fractal nature of the image. Further, we are able to develop mathematical models which can be used to differentiate and classify the many tissue types. Based on a limited number of cases of digitized mammograms, our computer algorithms have been able to distinguish tumorous from healthy tissue and to distinguish among various parenchymal tissue patterns. These preliminary results indicate that discrimination based on the fractal nature of images may well represent a viable approach to utilizing computers to assist in diagnosis.

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Accidental exposure to drugs and household products in young children and self-poisoning by adolescents are common clinical problems of important concern to the general pediatrician. This article reviews new developments in the field of pediatric toxicology including 1) epidemiologic data collected from poison centers and hospital admissions that illustrate the changing spectrum of pediatric poisonings; 2) progress in identifying clinical features or laboratory tests predictive of outcome in specific poisoning; 3) advances in and limitations involving decontamination methods and antidote therapy in different toxic ingestions; and 4) recent investigations toward prevention of pediatric poisoning with an emphasis on barriers to compliance.

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Thrombin displays remarkable specificity, effecting the removal of fibrinopeptides A and B of fibrinogen through the selective cleavage of two Arg-Gly bonds between the 181 Arg/Lys-Xaa bonds in fibrinogen. Significant advances have been made in recent years towards understanding the origin of the specificity of cleavage of the Arg16-Gly17 bond of the A alpha-chain of human fibrinogen. We have previously proposed a model for the bound structure of fibrinopeptide A7-16 (FPA), based upon NMR data, computer-assisted molecular modeling and the synthesis and study of peptidomimetic substrates and inhibitors of thrombin. We now report the structure of the ternary complex of an FPA mimetic (FPAM), hirugen and thrombin at 2.5 A resolution (R-factor = 0.138) and specificity data for the inhibition of thrombin and related trypsin-like proteinases by FPAM. The crystallographic structures of FPA and its chloromethyl ketone derivative bound to thrombin were determined. Although there are differences between these structures in the above modeled FPA structure and that of the crystal structure of FPAM bound to thrombin, the phi, psi angles in the critical region of P1-P2-P3 in all of the structures are similar to those of bovine pancreatic trypsin inhibitor (BPTI) in the BPTI-trypsin complex and D-Phe-Pro-Arg (PPACK) in the PPACK-thrombin structure. A comparison between these and an NMR-derived structure is carried out and discussed.

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