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A fatal case of non-menstrual toxic shock syndrome (TSS) is reported in a Chinese woman, which was associated with a vaginal Staphylococcus aureus infection. Cerebral haemorrhage and vasogenic white matter oedema was shown in cranial computed tomography (CT) before the terminal event.
Ch21 protein, a developmentally regulated chick embryo protein of 21,000 apparent molecular weight, was purified from culture medium of hypertrophic chondrocytes. The purification method included a DEAE cellulose chromatography column, a CM cellulose chromatography column and a HPLC molecular sieve column. The amino acid sequence of the amino terminal end of the protein was determined. Computer assisted analysis showed significant homology between this sequence and the amino terminal sequences of proteins that belong to the superfamily of the low molecular weight binding proteins sharing a basic framework for the binding and transport of small hydrophobic molecules. Determination of the amino terminal sequence of the chicken retinol binding protein excluded identity between this protein and the Ch21.
Previous electron microscopic studies of synaptic terminal distributions in the lateral geniculate nucleus have been flawed by potential sampling biases favoring larger synapses. We have thus re-investigated this in the geniculate A-laminae of the cat with an algorithm to correct this sampling bias. We used serial reconstructions with the electron microscope to determine the size of each terminal and synaptic type. We observed that RL (retinal) terminals are largest, F (local, GABAergic, inhibitory) terminals are intermediate in size, and RS (cortical and brainstem) terminals are smallest. We also found that synapses from RL terminals are largest, and thus most oversampled, and we used synaptic size data to correct for sampling errors. Doing so, we found that the relative synaptic percentages overall are 11.7% for RL terminals, 27.5% for F, and 60.8% for RS. Furthermore, we distinguished between relay cells and interneurons with post-embedding immunocytochemistry for GABA (relay cells are GABA negative and interneurons are GABA positive). Onto relay cells, RL terminals contributed 7.1%, F terminals contributed 30.9%, and RS terminals contributed 62.0%. Onto interneurons, RL terminals contributed 48.7%, F terminals contributed 24.4%, and RS terminals contributed 26.9%. We also found that RL terminals included many more separate synaptic contact zones (9.1 +/- 1.6) than did F terminals (2.6 +/- 0.2) or RS terminals (1.02 +/- 0.02). We used these data plus the calculation of overall percentages of each synaptic type to compute the relative percentage of each terminal type in the neuropil: RL terminals represent 1.8%, F terminals represent 14.5%, and RS terminals represent 83.7%. We argue that this relative synaptic paucity is typical for driver inputs (from retina), whereas modulator inputs (all others) require many more synapses to achieve their function.
The aim of this study was to evaluate working conditions using a personal computer with a flat panel display (FPD) in terms of visual and musculoskeletal comfort. Measurements of viewing distance, viewing angle, head angle, neck angle and electromyogram (EMG) activities of the neck, shoulder and back muscles of visual display terminal (VDT) operators were compared at workstations using an FPD and a desktop personal computer (DPC). A notebook personal computer (NPC) with a 10.4 inches FPD, was used in this experiment. Each of 10 healthy subjects performed word processing tasks using both NPC and DPC workstations. Significant differences in the work posture while using the NPC and DPC were seen with viewing distance, viewing angle and head angle. The characteristic features of the work posture using the NPC were a remarkably short viewing distance and a forward inclination of the head. The value of integrated EMG (IEMG) of the neck muscle was greater while using the NPC than when using the DPC. These phenomena were caused by the structure of NPCs; most NPCs have a display and keyboard which cannot be separated and are not adjustable without tilt and swivel mechanisms. VDT devices that cannot be adjusted may potentially make operators assume a poor posture while working, which could cause visual and musculoskeletal disorders. To prevent visual and musculoskeletal problems using NPCs, a more upright head and neck position was recommended. The addition of a mechanism for adjustment of the height of an NPC display would allow a comfortable downward gaze without the loss of correct posture.
We developed a manual including a checklist format for undertaking measures to prevent fatigue in visual display terminals (VDT) workers. With this manual, problems related to VDT work can be recognized by using checklists which allow for self-evaluation by the workers. The manual helps the workers to consider measures for improvement by themselves and will contribute to better occupational health education.
