The use of controlled-release oxycodone for the treatment of chronic cancer pain: a randomized, double-blind study

1. We have studied the effects of muscarinic cholinoceptor agonists and subtype-preferring antagonists on the isometric contraction of smooth muscle strips from dog prostate. 2. Acetylcholine and carbachol induced contraction of prostate strips from the peripheral zone, ('the capsule'). Bethanechol contracted the tissue but not at lower doses. McN-A-343 and oxotremorine-M showed the same effects. 3. Blocking alpha- and beta-adrenoceptors with phentolamine and propranolol, respectively, did not modify carbachol-induced contractions. 4. The nicotinic receptor blocker, hexamethonium (10(-6)-10(-4) M) did not affect the contractile response evoked by a single dose of carbachol (10(-5) M), whilst the muscarinic receptor antagonist, atropine (10(-11)-10(-9) M), inhibited it in a competitive manner. 5. The muscarinic M1 (pirenzepine), M2 [AF-DX 116, himbacine (M2/M4) and methoctramine], M3 (HHSID and f-F-HHSID), and putative M4 (tropicamide) antagonists reduced significantly the carbachol-induced contractions. The pIC50 values were: atropine (10.01) > himbacine (8.3) > methoctramine (7.85) > AF-DX 116 (7.60) > HHSID (7.21) > p-F-HHSID (7.10) > pirenzepine (7.30) > tropicamide (7.00). 6. The antagonist profile indicates that an predominant M2 receptor subtype could mediate the muscarinic contraction in the canine prostate.     

Intracranial hemorrhage associated with idiopathic thrombocytopenic purpura: report of seven patients and a meta-analysis

We present the results of a meta-analysis using clinical data obtained from seven of our patients and 24 previously reported patients with idiopathic thrombocytopenic purpura complicated by intracranial hemorrhage. Twenty-four had an intracerebral hemorrhage (ICH) and seven had a subdural hematoma (SDH). Mean age of the patients with ICH was significantly younger than those with SDH. The mortality rate of ICH associated with ITP was similar to that of spontaneous ICH. All seven patients with SDH improved without sequelae.     

Differential expression and distribution of focal adhesion and cell adhesion molecules in rat hepatocyte differentiation

The present study has examined the distribution of axons of differing sizes in the optic pathway of the ground squirrel. Axon diameters were measured from electron micrographs at various locations across sections of the optic nerve and tract, and total distributions and numbers were estimated. In both the nerve and tract, roughly 1.2 million optic axons were present. The population of optic axons had a unimodal size distribution, peaking at 0.9 microm in diameter and having an extended tail toward larger diameters. Local axon diameter distributions in the optic tract indicated distinct (though partially overlapping) axon diameter classes, including one of fine sizes peaking at 0.8-0.9 microm, a second of medium sizes peaking around 1.7-1.8 microm, and a third composed of the larger fibers with diameters up to 4.8 microm. The fine-caliber axons were found at all locations in the tract, and were the only axons present immediately adjacent to the pia, while the medium- and coarse-caliber axons were found at deeper locations. Curiously, the larger axons were found primarily in the medial parts of the tract, where axons from the dorsal retina normally course. A similarly restricted distribution of the larger axons was observed in the dorsotemporal parts of the optic nerve, suggesting that this difference in the tract may relate to an asymmetric distribution of ganglion cells on the retina giving rise to these axons. Measurements of axonal size taken within the optic fiber layer in dorsal and ventral parts of the retina confirmed this asymmetry, consistent with previous demonstrations of soma size differences in the dorsal versus ventral retina. The partial segregation of axons by size in the optic tract of the ground squirrel then reflects both the asymmetric distribution of retinal ganglion cell classes and the chronotopic reordering of optic axons that occurs within the chiasmatic region.     

Efficient Implementation of the Fuzzy c-Means Clustering Algorithms

This paper reports the results of a numerical comparison of two versions of the fuzzy c-means (FCM) clustering algorithms. In particular, we propose and exemplify an approximate fuzzy c-means (AFCM) implementation based upon replacing the necessary ``exact' variates in the FCM equation with integer-valued or real-valued estimates. This approximation enables AFCM to exploit a lookup table approach for computing Euclidean distances and for exponentiation. The net effect of the proposed implementation is that CPU time during each iteration is reduced to approximately one sixth of the time required for a literal implementation of the algorithm, while apparently preserving the overall quality of terminal clusters produced. The two implementations are tested numerically on a nine-band digital image, and a pseudocode subroutine is given for the convenience of applications-oriented readers. Our results suggest that AFCM may be used to accelerate FCM processing whenever the feature space is comprised of tuples having a finite number of integer-valued coordinates.     

Solubility of Si3N4 in Liquid SiO2

The nitrogen solubility in the SiO₂-rich liquid in the metastable binary SiO₂-Si₃N₄ system has been determined by analytical TEM to be 1%–4% of N/(O + N) at 1973–2223 K. Analysis of the near edge structure of the electron energy loss peak indicates that nitrogen is incorporated into the silicate network rather than being present as molecular N₂. A regular solution model with a positive enthalpy of mixing for the liquid was used to match the data for the metastable solubility of N in the presence of crystalline Si₃N₄ and to adjust the computed phase diagram. The solubility of Si₃N₄ in fused SiO₂ is far less than reported in liquid silicates also containing Al, Mg, and/or Y. Apparently, these cations act as modifiers that break anion bridges in the silicate network and, thereby, allow further incorporation of Si₃N₄ without prohibitive amounts of network cross-linking. Finally, indications emerged regarding the diffuse nature of the Si₃N₄-SiO₂ interface that leads to amorphous regions of higher N content.     

