Air embolism following removal of hemodialysis catheter

Introduction: Air embolism (AE) is a rare, but serious complication that can occur in the practice of hemodialysis. In contrast to careful techniques and meticulous care during insertions and manipulations of the central catheters, awareness of the risk of AE following catheter removal is less. We aimed to analyze the clinical characteristics of the all case reports with AE after catheter removal and summarize the mechanisms, clinical consequences, treatment and prevention of AE. Methods: In addition to our case, MEDLINE database was searched for all case reports with AE following catheter removal, and the clinical, diagnostic and outcome data were analyzed. Findings: A total of 10 patients (including our case) (M/F 6/4; median age 50.5 years) were found for the analysis. Procedures for prevention of AE were reported in a few patients (Trendelenburg position 2, airtight dressing 1). The time that elapsed between catheter removals and onset of AEs was ranged from seconds to 6 hours. The most common findings were dyspnea (90%), hypoxemia (70%), and cerebral dysfunction (70%). The most common sites where air could be detected were the left ventricle (40%), pulmonary artery (30%) and right ventricle (30%). Mortality was reported in 4 (40%) cases and the remaining 6 patients had complete recovery. Blocking of air portal was not reported in any of the fatal cases. Discussion: AE following catheter removal carries a major risk of mortality. Great awareness and attention to preventive procedures and appropriate care after development of AE seem mandatory.     

Porous rubber cryogels: effect of the gel preparation temperature

This paper examines the effect of the gel preparation temperature (T _prep) on the physical properties of the rubber-based macroporous organogels prepared by solution crosslinking in benzene at subzero temperatures. Cis-polybutadiene (CBR) and styrene-butadiene rubber (SBR) were used as the rubber components, while sulfur monochloride (S₂Cl₂) was the crosslinker in the gel preparation. It was shown that T _prep is an extremely important parameter to adjust the porous structure and thus, the cryogel properties. The networks formed by CBR and SBR showed an aligned porous structure with an exception of honey-comb structured porous SBR cryogels prepared at ?2 °C. 10¹- to 10²-μm sized regular pores of the networks caused by the benzene crystals act as a template during gelation, separated by 10–20 μm pore walls in thickness. They exhibit fast swelling and deswelling properties as well as reversible swelling–deswelling cycles in toluene and methanol, respectively. The ability of the organogels for the removal of petroleum products from aqueous solutions was also demonstrated using diesel and crude oil as model pollutants. In addition, the reusability of the organogels and their continuous sorption capacities were checked by repeated sorption–squeezing cycles. All the tests showed that the aligned porous organogels are suitable materials for the oil spill cleanup procedures.     

Intersymbol interference cancellation in CDMA 1xEVDO network

This paper presents the BER performance of the physical layer of the code division multiple access 1x Evolution Data Only (EVDO) standard for different data transmission formats, and shows the improvement on the BER performance of the EVDO system over intersymbol interference channel by adapting the low complexity turbo equalization scheme at the receiver. The radio frequency, channel condition, and mobile user data speeds were extracted from a mobile user with a drive experiment on a live wireless EVDO network. Then, the real data were utilized to simulate the actual mobile user's data speeds in our simulations to show the overall BER performance of the EVDO system application. The simulation results are shown over Gaussian and Proakis A channels and the results indicate that significant intersymbol interference cancellation is obtained with an adapted code division multiple access system and the advantages of turbo equalization on the EVDO system are discussed in this research. Copyright © 2012 John Wiley & Sons, Ltd.     

Anaerobic granular reactors for the treatment of dairy wastewater: A review

Considerable research has been conducted on the treatment of dairy wastewater by anaerobic granular reactors. Upflow anaerobic sludge blanket (UASB) reactors, anaerobic sequencing batch reactors (ASBR) and static granular bed reactors (SGBR) are the conventional granular reactor types most commonly applied in dairy wastewater treatment. Hybrid systems have also been developed to increase treatment efficiency and overcome the operational problems associated with the treatment of this substrate. Effects of parameters including temperature, organic loading and operating protocols on the performance of granular reactors are summarised. Individual and hybrid granular reactors are evaluated based on organic matter removal and methane production capacity.     

Differential contributions of BRCA1 and BRCA2 to early-onset breast cancer

BACKGROUND: Germ-line mutations in the BRCA1 and BRCA2 genes predispose women to breast cancer. BRCA1 mutations are found in approximately 12 percent of women with breast cancer of early onset, and the specific mutation causing a deletion of adenine and guanine (185delAG), which is present in 1 percent of the Ashkenazi Jewish population, contributes to 21 percent of breast cancers among young Jewish women. The contribution of BRCA2 mutations to breast cancer of early onset is unknown. METHODS: Lymphocyte specimens from 73 women with breast cancer diagnosed by the age of 32 were studied for heterozygous mutations of BRCA2 by a complementary-DNA-based protein-truncation assay, followed by automated nucleotide sequencing. In addition, specimens from 39 Jewish women with breast cancer diagnosed by the age of 40 were tested for specific mutations by an allele-specific polymerase chain reaction. RESULTS: Definite BRCA2 mutations were found in 2 of the 73 women with early-onset breast cancer (2.7 percent; 95 percent confidence interval, 0.4 to 9.6 percent), suggesting that BRCA2 is associated with fewer cases than BRCA1 (P=0.03). The specific BRCA2 mutation causing a deletion of thymine (6174delT), which is found in 1.3 percent of the Ashkenazi Jewish population, was observed in 1 of the 39 young Jewish women with breast cancer (2.6 percent; 95 percent confidence interval, 0.09 to 13.5 percent), indicating that it has a small role as a risk factor for early-onset breast cancer. Among young women with breast cancer, there are BRCA2 mutations that cause truncation of the extreme C terminus of the protein and that may be functionally silent, along with definite truncating mutations. CONCLUSIONS: Germ-line mutations in BRCA2 contribute to fewer cases of breast cancer among young women than do mutations in BRCA1. Carriers of BRCA2 mutations may have a smaller increase in the risk of early-onset breast cancer.     

