Clinically significant hearing loss in renal allograft recipients treated with intravenous erythromycin

BACKGROUND: Hearing loss is generally regarded as a rare side effect of erythromycin therapy. However, our own clinical experiences in erythromycin-treated patients led us to suspect that this complication may be more common among renal allograft recipients. The purpose of this study was to evaluate the incidence, predisposing factors, clinical characteristics, and outcomes of erythromycin-induced hearing loss among renal allograft recipients. METHODS: We reviewed medical records of renal transplant patients treated for pneumonia with intravenous erythromycin lactobionate. Patients were evaluated for the occurrence of clinically significant hearing loss (including onset, duration, and reversibility), other signs and symptoms of ototoxicity (vertigo and tinnitus), daily erythromycin dose and duration of treatment, concurrent ototoxic drug therapy, renal and hepatic function, and history of previous otic disease. RESULTS: Eleven (32%) of 34 courses of intravenous erythromycin therapy resulted in hearing loss. The incidence of hearing loss was 53% (eight of 15 courses) in patients treated with 4 g of erythromycin daily compared with 16% (three of 19 courses) among those receiving 2 g/d (P = .05). In addition, courses of erythromycin were longer in those suffering auditory toxicity (9.6 +/- 4.7 days) than in nontoxic patients (5.7 +/- 3.6 days) (P < .05). Hepatic and renal function did not differ between toxic and nontoxic patients. All episodes of erythromycin-induced hearing loss were reversible. CONCLUSIONS: We conclude that clinically significant hearing loss occurs in more than 30% of renal allograft recipients treated for pneumonia with intravenous erythromycin lactobionate. Patients who require prolonged courses of erythromycin and those treated with 4 g/d are at particular risk for the development of auditory toxicity. With prompt recognition and modification of therapy, erythromycin-induced hearing loss appears to be completely reversible.     

Effects of various post-treatments on carbon nanotube films for reliable field emission

In this report, the FE characteristics of carbon nanotubes (CNTs) treated using both thermal annealing and mechanical coatings on the as-grown CNTs systematically studied. It was found that in the high temperature annealed samples, CNTs were attacked at its root during annealing due to a small amount of oxygen, and were pulled out of the substrate in places after FE measurements because of the contact resistance. However, for the mechanically coated samples both with spin on glass (SOG) and polymethyl methacrylate (PMMA), CNTs were found to be nearly intact after FE measurements and showed reliable FE characteristics over repeatable voltage scan. The reliability of CNTs during FE could be owing to the strong adhesion of CNTs to the substrate both by SOG and PMMA coatings.     

Acidogenic fermentation of blended food‐waste in combination with primary sludge for the production of volatile fatty acids

The performance of a laboratory‐scale anaerobic acidogenic fermenter fed with a mixture of blended kitchen food‐waste and primary sludge from a sewage treatment plant was investigated for the production of volatile fatty acids (VFA). The operating variables for acidogenic fermentation were kitchen food‐waste content (10 and 25 wt %), hydraulic retention time (HRT: 1, 3 and 5 days), temperature (ambient: 18 ± 2 °C, and mesophilic: 35 ± 2 °C) and pH (varied from 5.2 to 6.7). The experimental results indicated that effluent VFA concentrations and VFA production rates were higher at ambient temperature than at mesophilic conditions. The net amount of VFA with 10 wt % food‐waste increased up to 920 mg dm^?3 with an increase of HRT, but contrasting results (a decrease of 2610 mg dm^?3) were found due to the conversion of VFA into biogas in the case of 25 wt % food‐waste, which increased significantly at HRT of 3–5 days. In terms of biogas composition (CO₂ and CH₄), the organic matter was converted into CO₂ through the oxidative pathway by facultative species at low temperature while mesophilic temperature and optimum pH (6.3–7.8) played a pivotal role in increasing rate of conversion of VFA into biogas by methanogenesis. Rates of VFA production and their conversion are dependent on the food‐waste content in the mixture. Yet, the higher concentration of food‐waste (25% compared with 10%) did not produce VFA proportionally due to the increased rate of conversion of VFA into gaseous products. The maximum VFA production rate (0.318 g VFA_produced g^?1 VS_fed day^?1) was achieved in the 10 wt % food‐waste at ambient temperature and at a 5‐day HRT. Copyright © 2005 Society of Chemical Industry     

