Percutaneous balloon pericardiotomy for patients with recurrent pericardial effusion: using a novel double-balloon technique with one long and one short balloon

Percutaneous balloon pericardiotomy is effective and less invasive for the treatment of recurrent pericardial effusion. This study suggests that the double-balloon method with 1 longer and 1 shorter balloon is the procedure of choice for percutaneous balloon pericardiotomy.     

Paracetamol poisoning in the north east of England: presentation, early management and outcome

1. Paracetamol is increasingly involved in self-poisoning in the United Kingdom and remains a common cause of fatal poisoning. 2. To document the epidemiology and early management of paracetamol poisoning data were collected on consecutive patients with suspected paracetamol poisoning presenting to 6 hospitals in the North East of England over 12 weeks in 1994. 3. There were 400 presentations (attendance rate 1.14/10(3) population/yr) involving 343 persons (45% male). Paracetamol concentrations at 4 h correlated weakly with reported paracetamol dose (R = 0.49, P < 0.0001) and were similar comparing those treated and not treated by gastric decontamination. 4. In 38 (9%) cases paracetamol concentrations were above the appropriate nomogram treatment line, including 3% and 20% of patients who reported ingesting less than and more than 12 g respectively. In 21 patients acetylcysteine treatment was deferred until admission to the ward, the mean delay involved was 2.8 h. 5. One patient died, from arrhythmias caused by co-ingested dothiepin. 6. Paracetamol poisoning is common. Most cases do not have potentially toxic plasma paracetamol concentrations, but those who do often present late and antidotal treatment may be delayed inappropriately.     

Preceramic organoboron–silicon polymers

Several boron-containing organosilicon polymers were synthesized from a sodium-coupling reaction of silicon and boron halides with and without alkyl halide in hydrocarbon solvents. The B–Si preceramic polymers were characterized using techniques such as IR, UV, and NMR spectrometry, gel permeation chromatography, elemental analysis, molecular weight measurement, and thermal analyses (TGA, DSC, DTA, and TMA). The chemical structures of the preceramic polymers were postulated based on the analytical results. Black ceramic materials were obtained from the precursor polymers upon thermal degradation at temperatures above 1000°C in an inert atmosphere. The precursor polymers had a ceramic yield of up to 70%. Thermogravimetric analysis of the ceramic material in air at a flow rate of 100 mL/min showed it was stable up to 1000°C with little weight gain or loss. Several methods were used to characterize the ceramic materials: XRD, solid NMR, high-temperature DTA, elemental analysis, and acid digestion. The analyses indicated that the ceramic materials comprised a mixture of silicon carbide (SiC), silicon borides (SiB₄, SiB₆), and amorphous Si–B–C ceramics, with small amounts of silica and free silicon.     

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.     

The globally Bi-3-connected property of the honeycomb rectangular torus

The honeycomb rectangular torus is an attractive alternative to existing networks such as mesh-connected networks in parallel and distributed applications because of its low network cost and well-structured connectivity. Assume that m and n are positive even integers with n ? 4. It is known that every honeycomb rectangular torus HReT(m,n) is a 3-regular bipartite graph. We prove that in any HReT(m,n), there exist three internally-disjoint spanning paths joining x and y whenever x and y belong to different partite sets. Moreover, for any pair of vertices x and y in the same partite set, there exists a vertex z in the partite set not containing x and y, such that there exist three internally-disjoint spanning paths of G-{z} joining x and y. Furthermore, for any three vertices x, y, and z of the same partite set there exist three internally-disjoint spanning paths of G-{z} joining x and y if and only if n ? 6 or m = 2.     

