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Organ transplantation is associated with an early bone loss that subsequently increases the risk of osteopenia and bone fractures. It is not known whether bone loss continues in long-term survivors, but persistent bone demineralization could further jeopardize an already diminished bone mass. To better define long-term bone status of kidney transplant recipients (KTR), we conducted cross-sectional and longitudinal evaluations of bone mineral density (BMD) in 70 KTR with a mean posttransplantation time of 8.1 years. BMD was determined by dual-energy X-ray absorptiometry and was repeated in 55 of the patients after a mean follow-up period of 22 +/- 5 months. Lumbar and femoral osteopenia, defined as a BMD lower than 2 standard deviations from mean value of sex- and age-matched controls, was present in 28.6% and 10.5% of patients, respectively. There was a significant negative correlation between cumulative prednisone dose and adjusted lumbar as well as femoral BMD (R = 0.45, P < 0.001 and R = 0.29, P < 0.05, respectively). Five patients had a vertebral BMD below a fracture threshold of 0.777 g/cm2. Vertebral fractures (VF) were found in four men and were associated with higher prednisone dosage (P < 0.05), larger cumulative prednisone dose (P < 0.05), and significantly lower BMD values. According to World Health Organization recent criteria for women, prevalences of lumbar and femoral osteopenia and lumbar and femoral osteoporosis in female patients reach 75%, 65%, 33%, and 10%, respectively. The longitudinal part of the study showed a persistent pathological lumbar demineralization process. Over the study period, BMD, expressed as a percentage of that of controls, decreased from 89 +/- 14% to 86 +/- 14% (P < 0.001). Annual change of bone mass was -1.7 +/- 2.8% per year. Accelerated vertebral bone loss (defined as a decrease of BMD, expressed as a percentage of that of controls, of more than 1% per year) was present in 56% of patients and was associated with higher prednisone dosage (P < 0.01). In conclusion, although VF are relatively infrequent in long-term survivors of renal transplantation, osteopenia is a frequent finding, and a substantial proportion of women present lumbar osteoporosis. An ongoing demineralization process of the spine is also demonstrated and probably contributes to long-term spinal osteoporosis incidence. Prednisone dosage remains the most constantly isolated risk factor.  相似文献   
164.
Grey box identification refers to the practice of identifying dynamical systems in model structures exploiting partial prior information. This contribution reviews a method for stochastic grey box identification and surveys experiences and lessons of applying it to a number of industrial processes. Issues to be addressed include advantages and costs of introducing stochastics into the model, the question of what contribution must be expected from the model designer as opposed to what can be formalized in computer algorithms, and an outlook on future plans to resolve present shortcomings.  相似文献   
165.
Until now, attention has been focused solely in the drying of squid mantle from an experimental point of view, neglecting the transport phenomenon studies of water in squid muscle. This work studies the drying of squid mantle (Loligo brasiliensis), previously salted and smoked by liquid smoking (hickory extract), using a tubular dryer in closed cycle with a silicagel fixed bed in series. The mass transfer phenomenon during drying was studied, based on the Fick's second law, with the effective diffusivity supposed constant, which enabled an analytical solution to the problem. The drying curve calculated with the resulting equation was compared with experimental data. The model was applied to a hollow cylinder geometry (round squid mantle), with its internal surface isolated from the drying environment by a plastic film. The latter was given a tubular form and introduced inside the mantle cavity (impervious wall boundary condition).  相似文献   
166.
The standard enzymatic assay for quantification of D-sorbitol in plasma was adapted to the automatic analyzer Cobas Mira S. In the assay, NAD (reagent) in the presence of sorbitoldehydrogenase (SDH; start reagent) converts D-sorbitol to fructose with formation of NADH, which was detected automatically as the difference between the first and last readings at 340 nm. The sample blank values for each specimen were subtracted to exclude both endogenous D-sorbitol and sugars, which also react as substrates for SDH. The method is simple, rapid (40 samples/h), precise down to endogenous concentrations (coefficient of variation < 5%; limit of determination: 0.38 mg/L) and linear up to 100 mg/L. Samples with higher D-sorbitol concentrations were estimated after dilution. The method was used to measure disposition curves of sorbitol in volunteers after a single intravenous dose of 0.8 g sorbitol.  相似文献   
167.
A structured genetic algorithm (SGA) approach is developed for robust controller design based on the concept of an H loop-shaping technique and the method of inequalities. Such an SGA is capable of simultaneously searching the orders and coefficients of the precompensator and postcompensator for the weighted plant. It is, therefore, not necessary to predefine the order of compensators as in usual practice. A multiple objective ranking approach is also incorporated so that the design criteria of extreme plants can be easily achieved. The effectiveness of such a technique is illustrated by a high-purity distillation column design example  相似文献   
168.
A novel isolation scheme named planarized trench isolation and field oxide formation using poly-silicon (PLATOP) Is described. PLATOP is applicable to high-performance submicron VLSI since it results in encroachment-free shallow trenches, and planarized field oxide. The process offers poly silicon-filled deep trenches. The process also relies on noncritical lithography and novel etch processes to planarize the deposited poly-silicon from the top of the active areas, and oxidation to consume the poly-silicon in the field regions. Electrical results are presented proving the viability of the isolation scheme  相似文献   
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PURPOSE: Little has been written regarding the ultrasound imaging features that might allow prediction of fetal viability in abdominal pregnancies. Toward this goal, we present our experience with a series of 11 abdominal pregnancies. MATERIALS AND METHODS: From 1981 to 1993, 11 patients presented to Universidad Catolica, Santiago, and Universidad de Austral, Valdivia, Chile, with third trimester abdominal pregnancies. Five had complete ultrasound examinations, and these five patients were managed expectantly. The other six women presented as acute abdominal emergencies and underwent emergent surgery. RESULTS: Four of five fetuses that survived had a complete placental attachment to the uterus, and one surviving neonate had a partial attachment of the placenta to the uterus. Three fetuses died prior to delivery, and all three had a complete mesenteric placental attachment. Two died in the early neonatal period. One had a complete uterine placental attachment, and the other had a partial attachment. CONCLUSIONS: The survival rate of abdominal pregnancies may be better than is generally believed. Placental attachment to the uterus appears to be a factor related to fetal survival and maternal morbidity. More cases are necessary to determine the feasibility of managing women with abdominal pregnancies expectantly.  相似文献   
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