Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas--Houston Medical School

Spontaneous resolution of deformities after excision of facial skin lesions has been known and used for a long time by plastic surgeons. The resorption mechanism of deformity is based on natural skin expansion, and seems to be directly related to the action of the muscles of facial expression and their skin relations. Natural expansion has been shown to be effective in children. Between 1990 and 1994 excision of skin lesions, including congenital nevi, leading to postoperative deformity of the cheek, labial commissure, nose, eyelid and forehead, was performed on 35 patients, aged from 3 month to 12 years. The average follow-up is 24 months. For 26 patients (74%), natural resorption was observed 4 or 6 weeks later with good aesthetic results. For 6 patients (17%), the deformity persisted 3 or 6 months later, but did not require any further surgery. For 3 patients (9%), a second operation was necessary. Using the skins natural capacity for expansion in the treatment of facial skin defects in children is a method of reconstruction which has already been used for excision in enforced position. The platysma and muscles of facial expression by their action on skin mobilisation, allow natural expansion. A better knowledge of cutaneous biomechanical properties enables plastic surgeons to find an alternative to other classical methods.     

Nasopharyngeal colonization in Costa Rican children during the first year of life

BACKGROUND: The establishment of the nasopharyngeal flora was followed in Costa Rican children from birth to 1 year of age. METHODS: Nasopharyngeal cultures were obtained at 1 (n = 413), 3 (n = 393), 6 (n = 376) and 12 months (n = 356) of age from children representative of the population in the Puriscal district. Weekly cultures were obtained from a subcohort of these children (n = 101). Mother-infant diads (n = 95) and preschool children (n = 208) attending day-care centers were also studied. RESULTS: The estimated proportion of colonized children in the population differed markedly depending on the frequency of culture. Quarterly cultures showed a slow increase in carrier rates from 3.9% for Haemophilus influenzae, 3.1% for Streptococcus pneumoniae and 6.5% for Moraxella catarrhalis at 1 month of age to 10.1% carrying H. influenzae and 19.4% carrying S. pneumoniae by the end of the first year. By quarterly culture the proportion of children colonized at least once was 36% for S. pneumoniae, 26% for H. influenzae and 28% for M. catarrhalis. In contrast weekly sampling showed that 95 to 100% of the children were colonized at least once during the first year of life with H. influenzae, S. pneumoniae or M. catarrhalis. Nasopharyngeal carriage of H. influenzae, S. pneumoniae and M. catarrhalis was low in the mothers, and very few mother-infant pairs carried identical bacteria at the same time. In contrast carrier rates were high in the siblings attending day care (H. influenzae 27.9%, S. pneumoniae 39.4%, both organisms 26.6%). Infants with siblings had significantly higher bacterial carriage at all ages than infants without siblings. CONCLUSIONS: Quarterly nasopharyngeal cultures showed that Costa Rican infants acquire their nasopharyngeal flora at a rate comparable with that for infants in developed countries and that siblings are an important source of the bacteria. Weekly samplings showed that virtually all children were colonized at least once during the first year of life.     

Dimer interface of glutathione S-transferase from Arabidopsis thaliana: influence of the G-site architecture on the dimer interface and implications for classification

The three-dimensional structure of glutathione S-transferase from Arabidopsis thaliana has been solved at 2.2 A resolution (Reinemer et al., 1996). The enzyme forms a dimer of two identical subunits. The structure shows a new G-site architecture and a novel and unique dimer interface. Each monomer of the protein forms a separate G-site. Therefore, the requirements on the dimer interface are reduced. As a consequence, the interactions between the monomers are weaker and residues at the dimer interface are more variable. Thus, the dimer interface looses its relevance for a classification of plant glutathione S-transferases and the formation of heterodimers becomes even more difficult to predict.     

