Multiparameter optimisation of a magneto-optical trap using deep learning

Machine learning based on artificial neural networks has emerged as an efficient means to develop empirical models of complex systems. Cold atomic ensembles have become commonplace in laboratories around the world, however, many-body interactions give rise to complex dynamics that preclude precise analytic optimisation of the cooling and trapping process. Here, we implement a deep artificial neural network to optimise the magneto-optic cooling and trapping of neutral atomic ensembles. The solution identified by machine learning is radically different to the smoothly varying adiabatic solutions currently used. Despite this, the solutions outperform best known solutions producing higher optical densities.

The use of the Minimum Data Set. Home Care in a case management project in Hong Kong

130 hospital-discharged elderly patients received our comprehensive assessment by using a Chinese Minimum Data Set-Home Care (MDS-HC). Our case manager developed and implemented care plans with reference to the computer-generated Clients Assessment Protocols. Results showed that the MDS-HC was sensitive to identify elderly persons' holistic needs, and helpful in formulating all-inclusive care plans.

Focal lobular spermatogenesis and pubertal acceleration associated with ipsilateral Leydig cell hyperplasia

Leydig cell tumors of the testis are the underlying cause in about 10% of the cases of precocious puberty in boys. Leydig cell hyperplasia is a less well-characterized cause, with an undocumented frequency. We describe a boy with precocious puberty associated with ipsilateral testicular enlargement and focal Leydig cell hyperplasia with spermatogenesis limited to the local adjacent testicular tissue.

Incidence of complicated healing and osteoradionecrosis following tooth extraction in patients receiving radiotherapy for treatment of nasopharyngeal carcinoma

A group of 43 patients requiring tooth extraction after radiotherapy for nasopharyngeal carcinoma (NPC) was studied retrospectively to determine the incidence of post-extraction complications. It was found that because of the method used in the delivery of radiation, extraction of maxillary posterior teeth resulted in the greatest risk of complications (28.9 per cent), including a 10.5 per cent risk of osteoradionecrosis (ORN). Based on the findings, a protocol was established for the dental care of such patients. It was concluded that when extraction of maxillary posterior teeth was necessary, prophylactic antibiotics were not sufficient to prevent the complication of delayed healing. The risk of ORN was 10.5 per cent within the field of maximal radiation dose. Hyperbaric oxygen may be the better choice of preventive measures. However, in view of the low risk of ORN, wholesale prescription of hyperbaric oxygen therapy may not be indicated. An additional patient who had tooth extraction two weeks prior to radiotherapy was included to show that if adequate time for wound healing was not allowed, ORN could develop.

High-performance liquid chromatography analysis of oxidized and reduced pyridine dinucleotides in specific brain regions

An ultrasensitive HPLC method has been developed for measuring NADP+, NADPH, NAD+, and NADH. A simple, rapid reaction of the oxidized nucleotides with cyanide in basic solution leads to two stable fluorescent products and allows all four nucleotides to be separated and quantitated on one chromatogram. Furthermore, only one extraction is needed, rather than prior procedures which require one acid extraction (for oxidized species) and one basic extraction (for reduced species). This method is particularly useful in quantitating pyridine dinucleotides in rodent brain, where no current method is adequate to quantitate the small amounts contained in various brain regions. The assay is sensitive enough to measure individual brain regions down to 10 mg of tissue. Due to the involvement of NAD(P)H enzymatic systems in combating oxidative stress it is important to be able to assess levels regionally in brain diseases.

Administration of drugs by infusion pumps in palliative medicine

A retrospective study was carried out in 100 adult patients with advanced malignant disease. They were given subcutaneous continuous infusions of medication for symptom relief. The drugs were administered through a butterfly needle inserted subcutaneously in the anterior chest wall using a battery-operated infusion pump. The indications for using this technique were inability to swallow due to deteriorating general condition, oesophageal obstruction, intestinal obstruction, severe nausea and vomiting, terminal dyspnoea and poor pain control with oral opiates. All patients received morphine; other drugs administered through the syringe driver included hyoscine, metoclopramide, cyclizine, dexamethasone and midazolam. Ninety-four patients continued subcutaneous infusion until death. The mean duration of treatment was 9.1 days. The treatment was well tolerated by the patients and controlled their symptoms satisfactorily in the great majority. The use of continuous subcutaneous infusion via a syringe driver gives good symptom control. In the last days of life when the patients have difficulty tolerating oral medication, continuous subcutaneous infusion is a superior alternative to frequent intermittent parenteral injections.

