BACKGROUND: Home parenteral nutrition (HPN) is used to treat intestinal failure. A minority of HPN patients are dependent on opiates and benzodiazepines to control pain and anxiety. The aim of this study was to determine what effects such drug dependence had on patient outcomes. METHODS: Ten dependent patients were prospectively compared with 10 well-matched, nondependent HPN patients for the same 12-month period. Episodes of line sepsis and other complications were documented and the cost of treatment estimated. Health status was measured using the SF36 and EuroQol instruments. RESULTS: The dependent group had significantly more episodes of central line sepsis (p = .0007) as well as other complications (p = .0002). This led to significantly longer periods of inpatient care (p = .0004) and therefore higher costs of treatment. Health status was lower in the dependent group; they reported more pain (p = .04) and less energy (p = .04). CONCLUSIONS: The complication rate and increased cost of treatment for opiate- and sedative-dependent patients receiving HPN significantly detract from the overall outcome of this therapy. 相似文献
Escherichia coli K4 bacteria synthesize a capsule polysaccharide (GalNAc-GlcA(fructose))n with the carbohydrate backbone identical to chondroitin. GlcA- and GalNAc-transferase activities from the bacterial membrane were assayed with acceptors derived from the capsule polysaccharide and radiolabeled UDP-[14C]GlcA and UDP-[3H]GalNAc, respectively. It was shown that defructosylated oligosaccharides (chondroitin) could serve as substrates for both the GlcA- and the GalNAc-transferases. The radiolabeled products were completely degraded with chondroitinase AC; the [14C]GlcA unit could be removed by beta-D-glucuronidase, and the [3H]GalNAc could be removed by beta-N-acetylhexosaminidase. A fructosylated oligosaccharide acceptor tested for GlcA-transferase activity was found to be inactive. These results indicate that the chain elongation reaction of the K4 polysaccharide proceeds in the same way as the polymerization of the chondroitin chain, by the addition of the monosaccharide units one by one to the nonreducing end of the polymer. This makes the biosynthesis of the K4 polysaccharide an interesting parallel system for studies of chondroitin sulfate biosynthesis. In the biosynthesis of capsule polysaccharides from E. coli, a similar mechanism has earlier been demonstrated for polysialic acid (NeuNAc)n (Rohr, T. E., and Troy, F. A. (1980) J. Biol. Chem. 255, 2332-2342) and for the K5 polysaccharide (GlcAbeta1-4GlcNAcalpha1-4)n (Lidholt, K., Fjelstad, M., Jann, K., and Lindahl, U. (1994) Carbohydr. Res. 255, 87-101). In contrast, chain elongation of hyaluronan (GlcAbeta1-3GlcNAcbeta1-4)n is claimed to occur at the reducing end (Prehm, P. (1983) Biochem. J. 211, 181-189). 相似文献
Nutrient uptake by the hindlimb was investigated utilising the arteriovenous difference technique in 5 Thoroughbred horses fed to maintenance a diet of 100% roughage or 52% oat grain and 48% roughage. Arterial blood was obtained from a catheter inserted into the carotid artery while venous blood was simultaneously collected from a catheter placed into the iliac vein via the medial saphenous vein. The arteriovenous difference for glucose was significant and represented a mean extraction of 10 +/- 1% with no effect of diet. If fully oxidised, glucose uptake (corrected for lactate and pyruvate arteriovenous difference) was sufficient to account for 78 +/- 13% or 107 +/- 15% of the oxygen consumed by the hindlimb in horses fed a roughage or 52% oat grain diet respectively. Acetate was also a major metabolite of the hindlimb, showing a 39 +/- 5% extraction with no effect of diet. However, the 52% oat grain diet did induce a significant decline in the concentration of acetate in arterial blood. The potential contribution to oxidation in the hindlimb was significantly reduced from 32 +/- 4% in horses fed roughage to 21 +/- 3% when fed 52% oat grain. D-3-Hydroxybutyrate uptake could account for 9 +/- 1% of the oxidation by the hindlimb with no effect of diet. The technique for measuring nutrient uptake across the hindlimb using the arteriovenous difference is relatively simple and would be valuable in investigating fuel use by muscle during exercise. 相似文献
This paper presents a model of heterogenous diffusion in capillary porous materials during the process of drying. The governing heat and mass transfer equations have been established using the liquid as well as vapor flow. Two models have been presented. Model 1 does not consider the heat conduction while the model 2 has been established by considering the conduction. The developed models and the numerical solutions of the resulting differential equations can take into account the moisture and temperature dependent thermophysical properties of the product. All equations have been established in spherical coordinates but the programme written for the purpose of calculations can be used for other geometries also. Numerical calculations have been performed for gas concrete and tiles using model 1, while model 2 has been used for gas concrete only because of the lack of data for thermophysical properties of the tile. For gas concrete it was seen that conduction has only marginal effect on the drying process and the numerical predictions of the drying process were reasonably accurate. 相似文献
It is not known whether impaired hematopoiesis noted during human immunodeficiency virus (HIV) infection results from infection of stem/progenitor cells or of cells of the bone marrow microenvironment. Normal adherent primary stromal layers were exposed to HIV to determine which of this mixture of endothelial cells, fibroblasts, and macrophages are susceptible to the virus. Viral p24 in supernatants was noted with monocytotropic HIV-1Ada, HIV-1Ba-L, and HIV-1JR-FL but not with lymphotropic HIV-1LAI nor HIV-1MN strain, and only stromal macrophages expressed the viral antigens. Coculture of the layers with PHA-activated normal lymphocytes failed to rescue lymphotropic virus. No p24 was produced when macrophage-depleted stromal cells were exposed to either HIV-1Ba-L or HIV-1LAI; proviral DNA was then amplified by PCR in cells exposed to either virus, though coculture with lymphocytes rescued only HIV-1Ba-L. Altogether, these data indicate that macrophages are the major targets of HIV in cultured stromal layers. As virus replication in macrophages did not affect the profile of major cytokines involved in regulating hematopoiesis, HIV infection could alter hematopoiesis by other as yet unspecified mechanisms. 相似文献
A CEC-funded project has been performed to tackle the problem of producing an advanced Life Monitoring System (LMS) which would calculate the creep and fatigue damage experienced by high temperature pipework components. Four areas were identified where existing Life Monitoring System technology could be improved:
1. 1. the inclusion of creep relaxation
2. 2. the inclusion of external loads on components
3. 3. a more accurate method of calculating thermal stresses due to temperature transients
4. 4. the inclusion of high cycle fatigue terms.
