Experimental and clinical validation of using enterosorption in mechanical jaundice

Experiments in 119 rats with the model of mechanical jaundice have shown the efficiency of enterosorption with polyphepan. The development of the pathological process was found to improve, lethality of the experimental animals to decrease. Favourable changes of the laboratory indices characteristic of endotoxemia were noted. The mechanism of medical action of enterosorption is realized by means of intensification of transfer of masses of metabolites and toxins through the intestine wall and their excretion through the gastrointestinal tract. One of important mechanisms of the medical action of enterosorption is the stimulation of intestinal peristalsis which is confirmed by data of the dynamics of bioelectrical activity. Enterosorption performed in 60 patients with mechanical jaundice was followed by a more rapid improvement of the general state, decrease of the indices characteristic of endotoxicosis as compared with 60 patients of the control group. The frequency of postoperative complications and lethality were reliably lower.     

Reconstruction of the nose in deep extensive facial burns

The nose is in the medial portion of the face and is frequently injured in trauma of this area. Due to its situation its structure and shape, and its essential function, this organ is particularly exposed in the case of facial burns. These injuries, are usually associated with larger injuries, and frequently with systemic problems, such as respiratory problems. The authors describe nasal burns in the larger context of facial burns, and summarize recent data on this topic. They then recall the fascinating story of rhinopoiesis through the ages. The third part is devoted to their personal approach to reconstruction of the nose in severe panfacial burns, using a forehead flap with one or several tissue expanders.     

Experimental study of transverse bed motion in rotary kilns

Slumping and rolling beds have been studied extensively in a continuous pilot kiln and batch rotary cylinders. Solids investigated include nickel oxide pellets, limestone, sand, and gravel. The effect of variables such as rotational speed, bed depth, cylinder diameter, particle size, and particle shape on bed motion has been determined. For a given material, the different modes of bed motion can be delineated conveniently on a Bed Behavior Diagram which is a plot of bed depthvs rotational speed. The scaling of bed behavior with respect to particle size and cylinder diameter requires similarity of Froude number modified by(D/d _p)^1/2, and pct fill. Measurements of key variables characterizing slumping and rolling beds have also been made.     

横观各向同性岩体中深埋圆形巷道的位移解析解

自然界中具有层状构造的沉积岩约占陆地面积的2/3,而中国占到77.3%,许多变质岩也具有显著的层状构造特征,所以在采矿工程中遇到大量的层状岩体稳定性问题。对于层状岩体,在力学上可将其处理成横观各向同性体。根据横观各向同性弹性力学的平衡方程、物理方程和几何方程,推导了横观各向同性岩体在极坐标系下的相容方程,得到了二向不等压应力条件下横观各向同性岩体中深埋圆形巷道的位移解析解。虽然在推导中假设巷道横断面平行于各向同性面,但位移解析解表明,围岩径向位移不仅与各向同性面上的弹性模量和泊松比有关,而且与垂直各向同性面方向的弹性模量和泊松比有关。     

自控系统设计及工作性能分析

对工业自动化控制系统的设计工作过程与性能进行了介绍和分析 ,并阐述了对系统的基本要求。     

Penile orthoplasty using dermal grafts in the outpatient setting

OBJECTIVES: To review and evaluate our extensive outpatient experience in the use of dermal grafts for the correction of significant residual chordee in patients requiring penile orthoplasty. METHODS: The medical records of all patients requiring surgical correction for severe penile curvature over the past 5 years were reviewed. Among these, 51 patients were identified in whom dermal grafts were used to correct severe residual chordee. Of these patients, 41 had severe hypospadias, 9 had epispadias, and 1 had urethral atresia. Graft harvest and placement technique, any resulting complications, and parental satisfaction with cosmetic and functional results were all evaluated. RESULTS: The dermal grafts were harvested from the hairless skin of the inguinal area, using one of two techniques. All were used to fill a tunical defect created by incising the tunica at the point of maximal penile curvature. No complications or postoperative hospitalizations resulted from any of the orthoplasty procedures. At a mean follow-up of 27 months, all patients had excellent cosmetic and functional results. CONCLUSIONS: In patients with significant residual chordee, a dermal graft is our preferred method of penile orthoplasty. This technique provides a straight phallus with a very minimal complication rate, it can easily and successfully be performed as an outpatient procedure, and it has assured an excellent cosmetic and functional result.     

A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals

INTRODUCTION: We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening. METHODS: The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older. RESULTS: Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical. CONCLUSIONS: Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.     