Redox cycling of MPP+: evidence for a new mechanism involving hydride transfer with xanthine oxidase, aldehyde dehydrogenase, and lipoamide dehydrogenase

MPP+ is redox active in the presence of cytochrome P450 reductase and induces the formation of O2.- and HO(.). In this study, we report the redox cycling capability of MPP+ with additional enzymes and with UV photolysis detected through ESR techniques. The treatment of MPP+ with UV light resulted in the production of HO. trapped as a spin adduct. Two of the enzymes examined in this study, xanthine oxidase and aldehyde dehydrogenase, produced O2.- in the presence of substrate. However, when MPP+ was added to the incubations, the radical trapped by DMPO was HO(.). This indicates that MPP+ redox cycles in the presence of these two enzymes or UV light, which produces HO.. Our data also suggest that MPP+ is reduced by lipoamide dehydrogenase. MPP+ stimulated the oxidation of reduced nicotinamide adenine dinucleotide (NADH) by the enzyme at concentrations between 2 mM and 8 mM of MPP+. Higher concentrations of MPP+ inhibited lipoamide dehydrogenase. MPP+ appears to be redox active with a number of redox enzymes. The mechanism involved may be hydride transfer from the enzymes to MPP+, rather than a direct single-electron reduction.

MPP+ and MPDP+ induced oxygen radical formation with mitochondrial enzymes

MPP+ has been reported to inhibit reduced nicotinamide adenine dinucleotide (NADH) dehydrogenase in mitochondria, which results in the formation of O2(.-). The current report demonstrates that H2O2 and HO. are also products of MPP+ interaction with NADH dehydrogenase. It is possible that MPP. formation precedes the formation of some of these active oxygen species. Reducing equivalents for radical formation come from NADH. MPP+ may be capable of interacting with submitochondrial particles at a site other than the rotenone site, which results in some formation of oxygen radicals. Plasma amine oxidase incubations with MPDP+ resulted in O2.- H2O2, and perhaps HO. formation. This is probably due to MPP. formation from the oxidation of MPDP+. This study presents new findings that indicate the potential importance of oxygen radical formation in mitochondria during MPTP toxicity.

Cognitive-behavioural group therapy for Hong Kong Chinese adults with mental health problems

Ninety-one Chinese in the community, aged between 18 and 45, with mental health problems ranging from mild to moderate degree, were treated by cognitive behavioural group therapy (CBGT) for a period of 3 months. All subjects were assessed on multiple measures at 4 time points: screening, pre-treatment (after 3 months), post-treatment and at 3-month follow-up. Attendance was good. A standard practice manual was developed to ensure consistent treatment by 2 group workers. After controlling for the placebo effect in the waiting period, treatment effect was demonstrated which was sustained after a three month period. The all-round improvement included a decrease in psychiatric symptoms, improvement in self-assessment, better and more social activities and being more able to cope with problems. In terms of psychiatric diagnosis, depressed subjects gained the most benefit and personality disorder subjects the least. Parents seemed to benefit more than non-parents.

Coupling of mitochondrial metabolism and protein synthesis in heart mitochondria

Although much is now known with regard to the processes of mammalian mitochondrial gene expression, relatively little is known concerning the quantitative regulation of this pathway in response to hormones or other physiological stimuli. In this paper the potential coupling of mitochondrial metabolism to mitochondrial protein synthesis was investigated and the concentration of nucleotides and substrates for optimal translation in isolated rat heart mitochondria was determined. It was demonstrated that optimal isolated heart mitochondrial protein synthesis required the presence of an oxidizable substrate. Of the substrates tested, glutamate (20 mM) supported translation best followed by malate, succinate, and alpha-ketoglutarate, whereas pyruvate supported synthesis poorly. Unlike other recent mammalian mitochondrial systems, the presence of an oxidizable substrate was required for translation even in the presence of medium ATP and an exogenous energy-generating system. Mitochondrial translation also required the presence of adenine nucleotide that could be added as ADP or ATP; however, ATP added above 0.5 mM became progressively inhibitory. As a result, synthesis was supported significantly better by ATP synthesized by the system from added ADP, than by ATP added directly to the system. However, if the phosphorylation of ADP was prevented by limiting the phosphate concentration, ADP itself strongly inhibited mitochondrial protein synthesis. This inhibition appeared to be closely related to the energy charge of the system rather than to absolute levels of ADP, indicating for the first time that mitochondrial translation, like its cytoplasmic counterpart is regulated by energy charge. Last, this system did not require the inhibition of guanine nucleotide or exogenous energy-generating systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Mitochondrial protein synthesis during thyroxine-induced cardiac hypertrophy

