In situ bypass and diabetes

From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p = 0.005). Critical limb-ischaemia was more often present in diabetic than non-diabetic patients (DM:57%, NDM:36%, p = 0.0002). Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.00001). There were no differences among diabetic and non-diabetic patients regarding three years primary and secondary patency (58% and 64% respectively), and regarding major amputations. However, the rate of minor amputations was higher in insulin-dependent compared with non-insulin-dependent diabetics, who in turn had a higher rate than non-diabetics (p < 0.00001). A markedly decreased survival rate was found in diabetics (p < 0.00005). We found the in situ bypass technique very useful in the treatment of critical ischaemia of the lower limb in diabetic patients. The overall results in diabetic patients, whether insulin-dependent or not, were equal to those in non-diabetic patients.     

Fabrication and characterization of planar and channel polymer wave guides. I. Plasma-polymerized HMDS films

Plasma-polymerized hexamethyldisiloxane (HMDS) films have been prepared as both planar and channel wave guides. The optical attenuation results measured in both the planar and channel HMDS wave guides were found to be similar, thus demonstrating that the inherent solvent resistance and chemical inertness of the plasma polymerized films allows the use of common photoresist techniques, including application of the photoresist, photomasking, and subsequent etching. This may be contrasted with wave guides made from conventional polymers, where careful consideration must be given to photoresist/polymer compatibility, because the photoresist solvents may adversely affect the underlying polymer and lead to degradation of the material during processing. © 1995 John Wiley & Sons, Inc.     

The OKT3 Antibody Response Study: a multicentre study of human anti-mouse antibody (HAMA) production following OKT3 use in solid organ transplantation

Human anti-murine antibody titres following patient exposure to the monoclonal antibody Orthoclone OKT3 (muromonab-CD3) are determined by laboratories using diverse analytical methods which are not standardized and whose concordance is not established. A multicentre study group therefore compared testing for IgG anti-OKT3 antibody among seven laboratories. A set of 270 sera was obtained from 30 heart, 30 kidney and 30 liver transplant recipients with no previous exposure to OKT3 who were receiving OKT3 for induction immunosuppression. Sera were collected from each patient prior to and at 24 +/- 2 days and 31 +/- 2 days following initial OKT3 exposure. Identical aliquots of all 270 sera were tested for IgG anti-OKT3 antibody by each laboratory. In addition, the limit of detection of each laboratory's method was estimated by titration of an affinity-purified IgG anti-OKT3 reference material of known concentration. Anti-OKT3 antibody formation differed greatly among the three organ groups. Cardiac patients demonstrated the least sensitization and almost exclusively lower titres, while kidney recipients had more frequent and higher titre antibody formation. Liver recipients yielded the highest sensitization rate and the most frequent high titre sera. Importantly, the seven laboratories differed widely in the number of pretreatment sera reported as positive (ranging from 0% to 41% among laboratories), the number of post-OKT3 sera reported as positive (17-63%), the number of post-OKT3 samples with titre > or = 1000 (2-31%), and the number of patients sensitized 19-69%). Concordance among laboratories was highly variable, with interlaboratory agreement ranging from 38% to 83% on the sample titres assigned to 180 post-OKT3 sera. Many of the discordant results were consistent with differences in the limit of detection of the analytical methods, which ranged from 0.19 microgram/ml to > or = 15 micrograms/ml, a nearly 100-fold difference among laboratories. This study demonstrated the presence of both good concordance and significant discordance among laboratories in determining human anti-mouse antibody titres, and demonstrated that common titre categories (100, 1000, 10,000) were not equivalent among laboratories. The level of concordance among methods should be considered when comparing anti-OKT3 antibody results from different centres and their correlation with clinical events. Universal comparative testing, patterned after proficiency testing programmes, is needed to assess differences among laboratories and to bring uniformity and a sound interpretative basis to this field of testing.     

Olfactory recognition of nonhosts aspen and birch by conifer bark beetlesTomicus piniperda andHylurgops palliatus

The field response ofTomicus piniperda (L.) andHylurgops palliatus (Gyll.) (Coleoptera: Scolytidae) to the attractant ethanol in combination with volatile wood constituents released from the nonhost tree speciesPopulus tremula L. (Salicaceae) andBetula pendula Roth (Betulaceae) was studied using flight barrier traps. The attraction of both species decreased when aspen or birch wood was added to the ethanol bait. The same was true forRhizophagus depressus (F.) (Coleoptera: Rhizophagidae), a predatory species associated with conifer bark beetles.Glischrochilus quadripunctatus (L-),Epuraea bickhardti St.-Claire Deville,E. unicolor (Oliv.) (Coleoptera: Nitidulidae), andRhizophagus parvutus (Payk.) (Coleoptera: Rhizophagidae) were caught in higher numbers in traps baited with both ethanol and wood of aspen or birch than in traps baited with ethanol alone. In a separate experiment, landings ofT. piniperda andH. palliatus on nonhosts (black plastic tubes) were demonstrated with sticky traps.     

An overview of FDA medical device regulation as it relates to deep brain stimulation devices.

The United States Food and Drug Administration (FDA) is charged with assuring the safety and effectiveness of a variety of medical products and the FDA's Center for Devices and Radiological Health is responsible for premarket and postmarket regulation of medical devices. In this paper, we review--from device classification and clinical studies to the final marketing application--FDA's premarket requirements and postmarket requirements as they relate to deep brain stimulation devices.     

Heat and Fluid Flow in an Optical Switch Bubble

The Agilent all-optical bubble switch uses bubbles in an organic fluid index matched to a silica planar lightwave circuit. The bubble is created and sustained by heaters that are deposited on an attached silicon substrate. Testing of the bubble shows how heater power and ambient pressure affect bubble shape, size, and optical reflection characteristics. Heat and fluid flow in the bubble were modeled in 2D and 3D using the homogeneous bubble model in the Flow3D modeling software. Fluid condensing on the trench wall causes a dimple on the bubble and hence nonoptimum optical reflection. To aid understanding, the bubble, silica walls, and heaters were also modeled as a thermal resistance network. Because the pressure drop across the bubble wall is fixed, the bubble size is determined by P_res/DeltaT_t , where P_res is the heater power and DeltaT_t is the temperature difference between the bubble and the substrate. Heating the trench walls beyond the bubble temperature with heaters located underneath the trench wall will dry out the trench wall and give a stable optical reflection. As DeltaT_t approaches zero, a bubble is sustained without any heater power and with zero fluid flow. This "static" bubble provides for a very stable optical reflection     

Aging and memory for words and action events: Effects of item repetition and list length.

We were concerned with the effects of item repetition, list length, and class of item on free recall in elderly as compared with young adults. In Experiment 1, samples of young and elderly adults recalled a list of 27 words and a list of 27 action events (minitasks performed by the subjects). Some items were presented once and some twice. Although the younger subjects showed better recall on both types of lists, the older sample benefited from item repetition as much as did the younger sample. This finding was replicated in Experiment 2. A second finding in Experiment 2 was a significant aging effect in the recall of long but not of short lists of both words and action events. The absence of an Age?×?Repetition Effect interaction was ascribed to the strength nature of the repetition manipulation. The age effects in the recall of the long lists were attributed to possible deficits in retrieval proficiency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)