This is a report of an ad hoc application of "predictive probability" to support the decision to terminate a traditional fixed sample phase II clinical trial of endocrine therapy in breast cancer after accrual of only 75% of the planned sample (18 of 25). The analysis was motivated by concerns over low accrual rates and a lower than expected response rate. Statistical analyses included the computation of several sets of probability estimates. The accumulated data were sufficient to reject H0: pi = 0.6 (the desired response rate) in favor of H1: pi less than 0.6 (p less than or equal to 0.02), and at study completion the 95% confidence interval for pi was expected to fail to include 0.6 with probability 0.92. Under no circumstances could the final observed response rate exceed 0.52. These and other computations provided assurance that early termination of the trial was unlikely to miss a treatment as good or better than the standard.
A skin cell segregating control system based on PC (personal computer) is presented in this paper. Its front controller is a single-chip microcomputer which enables the manipulation for 6 patients simultaneously, and thus provides a great convenience for clinical treatments for vitiligo. With the use of serial port communication technology, it's possible to monitor and control the front controller in a PC terminal. And the application of computer image acquisition technology realizes the synchronous acquisition of pathologic shin cell images pre/after the operation and a case history. Clinical tests prove its conformity with national standards and the pre-set technological requirements.
In contrast to the applications in everyday life computers have found only little acceptance hitherto in medical field. At the department of neurosurgery of the Landesnervenklinik Salzburg an input-terminal was installed and connected with its computing centre. The examining physician feeds the data obtained from the first physical examination with the typewriter keyboard of the input-terminal using an alphabetical and numerical key. The total findings are typed by the computer grammatically correct. The electronic storage of these data allows quick access to single findings and also an easy statistical evaluation.
The distributions of taurine-like and GABA-like immunoreactivities in the rat cerebellum were compared by analysis of consecutive semithin and ultrathin sections, postembedding labeled with the peroxidase-antiperoxidase technique or with an indirect immunogold procedure, respectively. Taurine-like immunoreactivity was selectively enriched in Purkinje cell bodies, dendrites and spines, and boutons in the cerebellar nuclei exhibiting ultrastructural features typical of Purkinje cell terminals. The stellate and basket cell bodies and terminals were very weakly labeled. A computer assisted quantitative assessment of the net immunogold labeling revealed that the mean gold particle density in the Purkinje cell terminals was about 70% higher than that in the Purkinje cell dendrites, and about 14 times higher than that in the stellate/basket cell terminals in the molecular layer. Stellate, basket and Purkinje cell terminals emerged as intensely immunoreactive in adjacent sections processed with an antiserum against conjugated GABA. These findings indicate, contrary to recent electrophysiological data, that GABA is a more likely transmitter candidate than taurine in the stellate cells. The apparent colocalization of GABA and taurine in the terminals of Purkinje cells raises the possibility that these terminals are capable of releasing two different inhibitory amino acids.
The application of MUMPS in a computerised recording system for herd health and production control on dairy farms is reviewed. MUMPS is an interactive multi-user database management system, which is both an operating system and a high level computer language. In this system, coding of veterinary and management events prior to data entry is not needed. Programmes and data structure can easily be adapted and extended due to the features of MUMPS. The system for dairy farms allows epidemiological analyses, due to the flexibility of the programme. The programme is used by farmers and veterinary surgeons by means of terminals linked to a central computer. The system provides action lists for farmers and veterinary surgeons; the information on these lists is presented in a multidisciplinary way. Several herd reports and analyses, including frequency distributions and graphs, are given. These reports enable the investigation of cross-relations between farm aspects, and aid in the detection of problem areas.
A computer model of cardiac excitation sequences was used to reproduce atrioventricular (AV) reentrant tachycardia (AVRT) and its termination by a single 'on-circuit' extrastimulus. The model simulated activation waves revolving along a one-dimensional circular pathway, the portions of which represented the atrial, AV nodal, His-Purkinje, ventricular, and accessory pathway sections of the tachycardia circuit. The modeled pathway was composed of 289 elements. The model distinguished only the depolarised and resting states of constituent elements, but introduced differential refractoriness and conduction velocity for each element. These values approximated the natural situation established in a patient suffering from AVRT associated with the right bundle branch block. The results of the study suggest that: (A) the usual impression of a regular recovery wave and of a regular excitable window moving uniformly along the macro-reentrant circular path is incorrect; (B) during the tachycardia, islands of repolarized cells appear which are surrounded by tissue that is still refractory; (C) an extrastimulus which captures the island of early repolarized tissue may cause an excitation restricted to a small part of the myocardium but the local refractoriness following such an extrastimulus may be sufficient to terminate the tachycardia.
