Significant Enhancement of the Optical Second Harmonic Generation in a Poled Azopolymer Thin Grating

Nonlinear optical properties of an electrically poled surface relief grating inscribed on a thin film of azopolymer have been investigated. The linear and nonlinear optical far-field diffraction patterns of the grating are compared, and they show a clear angular separation of the fundamental (lambda = 1.064 mum) and second harmonic generated beams that are diffracted at different angles. The intensity of the zero order transmitted second harmonic generation (SHG) beam from inscribed surface relief grating (SRG) areas has been recorded using the Maker fringe technique and compared to the response from flat areas that were only poled. Poled gratings exhibit a sharp second harmonic generation enhancement for coupling angles of theta(i) = +/-52 degrees due to a quasi-phase matching process. A simple phenomenological model allows one to explain both the second harmonic intensity generated from the thin polar film and the dispersion curve observed under "pp" polarization due to the mismatch of the angular coupling condition: this gives us a good indication of the intensity enhancement of the SHG beam in the forward direction.

Use of prophylactic anticoagulation and the risk of hepatic veno-occlusive disease in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis

Hepatic veno-occlusive disease is a serious regimen-related toxicity in patients undergoing hematopoietic stem cell transplantation. We performed a systematic review and meta-analysis of the literature on the effect of anticoagulation in preventing veno-occlusive disease. Several databases and online journals were searched for randomized controlled trials and cohort studies. Twelve studies (2782 patients) were eligible. Anticoagulation prophylaxis was associated with a statistically nonsignificant decrease in risk of veno-occlusive disease (pooled relative risk (RR), 0.90; 95% confidence interval (CI), 0.62-1.29). Results of one of three randomized controlled trials may have been affected by delayed introduction of anticoagulation. A second trial enrolled patients who received conventional chemoradiotherapy for early-stage disease (RR, 0.18; 95% CI, 0.04-0.78). The third trial was a pilot study with a small sample size (RR, 0.74; 95% CI, 0.53-1.04). Significant heterogeneity and methodologic weaknesses preclude drawing a meaningful conclusion from the pooled analysis. Despite some limitations, results of two of three eligible randomized controlled trials suggest that prophylactic anticoagulation may help prevent veno-occlusive disease. However, a large randomized controlled trial is needed for confirmation. Additionally, in future studies, owing to the wide spectrum of severity of veno-occlusive disease, outcomes such as 100-day mortality should strongly be considered.

Contamination of the nebulization systems used in the prophylaxis with amphotericin B nebulized in lung transplantation

The contamination of nebulizer may be the origin of respiratory infections. The aim of this study was to determine the incidence of contamination in nebulizers used to nebulize amphotericin B in lung transplant (LT) patients and the relationship with bacterial isolation in sputum culture. A prospective, cross-sectional study was conducted with 41 LT patients who were administered amphotericin B with a jet nebulizer. Samples were taken from the nebulizers (prior to nebulization). Sputum culture was carried out and patients were asked whether or not they followed a cleaning and disinfection protocol (washing and brushing with soap and water followed by subsequent disinfection with the Milton method after each nebulization). Contamination was defined as such when potentially pathogenic bacteria were isolated in the nebulizer. Seventeen of the 41 nebulizers (41.4%) were contaminated. In 7 of the 17 cases (41.1%) contamination was polymicrobial. The most common microorganism was Pseudomonas aeruginosa. Fourteen of the 41 patients (34.1%) presented positive sputum cultures, most common was P aeruginosa. In 10 patients (24.3%) pathogenic bacteria was isolated both in the nebulizer and in the sputum. In four of these patients (9.7%) the species was the same. The cleaning and disinfection protocol was carried out by 16 of the 41 patients (39.0%). In 2 of the 16 patients (12.5%) who were following the protocol the nebulizer was contaminated, compared to 15 of 25 patients (60.0%) whose nebulizer was not contaminated (P < .05). Two of the 16 patients (12.%) who were following the protocol presented positive sputum culture compared to 12 of 25 (48.0%) who did not (P < .05). In conclusion, the contamination of the nebulizing systems is frequent when no strict cleaning and disinfection protocol is followed. Patients who did not follow the protocol presented a greater isolation of pathogenic bacteria in the sputum.

