Hong Kong''s eastern and western medical history

BACKGROUND: Some clinical studies suggest that a combination of an H1- and H2-antagonist may be effective in the prophylaxis of allergic reactions. OBJECTIVE: The efficacy of pretreatment with an H1/H2-antagonist combination, H1-antagonist alone, or placebo in the prophylaxis of local and systemic adverse reactions to specific immunotherapy with Hymenoptera venom was compared. METHODS: In a prospective, randomized, double-blind, placebo-controlled study, 121 patients with Hymenoptera venom allergy were treated with rush immunotherapy and pretreatment with one of the following: 120 mg of terfenadine plus 300 mg of ranitidine, 120 mg of terfenadine alone, or placebo. The incidence of unwanted systemic adverse and local reactions was recorded for up to 50 weeks. RESULTS: In seven patients (6%), six in the placebo group and one in the terfenadine group, systemic side effects required cessation of therapy (p = 0.005). Subjective symptoms occurred in four patients (10%) in the terfenadine plus ranitidine group and in three patients (7%) in the terfenadine group. Regarding local reactions, significantly fewer patients treated with a combination of terfenadine and ranitidine and with terfenadine alone as compared with placebo had severe local symptoms of erythema (29%, 29%, and 49%), edema (24%, 18%, and 41%), and pruritus (13%, 11%, and 31%) at week 1 (p < 0.05). This therapeutic benefit was limited to the first 4 weeks of treatment. Treatment with a combination of terfenadine and ranitidine was not superior to treatment with terfenadine alone. CONCLUSIONS: Pretreatment with H1-antihistamines with or without H2-antihistamines significantly reduced local and systemic adverse reactions to immunotherapy with Hymenoptera venom and may therefore be helpful in the management of immunotherapy.     

Transient behavior of subthreshold characteristics of fullydepleted SOI MOSFETs

It has been found that the subthreshold currents of fully depleted silicon-on-insulator (SOI) MOSFETs show a transient behavior under certain front-gate and back-gate voltage conditions. The cause of this anomaly is explained, and applications for the phenomenon are pointed out. Particularly, a simple way to measure the silicon film thickness is suggested     

On the use of confidence levels in risk management

A framework for incorporating uncertainty in risk management is developed and applied to two aspects of decision making: meeting standards or safety goals, and cost-benefit criteria. The framework is applied to several case studies including toxic chemicals in water, failure of civil engineering structures and nuclear power plants. The framework proposes that decisions be based on a level of confidence, in addition to comparing best estimate or point values with standards and goals.     

Synfuel development impacts— econometric modelling and policy analysis

The prospects for rapid near-term development of a synfuel industry in the USA have decreased, due to depressed world oil prices, synfuel project cost overruns, and the lukewarm support of the Reagan administration. Nonetheless, socioeconomic and environmental impact analysis studies can provide valuable information for determining the regional welfare effects of proposed projects. The author discusses the results of a regional econometric analysis of the synfuel projects planned for Western Kentucky, which focuses on environmental impacts, and reveals the inevitable trade-offs that would accompany synfuel development. Some policy issues are briefly reviewed, especially that of efficient energy pricing.     

Penicillin vs. erythromycin in the treatment of diphtheria

PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure.     

Synthesis and Evaluation of Voltage-Gated Sodium Channel Blocking Pyrroline Derivatives Endowed with Both Antiarrhythmic and Antioxidant Activities

Under the hypothesis that cardioprotective agents might benefit from synergism between antiarrhythmic activity and antioxidant properties, a small series of mexiletine analogues were coupled with the 2,2,5,5-tetramethylpyrroline moiety, known for its antioxidant effect, in order to obtain dual-acting drugs potentially useful in the protection of the heart against post-ischemic reperfusion injury. The pyrroline derivatives reported herein were found to be more potent as antiarrhythmic agents than mexiletine and displayed antioxidant activity. The most interesting tetramethylpyrroline congener, a tert-butyl-substituted analogue, was at least 100 times more active as an antiarrhythmic than mexiletine.     

Fourier transform infrared study of high-purity maceral types

A suite of density-differentiated macerals from several coals was analysed by Fourier transform infrared spectroscopy to obtain information on the nature and magnitude of the variations exhibited by the various maceral fractions. The most characteristic change between maceral groups was the variation in aliphatic hydrogen content, with exinite ? vitrinite ? inertinite. Since the separation technique (density gradient centrifugation) generally provided a number of fractions within a maceral group region, some of these were also analysed. In a series of density fractions from a low rank vitrinite, it was found that the aliphatic hydrogen content decreased as the density increased. The inertinites also exhibited a decrease in aliphatic hydrogen. The inertinite C—O bands had extinction coefficients different from those of vitrinites or exinites. The data suggest that quite profound variations in organic structure as determined by FT-i.r. spectroscopy can exist within a maceral group, so that for the most critical work on coals it is necessary to take this into account.     

Estimation of parameters where dependent observations are related by equality constraints

Pirt's model for microbial growth and product formation are reparameterized to obtain multiresponse models with common parameters. The dependent variables in the models are related through the available electron and carbon balance constraints. Covariance adjustment is used to reduce the growth model to a unit variate linear model with covariates. Therefore, standard multiple regression programs can be used to obtain combined point and interval estimates of true biomass energetic yield, true product yield and maintenance coefficient. This approach may yield “better” estimates than the maximum likelihood approach when an appropriately selected subset of covariates is used. Nonlinear estimation procedures are also considered; these procedures are efficient with few responses; however, as the number of responses per observation increase, they may require a lot of computing time. For illustration several data from the biochemical engineering literature are analyzed by the proposed methods.