Enterococcal bacteremia in a medical center

BACKGROUND: The enterococci have become important nosocomial pathogens. They can cause multiple site infections and enterococcal bacteremia becomes more frequently associated with a high mortality rate. Previous studies of enterococcal bacteremia showed a variety of results. To establish the significance and importance of enterococci as nosocomial pathogens in this hospital, to characterize their clinical pictures and to search for the risk factors for mortality, this retrospective study was performed. METHODS: There were 208 cases of enterococcal bacteremia which occurred from 1988 to 1992. Twenty-seven cases had no medical charts, dismissing possibility of evaluation. Finally, 181 cases of enterococcal bacteremia were analysed. RESULTS: One hundred and eighteen episodes were nosocomial infections. Polymicrobial bacteremia occurred in 68.5% of the patients and the most common co-isolate was Pseudomonas aeruginosa. Those patients (78.5%) with underlying diseases and malignancies were the most common underlying problems. The portal of entry could be found in 69.6 percent of patients, with the gastrointestinal tract the most common sources. Antimicrobial susceptibility testing showed high gentamicin resistance rate (89.5%), and ampicillin still had about 80 percent sensitivity rate. The group who received specific antibiotic therapy for enterococcus showed lower mortality (36.4% versus 47.6%). Only one case had infective endocarditis. Forty-nine patients suffered from septic shock, the cause of 30 deaths. Totally 75 patients died during hospitalization. Besides sepsis, another major cause of death was their underlying diseases itself. CONCLUSIONS: Enterococci have no doubt become important nosocomial pathogens and enterococcal bacteremia were associated with high mortality, especially in elderly patients with underlying diseases such as malignancy or diabetes. When clinically dealing with sepsis from the gastrointestinal or biliary tract, especially when previous cephalosporins therapy showed no response, the possibility of enterococcal bacteremia should always be considered.     

Normal-incidence InAs self-assembled quantum-dot infrared photodetectors with a high detectivity

An InAs/AlGaAs quantum-dot infrared photodetector based on bound-to-bound intraband transitions in undoped InAs quantum dots is reported. AlGaAs blocking layers were employed to achieve low dark current. The photoresponse peaked at 6.2 /spl mu/m. At 77 K and -0.7 V bias, the responsivity was 14 mA/W and the detectivity, D*, was 10/sup 10/ cm/spl middot/Hz/sup 1/2//W.     

A Neural Network Approach for Signal Detection in Digital Communications

In this paper, we propose a new approach for signal detection in wireless digital communications based on the neural network with transient chaos and time-varying gain (NNTCTG), and give a concrete model of the signal detector after appropriate transformations and mappings. It is well known that the problem of the maximum likelihood signal detection can be described as a complex optimization problem that has so many local optima that conventional Hopfield-type neural networks fail to solve. By refraining from the serious local optima problem of Hopfield-type neural networks, the NNTCTG makes use of the time-varying parameters of the recurrent neural network to control the evolving behavior of the network so that the network undergoes the transition from chaotic behavior to gradient convergence. It has richer and more flexible dynamics rather than conventional neural networks only with point attractors, so that it can be expected to have much ability to search for globally optimal or near-optimal solutions. After going through a transiently inverse-bifurcation process, the NNTCTG can approach the global optimum or the neighborhood of global optimum of our problem. Simulation experiments have been performed to show the effectiveness and validation of the proposed neural network based method for the signal detection in digital communications.     

The effect of topical corticosteroids on refractive outcome and corneal haze after photorefractive keratectomy

BACKGROUND: The effect of topical corticosteroids after excimer laser photorefractive keratectomy (PRK) remains a matter of some controversy. Refractive effects may be different according to the amount of myopia and timing of instillation. METHODS: Two groups of patients were studied: Study A consisted of 215 eyes (128 patients) with PRK (mean baseline myopia, -6.53 +/- 2.22 D) that received no corticosteroids (No Corticosteroid Group) unless significant regression or corneal haze appeared (Delayed Corticosteroid Group), and in Study B, we randomly assigned eyes to the Initial Corticosteroid Group (mean baseline myopia, -6.39 +/- 1.84 D) or the No/delayed Corticosteroid Group (mean baseline myopia -5.78 +/- 2.02 D). Clinical results after PRK for low-to-moderate and high myopia were compared. RESULTS: In the first group, 70.9% (73 eyes) of moderately myopic eyes (mean, -4.56 +/- 1.10 D) belonged to the No Corticosteroid Group that had a mean refraction of -5.39 +/- 1.77 D. Delayed Corticosteroid Group eyes were more myopic (mean, -7.52 +/- 2.10 D), and showed more severe haze than those in the No Corticosteroid Group. In study B, only in high myopes with more than -6.00 D (mean, -7.76 +/- 1.15 D) did refraction and corneal haze outcomes show significant difference between the Initial Corticosteroid Group and the No/delayed Corticosteroid Group. CONCLUSIONS: The effects of topical corticosteroids after PRK were less in moderate myopes compared to high myopes. Delayed instillation of corticosteroids did not reverse the regression or haze whereas initial instillation showed a beneficial effect on high myopes but not on moderate myopes.     

荧光显示管直丝氧化物阴极有效逸出功的计算

阴极的逸出功是表征阴极发射能力的物理量，求定荧光显示管直丝氧化物阴极有效逸出功时，因其零场发射电流密度难于准确取值，温度无法直接测量，显得困难，须予解决，为此提出了一种计算阴极有产逸出功的办法，对某显示管的发射欠佳和“低温高效”的两种氧化物阴极的有效逸出功进行计算，有效逸出功率是靠测量相关物理量再同计算得出，精度不很高，文中所用办法也不例外，但所得结果能反映阴极发射能力，所需仪器少，是实用方法。     

Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia

Bony avulsion fractures of the posterior cruciate ligament of the tibia have commonly been treated by open reduction and internal fixation using the posterior approach. However, this approach, using the prone position, makes it difficult to investigate and treat other combined injuries of the knee joint. We report a case of posterior cruciate ligament avulsion of the tibia that was arthroscopically reduced and firmly fixed with two cannulated screws. The posterior sag was absent after the operation and the result was excellent. By arthroscopy, we got rigid fixation of the avulsed fragment for early rehabilitation, and detection of a concomitant injury was also possible.     

Color image retrieval based on hidden Markov models

In this correspondence, a new approach to retrieving images from a color image database is proposed. Each image in the database is represented by a two-dimensional pseudo-hidden Markov model (2-D PHMM), which characterizes the chromatic and spatial information about the image. In addition, a flexible pictorial querying method is used, by which users can paint the rough content of the desired images in a query picture. Image matching is achieved by comparing the query picture with each 2-D PHMM in the database. Experimental results show that the proposed approach is indeed effective.     

Recording of volume hologram using a beam pattern from taperedoptical fiber

A photorefractive volume hologram was recorded and probed using light diffracted from a tapered optical fiber as a reference beam. A single-mode fiber (SMF) was chemically etched and tapered to give a complicated beam pattern, and it is shown that the tapered optical fiber can be utilized to increase the storage density of the volume hologram. Spatial selectivity of the volume hologram with this method was increased by two times compared to the normal SMF referencing, which is due to the fact that the complicated beam pattern has little correlation with its shifted version