Clindamycin-resistant Fusobacterium varium bacteremia and decubitus ulcer infection

Bacteremia due to Fusobacterium spp. is unusual (<10% of cases of anaerobic bacteremia), and the isolation of Fusobacterium varium is especially uncommon. The most probable sources of Fusobacterium bacteremia are the respiratory, the gastrointestinal, and the genitourinary tracts. A.-M. Bourgault et al. (Clin. Infect. Dis. 25[Suppl. 2]:181-183) described 40 patients with Fusobacterium bacteremia; only 3 had Fusobacterium varium, and no one had decubitus scars as the portal of entry. In another published series (S. Henry, A. De Maria, and W. R. McCabe, Am. J. Med. 75:225-231, 1983) of 26 cases, two patients had concomitant pulmonary lesions and decubitus ulcers but there was no identification to the species level mentioned. We report a case of Fusobacterium varium bacteremia and infected sacral decubitus ulcer in an elderly patient.

Orientation distribution functions based upon both (P1), (P3) order parameters and upon the four (P1) up to (P4) values: application to an electrically poled nonlinear optical azopolymer film

The most probable orientational distribution functions of rod-like polar molecules contained in a noncentrosymmetric uniaxial system are established using the first-rank and third-rank Legendre polynomials, (P1(cos theta)) and (P3(cos theta)) order parameters, and the maximum entropy method. Emphasis is put on the different domains of existence in the ((P1), (P3)) plane for the various shapes of the distributions: it is thus shown that, for any positive (P1(cos theta)) value and for decreasing (P3(cos theta)) values, the distribution function may exhibit either a distorted oblate form with an intense maximum at 0 degrees, or a three-leaved rose curve with maxima at 60 degrees, 180 degrees, and 300 degrees, and finally another markedly oblate shape with a strong maximum at 180 degrees. As an illustrative example, we have considered the azobenzene molecular orientations in an electrically poled p(DR1M) homopolymer thin film after a thermal process and several relaxation periods. We have made use not only of the (P1) and (P3) parameters determined from polarized second-harmonic generation (SHG) measurements, but also of the (P2) values extracted from UV-visible spectra and of the (P4) values adjusted according to the information entropy theory. In such a thin film with very large nonlinear properties (d33 coefficients were varying from 437.0 to 117.0 pm/V at 1064 nm) it is evidenced that a strong polar order is maintained even after a long relaxation period of 42 days. So, the distribution functions demonstrate that the poling treatment was quite efficient and they emphasize the importance in the determination of both couples of odd and even order parameters in such uniaxially oriented optical elements.

Intracranial haemorrhage as initial presentation of severe haemophilia B: case report and review of Mayo Clinic Comprehensive Hemophilia Center experience

A neonate who had intracranial haemorrhage (ICH) at birth received a diagnosis of severe haemophilia B at 6 months of age. ICH had been the initial presentation of his bleeding disorder. His family history was negative for haemophilia. Review of our institutional experience as well as the literature indicates that intracranial bleeding as the initial presentation of haemophilia is rare.

Wilms' tumor and neuroblastoma

Significant differences exist between the European and North American treatment protocols for Wilms' tumor and neuroblastoma. There are variations in biopsy technique, timing and extent of initial surgery, chemotherapy protocols and dosage routines, as well as the type of salvage therapy. With the consolidation of the two major North American study groups into a single entity (Children's Oncology Group), the European and North American study groups represent the only remaining large-scale venues for treatment comparison. It is important to study and understand the variation in treatment protocols in order to maintain an open forum of scientific investigation that will lead to improving the care and outcome of children with cancer. It is anticipated that the unification of the North American groups will lead to greater interest and scientific cooperation with the European study group. This paper will serve as a forum for such a discussion at a local level.

Haemorrhage into a popliteal cyst: an unusual complication of haemophilia A

A 7(1/2)-year-old boy with severe haemophilia A had increasing discomfort and pain in his left knee after sledding on ice and landing on his knees. Left knee pain persisted for days despite recombinant factor VIII replacement. Imaging studies showed that by day 10 a popliteal cyst had ruptured, with diffusion of blood into the calf muscles. This case illustrates another possible bleeding complication in patients with a bleeding disorder and a popliteal cyst.

Guillain-Barré syndrome after allogeneic hematopoietic stem cell transplantation

Guillain-Barré syndrome is a rare complication in the setting of hematopoietic stem cell transplantation. We report three children with T cell lymphoma/leukemia in whom this syndrome developed soon after they received unrelated donor transplants. The rapid onset of symptoms raises the concern that the bone marrow transplant conditioning regimen (ie, total body irradiation, cyclophosphamide and cytosine arabinoside) might have precipitated the clinical syndrome of ascending polyneuropathy. Although central nervous system toxicity has been well described with high-dose cytosine arabinoside therapy, peripheral neuropathy of the Guillain-Barré type has been reported only infrequently. We review possible factors contributing to the development of this syndrome in these three patients.