Pediatric case study: hemolytic uremic syndrome

The nursing interventions necessary to care for this critically ill child were professionally challenging. Meeting the psychosocial, educational, and supportive needs of the family during this period of uncertainty, as well as, providing the dialysis therapy and support for this fragile child demonstrated the unique contributions of professional nursing. All outcomes were met, but the patient's extremely poor myocardial function made dialysis treatments and volume control difficult. The use of CVVHD was instrumental to providing dialysis in a safe, effective manner. The nursing care for S.B.K. and her family was physically and emotionally draining, but seeing her neurological status return was the great reward for all of our efforts.     

Effects of changing diagnostic criteria on the risk of developing diabetes

OBJECTIVE: The American Diabetes Association (ADA) has recommended that the fasting plasma glucose (FPG) level used to diagnose diabetes be changed from 7.8 mmol/l (the level recommended by the National Diabetes Data Group [NDDG] in 1979) to 7.0 mmol/l. We examined the impact of this change on rates of progression to overt diabetes from different levels of FPG. RESEARCH DESIGN AND METHODS: Using the laboratory database of Mayo Clinic, we assembled a cohort of 8,098 nondiabetic Olmsted County residents 40 years of age or older on 1 July 1983. Subjects were followed for a median of 9 years. RESULTS: Among 7,567 individuals with follow-up FPG data, 778 (10.3%) progressed to ADA diabetes and 513 (6.8%; P < 0.0001) progressed to NDDG diabetes. The risk of developing ADA diabetes was 7, 19, and 39% for individuals with initial FPG values in the ranges of <5.6, 5.6-6.0, and 6.1-6.9 mmol/l, respectively. For progression to NDDG diabetes, the respective risks were 3, 11, and 25%. A clear gradient of risk was observed within the "normal" range of FPG (<5.6 mmol/l). Among the 793 individuals who developed ADA diabetes, 222 (29%) developed NDDG diabetes simultaneously and 291 (37%) developed NDDG diabetes later. In all FPG subgroups, progression to ADA diabetes occurred approximately 7 years sooner than progression to NDDG diabetes. CONCLUSIONS: The baseline level of FPG is a major predictor of an individual's risk of developing diabetes. The proposed change in the diagnostic criteria for diabetes will lead to earlier diagnosis among individuals who are destined to develop the disease.     

Characterization of surface-modified polyurethane blends,poly(vinyl alcohol), and poly(4-hydroxybutyl acrylate) for biomedical application by electron spin resonance spectroscopy

Two polyurethane blends—poly(carbonate urethane)/poly(vinyl alcohol) [PCU/PVA] and the aliphatic poly(ether urethane) (Tecoflex?)/poly(pentanedioic acid mono-4-(acryloyloxy)butyl ester) [Tecoflex?/COOH]—were surface-modified. Poly(vinyl alcohol) [PVA] and poly(4-hydroxybutyl acrylate) [PHBA] were used as model surfaces. 4-Isocyanato butanoic acid methyl ester was coupled as a spacer molecule to PVA and the PVA-containing polyurethane blend. Saponification of the generated ester group was verified by means of Electron Spin Resonance (ESR) spectroscopy using the nitroxyl radical 4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO) as a reporter group. In the case of Tecoflex? and PHBA, glutaric anhydride served as a spacer molecule. 4-Amino-TEMPO was coupled to this spacer as well. ESR spectroscopy as a bulk method was used together with the surface-sensitive method X-Ray Photoelectron Spectroscopy (XPS) verifying the modification steps by elemental composition, ESR line shapes, and determination of the rotational correlation time τ_c. © 1995 John Wiley & Sons, Inc.     

Biodegradable block copolymers with poly(ethylene oxide) and poly(glycolic acid‐valine) blocks

Biodegradable ABA triblock copolymers with poly(ethylene oxide) and poly(glycolic acid‐valine) blocks were synthesized via ring‐opening polymerization of cyclo(glycolic acid‐valine) using Ca‐alcoholates of hydroxytelechelic PEO as the initiator. The L‐valine residue racemized during copolymerization of cyclo(glycolic acid‐valine). The crystallization of the block copolymers decreases with decreasing PEO content in the triblock copolymers and with increasing length of the poly(glycolic acid‐valine) block. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 86: 2916–2919, 2002     

Three-dimensional nonwoven scaffolds from a novel biodegradable poly(ester amide) for tissue engineering applications

Biodegradable polyesters are established biomaterials in medicine due to their chemical characteristics and options for material processing. A main problem, however, is the release of acid degradation products during biodegradation with severe local pH-drops and inflammatory reactions. Polyesteramides, in contrast, show a less prominent pH-drop during degradation. In this study, we developed a simple, reproducible synthesis of the poly(ester amide) (PEA) type C starting from ε-caprolactame, 1,4-butanediol, and adipic acid in a one-batch two-step reaction and conducted the manufacturing of PEA-derived 3D textile scaffolds applicable for tissue engineering purposes. The thermal and mechanical properties of PEA-type C were analysed and the structural conformity of different batches was confirmed by NMR spectroscopy and size exclusion chromatography. The polymer was formed into nonwovens by textile manufacturing. Cytotoxicity tests and X-ray photoelectron spectroscopy (XPS) were used to analyze the effect of scaffold extraction before cell seeding. The manufactured carriers were seeded with human preadipocytes and examined for cellular proliferation and differentiation. The production of PEA type C successfully occurred via simultaneous ring-opening polymerization of ε-caprolactame and polycondensation with 1,4-butanediol and adipic acid at 250 °C under high-vacuum. Soxhlet extraction allowed optimal cleaning of nonwoven scaffolds. Extracted PEA-derived matrices were capable of allowing good adherence, proliferation, and differentiation of preadipocytes. These results are encouraging and guidance towards an optimally prepared nonwoven carrier applicable for clinical use. K. Hemmrich and J. Salber have contributed equally.     

