Secure polarization-independent subcarrier quantum key distribution in optical fiber channel using BB84 protocol with a strong reference.

A quantum key distribution system based on the subcarrier wave modulation method has been demonstrated which employs the BB84 protocol with a strong reference to generate secure bits at a rate of 16.5 kbit/s with an error of 0.5% over an optical channel of 10 dB loss, and 18 bits/s with an error of 0.75% over 25 dB of channel loss. To the best of our knowledge, these results represent the highest channel loss reported for secure quantum key distribution using the subcarrier wave approach. A passive unidirectional scheme has been used to compensate for the polarization dependence of the phase modulators in the receiver module, which resulted in a high visibility of 98.8%. The system is thus fully insensitive to polarization fluctuations and robust to environmental changes, making the approach promising for use in optical telecommunication networks. Further improvements in secure key rate and transmission distance can be achieved by implementing the decoy states protocol or by optimizing the mean photon number used in line with experimental parameters.

Imaging high-dimensional spatial entanglement with a camera.

The light produced by parametric down-conversion shows strong spatial entanglement that leads to violations of EPR criteria for separability. Historically, such studies have been performed by scanning a single-element, single-photon detector across a detection plane. Here we show that modern electron-multiplying charge-coupled device cameras can measure correlations in both position and momentum across a multi-pixel field of view. This capability allows us to observe entanglement of around 2,500 spatial states and demonstrate Einstein-Podolsky-Rosen type correlations by more than two orders of magnitude. More generally, our work shows that cameras can lead to important new capabilities in quantum optics and quantum information science.

Picosecond time-resolved photoluminescence at detection wavelengths greater than 1500 nm.

We report what is to our knowledge the first application of high-efficiency InGaAs/InP photon-counting diode detectors in time-resolved photoluminescence measurements at wavelength greater than 1500 nm. When they were cooled to 77 K and used in conjunction with the time-correlated single-photon counting technique, the detectors were capable of an instrumental response of 230 ps and a noise equivalent power of 2x10(-17)W Hz(-1/2) . Preliminary measurement of a semiconductor heterostructure indicates sensitivity at photogenerated carrier densities as low as 10(14)cm (-3) . This development facilitates the detailed characterization of dominant recombination mechanisms in semiconductor optoelectronic materials and devices designed to operate in the third telecommunications spectral window.

[Expert system for aiding diagnosis in hearing tests]. / Expertensystem zur Diagnoseunterstützung bei Hörprüfungen.

For expert systems intended to aid diagnosis, a structure with five levels is proposed. These levels are the original area, the parameter and a reduced parameter layer, the classification and the final-decision layer. On the basis of this structures, an expert system was developed specifically for neonatal hearing screening with transitory evoked otoacoustic emissions (TEOAE). In a second step, this system was investigated for its suitability to classify emissions, regardless of patient age. For the comparison measurements in 252 mainly adult patients, some with an acquired hearing impairment, were used. To adapt the pass/fail decision to the extended evaluation criteria, the false classifications from a first run with the new data were used for training. Thereafter, the expert system, working with a wider data basis, classified the new data with a sensitivity that was increased by 4.8% to 97.2%, and a 2.0% improvement in specificity to 95.5% when classifying new data, These results, together with those of 97.3% and 94.3% achieved with exclusively neonatal TEOAE classification, clearly show the advantage of the expert system structures chosen, and document evidence of the practical applicability of the method.

Performance and design of InGaAs /InP photodiodes for single-photon counting at 1.55 microm.

The performance of selected, commercially available InGaAs/InP avalanche photodiodes operating in a photon-counting mode at an incident wavelength of 1.55 microm is described. A discussion on the optimum operating conditions and their relationship to the electric field distribution within the device is presented.

Trimethoprim-sulfamethoxazole therapy in outpatients: is hyperkalemia a significant problem?

