Positions and training of the indigenous health workforce

Laparoscopy and magnetic resonance imaging (MRI) are competetive tools in the diagnostic of non-palpable testis. Advantages and disadvantages of this methods will be demonstrate. 29 boys investigated for this indication with MRI. In case MRI failed to locate the testis laparoscopy was performed with a new miniaturized set of pediatric instruments (1.9 mm optic). The aim of laparoscopy was the identification of the spermatic duct and vessels and their topographic relation to the internal inguinal ring. All findings were verified by open surgical procedures. MRI revealed 10 inguinal and 7 abdominal testis. There was no false positive finding. In 12 boys MRI showed no testis. 4 cases were correct negative, 8 cases were false negative (32%). In these 8 MRI-negative patients laparoscopy revealed 7 inguinal and 1 abdominal testis. The optical quality of the mini-telescope was sufficient for a 100% correct diagnosis. Laparoscopy related complications did not occur. Laparoscopy proved to be a powerful low risk diagnostic method in non-palpable testis with high sensitivity and specifity (100% correct positive, 0% false negative). Therefore lapraroscopy is recommended as primary diagnostic access for this indication. In the same anesthesia a optimal therapy is possible. Nevertheless a positive MRI-finding locates the testis reliably, whereas a negative finding always needs further exploration because testis might have been missed.     

Measurement of ultralow gate tunneling currents using floating-gate integrator technique

We report for the first time that a gate tunneling current measurement sensitivity better than 3/spl times/10/sup -22/ A has been achieved by using a floating-gate integrator technique. The technique involves monitoring the charge change in the floating-gate integrated with an on-chip op-amp and an on-chip feedback capacitor. We used this technique to study the stress-induced leakage current (SILC) and its cycling dependence of 70 /spl Aring/ oxides in the direct tunneling region at oxide voltage as low as 1.9 V. The technique has been validated through correlation to direct measurement on MOSFET arrays and theoretical calculations. The measured SILC current is modeled with an Inelastic trap-assisted tunneling model.     

Thrombopoietin expands erythroid, granulocyte-macrophage, and megakaryocytic progenitor cells in normal and myelosuppressed mice

Thrombopoietin (Tpo), the ligand for the proto-oncogene receptor c-Mpl, increases megakaryocyte size, ploidy, and surface expression of platelet-specific glycoproteins, is inversely related to platelet mass, and is a potent in vivo stimulus of platelet production. However, several features of c-mpl biology, and that of its viral counterpart v-mpl, suggest that the action of Tpo may not be strictly limited to megakaryocytopoiesis. To investigate the possibility that Tpo might affect a multitude of cell lineages, we studied the effects of in vivo administration of the hormone on multiple types of marrow and splenic clonogenic hematopoietic progenitors. We report that Tpo acts to expand BFU-E, CFU-GM, and CFU-Mk and redistribute CFU-E in normal mice and to hasten the recovery of all of these progenitor cell types in myelosuppressed animals. These findings argue that the hematopoietic progenitor cell compartment responds to Tpo as a whole and that the in vivo effects of Tpo administration may be more wide-ranging than previously anticipated.     

Synergistic effects of thrombopoietin and granulocyte colony-stimulating factor on neutrophil recovery in myelosuppressed mice

Severe suppression of the hematopoietic system is a major factor in limiting chemotherapy dose escalation. To determine whether a combination of human recombinant granulocyte colony-stimulating factor (G-CSF) and thrombopoietin (TPO) would alter recovery of platelets, red blood cells (RBCs), or neutrophils after myeloablative therapy, myelosuppressed mice were treated with sc injections of TPO (90 micrograms/kg), G-CSF (250 micrograms/kg). TPO plus G-CSF or vehicle and complete blood counts were measured. Marrow and spleen cells were obtained at various times and assayed for erythroid, myeloid, and megakaryocytic progenitors. The prolonged neutropenia in vehicle controls (14 days) was significantly shortened in mice treated with G-CSF or TPO for 14 days. The combination of TPO plus G-CSF further reduced the duration of neutropenia. TPO and TPO plus G-CSF treatments also significantly shortened thrombocytopenia compared to vehicle. Recovery of RBCs was also enhanced in mice treated with either G-CSF or TPO, or the combination. Furthermore, treatment with G-CSF and/or TPO hastened myeloid, erythroid, and megakaryocyte progenitor recovery compared to vehicle controls. These results show that the combination of TPO plus G-CSF acts synergistically to accelerate neutrophil recovery in myelosuppressed mice and does not compromise the platelet or RBC response to TPO therapy.     

