Effects of gemfibrozil and ciprofibrate on plasma levels of tissue-type plasminogen activator, plasminogen activator inhibitor-1 and fibrinogen in hyperlipidaemic patients

Evaluation of fibrate treatment in humans has focused primarily on its anti-lipidaemic effects. A potentially favourable haemostasis-modulating activity of fibrates has also been recognized but the data are not consistent. We sought to learn more about this variability by examining the effects of gemfibrozil and ciprofibrate on plasma levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and fibrinogen in primary hyperlipidaemic patients after six and twelve weeks of treatment using different assay systems for PAI-1 and fibrinogen. Although both fibrates effectively lowered triglyceride and cholesterol levels, no effect on the elevated baseline antigen levels of t-PA and PAI-1 was observed after fibrate treatment. However, both fibrates influenced plasma fibrinogen levels, albeit in a different way. Fibrinogen antigen levels were elevated by 17.6% (p <0.05) and 24.3% (p <0.001) with gemfibrozil after six and twelve weeks, respectively, whereas with ciprofibrate there was no effect. Using a Clauss functional assay with either a mechanical end point or a turbidity-based end point, no significant change in fibrinogen levels was seen after six weeks of gemfibrozil treatment. However, after twelve weeks, gemfibrozil enhanced functional fibrinogen levels by 7.2% (p <0.05) as assessed by the Clauss mechanical assay, but decreased functional fibrinogen levels by 12.5% (p <0.0001) when a Clauss assay based on turbidity was used. After six or twelve weeks of ciprofibrate treatment, functional fibrinogen levels were decreased by 10.1% (p <0.001) and 10.5% (p <0.0001), respectively on the basis of Clauss mechanical and by 14.2% (p <0.001) and 28.2% (p <0.0001), respectively with the Clauss turbidimetric assay. A remarkable and consistent finding with both fibrates was the decrease in functionality of fibrinogen as assessed by the ratio of functional fibrinogen (determined by either of the two Clauss assays) to fibrinogen antigen. Taken together, our results indicate that at least part of the variability in the effects of fibrates on haemostatic parameters can be explained by intrinsic differences between various fibrates, by differences in treatment period and/or by the different outcomes of various assay systems. Interestingly, the two fibrates tested both reduced the functionality of fibrinogen.     

Preceramic organoboron–silicon polymers

Several boron-containing organosilicon polymers were synthesized from a sodium-coupling reaction of silicon and boron halides with and without alkyl halide in hydrocarbon solvents. The B–Si preceramic polymers were characterized using techniques such as IR, UV, and NMR spectrometry, gel permeation chromatography, elemental analysis, molecular weight measurement, and thermal analyses (TGA, DSC, DTA, and TMA). The chemical structures of the preceramic polymers were postulated based on the analytical results. Black ceramic materials were obtained from the precursor polymers upon thermal degradation at temperatures above 1000°C in an inert atmosphere. The precursor polymers had a ceramic yield of up to 70%. Thermogravimetric analysis of the ceramic material in air at a flow rate of 100 mL/min showed it was stable up to 1000°C with little weight gain or loss. Several methods were used to characterize the ceramic materials: XRD, solid NMR, high-temperature DTA, elemental analysis, and acid digestion. The analyses indicated that the ceramic materials comprised a mixture of silicon carbide (SiC), silicon borides (SiB₄, SiB₆), and amorphous Si–B–C ceramics, with small amounts of silica and free silicon.     

Effect of sodium nitroprusside on compound action potential thresholds in the gerbil cochlea

OBJECTIVE: Trials that do not allow rejection of the null hypothesis of no treatment effect may have had an inappropriate design. Trials are virtually never assessed for correlation between responses to different treatment modalities. METHODS: Using a hypothetical example and several published studies we examine the influence of correlation levels between treatment modalities on the sensitivity of testing. RESULTS: The level of correlation between responses to different treatment modalities is a major determinant of the sensitivity both of crossover and parallel group clinical trials. CONCLUSIONS: It is very relevant to assess a priori correlation levels between responses to the different treatment modalities of a trial. If a negative correlation is anticipated, a crossover design is likely to lack sensitivity. If a positive correlation is anticipated a parallel-group design seems less appropriate, because it would lack the extra sensitivity of accounting for the positive correlation. Both designs would seem suitable for approximately zero correlations (e.g. comparison vs baseline or vs placebo under the assumption that the number of placebo responders is negligible.     

