Internal auditory artery infarction: clinicopathologic correlation

Immunocytochemical examination for mitochondrial protein and cytochrome oxidase was performed to demonstrate oncocytes in normal adenohypophysis obtained from 28 patients of various age. A small number of solitary large epithelial cells showed intense cytoplasmic granular immunoreactivities for mitochondrial protein and cytochrome oxidase. The proportions of the cells positive for the former and the latter ranged from 0% to 5.9% (mean+/-SD; 1.5+/-1.7%) and from 0% to 4.9% (1.4+/-1.6%), respectively. These cells were either absent or extremely rare in young patients (under 10 years) but tended to increase in number with age (P < 0.0001). On the other hand, the mirror section technique showed that most of these cells were negative for adenohypophysial hormones, but a few of them were faintly positive for: alpha-subunit (8.0%), beta-subunits of follicle-stimulating hormone (4.8%), luteinizing hormone (2.5%), thyroid-stimulating hormone (1.0%), and growth hormone (0.5%), and were negative for prolactin and adrenocorticotropic hormone. We considered that these cells represent oncocytes that exist in varying numbers in normal adenohypophysis. It was suggested that oncocytes in normal adenohypophysis share various common features with tumorous oncocytes of pituitary oncocytomas.     

Pathways to nowhere

Early in the decade, health care discovered a powerful patient care management tool: the clinical path. Leaders in the field latched onto paths as the solution to cost and quality dilemmas, but they overlooked the importance of the underlying principles of quality management. Beyond Clinical Paths, a new book from American Hospital Publishing, focuses on the issues critical to successful quality improvement through clinical paths. The following excerpt by the book's editor, Patrice L. Spath, sets the stage for a new approach to clinical quality.     

A multi-criteria decision approach to sorting actions for promoting energy efficiency

This paper proposes a multi-criteria decision approach for sorting energy-efficiency initiatives, promoted by electric utilities, with or without public funds authorized by a regulator, or promoted by an independent energy agency, overcoming the limitations and drawbacks of cost–benefit analysis. The proposed approach is based on the ELECTRE-TRI multi-criteria method and allows the consideration of different kinds of impacts, although avoiding difficult measurements and unit conversions. The decision is based on all the significant effects of the initiative, both positive and negative, including ancillary effects often forgotten in cost–benefit analysis. The ELECTRE-TRI, as most multi-criteria methods, provides to the decision maker the ability of controlling the relevance each impact can have on the final decision in a transparent way. The decision support process encompasses a robustness analysis, which, together with a good documentation of the parameters supplied into the model, should support sound decisions. The models were tested with a set of real-world initiatives and compared with possible decisions based on cost–benefit analysis.     

Analysis of the mathematical model of the gas bubbling curtain injection on the bottom and the walls of a continuous casting tundish

In the present work, the behaviour of a gas bubbling curtain (GBC) in the continuous casting tundish of industry is studied by using a physical model in the scale of 1:3. This study was made with the following configurations of gas injection inside the tundish: no gas injection, gas injection on the bottom and combined gas injection (CGI) on the bottom and the walls. Mathematical simulations were performed using the Eulerian approach. Mathematical modelling was also used to determine the residence time distribution curves (RTD curves). For the validation of the mathematical model, experiments were made using the physical models to obtain the homogenisation time of salt solutions. All of the results were validated by the experimental results of the RTD curves. The plug flow fraction remained almost constant when gas injection was used on the walls, however the mean residence time and the dead volume fraction, increased and decreased, respectively. The CGI on the bottom and walls allowed the entire cross-section to be covered with the GBC which acted as a barrier to the passage of inclusions.