Monocular elevator paresis, Argyll Robertson pupils and sarcoidosis

Platelet concentrates were shown to contain 18 to 38 mg/dl of a phthalate plasticizer (DEHP) which arose by migration from the vinyl plastic packs in which the platelets were prepared and stored. Transfusion of these platelets into six adult patients with leukemia resulted in peak blood plasma levels of DEHP ranging from 0.34 to 0.83 mg/dl (approximately 0.02 mg/dl plasma per mg DEHP administered per square meter of surface area). The blood levels fell monoexponentially with a mean rate of 2.83 per cent per minute and a half-life of 28.0 minutes. Urine was assayed by a method that would measure unchanged DEHP as well as all phthalic acid-containing metabolites. In two patients, at most 60 and 90 per cent of the infused dose, respectively, was excreted in the urine collected for 24 hours posttransfusion. These estimates, however, could be high due to the simultaneous excretion of DEHP remaining from previous transfusions or arising from uncontrolled environmental exposures.     

Calculation of optimum emulsifier mixtures for phase inversion emulsification*

The phase inversion emulsification is a convenient method of preparing fine-disperse and long-term stable oil-in-water emulsions, which are stabilized with nonionic emulsifiers. On the basis of EACN-values (equivalent alkane carbon numbers) the calculation of phase inversion in concentrates (CAPICO) is possible, which yields emulsifier and oil mixing ratios corresponding to a given phase inversion temperature (PIT). The CAPICO-method is illustrated for the example of a cosmetic oil-in-water lotion containing an oil mixture, glyceryl monostearate and a fatty alcohol ethoxylate. Of special interest is the influence of silicone oils on the PIT. At a constant emulsifier oil ratio the complete phase behaviour of this emulsion system is represented in a temperature/water content graph. Optimum emulsification results are obtained if during PIT emulsification a microemulsion or a lamellar phase is passed. The emulsions were characterized by particle sizing, and emulsion stability against sedimentation was evaluated by ultrasonic velocity changes. A fine-disperse and long-term stable oil-in-water emulsion was prepared by a time and energy-saving two-step hot-cold process.     

Nitro‐blue tetrazolium staining of starch‐synthesizing enzymes in developing rice grains

An in situ nitro‐blue tetrazolium (NBT) staining method was used to locate the activities of enzymes involved in starch synthesis in developing grains of field grown rice (Oryza sativa L.) cultivar Tainung 67 and its early ripening mutant SA 419. The results indicated that all the tested enzymes, including sucrose synthase, invertase, hexokinase, ADP‐glucose pyrophosphorylase, UDP‐glucose pyrophosphorylase and starch synthase, were detectable in developing rice endosperms by using NBT staining. The activity of these enzymes was also measurable by using chemical assays. The expression of enzyme activity, as indicated by the formation of blue formazan precipitate, in growing grain of Tainung 67 were visualized in entire endosperm at 11 days after anthesis (DAA). However, NBT staining shifted from central to peripheral region of endosperm after 18 DAA, and the staining disappeared at 25 DAA. Similar staining patterns were also observed in the growing grains of mutant SA 419, but the shift of staining from central to peripheral endosperm occurred at 11 DAA. Electron microscopy examinations showed that the growing patterns of starch granules, sampled from central and peripheral regions of endosperm, varied between two cultivars, with SA 419 growing faster than Tainung 67. Both cultivars showed that the shifts of NBT staining pattern coincided with the changes in the growing pattern of starch granules located in central and peripheral regions of endosperms. The NBT staining results showed that the activities of sucrose to starch conversion enzymes in mutant SA 419 declined and disappeared earlier than its wild‐type Tainung 67 and therefore it ripened earlier than cultivar Tainung 67. Copyright © 2005 Society of Chemical Industry     

双渠道多级分销网络库存整合优化配置

针对拥有线下、线上销售渠道的实体零售企业分销网络运作成本居高不下的现状,研究综合渠道整合和线上订单履行问题下的双渠道库存优化配置问题。在“双渠道库存独立管理、线上订单分散履行”和“双渠道库存整合管理、线上订单集中履行” 2种不同分销网络运作模式下分别建立数学模型,并利用基于实数编码的遗传算法进行求解。通过对比这2种不同运作模式下的运作成本,同时在需求波动率增加条件下对运作成本进行敏感性分析,发现渠道库存整合、线上订单集中履行方法能够将库存总费用降低17.25%,能够将库存总费用从中下游往上游转移,减缓中下游节点的库存总费用。     

Guidelines as a strategy for preserving professional autonomy

Practice guidelines are often perceived as a threat to physician autonomy. However, the true challenge to physician autonomy is the rising costs of health care, which in turn is the result of continued progress in medical research. Since, inevitably, choices must be made about how our limited resources are expended, an increasing number of physicians are concluding that health care providers should assume financial risk for providing care--so that providers can make the decisions about which interventions are used for which patients. In this context, groups of physicians are adopting practice guidelines as an important strategy for providing high quality and efficient care under capitation. At least in some areas, practice guidelines are emerging as a critical tool for physicians to assume financial risk, and thereby protect professional autonomy.