Effects of gemfibrozil (Lopid) on hyperlipidemia in acitretin-treated patients. Results of a double-blind cross-over study

Retrospectively 78 patients with uni- or bilateral acute acoustic trauma (AAT) were evaluated to assess the therapeutic effect of hyperbaric oxygenation (HBO). All subjects received saline or dextran (Rheomacodrex) infusions with Ginkgo extracts (Tebonin) and prednisone. Thirty six patients underwent additional hyperbaric oxygenation at a pressure of 2 atmospheres absolute for 60 minutes once daily. Both treatment groups were comparable as far as age, gender, initial hearing loss and prednisone dose are concerned. The delay of therapy onset was 15 hours in both groups and treatment was started within 72 hours in all cases. Control audiometry was performed after 6.5 days, when the HBO group had had 5 exposures to hyperbaric oxygenation. The average hearing gain in the group without HBO was 74.3 dB and in the group treated additionally with HBO 121.3 dB (P < 0.004). It is concluded, that hyperbaric oxygenation significantly improves hearing recovery after AAT. Therefore acute acoustic trauma with significant hearing threshold depression remains an otological emergency. Minimal therapy involving waiting for spontaneous recovery, which is mostly incomplete leaving a residual C5 or C6 and handicapping tinnitus, is not the treatment of choice. Randomized prospective clinical trials with a larger patient series are needed and further experimental studies are required to understand the physiological mechanisms of HBO responsible for the clinical success in AAT.     

Non-quasi-static models including all injection levels and DC, AC,and transient emitter crowding in bipolar transistors

Two-dimensional equivalent-circuit models for bipolar junction transistors are systematically derived by solving the continuity equations for DC, AC, and transient excitations. These models take into account carrier propagation delay, all injection levels, as well as exponential doping profiles. They include analytically DC, AC, and transient emitter crowding in a more detailed and accurate manner than previously available. Extensions of the models to accommodate arbitrarily doped and heavily doped quasi-neutral layers and to include energy-gap narrowing due to the electron-hole plasma present at high current density are described. The analysis leads to compact large- and small-signal equivalent-circuit lumped models, suitable for use in circuit simulators such as SPICE. The analytical solutions obtained reveal the two-dimensional distribution of the current and carrier densities in the intrinsic base layer and the onset of emitter crowding. They also provide information for the extraction of the intrinsic base resistance. Several assumptions made in the derivations are assessed by the computer program PISCES. The methods presented apply to both homojunction and heterojunction bipolar transistors     

A case study on software risk analysis and planning in medical device development

Software failures in medical devices can lead to catastrophic situations. Therefore, it is crucial to handle software-related risks when developing medical devices, and there is a need for further analysis of how this type of risk management should be conducted. The objective of this paper is to collect and summarise experiences from conducting risk management with an organisation developing medical devices. Specific focus is put on the first steps of the risk management process, i.e. risk identification, risk analysis, and risk planning. The research is conducted as action research, with the aim of analysing and giving input to the organisation’s introduction of a software risk management process. First, the method was defined based on already available methods and then used. The defined method focuses on user risks, based on scenarios describing the expected use of the medical device in its target environment. During the use of the method, different stakeholders, including intended users, were involved. Results from the case study show that there are challenging problems in the risk management process with respect to definition of the system boundary and system context, the use of scenarios as input to the risk identification, estimation of detectability during risk analysis, and action proposals during risk planning. It can be concluded that the risk management method has potential to be used in the development organisation, although future research is needed with respect to, for example, context limitation and how to allow for flexible updates of the product.     

Intergroup biases and eyewitness testimony

The study examined how the in-group/out-group status of a perpetrator of a distinctly violent crime might influence an eyewitness's evaluation of his behavior and a witness's performance in an identification task. Immigrant and Swedish students saw a film showing a simulated robbery, with an immigrant or a Swede as the perpetrator. Results showed that both groups evaluated an ethnically dissimilar perpetrator as more culpable than an ethnically similar perpetrator. In a line-up task, both immigrant and Swedish participants mistakenly identified an innocent immigrant more often than an innocent Swede. Participants' biased evaluations of the perpetrator are discussed in terms of cognitive and motivational mechanisms. Expectations regarding the typical ethnicity of a perpetrator of this type of crime are suggested to account for the findings of the line-up task.     

Variations in lipid composition and sound velocity in melon from the North Atlantic pilot whale,Globicephala melaena melaena

Nonpolar lipids and sound velocity at different distances from the skin surface within a sample of pilot whale melon were studied. Thin layer chromatography, sensitive radioisotopic methods, and an ultrasonic echo scanner were used. Wax esters had a maximum concentration at 11–12 cm from the skin surface. Non- and monoisovalero triglycerides both exhibited a minimum at 8–10 cm, whereas the diisovalero species increased steadily from the skin surface towards the center of the pilot whale head. A minimum of sound velocity, ca. 1340 m/s, was found at 9–11 cm, thus coinciding with a region rich in isovaleric acid esterified in wax and diisovalero triglycerides. These findings are compatible with predictions based on the known correlations between lipid structure and sound velocity. Consequently, additional evidence for refraction of sound in pilot whale melon is presented. This is important in understanding the system of echolocation of toothed whales.     

