Infrequent association: massive inguinoscrotal bladder hernia, multiple scrotal lithiasis, and bilateral obstructive uropathy]

BACKGROUND AND AIMS OF THE STUDY: Surgical treatment of functional tricuspid regurgitation associated with advanced valvular disease remains controversial, mainly due to the difficulty in choosing between valve replacement or reconstructive surgery. Failure to correct tricuspid regurgitation during valvular surgery carries a poor prognosis, as reoperation may represent a significant risk to the patient. Thus correct tricuspid valve surgery is vital to achieve improved early and long-term clinical results. METHODS: A total of 142 patients underwent concomitant tricuspid annuloplasty with mitral valve replacement and their clinical outcome was assessed. RESULTS: Overall hospital mortality rate was 11.3%. Seven patients died during follow up. The overall actuarial survival rate for 10 years was 74.1 +/- 14.2%. Postoperatively, 75.8% of the patients had no residual tricuspid insufficiency, while 24.2% had first- or second-degree tricuspid insufficiency and were treated medically. All patients were in NHYA functional class I or II postoperatively. CONCLUSION: Clinically, it is important to assess the severity of functional tricuspid insufficiency before and/or during the operation. Bicuspidalization annuloplasty for functional tricuspid insufficiency has provided good results, with a low incidence of reoperation and significant clinical improvement. The technique could be used in most patients with functional tricuspid regurgitation.     

Deep oxidation of VOC mixtures with platinum supported on Al2O3/Al monoliths

Pt impregnated metallic monoliths prepared from anodised aluminium foils were tested to study their catalytic activity in complete oxidation of volatile organic compound (VOC) mixtures. The VOCs oxidised were 2-propanol, toluene, methyl ethyl ketone (MEK), acetone and their mixtures. Complete oxidation was obtained in all cases except for the case of 2-propanol, where acetone was found as an oxidation intermediate. Even if the adsorption of the VOC on the Al₂O₃ is governed by its polarity, the reactivity is mainly affected by the competition of the oxygen atoms chemisorbed on the Pt particles.     

Adaptive two-loop Voltage-mode control of DC-DC switching converters

A new two-loop control scheme for voltage-mode control (VMC) of dc-dc switching converters is presented. The proposed method adds a high-gain robust loop with two controllers to the conventional VMC loop, achieving an analog "adaptive" loop in which the "equivalent voltage regulator" varies with the changing power stage parameters given as follows: 1) input voltage; 2) load; and 3) component tolerances. The loop significantly improves the disturbance rejection of the control system, i.e., closed-loop output impedance and audiosusceptibility while preserving the stability and the loop gain crossover frequency to a significant extent. Both the small-signal analysis and the experimental results carried out on a buck converter demonstrate the superiority of the proposed scheme with respect to the conventional single loop.     

Graft copolymerization of different mixtures of acrylic monomers on amylopectin. Swelling behavior

Hydroxylic and nonhydroxylic acrylates—methyl acrylate (MA), ethyl acrylate (EA), butylacrylate (BA), hydroxypropyl methacrylate (HPMA), ethylenglycol dimethacrylate (EGDMA), and mixtures of HPMA–MA, HPMA–EA, HPMA–BA in a 50/50 feed composition—were grafted onto amylopectin with different amounts of crosslinking agent, EGDMA. Percent of total conversion, percent crude grafting, and influence of pH in water content were studied. In this sense it was only at pH 10 when a real variation in the water content could be seen. It was also proved that the highest values were obtained when one of the comonomers was EGDMA with a 34 mol% of the initial feed composition. © 1994 John Wiley & Sons, Inc.     

Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche

Girls with a history of premature pubarche, i.e. appearance of pubic hair before 8 years of age, show hyperinsulinism in response to an oral glucose tolerance test. As hyperinsulinaemia has a major role in dyslipaemia, and is considered an independent risk factor for cardiovascular disease, we assessed the patterns of plasma insulin concentration after a standard oral glucose tolerance test as well as fasting serum lipid, lipoprotein, and sex hormone-binding globulin concentrations in girls (n = 81) with premature pubarche compared with girls (n = 55) matched with them for stage and bone age to ascertain their metabolic states to identify those potentially at risk for the development of premature cardiovascular disease. Mean serum insulin concentrations were higher in patients at all pubertal stages, and associated with elevated serum triglyceride, very low density cholesterol and very low density triglyceride concentrations (p value range 0.04 to < 0.0001) but reduced sex hormone-binding globulin. Premature pubarche patients also displayed higher low density to high density lipoprotein cholesterol ratios compared with control subjects (p = 0.004 to 0.008). In conclusion, hyperinsulinaemia, decreased sex hormone-binding globulin concentrations and an unfavourable lipid pattern are common features in premature pubarche girls supporting the contention that atherogenic abnormalities composing the metabolic syndrome could start in childhood. To determine the clinical sequelae of such clustering of metabolic deviations, girls who were identified need to be followed up for the potential development of premature cardiovascular disease.     

Evaluation of the Nuclisens HIV-1 QT assay for quantitation of human immunodeficiency virus type 1 RNA levels in plasma

Nuclisens HIV-1 QT is a new version of the NASBA HIV-1 QT assay for quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in plasma. The specificity of this assay was 100% in one laboratory and 99%-with nonrepeatability of the initial false positive-in another. The test was linear between 2.0 and 6.0 log RNA copies per ml. According to the input HIV-1 RNA concentration, accuracy varied from -0.11 to +0.10 log RNA copy per ml and precision varied from 0.66 to 0.14 log RNA copy per ml. Reproducibility decreased when the HIV-1 RNA level was near the lower limit of quantitation of the test. HIV-1 RNA could be quantitated by Nuclisens HIV-1 QT in 36% (laboratory 1) and 24% (laboratory 2) of clinical samples with HIV-1 RNA levels lower than the lower limit of quantitation by NASBA HIV-1 QT. Nuclisens HIV-1 QT was not suitable for measurement of RNA from clade G and group O HIV-1 strains.     

NO reduction by CH4 over Pd/Co-sulfated zirconia catalysts

A series of sulfated zirconia supported Pd/Co catalysts was synthesized by the sol–gel method and examined for NO_x reduction by methane. The NO conversion increased up to a Co/S ratio of 0.43, and then decreased at a higher Co loading (Co/S = 0.95). Sulfate content was also essential for obtaining high selectivity to molecular nitrogen. A catalyst loaded with 0.06 wt.% Pd, 2.1 wt.% Co and 2.1 wt.% S (Pd/Co-SZ-2) exhibited remarkable performance under lean conditions and displayed stability in a long-term durability test using a synthetic reaction mixture containing 10% water vapor. This catalyst exhibited the highest sulfur retention most probably as cobalt sulfide. Besides, the catalytic oxidation of NO to NO_y groups was confirmed by FT-IR, in agreement with the general mechanism for the SCR of NO by hydrocarbons. In the absence of oxygen in the feed stream, the catalyst was highly active for NO reduction with methane. IR stretching bands assigned to N₂O and adsorbed nitro groups were identified upon adsorbing NO on Pd/Co-SZ-2. This indicates that under rich conditions disproportionation of NO to N₂O and NO₂ occurs and confirms that the formation of NO₂ species is an essential step for NO reduction by CH₄.     

Combustion of methane over palladium ZSM-5 and mordenite catalysts

The effect of Pd-loading on Pd-NaZSM-5 and Pd-NaMordenite catalysts prepared by ion exchange was studied for methane combustion with excess oxygen (1% CH₄, 18% O₂, balance N₂) in the temperature range 40–500°C. Fresh and calcined samples (3 h, 450°C) showed methane conversions proportional to Pd-loading on Pd-NaZSM-5 catalysts, while conversions decreased with Pd-loading on calcined Pd-NaMordenite catalysts. TOF (number of methane molecules converted per second per Pd²⁺ ion) for over exchanged Pd-NaZSM5-116 was low as compared to under exchanged Pd-NaZSM5-80 and Pd-NaZSM5-58 samples. Close TOF's were found for the last two samples at 330°C. TOF differences in Pd-NaMordenite catalysts demonstrate the heterogeneity of Pd⁺² sites due to structurally nonidentical locations of cations. TOF's appear to be related to Na/Pd ratios in both catalyst types. Apparent activation energies for Pd-NaZSM-5 materials are higher than those for Pd-NaMordenite catalysts.