Management of Intrathecal Catheter-Tip Inflammatory Masses: A Consensus Statement

In a companion article, we synthesized current clinical and preclinical data to formulate hypotheses about the etiology of drug administration catheter-tip inflammatory masses. In this article, we communicate our recommendations for the detection, treatment, mitigation, and prevention of such masses. Methods. We reviewed published and unpublished case reports and our own experiences to find methods to diagnose and treat catheter-tip inflammatory masses in a manner that minimized adverse neurological sequelae. We also formulated hypotheses about theoretical ways to mitigate, and possibly, prevent the formation of such masses. Results. Human cases have occurred only in patients with chronic pain who received intrathecal opioid drugs, alone or mixed with other drugs, or in patients who received agents that were not labeled for long-term intrathecal use. Most patients had noncancer pain owing to their large representation among the population with implanted pumps. Such patients also had a longer life expectancy and exposure to intrathecal drugs, and they received higher daily doses than patients with cancer pain. Clues to diagnosis included the loss of analgesic drug effects accompanied by new, gradually progressive neurological symptoms and signs. When a mass was diagnosed before it filled the spinal canal or before it caused severe neurological symptoms, open surgery to remove the mass often was not required. Anecdotal reports and the authors' experiences suggest that cessation of drug administration through the affected catheter was followed by shrinkage or disappearance of the mass over a period of 2-5 months. Conclusions. Attentive follow-up and maintenance of an index of suspicion should permit timely diagnosis, minimally invasive treatment, and avoidance of neurological injury from catheter-tip inflammatory masses. Whenever it is feasible, positioning the catheter in the lumbar thecal sac and/or keeping the daily intrathecal opioid dose as low as possible for as long possible may mitigate the seriousness, and perhaps, reduce the incidence of such inflammatory masses.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75020/1/j.1526-4637.2002.02055.x.pd

Phosphor-Free Apple-White LEDs with Embedded Indium-Rich Nanostructures Grown on Strain Relaxed Nano-epitaxy GaN

Phosphor-free apple-white light emitting diodes have been fabricated using a dual stacked InGaN/GaN multiple quantum wells comprising of a lower set of long wavelength emitting indium-rich nanostructures incorporated in multiple quantum wells with an upper set of cyan-green emitting multiple quantum wells. The light-emitting diodes were grown on nano-epitaxially lateral overgrown GaN template formed by regrowth of GaN over SiO2 film patterned with an anodic aluminum oxide mask with holes of 125 nm diameter and a period of 250 nm. The growth of InGaN/GaN multiple quantum wells on these stress relaxed low defect density templates improves the internal quantum efficiency by 15% for the cyan-green multiple quantum wells. Higher emission intensity with redshift in the PL peak emission wavelength is obtained for the indium-rich nanostructures incorporated in multiple quantum wells. The quantum wells grown on the nano-epitaxially lateral overgrown GaN has a weaker piezoelectric field and hence shows a minimal peak shift with application of higher injection current. An enhancement of external quantum efficiency is achieved for the apple-white light emitting diodes grown on the nano-epitaxially lateral overgrown GaN template based on the light -output power measurement. The improvement in light extraction efficiency, ηextraction, was found to be 34% for the cyan-green emission peak and 15% from the broad long wavelength emission with optimized lattice period

Visible light communication using InGaN optical sources with AlInGaP nanomembrane down-converters

We report free space visible light communication using InGaN sources, namely micro-LEDs and a laser diode, down-converted by a redemitting AlInGaP multi-quantum-well nanomembrane. In the case of microLEDs, the AlInGaP nanomembrane is capillary-bonded between the sapphire window of a micro-LED array and a hemispherical sapphire lens to provide an integrated optical source. The sapphire lens improves the extraction efficiency of the color-converted light. For the case of the downconverted laser diode, one side of the nanomembrane is bonded to a sapphire lens and the other side optionally onto a dielectric mirror; this nanomembrane-lens structure is remotely excited by the laser diode. Data transmission up to 870 Mb/s using pulse amplitude modulation (PAM) with fractionally spaced decision feedback equalizer is demonstrated for the micro-LED-integrated nanomembrane. A data rate of 1.2 Gb/s is achieved using orthogonal frequency division multiplexing (ODFM) with the laser diode pumped sample