New biomaterial: triblock copolymers of poly [3(S)-isobutyl-morpholine-2,5-dione]-poly(ethylene oxide)

ABA-type block copolymers with poly[3(S)-isobutyl-morpholine-2,5-dione](PIBMD, A) and poly(ethylene oxide) (M_n = 6000, PEO, B) blocks, PIBMD-b-PEO-b-PIBMD, were synthesised via ring-opening polymerization of 3(S)-isobutyl-morpholine-2,5-dione in the presence of hydroxytelechelic poly(ethylene oxide) with stannous octoate as a catalyst. These block copolymers may find applications in cell encapsulation and in drug delivery. M_n of the resulting copolymers increases with increasing 3(S)-isobutyl-morpholine-2,5-dione content in the feed at constant molar ratio of monomer (M) to catalyst (C) (M/C = 125). No racemization of the leucine residue takes place during both homopolymerization of IBMD and polymerization of IBMD in the presence of PEO and Sn(Oct)₂. The melting temperature of the PIBMD segments in the block copolymers depends on the length of the PIBMD blocks. The melting temperature of the PEO blocks is lower than that of the homopolymer, and the crystallinity of the PEO block decreases with increasing length of the PIBMD blocks. The PIBMD block crystallizes first upon cooling from the melt. This leads to only imperfect crystallization or no crystallization of the PEO blocks.     

Functionalization of electrospun fibers of poly(ε-caprolactone) with star shaped NCO-poly(ethylene glycol)-<Emphasis Type="Italic">stat</Emphasis>-poly(propylene glycol) for neuronal cell guidance

Microfibers produced with electrospinning have recently been used in tissue engineering. In the development of artificial implants for nerve regeneration they are of particular interest as guidance structures for cell migration and axonal growth. Using electrospinning we produced parallel-orientated biocompatible fibers in the submicron range consisting of poly(ε-caprolactone) (PCL) and star shaped NCO-poly(ethylene glycol)-stat-poly(propylene glycol) (sPEG). Addition of the bioactive peptide sequence glycine-arginine-glycine-aspartate-serine (GRGDS) or the extracellular matrix protein fibronectin to the electrospinning solution resulted in functionalized fibers. Surface characteristics and biological properties of functionalized and non-functionalised fibers were investigated. Polymer solutions and electrospinning process parameters were varied to obtain high quality orientated fibers. A polymer mixture containing high molecular weight PCL, PCL-diol, and sPEG permitted a chemical reaction between hydroxyl groups of the diol and isocyanante groups of the sPEG. Surface analysis demonstrated that sPEG at the fiber surface minimized protein adhesion. In vitro experiments using dorsal root ganglia explants showed that the cell repellent property of pure PCL/sPEG fibers was overcome by functionalization either with GRGDS peptide or fibronectin. In this way cell migration and axonal outgrowth along fibers were significantly increased. Thus, functionalized electrospun PCL/sPEG fibers, while preventing non-specific protein adsorption, are a suitable substrate for biological and medical applications.     

Patents-the suit against future infringement

Can a patent owner sue a competitor who is about to bring out an infringing product? That was the question before the court in the recent case of Interdigital Technology Corp. v. OKI America Inc. and Qualcomm Inc. The case involved the burgeoning field of cellular telephones. Interdigital owned patents which it believed gave it control of all cellular telephones that would satisfy two of the industry-wide standards set by the Telecommunications Industry Association. The Interdigital case shows that a patent owner need not stand idly by while a competitor makes plans to enter the market. If the patent owner can show that the competitor has made meaningful preparations to enter the market and intends to go forward in spite of the patent owner's protest, a court will hear the issue immediately. This action can significantly shorten the time to an ultimate judgment and injunction against the competitor's activities. Moreover, in the meantime, the fact that a lawsuit is pending can substantially handicap a competitor in the market because many customers may not want to deal with a supplier that may be put out of business in the future     

An improved method for the determination of iodine numbers

Summary A modified Rosenmund-Kuhnhenn method has been described in which, with one easily prepared and stable reagent, consistent and repeatable iodine numbers are obtained in one minute with all ordinary nonconjugated fats and oils. Presented before the American Oil Chemists' Society Meeting, Chicago, November 2, 1949.     

Influence of Initial pH Values on the Lag Phase of Escherichia coli and Bacillus licheniformis Batch Cultures

Robust and reproducible processes are necessary to achieve a constant and high quality of biotechnological products. Thus, suitable online measurement systems and an increased understanding of the parameters influencing the process are required. In this study, two online measurement devices were used to detect the influence of the initial pH value on the lag phase of three E. coli and one B. licheniformis strains cultivated in buffered mineral media. It was shown that the initial pH value, the type of buffer and its concentration have to be carefully chosen to avoid differences in the lag phase, unsuitable pH values during the cultivation, and osmotically inhibiting high buffer concentrations.