Laparoscopic operation of a Morgagni hernia

Morgagni hernias are the least common form of diaphragmatic hernias. Although they are congenital, most of them are not diagnosed until later in life. The indication for surgery is based on the patient's symptoms or on the radiological evidence of incarcerated tissue, and until quite recently involved a laparotomy or thoracotomy. Laparoscopy not only permits the suspected diagnosis to be confirmed--which is otherwise often difficult--but also makes it possible to close the hernia site by suturing. For improved security, the hernia site is augmented by fixing in place a non-absorbable mesh. The operative technique employed is described.     

A magnetic resonance imaging study of planum temporale asymmetry in men with developmental dyslexia

The influence of ionic strength and composition on the binding and inhibition of human leukocyte elastase by glycosaminoglycans with variable degree and position of sulfation was investigated. The kinetic mechanism of inhibition had a hyperbolic, mixed-type character with a competitive component that was promoted by low ionic strength, reduced by phosphate ions, and which also depended on the substrate and glycosaminoglycan structure. Enzyme binding was a cooperative phenomenon that varied with ionic strength and composition. The inhibition patterns correlated with the cationic character of elastase and with the distribution of arginines on its molecular surface, most notably with residues located in the vicinity of the substrate binding region. The order of affinity for elastase binding was chondroitin 4-sulfate < chondroitin 6-sulfate < dermatan sulfate, iduronate-containing derivatives being superior with respect to the glucuronate-containing counterparts. Additional sulfation at both the 4- and 6- positions or at the N- and 4-positions of the N-acetylgalactosamine moiety decidedly improved the inhibitory efficiency. The results highlight a fundamental physiological role of enzyme-glycosaminoglycan interactions. In the azurophil granule of the human polymorphonuclear neutrophil, elastase and other enzymes are bound to a matrix of chondroitin 4-sulfate because this is the only glycosaminoglycan that simultaneously offers good binding for enzyme compartmentalization together with prompt release from the bound state at the onset of phagocytosis.     

Effects of 17 beta-estradiol on nitric oxide and ventricular myocardium metabolism

BACKGROUND: Arrhythmias are frequent pathology in patients with chronic hemodialysis. We evaluated whether a relatively new technique, signal averaging, could be useful in predicting the development of complex arrhythmias in these patients. METHODS: Thirty-three patients, 18 male and 15 female, subjected to thrice weekly chronic hemodialytic treatment with various dialysis techniques, were studied. Exclusion criteria were the presence of antiarrhythmic and inotropic treatment. The following examinations were carried out in all patients: a Holter dynamic electrocardiography for a duration of 24 hours, begun on the day of dialysis, high resolution ECG pre- and post-dialysis to find out if there were any ventricular late potential (VLP). Four hundred beats were examined in order to obtain a background noise of less than 0.7 microV and a better definition of the signal. The following parameters were considered significant for the presence of VLP: a) filtered QRS duration > 120 msec; b) the root mean square of the signal expressed in the terminal portion of QRS (RMS) < 25 microV) high frequency low amplitude signals duration (HFLA) > 40 msec. A positive value in two of these parameters was considered indicative of the presence of VLP. In addition various pre and post-dialysis indices of dialytic efficiency and a mono and two-dimensional echocardiogram with pulsed and color Doppler were carried out. Of the 33 patients studied, ten were excluded because they presented too high a background noise at the high resolution ECG. Of the remaining 23 patients, 13 (56%) presented VLP and nine of these (69%) presented complex arrhythmias. Of the ten patients without VLP, 5 (50%) presented complex arrhythmias. The incidence of arrhythmias was highest during the last two hours of dialysis and in the two hours following it. The patients were then divided into two groups (A and B) according to the ejection fraction (EF) found at the echocardiogram. Group A was composed of 17 patients of whom 8 (47%) presented complex arrhythmias; group B (EF < 45%) was composed of the remaining six patients, who all presented complex arrhythmias. In group A nine patients (53%) out of 17 had LVP, in group B four out of six (66%) had it. All the patients except one presented an increase in the thickness of the ventricular wall and alterations of Doppler transmitral filling rate. Left ventricular hypertrophy was diagnosed in 22 out of the 23 patients. Four patients also had chronic ischaemic heart disease; of these three had LVP. There was no correlation between the presence of LVP and the hemodialytic indices and between the latter and complex arrhythmias. CONCLUSIONS: Our study showed that arrhythmias are more frequent in patients with LVP before dialysis than in those without. The difference was statistically significant (p < 0.006); the incidence of arrhythmias was higher in patients with FE < 45% (p < 0.001). The majority of patients (95%) had left ventricular hypertrophy; only four (17%) had ischaemic heart disease too. It is highly probable that the presence of LVP in our patients can be attributed to hypertension and subsequent left ventricular hypertrophy. As patients with LVP at the end of dialysis had a greater incidence of arrhythmias than those without LVP, we suggest that this method could be useful as a first screening in dialysed patients.     