Occurrence of aflatoxins in layer feed and corn samples in Konya province, Turkey

The natural occurrence ofaflatoxin was investigated in layer feed and corn samples brought to Konya Veterinary Control and Research Institute Laboratory between 15 April and 15 December 2002. Seventy-eight samples (52 feeds, 26 corn samples) were analysed for total aflatoxin (B₁ + B₂ + G₁ + G₂) by an ELISA screening method. Aflatoxin contamination was determined in 37 feed samples (71.1%) and 15 corn samples (57.7%), with a range of1.5-133 μg kg^-1. However, a majority ofthe aflatoxin contamination was less than 5 μg kg^-1 (50% within the positive samples). Two feed samples and two corn samples exceeded the maximum tolerated levels in feed (20 μg kg^-1) and feedstuffs (50 μg kg^-1) for total flatoxin.     

Modeling of Kinetic Expressions for the Reduction of NOx by Hydrogen in Oxygen‐Rich Exhausts Using a Gradient‐Free Loop Reactor

The reduction of NO_x by hydrogen under lean conditions is investigated in a gradient‐free loop reactor. Using this computer‐controlled reactor, the reaction rates can be measured under exact isothermal conditions. Systematic variation of the input concentrations of hydrogen, nitric oxide, oxygen as well as reaction temperature provides a complete data set of reaction rates for the given reaction system. A number of kinetic rate expressions were evaluated for their ability to fit the experimental data by using toolboxes of MATLAB. The temperature influence on reaction rate constants and adsorption equilibrium constants were correlated simultaneously using Arrhenius and van’t Hoff equations, respectively. The kinetic rate expression based on a Langmuir‐Hinshelwood‐type model describes the data and the model can be improved by introducing a correction term in square root of hydrogen partial pressure over the range of conditions investigated.     

Attentional factors in response time variability after traumatic brain injury: an ERP study

The activities of 21 enzymes (belonging to four classes of enzymes) involved in different metabolic pathways were assayed in blood sera of healthy young and adult/elderly groups of humans, rats and pigs, to determine whether activity changes coinciding with changes in age and aging could be detected. In all three species analysed, measurable activities (performed by highly specific and sensitive techniques, generally spectrofluorimetric procedures) were found, usually following a decreasing order of: among glycosidases, beta-N-acetylglucosaminidase (NAG) > alpha-L-fucosidase > alpha-mannosidase > beta-glucuronidase > beta-galactosidase > alpha-galactosidase. In addition, among esterases very high values were found for arylesterase and acid phosphatase. By contrast, no measurable activity was found for the remaining enzymes assayed (8 hydrolases, 1 oxidoreductase, 3 transferases and 1 lyase). In the elderly group of humans, significantly higher activities (P < or = 0.05) were found for NAG, alpha-mannosidase and beta-glucuronidase in comparison to the adult and young groups. However, several activities in rats and all activities in pigs decreased with age. In conclusion, differences in the activities of 6 lysosomal glycosidases and 2 esterases (but no significant differences for another 13 enzymes belonging to several enzyme classes) are found in the sera of healthy humans, rats and pigs. These differences coincide with changes observed in aging.     

Gyrase mutations in laboratory-selected, fluoroquinolone-resistant mutants of Mycobacterium tuberculosis H37Ra

To characterize mechanisms of resistance to fluoroquinolones by Mycobacterium tuberculosis, mutants of strain H37Ra were selected in vitro with ofloxacin. Their quinolone resistance-determining regions for gyrA and gyrB were amplified and sequenced to identify mutations in gyrase A or B. Three types of mutants were obtained: (i) one mutant (TKp1) had no mutations in gyrA or gyrB; (ii) mutants that had single missense mutations in gyrA, and (iii) mutants that had two missense mutations resulting in either two altered gyrase A residues or an altered residue in both gyrases A and B. The TKp1 mutant had slightly reduced levels of uptake of [14C]norfloxacin, which was associated with two- to fourfold increases in the MICs of ofloxacin, ciprofloxacin, and sparfloxacin. Gyrase mutations caused a much greater increase in the MICs of fluoroquinolones. For mutants with single gyrA mutations, the increases in the MICs were 4- to 16-fold, and for mutants with double gyrase mutations, the MICs were increased 32-fold or more compared with those for the parent. A gyrA mutation in TKp1 secondary mutants was associated with 32- to 128-fold increases in the MICs of ofloxacin and ciprofloxacin compared with the MICs for H37Ra and an eight-fold increase in the MIC of sparfloxacin. Sparfloxacin was the most active fluoroquinolone tested. No sparfloxacin-resistant single-step mutants were selected at concentrations of > 2.5 micrograms/ml, and high-level resistance (i.e., MIC, > and = 5 micrograms/ml) was associated with two gyrase mutations. Mutations in gyrB and possibly altered levels of intracellular accumulation of drug are two additional mechanisms that may be used by M. tuberculosis in the development of fluoroquinolone resistance. Because sparfloxacin is more active in vitro and selection of resistance appears to be less likely to occur, it may have important advantage over ofloxacin or ciprofloxacin for the treatment of tuberculosis.