Electrical coupling and impulse propagation in anatomically modeledventricular tissue

Computer simulations were used to study the role of resistive couplings on flat-wave action potential propagation through a thin sheet of ventricular tissue. Unlike simulations using continuous or periodic structures, this unique electrical model includes random size cells with random spaced longitudinal and lateral connections to simulate the physiologic structure of the tissue. The resolution of the electrical model is ten microns, thus providing a simulated view at the subcellular level. Flat-wave longitudinal propagation was evaluated with an electrical circuit of over 140,000 circuit elements, modeling a 0.25 mm by 5.0 mm sheet of tissue. An electrical circuit of over 84,000 circuit elements, modeling a 0.5 mm by 1.5 mm sheet was used to study flat-wave transverse propagation. Under normal cellular coupling conditions, at the macrostructure level, electrical conduction through the simulated sheets appeared continuous and directional differences in conduction velocity, action potential amplitude and V˙_max were observed. However, at the subcellular level (10 μm) unequal action potential delays were measured at the longitudinal and lateral gap junctions and irregular wave-shapes were observed in the propagating signal. Furthermore, when the modeled tissue was homogeneously uncoupled at the gap junctions conduction velocities decreased as the action potential delay between modeled cells increased. The variability in the measured action potential was most significant in areas with fewer lateral gap junctions, i.e., lateral gap junctions between fibers were separated by a distance of 100 μm or more     

Superconductivity in nearly single-phase Bi-Pb-Sr-Ca-Cu-O samples with different nominal compositions

The preparation conditions, phase composition, and superconducting properties of Bi-Pb-Sr-Ca-Cu oxide materials from different nominal compositions have been investigated. Nearly single-phase samples from Bi₂Pb_0.4Sr₂Ca₃Cu₄O _y , as well as from the proposed compositions Bi_1.8Pb_0.4Sr₂Ca₃Cu₄O _y and Bi_1.8Pb_0.4Sr₂Ca_2.5Cu_3.5O _y were obtained by a solid-state reaction in air. Samples with the third nominal composition showed the best superconducting properties (T _on=111 K and zero resistance atT ₀=103 K). A possible mechanism for the 2223 phase formation in the three investigated compositions has been discussed.     

Contraindications to metformin therapy in patients with NIDDM

OBJECTIVE: Treatment with metformin is occasionally associated with the development of severe lactic acidosis. However, this is usually observed in patients with major contraindications to the drug. In this study, we aimed to determine the prevalence of conditions currently regarded as either contraindications or cautions to the use of metformin in patients with NIDDM. RESEARCH DESIGN AND METHODS: The case notes of metformin-treated NIDDM patients (mean age 62 years) attending a United Kingdom university hospital diabetes clinic over a 3-month period were reviewed according to criteria reflecting a pragmatic view of current prescribing recommendations. RESULTS: Of 89 consecutive patients whose notes could be evaluated in detail, only 41 (46%) had no contraindications or cautions to metformin whatsoever. Concomitant chronic disorders associated with a potentially increased risk of hyperlactatemia were renal impairment (n = 2; plasma creatinine concentrations 1.7 and 2.3 mg/dl, respectively), cardiac failure (n = 2), and chronic liver disease (n = 2). Other potentially relevant disorders included ischemic heart disease (n = 20), clinical proteinuria (n = 14), peripheral vascular disease (n = 22), and pulmonary disease (n = 7). Multiple conditions (i.e., two, three, or four) were present in eight, five, and one patient(s), respectively. CONCLUSIONS: More than half the patients in our series had concomitant conditions or complications conventionally regarded as cautions or contraindications to metformin; approximately 10% had a multiplicity of such conditions. Regular surveillance is necessary to detect the development of complications such as renal impairment. Vigilance is also required in view of the increased risk of major intercurrent illnesses, which may independently disturb lactate metabolism in patients with NIDDM. Metformin should be withdrawn promptly under such circumstances.     

Handwritten word recognition with character and inter-characterneural networks

An off-line handwritten word recognition system is described. Images of handwritten words are matched to lexicons of candidate strings. A word image is segmented into primitives. The best match between sequences of unions of primitives and a lexicon string is found using dynamic programming. Neural networks assign match scores between characters and segments. Two particularly unique features are that neural networks assign confidence that pairs of segments are compatible with character confidence assignments and that this confidence is integrated into the dynamic programming. Experimental results are provided on data from the U.S. Postal Service.     

Intestinal obstruction and peritoneal carcinomatosis after endoscopic resection of transitional carcinoma of urinary bladder

Gut involvement in bladder tumours is low, even exceptional in the presence of surface, low-grade neoplasia. The authors explain their experience in the diagnosis and management of a patient treated endoscopically for a vesical surface tumour which subsequently exhibited peritoneal and gut metastatic seeding. The various mechanisms for gut dissemination of vesical neoplasias and the repercussion of their endoscopic management are discussed.     

Sub-optimal solutions to track detection problem using graph theoretic concepts

This paper demonstrates how the problem of tracking targets, which appear as either straight or curved lines in two-dimensional display images (or data images) can be formulated in terms of a directed weighted graph model and how dynamic programming techniques can be efficiently applied to reach an optimal or sub-optimal solution. In general, track detection algorithms providing optimal solutions have good detective ability, but most of them suffer from the inability to detect discontinuous lines or to resolve efficiently pairs of crossing lines. A sub-optimal solution is provided that efficiently overcomes these weaknesses. We focus on modeling the track detection problem in terms of a graph, formulating fast sequential/parallel sub-optimal track detection algorithms and testing them on simulated data in order to show their detective ability. Moreover, we specify the conditions under which sub-optimal algorithms can perform at least as well as their corresponding optimal algorithms. This is significant for the track detection problem where fast, accurate and real-time detection is considered a necessity.     

Computer-intensive methods in statistical analysis

As far back as the late 1970s, the impact of affordable, high-speed computers on the theory and practice of modern statistics was recognized by Efron (1979, 1982). As a result, the bootstrap and other computer-intensive statistical methods (such as subsampling and the jackknife) have been developed extensively since that time and now constitute very powerful (and intuitive) tools to do statistics with. This article provides a readable, self-contained introduction to the bootstrap and jackknife methodology for statistical inference; in particular, the focus is on the derivation of confidence intervals in general situations. A guide to the available bibliography on bootstrap methods is also offered     

Vitamin A deficiency and nocturnal vision in teenagers with cystic fibrosis

The aim of this study was to document plasma retinol status and nocturnal vision in ten eutrophic adolescents with cystic fibrosis (CF) receiving daily retinol supplementation. Plasma retinol, alpha and beta carotenes and retinol binding protein were measured in ten clinically stable CF patients (mean age: 14.3 years; Shwachman score: 80-100). Nocturnal vision evaluation was performed with a Beyne optometer. Plasma retinol (mean 0.42 +/- 0.16 mg/l), alpha carotene and beta carotene levels were below the lower limit of normal in all but one patient. Five out of ten patients with normal standard opthalmological examination presented a poor (n = 3 patients) or a pathological (n = 2) dark adaptation test. These two patients showed a dramatic increase in nocturnal vision after 1 year of adapted retinol supplementation. CONCLUSION: Low vitamin A levels occur frequently in clinically stable, eutrophic and retinol supplemented CF adolescents. Since vitamin A deficiency is associated with poor nocturnal vision and since this pattern can be reversed by adapted retinol supplementation, we recommend monitoring plasma vitamin A levels in CF patients and evaluation of dark adaptation in retinol deficient patients.