Diagnostic value of fundus examination in familial adenomatous polyposis

BACKGROUND: Multiple, bilateral lesions of congenital hypertrophy of the retinal pigment epithelium (CHRPE) have been described in patients suffering from familial adenomatous polyposis (FAP) since 1980. This study aimed to determine a reliable diagnostic criterion, based on the size and number of retinal CHRPE lesions, allowing the screening of patient carriers of the gene responsible for FAP. METHODS: 32 control subjects and 144 patients belonging to 85 FAP families were studied, divided into 124 carriers of the genetic alteration and 20 non-carriers. RESULTS: In carriers of the deleted gene, multiple, bilateral retinal lesions were consistently observed. Lesion situation, size, shape, and degree of pigmentation were variable however. A positive criterion for FAP was defined as the presence of at least four lesions whatever their size, or at least two lesions one of which is large. This criterion showed a high sensitivity (0.68) and a maximal specificity (1). Within each family, the retinal phenotypic expression was homogeneous. CHRPE lesions were observed in two thirds of the FAP families and absent from the remaining third. CONCLUSION: By using this new positive diagnostic criterion, fundus examination allows early detection of those children carrying the gene responsible for FAP in families positive at ocular examination.     

Densification involved in the UV-based photosensitivity of silicaglasses and optical fibers

A comprehensive survey of photosensitivity in silica glasses and optical fiber is reviewed. Recent work on understanding the mechanisms contributing to germanium or aluminum doped fiber photosensitivity is discussed within the framework of photoelastic densification models     

Water sorption of glycol-modified cross-linked gelatin-based hydrogels

The water sorption behaviour of several cross-linked gelatin-based systems were investigated and compared. The systems were gelatin, gelatin/ethyleneglycol, gelatin/polyoxypropylenediamine, and gelatin/polyethylene oxide. For all the systems, an increased water gain was obtained by raising the concentration of the second component, while the swelling was reduced by an increase of the cross-linking density. This revised version was published online in November 2006 with corrections to the Cover Date.     

Phase-only adaptive nulling with a genetic algorithm

This paper describes a new approach to adaptive phase-only nulling with phased arrays. A genetic algorithm adjusts some of the least significant bits of the beam steering phase shifters to minimize the total output power. Using small adaptive phase values results in minor deviations in the beam steering direction and small perturbations in the sidelobe level in addition to constraining the search space of the genetic algorithm. Various results are presented to show the advantages and limitations of this approach, in general, the genetic algorithm proves to be better than previous phase-only adaptive algorithms     

Wave-oriented signal processing of dispersive time-domainscattering data

Phase-space data processing is receiving increased attention because or its potential for furnishing new discriminants relating to classification and identification of targets and other scattering environments. Primary emphasis has been on time-frequency processing because of its impact on transient, especially wideband, short-pulse excitations. Here, we investigate the windowed Fourier transform, the wavelet transform, and model based superresolution algorithms within the context of a fully quantified and calibrated test problem investigated by us previously: two-dimensional (2-D) short-pulse plane wave scattering by a finite periodic array of perfectly conducting coplanar flat strips. Because the forward problem has been fully calibrated and parametrized, some quantitative measures can be assigned with respect to the tradeoffs of these time-frequency algorithms, yielding tentative performance assessments of the tested processing algorithms     

Wavelength selection for low-saturation pulse oximetry

Conventional pulse oximeters are accurate at high oxygen saturation under a variety of physiological conditions but show worsening accuracy at lower saturation (below 70%). Numerical modeling suggests that sensors fabricated with 735 and 890 nm emitters should read more accurately at low saturation under a variety of conditions than sensors made with conventionally used 660 and 900 nm band emitters. Recent animal testing confirms this expectation. It is postulated that the most repeatable and stable accuracy of the pulse oximeter occurs when the fractional change in photon path lengths due to perturbations in the tissue (relative to the conditions present during system calibration) is equivalent at the two wavelengths. Additionally, the penetration depth (and/or breadth) of the probing light needs to be well matched at the two wavelengths in order to minimize the effects of tissue heterogeneity. At high saturation these conditions are optimally met with 660 and 900 nm band emitters, while at low saturation 735 and 890 nm provide better performance     

Estimating local mean signal strength of indoor multipathpropagation

We explore techniques for the measurement of local mean signal strength at 900 MHz and 2 GHz. In particular, we characterize the impact of transmitter and receiver antenna rotation on the estimated local mean. Then, we explore the collection of high resolution data while moving along a linear trajectory and using linear averaging techniques to estimate the local mean. With this information, the best measurement techniques can be chosen depending on the required speed versus accuracy tradeoff. Finally, we use a ray tracing propagation model to evaluate different methods of calculating the local mean signal strength for indoor environments     

Snowboard traumatology: an epidemiological study

OBJECTIVE: To estimate the frequency of perioperative morbidities in patients who underwent anesthesia and a surgical procedure with no preoperative laboratory testing. MATERIAL AND METHODS: We conducted an electronic database search of medical records of 56,119 patients who underwent surgical or diagnostic procedures and anesthesia at Mayo Clinic Rochester in 1994 and found 5,120 who had no laboratory tests done within 90 days before the procedure. From this group, we randomly selected 1,044 patients (87 from each month) to document the absence of preoperative tests, the presence of preexisting disease (by organ system), the type of anesthetic agent, and the outcomes and tests intraoperatively and postoperatively. RESULTS: The 1,044 patients ranged in age from 0 to 95 years (median age, 21). No deaths or major perioperative morbidities occurred (0.0%; exact 95% confidence interval, 0.00 to 0.35%). Although 10 patients underwent blood typing and screening for antibodies immediately preoperatively, no blood transfusions were necessary. Intraoperatively, 17 laboratory tests and 1 electrocardiogram were obtained, and 3 results were abnormal. Postoperatively, 42 blood tests and 2 electrocardiographic procedures were performed. Five of the 42 blood tests showed abnormal results (hemoglobin levels in 3, serum sodium in 1, and arterial blood gases in 1). One electrocardiogram showed normal findings, and the other revealed normal results except for premature ventricular contractions. No laboratory test done intraoperatively or postoperatively was found to change surgical or medical management substantially. One patient who had unanticipated blood loss during an outpatient procedure was admitted to the hospital for observation. CONCLUSION: All 1,044 patients, 97% of whom were relatively healthy, with no recent laboratory testing safely underwent anesthesia and an operation. We conclude that patients who have been assessed by history and physical examination and determined to have no preoperative indication for laboratory tests can safely undergo anesthesia and operation with tests obtained only as indicated intraoperatively and post-operatively. Current anesthetic and medical practices rapidly identify perioperative indications for laboratory evaluation as they arise.