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.     

Designing Urban Pervasive Systems

A conceptual framework for designing and analyzing pervasive systems describes three aspects of these systems in the urban environment—architectural space, interaction space, and information sphere—and a spectrum of information "publicness."     

Deep brain stimulation for essential tremor

We examined the effects and safety of deep brain stimulation (DBS) as a treatment for essential tremor (ET). Ten ET patients with disabling medication-refractory tremor underwent stereotactic implantation of a DBS lead in the left Vim thalamic nucleus and completed a 6-month follow-up. The Clinical Tremor Rating Scale and disability assessments were performed at baseline, 1-, 3-, and 6-month follow-up. There were significant improvements in dressing, drinking, eating, bathing, and handwriting as reported by the subjects. Tremor severity, writing, pouring, and spiral and line drawing were significantly improved as rated by the examiner. Improvements persisted through the 6-month follow-up period. Although global disability significantly lessened in the group as a whole, one subject with hand-finger tremor accentuated by writing had no change in disability status. In this 6-month open-label study, DBS was effective and safe in reducing tremor and functional disability in ET.     

Creating a participant text: writing, multiple voices, narrative multiplicity

This article uses the ideas of social constructionism to explore how families change by investigating the way our perceptions of ourselves in relation to others are formed through language. The idea that language has the inherent potential to generate a reply has strongly influenced our thinking. We propose that the reply to others is shaped by our initial reply to ourselves in inner conversation. Interaction moves back and forth from inner conversation to conversation with others, from monologue to dialogue, becoming the "stuff" of new narratives. The particular focus on language in this article is on how adding writing to the session conversation produces a "participant text," a therapeutic narrative that is composed of the voices of the family and the therapists. These voices, often newly discovered or invented, allow our narrative discourse to expand and multiply. Using this approach with individuals, couples, and families from different socioeconomic levels, we have worked with mourning, divorcing couples, recovery from abuse, marital conflict, parenting dilemmas, and physical illness.     

Characterization and properties of metallic iron nanoparticles: spectroscopy, electrochemistry, and kinetics

There are reports that nano-sized zero-valent iron (Fe0) exhibits greater reactivity than micro-sized particles of Fe0, and it has been suggested that the higher reactivity of nano-Fe0 may impart advantages for groundwater remediation or other environmental applications. However, most of these reports are preliminary in that they leave a hostof potentiallysignificant(and often challenging) material or process variables either uncontrolled or unresolved. In an effort to better understand the reactivity of nano-Fe0, we have used a variety of complementary techniques to characterize two widely studied nano-Fe0 preparations: one synthesized by reduction of goethite with heat and H2 (Fe(H2)) and the other by reductive precipitation with borohydride (Fe(BH)). Fe(H2) is a two-phase material consisting of 40 nm alpha-Fe0 (made up of crystals approximately the size of the particles) and Fe3O4 particles of similar size or larger containing reduced sulfur; whereas Fe(BH) is mostly 20-80 nm metallic Fe particles (aggregates of <1.5 nm grains) with an oxide shell/coating that is high in oxidized boron. The FeBH particles further aggregate into chains. Both materials exhibit corrosion potentials that are more negative than nano-sized Fe2O3, Fe3O4, micro-sized Fe0, or a solid Fe0 disk, which is consistent with their rapid reduction of oxygen, benzoquinone, and carbon tetrachloride. Benzoquinone-which presumably probes inner-sphere surface reactions-reacts more rapidly with FeBH than Fe(H2), whereas carbon tetrachloride reacts at similar rates with FeBH and Fe(H2), presumably by outer-sphere electron transfer. Both types of nano-Fe0 react more rapidlythan micro-sized Fe0 based on mass-normalized rate constants, but surface area-normalized rate constants do not show a significant nano-size effect. The distribution of products from reduction of carbon tetrachloride is more favorable with Fe(H2), which produces less chloroform than reaction with Fe(BH).     

Relation of interfacial adhesion in Kevlar®/epoxy systems to surface characterization and composite performance

A central problem in composite materials is the poorly understood relation between the nature of the surfaces at the fiber/matrix interface, the actual interfacial bond strength, and interface-sensitive composite properties, in this study on the Kevlar®/epoxy composite system, the interface was varied chemically by fiber sizings. The sized and unsized fiber surfaces and the cured matrix surface were characterized by contact angle measurements. The interfacial shear strength was directly measured by single-filament pull-out tests of sized and unsized fibers in epoxy matrix. The shear strengths of the composites made with sized and unsized fibers were measured. The results from surface analysis, interfacial shear tests, and composite shear tests were consitent. This suggests that surface-contact-angle analysis and single-filament pull-out tests may be helpful in screening strength of the composite.     

刀具磨损的切削力监测

本文用动态分析的方法，对切削力与刀具磨损的内在联系进行了一些理论探索和实验考查，提出了切削力监测刀具磨损的新方法：频段均方值法．经实验、离线分析，该方法可以准确、及时、可靠地监测刀具磨损状态．     

Chronic illness, pain and health behaviors of community behavioral health clients.

Persons with comorbid medical disorders, along with substance use disorders and mental illness, present complex treatment needs that are seldom addressed. Chronic physical illness negatively affects treatment participation and retention, decreasing effectiveness. Studies documenting higher medical morbidity and mortality in such persons have long been available. Less is known about their health behaviors. Respondents (n = 418) at a community behavioral health center were surveyed for prevalence of illness, pain, health behaviors, and interest in lifestyle change. A total of 73% reported at least one chronic health problem, and nearly half rated their health between fair and very poor. Most reported at least one negative health indicator or behavior (e.g., smoking). Encouragingly, nearly 50% desired lifestyle changes including smoking cessation, exercise, and stress management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visualization of agonist-induced sequestration and down-regulation of a green fluorescent protein-tagged beta2-adrenergic receptor

To date, the visualization of beta2-adrenergic receptor (beta2AR) trafficking has been largely limited to immunocytochemical analyses of acute internalization events of epitope-tagged receptors in various transfection systems. The development of a beta2AR conjugated with green fluorescent protein (beta2AR-GFP) provides the opportunity for a more extensive optical analysis of beta2AR sequestration, down-regulation, and recycling in cells. Here we demonstrate that stable expression of beta2AR-GFP in HeLa cells enables a detailed temporal and spatial analysis of these events. Time-dependent colocalization of beta2AR-GFP with rhodamine-labeled transferrin and rhodamine-labeled dextran following agonist exposure demonstrates receptor distribution to early endosomes (sequestration) and lysosomes (down-regulation), respectively. The observed temporal distribution of beta2AR-GFP was consistent with measures of receptor sequestration and down-regulation generated by radioligand-receptor binding assays. Cells stimulated with different beta-agonists revealed time courses of beta2AR-GFP redistribution reflective of the intrinsic activity of each agonist.