A prospective, randomized clinical study was undertaken to determine the effect of standard-dose trimethoprim-sulfamethoxazole combination treatment on serum potassium concentrations in outpatients treated in an ambulatory clinic. Ninety-seven patients were treated with oral antibiotics for a variety of infections. Fifty-one patients treated with trimethoprim-sulfamethoxazole (trimethoprim, 320 mg/day; sulfamethoxazole, 1,600 mg/day) constituted the treatment group, while 46 patients treated with other antibiotics served as controls. Serum potassium, sodium, and chloride concentrations, serum carbon dioxide content, blood urea nitrogen level, serum creatinine level, and serum glucose concentration were measured. The baseline serum potassium concentration in the treatment group was 4.30 +/- (SD) 0.36 mmol/l, and it increased significantly (p < 0.001) to 4.66 +/- 0.45 mmol/l on day 5 of therapy. Subgroup analysis of mean serum potassium concentration on day 5 of therapy failed to detect clinically relevant hyperkalemia. In patients with a serum creatinine level equal to or greater than 1.1 mg/dl (K+, 4.83 +/- 0.48 mmol/l), a nonsignificant difference (p = 0.3) in the potassium concentration was noted on day 5 as compared with patients with a serum creatinine level <1.1 mg/dl (K+, 4.63 +/- 0.44 mmol/l). Although diabetics had a higher serum potassium concentration (K+, 4.91 +/- 0.44 mmol/l) than nondiabetics (K+, 4.61 +/- 0.44 mmol/l), the difference was not statistically significant (p = 0.055). Patients aged >/=50 years (K+, 4.82 +/- 0.59 mmol/l) had a significantly different (p = 0.046) serum potassium concentration on day 5 than patients aged <50 years (K+, 4.55 +/- 0.28 mmol/l). In contrast, the baseline serum potassium concentration in the control group was 4.37 +/- 0.45 mmol/l, and it decreased (p = 0.1) to 4.22 +/- 0.4 mmol/l on 5 days of drug therapy. Trimethoprim-sulfamethoxazole therapy, when used to treat a variety of infections, leads to an increase in serum potassium concentration in most patients. After 5 days of therapy with this drug, the treatment group developed a statistically significant rise in the serum potassium concentration as compared with the control group. However, severe hyperkalemia (K+ >/=5.5 mmol/l) occurred in only 3 patients (6%) treated with trimethoprim-sulfamethoxazole. In addition, none of the subgroups of treated patients developed clinically important hyperkalemia. This suggests that outpatients, in contrast to acquired immunodeficiency syndrome patients and hospitalized patients with mild renal insufficiency, develop severe or life-threatening hyperkalemia less commonly when treated with this antimicrobial regimen. However, outpatients having risk factors which may predispose to the development of hyperkalemia should be carefully monitored when treated with trimethoprim-sulfamethoxazole.

Optoelectronic Systems Based on InGaAs- Complementary-Metal-Oxide-Semiconductor Smart-Pixel Arrays and Free-Space Optical Interconnects.

Free-space optical interconnects have been identified as a potentially important technology for future massively parallel-computing systems. The development of optoelectronic smart pixels based on InGaAs/AlGaAs multiple-quantum-well modulators and detectors flip-chip solder-bump bonded onto complementary-metal-oxide-semiconductor (CMOS) circuits and the design and construction of an experimental processor in which the devices are linked by free-space optical interconnects are described. For demonstrating the capabilities of the technology, a parallel data-sorting system has been identified as an effective demonstrator. By use of Batcher's bitonic sorting algorithm and exploitation of a perfect-shuffle optical interconnection, the system has the potential to perform a full sort on 1024, 16-bit words in less than 16 mus. We describe the design, testing, and characterization of the smart-pixel devices and free-space optical components. InGaAs-CMOS smart-pixel, chip-to-chip communication has been demonstrated at 50 Mbits/s. It is shown that the initial system specifications can be met by the component technologies.

Time-of-Flight Optical Ranging System Based on Time-Correlated Single-Photon Counting.

The design and implementation of a prototype time-of-flight optical ranging system based on the time-correlated single-photon-counting technique are described. The sensor is characterized in terms of its longitudinal and transverse spatial resolution, single-point measurement time, and long-term stability. The system has been operated at stand-off distances of 0.5-5 m, has a depth repeatability of <30 mum, and has a lateral spatial resolution of <500 mum.

Automatic classification of transiently evoked otoacoustic emissions using an artificial neural network.

