Continuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method

OBJECTIVE: To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. DESIGN: Prospective direct comparison of the above two techniques. SETTING: Pediatric intensive care unit of a university hospital. PATIENTS: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. METHODS: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20s. INTERVENTIONS: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. RESULTS: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r2 = 0.98; P < 0.001; SEE = 0.41 l/min. The bias is absolute values and in percent of average cardiac output was - 0.05 l/min or - 4.4% with a precision of 0.32 l/min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. CONCLUSION: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.     

Maximizing the clinical exposure of dental students to conservative dentistry: design and evaluation of a novel system

A system has been designed to maximize the clinical experience that dental students receive in the discipline of conservative dentistry. Data on each operative procedure to be carried out for each patient under a student's care is entered into a customized computer database and each student is given a printout of this information every 4 months. Students feel that this system prospectively identifies areas of treatment in which they may lack experience and provides opportunities to review and amend any inaccurate information. This paper explains how the system was set up and administered.     

Calretinin in the cat retina: colocalizations with other calcium-binding proteins, GABA and glycine

Regeneration of skeletal muscle was studied in the sea bream Sparus aurata, in which extensive post-larval muscle hyperplasia contributes to its large adult size, and in the zebrafish Brachydanio rerio, which shows little post-larval hyperplasia and reaches only a small adult size. Small mechanical lesions of body wall muscle were made under general anaesthesia, and the progress of subsequent regeneration was assessed at various intervals by histology and electron microscopy (for general morphology), by immunostaining for desmin and myosin isoforms (to identify the phenotype of new fibres), and by 5'-bromo-2'-deoxyuridine (BrdU) incorporation (to identify proliferating cells). Despite the difference in normal growth-related hyperplasia in these fish, a vigorous regeneration occurred in both species, giving rise to new fibres with an initial myosin composition that differed from that in mature fast-white fibres. However, species differences in myosin expression in these fibres suggest that they may have derived from different myoblast populations. In sea bream, myosin expression in regenerating fibres resembled that seen in new fibres produced in post-larval white muscle, whereas in the zebrafish it resembled that of the primitive monolayer fibres formed during embryonic development. Subsequently, most regenerating fibres gradually transformed into the mature fast-white phenotype in both species.     

ACAT inhibitors derived from hetero-Diels-Alder cycloadducts of thioaldehydes

Acyl-CoA:cholesterol acyltransferase (ACAT) is the enzyme largely responsible for intracellular cholesterol esterification. A systemic inhibitor of ACAT is believed to be able to slow or even reverse the atherosclerotic process. Towards that goal, a series of cyclic sulfides, derived from the hetero-Diels-Alder reaction of thioaldehydes with 1,3-dienes, and bearing carboxamide substituents, were prepared and evaluated for in vitro (in several tissues and species) and ex vivo ACAT inhibition. Minor changes in subsequent structure were found to have a significant effect in optimization of the biological activity of this series of compounds.     

Granulation tissue polyposis associated with carcinoid tumours of the small intestine

We report two patients with ileal carcinoid tumours which were associated with polyps due to mucosal granulation tissue proliferation. In both cases the tumours had extensively infiltrated the small bowel wall and mesentery, and one had hepatic metastases. The mucosal surface of each specimen showed numerous, pale brown, sessile polyps which were restricted to the intestinal segment involved by carcinoid tumour, although not always closely related to neoplastic cells. The polyps were formed by the proliferation of capillaries, smooth muscle cells and myofibroblasts as demonstrated by immunohistochemistry and electronmicroscopy.     

A 16-Mbit/s adapter chip for the IBM token-ring local area network

The authors describe a 9.02×9.02-mm chip built in 1-μm CMOS with two levels of metal and an additional mask level for fabricating capacitors. It contains both analog and digital circuits and has provisions for self-test. The function includes the transmitter, receiver, protocol handler, an microprocessor, as well as interfaces for RAM/ROM storage, IBM PC bus, IBM PS/2 bus, IBM 3174 bus, and Motorola 68000 bus. The physical design terrains are formed by 24K circuits of standard cell gates, a 10K-circuit equivalent hand-honed custom microprocessor, and an analog macro. The chip operates from a single 5-V supply, and the power consumption is 0.8 W nominal at 16 Mb/s. The chip can also be operated at 4 Mb/s     

A Low-Complexity Circuit for On-Sensor Concurrent A/D Conversion and Compression

A low-complexity circuit for on-sensor compression is presented. The proposed circuit achieves complexity savings by combining a single-slope analog-to-digital converter with a Golomb-Rice entropy encoder and by implementing a low-complexity adaptation rule. The adaptation rule monitors the output codewords and minimizes their length by incrementing or decrementing the value of the Golomb-Rice coding parameter k. Its hardware implementation is one order of magnitude lower than existing adaptive algorithms. The compression circuit has been fabricated using a 0.35 muM CMOS technology and occupies an area of 0.0918 . Test measurements confirm the validity of the design.