Automatic tuning of decentralized PID controllers for MIMO processes

An automatic tuning algorithm for decentralized PID control in multiple-input multiple-output (MIMO) plants is presented. This algorithm generalizes the authors' recent auto-tuner for two-input two-output systems to any number of inputs and outputs. The algorithm consists of two stages. In the first, the desired critical point, which consists of the critical gains of all the loops and a critical frequency, is identified. The auto-tuner identifies the desired critical point with almost no a priori information about the process. During the identification phase all controllers are replaced by relays, thus generating limit cycles with the same period in all loops. It is shown that each limit cycle corresponds to a single critical point of the process. By varying the relays parameters different points can be determined. The auto-tuner contains a procedure which converges rapidly to the desired critical point while maintaining the amplitudes of the process variables as well as of the manipulated variables within prespecified ranges. In the second stage, the data of the desired critical point is used to tune the PID controllers by the Ziegler-Nichols rules or their modifications. This paper focuses on the first stage. The steady-state process gains, which are required for the appropriate choice of the desired critical point, are determined by the auto-tuner in closed-loop fashion simultaneously with the identification of the critical point. The identification of the process gains is achieved at no extra plant time. Based upon a large number of simulated cases, the proposed auto-tuner seems to be efficient and robust. The paper discusses the underlying principles of the auto-tuner and its properties and capabilities are demonstrated via examples.     

In Situ ceramic particle-reinforced aluminum matrix composites fabricated by reaction pressing in the TiO2 (Ti)-Al-B (B2O3) systems

Particulate TiB₂ reinforced aluminum-based metal matrix composites (MMCs) were successfully fabricated by means of the reaction processing method. TiB₂ particulates were formed in situ through the reaction of Ti and B in Ti-Al-B, TiO₂ and B in TiO₂-Al-B, and TiO₂ and B₂O₃ in TiO₂-Al-B₂O₃ systems. The results showed that in situ TiB₂ particulates formed in the Ti-Al-B system had a size of 5 μm and they exhibited block and rodlike structures. Moreover, coarse Al₃Ti blocks several tens of micrometers in size were also formed simultaneously. On the other hand, equiaxed Al₂O₃ and TiB₂ particulates with a size of less than 2 μm were formed in situ in the TiO₂-Al-B and TiO₂-Al-B₂O₃ systems. The Al₃Ti phase was completely eliminated in the TiO₂-Al-B system with increasing B content. Tensile tests revealed that the Al₂O₃ · TiB₂/Al composite fabricated from the TiO₂-Al-B system exhibits excellent mechanical properties. The yield strength of the Al₂O₃ · TiB₂/Al composite appeared to increase with increasing TiB₂ content. The yield strength of the Al₂O₃ · TiB₂/Al composite could be further increased by introducing CuO into the TiO₂-Al-B system. Such an increment in mechanical strength arose from the strengthening effect caused by the Al₂Cu precipitates. The incorporation of CuO had no effect on the in situ reaction process of the TiO₂-Al-B system. Finally, the effect of SiC addition on the microstructure and mechanical properties of the composites fabricated from the TiO₂-Al-B and TiO₂-Al-B-CuO systems was also investigated.     

Neural mechanism of pupillary dilation elicited by electro-acupuncture stimulation in anesthetized rats

The neural mechanisms to reflex dilation elicited by electro-acupuncture stimulation were investigated in anesthetized rats. Two needles, with 160 microns diameter and about 5 mm apart, were inserted into the skin and underlying muscle of a hindpaw. Repetitive 20 Hz, 0.5 ms electrical pulses at various intensities were used for stimulation for 30s. The pupil size was magnified about 44 times via a microscope and was continuously recorded on a videotape. Electro-acupuncture stimulation at more than 0.5 up to 6 mA induced stimulus intensity-dependent pupil dilation. These responses were abolished by the severance of the sciatic and saphenous nerve of the stimulated hindlimb. Compound action potentials were recorded from the distal cut end of the tibial of a saphenous nerve following electro-acupuncture stimulation of the hindpaw. The mean threshold of the compound action potentials of the myelinated fibers in saphenous nerves was 0.18 mA, while that of unmyelinated fibers was 3.0 mA. The mean threshold of the compound action potentials of the myelinated fibers in the tibial nerve was 0.20 mA of unmyelinated fibers was 3.3 mA. Severance of bilateral trunks did not affect the response, while severance of the third cranial nerves abolished the responses. In conclusion, electro-acupuncture stimulation applied to the hindpaws of the anesthetized rats induced excitation of myelinated or of both myelinated and unmyelinated afferent fibers of the tibial and saphenous nerve, and involved a reflex response of pupil dilation through the third cranial parasympathetic efferent nerve.