The Hartmann operation may be the most popular at present, but resection with primary anastomosis is the safest procedure for all stages of complicated diverticulitis, and reduces costs. There is no longer any clinical indication for the three-stage operation.

Escherichia coli, Bacillus subtilis, and Pseudomonas aeruginosa, each possessing a 5-enolpyruvylshikimate 3-phosphate synthase that is sensitive to inhibition by glyphosate [N-(phosphonomethyl)glycitie], provide a good cross-section of organisms exemplifying the biochemical diversity of the aromatic pathway targeted by this potent antimicrobial compound. The pattern of growth inhibition, the alteration in levels of aromatic-pathway enzynies, and the accumulation of early-pathway metabolites after the addition of glyphosate were distinctive for each organism. Substantial intracellular shikimate-3-phosphate accumulated in response to glyphosate treatment in all three organisms. Both E. coli and P. aeruginosa, but not B. subtilis, accumulated near-millimolar levels of shikimate-3-phosphate in the culture medium. Intracellular backup of commonpathway precursors of shikimate-3-phosphate was substantial in B. subtilis, moderate in P. aeruginosa, and not detectable in E. coli. The full complement of aromatic amino acids prevented growth inhibition and metabolite accumulation in E. coli and P. aeruginosa where amino acid end products directly control early-pathway enzyme activity. In contrast, the initial prevention of growth inhibition in the presence of aromatic amino acids in B. subtilis was succeeded by progressively greater growth inhibition that correlated with rapid metabolite accumulation. In B. subtilis glyphosate can decrease prephenate concentrations sufficiently to uncouple the sequentially acting loops of feedback inhibition that ordinarily link end product excess to feedback inhibition of 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase by prephenate. The consequential unrestrained entry of energy-rich substrates into the aromatic pathway, even in the presence of aromatic amino acid end products, is an energy drain that potentially accounts for the inability of end products to fully reverse glyphosate inhibition in B. subtilis. Even in E. coi, after glyphosate inhibition and metabolite accumulation were allowed to become fully established, a transient period where end products were capable of only partial reversal of growth inhibition occurred. The distinctive metabolism produced by dissimilation of different carbon sources also produced profound effects upon glyphosate sensitivity.Many antimetabolites that act against biosynthetic pathways mimic end products, causing inappropriate regulatory effects upon enzymes having early-pathway positions. In contrast, N-(phosphonomethyl)glycine (PMG), an herbicide known as glyphosate, is an exceedingly effective inhibitor of a mid-pathway enzyme of aromatic amino acid biosynthesis, 5-enolpyruvylshikimate 3-phosphate (EPSP) synthase. EPSP synthase has been shown to be a sensitive target of PMG action in procaryotes, lower eucaryotes, and higher plants (see reference 34 for reference citations). Although PMG is now under intensive study in higher plants by virtue of its potent herbicidal properties, antimicrobial studies are few. The presence of PMG during growth c...

Coronary artery MRI methods utilize breath holds, or diaphragmatic navigators, to compensate for respiratory motion. To increase image quality and navigator (NAV) gating efficiency, slice tracking is used, with more sophisticated affine motion models recently introduced. This study assesses the extent of remaining coronary artery motion in free breathing NAV and single and multi breath hold coronary artery MRI. Additionally, the effect of the NAV gating window size was examined. To visualize and measure the respiratory induced motion, an image containing a coronary artery cross section was acquired at each heartbeat. The amount of residual coronary artery displacement was used as a direct measure for the performance of the respiratory motion correction method. Suppression of respiratory motion artifacts is one of the major limiting factors in coronary MRI. Two primary approaches are used to suppress respiratory motion: breath hold imaging (1) and free breathing real-time navigator (NAV) gated imaging (2). Repeated breath holds have the disadvantages of limited scan time, need for patient compliance (3), diaphragmatic drift (4), and slice mis-registration for 3D or 2D contiguous slices acquired in consecutive breath holds. Navigator sequences use either intersecting planes excited by a 90°and 180°RF pulse (5) or a 2D selective "pencil-beam navigator" RF pulse (6). Navigators are commonly placed on the dome of the right hemidiaphragm to monitor respiratory motion. The position of the diaphragm is used to decide in real-time if the interface is within a pre-specified window, and thus whether data are accepted or rejected (7). The rejection of unwanted positions leads to decreased scan efficiency (% of accepted positions) and prolonged scan times.If a simple gating strategy is applied, only small gating windows can be used, frequently decreasing the scan efficiency to 30% or less. To allow for larger gating windows and thus higher NAV scan efficiencies, different models for correction of the respiratory motion have been developed. Since the dominant respiratory induced cardiac motion is in the superior-inferior (SI) direction (8), "slicetracking" implementations, i.e., 1-dimensional correction methods, were introduced to facilitate larger gating windows (9). Recently, more sophisticated models have been proposed, which use patient specific 3D translations or affine transformations to compensate for respiratory motion (10).The effectiveness of these methods for coronary MRI has been assessed by acquiring 3D coronary MRI volumes with different respiratory motion compensation methods and comparing subjective and objective image quality, e.g., for slice tracking (11), navigator location (12), navigator timing (13), NAV window size (9), and affine motion models (10). However, the residual respiratory motion has not been directly reported as a metric for comparing motion compensation methods. Furthermore, since only comparisons between methods have been reported, the baseline coronary artery motion of each method remains ...

In recent publications we have demonstrated that laparoscopic electrocautery of the ovarian surface (LEOS) is an effective method to reduce serum androgen concentrations, normalizing ovarian cycle length and the ovarian reaction to hormonal stimulation therapy in anovulatory patients with polycystic ovarian disease (PCOD). In this paper we show that these effects are not only temporary. Data from 206 patients undergoing LEOS and monitored for up to 72 months after surgery are evaluated; 145 patients achieved a total of 211 conceptions, giving a pregnancy rate of 70%, with a maximum of four conceptions in one patient. There were 38 early miscarriages (18%) and two late pregnancy losses as well as three ectopic implantations.