Disturbance of continuous, pump administration of cardiovascular drugs by hydrostatic pressure

Administration of highly concentrated, highly potent, and therefore highly dangerous drugs with syringe pumps is common in modern anaesthesia as well as in intensive care and emergency medicine. Because of their exact flow rates down to < 1 ml/h, these pumps are predestined for delivery of drugs with short half-lives, such as catecholamines and vasodilators. But intravenous application of drugs with syringe pumps is not without problems. While it is well known that syringes not fixed correctly into the pump can empty themselves by the influence of gravity, it seems not to be known that hydrostatic pressure can influence the flow rate of a correctly connected system even during continuous infusion. In this situation a change of height of the syringe pump in relation to the patient's position can have tremendous effects on hemodynamics due to unintended acceleration or deceleration of the flow rate. This case report demonstrates that the elevation of a connected epinephrine pump while moving a cardiac surgery patient after ACB operation from the operation table into his bed led to critical increases of heart rate, blood pressure and left atrial pressure. In order to quantify the problem we repeated the situation experimentally. It could be demonstrated that the elevation of the syringe pump by 80-100 cm delivers an additional bolus of 4-5 drops as the central venous catheter outlet. Lowering the pump consecutively leads to the opposite effect. In the case reported, the accidentally administered bolus of epinephrine was 12-15 micrograms (we use a concentration of 60 micrograms/ml epinephrine for continuous infusion with syringe pumps). From this accidental observation the following conclusion can be drawn: The change of height, in relation to the patient's position, of a running syringe pump during continuous infusion of highly concentrated cardiovascular drugs may cause considerable, even life-threatening hemodynamic disorders. Even in a closed infusion system (syringe-extension-central venous catheter), hydrostatic pressure influences infusion rate. Elevation of the pump leads to unintended bolus administration, and lowering of the pump is followed by an interruption of the infusion. In the knowledge of this phenomenon, unexpected hemodynamic reactions during transport of critically ill patients cannot always be interpreted as a result of inadequate anesthesia or volume load, but may be a consequence of incorrect handling of the syringe pumps as described in this report.     

Global folds of highly deuterated, methyl-protonated proteins by multidimensional NMR

The development of 15N, 13C, 2H multidimensional NMR spectroscopy has facilitated the assignment of backbone and side chain resonances of proteins and protein complexes with molecular masses of over 30 kDa. The success of these methods has been achieved through the production of highly deuterated proteins; replacing carbon-bound protons with deuterons significantly improves the sensitivity of many of the experiments used in chemical shift assignment. Unfortunately, uniform deuteration also radically depletes the number of interproton distance restraints available for structure determination, degrading the quality of the resulting structures. Here we describe an approach for improving the precision and accuracy of global folds determined from highly deuterated proteins through the use of deuterated, selectively methyl-protonated samples. This labeling profile maintains the efficiency of triple-resonance NMR experiments while retaining a sufficient number of protons at locations where they can be used to establish NOE-based contacts between different elements of secondary structure. We evaluate how this deuteration scheme affects the sensitivity and resolution of experiments used to assign 15N, 13C, and 1H chemical shifts and interproton NOEs. This approach is tested experimentally on a 14 kDa SH2/phosphopeptide complex, and a global protein fold is obtained from a set of methyl-methyl, methyl-NH, and NH-NH distance restraints. We demonstrate that the inclusion of methyl-NH and methyl-methyl distance restraints greatly improves the precision and accuracy of structures relative to those generated with only NH-NH distance restraints. Finally, we examine the general applicability of this approach by determining the structures of several proteins with molecular masses of up to 40 kDa from simulated distance and dihedral angle restraint tables.     

Dyspnea resulting from phrenic nerve paralysis after interscalene brachial plexus block in an obese male--a case report

While current psychiatric taxonomies recognise a classification of amphetamine dependence, derived from the notion of an alcohol dependence syndrome, little research has validated that such a condition exists for this drug. Current amphetamine users (N = 331), were interviewed using the World Health Organization operationalisation of DSM-III-R substance dependence criteria, and a measure of the psychological components of dependence. Structural analyses indicated that a unidimensional dependence syndrome as assessed by DSM-III-R and DSM-IV criteria exists for amphetamine, and that physiological, psychological and behavioural indicators were all important in accounting for the variance in responses. It was demonstrated that the concept of a dependence syndrome is applicable to amphetamine, and that the inclusion of the amphetamine dependence syndrome in DSM-III-R and DSM-IV is valid.     

