Ketamine as an adjunct to morphine in the treatment of pain

A double-blind multidose trial of the addition of ketamine (0-40 mg, i.m., 8 times per day) to intramuscular morphine therapy was undertaken in a 61-year-old man with chronic back pain related to osteoporosis who had received inadequate pain relief from anterior interbody fusion, dorsal column stimulation and morphine alone. The patient reported only mild side effects. Nausea, tiredness and well-being were not significantly influenced by the ketamine dose level. Visual analogue pain scores prior to each dose were not associated with the ketamine dose level, but pain scores 30 min after doses were significantly reduced in a dose-related manner. In addition, the amount of morphine used by the patient was significantly reduced as the ketamine dose increased. This patient experienced substantial benefit from the addition of ketamine to intramuscular morphine therapy.     

Effects of quasi-ballistic base transport on the high-frequencycharacteristics of bipolar transistors

High-frequency transport in bipolar transistors with quasi-ballistic base widths (on the order of a minority-carrier scattering length) is examined by using the approach of Grinberg and Luryi (1992) to solve the Boltzmann transport equation (BTE). By considering the phase angle of the dynamic distribution function in wave-vector space, it is shown that the ballistic mechanism of decay in the common-base current gain becomes important even for base widths in the quasi-ballistic regime. Simple expressions, which correctly yield both the magnitude and phase of all the forward characteristics, as predicted by the BTE, up to the intrinsic transit frequency, are found by combining the results from a one-flux approach with the well-known expressions of Thomas and Moll (1958). Expressions for the reverse small-signal parameters are also found by applying a “moving boundary condition” to the basic one-flux equations of Shockley (1962)     

Pressure drop and cavitation investigations on static helical-grooved square, triangular and curved cavity liquid labyrinth seals

Sodium cooled Fast Breeder Reactors (FBR) form the second stage of India's Nuclear power programme. Through a narrow annular space in the grid plate assembly of a prototype FBR, a very low leakage flow of liquid metal sodium should pass, experiencing a stipulated high pressure drop, and without much cavitation. To achieve this, a suitable labyrinth seal is required to be developed for use in the annulus. Water is employed as the model testing liquid which is estimated to experience a pressure drop ratio of 10.5 at the rated leakage flow. Previously studied circular or sinusoidal-grooved square, triangular or curved cavity labyrinth seals were unable to meet this value. In the present work, Computational Fluid Dynamics (CFD) analyses are carried out on Helical-grooved Square cavity Labyrinth Seals (HSLS), using commercial code Fluent. It is found that the geometrical configuration of the grooves plays a major role on the pressure drop. Experimental results reveal close agreement with CFD predictions. An optimal configuration of this square cavity seal is identified by applying genetic algorithm (GA) using commercial packages. It meets just about 24% of the targeted value. Later, using parametric CFD analyses, a Helical-grooved Triangular cavity Labyrinth Seal (HTLS) and different Helical-grooved Curved cavity Labyrinth Seals (HCLS) are analysed. The most favourable profile is tested and found to reach the required pressure drop. CFD cavitation analyses predict the intensity of cavitation in these seals to be below prohibitive levels.     

Gene expression in brain during cuprizone-induced demyelination and remyelination

When C57BL/6J mice, 8 weeks of age, received 0.2% Cuprizone in their diet, extensive demyelination in corpus callosum was detectable after 3 weeks, and there was massive demyelination by 4 weeks. As expected, the accumulation of phagocytically active microglia/macrophages correlated closely with demyelination. When Cuprizone was removed from the diet, remyelination was soon initiated; after 6 weeks of recovery, myelin levels were near-normal and phagocytic cells were no longer prominent. Steady-state levels of mRNA for myelin-associated glycoprotein, myelin basic protein, and ceramide galactosyltransferase were already profoundly depressed after 1 week of Cuprizone exposure and were only 10-20% of control values after 2 weeks. Unexpectedly, upregulation of mRNA for these myelin genes did not correlate with initiation of remyelination but rather with accumulation of microglia/macrophages. After 6 weeks of exposure to Cuprizone, mRNA levels were at control levels or higher-in the face of massive demyelination. This suggests that in addition to effecting myelin removal, microglia/macrophages may simultaneously push surviving oligodendroglia or their progenitors toward myelination.     

Linear phase cosine modulated maximally decimated filter banks withperfect reconstruction

We propose a novel way to design maximally decimated FIR cosine modulated filter banks, in which each analysis and synthesis filter has a linear phase. The system can be designed to have either the approximate reconstruction property (pseudo-QMF system) or perfect reconstruction property (PR system). In the PR case, the system is a paraunitary filter bank. As in earlier work on cosine modulated systems, all the analysis filters come from an FIR prototype filter. However, unlike in any of the previous designs, all but two of the analysis filters have a total bandwidth of 2π/M rather than π/M (where 2M is the number of channels in our notation). A simple interpretation is possible in terms of the complex (hypothetical) analytic signal corresponding to each bandpass subband. The coding gain of the new system is comparable with that of a traditional M-channel system (rather than a 2M-channel system). This is primarily because there are typically two bandpass filters with the same passband support. Correspondingly, the cost of the system (in terms of complexity of implementation) is also comparable with that of an M-channel system. We also demonstrate that very good attenuation characteristics can be obtained with the new system     

