Representation of change in controlled medical terminologies

Computer-based systems that support health care require large controlled terminologies to manage names and meanings of data elements. These terminologies are not static, because change in health care is inevitable. To share data and applications in health care, we need standards not only for terminologies and concept representation, but also for representing change. To develop a principled approach to managing change, we analyze the requirements of controlled medical terminologies and consider features that frame knowledge-representation systems have to offer. Based on our analysis, we present a concept model, a set of change operations, and a change-documentation model that may be appropriate for controlled terminologies in health care. We are currently implementing our modeling approach within a computational architecture.     

An in vitro tissue culture bilayer model to examine early events in Mycobacterium tuberculosis infection

A tissue culture bilayer system that mimics some aspects of early alveolar infection by Mycobacterium tuberculosis was developed. This model incorporates human lung epithelial type II pneumocyte (A549) (upper chamber) and endothelial cell (lower chamber) layers separated by a microporous membrane. This construction makes it possible to observe and quantify the passage of bacteria through the two layers, to observe the interaction of the bacteria with the various cell types, and to examine the basic mechanisms of immune cell recruitment to the site of infection. After 10(7) organisms were added to the upper chamber we microscopically observed large numbers of bacteria attached to and within the pneumocytes and we determined by viable-cell counting that a small percentage of the inoculum (0.02 to 0.43%) passed through the bilayer into the lower chamber. When peripheral blood mononuclear cells were added to the lower chamber, microscopic examination indicated a migration of the mononuclear cells through the bilayer to the apical surface, where they were seen associated with the mycobacteria on the pneumocytes. The added complexity of the bilayer system offers an opportunity to define more precisely the roles of the various lung cell types in the pathogenesis of early tuberculosis.     

Blockade of accumbens 5-HT3 receptor down-regulation by ondansetron administered during continuous cocaine administration

The present experiment examined whether ondansetron, co-administered with continuous cocaine, would block the down regulation of accumbens 5-HT3 receptors. Rats were exposed to a 14-day pretreatment regimen that involved the continuous infusion of 40 mg kg(-1) day(-1) cocaine or 0.9% saline via a subcutaneously implanted osmotic minipump. In addition to the continuous cocaine or saline administration, all subjects received daily subcutaneous (s.c.) injections of either vehicle or 0.1 mg kg(-1) ondansetron for the entire 14-day pretreatment regimen. The rats were then withdrawn from this pretreatment regimen for seven days, and slices from the nucleus accumbens obtained. The slices were perfused with 25 mM K+ in the absence and presence of 0, 12.5, 25, or 50 microM m-Chlorophenyl-biguanide HCl (mCPBG). The efflux samples were assayed for dopamine content by high pressure liquid chromatography (HPLC) with electrochemical detection. Continuous cocaine administration significantly attenuated the ability of mCPBG to facilitate K+-induce dopamine overflow compared to saline control rats. In addition, the rats that received ondansetron and cocaine during the 14-day pretreatment period, the ability of mCPBG to enhance K+ stimulated dopamine release was not significantly different from the saline control subjects. For all groups except the cocaine alone group, the effects of mCPBG on K+ stimulated dopamine release were Ca2+ dependent, suggesting that these effects are receptor mediated. These results suggest that continuous cocaine administration functionally down-regulates 5-HT3 receptors in the nucleus accumbens, and that this down-regulation can be blocked by chronic ondansetron administration. Hence, a functional down regulation of accumbens 5-HT3 receptors represents a significant contribution to the tolerance induced by continuous cocaine administration.     

Topology optimization of periodic layouts of dielectric materials

A topology optimization method is used to design two dimensional periodic structures with desirable transmission properties by distributing two materials of different permittivity over a rectangular representative cell. A plane wave expansion of the electric field at the input and output boundaries is used in the analysis. This allows non-homogeneous material distributions near the boundaries. Numerical examples are used to verify the robustness of the method and to investigate the importance of retaining higher modes in the expansions. It is found that the optimization problem typically admits possibly many local optima and the relevance of higher modes depends on the nature of the solution found. In some instances, higher modes play an important role and using only the dominant mode in the analysis is shown to result in errors in the evaluation of the performance of the design.     

Vibration-induced particle formation during yogurt fermentation—Effect of frequency and amplitude

Machinery such as pumps used for the commercial production of fermented milk products cause vibrations that can spread to the fermentation tanks. During fermentation, such vibrations can disturb the gelation of milk proteins by causing texture defects including lumpiness and syneresis. To study the effect of vibrations on yogurt structure systematically, an experimental setup was developed consisting of a vibration exciter to generate defined vibrational states and accelerometers for monitoring. During the fermentation of skim milk, vibrations (frequency sweep: 25 to 1,005 Hz) were introduced at different pH (5.7 to 5.1, step width 0.1 units) for 200 s. Physical properties of set gels (syneresis, firmness) and resultant stirred yogurts (visible particles, rheology, laser diffraction) were analyzed. Vibrational treatments at pH 5.5 to 5.2 increased syneresis, gel firmness, and the number of large particles (d > 0.9 mm); hence, this period was considered critical. The particle number increased from 34 ± 5 to 242 ± 16 particles per 100 g of yogurt due to vibrations at pH 5.4. In further experiments, yogurts were excited with fixed frequencies (30, 300, and 1,000 Hz). All treatments increased syneresis, firmness, and particle formation. As the strongest effect was observed by applying 30 Hz, the amplitude was set to vibration accelerations of a = 5, 10, 15, 20, and 25 m/s² in the final experiments. The number of large particles was increased due to each treatment and a positive correlation with the amplitude was found. We concluded that vibrations during gelation increase the collision probability of aggregating milk proteins, resulting in a compressed set gel with syneresis. Resultant stirred yogurts exhibit large particles with a compact structure leading to a reduced water-holding capacity and product viscosity.     

Specific recognition of HLA-E, but not classical, HLA class I molecules by soluble CD94/NKG2A and NK cells

The CD94/NKG2 receptors expressed by subpopulations of NK cells and T cells have been implicated as receptors for a broad range of both classical and nonclassical HLA class I molecules. To examine the ligand specificity of CD94/NKG2 proteins, a soluble heterodimeric form of the receptor was produced and used in direct binding studies with cells expressing defined HLA class I/peptide complexes. We confirm that CD94/NKG2A specifically interacts with HLA-E and demonstrate that this interaction is dependent on the association of HLA-E with peptide. Moreover, no interaction between CD94/NKG2A and classical HLA class I molecules was observed, as assayed by direct binding of the soluble receptor or by functional assays using CD94/NKG2A+ NK cells. The role of the peptide associated with HLA-E in the interaction between HLA-E and CD94/NKG2A was also assessed. All class I leader sequence peptides tested bound to HLA-E and were recognized by CD94/NKG2A. However, amino acid variations in class I leader sequences affected the stability of HLA-E. Additionally, not all HLA-E/peptide complexes examined were recognized by CD94/NKG2A. Thus CD94/NKG2A recognition of HLA-E is controlled by peptide at two levels; first, peptide must stabilize HLA-E and promote cell surface expression, and second, the HLA-E/peptide complex must form the ligand for CD94/NKG2A.