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The net impact of office and telecommunications equipment electricity consumption upon heating and cooling loads depends upon the net balance of cooling and heating primary energy consumption, averaged over the entire population of buildings and climates of the U.S. For instance, greater cooling energy consumption indicates that office equipment would tend to operate more often during cooling periods than during heating periods, and would thus increase cooling loads more than it displaces heating loads. In addition, the relative performance of heating and cooling equipment in primary energy terms determines the relative magnitude of any marginal load upon net heating or cooling. Excepting water-cooled chillers, most heating and cooling equipment have similar primary energy efficiencies Table 8-1 ; , meaning that any additional heat dissipation will not have a dramatic impact upon net primary HVAC energy consumption. Lighting and office equipment have similar impacts upon HVAC energy consumption, as they both represent additional building loads beyond shell and outside air loads. Sezgen and Koomey 1998 ; studied the impact of lighting loads upon building heating and cooling energy consumption for eleven different building types, of "new" and "existing" vintages, in five distinct climates. They found that lighting and, hence, office equipment ; heat dissipation had approximately no net impact upon HVAC primary energy consumption. A recent study of HVAC energy consumption based upon the CBECS 1995 survey data ADL, 2001 ; supports this conclusion, showing similar amounts of cooling and heating primary energy consumption 2.0 and 1.8 quads, respectively, including associated parasitic energy ; in commercial buildings. This, combined with the rough primary energy equivalence between heating and cooling systems shown in Table 8-1, supports the general conclusion of Sezgen and Koomey 1998 ; . There exists one major caveat: the majority of office and telecommunications equipment operates in office buildings139 which, on a national basis, consume appreciably more cooling energy than heating energy see Table 8-2.
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Carrageenan or aural arachidonic acid injection to produce pain and inflammation. Other studies have utilized intraperitoneal injections of lipopolysaccharide to produce endotoxemia or gastric disruption with acidified ethanol, carbachol, acid instillation, and ischemia-reperfusion to induce gastric ulcers. Such methods are used to produce pathology in the COX-2 studies and most other animal studies of human pathology because exposure to human risk factors or pathogens does not cause the desired damage. These artificial diseases do not reflect human pathology or responses, but are in fact different diseases entirely. 35. O. P. Flint, a researcher with Bristol-Meyers Squibb, got to the crux of the matter by noting that "it is impossible to establish the reliability of animal data until humans are exposed." O. P. Flint Bristol Myers Squibb ; , quoted in Pentreath VW ed ; . Neurotoxicology in vitro. Taylor & Francis, publishers, 1998: 9. 36. Another confounding factor precluding reliance on animal testing is the effect on the test animals of the unnatural, frightening, and painful laboratory environment in which they are trapped. Such basics of laboratory animal studies as manual handling, blood drawing, intravascular or intracavitary injections, orogastric gavage forcing drugs directly into an animal's stomach ; , vascular or other instrumentations, and anesthesia produce profound and lingering physiological alterations. Even such routine measures as entering an animal's room, moving its cage, using different types of bedding, lighting, noise, water availability, and dietary changes may alter animal behavior and physiology. Typical alterations include behavioral changes anxiety, fear.
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Treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant improvement in PFM strength from both effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy in treating MUI. International Urogynecology Journal 2005. 613. Patient characteristics and management of dermal allograft extrusions - Drake N.L., Weidner A.C., Webster G.D. and Amundsen C.L. [N.L. Drake, Department of Obstetrics and Gynecology, Division of Gynecologic Specialties, Duke University, Durham, NC 27710, United States] - INT. UROGYNECOL. J. PELVIC FLOOR DYSFUNCT. 2005 16 5 ; - summ in ENGL The objective of this study was to describe our rate of extrusion of dermal allograft material when used in anterior or posterior colporrhaphy and to review our success in treating extrusions with conservative management. A retrospective review of all subjects who underwent vaginal reconstruction using dermal allograft material from 1 January 2000 to 31 August 2003 was performed. Demographics, medical history, and follow-up were evaluated. For subjects who developed an extrusion, treatment details were recorded. Sixty-nine subjects underwent colporrhaphy using dermal allograft material during the defined time period: 21 anterior, 45 posterior, and 3 both. Five subjects did not appear for followup. Seven subjects 10.9% ; developed an extrusion: three subjects anteriorly and four subjects posteriorly. There were no differences between subjects with and without extrusions based on recorded risk factors. Median time to the discovery of extrusion was 4 weeks range: 1-6 weeks ; . All patients were managed with estrogen vaginal cream. Median documented healing time was 13 weeks range: 5-40 weeks ; , and no serious morbidity was encountered. Graft extrusion is an uncommon complication when reinforcing vaginal tissue with dermal allograft material and can be safely and effectively managed with vaginal estrogen and expectant management. International Urogynecology Journal 2005. 614. A new vaginal speculum for pelvic organ prolapse quantification POPQ ; - Diokno A.C. and Borodulin G. [A.C. Diokno, Department of Urology, William Beaumont Hospital, 3535 West 13 Mile Road, Royal Oak, MI 48073, United States] - INT. UROGYNECOL. J. PELVIC FLOOR DYSFUNCT. 2005 16 5 ; summ in ENGL The purposes of this study were to introduce a new vaginal speculum, describe the technique of using the new speculum in identifying and measuring the severity of pelvic organ prolapse POP ; , and present results of a pilot study comparing the new speculum to the conventional instruments used in performing POP quantification POPQ ; . The new speculum has retractable upper and lower blades marked in centimeters. POPQ was performed with one instrument using the new speculum and multiple instruments performing the conventional technique. Twenty-two patients underwent POPQ - 11 using the new speculum and 11 using conventional instruments. The duration of the procedure and the level of discomfort were assessed. The POPQ method using the new speculum is described. Preliminary experience with the new speculum showed that the length of examination is significantly shorter p 0.001 ; and the comfort level is better than with the conventional technique p 0.088 ; . A new vaginal speculum with adjustable blades simplifies POPQ. Preliminary testing suggests potential savings in procedure time and reduction in patient discomfort. International Urogynecology Journal 2005.
