Maternal complications from tocolytic treatment with beta-mimetics. Three cases of pulmonary edema

We report three cases of pulmonary edema associated with prolonged intravenous tocolytic therapy with beta 2-adrenergic agonists among patients with multiple pregnancies. Although beta 2-adrenergic agonists may have direct myocardial side-effects, the underlying pathophysiologic mechanisms are mainly noncardiogenic. The most important one appears to be the fluid overload, related to amounts of fluids given intravenously and to direct result of beta-sympathomimetic therapy on renal excretion of sodium and water. Neonatal benefit of prolonged tocolytic therapy remains hypothetical. If this strategy is used, the prevention of cardiovascular adverse effects requires an intensive maternal supervision, especially in case of multiple pregnancy, the use of beta 2-adrenergic agonists in concentrated solution in order to reduce the amounts of fluids given intravenously, and the association with progesterone therapy which can reduce the infusion rate and the duration of tocolytic therapy.     

Blood donor centres can effectively publicise cancer screening

We studied 100 healthy children looking for lactose malabsortion. We performed in all of them the lactose breath test. We found a 10% with lactose malabsortion. There was no correlation between lactose breath test and fecal reducing substances.     

Acidity near eroding polylactide-polyglycolide in vitro and in vivo in rabbit tibial bone chambers

Eroding poly(DL-lactide-co-glycolide)(PDLLG) washers were observed chronically in vitro and in vivo following loading in a bone chamber tibial implant (BCI). Images were recorded using intravital microscopy of the implanted rabbit and direct pH measurements were obtained of the tissue in the bone chamber using a combination probe-reference microelectrode. While statistically significant pH differences were found between the control (unloaded) and experimental (PDLLG-bearing) BCIs, they were only of the order of 0.2 pH units. This value proved to be physiologically insignificant as no statistically significant difference in bone defect healing, as indicated by angiogenesis, was detected. It was shown that the measured small pH changes during PDLLG washers erosion would result whether the buffer was phosphate-buffered saline replaced weekly or interstitial fluid subject to vascular exchanges.     

Traumatic myocardial infarction caused by lead shot

The authors report the case of a 32 year old woman who was shot with a shotgun. Acute inferior wall infarction was detected fortuitously on electrocardiography and coronary angiography showed occlusion of the right coronary artery with lead shot. The single coronary lesion, absence, of other cardiac complications (haemopericardium, cardiac perforation, ...) and the favourable outcome with conservative medical treatment has not been previously reported to the authors' knowledge.     

A randomized trial of cisplatin, etoposide and bleomycin (PEB) versus carboplatin, etoposide and bleomycin (CEB) for patients with 'good-risk' metastatic non-seminomatous germ cell tumors

BACKGROUND: Cisplatin-based combination chemotherapy will cure 70% to 80% of patients with metastatic non-seminomatous germ cell tumors but is associated with the possibility of severe neuro-, oto- and nephro-toxicities. Carboplatin, a cisplatin analogue, is an active drug in testicular cancer with a more favourable spectrum of side effects. In a randomized trial, the German Testicular Cancer Study Group compared a combination regimen of carboplatin, etoposide and bleomycin (CEB) to standard cisplatin, etoposide and bleomycin (PEB) chemotherapy for patients with 'minimal-' and moderate-disease' non-seminomatous germ cell tumors, according to the Indiana University classification. PATIENTS AND METHODS: PEB was given for three cycles at standard doses (given days 1-5), and the CEB regimen consisted of carboplatin (target AUC of 5 mg/ml x min) on day 1, etoposide 120 mg/m2 on days 1 to 3 and bleomycin 30 mg on days 1, 8 and 15. Four cycles of CEB were given, with the omission of bleomycin in the fourth cycle. Thus, the cumulative doses of etoposide and bleomycin applied in the two treatment arms were comparable. Fifty-four patients were entered on the trial, 29 were treated with PEB and 25 with CEB chemotherapy. Patients were stratified according to disease extent (minimal versus moderate) and the degree of tumor marker elevation. Thirty-two patients (59%) belonged to the group with minimal disease and low markers. RESULTS: No significant difference in response to chemotherapy was seen between the two arms, with CR rates of 81% for the PEB arm and 76% for CEB treatment. However, more patients treated with CEB (32% versus 13%) have relapsed after therapy, and 4 patients (16%) have died of disease progression after CEP in contrast to 1 (3%) after PEB therapy. The first interim analysis of negative events (relapse, vital tumor at secondary resection, death from disease and therapy-associated death) showed a significantly higher rate after CEB than after PEB therapy, and the trial was terminated early. After a median follow-up of 33 months for all patients, the calculation of negative events is still significantly in favour of PEB-treated patient, particularly since three late relapses > 2 years have been observed in the CEB arm (P = 0.03). CONCLUSION: This randomized trial demonstrates that even with the use of adequate doses of etoposide and full-dose bleomycin, carboplatin cannot altogether replace cisplatin in patients with testicular cancer. Treatment with the PEB regimen remains the standard approach in patients with 'good-risk' non-seminomatous germ cell tumors.     

