Anti-D in a D-positive renal transplant patient

PURPOSE: We report a case of postoperative reparalysis in the recovery room, following nebulized epinephrine. The patient was pharmacologically reversed with edrophonium after paralysis with rocuronium. CLINICAL FINDINGS: A 12-yr-old girl developed postoperative reparalysis following the intraoperative administration of rocuronium. A total of 0.92 mg.kg-1 rocuronium was administered. After surgery, pharmacological reversal was achieved with 20 mg edrophonium with 0.15 mg atropine sulfate iv 35 min after the last administration of rocuronium. Muscular relaxation was monitored using an ulnar peripheral nerve stimulator (PNS). After reversal, a full train-of-four and sustained tetanus at 50 Hz were present. In the recovery room, following nebulized epinephrine, the patient became apneic. The patient was paralyzed and an ulnar PNS demonstrated only one faint twitch. The paralysis was reversed with 1.5 mg neostigmine with 0.3 mg glycopyrrolate. CONCLUSION: Postoperative reparalysis following rocuronium may be a cause of postoperative respiratory distress. The definitive diagnosis is made using PNS and observing the response to pharmacological reversal. Nebulized epinephrine may have a previously undescribed role in the development of postoperative reparalysis.     

The rationale for cementless total hip replacement

Current cementing techniques of distal plugging, pulsatile water cleaning of the canal, and retrograde filling with PMMA in a low-viscous state prepared using porosity reduction techniques and then pressurized have been shown to give excellent results at 10 or more years after operation. However, physical and aging characteristics of PMMA do not guarantee that those results will hold up in the 20- to 30-year time frame. Fifteen-year experience with bony ingrowth systems indicate the development of a durable interface without PMMA, although the interface does appear more vulnerable to attack by the biologic reaction to HMWPE debris. Bone remodeling appears more favorable around proximally fixed bone ingrowth prostheses than around distally fixed prostheses. Softening of the physical characteristics of the stem tip may reduce the incidence of thigh pain. Patients with high activity potential and a life expectancy of greater than 25 years should be strongly considered for a proximally fixed bone ingrowth or ongrowth prosthesis.     

The development of the temporomandibular joint: a review with regard to the lateral pterygoid muscle

This review sets out to explore the relationship between the lateral pterygoid muscle and the meniscus. It examines the embryological evidence to explain the controversy surrounding the apparent morphological discrepancy in the attachment of the lateral pterygoid muscle to the meniscus. It shows that the contribution of the lateral pterygoid muscle to the formation of the meniscus remains in dispute. Morphogenetic studies have not been able to support either one or other viewpoint and no direct conclusions can therefore be made on the embryology of the temporomandibular joint.     

Parameters affecting the use of the lac repressor system in eukaryotic cells and transgenic animals

Elements of the lactose operon were used to study parameters affecting gene expression in cultured cells and transgenic animals. A Lac repressor protein containing a nuclear transport signal was shown to inhibit expression of a reporter gene by interacting with lac operator sequences. In cultured cells, operator sequence, operator placement and induction parameters were all shown to be important for obtaining tight repression of a reporter gene followed by high level expression upon induction. Induction levels were also dependent on the reporter gene, with the luciferase gene yielding higher induction levels than the chloramphenicol acetyltransferase gene. In transgenic animals, the lacI mRNA was not detected in the C57BL/6 mouse strain until the animal was exposed to a demethylating agent. After 5-azacytidine treatment, expression of lacI mRNA was detected in the brain, heart, kidney, lung and ovary. In the FVB transgenic mouse strain, expression of lacI mRNA was detected without 5-azacytidine treatment in the kidney, liver, lung, and testes. Preliminary experiments with double transgenic animals containing both lacI and operator/luciferase transgenes showed a decrease in luciferase expression compared to the luciferase-only animals in both tissue extracts and transgenic fetal primary cultures, although IPTG induction was not achieved in these animals or primary cultures. The applicability and challenges of the system for regulation of gene expression are discussed.     

High-resolution electron microscopy of the twinning and intergrowth in Ca4Al6SO16 and Ca3SrAl6SO16

The microstructures of unhydrated calcium aluminosulphate Ca₄Al₆SO₁₆ and Ca₃SrAl₆SO₁₆ have been studied by high-resolution electron microscopy (HREM). The results showed that twinning and twinned slabs could be introduced taking the [1 1 2] direction as the twin axis so that it seems to be coincident with the law of twinning formed in body-centred cubic structures. A previously reported superlattice with a repeat period twice that of the fundamental structure along the 〈1 1 0〉 direction has also been found in both matrix and twin variants. The close intergrowth of Ca₃SrAl₆SO₁₆ and another phase, possibly Sr₃Al₂O₆ existing as an inclusion between these two twin variants, was determined and clearly revealed by electron diffraction and HREM images. The coherent interphase boundaries and orientation relationship between them can also be deduced.     

Preparation and characterization of chitosan‐based dispersions

Complexation of chitosan in aqueous solutions by low molecular weight electrolytes is one of the simplest methods for the preparation of aqueous chitosan dispersions. In this work, the influence of storage time, sulfate concentration, method of preparation and surfactant content on some properties of the resultant chitosan dispersions (turbidity, viscosity and zeta potential) was analyzed. Turbidimetry was adequate to monitor the formation of particles, while viscometry was suitable to monitor changes in the dispersing phase. An analysis of the properties of these systems, mainly in terms of particle–particle and macromolecule–macromolecule interactions was carried out. Copyright © 2004 Society of Chemical Industry     

Optimization by random search with jumps

We give a random optimization (RO) algorithm to optimize a real‐valued function of n real variables. During the optimization process, interpolation points are examined to follow valleys, and jumps to new starting points are executed to avoid numerous iterations in local minima. Convergence with probability one to the global minimum of a function is proved. The proposed RO method is a simple, derivative‐free and computationally moderate algorithm, with excellent performance compared to other RO methods. Seven functions, which are commonly used to test the performance of optimization methods, are used to evaluate the performance of the RO algorithm given here. Copyright © 2004 John Wiley & Sons, Ltd.     

A model for preventive maintenance operations and forecasting

Equipment costs constitute the greatest majority of overall costs for semiconductor manufacturing. Therefore, maintaining high equipment availability has been regarded as one of the major goals in the industry. The ability to forecast correctly equipment preventive maintenance (PM) timing requirements not only can help optimizing equipment uptime but also minimizing negative impacts on manufacturing production efficiency. This research used grey theory and evaluation diagnosis to construct a PM forecasting model for prediction of PM timing of various machines. The results showed significant improvements of PM timing predictions compared to the existing method based on experience and an alternative method proposed by Li and Chang (Semiconductor Manufacturing Technology Workshop 2002: 10–11, pp. 275–277) for the same fab cases. Received: June 2005 / Accepted: December 2005