In situ bypass and diabetes

From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p = 0.005). Critical limb-ischaemia was more often present in diabetic than non-diabetic patients (DM:57%, NDM:36%, p = 0.0002). Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.00001). There were no differences among diabetic and non-diabetic patients regarding three years primary and secondary patency (58% and 64% respectively), and regarding major amputations. However, the rate of minor amputations was higher in insulin-dependent compared with non-insulin-dependent diabetics, who in turn had a higher rate than non-diabetics (p < 0.00001). A markedly decreased survival rate was found in diabetics (p < 0.00005). We found the in situ bypass technique very useful in the treatment of critical ischaemia of the lower limb in diabetic patients. The overall results in diabetic patients, whether insulin-dependent or not, were equal to those in non-diabetic patients.     

Fabrication and characterization of planar and channel polymer wave guides. I. Plasma-polymerized HMDS films

Plasma-polymerized hexamethyldisiloxane (HMDS) films have been prepared as both planar and channel wave guides. The optical attenuation results measured in both the planar and channel HMDS wave guides were found to be similar, thus demonstrating that the inherent solvent resistance and chemical inertness of the plasma polymerized films allows the use of common photoresist techniques, including application of the photoresist, photomasking, and subsequent etching. This may be contrasted with wave guides made from conventional polymers, where careful consideration must be given to photoresist/polymer compatibility, because the photoresist solvents may adversely affect the underlying polymer and lead to degradation of the material during processing. © 1995 John Wiley & Sons, Inc.     

Effect of quinidine on the interconversion kinetics between haloperidol and reduced haloperidol in humans: implications for the involvement of cytochrome P450IID6

Unequal metabolic responses to trauma by women and men have been suggested, but an explicit investigation demonstrating this conjecture has not been made. The responses of resting energy expenditure (REE) and nitrogen balance for 3 days before and 7 days after skeletal trauma were determined for female and male rats. Food intake and body weight were recorded daily, and 24-h urine samples were collected. Baseline REE and nitrogen balance were obtained for 3 consecutive days before induction of trauma. Then rats were divided into female trauma (n = 8), male trauma (n = 7), female control (n = 8), and male control (n = 7) groups. Trauma was produced by bilateral femoral fracture to anesthetized rats. Control rats were anesthetized without skeletal trauma. Traumatized rats were fed ad libitum for 7 days, and control rats were pair fed with the traumatized rats. The results showed that REE increased and nitrogen balance decreased in traumatized male rats relative to their controls. Traumatized female rats had increased REE and unchanged nitrogen balance compared with their controls. Traumatized female rats had a larger percentage increase in REE on days 5 through 7 than did traumatized male rats. These findings demonstrate a difference between female and male rats in response to trauma. Female rats use more energy and lose less nitrogen after trauma than do male rats. The results suggest that recommendations for increased energy and protein needs after trauma should consider the sex of the subject intended to be fed.     

The OKT3 Antibody Response Study: a multicentre study of human anti-mouse antibody (HAMA) production following OKT3 use in solid organ transplantation

Human anti-murine antibody titres following patient exposure to the monoclonal antibody Orthoclone OKT3 (muromonab-CD3) are determined by laboratories using diverse analytical methods which are not standardized and whose concordance is not established. A multicentre study group therefore compared testing for IgG anti-OKT3 antibody among seven laboratories. A set of 270 sera was obtained from 30 heart, 30 kidney and 30 liver transplant recipients with no previous exposure to OKT3 who were receiving OKT3 for induction immunosuppression. Sera were collected from each patient prior to and at 24 +/- 2 days and 31 +/- 2 days following initial OKT3 exposure. Identical aliquots of all 270 sera were tested for IgG anti-OKT3 antibody by each laboratory. In addition, the limit of detection of each laboratory's method was estimated by titration of an affinity-purified IgG anti-OKT3 reference material of known concentration. Anti-OKT3 antibody formation differed greatly among the three organ groups. Cardiac patients demonstrated the least sensitization and almost exclusively lower titres, while kidney recipients had more frequent and higher titre antibody formation. Liver recipients yielded the highest sensitization rate and the most frequent high titre sera. Importantly, the seven laboratories differed widely in the number of pretreatment sera reported as positive (ranging from 0% to 41% among laboratories), the number of post-OKT3 sera reported as positive (17-63%), the number of post-OKT3 samples with titre > or = 1000 (2-31%), and the number of patients sensitized 19-69%). Concordance among laboratories was highly variable, with interlaboratory agreement ranging from 38% to 83% on the sample titres assigned to 180 post-OKT3 sera. Many of the discordant results were consistent with differences in the limit of detection of the analytical methods, which ranged from 0.19 microgram/ml to > or = 15 micrograms/ml, a nearly 100-fold difference among laboratories. This study demonstrated the presence of both good concordance and significant discordance among laboratories in determining human anti-mouse antibody titres, and demonstrated that common titre categories (100, 1000, 10,000) were not equivalent among laboratories. The level of concordance among methods should be considered when comparing anti-OKT3 antibody results from different centres and their correlation with clinical events. Universal comparative testing, patterned after proficiency testing programmes, is needed to assess differences among laboratories and to bring uniformity and a sound interpretative basis to this field of testing.     