The increasing use of transiently evoked otoacoustic emissions (TEOAE) in large neonatal hearing screening programmes makes a standardized method of response classification desirable. Until now methods have been either subjective or based on arbitrary response characteristics. This study takes an expert system approach to standardize the subjective judgements of an experienced scorer. The method that is developed comprises three stages. First, it transforms TEOAEs from waveforms in the time domain into a simplified parameter set. Second, the parameter set is classified by an artificial neural network that has been taught on a large database TEOAE waveforms and corresponding expert scores. Third, additional fuzzy logic rules automatically detect probable artefacts in the waveforms and synchronized spontaneous emission components. In this way, the knowledge of the experienced scorer is encapsulated in the expert system software and thereafter can be accessed by non-experts. Teaching and evaluation of the neural network was based on TEOAEs from a database totalling 2190 neonatal hearing screening tests. The database was divided into learning and test groups with 820 and 1370 waveforms respectively. From each recorded waveform a set of 12 parameters was calculated, representing signal static and dynamic properties. The artifical network was taught with parameter sets of only the learning groups. Reproduction of the human scorer classification by the neural net in the learning group showed a sensitivity for detecting screen fails of 99.3% (299 from 301 failed results on subjective scoring) and a specificity for detecting screen passes of 81.1% (421 of 519 pass results). To quantify the post hoc performance of the net (generalization), the test group was then presented to the network input. Sensitivity was 99.4% (474 from 477) and specificity was 87.3% (780 from 893). To check the efficiency of the classification method, a second learning group was selected out of the previous test group, and the previous learning group was used as the test group. Repeating learning and test procedures yielded 99.3% sensitivity and 80.7% specificity for reproduction, and 99.4% sensitivity and 86.7% specificity for generalization. In all respects, performance was better than for a previously optimized method based simply on cross-correlation between replicate non-linear waveforms. It is concluded that classification methods based on neural networks show promise for application to large neonatal screening programmes utilizing TEOAEs.

Laser depth measurement based on time-correlated single-photon counting.

A method for acquiring range data based on time-correlated single-photon counting is described. This method uses a short-pulse ( approximately 10-ps) laser diode, a detector based on a silicon single-photon avalanche diode, and standard photon-counting timing electronics. The accuracy of the technique has been measured as approximately +/-30 microm in a laboratory experiment and corresponds closely to the results of a theoretical simulation.

Mechanical mitral valve prosthesis dysfunction from thrombus: transesophageal echocardiography has limitations.

Transesophageal echocardiography (TEE) is a useful clinical tool for the evaluation of a variety of cardiovascular lesions. In particular, TEE has been demonstrated to be a better diagnostic modality in the visualization of mechanical prosthetic heart valves than transthoracic echo-cardiography (TTE). Furthermore, TEE is noted to be particularly useful to evaluate the atrial surface of mitral prostheses, the usual location of thrombi or vegetations. We herein describe a patient with a dysfunctional St. Jude's mitral prosthesis resulting from an organized thrombus who underwent both TTE and TEE without visualization of the thrombus.

Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole.

OBJECTIVE: To determine the effect of standard-dose trimethoprim-sulfamethoxazole on serum potassium concentration in hospitalized patients. DESIGN: Prospective chart review. SETTING: Community-based teaching hospital. PATIENTS: 105 patients with various infections were hospitalized and treated. Eighty patients treated with standard-dose trimethoprim-sulfamethoxazole (trimethoprim, < or = 320 mg/d; sulfamethoxazole, < or = 1600 mg/d) composed the treatment group; 25 patients treated with other antibiotic agents served as the control group. MEASUREMENTS: Serum sodium, potassium, and chloride concentrations; serum carbon dioxide content; anion gap; blood urea nitrogen level; and serum creatinine level. RESULTS: The serum potassium concentration in the treatment group (mean +/- SD) was 3.89 +/- 0.46 mmol/L (95% CI, 3.79 to 3.99 mmol/L), and it increased by 1.21 mmol/L (CI, 1.09 to 1.32 mmol/L) 4.6 +/- 2.2 days after trimethoprim-sulfamethoxazole therapy was initiated. Blood urea nitrogen levels increased from 7.92 +/- 5.7 mmol/L (CI, 6.67 to 9.16 mmol/L) to 9.2 +/- 5.8 mmol/L (CI, 7.9 to 10.5 mmol/L), and serum creatinine levels increased from 102.5 +/- 49.5 mumol/L (CI, 91.4 to 113.6 mumol/L) to 126.1 +/- 70.7 mumol/L (CI, 110.3 to 141.9 mumol/L). Patients with a serum creatinine level of 106 mumol/L (1.2 mg/dL) or more developed a higher peak potassium concentration (5.37 +/- 0.59 mmol/L [CI, 5.15 to 5.59 mmol/L]) than patients with a serum creatinine level of less than 106 mumol/L (4.95 +/- 0.48 mmol/L [CI, 4.80 to 5.08 mmol/L]). Patients with diabetes had a slightly higher peak potassium concentration (5.14 +/- 0.45 mmol/L [CI, 4.93 to 5.39 mmol/L]) than did patients without diabetes (5.08 +/- 0.59 mmol/L [CI, 4.93 to 5.23 mmol/L]), but the difference was not statistically significant. The serum potassium concentration in the control group was 4.33 +/- 0.45 mmol/L (CI, 4.15 to 4.51 mmol/L), and it decreased nonsignificantly over 5 days of therapy. CONCLUSIONS: Standard-dose trimethoprim-sulfamethoxazole therapy used to treat various infections leads to an increase in serum potassium concentration. A peak serum potassium concentration greater than 5.0 mmol/L developed in 62.5% of patients; severe hyperkalemia (peak serum potassium concentration > or = 5.5 mmol/L) occurred in 21.2% of patients. Patients treated with standard-dose trimethoprim-sulfamethoxazole should be monitored closely for the development of hyperkalemia, especially if they have concurrent renal insufficiency (serum creatinine level > or = 106 mumol/L).