Plasma or serum [ 0.1-1.0 ml] was digested with phospholipase C and total lipid extracts were prepared and silylated in the presence of tridecanoylglycerol as internal standard. The neutral lipid and free fatty acid profiles were determined by means of an automated GLC system equipped with an unheated on-column inlet, time actuated liquid injector, programmed heating, cooling and equilibration cycles, and an electronic peak area integrator. The separations were accomplished on a 50 cm x 2 mm i.d. steel column packed with 3% OV-1 on100-120 mesh Gas Chrom Q using nitrogen as a carrier gas in the temperature range 175-350 degrees C. The tube number, peak retention time and peak area were recorded on a punched paper tape, which was subsequently read into a computer via a time-share terminal. The composition of the sample was calculated in relation to the internal standard using a modification of a commercially available computer program and the results were expressed as mg or mole % and characteristic molar ratios of lipid classes. In addition to estimates for total cholesterol and triglyceride, the method provides a detailed account of individual or small groups of molecular species of various lipid classes, which is a major advantage over other automated methods of plasma lipid analyses.
OBJECTIVE: To ascertain the number and type of obstetric computer systems (OCS) in Great Britain, and to ascertain user satisfaction with these systems. DESIGN: A postal questionnaire was circulated to every consultant obstetrician in Great Britain at the beginning of 1992. MAIN OUTCOME MEASURES: Information was sought on the hardware, software and uses of obstetric computer systems. Satisfaction with, benefits and problems of the system were also assessed. RESULTS: There was an 87.5% response rate. Of the 264 units questioned, 100 units reported that they had a computer system. Sixty-five units used terminals connected to a mainframe or minicomputer and 17 used stand-alone personal computers (PCs). Local area networks (LANs) were used in 19 units and wide area network (WANs) in 22 units. Software varied from commercial turnkey systems to in-house systems. The quoted annual running cost ranged from 50 pounds to 48,000 pounds. Most units were satisfied with their system. Problems included slow operating times, unreliability, user unfriendliness, deficiencies in training and inadequate customer support services. CONCLUSIONS: Obstetric computer systems are now coming into widespread use. Despite problems, the use of such systems is likely to increase. This survey establishes a database for those units who are considering acquiring or changing their computer system for the purpose of audit or research.
A new method (Pain-Track) for recording subjective symptoms was evaluated for its capacity to quantify clinical itch. The Pain-Track system includes portable data loggers carried by the patients, a personal computer with a software package for storage and analysis of the data and a terminal unit to connect the loggers and computer. Every 60 min a signal from the logger commands the patient to mark his presence and rate the itch intensity. During night time the hourly buzz can be turned off but the intensity rate can be adjusted whenever wanted. The antipruritic effect of betamethasone dipropionate and its cream base was studied according to a double-blind, crossover protocol in 30 adult outpatients with atopic dermatitis, 26 of whom completed the study. Analysis with parametric and nonparametric methods showed that the itch intensity was significantly lower during active treatment than with placebo. Onset of the antipruritic action was rapid. Examination of the 'itch profile' revealed that atopics have more intense itch both in the mornings and evenings than during the day. It is concluded that by using a drug with known antipruritic effect we have shown that Pain-Track is a useful tool for assessing clinical pruritus and the antipruritic effects of drugs. The main advantages are possibilities for frequent recordings, surveillance of compliance improving authenticity, and storage and analysis of a large amount of data.
