Differences in Dialysis Practice Are the Main Reasons for the High Mortality Rate in the United States Compared to Japan

The cumulative survival of Japanese hemodialysis patients is more than 2.5 times better than that of dialysis patients in the United States (U.S.). The difference is particularly pronounced in older patients, being 4 times better in patients over the age of 50 years. The mortality in U.S. patients has increased from 10 to 25% over the last three decades, but has remained stable at around 10% in Japan.
There is no obvious difference in patient selection. The Japanese accept almost as high a proportion of diabetic patients as does the United States, and the mean age of incident patients is higher in Japan.
Renal transplantation, virtually absent in Japan, should increase mortality in U.S. dialysis patients by removing patients with the highest probability of survival, but even if one adds surviving transplant patients and studies prevalent populations, the survival rate is much better in Japan. Genetic factors are unlikely to explain differences in mortality, as older Americans live much longer than older Japanese.
We speculate that the difference lies in the practice of dialysis. Patients in the United States are generally treated by much faster and shorter dialysis than in Japan. This puts a severe burden on the cardiovascular system of older patients, leading to the poorer survival rate. Japanese physicians also appear to be better trained in dialysis and to spend more time with their patients. The nursing shortage in the United States may also contribute to the increased mortality. Whatever the explanations, the U.S. dialysis community must work to equal and, hopefully, surpass the now superior survival of Japanese dialysis patients.     

Menarcheal age in University of Warwick young women

The influence of ischemia on purine nucleotide and their catabolite concentration in human myocardium was investigated during surgery of acquired and congenital heart defects. This was compared with the influence of ischemia on rat heart. Concentrations of adenine and guanine nucleotides and their catabolites were measured in the extracts of heart biopsies taken at the onset of ischemia and at the time of reperfusion. The content of myocardial ATP in human heart decreased from the initial value of 22.3 +/- 1.1 to 14.6 +/- 1.5 nmol/mg protein and total adenine nucleotide pool decreased from 34.2 +/- 1.8 to 27.6 +/- 1.5 nmol/mg protein during the operation. Significant increases in myocardial concentrations of purine catabolites were also observed with the most prominent rise in inosine from below 0.5 at the onset of the ischemia to 3.0 +/- 0.5 nmol/mg protein at the time of reperfusion. A positive correlation was demonstrated between the concentration of purine catabolites in the heart at the end of ischemia with the decrease of both ATP and the total nucleotide pool. An interesting metabolic specificity of the ischemic human heart appeared to be only a small accumulation of inosine monophosphate (IMP). The increase of IMP in the rat heart after ischemia was several-fold higher. Thus, cardiac surgery of congenital and acquired heart defects was associated with a significant decrease in myocardial adenylate pool and a single biopsy collected at the end of ischemia seems to be sufficient to evaluate the extent of this metabolic and possibly functional impairment of the heart.     

Classification of temporal patterns in dynamic biological networks

A general method is presented to classify temporal patterns generated by rhythmic biological networks when synaptic connections and cellular properties are known. The method is discrete in nature and relies on algebraic properties of state transitions and graph theory. Elements of the set of rhythms generated by a network are compared using a metric that quantifies the functional differences among them. The rhythms are then classified according to their location in a metric space. Examples are given, and biological implications are discussed.     

Effects of growth with ethanol on fermentation and membrane fluidity of Saccharomyces cerevisiae

Saccharomyces cerevisiae HSc was grown with ethanol at concentrations up to 10% (v/v). The immediate effects of additions of externally added ethanol on CO₂ production and O₂ consumption of washed organisms were studied by stopped-flow membrane inlet quadrupole mass spectrometry. Fermentative activities of organisms grown with ethanol (0–5% v/v) showed similar sensitivities to inhibition by ethanol, whereas those grown with 10% (v/v) ethanol had become protected and were markedly less sensitive. The fluidity of subcellular membrane fractions was measured by determination of the temperature dependence of the rotational order parameter of the spin label 5-doxyl stearic acid (free radical) by electron spin resonance. Mitochondria prepared from yeasts grown with 0, 7 and 9% (v/v) ethanol showed similar overall fluidity, although differences in temperature-dependent behaviour indicate altered lipid composition or lateral phase separations. On the other hand the microsomal fraction from organisms grown with 9% ethanol showed a remarkable increase in fluidity. These data suggest that the protective effects of growth with ethanol near the limit of tolerance on fermentative activities may arise from altered plasma membrane fluidity properties.     

