The changing presentation of pyloric stenosis

A triplet pregnancy in a 23-year-old woman was terminated at 15 weeks of gestation because of her severe hypertension, lung edema, and secondary hyperthyroidism. The pregnancy consisted of a hydatidiform mole with a 46,XY karyotype and two fetuses each with 46,XX and a 46,XY karyotype. To determine the zygosity and genetic origin of the mole and fetuses, PCR- and computer-assisted genotyping were performed at 27 CA-repeat marker loci that were distributed evenly over the genome. As a result, genotypes of the three pregnancy products were distinct from each other, indicating that the triplets were trizygotic. The mole lacked any maternal alleles but inherited both of the paternal alleles and/or one paternal allele in duplicate. This, along with the XY sex chromosome constitution, indicated that the mole resulted from dispermic androgenesis. The mother developed a persistent trophoblastic tumor thereafter.     

Support-induced promotional effects on the activity of automotive exhaust catalysts 1. The case of oxidation of light hydrocarbons (C2H4)

The kinetics of oxidation of a light hydrocarbon (C₂H₄) were studied on catalysts comprising of combinations of one of three metals, Pt, Pd or Rh supported on five different supports, that is, SiO₂, γ-Al₂O₃, ZrO₂ (8% Y₂O₃), TiO₂ or TiO₂ (W⁶⁺). Significant variation of turnover frequency with the carrier was observed, which cannot be explained by structure sensitivity considerations and is attributed to interactions between the metal crystallites and the carrier. The catalytic activity of these metal-support combinations was investigated over a wide range of partial pressures of ethylene and oxygen. In a separate set of experiments, the kinetics of C₂H₄ oxidation were also investigated on polycrystalline Rh films interfaced with ZrO₂ (8 mol% Y₂O₃) solid electrolyte in a galvanic cell of the type: C₂H₄, O₂, Rh/YSZ/Pt, air, during regular open-circuit conditions as well as under Non-Faradic Electrochemical Modification of Catalytic Activity (NEMCA), that is, closed-circuit conditions. Up to 100-fold increase in catalytic activity was observed by supplying O²⁻ ions to the catalyst surface via positive potential application to the catalyst. The observed kinetic behavior upon increasing catalyst potential parallels qualitatively the observed alteration of turnover frequency with variation of the support of the Rh crystallites.     

Predictive value of monitoring parameters in fetal surgery

BACKGROUND/PURPOSE: The choice of monitoring parameters in fetal surgery has thus far been based on feasibility rather than on predictability. Ideally, monitoring should be noninvasive, have a rapid response time and high sensitivity, and be applicable to open and endoscopic techniques. Herein, the authors studied the response of several parameters to standardized episodes of fetal ischemia and stress. METHODS: Eight time-dated fetal lambs (110 days, term, 145 days) were used. Under general anesthesia, a balloon occluder was placed around the umbilical cord. Pulse oximetry (POx + heart rate, HR), electrocardiography (ECG), direct oximetry (DOx), and blood pressure (BP) were recorded continuously. After stabilization, the umbilical cord was completely occluded for 5 seconds, then released. False-negative recordings were defined as failure of a parameter to respond to umbilical occlusion; false-positive episodes were defined as 10% change in value over < or = 10 seconds during stabilization (baseline) period. RESULTS: The fetuses were monitored for an aggregate of 358 minutes. Baseline DOx was 64%+/-5%, POx, 66%+/-16%; HR, 141+/-18 beats per minute (bpm); systolic BP (SBP), 51+/-3 torr; and diastolic BP (DBP), 38+/-2 torr. During umbilical occlusion (n=15), SBP increased to 56+/-3 torr and DBP to 43+/-2 torr at 0.5 seconds, then returned to baseline at 8.0 seconds. A decrease was seen in DOx (start at 3.5s, maximum delta 9.9+/-1.5% at 10.5 seconds) and POx (start at 4.2 seconds, maximum delta 7.3+/-2.4% at 20.5 seconds). Heart rate showed <10% decrease (start at 8.5 seconds, nadir 131+/-14 bpm at 19.5 seconds). No ECG changes were noted. Sensitivity was 100% for DOx, POx, and BP, but only 14% for HR; specificity was 97% for DOx and 88% for POx; positive predictive value was 58% for DOx and 37% for POx; negative predictive value was 100% for DOx and POx. CONCLUSIONS: Direct intravascular oximetry and blood pressure provide a prompt and reliable response to acute fetal stress, but are too invasive for routine use. Bradycardia is an insensitive and late sign of fetal distress. Pulse oximetry has a rapid response time (<5 seconds), high sensitivity, and negative predictive value. In addition, its application is noninvasive and has proven to be feasible in open and endoscopic fetal surgical procedures. It therefore appears to be the monitoring parameter of choice for fetal surgery.     

Methodology for Improving Quality of Instruction

This paper describes a Teaching Effectiveness Improvement Program based on a multidisciplinary approach and the use of Total Quality Management (TQM) principles. The success of the program underscored the value of cross-functional teams for teaching effectiveness improvement programs. In the case study discussed in this paper, the College of Education, the College of Engineering, the University administration and students participated extensively in framing the requirements and the structure of the program. The program was implemented in the College of Engineering at the University of Cincinnati to improve teaching effectiveness over the last three years. The Plan, Do, Study, Act (PDSA) cycle was used as a framework for improving teaching. The Student evaluations of faculty were used to measure the effectiveness of this program and the results are very promising.     

Parlay‐based service provision in circuit‐ and packet‐switched telecommunications networks

The spectrum of potential value added services over Internet telephony is wide, but the current service provision solutions are inadequate or proprietary. The nature of Internet differs significantly from that of circuit switched network, however, VoIP architectures can capitalize service control architectures in the PSTN world. We describe such an architecture based on the intelligent network and the Parlay, employing distributed objects and mobile agents as enabling technologies. This architecture has been implemented in the PSTN and the Internet and it has provided a framework for service provisioning, augmenting the space of supported services. Copyright © 2004 John Wiley & Sons, Ltd.     

Spray Drying of Raisin Juice Concentrate

Raisin juice concentrate is a natural sweetener in syrup or paste form and it is produced from second-grade dry raisins by leaching them with water. Dried raisin juice, although is easier to handle and has more potential applications than the syrup, is not available in the market. In the present study, raisin juice powder was produced with a lab-scale spray dryer. The problem of stickiness in the drying chamber was overcome through the use of 21 DE, 12 DE, and 6 DE maltodextrins as drying aid agents. For each type of maltodextrin, the dryer operating conditions and the minimum concentration of maltodextrin in the feed, necessary for successful powder production, were determined. The maximum ratio of (raisin juice solids)/(maltodextrin solids) achieved was 67/33 and was made possible with the use of 6 DE maltodextrin. The inlet and outlet drying air temperatures were 110 and 77°C respectively, while the feed contained 40% w/w total solids. The physical and sensory properties of all powders produced were determined and found to be satisfactory, the only exception being their high hygroscopicity.     

Fetal lung growth after tracheal ligation is not solely a pressure phenomenon

We investigated cell proliferation and cell death in the olfactory epithelium (OE) of mice from birth to maturity using bromodeoxyuridine and terminal deoxynucleotidyl transferase nick end labeling. We show that cell death events and proliferative activity diminish concomitantly with age in the OE. Thus, the age-dependent and coordinate diminution in cell proliferative activity and cell death events may serve to maintain the thickness of the OE as mice mature and age.