Outcome of patients with chlorpyrifos intoxication.

INTRODUCTION: There is a paucity of literature analyzing outcome of chlorpyrifos intoxication. METHODS: A total of 40 patients with chlorpyrifos intoxication were seen at Chang Gung Memorial Hospital between 2008 and 2017. Patients were stratified into two subgroups according to their prognosis, as good (n = 12) or poor (n = 28). Good prognosis group were defined as patients who survived without serious complications, and poor prognosis group included patients who died and survived after development of severe complications. Demographic, clinical, laboratory, and mortality data were obtained for analysis. RESULTS: Patients aged 53.8 ± 16.3 years and most were male (80.0%). All patients (100.0%) developed acute cholinergic crisis such as emesis (45.0%), respiratory failure (42.5%), tachycardia (30.0%), kidney injury (22.5%), and seizure (7.5%). Intermediate syndrome developed in 12.5% of patients, but none had delayed neuropathy (0%). The poor prognosis group suffered higher incidences of respiratory failure (p = 0.011), kidney injury (p = 0.026), and prolonged corrected QT interval (p = 0.000), and they had higher blood urea nitrogen level (p = 0.041), lower Glasgow coma scale score (p = 0.011), and lower monocyte count (p = 0.023) than good prognosis group. All patients were treated with atropine and pralidoxime therapy, but six patients (15.0%) still died of intoxication. In a multivariate logistic regression model, blood urea nitrogen was a significant risk factor for poor prognosis (odds ratio: 1.375, 95% confidence interval: 1.001-1.889, p = 0.049). Nevertheless, no mortality risk factor could be identified. CONCLUSION: The mortality rate of patients with chlorpyrifos intoxication was 15.0%. Furthermore, acute cholinergic crisis, intermediate syndrome, and delayed neuropathy developed in 100.0%, 12.5%, and 0% of patients, respectively.

Influence of age on PPV of sonographic BI-RADS categories 3, 4, and 5.

PURPOSE: The purpose of this retrospective study was to calculate the positive predictive value (PPV) of sonographic Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 in different age groups to investigate whether age influences the PPV of the BI-RADS category in breast ultrasound. MATERIALS AND METHODS: From our sonography-guided core biopsy database of breasts between 2006 and 2008, we identified 2817 BI-RADS category 3, 4, and 5 lesions with known pathological diagnosis in 2587 women, all of whom underwent the earlier breast assessment via ultrasound with a sonographic BI-RADS lexicon and later sonography-guided core biopsy. All lesions were classified into three age groups (< 45, 45 - 59, and > 59 years). The age-related PPVs of each BI-RADS category among three age groups were calculated on the basis of pathological diagnoses and were compared using a χ(2)-test. RESULTS: The overall PPV of each BI-RADS category was 2.2 % in category 3, 6.5 % in category 4a, 35.2 % in category 4b, 79.6 % in category 4c, and 99.6 % in category 5. The age-related PPVs of category 3 varied significantly among the three age groups (0.9 % versus 3.9 % versus 2.0 % p = 0.048), and notably, the age-related PPV in group 2 was higher than the others. Additionally, there was a significant positive association between the age-related PPVs and increasing age in categories 4a and 4b (4a, p < 0.0001 and 4b, p = 0.0139), but not in categories 4c and 5 (4c, p = 0.1853 and 5, p = 0.2871). CONCLUSION: The incidence of female breast cancer differs not only in different sonographic BI-RADS categories, but also in different age groups. Therefore, more attention should be paid to the special age group that we found for sonographic BI-RADS categories 3, 4a, and 4b.

Comparison of the APACHE II, GCS and MRC scores in predicting outcomes in patients with tuberculous meningitis.

OBJECTIVE: To evaluate different scoring systems, including Acute Physiology and Chronic Health Evaluation (APACHE) II, the Glasgow Coma Scale (GCS) and the Medical Research Council (MRC) staging system, as well as other prognostic factors, in predicting the discharge outcomes of adult patients with tuberculous meningitis (TBM). DESIGN: We conducted a retrospective analysis of patients admitted with a diagnosis of TBM to a tertiary hospital in northern Taiwan from March 1996 to February 2006. We used APACHE II, GCS, MRC and a variety of factors within 24 h of admission to predict discharge outcomes recorded by the Glasgow Outcome Scale (GOS). RESULTS: Among 43 TBM patients, 33 had a favourable outcome (GOS 4-5), and 10 had an unfavourable outcome (GOS 1-3). The severity of APACHE II, GCS, MRC and presence of hydrocephalus correlated well with the neurological outcomes (P < 0.05). The APACHE II and GCS scoring systems were more sensitive and specific than those of the MRC in receiver operating characteristic analysis. Furthermore, in-hospital mortality could be predicted accurately with APACHE II and GCS. CONCLUSIONS: The APACHE II scoring system is at least as effective as GCS and superior to MRC in predicting the discharge outcomes of adult patients with TBM.