The goal of this paper was to determine the effects of 3,5,3'-triiodothyronine (T3)-thyroxine-induced cardiac hypertrophy on the rates of synthesis of mitochondrial proteins by both the cytoplasmic and mitochondrial protein synthesis systems and to compare the results with total protein synthesis and cardiac enlargement. Daily injections of T3-thyroxine in the rat resulted in a 25% increase in the growth of the ventricle compared with controls. The cytoplasmic synthesis of both mitochondrial and total proteins as measured in the isolated perfused heart was stimulated by T3-thyroxine injection to a peak of 155 and 146%, respectively, of vehicle-injected controls after 3 days of hormone treatment. This peak was followed by a gradual decline in stimulation in total protein synthesis to 132% of control by 9 days of injection, whereas the decline in stimulation of cytoplasmic synthesis of mitochondrial proteins was significantly steeper, falling to 119% of vehicle control. The rate of protein synthesis within the mitochondrial compartment was also measured during the time course of T3-thyroxine-induced hypertrophy. These rates were measured in an isolated intact heart mitochondrial protein synthesis system described and characterized in the companion papers [E. E. McKee, B. L. Grier, G. S. Thompson, and J. D. McCourt. Am. J. Physiol. 258 (Endocrinol. Metab. 21): E492-E502, 1990; and E. E. McKee, B. L. Grier, G. S. Thompson, A. C. F. Leung, and J. D. McCourt. Am. J. Physiol. 258 (Endocrinol. Metab. 21): E503-E510, 1990]. Rates of mitochondrial protein synthesis were dramatically stimulated by T3-thyroxine injection.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma exchange in patients with rapidly progressive idiopathic IgA nephropathy: a report of two cases and review of literature

Primary IgA nephropathy is generally considered an indolent disease, but progression to chronic renal failure is not uncommon, and a rapidly progressive course is observed in some cases, especially when extensive fibrocellular crescents are present. The therapeutic benefit of immunosuppression and plasma exchange remains controversial. We described two patients with primary IgA nephropathy and rapidly progressive renal failure. Both patients showed extensive glomerulosclerosis and crescent formation in their renal biopsies. Corticosteroid and immunosuppressive therapy failed to control the progression of the disease, and plasma exchanges were performed. In both cases, the serum creatinine and creatinine clearance initially improved with plasma exchange and the rapid progression of renal failure was apparently halted. In one patient, the serum creatinine rose when treatment was discontinued and fell again when plasma exchange was recommenced. Nevertheless, the long-term benefit of plasma exchange in crescentic IgA nephropathy was unsatisfactory as the renal function continued to deteriorate in the following 12 months despite an initial stabilization.

Polyarteritis presenting with thrombocytosis and central retinal vein thrombosis

We report a case of polyarteritis in a 54 year old woman who presented with marked thrombocytosis and acute blindness in one eye secondary to central retinal vein thrombosis. She also developed bilateral pulmonary infiltrates and renal failure. The diagnosis was confirmed by histological changes in the renal biopsy. Treatment with immunosuppressives, plasma exchange and antiplatelet drugs led to rapid clinical improvement and recovery of renal function and prevented further thromboembolic episodes. Plasma exchange and antiplatelet drugs should be considered in polyarteritis group of systemic vasculitis especially in the presence of thromboembolic complications or thrombocytosis.

Hemofilter reuse in maintenance hemofiltration

The practice of multiple use of hemofilter was examined on 16 patients in our dialysis center. The hemofilters were cleaned by reverse ultrafiltration using positive pressure in the blood and filtrate compartment of the hemofilter. Ten hemofilters used for continuous arteriovenous hemofiltration, 6 hemofilters used for pump-assisted acute hemofiltration and seventy hemofilters used for chronic maintenance hemofiltration were studied for the clearances of urea nitrogen and creatinine and sieving coefficients of albumin and electrolytes. Hemofilters were successfully reused in pump-assisted acute hemofiltration and chronic hemofiltration. In continuous arteriovenous hemofiltration, hemofilters could not be reused mainly because of clotting of fibers. The practice is safe, efficient and highly cost-saving.

An overlapping syndrome of IgA nephropathy and lipoid nephrosis

The authors studied eight cases of IgA nephropathy presenting with nephrotic syndrome. Renal biopsy revealed only mild mesangial proliferation or minor glomerular changes on light microscopic examination but typical features of IgA nephropathy on immunofluorescent and electron microscopic examination. A satisfactory response characterized by correction of hypoalbuminemia, clearance of proteinuria, and an increase of endogenous creatinine clearance occurred with corticosteroid therapy. These cases represent a variant of IgA nephropathy associated with a nephrotic syndrome that resembles lipoid nephrosis in its responsiveness to steroid.