Energy relaxation in GaInAs/AlInAs heterojunctions and GaAs/AlGaAs multiple quantum wells

We have studied electron energy relaxation in GaInAs/AlInAs heterojunctions and GaAs/AlGaAs multiple quantum wells using mobility measurements as a function of electric field and temperature, in the range 3K to 300K. The results in the range 3 to 20K show a power loss rate which is dependent on (T_e − T_l), suggesting that the energy relaxation occurs through acoustic phonon scattering. At electron temperatures greater than 20K, the experimental results are modelled using a standard expression for polar optical phonons. This modelling yields 30meV and 31meV for the polar optical phonon energy in GaAs and InGaAs respectively.     

The soluble alpha-mannosidases of Drosophila melanogaster

The alpha-mannosidases are implicated in both the catabolism of carbohydrates and the N-linked glycosylation pathway in insects, but little is known of the biochemistry of these glycosidases. In order to study the soluble alpha-mannosidases of Drosophila melanogaster we have used artificial fluorogenic substrates for detection of activity in situ following non-denaturing gel electrophoresis. This approach also permitted examination of the mannosidases present in different tissues and the sensitivity of the enzymes to known mannosidase inhibitors. Fluorogenic substrates were also used to determine the pH optima of partly purified mannosidases. We report that D. melanogaster contains several soluble alpha-mannosidase activities. Acidic mannosidases were detected in the gut, fat body and haemolymph of third-instar larvae. The major activity detected in larval guts was a neutral mannosidase presumed to be involved in digestion.     

High-Temperature Chemical Stability of Plasma-Sprayed Ca05Sr05Zr4P6O24 Coatings on Nicalon/SiC Ceramic Matrix Composite and Ni-Based Superalloy Substrates

The potential application of Ca05Sr05Zr4P6O24 (CS50) as a corrosion-resistant coating material for Si-based ceramics and as a thermal barrier coating material for Ni-based superalloys was explored. A ∼200 (xm thick CS50 coating was prepared by air plasma spray with commercially available powder. A Nicalon/SiC ceramic matrix composite and a Ni-based superalloy coated with a ∼200 (xm thick metallic bond coat layer were used as substrate materials. Both the powder and coating contained ZrP2O7 as an impurity phase, and the coating was highly porous as-deposited. The coating deposited on the Nicalon/SiC substrate was chemically stable upon exposure to air and Na2SO4/O2 atmospheres at 1000°C for 100 h. In contrast, the coating sprayed onto the superalloy substrate significantly reacted with the bond coat surface after similar oxidation in air.     

Quantitative studies on the movement of fluid and lymphocytes through periodontal tissue and into the draining lymph.

Chronic lymph drainage techniques in sheep have been used to map the pathways and to quantify the fluid and cell traffic through periodontal tissues. The continuous collection of cervical and prescapular lymph has demonstrated that 65% of labelled protein tracer injected into the periodontal tissues could be found in lymph over a period of 7.5 hours. Nearly 90% of the total radioactivity could be accounted for between the lymph and the tissue site. When silk was impregnated with radiolabelled albumin and a tooth ligated, the kinetics of the subsequent appearance of the tracer in lymph emphasized the ease with which macromolecules surrounding the teeth gain access to the lymphatics, regional lymph nodes, and immune apparatus. Animals were primed with BCG and then tuberculin (delayed hypersensitivity) lesions were simultaneously induced in the skin, bowel, and periodontium. When T cells were labelled with radioisotopes and their migration from blood to lymph measured, the periodontal tissue traffic pattern was distinct from the traffic pattern through DTH in the skin and also distinct from the pattern through the small intestine. This indicates that the lymphocyte traffic through the inflamed periodontium has unique features. This tissue specificity was not apparent when lesions were induced with TNFalpha. The static assessment of lymphocyte subsets within the tissues was also assessed with immunohistochemistry.