Partial cricotracheal resection with primary anastomosis in the pediatric age group

The traditional approach to severe subglottic stenosis (SGS) in the pediatric age group is laryngotracheal reconstruction (LTR). This approach may be complex and multistaged, with variable and unpredictable success rates in the individual patient. Excellent results have been reported in adults who had severe SGS and underwent partial resection of the cricoid and primary thyrotracheal anastomosis. This procedure has not been widely reported in infants and children. We report our experience with this procedure in 16 pediatric patients with grade III or IV SGS. Eleven patients had multiple previous LTR operations. The preoperative evaluation, surgical techniques, postoperative care, complications, and final results are described and discussed. Fourteen patients were decannulated after the procedure, 1 patient needed a second open procedure prior to decannulation, and 1 patient with concomitant bronchopulmonary dysplasia remains cannulated, for an overall 94% decannulation rate. Fourteen patients have no limitation of respiration, and 1 patient has moderate exercise intolerance. The results of this series suggest that partial cricotracheal resection with primary anastomosis is a relatively safe and effective procedure for pediatric patients with severe SGS.     

Task Planning For A Mobile Robot In An Indoor Environment Using Object-oriented Domain Information

For a mobile robot to be practical, it needs to navigate in dynamically changing environments and manipulate objects in the environment with operating ease. The main challenges to satisfying these requirements in mobile robot research include the collection of robot environment information, storage and organization of this information, and fast task planning based on available information. Conventional approaches to these problems are far from satisfactory due to their requirement of high computation time. In this paper, we specifically address the problems of storage and organization of the environment information and fast task planning in the area of robotic research. We propose an special object-oriented data model (OODM) for information storage and management in order to solve the first problem. This model explicitly represents domain knowledge and abstracts a global perspective about the robot's dynamically changing environment. To solve the second problem, we introduce a fast task planning algorithm that fully uses domain knowledge related to robot applications and to the given environment. Our OODM based task planning method presents a general frame work and representation, into which domain specific information, domain decomposition methods and specific path planners can be tailored for different task planning problems. This method unifies and integrates the salient features from various areas such as database, artificial intelligence, and robot path planning, thus increasing the planning speed significantly     

Evaluation of multicast routing algorithms for real-timecommunication on high-speed networks

Multicast (MC) routing algorithms capable of satisfying the quality of service (QoS) requirements of real-time applications will be essential for future high-speed networks. We compare the performance of all of the important MC routing algorithms when applied to networks with asymmetric link loads. Each algorithm is judged based on the quality of the MC trees it generates and its efficiency in managing the network resources. Simulation results over random networks show that unconstrained algorithms are not capable of fulfilling the QoS requirements of real-time applications in wide-area networks. Simulations also reveal that one of the unconstrained algorithms, reverse path multicasting (RPM), is quite inefficient when applied to asymmetric networks. We study how combining routing with resource reservation and admission control improves the RPM's efficiency in managing the network resources. The performance of one semiconstrained heuristic, MSC, three constrained Steiner tree (CST) heuristics, Kompella, Pasquale, and Polyzos (1992), constrained adaptive ordering (CAO), and bounded shortest multicast algorithm (BSMA), and one constrained shortest path tree (CSPT) heuristic, the constrained Dijkstra heuristic (CDKS) are also studied. Simulations show that the semiconstrained and constrained heuristics are capable of successfully constructing MC trees which satisfy the QoS requirements of real-time traffic. However, the cost performance of the heuristics varies. The BSMA's MC trees are lower in cost than all other constrained heuristics. Finally, we compare the execution times of all algorithms, unconstrained, semiconstrained, and constrained     

Substitution of an aspartic acid results in constitutive activation of c-kit receptor tyrosine kinase in a rat tumor mast cell line RBL-2H3

The c-kit protooncogene encodes a receptor tyrosine kinase that mediates signals required for differentiation, proliferation and survival of mast cells. We have already shown the constitutive activation of c-kit receptor tyrosine kinase (KIT) in a human mast cell leukemia line (HMC-1) and a murine mastocytoma cell line (P-815). We here examined whether such constitutive activation of KIT occurred in the rat tumor mast cell line RBL-2H3 as well, which is frequently used as a tool for studying functions of mast cells. In RBL-2H3 cells, KIT was constitutively phosphorylated on tyrosine and activated in the absence of autocrine production of its ligand, stem cell factor (SCF). Sequencing analysis revealed that one of c-kit genes of RBL-2H3 cells had a point mutation, resulting in amino acid substitution of Tyr for Asp in codon 817. When rat wild-type c-kit cDNA and mutant-type c-kit cDNA encoding KITTyr817 were transfected into cells of a human embryonic kidney cell line (293T), only mutant form KITTyr817 was constitutively phosphorylated on tyrosine and activated in the absence of SCF. Since mutations at the same Asp codon constitutively activated KIT in all the human HMC-1, murine P-815, and rat RBL-2H3 cell lines, and since the incorporation of antisense oligonucleotides of c-kit messenger RNA significantly suppressed the proliferation of RBL-2H3 cells, the activating mutations in the Asp codon of the c-kit gene appeared to be involved in neoplastic growth of mast cells.     