拉西瓦高拱坝岩体力学、工程地质研究成果综述

拉西瓦水电站高拱坝建基岩体工程地质、岩体力学研究是中国水电顾问集团2004年度专题科研成果之一“高混凝土拱坝建基岩体工程地质、岩体力学综合研究”的主要成果,其重点内容为岩体风化、卸荷、岩体质量级别的定量划分、河谷应力场分带、建基岩体主要岩体力学参数研究,坝肩抗滑稳定、开挖后综合检测验证等;在理论探讨、方法实践、预测验证和创新尝试等方面取得了一定成果,具有一定的社会、经济效益。     

Prenatal diagnosis of an extensive fetal lymphangioma using ultrasonography, magnetic resonance imaging and cytology

An unusual case of fetal lymphangioma diagnosed before delivery is reported in a second trimester pregnant woman. The lymphangioma was suspected at 28 weeks on the basis of the ultrasound appearances and progression of the lesions with advancing gestation. MRI was used to evaluate the extent and the tissue characteristics of the lesions. Cytology of the fluid aspirated from the cystic lesions showed abundant lymphocytes and macrophages, confirming the diagnosis of a lymphangioma. The parents opted for a pregnancy termination because of the rapid growth of the lesions and the poor prognosis. It is suggested that the combination of these tests could enable the early diagnosis of these tumours at a stage when the lesion is relatively limited and accessible to therapy in utero.     

Real-time homogenous translucent material editing

This paper presents a novel method for real-time homogenous translucent material editing under fixed illumination. We consider the complete analytic BSSRDF model proposed by Jensen et al. [ [JMLH01] ], including both multiple scattering and single scattering. Our method allows the user to adjust the analytic parameters of BSSRDF and provides high-quality, real-time rendering feedback. Inspired by recently developed Precomputed Radiance Transfer (PRT) techniques, we approximate both the multiple scattering diffuse reflectance function and the single scattering exponential attenuation function in the analytic model using basis functions, so that re-computing the outgoing radiance at each vertex as parameters change reduces to simple dot products. In addition, using a non-uniform piecewise polynomial basis, we are able to achieve smaller approximation error than using bases adopted in previous PRT-based works, such as spherical harmonics and wavelets. Using hardware acceleration, we demonstrate that our system generates images comparable to [ [JMLH01] ]at real-time frame-rates.     

Parasitic Bipolar Junction Transistors in a Floating-Gate MOSFET for Fluorescence Detection

In this letter, we examined whether the parasitic bipolar junction transistors (BJTs) in the MOSFET fabricated by the standard CMOS process can play a role as a fluorescence detector. To suppress the action of two vertical parasitic BJTs, the gate and n-well were tied in the parasitic BJTs, and the body node was connected to the drain. The proposed device was compared with the inherent and the parasitic diodes in the MOSFET. It had 100 times higher photocurrents than the diodes in the MOSFET. In addition, it was applied for the detection of the fluorescent signal, and could detect near 10 nM of Alexa 546. Therefore, CMOS-process-compatible parasitic BJTs can be used as a photodetector in an integrated fluorescence detector.     

Preparations of nanosized TiO2 in reverse microemulsion and their photocatalytic activity

Nanosized titania sol has been produced by the controlled hydrolysis of titanium tetraisopropoxide (TTIP) in sodium bis(2-ethylhexyl)sulfosuccinate (AOT) reverse micelles. The physical properties, such as surface area, crystallite size and crystallinity according to R and W₀ ratio, have been investigated by TEM, XRD, BET, FT–IR, TGA and DTA. In addition, the photocatalytic decomposition of p-nitrophenol has been studied by using a batch reactor in the presence of UV light in order to compare the photocatalytic activity of prepared nanosized titania. It is shown that the anatase structure appears in the 300–600 °C calcination temperature range and the transformation of anatase into rutile starts above 700 °C. The crystallite size increases with increasing R and W₀ ratio but W₀ ratio shows a stronger effect on the crystallite size than R ratio. In the photocatalytic decomposition of p-nitrophenol, the photocatalytic activity is mainly determined by the crystallinity of titania. In addition, the titania calcined at 500 °C shows the highest activity on the photocatalytic decomposition of p-nitrophenol() and the pure anatase structure.