Regulation of prostaglandin synthesis and of the selective release of lysosomal hydrolases by mouse peritoneal macrophages

Macrophages isolated from the peritoneal cavity of untreated mice and maintained in tissue culture synthesize and release prostaglandins when challenged with zymosan. These cells also selectively release lysosomal acid hydrolases under the same conditions. The major prostaglandins released into the media are found to be prostaglandins E1, E2 and 6-oxoprostaglandin F1a, whereas prostaglandin F2a is not detected. Macrophages isolated from mice that have received an intraperitoneal injection of thioglycollate broth are far less responsive to zymosan challenge. These cells require 300 microgram of zymosan to synthesize and release one-third the amount of prostaglandins released from non-stimulated macrophages exposed to 50 microgram of zymosan. In addition, thioglycollate-stimulated macrophages release less than 10% of their lysosomal acid hydrolases when exposed to 300 microgram of zymosan whereas non-stimulated cells release approximately 50% of these enzymes after treatment with 50 microgram of zymosan. The zymosan-stimulated synthesis and release of prostaglandins are completely inhibited by indomethacin, whereas the increased selective release of lysosomal acid hydrolases is not affected. Macrophages, unlike fibroblasts, do not synthesize and release prostaglandins when exposed to serum or to bradykinin.     

A note on stability,least square estimation and inners

In this note the polynomial F_N(z) is considered as the inverse filter of an all-pole system. From the auto correlation function of the output of this system a matrix R_I is constructed. Using the theory of least-square estimation, it is shown that F_N(z) has all its zeros outside the unit circle if and only if matrix R_I is a positive innerwise (P.I.). Furthermore the number of zeros of F_N(z) inside the unit circle is equal to the number of negative ratios of inners determinants.     

Some kanban-controlled manufacturing systems: a first stabilityanalysis

The blockage/starvation patterns of known instability examples suggest using local demand information-which is precisely what is provided by the widely advocated kanban approach to flow control in manufacturing systems. Therefore, we have re-analyzed for stability the examples described in the 1990 Kumar-Seidman paper when modified by introducing kanban control. It is found that this does not ensure stability and, in fact, some interesting new instability phenomena arise. Counterintuitively, it is possible that increasing some reserve in a stable system may induce instability     

Evaluating a speech-reception threshold model for hearing-impaired listeners

Plomp's speech reception threshold (SRT) model [R. Plomp, J. Acoust. Soc. Am. 63, 533-549 (1978)] incorporates a distortion and an attenuation factor that are both expressed in dB and, for hearing-impaired listeners, are greater than 0 dB. The distortion factor is hypothesized to affect the SRT in quiet and in noise and suggests that a hearing-impaired listener will always demonstrate a higher SRT than a normal-hearing listener. The present study examines whether this distortion factor can be explained for many listeners simply by inaudibility of a portion of the speech spectrum. SRTs were obtained from normal-hearing and mild-to-moderately hearing-impaired listeners in quiet and at various noise levels. The results indicate that, at high noise levels, when the noise, rather than the quiet threshold, becomes the dominating factor, the SRT functions of both the normal and the mild-to-moderately hearing-impaired group converge and the distortion factor diminishes to zero. Predictions were also made using an articulation index and similar convergence of the two functions was observed.     

Discrete return lidar-based prediction of leaf area index in two conifer forests

Leaf area index (LAI) is a key forest structural characteristic that serves as a primary control for exchanges of mass and energy within a vegetated ecosystem. Most previous attempts to estimate LAI from remotely sensed data have relied on empirical relationships between field-measured observations and various spectral vegetation indices (SVIs) derived from optical imagery or the inversion of canopy radiative transfer models. However, as biomass within an ecosystem increases, accurate LAI estimates are difficult to quantify. Here we use lidar data in conjunction with SPOT5-derived spectral vegetation indices (SVIs) to examine the extent to which integration of both lidar and spectral datasets can estimate specific LAI quantities over a broad range of conifer forest stands in the northern Rocky Mountains. Our results show that SPOT5-derived SVIs performed poorly across our study areas, explaining less than 50% of variation in observed LAI, while lidar-only models account for a significant amount of variation across the two study areas located in northern Idaho; the St. Joe Woodlands (R² = 0.86; RMSE = 0.76) and the Nez Perce Reservation (R² = 0.69; RMSE = 0.61). Further, we found that LAI models derived from lidar metrics were only incrementally improved with the inclusion of SPOT 5-derived SVIs; increases in R² ranged from 0.02–0.04, though model RMSE values decreased for most models (0–11.76% decrease). Significant lidar-only models tended to utilize a common set of predictor variables such as canopy percentile heights and percentile height differences, percent canopy cover metrics, and covariates that described lidar height distributional parameters. All integrated lidar-SPOT 5 models included textural measures of the visible wavelengths (e.g. green and red reflectance). Due to the limited amount of LAI model improvement when adding SPOT 5 metrics to lidar data, we conclude that lidar data alone can provide superior estimates of LAI for our study areas.