Diagnostic value of the study of caffeine elimination in chronic liver diseases

Data from the past few years have shown that as caffeine metabolizes solely in the liver, caffeine elimination can serve as a liver function test. We have collected data by monitoring 40 persons with liver diseases (11 chronic alcoholic hepatitis, 24 liver cirrhosis, 5 non-cirrhotic liver disease). Eight subjects served as controls. The patients with liver cirrhosis were classified according to the Child--Pugh scoring system. To determine caffeine elimination blood samples were collected before and at 3, 6, 9 and 12 hours after oral administration of 0.2 g caffeine. Fasting serum caffeine concentration and concentration 12 hours after administration, serum clearance, half life, peak concentration and volume of distribution have been compared. The respective values measured in patients with non-cirrhotic liver diseases did not differ significantly from the controls. The disappearance of caffeine was significantly decreased in cirrhotics. Our results demonstrated a good correlation between impairment of caffeine elimination and assessment of severity of liver disease by the Child--Pugh classification. Measuring serum levels in samples taken 12 hours after caffeine administration is a simple and useful method in the diagnosis of liver diseases at cirrhotic stage.     

Decision by the Principle Board of the Polish Allergy Society

A review of isolates of Neisseria meningitidis and other laboratory evidence of meningococcal infection was carried out for the period 1990-1995. Thirty-three patients with evidence of meningococcal disease were identified over the six year period. Group B organisms were the most commonly identified, but an increase in Group C has occurred and is almost equal in number. Data from clinical, laboratory and public health sources should be centralized in a National Surveillance Centre.     

A high-speed gateable image pipeline

We present the performance of a high-speed gateable vacuum image pipeline, which permits individual images to be delayed and selected from continuous non-repetitive image stream. This device is composed of a vacuum tube equipped with a photocathode at one end, a phosphor screen at the other end, and a system of metal grids in between. Photoelectrons produced by the images focused on the photocathode, are guided by a uniform magnetic field, parallel to the tube axis. By changing the grid potentials, the drift time of the photoelectrons inside the tube can be varied from 0.35 to 1.5 μs. An image can then be selected by an external trigger with a time resolution in the range of 4–30 ns, depending on the delay time. The selected photoelectrons are finally accelerated onto the phosphor screen, set at 10 kV, where they reproduce the desired image. With a magnetic field of 0.1 T, a spatial resolution of 33 lp/mm was obtained. The high spatial and time resolution make this device an interesting tool for high-energy physics and astrophysics experiments, and for high-speed photography.     

The morphological stability of lateral growth in solid-solid phase transformation during thin-film interdiffusion in Al/Cu bimetal films

This article describes the phenomenon of morphological instability in solid-solid phase transformations during thin-film interdiffusion, specifically related to the initial stages of precipitation when phase growth occurs along the interface between thin films. The experimental observations that revealed this effect will be presented, and a working hypothesis will be discussed. Experimental observations suggest that the ledge mechanism of growth is present in this system but does not inhibit the formation of interfacial instabilities. It is proposed that morphological stability for solid-phase growth occurring during thin-film interdiffusion can be treated by the inclusion of a solute-source term into the two-dimensional perturbation approach generally used to study unstable growth morphologies. Experimental observations that provide qualitative and semiquantitative support for the solute-source model are also presented.     

The structure and management of service level agreements innetworks

The paper proposes a structure for quality-of-service (QoS)-centered service level agreements (SLA), and a framework for their real-time management in multiservice packet networks. The SLA is structured to be fair to both parties, the service provider and their customer. The SLA considered here are for QoS assured delivery of aggregate bandwidth from ingress to egress nodes; however, the control and signaling is for the more granular flows or calls. A SLA monitoring scheme is presented in which revenue is generated by the admission of flows into the network, and penalty incurred when flows are lost in periods when the service provider is not SLA compliant. In the SLA management scheme proposed, the results of a prior off-line design are used, in conjunction with measurements taken locally at ingress nodes, to classify the loading status of routes. The routing and resource management are based on virtual partitioning and its supporting mechanism of bandwidth protection. The effectiveness of SLA management is measured by the robustness in performance in the presence of substantial diversity in actual traffic conditions. A simulation testbed called D'ARTAGNAN has been built from which we report numerical results for a case study. The results show that the SLA management scheme is robust, fair and efficient over a broad range of traffic conditions     

Test Case Generation as an AI Planning Problem

While Artificial Intelligence techniques have been applied to a variety of software engineering applications, the area of automated software testing remains largely unexplored. Yet, test cases for certain types of systems (e.g., those with command language interfaces and transaction based systems) are similar to plans. We have exploited this similarity by constructing an automated test case generator with an AI planning system at its core. We compared the functionality and output of two systems, one based on Software Engineering techniques and the other on planning, for a real application: the StorageTek robot tape library command language. From this, we showed that AI planning is a viable technique for test case generation and that the two approaches are complementary in their capabilities.     

Prevalence of adrenal carcinoma among incidentally discovered adrenal masses. A retrospective study from 1989 to 1994. Gruppo Piemontese Incidentalomi Surrenalici

BACKGROUND: The incidental discovery of an adrenal mass poses the problem of distinguishing between the frequent benign masses and the infrequent malignant ones that require surgery. Univocal guidelines to approach this problem are unavailable. OBJECTIVE: To perform a survey of the clinical management of incidentally discovered adrenal masses (ie, adrenal incidentalomas). DESIGN: A multicentric retrospective analysis of hospital medical records of adrenal incidentalomas diagnosed during a 5-year period; the medical records were scrutinized for demographic data and clinical details by means of a specifically tailored questionnaire. SETTING: The major surgical and medical centers of Piedmont, a northern Italian region with approximately 4 million inhabitants. The recruitment pattern of these centers was unselected. PATIENTS: The definition of adrenal incidentaloma was limited to patients with a physical examination and a clinical history unindicative of adrenal disease. Exclusion criteria also included hypertension of suspected endocrine origin and a history of neoplasms known to metastasize frequently in the adrenal glands. Two hundred twenty-four medical records were collected, and 210 were analyzed (14 excluded a posteriori). RESULTS: Most patients were in their 50s and 60s, and women were predominantly affected. The frequency of adrenocortical cancer was 13% among patients operated on. The tumor diameter was highly correlated with the risk of cancer; a cutoff at 5 cm had a sensitivity of 93% with a specificity of 64% in discriminating between benign and malignant cortical lesions. CONCLUSIONS: The occurrence of adrenocortical carcinoma among adrenal incidentalomas is not rare. The evaluation of the mass size is a simple and effective method for selecting patients at risk for cancer. The indication for surgery of masses larger than 5 cm, or of masses of any diameter that have suspicious imaging characteristics, limits unnecessary operations and costs.