Imaging perturbed shock propagation in powders.

A novel experimental methodology is presented to study the deviatoric response of powders in shock regimes. The powders are confined to a cylindrical wedge volume, and a projectile-driven shock wave with a sinusoidally varying front propagates through the powder. The perturbed shock wave exhibits a damping behavior due to irreversible processes of viscosity and strength (deviatoric) of the powder with propagation through increasing powder thicknesses. The inclined surface of the wedge is polished and coated to establish a diffuse surface suitable for reflecting incident laser light into a high-speed camera imaging at 5 MHz. Images of the contrast loss upon shock wave arrival at the observation surface are post-processed for qualitative and quantitative information. New data of shock damping behavior with parameters of perturbation wavelength and initial shock strength are presented for powders of copper, tantalum, and tungsten carbide as well as their mixtures. We present the first full-field images showing additional spatial disturbances on the perturbed shock front that appear dependent on particle material and morphology.

Safe and effective use of alitretinoin in children with recalcitrant hand eczema and other dermatoses - a retrospective analysis.

BACKGROUND: Alitretinoin is a systemic retinoid licensed for use in adult patients suffering from chronic hand eczema recalcitrant to potent topical steroids. Experience with its use in childhood is lacking. OBJECTIVES: To report on the efficacy and safety of alitretinoin treatment in a cohort of children and adolescents with chronic hand eczema (CHE) and other inflammatory skin diseases. METHODS: We performed a retrospective chart review of all consecutive patients under the age of 18 years treated with alitretinoin at our paediatric skin centre. Physician's Global Assessment (PGA) was used as the primary outcome measure. RESULTS: Thirteen children (9 girls and 4 boys) were enrolled in this study. The median age at start of treatment with alitretinoin was 11.5 years (range 5.8-15.8 years). Nine children were diagnosed with CHE, two with severe atopic dermatitis (AD), and two with inherited ichthyosis [netherton syndrome (NS), autosomal recessive congenital ichthyosis (ARCI)]. Moderate to excellent response (PGA decrease of ≥1 point) was observed in 7 (78%) of the nine patients with CHE, one of the two patients with extensive AD and in the one patient with ARCI. In the remaining four subjects, no convincing effect was documented. Tolerability was overall very good. The most common adverse event was headache in 10 patients (77%) during the initiation of treatment, leading to interruption of therapy in one subject. CONCLUSIONS: Alitretinoin seems to be highly effective and safe for the treatment of paediatric CHE and should thus be considered in children with refractory disease under topical therapy. Larger studies are required to corroborate these findings.

Transverse Anderson localization of surface plasmon polaritons.

We investigate the effect of disorder on the propagation of surface plasmon polaritons in arrays of evanescently coupled dielectric loaded surface plasmon polariton waveguides. Diagonal disorder is implemented by randomly varying the heights of the waveguides. Real-space as well as momentum-space images of the surface plasmon polariton intensity distribution in the waveguide arrays are recorded by leakage radiation microscopy. In real space, increasing disorder results in a transverse localization of surface plasmon polaritons. In the momentum distribution, we observe for the first time a disorder-induced transition from a continuous band to a set of discrete modes.

[PASTA-lesions--debridement versus repair]. / PASTA-Läsionen--Debridement versus Naht.

BACKGROUND: Partial articular supraspinatus tendon avulsions (PASTA) lesions remain challenging with regard to diagnosis and treatment. DIAGNOSTICS: For the diagnosis of PASTA lesions, arthroscopic evaluation of the supraspinatus tendon is key. Preoperative imaging alone is usually not sufficient to make the treatment decision. OPERATIVE TECHNIQUE: For non-significant partial tears of less than 50 % of the tendon thickness a simple debridement is indicated. Two basic repair techniques, a transtendon repair technique and a repair after tear completion, can be distinguished. In PASTA lesions, a repair is generally preferred to debridement. RESULTS: Results in the literature do not favor one repair technique over the other. Prospective randomized trials comparing debridement with repair are lacking in the literature. From a technical standpoint tear completion and repair seem to be a bit more reproducible.

[Diverticulum of the ductus arteriosus. Cause of traumatic aortic ruptures?]. / Ductus-arteriosus-Divertikel. Ursache traumatischer Aortenrupturen?

