Penicillin vs. erythromycin in the treatment of diphtheria

PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure.     

Sympathetic blockade of isolated rat hindlimbs by intra-arterial guanethidine: the effect on blood flow and arterial-venous shunting

In order to improve the understanding of the role of sympathetic nerve degeneration in reimplantation failure, the hindlimbs of eight rats (Group I) underwent near-complete amputation. The soft tissues of the hindlimb were transected at the proximal thigh with the femoral artery, vein and femur left intact. The femoral vessels were clamped and guanethidine was infused into a branch of the femoral artery of the right leg of each animal, while saline was injected into the left leg. The clamps were removed after 15 minutes. A baseline preoperative injection of radiolabeled microspheres was made, and subsequent injections at 6, 12, 18, and 24 hours postoperation. Twelve rats (Group II) were then used to assess the amount of arterial-venous shunting preoperatively (n = 6) and at 18 hours postoperation (n = 6), by venous sampling. Blood flow to both limbs increased postoperation, but there was significantly more flow in the guanethidine treated limb at 18 and 24 hours postoperation. The amount of shunting was approximately 50% in both limbs at 18 hours, as compared to 10% preoperation. These results highlight the potential benefit of guanethidine and other sympathetic blocking agents in reimplantation to increase blood flow, decrease tissue ischemia and increase anastomotic patency rates. They also suggest that sympathetic nerve degeneration did not affect the volume of arterial-venous shunting in this model, but the difference in blood flow was likely due to arteriolar vasospasm. Further study is needed to elucidate the clinical significance of sympathetic nerve degeneration in reimplantation failure.     

Van der Pauw measurement of metal fibre orientation in a plastic-metal composite

Stainless steel fibres in ABS plastic form a composite with an anisotropic resistivity. Samples are rectangular shapes with uniform thickness. By assuming two principal resistivities and by using van der Pauw's technique, we find ² = _{x y} . For rectangular samples, field theory determines _y / _x and hence fibre direction. Results for three sample geometries agree with the theoretical predictions of the fibre patterns and with X-ray data. Samples formed by a centre-sprue feed are the best for fabricating large, uniform samples, while samples with a large length-to-width ratio have the most uniform metal density and fibre orientation. Resistivity was also measured by the more-common two-probe technique. Results correlate well to van der Pauw data, with 95% confidence.     

Castor polyols for urethane foams

Summary A systematic investigation of some 21 castor polyols as base materials for preparing urethane foams was carried out. Prepolymers were prepared both from individual castor polyols and from mixtures of them with an anhydrous castor oil. Foams formed from these prepolymers were checked for shrinkage on cure, density, and modulus. From the wide range of results obtained it is evident that castor polyols can serve as effective urethane components. Aside from serving as major polyols for reaction with di-isocyanates, they can also be used as modifying polyols a) to speed up prepolymer preparation, b) to adjust prepolymer viscosity to any required degree, c) to minimize loss of modulus on humid aging, and as cross-linking centers with negligible loss of foam modulus. Details covering the preparation of a nonshrinking, semi-rigid, light-weight urethane foam based on an 85% anhydrous castor oil/15% epoxidized castor oil mix are outlined in the article. Presented at the Spring Meeting, American Oil Chemists' Society, Memphis, Tenn., April 20–23, 1958.     

Active fault tolerant control for nonlinear systems with simultaneous actuator and sensor faults

The goal of this paper is to describe a novel fault tolerant tracking control (FTTC) strategy based on robust fault estimation and compensation of simultaneous actuator and sensor faults. Within the framework of fault tolerant control (FTC) the challenge is to develop an FTTC design strategy for nonlinear systems to tolerate simultaneous actuator and sensor faults that have bounded first time derivatives. The main contribution of this paper is the proposal of a new architecture based on a combination of actuator and sensor Takagi-Sugeno (T-S) proportional state estimators augmented with proportional and integral feedback (PPI) fault estimators together with a T-S dynamic output feedback control (TSDOFC) capable of time-varying reference tracking. Within this architecture the design freedom for each of the T-S estimators and the control system are available separately with an important consequence on robust L ₂ norm fault estimation and robust L ₂ norm closed-loop tracking performance. The FTTC strategy is illustrated using a nonlinear inverted pendulum example with time-varying tracking of a moving linear position reference.     

