The applicability of using infrared absorption spectroscopy for an implantable glucose sensor was tested by measuring absorbance at 9.66 microns for glucose in aqueous solution at known concentrations. A commercial Fourier transform infrared spectrometer was used with an attenuated total reflection technique (ATR). Absorbance measurements were reproducible and linearity was excellent (coefficient of correlation: 0.996), in spite of pH and temperature changes over values that span the human physiologic ranges (pH 6.8-7.8, temperature, 32-43 degrees C) and 18-34% decreases in incident infrared energy. The minimum detectable concentration of glucose, however, was 31 mmol/L (560 mg/d) and, to use infrared sources and detectors compatible with an implantable device, an absorbance peak between 1 and 3 microns must be used. To solve the detection sensitivity and wavelength problems, the ATR prism was coated with a hydrophobic liquid membrane. The absorbance of water varied at 2.95 microns in inverse linear proportion to glucose concentration between 2-31 mmol/L (35-560 mg/dL, r = -0.992). Estimated incident infrared energy at 2.95 microns (0.2 micron bandwidth) was low enough to theoretically allow the use of a lithium battery small enough for implantation. These findings support the concept of using infrared absorption spectroscopy for an implantable glucose sensor.

Biosensing Techniques↗

PubMedDate not supplied

Binocular blindness following dynamic cardiomyoplasty.

A 40-year-old man with viral cardiomyopathy underwent uncomplicated dynamic cardiomyoplasty. On the third postoperative day, he was rescued from an 8-hour period of severe cardiogenic shock. Eleven days postoperatively, he was withdrawn and uncooperative, preferring to be left alone. He then complained of total blindness, which persisted to his sudden death on postoperative day 26. Clinical examination revealed no neurological abnormality except for signs consistent with a diagnosis of ischemic optic neuropathy. The optic nerve in the scleral canal is especially vulnerable to hypoperfusion. Blindness has been reported following severe hemorrhage, bilateral neck dissection, and has an incidence of 1 per 1100 cases following cardiopulmonary bypass. Anemia and hypotension may be consistent risk factors predisposing patients to this catastrophic complication.

Adult↗

PubMedDate not supplied

Slow-rate, high-pressure ventilation: a method of management of difficult transplant recipients during sequential double lung transplantation for cystic fibrosis.

Single and double lung ventilation can be extremely difficult in patients with cystic fibrosis who require sequential double lung transplantation. This article reports the successful use of slow-rate, high-pressure ventilation in the management of two ventilator-dependent patients who would otherwise have needed to be supported by cardiopulmonary bypass.

Adolescent↗

PubMedDate not supplied

The great eights debate: do the mandibular third molars affect incisor crowding? A review of the literature.

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Humans↗

PubMedDate not supplied

Microcystin hepatitis.

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Adult↗

PubMedDate not supplied

Normal rectal mucosa. Should we biopsy?

BACKGROUND/AIMS: To determine the practice of routine rectal biopsy in the United Kingdom, and assess the diagnostic yield and complications of rectal biopsy in patients presenting with diarrhea. MATERIALS AND METHODS: A postal questionnaire was sent to consultant members of the British Society of Gastroenterology. An audit of the diagnostic yield and complications resulting from routine biopsy of normal looking rectal mucosa in patients presenting with diarrhea was performed. RESULTS: Ninety five (35%) consultants "nearly always" biopsy normal looking mucosa, with a further 56 (20%) taking a biopsy in more than fifty percent of cases. Fifty five (20%) almost never biopsy if the mucosa looks normal, with 68 (20%) taking a biopsy less than fifty percent of the time. Biopsies were taken from 50 patients referred with diarrhea whose rectal mucosa looked normal. Abnormal histology was reported in 11 (22%) cases. The rectal biopsy led to a positive diagnosis and change in management in 4 (8%) cases. The remaining biopsies showed minor inflammatory changes that were not considered clinically important. One significant complication occurred due to rectal biopsy. CONCLUSIONS: Clinicians disagree on the value of routine rectal biopsy in the investigation of diarrhea. In patients presenting with diarrhea, the diagnostic yield from biopsy of normal looking rectal mucosa is low. Life threatening complications can occur and in unselected patients routine biopsy should not be performed.

Adolescent↗