The globally Bi-3-connected property of the honeycomb rectangular torus

The honeycomb rectangular torus is an attractive alternative to existing networks such as mesh-connected networks in parallel and distributed applications because of its low network cost and well-structured connectivity. Assume that m and n are positive even integers with n ? 4. It is known that every honeycomb rectangular torus HReT(m,n) is a 3-regular bipartite graph. We prove that in any HReT(m,n), there exist three internally-disjoint spanning paths joining x and y whenever x and y belong to different partite sets. Moreover, for any pair of vertices x and y in the same partite set, there exists a vertex z in the partite set not containing x and y, such that there exist three internally-disjoint spanning paths of G-{z} joining x and y. Furthermore, for any three vertices x, y, and z of the same partite set there exist three internally-disjoint spanning paths of G-{z} joining x and y if and only if n ? 6 or m = 2.     

C pm MPPAC for manufacturing quality control applied to the precision voltage reference process

The multiprocess performance analysis chart (MPPAC) based on the process capability index C_pm, called C_pm MPPAC, is developed for analysing the manufacturing quality of a group of processes in a multiple process environment. The C_pm MPPAC conveys critical information of multiple processes regarding the departure of the process and process variability from one single chart. Existing research works on MPPAC are restricted to obtaining quality information from one single sample of each process ignoring sampling errors. The information provided from existing MPPAC charts, therefore, is unreliable and misleading and results in incorrect decisions. In this paper, we consider the natural estimator of C_pm based on multiple samples. Based on the natural estimator of C_pm, we consider the sampling errors by providing an explicit formula with the Matlab program to obtain the estimation accuracy of the C_pm. We tabulate the sampling accuracy of C_pm for sample size determination so that the engineers/practitioners can use it for their in-plant applications. An example of multiple precision voltage reference (PVR) processes is presented to illustrate the applicability of C_pm MPPAC for manufacturing quality control.     

Cracking Go

Many of the early computer-chess researchers hailed from the fields of psychology or artificial intelligence and believed that chess programs should mimic human thinking. Specifically, they wanted computers to examine only playing sequences that were meaningful according to some human reasoning process. In computer chess this policy, known as selective search, never really made progress. The reason is that humans are extremely good at recognizing patterns; it is one of the things that we do best. The article focuses on weiqi, an ancient Chinese board game, better known in the West by the Japanese name of Go, whose combinatorial complexity is many orders of magnitude greater than that of chess. Go is played on a board crisscrossed by 19 vertical and 19 horizontal lines whose 361 points of intersection constitute the playing field. The object is to conquer those intersection points.     

Genitourinary trauma in the pediatric patient

Trauma is the major source of mortality in the pediatric population. A retrospective review was performed on patients admitted to the Children's Hospital and Health Center Trauma Program, San Diego, California, from August 1984 to May 1990. The purpose of this review was to evaluate pediatric trauma and to determine the best treatment and evaluation for genitourinary injuries. Blunt trauma was responsible for 98 percent of the injuries, with renal injuries being the most common. Bladder (7) and male urethral (2) injuries, and vaginal lacerations (8) also occurred. The most severe renal injuries (70%) and all significant bladder and urethral injuries were associated with gross hematuria. Hypotension was present in 31 percent of patients but rarely required surgical exploration for correction. Eighty-six patients underwent radiographic imaging. Computerized tomography (CT) scans demonstrated the most information about intra-abdominal solid organ injuries but was inaccurate in detecting bladder or urethral injuries. Genitourinary injury is common in children but rarely requires surgical management. CT scan is the best study to determine extent of solid-organ injury but is inferior to cystourethrography to diagnose bladder or urethral injuries.     

Treatment algorithm use to optimize management of symptomatic patients with a history of mania

BACKGROUND: While monotherapy has significant limitations in bipolar disorder, few published data addressing alternatives exist. Treatment algorithms have been proposed, but none have undergone empirical evaluation. This study provides a systematic prospective, open evaluation of the effectiveness and tolerability of a treatment algorithm for patients with histories of mania. METHOD: Twenty-eight symptomatic outpatients from a public mental health facility who were diagnosed as having either bipolar I or schizoaffective illness, bipolar type, entered the study. Minimum blood levels of lithium and divalproex sodium were defined. Medications were pushed to predetermined levels (as tolerated) before proceeding to the next algorithm step. Clinical symptoms were assessed monthly using the Brief Psychiatric Rating Scale (BPRS, 27 item) and Clinical Global Impressions scale. RESULTS: Pretreatment and posttreatment clinical symptoms were compared. Over 50% of patients attained 30% improvement from baseline BPRS after 4 months. Thirty-six percent of patients (N = 10) became mood stable, 46% (N = 13) remained mood unstable, and 18% (N = 5) dropped out before completing the algorithm. Although patients who finished the algorithm were taking more medication, either dosage and/or drugs, somatic complaints did not increase. CONCLUSION: The potential benefit of a defined treatment algorithm was demonstrated for these complex and persistently ill patients. Despite long treatment histories, patients improved with more frequent visits and addition of medication(s). A randomized controlled trial comparing a similar treatment algorithm with treatment-as-usual is warranted.