INTRODUCTION: According to angiographic studies 9-26% of all adult aortae show a ductus arteriosus diverticulum (DAD), i.e. an indention of the aortic wall at the insertion of the obliterated ductus arteriosus. This region is predisposed for traumatic aortic rupture. Up to now fixation at the transition from aorta transversa to fixed aorta descendens is regarded as cause. It is unclear whether ductus diverticulum favours traumatic aortic rupture. MATERIAL AND METHODS: A total of 143 thoracic aortas (female symbol:37; male symbol:106, 17-91 years) were scanned histomorphologically for DAD. Calcification was quantified by CT multislice volume scan. RESULTS: A DAD was detected in 44% of macroscopically non-calcified and slightly calcified aortic specimens. Histologically, autochthonal elastic and collagenous fibres of the media were disrupted. CT in macroscopically non-calcified aortas proved isolated calcification in 78%. DISCUSSION: The incidence of 44% DAD-higher than in angiographic studies-can be explained by the method (histopathology), allowing diagnosis of diverticula down to microm. These morphological alterations are to be seen, at least in part, as a causative factor for the predilection to traumatic aortic ruptures.

Bleeding complications in the uremic patient.

Many patients seen in podiatric medicine may have some degree of renal disease. An often neglected and unrecognized complication of renal disease may be abnormal bleeding. Presented in this paper is a review of the etiologies and treatment of uremia-induced bleeding complications. Included is a case presentation in which the authors discuss a patient in acute renal failure who developed postoperative bleeding following an incision and drainage for a diabetic foot infection.

SSM Data Center: a tool in the healthcare apostolate.

In 1967 the Sisters of St. Mary established the SSM Data Center to support the mission of the healthcare system by providing computer tools for all areas involved in the care of the sick and injured. To accomplish this, the data processing function was organizationally structured to report to the highest decision-making body of the healthcare system. This has encouraged every unit in the healthcare system to actively participate in the development and use of the computer system. The key to the system is a distributed network, which includes a host computer interconnected with microcomputers and minicomputers at each institution within the healthcare system. The center provides services designed around the uppermost administrative level acting as the nucleus but flexible enough to be tailored to each hospital's specific needs. This encourages the sharing of ideas among organizations but allows each hospital to maintain its unique identity and culture. The data center also provides a Resource Center to help in the use of personal computers and a data processing account representative in each hospital who acts as a liaison with the data center.

Shared hospital services: study report.

The study of shared hospital services reported in this article was conducted to determine the magnitude of shared administrative and clinical programs, what institutions participate, and most frequently shared services. To ensure that hospitals with different characteristics and in various areas were represented, the investigators mailed questionnaires to 1,731 of the nation's 5,987 short-term, acute care general hospitals in nine census regions. Responses indicated the following trends: Not-for-profit hospitals outrank other types of hospitals in using shared services. About 90 percent of hospitals with 200 to 499 beds shared services. For almost all categories of services, a percentage increase occurred in the number of hospitals participating in shared programs. The three most shared services were purchasing, data processing, and insurance programs. Hospitals shared more administrative than clinical services. According to administrators' responses, cost containment was the most common reason for sharing services. As the pressures to control health care costs increase, the investigators predict that hospitals will share more clinical services. Shared services decrease unit cost, however, only when providers have an excess capacity.

Liquid membrane capsules for treatment of uremia.

The objective of the program is to use ingested liquid membrane capsules (LMC) as gastrointestinal toxin traps as an adjunct to dialysis. Urea has been selected as the model toxic component to study before expanding the technology to other toxins. Transport across the small intestinal mucosa has been indicated to be adequate. There is no indication of reduction of mucosal transport or damage to the intestinal mucosa over short term but repetitive LMC perfusions. Performance of LMC perfused through Thiry Vella small intestinal loops is as good as in vitro performance and can be predicted. Substantial progress has been made toward developing LMC to perform in the more complex environment of the intact gastrointestinal tract. The demonstration of LMC performance in vivo with intact gastrointestinal tracts, and perhaps some increase in rate of toxin removal, will be required before LMC can be considered practical candidates for clinical use.