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MENEVEAU, The Johns Hopkins University, LUCIANO CASTILLO, Rensselaer Polytechnic Institute -- Measurements are performed in the Stanley Corrsin Wind Tunnel Facility at The Johns Hopkins University to study the effects of freestream turbulence on a rough surface turbulent boundary layer. The upstream turbulence was generated with the use of an active grid, resulting in freestream turbulence levels of 6.2 % and 5.2 %. The effects of the freestream turbulence on this rough surface, alter the mean velocity deficit profiles. The effects of freestream turbulence are identifiable in the streamwise Reynolds stress profiles throughout the entire boundary layer, but not necessarily for the wall-normal and shear stress profiles. The reduced velocity gradient reduced the production term in the streamwise Reynolds stress despite the increase in the u2 profiles. Thus, an important mechanism becomes the turbulent diffusion from the freestream turbulence as it relates to the Reynolds stress equations.
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Endocrine Research Unit P.Y.L., P.D.R., J.D.V. ; and Department of Internal Medicine P.Y.T. ; , Mayo Clinic School of Graduate Medical Education, General Clinical Research Center, Mayo Clinic, Rochester, Minnesota 55905.
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E-00434-2003.R1 9. Czubryt MP, McAnally J, Fishman G and Olson EN. Regulation of peroxisome proliferator-activated receptor coactivator 1 PGC-1 ; and mitochondrial function by MEF2 and HDAC5. Proc Natl Acad Sci USA 100: 1711-1716, 2003. Fisher JS, Gao J, Han DH, Holloszy JO, and Nolte LA. Activation of AMP kinase enhances sensitivity of muscle glucose transport to insulin. J Physiol Endocrinol Metab 282: E18-E23, 2002. 11. Ford ES, Giles WH, and Dietz WH. Prevalence of the metabolic syndrome among US adults. Findings from the third National Health and Nutrition Examination Survey. JAMA 287: 356-359, 2002. Gaster M, Ottosen PD, Vach W, Christiansen H, Staehr P, Beck-Nielsen H, and Schroder HD. GLUT4 expression in human muscle fibres is not correlated with intracellular triglyceride TG ; content. Is TG a maker or a marker of insulin resistance? APMIS 111: 338348, 2003. Gerich JE. Contributions of insulin-resistance and insulin-secretory defects to the 13. pathogenesis of type 2 diabetes mellitus. Mayo Clin Proc 78: 447-456, 2003. Goodpaster BH, He J, Watkins S, and Kelley DE. Skeletal muscle lipid content and insulin resistance: evidence for a paradox in endurance-trained athletes. J Clin Endocrinol Metab 86: 5755-5761, 2001. Goodpaster BH, Thaete FL, Simoneau JA, and Kelley DE. Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat. Diabetes 46: 1579-1585, 1997. Hansen PA, Gulve EA, Marshall BA, Gao J, Pessin JE, Holloszy JO, and Mueckler M. Skeletal muscle glucose transport and metabolism are enhanced in transgenic mice overexpressing the Glut4 glucose transporter. J Biol Chem 270: 1679-1684, 1995. Harvey JN and Barnett D. Endocrine dysfunction in Kearns-Sayre syndrome. Clin Endocrinol 37: 97-103, 1992. Hegarty BD, Furler SM, Ye J, Cooney GJ, and Kraegen EW. The role of intramuscular lipid in insulin resistance. Acta Physiol Scand 178: 373-383, 2003.
