Enterococcal bacteremia in a medical center

BACKGROUND: The enterococci have become important nosocomial pathogens. They can cause multiple site infections and enterococcal bacteremia becomes more frequently associated with a high mortality rate. Previous studies of enterococcal bacteremia showed a variety of results. To establish the significance and importance of enterococci as nosocomial pathogens in this hospital, to characterize their clinical pictures and to search for the risk factors for mortality, this retrospective study was performed. METHODS: There were 208 cases of enterococcal bacteremia which occurred from 1988 to 1992. Twenty-seven cases had no medical charts, dismissing possibility of evaluation. Finally, 181 cases of enterococcal bacteremia were analysed. RESULTS: One hundred and eighteen episodes were nosocomial infections. Polymicrobial bacteremia occurred in 68.5% of the patients and the most common co-isolate was Pseudomonas aeruginosa. Those patients (78.5%) with underlying diseases and malignancies were the most common underlying problems. The portal of entry could be found in 69.6 percent of patients, with the gastrointestinal tract the most common sources. Antimicrobial susceptibility testing showed high gentamicin resistance rate (89.5%), and ampicillin still had about 80 percent sensitivity rate. The group who received specific antibiotic therapy for enterococcus showed lower mortality (36.4% versus 47.6%). Only one case had infective endocarditis. Forty-nine patients suffered from septic shock, the cause of 30 deaths. Totally 75 patients died during hospitalization. Besides sepsis, another major cause of death was their underlying diseases itself. CONCLUSIONS: Enterococci have no doubt become important nosocomial pathogens and enterococcal bacteremia were associated with high mortality, especially in elderly patients with underlying diseases such as malignancy or diabetes. When clinically dealing with sepsis from the gastrointestinal or biliary tract, especially when previous cephalosporins therapy showed no response, the possibility of enterococcal bacteremia should always be considered.     

An improved Gaussian approximation for probability of bit-erroranalysis of asynchronous bandlimited DS-CDMA systems with BPSK spreading

This paper analyzes probability of bit-error (P_e) performance of asynchronous bandlimited direct-sequence code-division multiple-access systems with binary phase-shift keying spreading. The two present methods of P_e analysis under bandwidth-efficient pulse shaping: the often-cited standard Gaussian approximation and the characteristic function (CF) method suffer from either a low accuracy in regions of low P_e (< 10^-3) or a prohibitively large computational complexity. The paper presents an alternate method of P_e analysis with moderate computational complexity and high accuracy based on a key observation. A sequence of chip decision statistics (whose sum yields a bit statistic) forms a stationary, m-dependent sequence when conditioned on the chip delay and phase offset of each interfering signal. This observation permits the generalization of the improved Gaussian approximation previously derived for the rectangular pulse and the derivation of a numerically efficient approximation based on the CF method. Numerical examples of systems using the square-root raised-cosine and IS-95 pulses illustrate THE P _e performance, user capacity and the accuracy of the proposed method     

Poly(butylene terephthalate)–clay nanocomposites prepared by melt intercalation: morphology and thermomechanical properties

Nanocomposites based on poly(butylene terephthalate) (PBT) and an organoclay (Cloisite 30B) were prepared by melt blending using a twin‐screw extruder. Two kinds of PBTs, ie PBT‐A and PBT‐B, with different inherent viscosities (η_inh), were used for this study (η_inh of PBT‐A and PBT‐B were 0.74 and 1.48, respectively). Dispersion of the clay layers in the PBT nanocomposites was characterized by using X‐ray diffraction (XRD) and transmission electron microscopy (TEM). Tensile and dynamic mechanical properties and non‐isothermal crystallization temperatures of the nanocomposites were also examined. Nanocomposites based on the higher‐viscosity PBT (PBT‐B) showed a higher degree of exfoliation of the clay and a higher reinforcing effect when compared to the composites based on the lower‐viscosity PBT (PBT‐A). The clay nanolayers dispersed in PBT matrices lead to increases in the non‐isothermal crystallization temperatures of the PBTs, with such increases being more significant for the PBT‐B nanocomposites than for the PBT‐A nanoocomposites. Copyright © 2004 Society of Chemical Industry     

Holographic polymer‐dispersed liquid crystal fabrication under electric field

The transmission mode of holographic polymer‐dispersed liquid crystals (HPDLCs) was developed an under electric field. It is reported that orientation of LC molecules under an electric field induces orientation of oligomer molecules giving rise to low off‐state diffraction and small grating shrinkage. Copyright © 2005 Society of Chemical Industry     

Synthesis and characterization of an interpenetrating polymer network composed of poly(methacrylic acid) and poly(vinyl alcohol)

Temperature and pH‐responsive interpenetrating polymer network (IPN) hydrogels, constructed with poly(methacrylic acid) (PMAA) and poly(vinyl alcohol) (PVA), by a sequential IPN method, were studied. The characterization of IPN hydrogels was investigated by Fourier‐transform infrared spectroscopy, differential scanning calorimetry (DSC) and swelling under various conditions. The IPN hydrogels exhibited relatively high swelling ratios, in the range 230–380 %, at 25 °C. The swelling ratios of the PMAA/PVA IPN hydrogels were pH and temperature dependent. DSC was used for the quantitative determination of the amounts of freezing and non‐freezing water. The amount of free water increased with increasing PMAA content in the IPN hydrogels. Copyright © 2004 Society of Chemical Industry     

Effects of flux enhancing polymer on the characteristics of sludge in membrane bioreactor process.