Permanent open shunt as a reason for impotence or reduced potency after surgical treatment of priapism in 26 patients

A permanent open shunt as a cause of impotence or impaired potency after a shunt operation for priapism is an unusual situation. In this series we studied the persistence of an open shunt in 26 patients who had developed impotence or impaired potency after operative treatment for priapism. All patients had been examined by cavernosography on the suspicion of an open shunt, giving a positive finding in five of 26 cases, in all of which impotence was cured by closure of the shunt. In five patients without a permanent open shunt potency returned to normal only after 6-12 months.     

Prediction of survival with fluorine-18-fluoro-deoxyglucose and PET in head and neck cancer

The aim of this prospective study was to investigate if high uptake of 18F-fluoro-2-deoxy-D-glucose (FDG) is associated with aggressiveness in head and neck cancer and low probability of survival. METHODS: Thirty-seven patients with squamous-cell carcinoma of the head and neck underwent FDG-PET in the fasting state before cancer treatment. FDG uptake in primary tumor was quantitated as the standardized uptake value of FDG normalized to the predicted lean body mass (SUVlean, n = 37) and as the graphically determined metabolic rate for FDG (rMR[FDG], n = 34). Paraffin-embedded tumor samples were used for histologic evaluation, and expression of cytokeratin and Ki-67 antigen were assessed by immunohistochemistry. RESULTS: Interobserver agreement for the determination of quantitative uptake of FDG in tumors was excellent (r2 = 0.996, p < 0.00001), and all 37 primary tumors were visualized. A high uptake of FDG as assessed by SUVlean was associated with a higher than the median mitotic count (p = 0.01), absence of keratinization (p = 0.03), low or moderate histological grade of differentiation (p = 0.046) and advanced stage (p = 0.03), but not with Ki-67 expression (p = 0.11). The overall survival of patients with a SUVlean lower than or equal to the median value (9.0) was clearly better in univariate analysis than that of patients with a SUVlean higher than the median (3-yr survival 73% versus 22%, relative risk of death (RR) 4.2, 1.6-11.0). However, in a multivariate analysis the only independent predictors of survival were the mitotic count (RR 4.0, 1.4-11.7) and stage (3.8, 1.2-12.2). CONCLUSION: High uptake of FDG in untreated head and neck cancer is associated with advanced disease, and may portend poor survival. Aggressive treatment approaches should be considered for patients presenting with a tumor with high uptake of FDG.     

Dioctyl sodium sulphosuccinate increases net ultrafiltration in peritoneal dialysis

BACKGROUND: The surface-active substance dioctyl sodium sulphosuccinate (DSS) has been reported to increase the peritoneal clearances of urea and creatinine. This study investigated the effects of DSS on the fluid and solute transport characteristics of the peritoneum. DESIGN: A 4-h single-dwell experiment session of peritoneal dialysis using 25 ml of 3.86% glucose dialysis solution with an intraperitoneal volume maker was performed in 16 male Sprague-Dawley rats. In eight rats, 0.005% (50 p.p.m.) DSS was added to the dialysis fluid. No DSS was given to the other eight rats (control group). The transport of fluid, glucose, potassium, sodium, urea, phosphate and urate were analysed. RESULTS: There was a significant increase in the intraperitoneal volume in the DSS group. At 240 min, the drain volume in DSS group (33.0 +/- 2.9 ml) was significantly higher compared to the control group (28.8 +/- 2.1 ml, P < 0.01). This increase in the drain volume was mainly due to a decrease in peritoneal fluid absorption rate in the DSS group (0.040 +/- 0.013 ml/min) as compared to the control group (0.054 +/- 0.010 ml/min, P < 0.05). There was no significant difference in the diffusive permeability and sieving coefficient for the small solutes between these two groups. However, the clearances for urea and sodium were higher in the DSS group, mainly due to the increase in the dialysate volume. CONCLUSION: Our results suggest that DSS significantly increases the net ultrafiltration of peritoneal dialysis. This effect, which was mainly due to a decrease in the fluid absorption rate, contributed to the increased clearances for urea and sodium. DSS did not alter the diffusive permeability and sieving coefficient for the small solutes.     

Bioactive double glass coatings for Co-Cr-Mo alloy

Glass compositions for double coatings for a Co-Cr-Mo alloy were developed. The glass compositions were chosen to fulfil such requirements as matching thermal expansion, low glass transition temperature and moderate solubility. For the ground coat a fairly high durability is required, whereas the cover coat must be bioactive, i.e. become attached to living bone by a chemical bond. Two compositions of each type were developed by computer-aided optimization. The glasses were chosen in the Na₂O–CaO–B₂O₃–Al₂O₃–SiO₂–P₂O₅ system. The bioactivity was tested in vitro by immersion in a simulated body fluid. The double coatings on Co–Cr–Mo alloy released hexavalent chromium into the solution as detected by yellow colouration and spectrophotometry. This colouration was strong at the margin between coated and uncoated metal and may be explained by oxidation of trivalent chromium of the alloy in the presence of glass. The released chromium did not have any notable effect on the calcium phosphate formation. After replensihing the solution no coloration was observed. This suggests that the chromate is easily dissolved and that it may be possible to wash it out prior to implantation.