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.     

Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor: an analysis of 497 patients

BACKGROUND: There is great interpatient variability in the number of peripheral blood stem cells collected, as measured by CD34+ cell content, after the administration of chemotherapy and a growth factor. The ability to predict patients who fail to yield adequate quantities of CD34+ cells would be of value. However, very few reports include large numbers of patients treated in an identical fashion. STUDY DESIGN AND METHODS: Between 1991 and 1995, 497 consecutive patients with a variety of malignant diseases received cyclophosphamide (4 g/m2), etoposide (600 mg/m2), and granulocyte-colony-stimulating factor (6 micrograms/kg/day) for mobilization and collection of a target dose > or = 2.5 x 10(8) CD34+ cells per kg. Multivariate analyses were performed to determine the factors associated with failure to achieve this target harvest. RESULTS: A median of 14.71 x 10(6) CD34+ cells per kg (range, 0.08-137.55) was harvested with a median of 2 (range, 1-11) apheresis procedures. Ninety-one percent of patients yielded > or = 2.5 x 10(5) CD34+ cells per kg. Patients with Stage II-III breast cancer, who had pretreatment platelet counts > or = 150 x 10(9) per L and patients who underwent < or = 1 prior chemotherapy regimen had improved CD34+ cell yields. However, most patients with adverse risk factors yielded > or = 2.5 x 10(6) CD34+ cells per kg. CONCLUSION: A regimen of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor led to the successful collection of adequate numbers of CD34+ cells in most patients without excessive toxicity. These observations confirm previous reports that intense prior therapy adversely affects the quantity of CD34+ cells harvested. Pretreatment and posttreatment variables did not predict with any certainty the small fraction of patients who fail to yield > or = 2.5 x 10(6) CD34+ cells per kg via multiple apheresis procedures.     

Subependymal astrocytic hamartomas in the Eker rat model of tuberous sclerosis

Tuberous sclerosis (TSC) is an autosomal dominant syndrome that is linked to two genetic loci: TSC1 (9q34) and TSC2 (16p13). Brain manifestations such as cortical tubers and subependymal hamartoma/giant cell astrocytomas are major causes of TSC-related morbidity. In this study, we describe the central nervous system involvement in a unique rodent model of tuberous sclerosis. The Eker rat carries a spontaneous germline mutation of the TSC2 gene and is predisposed to multiple neoplasia. In a series of 45 adult Eker carriers (TSC2 +/-), three types of focal intracranial lesions were found, of which the subependymal and subcortical hamartomas were most prevalent (65%). There exist remarkable phenotypic similarities between the Eker rat and human subependymal lesions. Our study indicates that the predominant cellular phenotype of the subependymal hamartomas is astroglial and suggests that the neuronal contribution within these lesions is, in part, the result of pre-existing myelinated axons. The hamartomas did not show evidence of loss of the wild-type TSC2 allele; it remains to be determined whether TSC2 inactivation is necessary for their pathogenesis. This genetically-defined rodent model may be useful in elucidating the molecular and developmental basis of the subependymal giant cell astrocytoma in humans.     

A linear minimum mean square error multiuser receiver inRayleigh-fading channels

We generalize the multiuser (CDMA spread spectrum) communication systems to the fading environments. We first extend Verdu's (1986) conventional optimum receiver to Rayleigh-fading environments and then evaluate its performance. Having no knowledge of the received power at the receiving end, we therefore need an estimator to efficiently estimate the received signal strength of each user in fading environments. A linear minimum mean square error (LMMSE) unbiased estimator is proposed to attain this goal. By using the minimum mean square error (MMSE) Bayesian estimation, we further propose the LMMSE bit estimator for efficient demodulation. Its performance is close to the optimum multiuser receiver but with a much simpler polynomial complexity. To further reduce the complexity, we extend the LMMSE estimator to the sequential LMMSE estimator. In sequential estimation, we do not need to implement the matched filter banks and to perform the matrix inversion when estimating. In addition, it converges after approximately 2k iterations, where k is the number of users. With this fast convergence property and the simple structure, the sequential LMMSE estimator provides an attractive alternative to the implementation of a multiuser system     