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When first used in the treatment of established sepsis, metronidazole was usually given after drainage of pus. Simple drainage of abscesses caused by anaerobic bacteria may sometimes suffice but additional chemotherapy is justified to reduce the likelihood of recurrence. Where an abscess yields a mixed growth of aerobic and anaerobic bacteria, metronidazole alone usually prevents recurrence but should be given with an antimicrobial effective against aerobic bacteria if the patient is immunosuppressed or if drainS. G. B. AMYES University ofEdinburgh Medical School, age is incomplete because of the possibility of Edinburgh, EH8 9AG, Scotland binding and inactivation of metronidazole by aerobic bacteria Edwards el al., 1979 ; . Good results have been obtained in treatment of anaerobic sepsis with all three routes of administration: oral, rectal and parenteral. References There is a vogue for giving metronidazole Berg, D. E., Davies, J., Allet, B. & Rochaix, J. D. as part of the 'blind' treatment of patients Transposition of R-factors genes to bacteriophage. Proceedings of the National Academy of developing fever or shock after surgery. When there is no evidence of an abscess in a Sciences U.S.A. 72: 3628-32 1975 ; . patient with a bladder catheter, aerobic Davies, J. & Smith, D. I. Plasmid determined resistance to antimicrobial agents. Annual Gram-negative bacilli are usually responsible and this practice is unnecessary, very expenReview ofMicrobiology 32: 469-518 1978 ; . Guiney, D. G. & Davis, C. E. Identification of a sive and potentially toxic. On the other conjugative R. plasmid in Bacteroides ochraceus hand, anaerobic bacteria can cause shock capable of transfer to Escherichia colt Nature Bodner, Koenig & Goodman, 1970 ; so London ; 274: 181-2 1978 ; . 'blind' use of metronidazole can be justified Pattinshall, K. M., Acar, J., Burchall, J. J., in shocked or very ill patients, pending Goldstein, F. W. & Harvey, K. i. Two distinct results of blood culture. Similarly, metronitypes of trimethoprim-resistant dihydrofolate reductases specified by R. plasmids of different dazole is often used in a therapeutic trial, compatibility groups. Journal of Biological where anaerobic sepsis is suspected but, it is argued, before a definite local infection has Chemistry 252: 2319-23 1977 ; . developed. Obviously, this practice cannot be evaluated. 'Blind' therapy is also used in the occasional patient with clinical evidence of intra-abdominal sepsis, in whom surgical drainage is ruled out by the combination of How should we use metronidazole? Metronidazole was introduced in 1960, as an poor general condition and the lack of any anti-protozoal agent and although Shinn clear indication as to location of the abscess. On these unusual occasions the higher levels reported its coincidental effectiveness in of metronidazole achieved by the parenteral acute ulcerative gingivitis in 1962, a decade route, may be needed to ensure adequate elapsed before Tally, Sutton & Finegold concentration in pus and perhaps to counter 1972 ; , noted its potency in infections caused act binding in a mixed infection. by Bacteroides species. Its use as an antiPrevention of anaerobic sepsis by metronibacterial has gained momentum exponentially since then both in treatment of estab- dazole has been convincingly demonstrated. lished infection and in prevention of Benefit was shown in circumstances where contamination of a surgical wound by 'surgical' sepsis. Metronidazole penetrates well into all anaerobic bacteria was inevitable. In the case of colonic surgery, metronibody fluids, including bile Pieri, Andre & Abed, 1969 ; and CSF Jokipii el al, 1977 ; , dazole and kanamycin, given for two days even when the meninges are not inflamed. before operation resulted in a halving of the Sixty per cent is excreted unchanged in primary wound infection rate Goldring el the urine Ings, Law & Parnell, 1966 ; and pro- al., 1975 ; . A subsequent trial Keighley el al, longation of the dose interval is appropriate 1979 ; , comparing oral with systemic administration of these two agents, found that in renal failure.
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Ave you ever wondered how those who developed the iron lung for victims of polio felt about Jonas Salk? Given the promise of drug-coated stents, one wonders if the extensive work done in perfecting vascular brachytherapy may soon be valued only as an historical anecdote. After innumerable therapeutic failures, vascular brachytherapy was the first effective antiproliferative treatment for restenosis. To date, more than a dozen randomized trials have demonstrated its safety and efficacy.111 After redilatation of in-stent restenosis, brachytherapy reduces the risk of subsequent recurrence by 50%. Its adoption by the interventional cardiology community was widespread and extraordinarily rapid. Today, less than 3 years after FDA approval, brachytherapy is used in more than 400 US catheterization laboratories, and each year 40 000 patients receive brachytherapy for in-stent restenosis. The current enthusiasm for drugeluting stents, however, may soon make vascular brachytherapy obsolete. Drug-coated stents may abolish, or nearly abolish, in-stent restenosis. Because coronary brachytherapy has only been proven effective as a treatment for in-stent restenosis, its fate in the drug-eluting stent world is uncertain. When drug-eluting coated stents are widely available, vascular brachytherapy risks being discarded just as quickly as it was embraced only a few years ago. Will drug-coated stents transform vascular brachytherapy into a cure without a disease? Let's examine the evidence. As of October 2002, we have data from numerous large randomized trials. The largest of these, a randomized, double-blind and dandelion.
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It is supposed that the gelation time depends strongly on the CO2 concentration. To study this effect, the gelation time was measured as a function of the CO2 content in the system. The experimental results are presented in Figure 3-9. The solid line represents the trend line fitted to the experimental data. The trend parameters are noted in the legend. It can be seen that the gelation time decreases rapidly with increasing CO2 content and approaches a constant value when the total CO2 concentration reaches 20 wt %. Further addition of CO2 does not enhance the reaction significantly. As CO2 was added to the sol solution, it dissolved partly therein. Just after the CO2 addition, the pressure increased and than decreased rapidly because of the dissolution of CO2 in the liquid phase. Generally, equilibrium was reached within 15-30 min, depending on the total amount of CO2 added. After equilibrium was reached, the pressure remained constant and this value was taken for evaluation. The final pressure above the sol determines the CO2 solubility. The dependence of the CO2 concentration on the final pressure in the system is shown in Figure 3-10 and dantrolene.
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