Demonstration of delayed hypersensitivity in Chlamydia trachomatis salpingitis in monkeys: a pathogenic mechanism of tubal damage

The role of delayed hypersensitivity in the pathogenesis of Chlamydia t trachomatis salpingitis was studied in the monkey "pocket" model. Pigtailed monkeys (Macaca nemestrina) were sensitized by inoculation of live C. trachomatis organisms (E/UW-5/Cx) into subcutaneous pockets containing salpingeal autotransplants. At 21 days, affinity-purified recombinant C. trachomatis heat-shock protein (rhsp60) was injected into pockets either previously sensitized with C. trachomatis or not sensitized in the same monkey. Delayed-type hypersensitivity reaction was observed, characterized by mononuclear cell infiltration with peak reaction at 48 h. Injection of rhsp60 into the pockets of a naive animal did not induce inflammation. This study showed that C. trachomatis infection in monkeys induced delayed hypersensitivity, which is mediated by hsp60. Histologic findings of the salpinx were consistent with delayed hypersensitivity reaction observed in ocular C. trachomatis infection, further suggesting a similar pathogenesis for both salpingitis and trachoma.     

Changing patterns of localization of the tobacco mosaic virus movement protein and replicase to the endoplasmic reticulum and microtubules during infection

Tobacco mosaic virus (TMV) derivatives that encode movement protein (MP) as a fusion to the green fluorescent protein (MP:GFP) were used in combination with antibody staining to identify host cell components to which MP and replicase accumulate in cells of infected Nicotiana benthamiana leaves and in infected BY-2 protoplasts. MP:GFP and replicase colocalized to the endoplasmic reticulum (ER; especially the cortical ER) and were present in large, irregularly shaped, ER-derived structures that may represent "viral factories." The ER-derived structures required an intact cytoskeleton, and microtubules appeared to redistribute MP:GFP from these sites during late stages of infection. In leaves, MP:GFP accumulated in plasmodesmata, whereas in protoplasts, the MP:GFP was targeted to distinct, punctate sites near the plasma membrane. Treating protoplasts with cytochalasin D and brefeldin A at the time of inoculation prevented the accumulation of MP:GFP at these sites. It is proposed that the punctate sites anchor the cortical ER to plasma membrane and are related to sites at which plasmodesmata form in walled cells. Hairlike structures containing MP:GFP appeared on the surface of some of the infected protoplasts and are reminiscent of similar structures induced by other plant viruses. We present a model that postulates the role of the ER and cytoskeleton in targeting the MP and viral ribonucleoprotein from sites of virus synthesis to the plasmodesmata through which infection is spread.     

Identification of anovulation and transient luteal function using a urinary pregnanediol-3-glucuronide ratio algorithm

The sensitivity and specificity of a urinary pregnanediol-3-glucuronide (PdG) ratio algorithm to identify anovulatory cycles was studied prospectively in two independent populations of women. Urinary hormone data from the first group was used to develop the algorithm, and data from the second group was used for its validation. PdG ratios were calculated by a cycles method in which daily PdG concentrations indexed by creatinine (CR) from cycle day 11 onward were divided by a baseline PdG (average PdG/Cr concentration for cycle days 6-10). In the interval method, daily PdG/CR concentrations from day 1 onward were divided by baseline PdG (lowest 5-day average of PdG/CR values throughout the collection period). Evaluation of the first study population (n = 6) resulted in cycles with PdG ratios > or = 3 for > or = 3 consecutive days being classified as ovulatory; otherwise they were anovulatory. The sensitivity and specificity of the PdG ratio algorithm to identify anovulatory cycles in the second population were 75% and 89.5%, respectively, for all cycles (n = 88); 50% and 88.3% for first cycles (n = 40) using the cycles method; 75% and 92.2%, respectively, for all cycles (n = 89); and 50% and 94.1% for first cycles (n = 40) using the interval method. The "gold standard" for anovulation was weekly serum samples < or = 2 ng/ml progesterone. The sensitivity values for all cycles and for the first cycle using both methods were underestimated because of apparent misclassification of cycles using serum progesterone due to infrequent blood collection. Blood collection more than once a week would have greatly improved the sensitivity and modestly improved the specificity of the algorithm. The PdG ratio algorithm provides an efficient approach for screening urine samples collected in epidemiologic studies of reproductive health in women.     

Variability and misclassification of worker estimated hand force

Ergonomic studies often use worker estimated hand force reproduced on a dynamometer to quantify force exposures but this method has not been well-studied in real work settings. This study evaluated the validity of worker estimates of hand force in a field study and determined the misclassification of worker estimated hand force exposures compared to directly measured forces. Eight experienced sheet metal assemblers completed ¼-inch diameter fastener installations using 6 different pneumatic tools. Grip forces were recorded by a pressure mat and were compared to worker estimated forces demonstrated on a dynamometer. Directly measured and worker estimated readings showed moderate correlations (0.53–0.67) for four installation tools and fair to moderate for two tools. The coefficient for variation of force estimates was 65% within repeated subject trials and 78% between averaged subject trials but 69% between subject trials during actual tool installations. Misclassification of worker estimated exposures varied by two cut-points: 29% using 4.0 kg and 49% using 6.0 kg. The force match procedure may provide adequate differentiation of high and low exposures in some settings, but is likely to result in substantial misclassification in other settings.