Phase transformation of calcia-alumina-magnesia fibres produced by inviscid melt spinning

CaO-Al₂O₃-MgO (CAM) ceramic fibre produced via inviscid melt spinning (IMS) was investigated for phase transformation. Differential thermal analysis (DTA) on the as-spun CAM fibre gave two transformation peaks, one for exothermic peak at around 927°C and the other for endothermic one at around 1100°C. In order to identify each phase transformation x-ray diffraction (XRD) analysis was performed on the CAM fibres heat-treated to each phase transformation completion temperature. The exothermic peak was determined to represent crystallization of remaining amorphous phase in the as-spun CAM fibre. The endothermic peak was determined to correspond to transformation of non-equilibrium CaO · Al₂O₃ phase to equilibrium 3CaO· 5Al₂O₃ phase.     

Cryptanalysis of an involutional block cipher using cellular automata

In 2006, an involutional block cipher using cellular automata was proposed. A self-invertible CA-based structure allows for an efficient hardware implementation. This paper analyzes the insecurity of the cipher due to its conjugate property. The results of this study will make it possible to construct a decryption process without knowledge of the secret key.     

Microstructure of aragonite grown at an air–liquid interface

Aragonite particles dispersed in a bioresorbable polymer matrix are considered to be a good candidate for bone prosthesis materials. It is important to characterize the microstructure of synthetic aragonite used for biomedical applications, since the microstructure may influence its integration, resorption and replacement by bone. We studied late stages of aragonite growth, at an air–liquid interface, from a solution not doped with additives. Comparison was made between the types of synthetic aragonite microstructure and that of aragonite which is found in nature (mollusc shells, gallstones, Earth's crust). The microstructure of natural aragonite is unique to certain classes of living organisms and the understanding of its structure/function relationships may help to select the types of synthetic aragonite for specific biomedical applications. Three types of synthetic aragonite were observed based on grain size and grain morphology. This revised version was published online in November 2006 with corrections to the Cover Date.     

Cardio-pulmonary function during acute unilateral occlusion of the pulmonary artery in broilers fed diets containing normal or high levels of arginine-HCl

Cardio-pulmonary function was measured in male broilers reared on diets formulated to contain 1.5% arginine (NORMAL group) or 2.5% arginine (ARGININE group). A snare placed around the right pulmonary artery permitted acute shunting of the entire cardiac output (CO) through the left pulmonary artery, resulting in sustained increases in blood flow (BF) through the left lung in both groups. The unilateral increase in BF was accompanied by sustained increases in pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) in the NORMAL group. However, following initial transient increases in PAP and PVR in the ARGININE group, subsequent pulmonary vasodilation gradually reduced PVR, and thus PAP, in spite of the ongoing elevation of BF through the left lung. The capacity of the pulmonary vasculature in the ARGININE group to accommodate an increased BF at a normal PAP accounts for the previously reported lower incidence of pulmonary hypertension syndrome (PHS, ascites) in cold-stressed broilers fed supplemental dietary arginine. Hypoxemia and respiratory acidosis ensued rapidly in both groups after tightening the pulmonary artery snare, in spite of a compensatory increase in the respiratory rate. The gradual return of PVR and PAP to presnare levels in the ARGININE group did not eliminate the concurrent ventilation-perfusion mismatch caused by the increased rate of BF through the left lung. Tightening the pulmonary artery snare caused mean systemic arterial pressure (MAP) to drop from control levels of approximately 98 mm Hg to sustained hypotensive levels of approximately 65 mm Hg in both groups. This systemic hypotension was caused by decreases in CO and total peripheral resistance (TPR). The reduction in CO were caused by reduction in stroke volume (SV) rather than heart rate (HR), suggesting that acutely tightening the pulmonary artery snare increased PVR sufficiently to impede left ventricular filling. Accordingly, the maximum increment in PAP attainable by the right ventricle during acute increases in PVR apparently was inadequate to propel the entire CO through the pulmonary vasculature, setting the stage for the congestive right-sided pooling of blood routinely associated with PHS in broilers.