Clinical Characteristics and Risk Factors for Mortality in Patients with Meningitis Caused by Staphylococcus aureus and Vancomycin Minimal Inhibitory Concentrations Against These Isolates

Background/PurposeBacterial meningitis caused by Staphylococcus aureus is uncommon but has a high mortality rate. The aims of this study were to better understand the clinical manifestations of S. aureus meningitis, to identify the risk factors for mortality in the affected patients, and to determine the levels of vancomycin minimal inhibitory concentrations (MICs) against these pathogens.MethodsA retrospective study of patients with S. aureus meningitis hospitalized between December 2000 and December 2008 was made, and vancomycin MICs against S. aureus isolates was determined using Etest.ResultsAmong 37 patients with S. aureus meningitis, fever was most commonly observed. Twenty-six patients (70.3%) had received prior neurosurgery, and 24 (64.9%) patients were suffering from methicillin-resistant S. aureus (MRSA) infections. The vancomycin MIC of 2 μg/mL was found in 23 (74.2%) of 31 S. aureus isolates available for testing. Excluding three patients who did not receive antibiotics for their S. aureus meningitis the mortality rate was 35.3% in the 34 remaining patients, with concurrent infective endocarditis an independent risk factor for mortality (odds ratio = 21.00; 95% confidence interval, 1.834-240.515; p = 0.01).ConclusionPatients with S. aureus meningitis and concurrent infective endocarditis were at a higher risk of mortality. A vancomycin MIC of 2 μg/mL against a substantial number of S. aureus isolates that grew from the cerebrospinal fluid suggests the importance of obtaining trough vancomycin concentrations of 15-20 μg/mL for the treatment of MRSA meningitis

THE DESIGN MODEL OF MICRO END-MILLS MADE BY USING THE FINITE ELEMENT METHOD

The green processing technology has been brought to the focus of attention around the world. The development and application of green cutting depend on the machine and cutting tool technology progress, in so far as the development of cutting tool technology has quite a big influence. The study was focused on the simulation analysis model for micro milling SKD61 tool steel developed by the finite element method. First, because the impact of the effective rake angle on the oblique cutting model is equivalent to that of the rake angle on the orthogonal cut model, the complex tool geometry of an end-mill will be simplified to the orthogonal cutting model. Using the Taguchi method, the FEM simulation of orthogonal cutting operation was performed under different cutting speeds, cutting depths, effective rake angles and relief angles were modified. The cutting force, tool maximum temperature, tool maximum temperature and tip distance, and the contact length of tool and chip are the major performance indexes of micro milling process. Finally, the multiple cutting performance characteristic resulting from the grey relational analysis reveals that the influencing priority ranks for micro end-mills made of SKD61 tool steel are cutting speed, effective rake angle, relief angle, and cutting depth. The FEM model is suitable for simulating the cutting performance of micro cutting process, and can also be used as a design base for micro endmills

SAGITTAL AND FRONTAL LOWER LIMBS KINETICS DURING STEPPING DOWN IN TAICHI ELDERLY

The aim was to compare the kinetic characteristics of the beginning stance phase during stepping down in Taichi and normal elderly. Nine elderly taichi subjects and eleven matched controls participated in the study. Whole body kinematics and ground reaction forces (GRF) were recorded using 10 Vicon cameras (250Hz) and two Kistler force plates (1000Hz). Sagittal and frontal kinetic parameters were calculated by using Visual3D software. Differences in variables between groups were tested using t-test. The results indicated hip extensor / knee flexor / ankle plantarflexor / support moment and peak hip/knee/ankle power were greater in Taichi group. It was concluded that Taichi group has ability to translate forward movement (hip moment / power), to control body (knee moment /power) and to absorption energy (ankle moment / power) in sagittal plane

Interpersonal Relationships among University Safety Professionals: The Impact of a Safety Departmentf

PresentationForming strong interpersonal relationships enables an organization or individual to achieve more favorable outcomes. The objectives of this study were to examine the frequency of interpersonal interactions among safety professionals (SPs) employed at Taiwanese universities and the factors that affected this frequency. To accomplish these objectives, we mailed questionnaires to a simple random sampling of 200 university SPs. Moreover, an interpersonal relationship scale was developed in this study; exploratory factor and internal consistency analyses revealed that the scale was valid and reliable. Results derived from the questionnaire revealed that in SP interpersonal relationships, general affairs department personnel, laboratory or internship unit supervisors, and teaching staff ranked highest in frequency of interactions. Multivariate analysis of variance results showed that establishing a safety department exerted a statistically significant effect on SP interpersonal relationships. SPs employed by universities with safety departments interacted more frequently with both internal and external relationships. Therefore, we suggest that universities without a safety department establish such a department to strengthen the labor safety and health structure, thereby benefitting SPs in fulfilling responsibilities to promote safety and health management

Differentiation of Col I and Col III Isoforms in Stromal Models of Ovarian Cancer by Analysis of Second Harmonic Generation Polarization and Emission Directionality

AbstractA profound remodeling of the extracellular matrix occurs in many epithelial cancers. In ovarian cancer, the minor collagen isoform of Col III becomes upregulated in invasive disease. Here we use second harmonic generation (SHG) imaging microscopy to probe structural differences in fibrillar models of the ovarian stroma comprised of mixtures of Col I and III. The SHG intensity and forward-backward ratios decrease with increasing Col III content, consistent with decreased phasematching due to more randomized structures. We further probe the net collagen α-helix pitch angle within the gel mixtures using what is believed to be a new pixel-based polarization-resolved approach that combines and extends previous analyses. The extracted pitch angles are consistent with those of peptide models and the method has sufficient sensitivity to differentiate Col I from the Col I/Col III mixtures. We further developed the pixel-based approach to extract the SHG signal polarization anisotropy from the same polarization-resolved image matrix. Using this approach, we found that increased Col III results in decreased alignment of the dipole moments within the focal volume. Collectively, the SHG measurements and analysis all indicate that incorporation of Col III results in decreased organization across several levels of collagen organization. Furthermore, the findings suggest that the collagen isoforms comingle within the same fibrils, in good agreement with ultrastructural data. The pixel-based polarization analyses (both excitation and emission) afford determination of structural properties without the previous requirement of having well-aligned fibers, and the approaches should be generally applicable in tissue

Papillary Adenocarcinoma of Rete Testis Mimics Inflammatory Lump: A Case Report

We presented a rare extratesticular neoplasm, papillary adenocarcinoma of rete testis, which manifested variable symptoms and mimicked most frequently seen benign extratesticular lesions. Due to its rarity, the treatment is therefore uncertain. Our patient's clinical manifestations mimicked an inflammatory lump and underwent radical orchiectomy after pathological report had been confirmed. Unlike other reports, our patient survives and has a good outcome. No definite predictor and tumor marker can be used to define the prognosis. Early diagnosis and surgical treatment may have a good outcome