Comparison of four methods for sperm preparation for IUI.

We compared the pregnancy rates and sperm characteristics of semen prepared by the albumin, Percoll, Puresperm, and swim-up methods. Semen analysis was performed by a computer-assisted system (CASA). The overall pregnancy rate was 14% per patient and 11% per cycle. The albumin and Percoll methods had the highest pregnancy rates, up to 12% per cycle. We then compared each method with the albumin method. The swim-up technique yielded the highest percentage of motile sperm. The Percoll method yielded statistically significant changes in average path velocity and straight-line velocity, while the Puresperm method revealed the same statistical changes in total concentration and hyperactive motile sperm percentage. After adjusting for age, methods, and CASA estimates, only straight-line velocity was significantly correlated with pregnancy. Although the Percoll method was associated with the best pregnancy rate, this product has been withdrawn from the market because of toxic contamination. Puresperm had replaced it in our laboratory but showed an unsatisfactory pregnancy rate. The swim-up method is the best choice for IUI.

Obstacle avoidance for autonomous land vehicle navigation in indoor environments by quadratic classifier.

A vision-based approach to obstacle avoidance for autonomous land vehicle (ALV) navigation in indoor environments is proposed. The approach is based on the use of a pattern recognition scheme, the quadratic classifier, to find collision-free paths in unknown indoor corridor environments. Obstacles treated in this study include the walls of the corridor and the objects that appear in the way of ALV navigation in the corridor. Detected obstacles as well as the two sides of the ALV body are considered as patterns. A systematic method for separating these patterns into two classes is proposed. The two pattern classes are used as the input data to design a quadratic classifier. Finally, the two-dimensional decision boundary of the classifier, which goes through the middle point between the two front vehicle wheels, is taken as a local collision-free path. This approach is implemented on a real ALV and successful navigations confirm the feasibility of the approach.

Effect of vapor phase corrosion inhibitor on microbial corrosion of aluminum alloys.

Vapor phase corrosion inhibitors were used to investigate the antimicrobial activities and anticorrosion of aluminum alloy. Aspergillus flavus, A. niger, A. versicolor, Chaetomium globosum and Penicillium funiculosum had moderate to abundant growth on the aluminum alloy AA 1100 at Aw 0.901, while there was less growth at Aw 0.842. High humidity stimulated microbial growth and induced microbial corrosion. Dicyclohexylammonium carbonate had a high inhibitory effect on the growth of test fungi and the microbial corrosion of aluminum alloy, dicyclohexylammonium caprate and dicyclohexylammonium stearate were the next. Aluminum alloy coating with vapor phase corrosion inhibitor could prevent microbial growth and retard microbial corrosion.

Two-step cell disruption for the extraction of membrane-associated recombinant protein from Saccharomyces cerevisiae.

The use of rDNA technology to express heterologous proteins has been very successful during the last several years. Choice of an expression host is very important in order to retain the biological activity of recombinant proteins. Baker's yeast, Saccharomyces cerevisiae, is a eucaryotic GRAS organism suitable for the expression of biologically active proteins. Specifically, hepatitis B surface antigen (HBsAg) is expressed in baker's yeast. Because the yeast cells need to be disrupted for the recovery of bioactive intracellular proteins and because the protein HBsAg is hydrophobic and has a tendency to become associated with cell membranes, the use of detergent increases the recovery yield. In order to remove most of the contaminants from yeast, a two-step disruption/extraction scheme has been developed that facilitates downstream processing. Furthermore, it also has the advantage of minimizing proteolytic actions on the recombinant protein by removing most of the contaminants and proteases into the supernatant during the first disruption step, while keeping the desired protein in the pellet fraction. Final recovery is then achieved by the extraction process. Parameters affecting the disruption/extraction processes have been discussed.