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ADT can potentially benefit those with residual cancer and or metastatic disease. Serial PSA measurements in the ensuing months following surgery can be used to help determine the likelihood that a patient is more or less likely to benefit from salvage radiation therapy.11, 22, 23, 24 Undetectable baseline PSA levels defined as 0.2 ng L following RP, which later become detectable and progressively rise, suggest locally recurring cancer in the prostatic fossa11 as indicated by the patient example in Figure 1 ; . Detectable PSA levels at baseline that show progressive increases over time likely represent microscopic metastatic disease that was present prior to RP.22, 23 In the former scenario, salvage external beam RT EBRT ; may be indicated, whereas systemic salvage treatment using ADT would appear to be indicated in the latter scenario.24 A recent paper examined the four-year benefits of salvage EBRT for post-RP PSA relapse. This retrospective study involved 501 men from five academic institutions. Overall, the results showed an overall fouryear progression-free probability of only 45%. Analysis of the data revealed several factors that significantly predicted disease progression following EBRT: Adverse Predictive Factor Pathology Gleason score of 8, 9 or Pre-EBRT PSA level 2.0 ng mL Negative surgical margins PSADT 10 mos. Hazard p Value Ratio 2.6 2.3 1.9 adverse predictive factors was 77%, indicating that such therapy can provide durable responses in selected patients. Since these criteria include both a preEBRT PSA value 2.0 ng mL and a PSADT 10 months, the lead-time afforded by a third-generation PSA assay with its superior low-end precision can prove useful for identifying patients likely to have an early disease relapse, as well as for guiding medical decision-making regarding salvage therapy options and propulsid.
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86. Shah DM, Darling RC, Chang BB, Bock DEM, Paty PSK, Leather RP. Carotid endarterectomy in awake patients: its safety, acceptability, and outcome. J Vasc Surg 19 6 ; : 101520, 1994. 87. Sieber FE, Toung TJ, Diringer MN, et. al. Preoperative risks predict neurological outcome of carotid endarterectomy related stroke. Neurosurgery 30: 847854, 1992. Spencer MP. Transcranial doppler monitoring and causes of stroke from carotid endarterectomy. Stroke 28 4 ; : 68591, Apr 1997. 89. Srinivasan J, Mayberg MR, Weiss DG, Eskridge J. Duplex accuracy compared with angiography in the Veterans Affairs Cooperative Studies trial for symptomatic carotid stenosis. Neurosurgery 36: 64855, 1995. Taylor DC, Strandness DE Jr. Carotid artery duplex scanning. J Clin Ultrasound 15: 63544, 1987. Till JS, Toole JF, Howard VJ, et. al. Declining morbidity and mortality of carotid endarterectomy. The Wake Forest University Medical Center Experience. Stroke 18: 823829, 1987. Timsit SG, Sacco RL, Mohr JP, et. al. Early clinical differentiation of cerebral infarction from severe atherosclerotic stenosis and cardioembolism. Stroke 23: 486491, 1992 and clemastine.
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I. Falcao-Pires, M. Vasconcelos, J. Magalhaes, C. Bras-Silva, A. Leite-Moreira. Faculty of Medicine, Physiology Department, Porto, Portugal Apelin, an endogenous vasoactive that binds to the APJ receptor, is widely expressed in the cardiovascular system and increases inotropism on the intact heart. To clarify this effect, particularly to evaluate whether it results from a direct myocardial action or depends on the interaction with peripheral and coronary circulations we compared the contractile effects of apelin in the intact heart and in isolated cardiac muscle. The experiments were performed in Wistar rats n 14 ; . Six rats were instrumented with a 3F pressure tip micromanometer. An iv infusion of 0.05mg kg min of apelin-16 was given for 20min. Systolic Pmax ; and end-diastolic LV pressures EDP ; , dP dtmax, dP dtmin and time constant Tau were measured before, every 5min during and 5min after infusion. In 8 rats papillary muscles were isolated Krebs-Ringer: 1, 8mM CaCl2, 35C ; and the effect of 10e-7M of apelin-16 was studied. Results are expressed as meanSEM % change from baseline, p 0.05 and cloxacillin.
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