Polyarteritis nodosa and monocytic leukaemia

A 67 year old man presented with a polyarteritis nodosa-like syndrome with renal, pulmonary joint and neurological involvement during the 'preleukaemic' stage of monocytic leukaemia. The association between these two conditions is discussed.

Clostridium difficile-associated colitis in uremic patients

Five uremic patients managed in a renal unit developed Clostridium difficile-associated colitis. Four cases occurred in a cluster at about the same time. All patients had previously received or were on antibiotic therapy at the onset of diarrhea and one patient was also on oral steroid therapy. Cefotaxime, a third generation cephalosporin was involved in all five cases. All patients had severe diseases with explosive diarrhea and systemic toxicity. The diagnosis was confirmed in all cases by culture of C. difficile and demonstration of high titers of C. difficile cytotoxin in the stool. Histology from rectal biopsy in one patient showed classical pseudomembranous colitis. Response to treatment with vancomycin was generally good though one patient had two relapses. Uremic patients have impaired immune response and intestinal motility and are predisposed to C. difficile infection. Cross-infection can occur and the isolation of affected patients seems prudent.

Polyarteritis group of systemic vasculitis--new diagnostic criteria

We have used new diagnostic criteria to define patients with the polyarteritis nodosa (PAN) group of vasculitis. These were the combination of a necrotising glomerulitis without diffuse deposits of immunoglobulins or complement components in a patient presenting with systemic disease and multi-organ involvement. Twenty-two patients who fulfilled these criteria presented to our unit between 1975 and 1982. The diagnosis of PAN was confirmed by traditional histological criteria in eight. We anticipate that the use of these criteria will lead to earlier diagnosis and thereby improve the management of this potentially lethal disorder.

Phenylbutazone-induced systemic vasculitis with crescentic glomerulonephritis

Two patients had phenylbutazone-induced systemic vasculitis syndrome. Both presented with acute oliguric renal failure, and renal biopsies showed severe crescentic glomerulonephritis with marked interstitial inflammatory cell infiltration. Withdrawal of phenylbutazone and treatment with immunosuppressives and plasma exchange led to recovery of renal function in one case.

Successful management of Graves' disease in a patient undergoing regular dialysis therapy

Classic Graves' disease associated with thyroid-stimulating hormone receptor antibodies developed in a woman undergoing regular hemodialysis for uremia from chronic pyelonephritis. Her condition responded well to treatment initially with carbimazole and then an ablative dose of sodium iodide I 131 therapy. To our knowledge this is only the second documented case of hyperthyroidism in a patient with chronic renal failure, and it demonstrates that conventional forms of therapy are efficacious and safe.

Acute oliguric renal failure secondary to lymphomatous infiltration of the kidneys

A case of lymphomatous infiltration of the kidneys presenting as acute oliguric renal failure of unknown cause is described. Renal biopsy was required to establish the diagnosis. Combined chemotherapy (MOPP) produced significant improvement in renal function.

Diphtheroid peritonitis associated with continuous ambulatory peritoneal dialysis

Five patients on continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis caused by diphtheroid bacteria. Peritoneal catheter exit site inflammation and/or discharge preceded all cases and relapses were common. Antimicrobial therapy alone failed to eradicate the bacteria and peritoneal catheter removal was required before peritonitis resolved. Laboratory culture of the diphtheroid bacteria was difficult and prolonged incubation was often necessary. Diphtheroid bacteria are important opportunistic pathogens in immunocompromised patients and should be carefully sought for in all cases of culture-negative CAPD-associated peritonitis.

Aluminium hydroxide versus sucralfate as a phosphate binder in uraemia

In an attempt to discover a phosphate binding agent for use in uraemia that would not lead to appreciable systemic absorption of aluminium the effect of sucralfate was evaluated after three weeks and compared with that of the existing standard agent aluminium hydroxide. Sucralfate caused a decrease in serum phosphate concentration comparable with that obtained with aluminium hydroxide, but similar absorption of aluminium resulted. Sucralfate may be the phosphate binder of choice in patients with uraemia and peptic ulceration; care should be taken in using large doses of the drug in patients with normal renal function.

Successful treatment of multiresistant pseudomonas peritonitis with combination of azlocillin and amikacin

Multiresistant Pseudomonas infection remains a problem in hospital practice. We report a case of pseudomonas peritonitis successfully treated by a combination of azlocillin and amikacin. This is the first case report of the intraperitoneal use of azlocillin.