Relationship of seizure duration to antidepressant efficacy in electroconvulsive therapy

BACKGROUND: Aprotinin and epsilon-aminocaproic acid are routinely used to reduce bleeding during cardiac surgery. The marked difference in average wholesale cost between these two drug therapies (aprotinin, $1,080 vs. epsilon-aminocaproic acid, $11) has generated significant controversy regarding their relative efficacies and costs. METHODS: In a multicenter, randomized, prospective, blinded trial, patients having repeated cardiac surgery received either a high-dose regimen of aprotinin (total dose, 6 x 10(6) kallikrein inactivator units) or epsilon-aminocaproic acid (total dose, 270 mg/kg). RESULTS: Two hundred four patients were studied. Overall (data are median [25th-75th percentiles]), aprotinin-treated patients had less postoperative thoracic drainage (511 ml [383-805 ml] vs. 655 ml [464-1,045 ml]; P = 0.016) and received fewer platelet transfusions (0 [range, 0-1] vs. 1 [range, 0-2]; P = 0.036). The surgical field was more likely to be considered free of bleeding in aprotinin-treated patients (44% vs. 26%; P = 0.012). No differences, however, were seen in allogeneic erythrocyte transfusions or in the time required for chest closure. Overall, direct and indirect bleeding-related costs were greater in aprotinin- than in epsilon-aminocaproic acid-treated patients ($1,813 [$1,476-2,605] vs. $1,088 [range, $511-2,057]; P = 0.0001). This difference in cost per case varied in magnitude among sites but not in direction. CONCLUSIONS: Aprotinin was more effective than epsilon-aminocaproic acid at decreasing bleeding and platelet transfusions. Epsilon-aminocaproic acid, however, was the more cost-effective therapy over a broad range of estimates for bleeding-related costs in patients undergoing repeated cardiac surgery. A cost-benefit analysis using the lower cost of half-dose aprotinin ($540) still resulted in a significant cost advantage using epsilon-aminocaproic therapy (P = 0.022).     

Electromagnetic properties of electrophoretic YBa2Cu3O7−δ films

In order to apply highT _c superconductivity to general microwave cavities and to shielding devices for quasistationary magnetic fields, we have developed an electrophoretic coating technique. This work reports about the continuation of our experiments. More than 60 samples of electrophoretic layers deposited on silver substrates were fabricated by systematically varying the processing parameters. The r.f. surface resistance measured at 21.5 GHz and 77 K at low excitation fields is found to be a sensitive measure of the quality of the samples and falls rapidly with increasing average grain size. Textured electrophoretic layers of large grain size show the smallest sensitivity ofR _s against the r.f. surface magnetic fieldH _s. The magnetic sensitivitydR _s /dH _s is found to be in direct proportion toR _s (77 K). After optimizing the sintering procedure the electrodes of the prototype cavity for a compact hydrogen maser were coated. The cavity was successfully operated at 1.42 GHz, and a surface resistance of 1 mΩ was achieved at 77 K. This compares to 4 mΩ for copper at the same temperature.     

A MCM-D-type module for the ATLAS pixel detector

For the ATLAS experiment at the planned Large Hadron Collider (LHC) at CERN hybrid pixel detectors are being built as innermost layers of the inner tracking detector system. Modules are the basic building blocks of the ATLAS pixel detector. A module consists of a sensor tile with an active area of 16.4 mm×60.4 mm, 16 read out ICs, each serving 24×160 pixel unit cells, a module controller chip, an optical transceiver and the local signal interconnection and power distribution busses. The dies are attached by flip-chip assembly to the sensor diodes and the local busses. In the following a module based on MCM-D technology will be discussed and prototype results will be presented     

Digital-noise reduction with on-chip inductors

Digital-noise reduction with decoupling capacitors in ever faster (lower voltage/impedance) technologies for mixed-signal applications is being gradually rendered ineffective by line resistance to the capacitors. In contrast, blocking inductors show excellent noise reduction in SPICE simulations, the LdI/dt self-perturbance being solved with local auxiliary capacitors. The needed values for both inductances and capacitances are small, allowing their implementation in a multichip module (MCM), or alternative, technologies. Dynamic energy consumption is analyzed in the search for a capactive-inductive energy flow to partly circumvent the αCV² dissipative mechanism.     

Spectral domain technique for analysing 3-D metallisation structures

The spectral domain analysis method is used to calculate the S parameters of unshielded microwave components containing bondwires and airbridges. The general formulation and the procedure of the method are described. The application of the theory is given by a comparison of measured and calculated results for a spiral inductor.<>     

THE EFFECTIVENESS OF POINT-SOURCE CHLORINATION IN IMPROVING WATER QUALITY IN INTERNALLY DISPLACED COMMUNITIES IN ANGOLA

Demographic displacement throughout Angola has created a large number of informal peri-urban communities, many of which depend upon groundwater sources for their primary water supply. These ground-water sources are at increased risk of pollution due to limited access to safe faecal disposal. This paper describes a study which was undertaken in Angola during the period 1999–2001 to assess the effectiveness of different types of hand-dug well protection. The study demonstrates that (a) point-source disinfection of traditional wells improves water quality to within universally accepted minimum standards for humanitarian assistance (SPHERE), and (b) chlorination can be a cost-effective method of groundwater-source protection.     

Sulfur mustard induces apoptosis and necrosis in endothelial cells

Sulfur Mustard (SM) is a vesicant or blistering chemical warfare agent, for which there still is no effective therapy. Endothelial cells are one of the major cellular targets for SM. The mechanism of endothelial cell death during SM injury is poorly understood. We studied the effect of exposure of endothelial cells to 0-1000 microM SM over the time course of 2-24 hr to determine the role of apoptotic and necrotic patterns of cell death in endothelial injury induced by SM. SM concentrations < or = 250 microM induced exclusively apoptosis which was observed after 5 hr in 30% of endothelial cells. Exposure to SM concentrations > or = 500 microM caused apoptosis and necrosis to the same extent in 60-85% of all cells after 5 to 6 hr. Necrosis was accompanied by a significant (approximately 50%) depletion of intracellular ATP, while in apoptotic cells ATP remained at the level similar to healthy cells. Interestingly, disruption of the long actin filament stress fibers and rounding of cells preceded other features of apoptosis--DNA fragmentation, membrane budding, and apoptotic body formation. In apoptotic cells, microfilaments formed constricted perinuclear bands, which were not observed in necrotic cells. Pretreatment with 50 mM N-acetyl-L-cysteine (NAC), a sulfhydryl donor and antioxidant, nearly eliminated the apoptotic features of cell death but did not prevent necrosis in response to SM. NAC pretreatment alone induced reorganization of actin filaments into an enhanced network of long stress fibers instead of a dominant cortical band of actin. NAC pretreatment prevented loss of cell adherence and cell rounding following exposure to 250 microM SM. The effect of NAC on cytoskeletal organization and its ability to eliminate SM-induced apoptosis suggests that actin filament organization may be an important element in cellular susceptibility to apoptotic stimuli.