It has been reported that gentamicin causes natriuresis, magnesuria and calciuria in neonates. The aim of this study was to determine the acute effects of trough and peak levels of gentamicin on the values of serum creatinine (SCr), urine albumin/urine creatinine (UA/UCr), fractional excretion of sodium and potassium (FENa, FEK) and urine calcium/urine creatinine (UCa/UCr) in preterm neonates treated with gentamicin for suspected infection. Baseline levels of serum and urine Cr, Na and K and urine albumin and Ca levels together with trough and peak gentamicin levels were measured in 61 preterm neonates at the start of the therapy, on the day of the third gentamicin dose and 48–72 h after the cessation of the gentamicin therapy. Therapeutic trough and peak levels were recorded in 56 (91.8%) and 39 (63.9%) of the preterm neonates, respectively, whereas high trough (>2 mg/dl) and peak (>9.99 mg/dl) levels were recorded in five (8.1%) and 11 (18%) of the 61 preterm neonates, respectively. Trough and peak levels of gentamicin were positively correlated with SCr, UA/UCr, FENa, FEK and UCa/UCr values. The UA/UCr, FENa and UCa/UCr values recorded during treatment were statistically significantly different from sub-therapeutic, therapeutic and high peak gentamicin levels. Gentamicin was found to have a serum peak level-dependent microalbuminuric, natriuric and calciuric effect in preterm neonates. Based on these results, we suggest that when the monitoring of serum gentamicin levels is not possible, the monitoring of UA/UCr, FENa and UCa/UCr can be useful as a noninvasive alternative.

Acute effects of gentamicin on glomerular and tubular functions in preterm neonates

The authors describe the structure of an improvement process using total quality control. Improvement is achieved by changing the process mechanism, starting from an external symptom. If the problem is limited, the procedure for improvement becomes easier. Software or hardware developments are a net of transformation processes, which is regarded as a cause-and-effect net. Other structures such as the development organization net and work practice net also constitute cause-and-effect nets. Refining the process makes the quality improve. It is concluded that these procedures for improvement are universal and applicable to various aspects of organization. >

Structural way of thinking as applied to improvement process

Some major structures for improving the quality of software are described. It is noted that defects in software are the result of imperfections in the development process and that high quality is achieved through aiming for a better process. Structures are introduced in the product structure, the product architecture, and the work processes. As people constitute an essential part of the process, the human error problem and work time constancy are considered. Based on these, structures and general principles for improving quality are explained. Progress is attained by education in the broad sense. The present work is written for managers in software fields. >

Structural way of thinking as applied to quality assurance management

Structures residing in methods for improving software productivity are reported. A development process may be hierarchically broken down into elementary processes, showing a constancy of man-hours for the work. Improvement of productivity is reduced to improving the processes. Progress is reached by a learning or feedback process of analyzing and devising better procedures based on previous experiences. >

Structural way of thinking as applied to productivity

This paper describes the outline, the approach and current status of the Software Creation project. The main idea is to follow the design steps of human designers by extracting and reusing the design process knowledge in a hierarchically organized work process. The presently implemented system consists of a SDL CASE tool and an expert system for applying the design process knowledge. This system serves as an experimental platform for the study of human design by simulating the design at the lowest level. The experiments are being made on designing switching software. At the moment, the system can detail the input design data in SDL graphic symbols to around 100 times complex C code.

Software Creation: Towards Automatic Software Design By Simulating Human Designers.

The authors attempt to clarify the principle involved in achieving high-quality design. The nature of human errors inherent in software and hardware design is summarized. A structural method of thinking introduced previously is described and used as a basis for high-quality design. >

Structural way of thinking as applied to high quality design

The authors report the result of a quantitative analysis of the data structure of a relatively early electronic switching system and its evolution. The evolutionary process is a kind of total quality control (TQC). On the basis of quantitative studies of the existing system, it has been found that the data memory area (static aspect) and the access frequency to data (dynamic aspect) obeys Pareto's principle, i.e. a few vitals consume a major part of the memory space and the real-time consumption. These and other studies lead to a clearer data structure and control structure. >

Structural way of thinking as applied to data structure

The authors describe a structural approach toward increasing customer satisfaction and apply it to product design. They first describe several difficulties in product development, and then structures of product development are explained to make the key points clear. A development procedure is described. The method consists of gradual realization steps of working with customers and rational and effective use of quality function deployment. A rational approach based on human factors and total quality control is used. >

Z. Koono

Papers

Structural way of thinking as applied to high quality design

Structural way of thinking as applied to productivity

Structural way of thinking as applied to data structure

Structural way of thinking as applied to good design. 2. Increasing customers' satisfaction