Time-resolved photoluminescence measurements of InGaAs/ InP multiple-quantum-well structures at 1.3-µm wavelengths by use of germanium single-photon avalanche photodiodes.

A commercially available germanium avalanche photodiode operating in the single-photon-counting mode has been used to perform time-resolved photoluminescence measurements on InGaAs/lnP multiple-quantum-well structures. Photoluminescence in the spectral region of 1.3-1.48 µm was detected with picosecond timing accuracy by use of the time-correlated single-photon counting technique. The carrier dynamics were monitored for excess photogenerated carrier densities in the range 10(18)-10(15) cm(-3). The recombination time is compared for similar InGaAs-based quantum-well structures grown by use of different epitaxial processes.

Components for the implementation of free-space optical crossbars.

We describe an optical system developed to form the basis of a 64 × 64 free-space optical matrix-matrix crossbar switch. The design and performance of each of the main optical components is discussed: lenses, diffractive optical elements, and polarizing beamsplitters, together with the optomechanical hardware design. For these components, throughput levels of -6.9 dB have been achieved, which is compatible with full system operation at 10(-12) bit error rates at ≥270 Mbits s(-1).

Case reports: pericarditis and lymphadenitis due to Rhodococcus equi.

Most patients with Rhodococcus equi infection are immunocompromised by either HIV infection, malignancy, or medication. Diagnosis is frequently missed or delayed because the organisms, resembling diphtheroids on smears, may be regarded as contaminants. Their clinical, pathologic, histochemical, and microbiologic resemblance to mycobacteria can result in misdiagnosis. Two cases were seen recently in our institution. R. equi pericarditis developed in a 29-year-old woman with failed renal transplant and R. equi axillary lymphadenitis developed in an asymptomatic 27-year-old man. These patients are important because the former is the first reported case of R. equi pericarditis, and the second case was unusual because of the absence of immunocompromise.

Nephrotic syndrome associated with agnogenic myeloid metaplasia.

Agnogenic myeloid metaplasia (AMM), a myeloproliferative disorder of clonal origin, can affect the kidneys via several mechanisms. Associated disorders include asymptomatic interstitial extramedullary hematopoiesis, obstructive uropathy and nephrolithiasis. Currently, there are no descriptions of the nephrotic syndrome associated with AMM. We present a case of AMM associated with the nephrotic syndrome, a mesangial proliferative glomerular lesion and extramedullary hematopoiesis.

NSAID nephrotoxicity revisited: acute renal failure due to parenteral ketorolac.

The success of ketorolac as a nonnarcotic analgesic is likely to propagate its widespread use to control moderate to severe postoperative pain. Indeed, of the patients treated with ketorolac and described in the medical literature, nearly 90% had had a major surgical procedure. Since any such procedure may be associated with significant third-spacing of the fluid and result in renal hypoperfusion, care must be taken in administering ketorolac. Close attention to urine output and parameters of renal function must be maintained. Moreover, postoperative ketorolac therapy should be avoided in patients who have conditions that predispose to NSAID nephrotoxicity (as in our Case 1). Likewise, in nonsurgical patients the same degree of caution should be used with ketorolac as with any oral NSAID. Finally, since ketorolac is excreted almost entirely by the kidney, either elderly patients or patients with underlying renal insufficiency must have an adjustment of the dosing interval, or this medication should be avoided in such patients altogether.

Successful treatment of cystinuria with captopril.

Cystinuria is an autosomal recessive hereditary disorder associated with nephrolithiasis and its attendant complications. Traditional management aimed at increasing urinary cystine solubility using oral alkali, D-penicillamine, or mercaptopropionyglycine is often unsuccessful due to intolerable side effects. Two cystinuric patients intolerant of traditional therapy were treated with captopril for 1 year, resulting in a marked decline in urinary cystine excretion. Neither patient experienced recurrent nephrolithiasis or adverse drug effects. Captopril should be considered an alternative to traditional drug management of cystinuria.