The possible influence of the menstrual cycle on the adherence of Candida albicans to human buccal epithelial cells in vitro

Although the influence of the menstrual cycle on both vaginal candidosis and Candida albicans adherence to vaginal epithelial cells in vitro has been shown to be significant, similar studies have not been made on oral candidosis and adherence to buccal epithelial cells. The aim of this study was therefore to use an in vitro adherence assay to investigate the possible influence of the menstrual cycle on the adherence of C. albicans to buccal epithelial cells. Epithelial cells were collected from a single, healthy, female volunteer on days 5, 15, 22 and 28 of six menstrual cycles. Adherence of C. albicans was significantly higher to buccal epithelial cells collected on day 5 of the menstrual cycle when compared with days 15, 22 and 28, both in terms of the percentage of buccal epithelial cells with adherent C. albicans and the number of C. albicans adhering per 200 buccal epithelial cells in four out of six menstrual cycles (p < 0.001). This result indicates that hormonal influences should be considered when buccal epithelial cells are used in vitro to assess candidal adherence and may implicate hormonal factors in the aetiology of oral candidosis.     

Olfactory recognition of nonhosts aspen and birch by conifer bark beetlesTomicus piniperda andHylurgops palliatus

The field response ofTomicus piniperda (L.) andHylurgops palliatus (Gyll.) (Coleoptera: Scolytidae) to the attractant ethanol in combination with volatile wood constituents released from the nonhost tree speciesPopulus tremula L. (Salicaceae) andBetula pendula Roth (Betulaceae) was studied using flight barrier traps. The attraction of both species decreased when aspen or birch wood was added to the ethanol bait. The same was true forRhizophagus depressus (F.) (Coleoptera: Rhizophagidae), a predatory species associated with conifer bark beetles.Glischrochilus quadripunctatus (L-),Epuraea bickhardti St.-Claire Deville,E. unicolor (Oliv.) (Coleoptera: Nitidulidae), andRhizophagus parvutus (Payk.) (Coleoptera: Rhizophagidae) were caught in higher numbers in traps baited with both ethanol and wood of aspen or birch than in traps baited with ethanol alone. In a separate experiment, landings ofT. piniperda andH. palliatus on nonhosts (black plastic tubes) were demonstrated with sticky traps.     

An overview of FDA medical device regulation as it relates to deep brain stimulation devices.

The United States Food and Drug Administration (FDA) is charged with assuring the safety and effectiveness of a variety of medical products and the FDA's Center for Devices and Radiological Health is responsible for premarket and postmarket regulation of medical devices. In this paper, we review--from device classification and clinical studies to the final marketing application--FDA's premarket requirements and postmarket requirements as they relate to deep brain stimulation devices.     

Heat and Fluid Flow in an Optical Switch Bubble

The Agilent all-optical bubble switch uses bubbles in an organic fluid index matched to a silica planar lightwave circuit. The bubble is created and sustained by heaters that are deposited on an attached silicon substrate. Testing of the bubble shows how heater power and ambient pressure affect bubble shape, size, and optical reflection characteristics. Heat and fluid flow in the bubble were modeled in 2D and 3D using the homogeneous bubble model in the Flow3D modeling software. Fluid condensing on the trench wall causes a dimple on the bubble and hence nonoptimum optical reflection. To aid understanding, the bubble, silica walls, and heaters were also modeled as a thermal resistance network. Because the pressure drop across the bubble wall is fixed, the bubble size is determined by P_res/DeltaT_t , where P_res is the heater power and DeltaT_t is the temperature difference between the bubble and the substrate. Heating the trench walls beyond the bubble temperature with heaters located underneath the trench wall will dry out the trench wall and give a stable optical reflection. As DeltaT_t approaches zero, a bubble is sustained without any heater power and with zero fluid flow. This "static" bubble provides for a very stable optical reflection     

The most frequently prescribed medications in the elderly and their impact on dental treatment

The high prevalence of multiple chronic medical conditions in the elderly and the likelihood of multiple drug therapies dramatically increase the chance of drug-specific adverse effects and drug-drug interactions. This article reviews the age-associated alterations in pharmacokinetics and pharmacodynamics along with the most frequently prescribed medications for the elderly. Adverse drug reactions, drug-drug interactions and oral side effects are reviewed along with the impact these medications may have on dental treatment planning and management.