Stochastic models for geriatric in-patient behaviour

Departments of geriatric medicine engage in two distinct formsof clinical activity: acute/rehabilitative and long-stay care.These are organizationally distinct and have very differentresource needs. Current hospital planning models, however, assumethat patients all move through the system at the same rate,thereby ignoring this effect of inherent heterogeneity in patientbehaviour. The present paper describes the movement of patientsthrough geriatric hospitals by a two-stage continuous-time Markovmodel, where the stages represent acute/rehabilitative and long-staypatients respectively. Patients are initially admitted to thefirst stage, from which they may depart from the system, bydeath or discharge, or move into the second stage, from whichthey eventually depart by death or discharge (unlikely). Admissionsare modelled in two ways: either as replacements for departuresor as a Poisson stream. Expressions for the distribution andmovement of numbers of patients are derived and evaluated fordata from a number of hospitals. Such an approach has the advantage,over previous crude models, of taking into account differenttypes of patients and introducing variability, thus making itpossible to extract variances as well as means of numbers ofgeriatric patients requiring hospital care.     

Additive effects of earthworm extract with HpD-laser on the enhancement of reactive oxygen production and the inhibition of[~3H]—thymidine.uptake in mouse ascitic tumor cells

The effects of combined use of earthworm extract(912)and HpD-laser on the produc-tion of reactive oxygen and the biosynthesis of DNA in S_(180) tumor cells were studied throughchemiluminescence measurement and[~3H]-TdR incorporation assay.The results showed that as com-pared with the control,the intensity of chemiluminescence emitted by tumor cells treatedsimultaneously with 912 and HpD-laser was enhanced more than ten-folds,while that treated with912 or HpD-laser alone was increased only 2～4 folds.The[~3H]-TdR incorporation into tumorcells of the former group was inhibited upto 74.1%,and that of the latter groups decreased onlyby 42.2% and 40.0%,respectively.In accordance with these biochemical changes,the ultrastructuraldamage of tumor cells of the former,combinedly treated group appeared to be the most serious.This suggests an additive effect of 912 with HpD-laser on tumor cells.In addition,if free radicalscavengers,such as catalase and superoxide dismutase,were added to the reaction systembefore chemiluminescence assay,the luminescent enhancement effect mentioned above was dramaticallyalleviated,implying the presence of O_2~ and H_2O_2 in the system.Therefore,as to the toxic effecton tumor cells,912 and HpD-laser are not only additive in efficiency,but also similar in theunderlying mechanism of action.     

Epilepsy in Ancient India

The ancient Indian medical system, Ayurveda, meaning science of life, is the oldest system of medicine in the world. Epilepsy is defined as Apasmara: apa, meaning negation or loss of; smara, meaning recollection or consciousness. Aura was recognized and was called Apasmara Poorva Roopa. A large number of symptoms indicative of aura were listed. Worthy of mention are subjective sensation of sounds, sensation of darkness, feeling of delusion, and dream-like state. An actual attack of Apasmara includes falling down; shaking of the hands, legs, and body; rolling up of the eyes; grinding of the teeth; and foaming at the mouth. Four major types of epilepsy based on the disturbance of doshas (humors) that govern the physiological and physiochemical activities of the body are mentioned. Apasmara is considered a dangerous disease that is chronic and difficult to treat. Several causes are mentioned. Treatment included correcting the etiological factors and dietary regimen and avoiding dangerous places that may result in injuries.     

Polymorphisms in manganese superoxide dismutase and catalase genes: functional study in Hong Kong Chinese asthma patients

BACKGROUND: Reactive oxygen species may contribute to the pathogenesis of asthma. Functional genetic polymorphisms of antioxidant enzymes, superoxide dismutase (SOD) and catalase are good candidates for asthma susceptibility. OBJECTIVE: To investigate the association of the manganese-containing form of SOD (MnSOD) gene at amino acid position 16 (Val16Ala) and catalase gene in the promoter at A-21T and C-262T polymorphisms and asthma in a Hong Kong Chinese population. METHODS: The association study was conducted in a case-control design in asthma patients (n=251) and healthy controls (n=316) by genotyping. The functional significance was assessed by determining erythrocyte SOD and catalase activity. RESULTS: The Val allele of MnSOD at Val16Ala and the A allele of catalase gene at A-21T were not different between patients and controls, while the C allele of catalase gene at C-262T was found to be significantly different between patients and controls (P=0.033). The less frequent variant of catalase gene (-262T) was found to be protective from the development of asthma in a Hong Kong Chinese non-smoking population (adjusted odds ratio=0.35, 0.15-0.85; P=0.017). Asthma patients had elevated erythrocyte SOD and catalase activities in comparison with healthy controls (P<0.01). However, their activities were not associated with different genotypes within healthy controls or asthma patients. CONCLUSION: This is the first report showing that SOD and catalase functional activities are not associated with their respective genetic polymorphisms but related to the presence of asthma in a Hong Kong Chinese population.     

