Use of a modified non-rebreathing mask during upper intestinal endoscopy

BACKGROUND AND STUDY AIMS: Recently, attention has been drawn to the significant occurrence of respiratory and other complications during upper intestinal endoscopy. This prospective study was designed to compare the incidence and severity of oxygen desaturation when two different methods of oxygen delivery were used during elective oesophagogastroduodenoscopy. PATIENTS AND METHODS: After local medical ethics committee approval and written informed consent, one hundred patients undergoing elective oesophagogastroduodenoscopy were randomly allocated to receive supplemental oxygen at either four litres per minute via nasal specular or ten litres per minute through a specially modified non-rebreathing mask. Oxygen saturations during endoscopy facilitated by midazolam sedation were recorded, and non-parametric tests were used to compare the oxygen saturations in the two groups. RESULTS: The mean oxygen saturations were significantly better during the procedure for American Society of Anesthesiology (ASA) grade 2 and 3 patients who received oxygen with the modified mask than for those who received oxygen via nasal specular (98.6% vs. 97.0%, P = 0.004 for ASA grade 2 and 98.4% vs. 95.5, P = 0.006 for ASA grade 3). CONCLUSIONS: For ASA grade 2 and 3 patients, the modified non-rebreathing mask significantly improves oxygen saturations during upper intestinal endoscopy. This technique should be more widely used for patients at moderate and high risk.     

Efficacy of surgical treatment in traumatic central cord syndrome

BACKGROUND: Controversy surrounds the treatment of traumatic central cord syndrome (TCCS), as there are strong advocates for nonsurgical treatment for most patients. However, conservative treatment has been shown to yield a longer period of discomfort from pain and weakness in certain cases. METHODS: In a retrospective review of 114 patients presenting with acute or chronic TCCS from 1988-94, four different age groups were separately observed under different treatments. Motor and sensory recovery were assessed. RESULTS: Better results were achieved in younger patients, with or without radiographic abnormalities, and in patients with clinically correlated encroaching cord lesions who received early surgical decompression. CONCLUSIONS: Surgical intervention for TCCS must be addressed with careful clinical and radiographic survey. Removal of offending lesions in the subacute period results in significant motor and sensory improvement in short-term and long-term follow-up.     

Memory complaints in epilepsy: correlations with cognitive performance and neuroticism

Experimental results are presented to show that the adhesion force is the single most important limiting factor in high-resolution atomic force microscopy of DNA in air, prepared by the cytochrome-C-assisted spreading method. It is also shown that humidity plays a minor role in the control of probe force. Using a pure carbon film as the substrate to clean the AFM tip prior to imaging, it is demonstrated that 4-6 nm resolution on DNA can be routinely obtained by the atomic force microscope with commercial Si3N4 pyramid cantilevers. We also show that in organic solvents a resolution of up to 3 nm can be obtained under optimal conditions.     

Cyromazine toxicity in different laboratory strains of the tobacco hornworm (Lepidoptera:Sphingidae)

Three different strains of tobacco hornworm, Manduca sexta (L.), were treated with cyromazine ingestion of cyromazine-treated artificial diet or by intrahemocoelic injection. The effect of cyromazine on larval growth and the onset and severity of poisoning symptoms were similar in the wild-type green-pigmented strain and the white-pigmented mutant. Feeding times of 4 h or greater and injected doses of 22.6 micrograms/g larva or more resulted in lower weight gains than were observed with controls. Elongation caused by exposure was evident within 12-24 h. The incidence of cuticular rupture was 55 and 67% in the dietary exposure tests and 24 and 22% in the injection tests for the green and white strains, respectively. The response of the black strain to cyromazine differed by the route of administration. Like the other strains, dietary exposure times of 4 h or greater led to smaller weight gains than in the controls. Injected doses of 2.8 micrograms/g larva or more caused a decrease in the weight gain of the treated versus controls. A smaller proportion (21%) of black larvae consuming treated diet developed cuticular ruptures, whereas injected treatments had a higher incidence (87%). The differences in the pigmentation of the white and black strains had been linked to high and low juvenile hormone titers, respectively. The greater susceptibility of the juvenile hormone-deficient black strain raises the possibility that the mode of action of cyromazine involves a hormonal component. In a separate series of experiments, the poisoning symptoms of cyromazine were attenuated or eliminated by periods of starvation of 1-3 d following exposure to the chemical. Starvation for 3 d preceding treatment attenuated but did not eliminate signs of poisoning.     

