Structural studies of TiN/ZrN multilayer coating deposited by physical vapour deposition

Multilayer coatings have been produced using unbalanced magnetron physical vapour deposition in which discrete layers of TiN and ZrN were co-deposited. It has been shown that the multilayers exhibited two-fold periodicity having values of 13 and 2.8 nm. This periodicity, measured both by cross-sectional transmission electron microscopy and low-angle X-ray diffraction, has been precisely related to the process parameters used. Analysis has shown that a third, previously unreported, phase existed within the coating having a lattice parameter comparable to that of TiN and a well-defined orientation relationship with the primary phases. The existence of this phase has been explained in terms of variations in the stoichometry of the coating due to non-uniform metal to nitrogen deposition rates within the chamber. Textural studies revealed that preferred orientation existed in the coating; the degree of which was greater in the ZrN layers than the TiN layers.     

A study of self poisoning with oral salbutamol--laboratory and clinical features

A review of 35 patients > 60 years of age with odontoid fractures showed that a type II injury (Anderson and D'Alonso) was the most common fracture pattern (82% of cases). On the basis of mechanism of injury and sex incidence, we deduced that osteopenia is a contributory factor in the occurrence of odontoid fractures. A fall in a domestic setting was the cause in 53%. The peg was posteriorly displaced in 88% of type II fractures, and primary union occurred in 23%. The incidence of concomitant spinal cord injury with type II fractures was higher in older patients than it was in those < 60 years of age. The outcome for these patients was largely determined by their neurological status at presentation. Myelopathy as a late complication of nonunion was not observed in nine patients with an average follow-up of 21 months. The data suggest that vigorous attempts to secure both primary union and a sound arthrodesis for non-union are questionable in the elderly except in unusual circumstances.     

Spherical-wave source-scattering matrix analysis of coupled antennas; A general system two-port solution

Expressions are given for the coupling between two antennas in terms of each antenna's spherical-wave source-scattering matrix. A comparison with the "classical" scattering matrix representation is given in sufficient detail to permit conversion back and forth between the source-scattering matrix and the classical scattering matrix. Expressions for the transmission formulas, showing two different expressions corresponding to reversing the direction of propagation are given. However, if both antennas are reciprocal with equal characteristic waveguide impedances, then the two-port scattering matrix is a symmetric matrix.     

A model for bilayer membrane electroporation based on resultant electromechanical stress

Reconsideration of the effect of an electrical field applied across a phospholipid bilayer membrane shows that, in addition to a compressive stress normal to the membrane plane, transverse traction stresses are generated in the lateral plane of the membrane. In the fields usually employed for electroporation these transverse stresses are likely to be sufficient to reduce the membrane tension considerably, causing electroporation and rupture. This mode of field-induced change in the membrane provides a natural model for the various forms of electroporation.     

Nuclear-chemical synthesis of tritium-labeled phenyl-substituted picoline derivatives

Ion-molecule reactions of free phenyl cations with six-membered nitrogen-containing heterocyclic compounds: α-, β-, and γ-picolines, were studied. Phenyl cations were generated by tritium β-decay in double-labeled benzene. The mechanism of competing reactions of electrophilic addition to the nitrogen heteroatom in the ring and electrophilic substitution of the C-H bond in the pyridine ring was examined. The effect of methyl substituent in the pyridine molecule on the reaction pathway was evaluated. A one-step procedure for nuclear-chemical synthesis of tritium-labeled N-phenylpicolinium salts and phenyl-substituted picolines was developed.     

A strategy for improving patient satisfaction by the intensive training of residents in psychosocial medicine: a controlled, randomized study

PURPOSE: To use a controlled, randomized design to assess the effect on patient satisfaction of an intensive psychosocial training program for residents. METHOD: Twenty-six first-year residents, in two internal medicine and family practice community-based programs affiliated with the Michigan State University College of Human Medicine, were randomly assigned during 1991 and 1992 to a control group or a one-month intensive training program. Experiential teaching focused on many psychosocial skills required in primary care. A 29-item questionnaire administered before and after the residents' training evaluated their patients' satisfaction regarding patient disclosure, physician empathy, confidence in physician, general satisfaction, and comparison of the physician with other physicians. Analyses of covariance with groups and gender as factors and pre-training patient satisfaction scores as the covariate evaluated the effect of the training. RESULTS: The patients of the trained residents expressed more confidence in their physicians (p = .01) and more general satisfaction (p = .02) than did the patients of controls. The effect of training on patient satisfaction with patient disclosure (p < .01) and physician empathy (p < .05) was greater for female than for male residents. CONCLUSION: The intensive psychosocial training program for residents improved their patients' satisfaction.     