High-Temperature Fracture Mechanism of Low-Ca-Doped Silicon Nitride

High-purity Si₃N₄ (with 2.5 wt% glassy SiO₂) doped with 0 to 450 at.ppm of Ca was prepared as a model system to investigate the effects of grain-boundary segregants on fracture phenomenology at 1400°C. Subcritical crack-growth (SCG) resistance as well as creep resistance was degraded significantly by the presence of a small amount of Ca. The internal friction of the doped materials exhibited the superposition of a grain-boundary relaxation peak and a high-temperature background, and the apparent viscosity of the grain-boundary film was determined from the peak. Based on these experimental data, the fracture mechanism at 1400°C was divided into three regions: "brittle," SCG, and creep failure as a function of both external strain rate and Ca concentration, C _Ca. From the investigation of the C _Ca dependence of the critical strain rate for the transition from "brittle" to SCG fractures, the SCG phenomenon is suggested to be triggered by small-scale, grain-boundary sliding. The C _Ca dependence of "steady-state" creep rate was far from the theoretical dependence of diffusional creep via a solution-precipitation mechanism. The discrepancy was interpreted to be due to the presence of an impurity-insensitive creep component. This component may correspond to the lowest limit of the tensile creep rate in Si₃N₄ polycrystalline materials containing intergranular glassy-SiO₂ film.     

Advanced oxidant reactivity pertaining to granular activated carbon beds for air pollution control

The Pennsylvania State University is researching an advanced oxidation system, which includes an air-phase photolytic chamber, an air/water stripping tower, and granular activated carbon (GAC) beds, for controlling volatile organic compounds (VOCs).A laboratory-scale experimental procedure has been employed that simulated certain aspects of several full-scale installations. The apparatus has been used to characterize the loading capacity and mass transfer zone of selected VOCs on coconut shell GAC. The GAC bed has then been placed in series with an ultraviolet reactor, which generates ozone and advanced oxidants in order to regenerate the loaded GAC at intensities of advanced oxidants that were higher than full-scale installations.VOC loading tests revealed that the adsorption of methyl isobutyl ketone (MIBK) was characterized by a well-defined mass transfer zone. Upon exposure to UV/O₃, desorption and/or destruction of the MIBK and other VOCs occurred most prominently within the first inch of the GAC bed. This correlated with the penetration of advanced oxidants into the GAC bed, which also occurred most significantly in the bed's first inch. However, the amount of oxidant penetration increased with time. The removal of oxidants from air by GAC was accompanied by a decrease in mass of the GAC. The ability of oxidants to penetrate a GAC bed was altered when the bed was loaded with a VOC.     

Statistical Analysis of the Intergranular Film Thickness in Silicon Nitride Ceramics

Silicon nitride materials typically reveal thin amorphous intergranular films along grain boundaries, with only the exception of special boundaries. It is known that such grainboundary films strongly affect the high-temperature properties of the bulk material. High-resolution electron microscopy (HREM) was used to study these amorphous films in different Si₃N₄ ceramics. The observed film thicknesses at grain boundaries in these materials varied between 5and 15 Å. It was shown that the grain-boundary film thickness strongly depends on film chemistry. Careful inspections of film-thickness measurements across grain boundaries in a given material suggest that the film widths vary on the order of 1 Å. Therefore, a quantitative evaluation should allow for the determination of the standard deviation of the film thickness. The amorphous film widths along grain boundaries in four materials were measured over the entire length (up to 1 μm) of the grain boundary between two triple points. Forty to fifty data points were evaluated for each boundary, giving a Gaussian-like distribution of the film thickness around a median value, which corresponded well with the film width measured from single HREM micrographs. The accuracy achieved by the statistical method was better than ± 1 Å.     

Trace detection of krypton using laser-induced fluorescence

Highly sensitive detection of neutral Kr atoms was accomplished by the use of laser-induced fluorescence. In one experiment, Kr at 40 parts per 10(12) in He was detected at a signal-to-noise ratio of 500 by time-resolved fluorescence measurements. The Kr metastable 1s(5) level was populated by cascade after two-photon excitation to the 2p(6) level by the frequency-tripled output of a pulsed single-longitudinalmode dye laser. After a delay, when scattered laser light and cascade resonance fluorescence became negligible, trace quantities of Kr were detected by the use of a pulsed-laser pumping scheme. In a related experiment, (78)Kr/(86)Kr isotope ratios ranging from 1 to 0.1 were measured with a resonant isotopic depletion technique first proposed by Makarov [Sov. J. Quantum Electron. 13, 722 (1983)]. The (86)Kr metastable population was selectively depleted by optical pumping to a higher-lying state that relaxed to the ground state by means of radiative cascade. After the (78)Kr/(86)Kr ratio of metastables had been enriched by a factor of 10, the (78)Kr population was probed by pulsed excitation. Premixed (78)Kr/(86)Kr ratios were measured to within an accuracy of 10%, even for unresolved, Doppler-broadened transitions.     

Tennessee's failed managed care program for mental health and substance abuse services

In July 1996, Tennessee initiated a managed mental health and substance abuse program called TennCare Partners. This publicly funded "carve-out" experiment started chaotically and soon deteriorated into a crisis. Many patients did not receive care or lost continuity of care, and the traditional "safety net" mental health system nearly disintegrated. This qualitative case study sought to ascertain the impact of the TennCare Partners program. It points out that the program's difficulties stemmed directly from a flawed design that spread funds previously earmarked for severely mentally ill patients across the entire Medicaid population. States contemplating similar reforms should strive to protect vulnerable patients by risk-adjusting capitation payments and by focusing resources on care for severely mentally ill persons. States should also minimize program complexity and ensure the accountability of managed care networks for their patients' behavioral health care needs.