Investigation for long wavelength fir laser lines for EPR studies: New lines from CH2=CF2

The results described in this work are part of a systematic search for long wavelength laser lines to be used in high magnetic field EPR applications and in plasma diagnostic. Four new far-infrared laser lines of CH₂ = CF₂ (1,1 difluoroethylene), optically pumped by a waveguide CO₂ laser, have been discovered and characterized in wavelength, polarization relative to the pumping radiation and offset relative to the CO₂ center frequency. New measurements of polarization and offset of 5 already known laser lines are also reported. A table of all of the known CO₂ pumped FIR laser lines from this molecule is given.     

Empowering a society of future users of information technology: a longitudinal study of an application in early education

This paper presents a six-year study of the use of computers in a Greek primary school, based on the premise that, in contrast to current technocentric views regarding the use of information technology in the Greek educational system, computers can be used as tools for self-enhancement. The aim of the school project was to infuse a child-centred pedagogy, through the learning of Logo programming, into the whole of the school's society, i.e. all children and all teachers. Within this context, we have identified and explored how children may learn programming through a process of forming ‘naive’ or locally applicable theorems concerning key programming ideas such as the use of primitives, structuring a problem by means of writing procedures, and constructing and working with generalised notional objects by means of defining procedures with variable inputs. We discuss the emerging interrelated educational and technological aspects concerning this kind of learning, and then set these against the challenge to exploit the developing technology further in order to design expressive media of increasing flexibility and power, and to focus on specific learning domains.     

Tree-structured piecewise linear adaptive equalization

The use of a tree-structured piecewise linear filter as an adaptive equalizer is proposed. In the tree equalizer, each node in a tree is associated with a linear filter restricted to a polygonal domain, and each subtree is associated with a piecewise linear filter. A training sequence is used to adaptively update the filter coefficients and domains at each node, and to select the best subtree and corresponding piecewise linear filter. The tree-structured approach offers several advantages. First, it makes use of standard linear adaptive filtering techniques at each node to find the corresponding conditional linear filter. Second, it allows for efficient selection of the subtree and corresponding piecewise linear filter of appropriate complexity. Overall, the approach is computationally efficient and conceptually simple. Numerical experiments are performed to show the advantages of tree-structured piecewise linear and piecewise decision feedback equalizers over linear, polynomial, and decision feedback equalizers for the equalization of channels with severe intersymbol interference     

Accurate and efficient computation of dielectric losses inmulti-level, multi-conductor microstrip for CAD applications

An approach to accurate and efficient computation of dielectric losses in complex microstrip structures is proposed. It can be used in lieu of lossy, full-wave solutions to provide accurate and efficient data for the CAD of multilevel, multiconductor MIC and MMIC structures. Results that are as accurate as lossy full-wave techniques over a wide range of frequencies, including the dispersive region, are obtained. In addition to providing accurate results, the method is up to three times faster, depending on the number and type of substrates or superstrates. Results for various multiconductor, multilevel structures that compare well with the lossy, full-wave approach and require significantly less computer time to compute are shown