PURPOSE: As Internet-based health care applications grow, it is important to determine their acceptability to ill persons and the likely outcomes resulting from their use. This randomized field investigation demonstrated the use and effects of a specialized computer network, the ComputerLink, among persons living with AIDS (PLWA). HYPOTHESIS: This study was designed to determine whether a home-based computer network designed for people with AIDS (PLWA) would be used and whether it would reduce social isolation and improve confidence and skill in decision making without causing differential decline in health status among PLWA. INTERVENTION: Wyse 30 terminals were placed in private homes, linked via a 1200 baud modem to a public access computer network. Services available to PLWA included an on-line electronic encyclopedia, public and private communication and a decision support system; all services were coordinated by a registered nurse. DESIGN: A six-month randomized trial involved 57 community-dwelling PLWA; 31 were in the experimental group. Mean age was 33, 93% were male, 61% white, 34% working, 13.5 mean years education. Six participants were lost to follow-up. RESULTS: 8449 accesses to the system were made during the study period. Mean number of access per participant was 192, the median, 129. Duration of access averaged 12 min. PLWA used two services during each session. First order hypotheses testing revealed no significant difference between experimental and control group participants. Post hoc exploration indicated that use of the system did reduce social isolation once participants levels of depression were controlled and that decision making confidence improved as a function of number of accesses. CONCLUSION: Computer networks provide feasible alternatives for the delivery of health services to home-bound individuals. Communication services were used more extensively than other services, suggesting that the primary mechanism of intervention is peer contact. Similar to other experiments, system use improves confidence, though not skill, in decision making. The Internet represents a promising pathway to reaching home-bound patients and providing them with information, communication and decision assistance.
Dynamic computed tomography (CT) has been widely used because of its simplicity, but regional cerebral perfusion of brain tumors has not critically been evaluated. This study was conducted to evaluated parameters obtained from the dynamic perfusion study in brain tumors and to clarify the usefulness of the dynamic CT comparing with Xe-enhanced CT. Dynamic CT was performed on 20 patients with brain tumor (three meningiomas, one pineal tumor, three metastatic brain tumors, thirteen gliomas). Dynamic CT consisted of performing six rapid sequential scans after a bolus intravenous injection of 40 ml of iodinated contrast medium. In this study, five parameters (corrected first moment, area, peak, time to peak, percent terminal height) were obtained from computer analysed curve fit on time density curve profile of serial scanning. In Xe-enhanced CT, serial CT was taken every three or five minutes during inhalation of 40 to 50 percent stable xenon. Flow rate constant (K), partition coefficient (lambda) and cerebral blood flow (CBF) for each pixel were calculated from delta HU (Hounsfield unit) and end-tidal air curve and displayed on CRT as images. In patients with meningioma, values of area and percent terminal height of the tumor were much higher than those of contralateral gray matter, and these findings show excessive increase of the intratumoral blood volume and extreme extravasation of iodinated contrast medium respectively. In patients with metastatic brain tumor or malignant glioma, which were enhanced by contrast medium, the values of all parameters of the tumors were higher than contralateral gray matter. Increase of intratumoral blood volume and destruction of blood brain barrier are suggested in these tumors. In the remaining patients with glioma, which was not enhanced, the values of corrected first moment and time to peak of the tumors were higher but area and peak were lower than contralateral gray matter. These findings show decrease of intratumoral blood volume and delay of mean transit time and arrival time of the bolus. Compared with CBF measured by Xe-enhanced CT, it was suggested that high density area of metastatic brain tumor or malignant glioma consisted of viable tumor cells, and in patients with glioma, low density area adjacent to the tumor with contrast enhancement was the invasive site of the tumor. Using dynamic CT, we were also able to distinguish the tissue contains viable tumor cells from the other part of brain by the differences in the parameter value.
We report a computer-assisted technique for comparison of dose-response curves. Slopes and ED50 values are calculated on the percentage response and the probit transformation of that response, and these are then compared by using an analysis of variance. The technique is much more sensitive than the usual approach of point-by-point comparison and enables several curves to be compared simultaneously. The program, which is written in APL, is interactive and can be used from a terminal by those unfamiliar with computing.
Subjective multivariable analysis by computer was utilized to evaluate the results in a series of 659 patients undergoing coronary artery saphenous vein bypass surgery. A video terminal gave access to a remote computer. The postoperative subjective response was evaluated by questionnaires sent to patients at 6- to 12-month intervals, and was augmented by treadmill testing and postoperative coronary arteriography. Operative risk and subjective response are related only to the degree of ventricular function lost prior to surgery. Long-term results were best in patients in whom complete revascularization was possible. Current operative risk is less than 1%; a five-year survival rate of 90% to 95% is predicted. More than 90% of patients were asymptomatic or "greatly improved." Postoperative treadmill tests were negative in 88% of patients in these groups. In patients who were only "slightly improved" or "not improved," repeat catherization showed a graft patency rate of 84%, suggesting that recurrent symptoms were related to the extent of preoperative disease or to the progression of disease in nongrafted vessels, rather than to graft occlusion.