Determination of tricyclic antidepressants for ED analysis

Both the Biosite Triage (Biosite Diagnostics, San Diego, CA) method and the Du Pont aca (Du Pont Company, Wilmington, DE) method give qualitative tricyclic antidepressant (TCA) results to aid in the diagnosis of a TCA overdose. The Triage method uses urine samples and the aca uses serum samples. Although the cutoff values vary considerably between the two methods, the Triage results agreed well with the aca results. The Triage test has an advantage in instrument maintenance and time savings, allowing a reduction in turn-around time for our emergency department. Both urine and serum samples were obtained from 44 patients who were admitted to the emergency department with a diagnosis of "possible tricyclic overdose." Discrepancies between the two methods were resolved by thin layer chromatography (Toxi-Lab, Ansys, Inc, Irvine, CA). Both methods were in agreement with the exception of five patients' samples. In this study, the Triage method allowed for detection of TCA using urine that is simple for the user and yielded higher sensitivity and specificity results compared with the Du Pont aca method.     

Is vertical vein ligation necessary in repair of total anomalous pulmonary venous connection?

BACKGROUND: In the repair of total anomalous venous connection, vertical vein ligation is recommended to eliminate left-to-right shunting. However, the small left heart chambers may not always tolerate the immediate increase in blood flow after combined repair and vein ligation. METHODS: A retrospective review of 23 infants and children undergoing correction of total anomalous pulmonary venous connection was undertaken to determine whether vertical vein ligation is a necessary component of successful surgical repair. In 14 patients this vein was ligated, whereas in 9 it was left patent. Six patients who underwent ligation and 5 who did not had pulmonary venous obstruction before operation. RESULTS: The operative mortality rate was 36% (5 of 14 patients) for the ligated group compared with 0% (0 of 9 patients) for the nonligated group (p = 0.06). All deaths occurred in patients with preoperative obstruction and a low mean left atrial pressure, and four of the deaths were directly attributable to left heart failure. Follow-up echocardiography in patients in whom the vertical vein was not ligated revealed adequate cardiac function and no residual left-to-right flow through the previously patent venous conduit. CONCLUSION: Vertical vein ligation during the repair of total anomalous pulmonary venous connection is not routinely necessary and actually may be undesirable in patients with preoperative obstruction, in whom the left heart chambers are particularly small.     

Cytotoxic lignans from Formosan Hernandia nymphaeifolia

The autolytic site Arg105 of rat trypsin was replaced with Cys by DNA site-directed mutagenesis method. Comparison of expression and purification of R105C trypsin along with the wild type and some other Arg105 mutants indicates that R105C trypsin could be expressed as well but with a lower expression level. It is unexpected that R105C trypsin has no detectable activity toward trypsin substrate TAME, quite different from the wild type and other Arg105 mutants. Native gel electrophoresis analysis indicates that R105C trypsin has a similar mobility rate to that of wild type trypsin. FPLC also gives similar retaining time. The loss of activity of R105C trypsin may result from the conformational change around active site, but not the dimer formation.     

用16～100V电源提供12V及3A输出的宽范围稳压器

同步降压稳压器具有高效率，广泛用于输入电压为12V或12V以下的设备中。但随着输入电压接近100V，宽范围稳压器设计变得越来越困难，合适IC的选择范围亦变得相当窄。本设计实例将用于回扫稳压器电路的电流模式PWMIC与100V的栅极驱动器IC相结合，产生可在高达100V输入电压下工作的高性能同步降压稳压器。     

Effects of annealing in O2 and N2 on the electrical properties of tantalum oxide thin films prepared by electron cyclotron resonance plasma enhanced chemical vapor deposition

The tantalum oxide thin films with a thickness of 14 nm were deposited at 95°C by electron cyclotron resonance plasma enhanced chemical vapor deposition (ECRPECVD), and annealed at various temperatures (700∼850°C) in O₂ and N₂ ambients. The microstructure and composition of the tantalum oxide thin films and the growth of interfacial silicon oxide layer were investigated and were related to the electrical characteristics of the film. Annealing in an O₂ ambient led to a high dielectric constant (ε_r(Ta₂O₅) = 24) as well as a small leakage current (E_bd = 2.3 MV/cm), which were due to the improved stoichiometry and the decreased impurity carbon content. Annealing in an N₂ ambient resulted in poor and nonuniform leakage current characteristics. The as-deposited tantalum oxide films were crystallized into δ-Ta₂O₅ after annealing at above 750°C regardless of the ambient. The leakage current of the film abruptly increased after annealing at 850°C probably because of the stress caused by thermal expansion or contraction.     

Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial

BACKGROUND: Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-related groin pain in athletes. METHODS: 68 athletes with long-standing (median 40 weeks) adductor-related groin pain--after examination according to a standardised protocol--were randomly assigned to AT or PT. The treatment period was 8-12 weeks. 4 months after the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome measure was full return to sports at the same level without groin pain. Analyses were by intention to treat. FINDINGS: 23 patients in the AT group and four in the PT group returned to sports without groin pain (odds ratio, multiple-logistic-regression analysis, 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p=0.006) linear trend towards a better effect in the AT group. A per-protocol analysis did not show appreciably different results. INTERPRETATION: AT with a programme aimed at improving strength and coordination of the muscles acting on the pelvis, in particular the adductor muscles, is very effective in the treatment of athletes with long-standing adductor-related groin pain. The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, clinical trials.     

Profiling care and benchmarking best practice in care of hospitalized elderly: the Geriatric Institutional Assessment Profile

This article reports on a new instrument, the Geriatric Institutional Assessment Profile (GIAP), developed to assess (1) hospital workers' knowledge, attitudes, and perceptions regarding care of geriatric patients, and (2) the perceived adequacy of an institutional environment to serve geriatric patients' needs. Findings are reported from 303 questionnaires completed by health care employees from a 658-bed academic medical center. Internal consistency estimates were consistently high for the various components of the GIAP. Factor analysis was performed to examine underlying dimensions of knowledge and institutional environment. The GIAP has the potential to narrow the gap between actual and best practice in geriatric care by identifying staff information needs and concerns, as well as institutional barriers and facilitators to providing quality geriatric hospital care.