Site and query scheduling policies in multicomputer databasesystems

We study run-time issues, such as site allocation and query scheduling policies, in executing read-only queries in a hierarchical, distributed memory, multicomputer system. The particular architecture considered is based on the hypercube interconnection. The data are stored in a base cube, which is controlled by a control cube and host node hierarchy. Input query trees are transformed into operation sequence trees, and the operation sequences become the units of scheduling. These sequences are scheduled dynamically at run-time. Algorithms for dynamic site allocation are provided. Several query scheduling policies that support interquery concurrency are also studied. Average query completion times and initiation delays are obtained for the various policies using simulations     

Evaluation of a parallel branch-and-bound algorithm on a class ofmultiprocessors

We propose and evaluate a parallel “decomposite best-first” search branch-and-bound algorithm (dbs) for MIN-based multiprocessor systems. We start with a new probabilistic model to estimate the number of evaluated nodes for a serial best-first search branch-and-bound algorithm. This analysis is used in predicting the parallel algorithm speed-up. The proposed algorithm initially decomposes a problem into N subproblems, where N is the number of processors available in a multiprocessor. Afterwards, each processor executes the serial best-first search to find a local feasible solution. Local solutions are broadcasted through the network to compute the final solution. A conflict-free mapping scheme, known as the step-by-step spread, is used for subproblem distribution on the MIN. A speedup expression for the parallel algorithm is then derived using the serial best-first search node evaluation model. Our analysis considers both computation and communication overheads for providing realistic speed-up. Communication modeling is also extended for the parallel global best-first search technique. All the analytical results are validated via simulation. For large systems, when communication overhead is taken into consideration, it is observed that the parallel decomposite best-first search algorithm provides better speed-up compared to other reported schemes     

Partitioned encoding schemes for algorithm-based fault tolerance inmassively parallel systems

Considers the applicability of algorithm based fault tolerance (ABET) to massively parallel scientific computation. Existing ABET schemes can provide effective fault tolerance at a low cost For computation on matrices of moderate size; however, the methods do not scale well to floating-point operations on large systems. This short note proposes the use of a partitioned linear encoding scheme to provide scalability. Matrix algorithms employing this scheme are presented and compared to current ABET schemes. It is shown that the partitioned scheme provides scalable linear codes with improved numerical properties with only a small increase in hardware and time overhead     

The performance of cache-based error recovery in multiprocessors

Several variations of cache-based checkpointing for rollback error recovery from transient errors in shared-memory multiprocessors have been recently developed. By modifying the cache replacement policy, these techniques use the inherent redundancy in the memory hierarchy to periodically checkpoint the computation state. Three schemes, different in the manner in which they avoid rollback propagation, are evaluated in this paper. By simulation with address traces from parallel applications running on an Encore Multimax shared-memory multiprocessor, we evaluate the performance effect of integrating the recovery schemes in the cache coherence protocol. Our results indicate that the cache-based schemes can provide checkpointing capability with low performance overhead, but with uncontrollable high variability in the checkpoint interval     

Unicast-based multicast communication in wormhole-routed networks

Multicast communication, in which the same message is delivered from a source node to an arbitrary number of destination nodes, is being increasingly demanded in parallel computing. System supported multicast services can potentially offer improved performance, increased functionality, and simplified programming, and may in turn be used to support various higher-level operations for data movement and global process control. This paper presents efficient algorithms to implement multicast communication in wormhole-routed direct networks, in the absence of hardware multicast support, by exploiting the properties of the switching technology. Minimum-time multicast algorithms are presented for n-dimensional meshes and hypercubes that use deterministic, dimension-ordered routing of unicast messages. Both algorithms can deliver a multicast message to m-1 destinations in [log ₂ m] message passing steps, while avoiding contention among the constituent unicast messages. Performance results of implementations on a 64-node nCUBE-2 hypercube and a 168-node Symult 2010 2-D mesh are given     

Structuring fault-tolerant object systems for modularity in adistributed environment

The object-oriented approach to system structuring has found widespread acceptance among designers and developers of robust computing systems. The authors propose a system structure for distributed programming systems that support persistent objects and describe how properties such as persistence and recoverability can be implemented. The proposed structure is modular, permitting easy exploitation of any distributed computing facilities provided by the underlying system. An existing system constructed according to the principles espoused here is examined to illustrate the practical utility of the proposed approach to system structuring     

On the design of dynamic associative neural memories

We consider the design problem for a class of discrete-time and continuous-time neural networks. We obtain a characterization of all connection weights that store a given set of vectors into the network, that is, each given vector becomes an equilibrium point of the network. We also give sufficient conditions that guarantee the asymptotic stability of these equilibrium points.