Nonepileptic posttraumatic seizures

BACKGROUND: The aim of this experimental study was to evaluate the risk of tumor recurrence after laparoscopic cecal resection (LCR) of colonic carcinoma in the rat. METHODS: The experimental cancer consisted of one million cells (DHK/K12), incorporated in an extracellular matrix, placed and secured to the cecal serosa in 110 BD9 rats. Four weeks later, all animals were reoperated through a laparotomy to control tumor growth, and animals with diffuse carcinomatosis were excluded. Eligible animals were randomized either to laparoscopic cecal resection (group LCR, n = 10), to open resection (group OCR, n = 13), or to a control group without resection (group C, n = 13). Resection was always considered as macrocopically complete. All animals were killed 4 weeks after the resection to determine the tumor recurrence and quantify carcinomatosis. RESULTS: We noted diffuse carcinomatosis in 70% of rats in groups C and LCR versus 23% in group OCR (p = 0.038). For tumors noted as S- (not extending outside the serosa), diffuse carcinomatosis was observed in all animals of group C (3 of 3), in 6 of 8 in group LCR, and 0 of 6 in group OCR (p = 0.004). The rate of port site or incisional metastases was not significantly different between groups. CONCLUSIONS: These preliminary results demonstrated the deleterious impact of the laparoscopy for resection of large bowel malignancy. LCR increased significantly the incidence of a diffuse carcinomatosis even when performed for locally noninvasive tumors (S-).     

An assay to measure antibiotic efficacy against Staphylococcus epidermidis biofilms on implant surfaces

Infection is a major limitation of implantable devices. Optimal antibiotic therapeutic regimes have not yet been defined. Implant-associated infections have a number of differentiating characteristics, which include the predominance of Staphylococcus epidermidis and other skin bacteria of normally low pathogenicity as the causative agents, together with a relative resistance to host defenses and to antibiotic therapy. These properties have been ascribed to the ability of the bacteria to exist on implant surfaces in the biofilm phase, which is protective. An assay of antibiotic activity using a standardized bacterial biofilm preparation of S. epidermidis is described. The assay is used to evaluate the relative efficacy of antibiotics to sterilize the biofilm, when they are used singly, or in double or triple combinations. The modulating effects of changing antibiotic concentrations and modifying the environment with CAPD variables (fresh and spent dialysis fluid, common PD solution additives) are also measured and the data summarized. It is hoped that, by using this and similar assays, individualized optimal therapeutic regimes of implant-associated infections may be logically planned.     

NaCl-preferring NZB/B1NJ mice and NaCl-avoiding CBA/J mice have similar amiloride inhibition of chorda tympani responses to NaCl

After intracameral injection calcitonin gene-related peptide has been demonstrated to break the blood aqueous barrier and increase intraocular pressure in rabbits. However in cats, calcitonin gene-related peptide decreases intraocular pressure by increasing the outflow facility of aqueous humor. In the present study, the effect of intracameral injection of calcitonin gene-related peptide on the outflow facility in rabbits has been investigated and the intraocular pressure and outflow facility were measured following intravitreal administration of calcitonin gene-related peptide. The results demonstrate that in spite of the apparent pseudofacility component caused by a breakdown of the blood aqueous barrier also the true trabecular outflow is probably increased in the rabbit eye after intracameral injection of calcitonin gene-related peptide. The intravitreal administration of calcitonin gene-related peptide leaves the blood aqueous barrier intact and causes an increase in the outflow facility of aqueous humor with a concomitant long-lasting decrease in intraocular pressure.     

Excimer laser angioplasty versus balloon angioplasty in functional and total coronary occlusions

Registries of excimer laser coronary angioplasty have reported good results in the treatment of complex coronary artery disease, including total or subtotal coronary occlusions. One hundred three patients (103 lesions) with a functional or total coronary occlusion were included in a randomized trial (Amsterdam-Rotterdam [AMRO] trial, total of 308 patients), 49 patients were allocated to laser angioplasty and 54 patients to balloon angioplasty. The primary clinical end points were death, myocardial infarction, coronary bypass surgery, or repeated coronary angioplasty of the randomized segment during a 6-month follow-up period. The primary angiographic end point was the minimal lumen diameter at follow-up in relation to the baseline value (net gain), as determined by an automated contour-detection algorithm. Laser angioplasty was followed by balloon angioplasty in all procedures. The angiographic success rate was 65% in patients treated with excimer laser-assisted balloon angioplasty compared with 61% in patients treated with balloon angioplasty alone. No deaths occurred. There were no significant differences between the laser angioplasty group and the balloon angioplasty group in the incidence of myocardial infarctions (1 patient vs 3, respectively, p = 0.36), coronary bypass surgery (4 patients vs 2, respectively, p = 0.34), repeat angioplasty (10 patients vs 8, respectively, p = 0.46) or primary clinical end point (15 patients vs 12, respectively, p = 0.34). The net gain in minimal lumen diameter and restenosis rate (>50% diameter stenosis at follow-up) were 0.81 +/- 0.74 mm and 66.7%, respectively, in patients treated with laser angioplasty compared with 1.04 +/- 0.68 mm and 48.5%, respectively, in patients treated with balloon angioplasty (p = 0.59 and p = 0.15, respectively). Excimer laser-assisted balloon angioplasty demonstrated no benefit over balloon angioplasty with respect to initial and long-term clinical and angiographic outcome in the treatment of patients with functional or total coronary occlusions of >10 mm in length.