The creep relaxation problem was solved using stress reduction factors in an analytical in-elastic stress calculation. The stress reduction factors were produced for a number of common geometries and materials by means of non-linear finite element analysis. External loads were catered for by producing influence coefficients from in-elastic analysis of the particular piping system and using them to calculate bending moments at critical positions on the pipework from load and displacement measurements made at the convenient points at the pipework. The thermal stress problem was solved by producing a completely new solution based on Green's Function and Fast Fourier transforms. This allowed the thermal stress in a complex component to be calculated from simple non-intrusive thermocouple measurements made on the outside of the component. The high-cycle fatigue problem was dealt with precalculating the fatigue damage associated with standard transients and adding this damage to cumulative total when a transient occurred.
The site testing provided good practical experience and showed up problems which would not otherwise have been detected. 相似文献
A method is considered for increasing the immunity from interference of broadband systems for measuring and transmitting information.
It is based on utilizing nonlinear methods to process spread-spectrum signals. The possibility is investigated of using a
quasioptimal receiving device which can be implemented in practice. It is shown that the proposed method makes it possible
to solve the rejection problem at the physical level.
Translated from Izmeritel'naya Tekhnika, No. 11, pp. 13–15, November, 1996. 相似文献
Most divers and diving medicine specialists know that application of normobaric oxygen as first aid after a bubble disease incident is highly effective. However, as yet technical difficulties acted as a deterrent to using normobaric oxygen at the diving site. This can now be overcome by a newer technique. To be efficient, any therapy of bubble disease should follow three main principles: maximal partial pressure of inhaled oxygen (i.e. 100 kpa in normobaric, and 280 kpa in hyperbaric conditions); minimal partial pressure of inhaled nitrogen, which should ideally be near zero; immediate start of therapy, if possible at the diving site, but not later than 2 hours after the onset of the first symptoms. However, it has to be borne in mind that for an efficient normobaric oxygenation (100%), the standard apparatus design without oxygen reservoir is obsolete, for it offers at most 40% oxygen to the lungs. Currently the following technical approaches for an efficient normobaric oxygenation are available: open one-way systems with tightly fitting mask and oxygen reservoir bag (type Ambu or Leardal, etc.); open systems with on-demand regulation and tightly fitting mouth piece (type SCUBA, or Bird-respirator); closed systems with CO2 absorber (type oxygen rebreathing diving gear). The closed system is a genuine technical advance, because it needs 15 times less oxygen than open systems (about 90 liters oxygen for a 3-hours oxygenation run). Such an apparatus is thus of light weight, far less cumbersome, and nevertheless highly efficient. The therapy should start immediately at the site of the mishap and be maintained during the transport to the next HBO-unit (usually 3 to 6 hours).(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
Given the enormous size of the genome and that there are potentially many other types of measurements we need to do to understand it, it has become necessary to pick and choose one's targets to measure because it is still impossible to evaluate the entire genome all at once. What has emerged is a need to have rapidly customizable microarrays. There are two dominant methods to accomplish custom microarray synthesis, Affymetrix-like microarrays manufactured using light projection rather than semiconductor-like masks used by Affymetrix to mass manufacture their GeneChip/sup TM/ arrays now, or the ink-jet printing method employed by Agilent. The manufacture of these custom Affymetrix-like microarrays can now be done on a digital optical chemistry (DOC) machine developed at the University of Texas Southwestern Medical Center, and this method offers much higher feature numbers and feature density than is possible with ink-jet printed arrays. On a microarray, each feature contains a single genetic measurement. The initial DOC prototype has been described in several publications, but that has now led to a second-generation machine. This machine reliably produces a number of arrays daily, has been deployed against a number of biomedical questions, is being used in new ways and has also led to a number of spin-off technologies. 相似文献