A newly developed membrane performance enhancer (MPE) was used to prevent membrane fouling in a membrane bioreactor (MBR) process. It transpired that 1,000 mg/l of MPE reduced polysaccharide levels from 41 mg/I to 21 mg/I on average under the experimental condition. Repeated experiments also confirmed that 50-1,000 mg/l of MPE could reduce membrane fouling significantly and increase the intervals between membrane cleanings. Depending on MPE dosages and experimental conditions, trans-membrane pressure (TMP) increase was suppressed for 20-30 days, while baseline TMP surged within a few days. In addition, MPE allowed MBR operation even at 50,000 mg/l of total solid and reduced permeate COD. However, no evidence of toxicity for sludge was found from respiratory works.     

Production and structural features of a water-soluble polysaccharide from a mutant strain of Agrobacterium sp.

We have developed a mutant strain derived from Agrobacterium sp. ATCC 31750, which produces a water-soluble polysaccharide having potential utility to the food, feed, pharmaceutical and cosmetic industries. A high concentration of product (15 g/L) is obtained by 48 h cultivation of the mutant strain under optimized fermentation conditions. The water-soluble polysaccharide obtained from cultures of the mutant strain beta82 has Glc:Man:Gal in approximate molar ratios of 5.8:6.7:1.0. The molecular weight of the polysaccharide was determined to be approximately 1000 kDa by HPSEC analysis. Linkage analysis contained 3-Glcp, 3-Manp, terminal Glcp and terminal Manp, as well as a small proportion of 3- and 3,4-Galp, and 4,6-Manp residues. Based on analyses using FT-IR and ¹³C NMR spectrometers, most glycosidic bonds joining these sugar residues are of the α-type, and acetyl groups are apparently attached to the polymer chain at random.     

Dye adsorption characteristics of alginate/polyaspartate hydrogels

This study examined the removal of some basic dyes, such as Methylene Blue, Malachite Green and Methyl Orange, using alginate or alginate/polyaspartate composite gel beads. The adsorption of dyes from aqueous solutions at 25 °C was examined using a batch sorption technique. The effects of CaCl₂ and the dye concentration on the adsorption were examined. Type-S adsorption isotherms were obtained, which is characteristic of a weak solute–solid interaction. The ionic interaction between the dye molecule and gel matrix appears to be responsible for the efficient adsorption of cationic dyes in this system. These results suggest that an alginate/polyaspartate gel can be used as an effective sorbent for water pollutants such as dyes, and the immobilization of these organic contaminants in the hydrogels from wastewater can solve one of the most important environmental problems in the related industry.     

Prediction and quality control of the melt index during production of high-density polyethylene

In polyolefin processes the melt index (MI) is the most important control variable indicating product quality. Because of the difficulty in the on-line measurement of MI, a lot of MI estimation and correlation methods have been proposed. In this work a new dynamic MI estimation scheme is developed based on system identification techniques. The empirical MI estimation equation proposed in the present study is derived from the 1 ^st -order dynamic models. Effectiveness of the present estimation scheme was illustrated by numerical simulations based on plant operation data including grade change operations in high density polyethylene (HDPE) processes. From the comparisons with other estimation methods it was found that the proposed estimation scheme showed better performance in MI predictions. The virtual sensor model developed based on the estimation scheme was combined with the virtual on-line analyzer (VOA) to give a quality control system to be implemented in the actual HDPE plant. From the application of the present control system, significant reduction of transition time and the amount of off-spec during grade changes was achieved     

Preparation of multi-compositional gas sensing films by combinatorial solution deposition

Various compositions of gas sensing films were prepared by the combinatorial deposition of SnO₂, ZnO, and WO₃ sol solutions and their gas sensing behaviors were investigated. The film composition could be manipulated conveniently via the alternate dropping of different oxide sol solutions. From the correlation between film compositions and gas sensitivities, the selective detection of C₂H₅OH and CH₃COCH₃ in the presence of CO, C₃H₈, H₂, and NO₂ could be attained. In addition, the discrimination between C₂H₅OH and CH₃COCH₃, which is a challenging issue due to their similar chemical nature, becomes possible. This research demonstrates the precise design of the sensor-material composition for the selective gas detection via the combinatorial approach.