C pm MPPAC for manufacturing quality control applied to the precision voltage reference process

The multiprocess performance analysis chart (MPPAC) based on the process capability index C_pm, called C_pm MPPAC, is developed for analysing the manufacturing quality of a group of processes in a multiple process environment. The C_pm MPPAC conveys critical information of multiple processes regarding the departure of the process and process variability from one single chart. Existing research works on MPPAC are restricted to obtaining quality information from one single sample of each process ignoring sampling errors. The information provided from existing MPPAC charts, therefore, is unreliable and misleading and results in incorrect decisions. In this paper, we consider the natural estimator of C_pm based on multiple samples. Based on the natural estimator of C_pm, we consider the sampling errors by providing an explicit formula with the Matlab program to obtain the estimation accuracy of the C_pm. We tabulate the sampling accuracy of C_pm for sample size determination so that the engineers/practitioners can use it for their in-plant applications. An example of multiple precision voltage reference (PVR) processes is presented to illustrate the applicability of C_pm MPPAC for manufacturing quality control.     

Cracking Go

Many of the early computer-chess researchers hailed from the fields of psychology or artificial intelligence and believed that chess programs should mimic human thinking. Specifically, they wanted computers to examine only playing sequences that were meaningful according to some human reasoning process. In computer chess this policy, known as selective search, never really made progress. The reason is that humans are extremely good at recognizing patterns; it is one of the things that we do best. The article focuses on weiqi, an ancient Chinese board game, better known in the West by the Japanese name of Go, whose combinatorial complexity is many orders of magnitude greater than that of chess. Go is played on a board crisscrossed by 19 vertical and 19 horizontal lines whose 361 points of intersection constitute the playing field. The object is to conquer those intersection points.     

Metabolic factors have a major impact on kidney allograft survival

BACKGROUND: At the present time, late graft loss is the major cause of kidney failure after transplantation. However, the influence of metabolic factors on this process is ill-defined. METHODS: To identify the impact of lipid metabolism, glucose metabolism, and blood pressure and their prognostic value for graft survival, data for all recipients of a kidney allograft with a potential graft survival of >15 years and a minimum graft survival of 1 month were analyzed retrospectively. Recipients of kidney grafts functioning more than 15 years (n=32) were compared with those with a graft function of less than 10 years (n=152, controls) and evaluated in a multivariate analysis. RESULTS: Low levels of serum cholesterol, triglycerides, and glucose, before and after transplantation, were accompanied by a prolonged graft survival. Prognostic factors for early graft failure included serum triglycerides >300 mg/dl, cholesterol >250 mg/dl before transplantation, serum creatinine >4.0 mg/dl 1 month after transplantation, and donor age above 45 or less than 10 years. Additionally, systolic and, particularly, diastolic blood pressure was lower in the group with a prolonged graft function as compared with controls immediately before and after transplantation. In addition, the incidence of primary graft function was lower and the incidence of acute rejection episodes higher in controls. Cold and warm ischemic time, body mass index, recipient age, and gender did not differ significantly. CONCLUSIONS: Our data suggest that metabolic parameters play an important role in the process of late graft loss after kidney transplantation.     

The high jugular bulb: report of five cases and a review of the literature

The jugular bulb varies widely in position and dimensions. A high jugular bulb is not an uncommon finding in temporal bones. Besides our five cases with different clinical manifestations, we review 52 cases diagnosed clinically and published previously in the English literature. The high jugular bulb occurs more often on the right temporal bone. Certain pathologic conditions, such as an abnormal bone formation, an aberrant sinusojugular system, or decreased pneumatization of the mastoid bone, may predispose an individual to its occurrence. Most people with this anatomical variation remain asymptomatic. However, various otologic problems and symptoms may be attributed to this condition. A high resolution computed tomography scan is the most convenient diagnostic tool at present. Law projection plain mastoid radiography may reveal a high jugular bulb in certain cases, providing a preoperative warning to an otologic surgeon. An exploratory tympanotomy is not suggested for those with a high jugular bulb with a conductive hearing loss, while jugular vein ligation has been reported to have good results in alleviating intractable pulsatile tinnitus. For most asymptomatic patients, regular long-term follow-up is recommended.