The appropriateness of the systematic framework to develop diagnosis procedures of nuclear power plants—an experimental verification

It has been well recognized that a diagnosis procedure that allows operators to successfully identify the nature of an on-going event is inevitable for an effective and appropriate recovery. Unfortunately, studies for a framework that can suggest a unified and consistent process in constructing a serviceable diagnosis procedure seem to be scant. Thus, Park et al. have suggested a systematic framework that can be used to construct a useful diagnosis procedure. In addition, the diagnosis procedure that is currently in use at the reference nuclear power plant (NPP) is reformed in order to demonstrate the appropriateness of the suggested framework. However, the necessity of a well-designed experiment is proposed to confirm the appropriateness of the suggested framework.In this regard, in this study, an experiment is conducted using a full-scope simulator of the reference NPP. From the experiment, two sets of operators' diagnosis performance data are collected, and then they are compared to investigate the change of an operator's diagnosis performance with respect to two types of diagnosis procedures.As a result, it is shown that an operator's diagnosis performance is improved when the revised diagnosis procedure is used. Therefore, it is reasonable to conclude that the suggested framework is useful in constructing an effective diagnosis procedure.     

In-Situ and Real-Time Investigation of Columnar-to-Equiaxed Transition in Metallic Alloy

In this article, we present a review of observations during Al-3.5 wt pct Ni alloy solidi.cation experiments performed at the European Synchrotron Radiation Facility (ESRF) in Grenoble. These experiments provide direct access to dynamical phenomena during columnar growth (initial transient and breakdown of a planar solid-liquid interface), and for the first time to the transition from columnar-to-equiaxed microstructure (nucleation ahead of a columnar front and blocking of a columnar front by an equiaxed microstructure) and fully equiaxed growth (propagation of an effective front). Based on these experimental observations, critical parameters such as columnar growth velocity variation during the transition or equiaxed-grain diameter are measured and discussed. This article is based on a presentation made in the symposium entitled “Solidi.cation Modeling and Microstructure Formation: In Honor of Prof. John Hunt,” which occurred March 13–15, 2006, during the TMS Spring Meeting in San Antonio, Texas, under the auspices of the TMS Materials Processing and Manufacturing Division, Solidification Committee.     

Factors affecting the activity of anammox bacteria during start up in the continuous culture reactor.

Factors affecting cultivation of extremely slow-growing bacteria (anaerobic ammonium oxidiser, doubling time 11 days) were investigated by using upflow anaerobic sludge blanket (UASB) reactors which can maintain high solid retention time. The effects of concentrations of DO, free ammonia (FA), and nitrite on activation of anammox activity were tested during the start-up period. The reactor was inoculated with granular sludge collected from a full-scale UASB reactor used for treating brewery wastewater, and sludge from a piggery wastewater treatment plant and rotating biological contactor treating sewage. Results of continuous operation showed that concentrations of DO, free ammonia (FA) and nitrite in the reactors played a key role in stimulating the anammox activity during start-up period. It is crucial to keep DO below 0.2 ppm, FA below 2 mg/L and nitrite nitrogen below 35 mg/L to cultivate anammox cells in the continuous bioreactor. When the levels of DO, FA and nitrite in the influent were controlled at less than the inhibition levels, the anammox activity increased gradually in the anaerobic condition. Addition of hydrogen sulphide into the reactor enhanced anammox activity in the continuous culture. Through the SEM, TEM and FISH analysis, anammox bacteria were detected in the granular sludge after 3 months of continuous operation.