A case of paraquat poisoning and subsequent fatality presenting to an emergency department

Paraquat (1,1'-dimethyl-4,4'-dipyridylium) is an herbicide associated with both accidental and intentional ingestion, leading to severe and often fatal toxicity. Prognosis is largely dependent on the amount of paraquat absorbed. Rapid identification of the symptoms of paraquat toxicity (burns or ulceration at the site of ingestion or injection, acute respiratory distress, and renal failure) can facilitate early treatment intervention to limit absorption. We report a case of a 71-year-old man with a suicidal ingestion of paraquat 2 days prior to presentation. Serum paraquat levels, time elapsed since ingestion, and clinical symptoms all indicated poor prognosis. The patient developed severe respiratory distress and progressive renal failure, and died 6 days after admission to the hospital.     

Rectus abdominis muscle flap (RAMF) technique for the management of bladder exstrophies: late clinical outcome and urodynamic findings

OBJECTIVE: To investigate the efficacy of the rectus abdominis muscle flap (RAMF) technique for the closure and augmentation of small, non-compliant bladder exstrophies. PATIENTS AND METHODS: The RAMF technique was used in two girls and two boys (mean age at operation, 31.7 months, range 3-72) with bladder exstrophy. The clinical outcome and urodynamics were assessed during a follow-up of 29 months to 6 years (mean 49.2 months) and included imaging, cystoscopy, biochemical and microbiological studies. RESULTS: There were no urinary tract infections, metabolic problems or electrolyte disturbances and kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMF with uroepithelium. No stone formation or mucus production were detected. Currently, three patients void using clean intermittent catheterization through the native urethra and the fourth through an appendiceal Mitrofanoff valve. However, the bladder volume was insufficient at the late follow-up and three patients required bladder augmentation. CONCLUSIONS: The RAMF technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity; however, although there is a mild improvement in bladder capacity and compliance. RAMF should not be used as a bladder augmentation procedure. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.     

Higher order soliton pulse compression in dispersion-decreasingoptical fibers

Compression of higher order optical solitons in fibers with anomalous dispersion decreasing along their length is investigated. We demonstrate high-quality compression of pulses with initial soliton order 1相似文献   

Evolution of grain structure in thin film reactions

In this paper, we examine, both experimentally and theoretically, the kinetics of formation and microstructure of product phases in thin film reactions, using the Nb/Al and Ti/Al systems as our prototypes. The results of calorimetry and microscopy studies are interpreted using simple kinetic and morphology models. In particular, the kinetic models employed here focus on the nucleation and growth components of the phase formation process and the morphology models provide a starting point for the classification of product grain structures. An erratum to this article is available at .     

Characterization and modeling of a noncollinearly phase-matchedfemtosecond optical parametric oscillator based on KTA and operating tobeyond 4 μm

We describe the design and operation of a critically phase-matched femtosecond optical parametric oscillator based on KTA. By employing a small pump-signal noncollinear angle, tuning of the idler to beyond 4 μm is achieved using a Ti:sapphire pump laser. A Gaussian-beam model is described which can be used to identify the optimal noncollinear phase-matching geometry. Idler and signal pulses are characterized fully both temporally and spectrally and interferometric autocorrelation data at 3.5 μm showing idler pulses of only eight optical cycles duration are presented     

Generation of frequency-chirped optical pulses in a large-slippagefree-electron laser

We have investigated the optical output of the free-electron laser for infrared experiments (FELIX) when it is driven by an electron beam with a ramped energy. We show that the applied slow ramp on the electron beam energy leads to a frequency chirp on each picosecond optical pulse. Typical values for the chirp are 0.2% frequency sweep across a 1.5-ps-long optical pulse. The optical pulses were analyzed with a double-grating pair and with a second-order autocorrelator. The pulse duration was reduced in the double-grating pair by 20%. A linear dependence of the chirp on the cavity desynchronization was measured     

Microbiological safety of kinema, a fermented soya bean food

Kinema is a fermented soya bean food of Nepal and the hilly regions of North-eastern States of India. Generally, the fermentation is dominated by Bacillus spp. that often cause alkalinity and desirable stickiness in the product. The present study was undertaken in a limited number of commercial (market) kinema samples to test for the presence of foodborne pathogens and their properties. Bacillus cereus was present in numbers exceeding 10⁴ cfu/g product in five of the tested 15 market samples. Enterobacteriaceae and coliform bacteria exceeded 10⁵ cfu/g in 10 of the 15 samples. Escherichia coli exceeding 10⁵ cfu/g was found in two samples. Staphylococcus aureus was not detected in any of the tested samples. Of 31 isolated typical and atypical strains of B. cereus, 18 representative strains were tested qualitatively for the ability to produce diarrhoeal type enterotoxin (BCET) using an Oxoid BCET-RPLA test kit. Overall, BCET was formed by 12 strains in BHIG (brain heart infusion broth +1% glucose), by seven strains on sterilized cooked rice, and by five strains on sterilized cooked soya beans. Semi-quantitative tests on BCET revealed that levels exceeding 256 ng/g soya beans, produced by single pure culture inoculation with the isolated B. cereus strains, were reduced to ≤ 8 ng/g by frying kinema in oil, a common procedure when making kinema curry. It was also shown in a mixed pure culture experiment that a kinema strain B. Subtilis DK-W1, is able to suppress growth and BCET formation by a selected toxin producing strain (BC7-5) of B. cereus. It is concluded that the traditional way of making kinema and its culinary use in curries is safe. However, for novel applications of kinema, safety precautions are advisable.     

Reuse efficiency for non-uniform traffic distributions in CDMAsystems

An exact and simple method to evaluate the frequency reuse efficiency for the reverse link of cellular CDMA systems over a non-uniform traffic distribution is presented. This method is based on a traffic redistribution and decomposition process and on standard curves with which partial reuse efficiencies are obtained and conveniently added to give the final parameter     

Multilevel optimization applied to hull girder design using three panel forms

A multilevel design scheme for ship's hull girders (longitudinal members between two adjacent transverse frames) is presented in this paper. This design scheme handles, very conveniently, the complexity of using an optimization algorithm for such complex design problems having a large number of design variables, nonlinear constraints dealing with different failure modes and interactions among substructures, and nonlinear design objectives. The conventional multilevel design technique is modified by introducing an approach called constraint coordination to increase the probability of achieving the overall optimum very efficiently.The scheme is demonstrated by application to the structural design of hull girders with simple structural modelling to represent inland waterway ships on which there was a special emphasis in the original research project (Rahman 1991). Three possible panel (consisting of one stiffener and its attached plating) forms; tee stiffened, flat-bar stiffened and corrugated, are optimized to synthesize the hull girder in order to achieve the most efficient structure. The effect of price-structure (labour rate to material price ratio) on the design is also investigated.