Respiratory symptoms associated with the use of azodicarbonamide foaming agent in a plastics injection molding facility

Respiratory health variables were studied cross-sectionally in 227 employees of a plastics molding facility where numerous complaints had been apparently associated with the use of azodicarbonamide foaming agent in injection molding. Pre- and postshift respiratory status measures and azodicarbonamide concentrations were also obtained for 17 employees. Cross-sectional pulmonary function differences by injection molding status were not observed. Modest decrements in pulmonary function measures were observed between start and end of shift but with no dose-effect relationship. A strong association was observed for injection molding workers for eye/nose/throat irritation, cough, and wheezing. Additionally, wheezing, chest tightness, and symptoms of chronic bronchitis were strongly associated with work in injection molding during periods in which azodicarbonamide was in use. These results suggest respiratory symptom causation by some combination of azodicarbonamide itself, reaction products of azodicarbonamide formed during injection molding, or other unidentified agents uniquely associated with the process of injection molding with azodicarbonamide foaming agent.     

流动注射分析法测定醋酸泼尼松片含量均匀度的研究

根据蓝四氮唑与泼尼松生成蓝色产物,并于525nm 波长处测定吸光度。测定条件为:反应管长度为3.8m(0.5mm id);流速为1.6ml/min;反应温度为55±0.5℃;注射样品溶液为100μl;本测定系统的测定速度可达100次/h;线性范围可达0.09mg/ml;检测限量为1.54μg/ml;测定结果的变异系数小于1%。     

曲肘式机构的优化设计

以功效系数为目标函数,相应地确定了设计变量和约束函数,对塑料注塑机合模机构的参数进行优化计算,提高了机构的综合性能。     

黄芪注射液治疗充血性心力衰竭的临床观察

目的 :观察黄芪注射液对充血性心力衰竭 (CHF)的治疗效果。方法 :将 12 7例心衰病人随机分为 2组。对照组 5 5例 ,给予传统治疗心衰药物洋地黄、利尿剂及休息、低盐饮食、吸氧等治疗 ;治疗组 72例 ,在对照组病人用药的基础上加黄芪注射液 40ml ,静脉滴注 ,每日 1次 ,2组均连续用药 15天。结果 :总有效率治疗组 91 7%,对照组 6 7 3%,治疗组效果明显优于对照组 (P <0 0 1) ,且 2组自身对照 ,治疗后好转程度 ,治疗组优于对照组 ,左室射血分数 (LVEF)明显好于对照组。结论 :在常规治疗CHF的同时加用黄芪注射液可显著提高疗效。     

Measurement of free and total hydroxyproline by automated flow injection of serum or urine samples from maintenance hemodialysis patients with renal osteodystrophy

An automated measurement of total and free hydroxyproline in serum or urine is presented that uses flow injection analysis. After exclusion of nonspecific substances, hydroxyproline was oxidized by chloramine- T and L-cysteine with Ehrlich's reagent. The linearity obtained was from 3.8μmole/ L to 1.22 mmole/L with good precision (CV <3%). Comparison of the proposed method with HPLC yielded r = 0.939 as the correlation coefficient. Reference intervals of free and total hydroxyproline are 1.4–9.7 μmole/L, 3.8–27.2 μmole/L for serum, and 10.0–72.5 μmole/L, 25.2–303.6 μmole/L for urine, respectively. Serum free and total hydroxyproline levels in renal osteodystrophy patients on maintenance hemodialysis (N = 71) were significantly higher than in controls (P<0.0001). This method is superior to the use of HPLC with regard to stability of the color reaction. The measurement of serum free and total hydroxyproline is a useful marker for therapeutic observation of renal osteodystrophy patients. © 1994 Wiley-Liss, Inc.