Experimental validation of flow and tracer-dispersion models in a four-strand billet-casting tundish

An exhaustive literature search indicates that, despite a large number of physical and mathematical model studies, very little efforts have been made to assess predicted flow and turbulence parameters in the tundish directly against equivalent experimental measurements until recently. Consequently, experimental measurements on the instantaneous velocity and residence-time distribution (RTD) were carried out in a scaled water model of a four-strand billet-casting tundish. While particle-image velocimetry (PIV) was applied to measure instantaneous flow, the electrical-conductivity measurement technique was applied to determine the RTD. Through PIV, the mean and the fluctuating components were derived along the central vertical plane of the tundish at two different liquid inflow rates: 1.55×10^?4 m³/s and 3.10×10^?4 m³/s, respectively. Similarly, RTD curves were obtained for tundish operations without and with a dam+turbulence inhibitor device (TID). Parallel to these operations, the flow and tracer dispersion were numerically predicted by FLUENT®. It is shown that the predicted time-average velocity components within the bath bear excellent correspondence with PIV measurements. On the assumption of isotropic fluctuations, turbulent kinetic energy was derived from experimental measurements, which agreed moderately with predictions. Furthermore, the experimentally derived fluctuating velocity components were compared with those obtained from the Reynolds stress model. This indicated very reasonable agreement between measurement and predictions (within ±20 pct). Despite such a difference, however, the extent of agreement between the measured and computed C curves was found to be excellent.     

A clinical, MRI and neurophysiological study of acute transverse myelitis

There is paucity of studies correlating the MRI and evoked potential changes in acute transverse myelitis (ATM). We studied ten patients with ATM (age range 14-57 years; 8 men, 2 women) who were subjected to clinical, MRI and neurophysiological evaluation. The latter included median and tibial somatosensory evoked potentials (SEP), motor evoked potentials (MEP) to upper and lower limbs and concentric needle EMG. The outcome was defined on the basis of three month Barthel Index score. All the patients had pronounced lower limb and three had upper limb weakness. Magnetic resonance imaging scans revealed diffuse to hypointense lesions in T1, which became hyperintense in T2 in all except one patient, who had patchy hyperintense lesions in both T1 and T2 sequences suggesting haemorrhage. The signal changes extended at least three segments above the sensory level. Tibial SEP and central motor conduction time to tibialis anterior (CMCT-TA) were abnormal in nine patients each. Median SEP was normal in all, but CMCT to abductor digiti minimi (CMCT-ADM) was abnormal in four patients. The extent of MRI signal alterations and CMCT-TA correlated with the outcome. Seven patients had a poor outcome, in them MRI changes extended 10 spinal segments or more. In these patients, MEP on lumbar stimulation was either unrecordable or of low amplitude and extensive fibrillations were present in the lower limb muscles. From this study, we conclude that in ATM, extensive MRI changes, unrecordable MEP to lower limbs especially on lumbar stimulation and evidence of denervation in leg muscles seem to predict a poor outcome.     

Experimental validation of two classroom observation systems.

Studied the theoretical structure of 2 classroom observation systems and the extent to which the systems discriminated between experimentally ordered aspects of classroom situations. Both systems, B. B. Brown's (1968) Teacher Practices Observation Record and D. Denny's (1968) Classroom Creativity Observation Schedule, were used by trained student teacher observers ( N = 24) in 36 classrooms in 9 Northern Ireland primary schools. The factor structure of the observation schedule was in close agreement with the 2 dimensions postulated by Denny, whereas the observation record sampled several dimensions of teacher control and classroom organization. Both systems discriminated consistently between teachers, schools, curriculum areas, and curriculum content. A dimension of convergency-divergency, which distinguished math lessons, as convergent, from English lessons, as divergent, was common to both systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Polygraphic validation of distraction tasks in clinical differential tremor diagnosis

We studied the effect of inhaled nitric oxide (NO) on 80 patients who had undergone cardiac surgery in our center. The indications for receiving NO inhalation and the number of patients were as follows: Pp/Ps > 0.5 for pulmonary hypertension (PH) (n = 32; 21 children and 11 adults), severe PH crisis (n = 9), high pulmonary vascular tone (Glenn pressure more than 18 mm Hg after bidirectional Glenn operation) or arterial oxygen saturation (SaO2) less than 70% despite an FiO2 of 1.0 after Blalock-Taussig shunt (n = 6), mean pulmonary artery pressure (PAP) > 15 mm Hg and transpulmonary gradient (TPG) (mean PAP - left atrial pressure [LAP]) > 8 mm Hg after Fontan-type operation (n = 18), elevated pulmonary vascular tone (mean PAP > 30 mm Hg and left ventricular assist system [LVAS] flow rate < 2.5 L/min/m2) in patients with LVAS (n = 3), and impaired oxygenation (PaO2/FiO2 < 100 under positive end-expiratory pressure [PEEP] > 5 cm H2O) (n = 12). Low dose inhaled NO (10 ppm) had the following effects. In adult PH patients, it significantly reduced the mean PAP (from 37.3 to 27.0 mm Hg; average values are given) and increased the mean systemic arterial pressure (SAP) (64.7 to 75.3 mm Hg). In infant PH patients, it increased the mean SAP (51.8 to 56.1 mm Hg). In patients with a PH crisis, it significantly reduced the central venous pressure (CVP) (13.3 to 8.8 mm Hg) while increasing both the mean SAP (49.4 to 57.9 mm Hg) and PaO2/FiO2 (135 to 206). In patients after a Fontan-type operation, it significantly reduced the mean PAP (16.8 to 13.8 mm Hg) and TPG (9.5 to 5.8 mm Hg). In patients under LVAS, it reduced the CVP (11.7 to 8.0 mm Hg) and mean PAP (32.0 to 24.7 mm Hg). In impaired oxygenation patients, PaO2/FiO2 was increased (75 to 106). Sixty-five patients were all followed for 2.0-4.3 years (average, 3.1 years). All 65 patients remained free from oxygen requirement, and possible chronic adverse effects including the occurrence of malignant tumors or chronic inflammation in the respiratory tract were not observed.     

