Infections in patients with cystic fibrosis following lung transplantation

BACKGROUND: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation. METHODS: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center. RESULTS: As of May 1996, 21 patients with CF underwent bilateral lung transplantation. The first patient died within 24 h of transplantation from sepsis due to Stenotrophomonas maltophilia. Of the remaining 20 patients, 17 (85%) are alive and in stable condition. The three deaths were related primarily to bronchiolitis obliterans at 4 and 18 months in two patients and to cytomegalovirus pneumonitis at 5 months in the other patient. The 17 surviving patients have been followed up for a mean of 13 months (range, 0.5 to 34 months). Most of them were colonized and infected with multidrug-resistant organisms before transplantation. Following transplantation, 11 patients had complications from infections. One patient had bacteremia due to a panresistant Burkholderia cepacia and was treated successfully. Two patients had bacteremia and wound infection due to Burkholderia gladioli, previously thought to be pathogenic only in plants. Both patients were treated successfully. Of the six patients with Aspergillus fumigatus isolated from cultures before transplantation, only one had invasive disease following transplantation and responded to treatment. CONCLUSION: The organisms present before transplantation were not the primary cause of mortality in our patient population. Our findings suggest that lung transplantation should be considered in CF patients infected with multidrug-resistant organisms.     

Mentoring relationships of New Zealand nurses: an empirical study (Part 1)

A national, random, postal survey (n = 298) of mentoring behaviour among New Zealand nurses was undertaken. The initial research problem was to seek an explanation for the apparent lack of mentoring in New Zealand nursing. However, as the study evolved the lack of agreement concerning the definition of mentoring became a major research obstacle. A new conceptual framework of mentoring grounded in the work of Kathy Kram (1985) was devised. A quantitative global measure of mentoring behaviour (the TMS score) was used to measure levels of mentoring behaviour. This score was used as the dependent variable in subsequent statistical tests of: the definitional hypothesis-the study's validity check; the peer mentoring hypothesis which explored selected dynamics of mentor protégé relationships, and four allied research questions. The conceptual framework and approach are discussed in part one.     

Strength of synaptic transmission at neuromuscular junctions of crustaceans and insects in relation to calcium entry

Crustacean and insect neuromuscular junctions typically include numerous small synapses, each of which usually contains one or more active zones, which possess voltage-sensitive calcium channels and are specialized for release of synaptic vesicles. Strength of transmission (the number of quantal units released per synapse by a nerve impulse) varies greatly among different endings of individual neurons, and from one neuron to another. Ultrastructural features of synapses account for some of the physiological differences at endings of individual neurons. The nerve terminals that release more neurotransmitter per impulse have a higher incidence of synapses with more than one active zone, and this is correlated with more calcium build-up during stimulation. However, comparison of synaptic structure in neurons with different physiological phenotypes indicates no major differences in structure that could account for their different levels of neurotransmitter release per impulse, and release per synapse differs among neurons despite similar calcium build-up in their terminals during stimulation. The evidence indicates differences in calcium sensitivity of the release process among neurons as an aspect of physiological specialization.     

Frequency offset retrodirective antenna array

A new architecture for the Van Atta self-steering array is presented. Active antenna techniques are used to realise a compact self-steering array with enhanced retrodirective properties. The experimental performance of the array is demonstrated and a technique is described which compensates for the beam pointing error induced by antenna array element directivity     

A series active power filter based on a sinusoidalcurrent-controlled voltage-source inverter

A series active power filter working as a sinusoidal current source, in-phase with the mains voltage, has been developed and tested. The amplitude of the fundamental current in the series filter is controlled through the error signal generated between the load voltage and a pre-established reference. The control allows an effective correction of power factor, harmonic distortion and load voltage regulation. Compared with previous methods of control developed for series active filters, this method is simpler to implement because it is only required to generate a sinusoidal current, in-phase with the mains voltage, the amplitude of which is controlled through the error in the load voltage. The proposed system has been studied analytically and tested using computer simulations and experiments. In the experiments, it has been verified that the filter keeps the line current almost sinusoidal and in-phase with the line voltage supply. It also responds very quickly under sudden changes in load conditions, reaching its steady-state in about two cycles of the fundamental     

Evolution of grain structure in thin film reactions

In this paper, we examine, both experimentally and theoretically, the kinetics of formation and microstructure of product phases in thin film reactions, using the Nb/Al and Ti/Al systems as our prototypes. The results of calorimetry and microscopy studies are interpreted using simple kinetic and morphology models. In particular, the kinetic models employed here focus on the nucleation and growth components of the phase formation process and the morphology models provide a starting point for the classification of product grain structures. An erratum to this article is available at .     

Monte Carlo simulations of homogeneous upconversion in erbium-dopedsilica glasses

Quenching of Er³⁺ ions by homogeneous energy-transfer upconversion in high-concentration erbium-doped silica glasses has been theoretically investigated, The results indicate that at Er³⁺ concentrations of 1.0-2.0·10²⁶ m^-3 or below, the kinetic limit of strong migration is not reached, and hence the widely accepted quadratic upconversion model is not generally valid. Nevertheless, the results offer an explanation of the experimental observations of quadratic upconversion. Furthermore, it has been shown that at a given population inversion, the quenching rate depends on the rate of exchange of the excited Er³⁺ ions by emission and absorption     

Finite-difference time-domain analysis and experimental examinationof the performance of a coupled-cavity MQW laser/active waveguide at1.54 μm

The performance characteristics of a coupled cavity InGaAsP-InP MQW laser/active waveguide made by one-step epitaxy and well-controlled reactive ion etching (RIE) have been theoretically analyzed and experimentally determined. A theoretical model based on a finite-difference time-domain (FDTD) technique was used to simulate the propagation of an optical wave launched in the coupled system and determine the reflectivity of the facets created by RIE. The calculated effective reflectivity of the coupling region consisting of two facets and an air gap is between 0.45 and 0.55, which is in good agreement with the experimentally measured value of 0.5. The reflectivity of a single etched mirror derived from this value is estimated to be 0.3. A 120-μm-long monolithically integrated active waveguide when biased as a modulator and excited by the laser shows a maximum extinction ratio of 8 dB and a modulation bandwidth ⩾14 GHz at a dc bias of -0.5 V with a bias swing of 2 V