Ventricular perforation associated with central venous introducer-dilator systems

BACKGROUND: An erythrocyte sedimentation rate (ESR) of at least 40 mm/h is considered an important requisite for the diagnosis of polymyalgia rheumatica (PMR). However, the relative frequency and clinical features of PMR in patients without a significantly increased ESR are unclear. METHODS: We performed a retrospective study of patients diagnosed as having PMR at the rheumatology divisions of 3 teaching hospitals. The diagnosis of PMR was established, regardless of the ESR, in 201 consecutive patients fulfilling the following criteria: (1) age 50 years or older, (2) severe proximal pain for more than 1 month in at least 2 of 3 areas: neck, shoulder, and/or pelvic girdles, and (3) rapid resolution of the syndrome while taking low-dose prednisone. Patients with giant cell arteritis were previously excluded from the study. The frequency and clinical features of patients with PMR and an ESR lower than 40 mm/h were analyzed. A comparative study between these patients and those with high ESRs was performed. RESULTS: An ESR lower than 40 mm/h was found in 41 patients (20.4%). These patients were younger (P = .02), were more frequently men (P = .006), and experienced a lower frequency of fever (P = .003) and weight loss (P = .07). Furthermore, these patients were characterized by an absence of anemia (P = .002) and a lower frequency of abnormal protein electrophoresis results (P < .001). Otherwise, their clinical syndrome, response to therapy, and frequency of relapses were similar to those of patients with classic PMR. In the entire population of 201 patients, the ESR was related to the length of treatment, number of areas involved, presence of fever, weight loss, and laboratory test result abnormalities, but it was unrelated to the duration of the illness prior to diagnosis. CONCLUSIONS: It is not uncommon to find a patient with PMR with an ESR lower than 40 mm/h. This syndrome is more frequent in men and it is clinically less severe than the classic form of PMR. Its recognition will allow these patients to benefit from an effective treatment with low-dose corticosteroids.     

Method for error recovery of line spectral frequencies

The authors have exploited the ideas used in vector quantisation for error recovery of scalar quantised LSFs. The good performance of this method has provided high resistance of the LSFs to channel errors, outperforming other schemes by, possibly, a considerable margin. Better objective and subjective performances were obtained with this new method which obviates the need for more powerful FEC schemes for transmission over noisy channels.<>     

The limit of viability--neonatal outcome of infants born at 22 to 25 weeks' gestation

BACKGROUND: With improved survival of preterm infants, questions have been raised about the limit of viability. To provide better information and counseling for parents of infants about to be delivered after 22 to 25 weeks' gestation, we evaluated the mortality and neonatal morbidity of preterm infants born at these gestational ages. METHODS: We studied retrospectively all 142 infants born at 22 to 25 weeks' gestation (as judged by best obstetrical estimate) from May 1988 through September 1991 in a single hospital. Mortality in the first six months, including stillbirths, and neonatal morbidity (i.e., the presence of intracranial pathologic conditions, chronic lung disease, and retinopathy of prematurity) were analyzed. RESULTS: Fifty-six infants (39 percent) survived for six months. Survival improved with increasing gestational age; none of 29 infants born at 22 weeks' gestation survived, as compared with 6 of 40 (15 percent) born at 23 weeks, 19 of 34 (56 percent) born at 24 weeks, and 31 of 39 (79 percent) born at 25 weeks. There were seven stillbirths at 22 weeks' gestation and four stillbirths at 23 weeks. The more immature the infant, the higher the incidence of neonatal complications as determined by the number of days of mechanical ventilation, the length of the hospital stay, and the presence of retinopathy of prematurity, periventricular or intraventricular hemorrhage, or periventricular leukomalacia. Only 2 percent of infants born at 23 weeks' gestation survived without severe abnormalities on cranial ultrasonography, as compared with 21 percent of those born at 24 weeks and 69 percent of those born at 25 weeks. CONCLUSIONS: We believe that aggressive resuscitation of infants born at 25 weeks' gestation is indicated, but not of those born at 22 weeks. Whether the occasional child who is born at 23 or 24 weeks' gestation and does well justifies the considerable mortality and morbidity of the majority is a question that should be discussed by parents, health care providers, and society.     