Determination of intraparticulate mass transfer coefficients via permeation measurements: theory and experimental validation

A mathematical model of mass transfer through a heterogeneous, multiphase barrier has been developed where the dispersed phase is capable of uptake of the diffusant according to a linear relationship. The model was used to describe the penetration of drugs through dispersions of permeable globules in media of known diffusional properties. Water-in-oil-in-water (W/O/W) multiple emulsions have been studied by this method. When used to analyze data obtained with a simple diffusion cell, the model allows the calculation of the mass transfer coefficient which characterizes the diffusional mass transfer across oil-water interfaces within the emulsions. The mass transfer coefficient is directly related to the drug release rate from the internal phases of multiple emulsions. Those cases where instantaneous equilibria are established or where impermeable globules are present can be treated as special limiting cases. Differential equations which express diffusant concentrations as functions of time, space, and dispersion system parameters have been solved by Laplace transformation without recourse to numerical methods. The values of the mass transfer coefficient are shown to reflect the physical characteristics of multiple emulsion systems.     

A 4-MB on-chip L2 cache for a 90-nm 1.6-GHz 64-bit microprocessor

A 4-MB L2 data cache was implemented for a 64-bit 1.6-GHz SPARC(r) RISC microprocessor. Static sense amplifiers were used in the SRAM arrays and for global data repeaters, resulting in robust and flexible timing operation. Elimination of the global clock grid over the SRAM array saves power, enabled by combining the clock information with array select signals. Redundancy was implemented flexibly, with shift circuits outside the main data array for area efficiency. The chip integrates 315 million transistors and uses an 8-metal-layer 90-nm CMOS process.     

Analysing inaccurate artifact usages in workflow specifications

Although many workflow models have been proposed, analyses on artifacts are seldom discussed. A workflow application with well structured and adequate resources may still fail or yield unexpected results in execution due to inaccurate artifact manipulation, for example, inconsistency between data flow and control flow, or contradictions between artifact operations. Thus, artifact analysis is very important since activities cannot be executed properly without accurate information. This paper presents a three-layer workflow model for designing a workflow and characterises the behaviour of an artifact by its state transition diagram. By abstracting common usages of artifacts, six types of inaccurate artifact usage affecting workflow execution are identified and a set of algorithms to detect these inaccurate usages in workflow specifications is presented. An example is demonstrated and then related works are compared.     

A 4.5-GHz 130-nm 32-KB L0 cache with a leakage-tolerant self reverse-bias bitline scheme

This paper describes a 32-KB two-read, one-write ported L0 cache for 4.5-GHz operation in 1.2-V 130-nm dual-V/sub TH/ CMOS technology. The local bitline uses a leakage-tolerant self reverse-bias (SRB) scheme with nMOS source-follower pullup access transistors, while preserving robust full-swing operation. Gate-source underdrive of -220 mV on the bitline read-select transistors is established without external bias voltages or gate-oxide overstress. Device-level measurements in the 130-nm technology show 72/spl times/ bitline active leakage reduction, enabling low-V/sub TH/ usage, 40% bitline keeper downsizing, and 16 bitcells/bitline. 11% faster read delay and 2/spl times/ higher dc noise robustness are achieved compared with high-performance dual-V/sub TH/ bitline scheme. Sustained performance and robustness benefits of the SRB technique against conventional dynamic bitline with scaling to 100- and 70-nm technology is also presented.     

Two schemes for detecting CMOS analog faults

A design-for-testability scheme for detecting CMOS analog faults was reported by Favalli et al. (see ibid., vol.25, no.5, p.1239-46, 1990). The authors propose two alternative designs, one for small circuits and another for large circuits, which require significantly less area overhead (about 1/4 to 1/3) than that of Favalli's design. With the proposed modification in the first design, the untestable problem, which occurred in Favalli's design, can be alleviated. Furthermore, the proposed schemes are also fit to be implemented in VLSI circuits