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.     

Lorazepam-valproate interaction: studies in normal subjects and isolated perfused rat liver

Valproate (VPA) has been shown to interact with all the major antiepileptic drugs (AEDs) through two mechanisms of action: displacement from albumin binding sites and inhibition of drug metabolism. More recently, evidence showed that VPA inhibits the elimination of drugs metabolized by glucuronide conjugation. Lorazepam (LZP), which is primarily eliminated by conjugation with glucuronic acid, is administered concurrently with VPA both in treatment of epilepsy and in patients treated with VPA for psychiatric disorders. Therefore, a significant drug interaction is likely. We investigated such interaction both in in vitro isolated perfused rat liver (IPRL) and in normal subjects. LZP [2 mg, intravenous (i.v.) bolus] was administered to 8 normal volunteers before and after chronic dosing with VPA. In 6 of 8 subjects, VPA significantly decreased LZP plasma clearance by an average of 40% (p < 0.05) and increased LZP concentrations by decreasing formation clearance of the LZP glucuronide. In the IPRL studies, VPA also significantly decreased formation of LZP glucuronide (from 0.72 +/- 0.14 to 0.22 +/- 0.15 ml/h/kg, p < 0.05), indicating that IPRL is a useful tool for evaluation of the effect of VPA on drugs eliminated by glucuronide conjugation.     

A PC program for diagnosing abnormal growth, growth velocity and acceleration from longitudinal observations

A human fibroblastic cell line transformed by the SV40-T antigen sequence and continuously cultured for 7 months displayed large periodic variations in cell proliferation. This contrasted with other characteristics of this cell line that remained constant: mosaic cell shape, absence of cell contact inhibition, and predominance of a hypodiploid population. Similar fluctuations in proliferative capacity were also found during the long-term growth of a transformed but nonimmortalized human fibroblastic line prior to senescence, and in the established hamster fibroblastic Nil cell line. This growth pattern suggests a recurrent stimulation of growth in these three transformed cell lines. The proliferation pattern from cultured transformed cells may thus be complex and requires further investigation. These variations presumably influence major cell functions. This observation has important implications for the analysis of data from such cell lines.     

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     

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     

Infinite-dimensional convex optimization in optimal and robustcontrol theory

Many engineering problems can be shown to be equivalent to solving semidefinite programs (SPs), i.e., convex optimization problems involving linear matrix inequalities (LMIs). Powerful computation tools are available for such problems in the finite-dimensional case. However, the problems arising in optimal and robust control theory are often infinite dimensional, and so adequate computation tools are not available. The key to tackling such problems with finite computation tools is to have a primal-dual formulation of the problem without duality gap. In this paper we study infinite-dimensional SPs and present a lifting technique to recast SPs as parameterized linear programs (LPs). This enables the wealth of theoretical tools available for infinite-dimensional LPs to be extended to infinite-dimensional SPs. In particular, we develop some new sufficient conditions for the lack of a duality gap for infinite-dimensional SPs and give an exact characterization of the primal and dual problems for these cases. Both primal and dual problems are formed as infinite-dimensional SP problems, with finite truncations to each giving upper and lower bounds, respectively, on the exact solution to the infinite-dimensional problem. Thus, these results can form the basis of practical computation schemes for infinite-dimensional problems, which require only finite-dimensional computation tools. To illustrate the power of these tools we apply the results to two previously unsolved optimization problems, namely minimizing the l₁ norm of a closed-loop system subject to bounds on the frequency response magnitude at a finite number of points and/or bounds on the H₂ norm     

Homogeneity of fruits and vegetables comminuted in a vertical cutter mixer

The homogeneity of comminuted composites of 20 lb samples of apples, cabbage, and green beans containing field-incurred residues of p, p'-methoxychlor was studied to determine whether a 5 min comminution in a 40 qt vertical cutter mixer produces a homogeneous composite and whether the size of test portions used accurately represents the composite. Duplicate test portions of 100, 50, 25, 10, 5, and 2 g taken from each of 6 separate sections of the mixer were analyzed by standard pesticide residue methodology for p, p'-methoxychlor. Results of this study confirmed that comminution of fresh produce in a 40 qt vertical cutter mixer, according to instructions described in the U.S. Food and Drug Administration's Pesticide Analytical Manual, Volume I, Section 203B, produces a homogeneous composite. No significant differences were found in the data for the 3 crops taken from the 6 sections of the mixer. Test portion weights of 100, 50, and 25 g produced equivalent results for all 3 crops. Statistically significant differences were observed for cabbage at 2, 5, and 10 g and for green beans at 2 g.