Red blood cell glutathione status in patients with gastrointestinal malignancies treated with 5-fluorouracil

As an alternative to surgical splenectomy, partial splenic embolization was performed in seven children for hypersplenism manifested by splenomegaly, thrombocytopenia, leukopenia, and erythrocyte hemolysis. Within a few days, platelet and leukocyte counts rose significantly in all patients and were maintained in six of seven patients during a follow-up period of 9 to 69 months. Spleen size and abdominal distention also decreased significantly in all children. There were no infectious complications.     

Investigating the Social Dimensions of Transport Disadvantage II: From Concepts to Methods through an Empirical Case Study

This article is the second of two papers that review the field of spatially sensitive social scientific research into the links between social status and transport disadvantage. The first paper undertook a comprehensive review of the social scientific and transport planning literature to mark the level of development in the field and identify conceptual and methodological issues and constraints in this field of inquiry. The present article supports the advancement of socially and geographically sensitive transport research by opportunities for the development of more sophisticated spatial analytical methodologies. The approach we present is able to account for factors not previously addressed in either social or transport planning research, in particular the temporal dimensions of transport service accessibility. The article articulates the methodology through an empirical case study of socio-spatial transport disadvantage within the Gold Coast City. The article demonstrates that there are important theoretical and practical lessons to be gained for researchers and policy makers in addressing the social dimensions of transport and infrastructure provision. Further, the article argues that an attentiveness to new ways of combining and representing social and transport data-sets can promote policy relevant empirical social inquiry. The article also contributes in a productive way to the empirical knowledge of Australia's sixth-largest metropolitan area, which is often overlooked by urban scholars.     

Enhanced Image Detection on an ARM based Embedded System

This paper presents a new technique for thedetection of Integrated Circuits within images of Printed Circuit Boards autonomouslyand without the need to be assisted by CAD data. The technique is a key partof a suite of algorithms targeted for an embedded System On Chip architecturebased on the ARM7 platform for real time detection of PCB images for diagnosticpurposes. The technique has a significant reduction in complexity when comparedto conventional approaches such as the Hough Transform. The reduction in complexitymakes the approach ideal for an embedded vision application suchas the one described in this paper. This paper presents the technique, thetarget embedded architecture and results showing the reduction in complexitywhen compared to a Hough Transform.     

A note on the use of conductimetry in brewery microbiological control

The growth in beer of 15 brewery strains of Lactobacillus was detected using the automatic conductance measuring technique afforded by the Malthus 8 Growth Analyser. 0·15% ammonium chloride was added to the beer as an electrolyte and sodium acetate was used to raise the pH from ca 4·0 to 4·2 or above. No measurable responses were obtained using unmodified beer. The value of the method for development in routine brewery microbiological control is briefly discussed.     

Optimum Design for RF-to-Optical Up-Converter in Coherent Optical OFDM Systems

In this letter, we conduct analysis on the optimum design for RF-to-optical up-converter in coherent optical OFDM systems using an optical I/Q modulator. We first derive closed-form expressions for the nonlinearity in the optical I/Q modulator, represented by two-tone intermodulation products as a function of the bias point and modulation index. Additionally, we perform a numerical simulation to identify Q-penalty and the excess modulation insertion loss under various transmitter conditions. We find that in contrast to the direct-detected system, the optimal modulator bias point for the coherent system is pi, where the Q-penalty and excess loss are minimized     

The Silicon Backplane Design for an LCOS Polarization-Insensitive Phase Hologram SLM

Polarization-insensitivity is achieved in a reflective spatial light modulator by laying a quarter-wave plate (QWP) at the incident wavelength directly over the mirror pixels of a silicon backplane, and forming a nematic Freedrickcz cell over the QWP to modulate the reflected phase. To achieve the highest drive voltage from the available silicon process, a switched voltage common front electrode design is described, with variable amplitude square wave drive to the pixels to maintain constant root-mean-square drive and minimize phase fluctuations during the dc balance refresh cycle. The silicon has been fabricated and liquid-crystal-on-silicon cells both with and without the QWP assembled; applications include optically transparent switches for optical networks, beam steering for add-drop multiplexers for wavelength-division-multiplexing telecommunications, television multicast, and holographic projection.