Attitudes of women of childbearing age towards prenatal diagnosis in southeastern France

The objective of this study was to explore women's attitudes towards prenatal diagnosis of trisomy 21 and to examine some of the factors possibly responsible for these attitudes before implementing in real practice serological screening of pregnant women at risk for trisomy 21. We carried out a telephone survey on a representative sample of women who had recently had a normal livebirth delivery in the Marseille district in 1990. The participation rate was 80 per cent and the average age of the mothers was 28.9 years. Among the 514 women interviewed, 78 per cent stated that they would ask for an amniocentesis for a 1 per cent risk of trisomy 21 at their next pregnancy. When adjusting for confounding factors, the decision to have or not to have an amniocentesis was found to depend not only on the women's attitude towards induced abortion, but also on their understanding of the risk involved and on the social context (knowing a handicapped child, discussion with the father). It also depended on the women's age and on what they knew about amniocentesis from the medical point of view. The risk of miscarriage can influence a woman's choice but this objection was not found to affect the women's decisions significantly in our survey. The data showed the existence of a high potential demand for fetal karyotyping.     

Anti beta 2glycoprotein I antibodies and lupus anticoagulant in patients with recurrent pregnancy loss: prevalence and clinical significance

Over 2000 electrocution deaths were identified among U.S. construction workers from 1980 to 1991, with the highest mean annual crude mortality rate (2.5 per 100,000 people), and second highest mean age-adjusted rate (2.7 per 100,000 people) of all industries. Although the crude fatality rates showed a downward trend, construction workers are still about four times more likely to be electrocuted at work than are workers in all industries combined. Nearly 40% of the 5083 fatal electrocutions in all industries combined occurred in construction, and 80% were associated with industrial wiring, appliances, and transmission lines. Electrocutions ranked as the second leading cause of death among construction workers, accounting for an average of 15% of traumatic deaths in the industry from 1980 to 1991. The study indicates that the workers most at risk of electrical injury are male, young, nonwhite, and electricians, structural metal workers, and laborers. The most likely time of injury is 11 a.m. to 3 p.m. from June to August. Focusing prevention on these populations and characteristics through better methods of worker and supervisor electrical safety training, use of adequate protective clothing, and compliance with established procedures could minimize the average annual loss of 168 U.S. construction workers.     

Demographic study of first-ever stroke and acute myocardial infarction in Okinawa, Japan

We performed a cross-sectional survey of stroke and acute myocardial infarction (AMI) in Okinawa, Japan with a census population of about 1.2 million. A total of 3,644 cases of first-ever stroke and 898 cases of initial acute myocardial infarction (AMI) were detected. The age-adjusted annual incidence rate for stroke was 105 per 100,000 standard population of Japan, and that of AMI was 26. The case-fatality rate of stroke within 28 days of onset was 12.8%, and that of AMI was 22.2%. Of the stroke cases, 51.4% were diagnosed as brain infarction, 38.7% as brain hemorrhage, and 9.3% as subarachnoid hemorrhage. The diagnosis of stroke subtypes were confirmed by computed tomography or magnetic resonance imaging in 98.4% of all stroke cases. In Okinawa, the incidence rate of AMI was still considerably lower than that in the Western population, and the rate of stroke was similar to that in the Western population.     

Electronic `how things work' articles: two early prototypes

The electronic encyclopedia exploratorium (E³) is a vision of a future computer system-an electronic book describing how thing work. Typical articles in E³ will describe such mechanisms as compression refrigerators, engines, telescopes, and mechanical linkages. Each article will provide simulations, three-dimensional animated graphics that the user can manipulate, laboratory areas that allow a user to modify the device or experiment with related artifacts, and a facility for asking questions and receiving customized, computer-generated English-language explanations. Some of the foundational technology is discussed, focusing on topics in artificial intelligence, graphics, and user interfaces. The initial prototype system and the technical lessons learned from it, as well as the second prototype currently under construction, are described