Experimental and clinical pulmonary pneumocystosis

Rat lungs with hydrocortisone-induced pneumocystosis and a necropsy material from 5 patients with AIDS were studied light- and electron-microscopically. The identity of basic morphological features of lung pneumocystosis development in experiment and humans is demonstrated. Three main periods--latent, pronounced, terminal (pneumocystic pneumonia) are distinguished taking into account the relation of productive and vegetative forms of Pneumocystis carinii, state of the surfactants, type I alveolocytes and inflammation cells.     

Experimental evaluation of hepatic functional reserve using 111In colloid for clinical application

Gastric smooth muscle of cats was used to investigate the involvement of protein kinase in vanadate-induced contraction. Vanadate caused a contraction of cat gastric smooth muscle in a dose-dependent manner. Vanadate-induced contraction was totally inhibited by 2 mM EGTA and 1.5 mM LaCl3 and significantly inhibited by 10 microM verapamil and 1 microM nifedipine, suggesting that vanadate-induced contraction is dependent on the extracellular Ca2+ concentration. and the influx of extracellular Ca2+ was mediated through voltage-dependent Ca2+ channel. Both protein kinase C inhibitor and tyrosine kinase inhibitor significantly inhibited the vanadate-induced contraction and the combined inhibitory effect of two protein kinase inhibitors was greater than that of each one. But calmodulin antagonists did not have any influence on the vanadate-induced contraction. On the other hand, both forskolin (1 microM) and sodium nitroprusside (1 microM) significantly inhibited vanadate-induced contraction. Therefore, these results suggest that both protein kinase C and tyrosine kinase are involved in the vanadate-induced contraction which required the influx of extracellular Ca2+ in cat gastric smooth muscle, and that the contractile mechanism of vanadate may be different from that of agonist binding to its specific receptor.     

Early complications and value of initial clinical and paraclinical observations in victims of smoke inhalation without burns

OBJECTIVE: To evaluate the incidence of early pulmonary complications and the value of initial clinical signs and paraclinical investigations in victims of smoke inhalation not suffering from burns following structural fires. DESIGN: Retrospective chart review. SETTING: Thirteen-bed ICU. PATIENTS: Sixty-four victims of smoke inhalation following household fires were admitted to the ICU between January 1987 and December 1992. Exclusion criteria from the study were patients with cutaneous burns or multiple trauma or blast injury, and patients found in cardiac arrest. METHODS: Clinical, biological, and radiologic parameters were collected over a 5-day period. RESULTS: The mortality rate in relation to progressive respiratory failure was 3.1%. Mean ICU stay was 5.8 days (range, 1 to 33 days), and was longer in the patients presenting with soot deposits in the oropharynx (p = 0.02), dysphonia (D) (p = 0.05), or ronchi (R) (p = 0.0004) at the first examination, and in those having a positive sputum bacteriologic analysis (p = 0.003) or requiring parenteral bronchodilator agents for more than 24 h (p = 0.04). Thirty-five patients underwent mechanical ventilation (MV) for a mean of 101.2 h (range, 8 to 648 h). Mean MV duration was higher in the patients presenting initially with R (p = 0.003), high carbon monoxide (but not cyanide) levels (p = 0.02), or a positive bacteriologic sample (p = 0.0001). Positive bacteriologic sampling correlated with the presence of D (p = 0.02) or R (p = 0.04) and with immediate intubation (p = 0.0003). No correlation was found with chest radiograph. CONCLUSIONS: In this selected series of fire victims without cutaneous burns, respiratory injury was frequent. The initial clinical signs may be helpful to predict pulmonary complications.     

Experimental studies on myocardial metabolism of carbohydrate and lipid in surface-induced deep hypothermia

In surface-induced deep hypothermia, metabolic acidosis resulting from lactacidemia was observed. In the aspect of myocardial metabolism, the rate of reduction in coronary A-V difference ratio of lactate, pyruvate and NEFA was less than that of coronary flow and myocardial oxygen consumption in the hypothermic heart. Namely, it seems that lactate, pyruvate and NEFA play an important role as energy fuel in the hypothermic heart. On the other hand, myocardial metabolism of glucose was reduced in the hypothermic heart. Moreover, it seems that exogenous corticosteroid and ATP do not influence on the myocardial metabolism of carbohydrate and lipid in the hypothermic heart.