A monitoring, feedback, and triggering system for reproducible breath-hold MR imaging

OBJECTIVE: To evaluate the diagnostic accuracy and clinical usefulness of high-resolution transvaginal duplex Doppler ultrasound in postpartum and post-abortion patients with excessive hemorrhage who are suspected of having residual trophoblast. METHODS: Forty-eight women with excessive hemorrhage referred for possible residual trophoblastic tissue were evaluated by transvaginal duplex Doppler ultrasonography. Based on two-dimensional imaging, the patients were divided prospectively into groups: women who had an empty uterus with a normal uterine cavity, those with a pure endometrial fluid collection and no echogenic foci, those who had a mixed endometrial fluid collection with foci of echogenicity, and those with intracavitary heterogeneous material with mixed echo patterns of fluid and solid components. In each group, Doppler studies were performed and the resistance index (RI) was calculated. The two-dimensional patterns and Doppler results were correlated with clinical and pathologic follow-up. RESULTS: Twenty-eight subjects had a normal uterine cavity and seven had a pure endometrial fluid collection; all were treated conservatively and none showed later clinical evidence of residual trophoblastic tissue. In 13 women, residual trophoblast was strongly suggested from the images of two-dimensional ultrasonography: Five showed an endometrial fluid collection with some echogenic foci, and eight exhibited intracavitary mixed echogenic material. All underwent curettage, and residual trophoblastic tissue was found in ten of the 13. The mean (+/- standard deviation) RI to flow in the myometrial arteries was 0.54 +/- 0.15 in women without residual trophoblast and 0.35 +/- 0.1 in those with residual trophoblastic tissue (P < .01). CONCLUSION: Our experience suggests that transvaginal duplex Doppler ultrasonography is an effective noninvasive method for evaluating patients with excessive postpartum and post-abortion hemorrhage who are suspected of having residual trophoblastic tissue. Its use enhances the positive preoperative diagnosis of residual trophoblastic tissue and may reduce unnecessary curettage procedures.     

Compulsory notification of cysticercosis in Ribeir?o Preto-SP, Brazil

Cysticercosis is a severe public health problem in several regions of Asia, Africa and Latin America. Epidemiologic studies based on the frequency of cases observed in specialized neurology, neurosurgery and computed tomography services, at autopsy and in seroepidemiologic studies do not permit the determination of the true prevalence of the disease in the population. The objective of the present study was to investigate the prevalence of cysticercosis by compulsory notification. The coefficient of prevalence was 54 cases/100,000 inhabitants in the municipality of Ribeir?o Preto. The results also indicated that cysticercosis is not under control in our region since 21% of cases presented the active form of the disease. Compulsory notification proved to be a valuable resource for the epidemiologic study of cysticercosis, also permitting the mapping of more affected areas for a better direction of prevention strategies.     

Primary hybrid total hip arthroplasty: an interim followup

The senior authors' initial experience with primary hybrid hip replacement in patients with osteoarthritis was studied to evaluate the efficacy of the procedure. Hybrid total hip arthroplasty (uncemented Harris-Galante acetabular component and cemented Iowa precoated femoral component) was performed in 131 consecutive, nonselected hips in 118 patients with the diagnosis of primary osteoarthritis. Followup was performed at 8 to 9 years after the procedure. The average age at the time of the procedure was 68 years (range, 45-87 years). There were 50 men (55 hips) and 68 women (76 hips). At final followup 19 patients (22 hips) had died. The femoral component had been revised for aseptic loosening in 8 hips (6.1%). One additional hip showed definite radiographic loosening. Hence, the prevalence of radiographic femoral failure was 6.9% (9 hips). No acetabular component had been revised for aseptic loosening and no acetabular component had migrated. The senior author continues to perform hybrid total hip arthroplasty in all patients with primary osteoarthritis. However, design modifications have been made in the femoral component that is used.