Effect of lactation stage and concurrent pregnancy on milk composition in the bottlenose dolphin

Although many toothed whales (Cetacea: Odontoceti) lactate for 2–3 years or more, it is not known whether milk composition is affected by lactation stage in any odontocete species. We collected 64 pooled milk samples spanning 1–30 months postpartum from three captive bottlenose dolphins Tursiops truncatus. Milks were assayed for water, fat, crude protein (TN × 6.38) and sugar; gross energy was calculated. Ovulation and pregnancy were determined via monitoring of milk progesterone. Based on analysis of changes in milk composition for each individual dolphin, there were significant increases (P<0.05) in fat (in all three dolphins) and crude protein (in two of three), and a decrease (P<0.05) in water (in two of three) over the course of lactation, but the sugar content did not change. In all three animals, the energy content was positively correlated with month of lactation, but the percentage of energy provided by crude protein declined slightly but significantly (P<0.05). At mid-lactation (7–12 months postpartum, n=17), milk averaged 73.0±1.0% water, 12.8±1.0% fat, 8.9±0.5% crude protein, 1.0±0.1% sugar, 1.76±0.09 kcal g−1 (=7.25 kJ g−1) and 30.3±1.3% protein:energy per cent. This protein:energy per cent was surprisingly high compared with other cetaceans and in relation to the growth rates of calves. Milk progesterone indicated that dolphins ovulated and conceived between 413 and 673 days postpartum, following an increase in milk energy density. The significance of these observed compositional changes to calf nutrition will depend on the amounts of milk produced at different stages of lactation, and how milk composition and yield are influenced by sampling procedure, maternal diet and maternal condition, none of which are known

Monolithically integrated white light LEDs on (11-22) semi-polar GaN templates

Carrier transport issues in a (11–22) semi-polar GaN based white light emitting diode (consisting of yellow and blue emissions) have been investigated by detailed simulations, demonstrating that the growth order of yellow and blue InGaN quantum wells plays a critically important role in achieving white emission. The growth order needs to be yellow InGaN quantum wells first and then a blue InGaN quantum well after the growth of n-type GaN. The fundamental reason is due to the poor hole concentration distribution across the whole InGaN quantum well region. In order to effectively capture holes in both the yellow InGaN quantum wells and the blue InGaN quantum well, a thin GaN spacer has been introduced prior to the blue InGaN quantum well. The detailed simulations of the band diagram and the hole concentration distribution across the yellow and the blue quantum wells have been conducted, showing that the thin GaN spacer can effectively balance the hole concentration between the yellow and the blue InGaN quantum wells, eventually determining their relative intensity between the yellow and the blue emissions. Based on this simulation, we have demonstrated a monolithically multi-colour LED grown on our high quality semi-polar (11–22) GaN templates

Grundlegende Untersuchungen zur Charakterisierung physikalisch-chemischer Prozesse bei der Plasmamodifizierung von Polymeroberflaechen Abschlussbericht

Low-density polyethylene and amorphous polystyrene as model materials have been subjected to low-temperature plasma and to ion beam treatment at controlled ion energy distribution function at the discharge electrode and with different ion sources (Ar, O_2, CF_4). Polymer modification and depth profiles were studied by ftir, ellipsometry, in situ microgravimetry and XPS. A direct effect of VUV irridation could be excluded. The kind of ion source strongly influences the polymer degradation. Under remote conditions as compared to the direct effect of plasma and ion beams the polymer degradation degree is strongly reduced, and with oxygen as the process gas more defined carbonyl structures are obtained. Under stationary conditions oxidized surface layers of &lt;3 nm were found at both model polymers, which application of a CF_4 plasma resulted in F-containing layers of &lt;10 nm. (WEN)SIGLEAvailable from TIB Hannover: F97B685+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman