Acute Viral Hepatitis C-Induced Jaundice in Pregnancy

SummaryObjectiveAcute viral hepatitis C-induced jaundice in pregnancy is very rare and may be fatal. Here, we report a complicated case with acute hepatitis C-induced jaundice in pregnancy with successful managementCase ReportA 27-year-old pregnant woman, gravida 2, para 1, with gestational age of 36 weeks and 5 days, was referred to our hospital due to jaundice and elevated liver enzymes of undetermined cause. She had been suffering from general weakness, diarrhea and vomiting for 1 week, and jaundice with tea-colored urine for 3 days. At our medical center, acute viral hepatitis C-induced jaundice was suspected. Since her general condition deteriorated at 36 weeks and 6 days of gestation, we decided to induce labor. A male baby was born smoothly via the vaginal route, with birth weight 2,857 g, birth length 48.6 cm, and 1- and 5-minute Apgar scores of 7 and 9, respectively. Maternal condition improved dramatically after delivery and her serum liver enzymes and bilirubin levels gradually approached normal ranges.ConclusionMothers and fetuses with acute viral hepatitis C-induced jaundice during pregnancy are at great risk of mortality and morbidity. Timely termination may be one of the choices of treatment when fetal maturity has been reached and the maternal condition has deteriorated

A delayed differentiation multi-product FPR model with scrap and a multi-delivery policy – II: Using two-machine production scheme

This paper concerns a delayed differentiation multi-product finite production rate (FPR) model with scrap and multi-delivery policy using a two-machine production scheme. Conventional FPR model considers a single product, single-stage production with all products fabricated being of perfect quality, and product demand satisfied by a continuous inventory issuing policy. However, in real vendor-buyer integrated systems, most vendors would adopt a multi-product production plan to maximize machine utilization. They often use a periodic or multi-shipment policy to distribute their finished products. When planning to produce a cluster of multiple products that share a common intermediate part, the vendor would often evaluate a two-stage production scheme. The first stage manufactures only the common parts for all products and the second stage separately manufactures the end products. The aim is to shorten the replenishment cycle time and reduce overall production-inventory related costs. This study considers a two-machine production scheme and the two-stage production process with the objective of determining the optimal production cycle time and number of deliveries. A numerical example with sensitivity analysis is provided to demonstrate practical use of the obtained results as well as to compare the proposed production scheme to that of using a single machine in the multi-product two-stage FPR model

Power-efficient memory bus encoding using stride-based stream reconstruction

With the rapid increase in the complexity of chips and the popularity of portable devices, the performance demand is not any more the only important constraint in the embedded system. In stead, energy consumption has become one of the main design issues for contemporary embedded systems, especially for I/O interface due to the high capacitance of bus transition. In this paper, we propose a bus encoding scheme, which may reduce transitions by reconstructing active address streams with variable cached strides. The key idea is to obtain the variable strides for dierent sets of active addressing streams such that the decoder reconstructs these interlaced streams with these strides. Instead of sending the full address, the encoder may only send partial ad- dress or stride by using either one-hot or binary-inversion encoding. To exploit the locality and dynamically adjust the value of stride of active address streams, we partially compare the previous addresses of existing streams with the current address. Hence, the data transmitted on the bus can be minimally encoded. Experiments with several MediaBench benchmarks show that the scheme can achieve an average of 60% reduction in bus switching activity.Facultad de Informátic

Pathophysiology of Neuropathic Pain in Type 2 Diabetes: Skin denervation and contact heat–evoked potentials

OBJECTIVE: Neuropathic pain due to small-fiber sensory neuropathy in type 2 diabetes can be diagnosed by skin biopsy with quantification of intra- epidermal nerve fiber ( IENF) density. There is, however, a lack of noninvasive physiological assessment. Contact heat-evoked potential ( CHEP ) is a newly developed approach to record cerebral responses of A fiber- mediated thermonociceptive stimuli. We investigated the diagnostic role of CHEP. RESEARCH DESIGN AND METHODS: From 2006 to 2009, there were 32 type 2 diabetic patients (20 males and 12 females, aged 51.63 10.93 years) with skin denervation and neuropathic pain. CHEPs were recorded with heat stimulations at the distal leg, where skin biopsy was performed. RESULTS: CHEP amplitude was reduced in patients compared with age- and sex-matched control subjects (14.8 15.6 vs. 33.7 10.1 V, P < 0.001). Abnormal CHEP patterns ( reduced amplitude or prolonged latency) were noted in 81.3 % of these patients. The CHEP amplitude was the most significant parameter correlated with IENF density (P = 0. 003) and pain perception to contact heat stimuli (P = 0.019) on multiple linear regression models. An excitability index was derived by calculating the ratio of the CHEP amplitude over the IENF density. This excitability index was higher in diabetic patients than in control subjects (P = 0.023), indicating enhanced brain activities in neuropathic pain. Among different neuropathic pain symptoms, the subgroup with evoked pain had higher CHEP amplitudes than the subgroup without evoked pain (P = 0.011). CONCLUSIONS: CHEP offers a noninvasive approach to evaluate the degeneration of thermonociceptive nerves in diabetic neuropathy by providing physiological correlates of skin denervation and neuropathic pain

A retrospective study on the course and outcome of fetal ventriculomegaly

AbstractObjectiveTo evaluate the outcomes associated with fetal ventriculomegaly.Materials and methodsReports of women who underwent ultrasound scanning between 18 and 36 weeks of gestation during the period from January 1, 2000, to December 31, 2010, were reviewed. According to the defined severity of ventriculomegaly of affected fetuses, the women were divided into the following groups: (1) mild ventriculomegaly (Group A); (2) moderate ventriculomegaly (Group B); and (3) severe ventriculomegaly (Group C). The women were classified into the “gray zone” group if the fetal lateral ventricle measured between 7 mm and <10 mm. All cases were followed up with additional ultrasound scans. Postnatal information was obtained from the computer database or the medical charts.ResultsA total of 41 cases were recruited for this analysis. Four (9.8%) cases had an abnormal karyotype. Twelve women (29.3%) opted for termination of pregnancy. Of the 29 women who delivered, 56.1% (N = 23) were from Group A, 14.6% (N = 6) were from Group B, and none was from Group C. All children in Group A had normal neurological development. Three children in Group B had normal neurological development, whereas the other three had neurologic deficits. A total of 432 cases were classified into the “gray zone” group. Of these cases, 2.8% (N = 12) progressed to ventriculomegaly.ConclusionCases of isolated and mild ventriculomegaly without additional structural anomalies or chromosomal aberrations had good prognoses. However, the parents of fetuses with moderate or severe ventriculomegaly should be counseled regarding related risks. If the ventricular size of the fetus falls within the “gray zone”, at least one additional exam in the third trimester should be performed, for early detection of ventriculomegaly and other related abnormalities. It is important to make the parents of these fetuses aware of these risks, from a medico-legal point of view

Growth behaviour of Ge nano-islands on the nanosized Si{111} facets bordering on two {100} planes

Abstract Si(100) substrates were used to fabricate various nanosized {111} facets between the (100) planes using photolithography and anisotropic wet chemical etching. Following simultaneous Ge chemical vapour deposition on the neighbouring (100) and {111} facets, the Ge nano-island formation and distribution was observed on both the (100) terraces and the {111} side walls using a dynamical atomic force microscope. The nano-island formation on the nanosized {111} strip facets was found to be strongly suppressed upon reducing the strip width due primarily to the interaction of adatoms on the neighbouring facets. Specifically, the difference in the effective chemical potential of Ge adatoms on the two neighbouring facets leads to the depletion of nano-islands on the {111} strip with width &lt;500 nm under the growth condition used in this study