Target blood pressure with antihypertensive therapy and 24-hour-RR measurement

In younger and middle-aged patients treatment should lower the blood pressure to below 140/90 mmHg and in the elderly aged 65 and more to 160/90 mmHg. Numerous interventional studies have shown that this can appreciably reduce the complications of hypertension. However, account must always be taken of the individual risk, so that in a particular case, it might be desirable to aim for lower values, for example, in diabetic nephropathy or when there is a summation of risks. The question as to whether there is a "point of reversal", that is, a renewed increase in complications associated with too great lowering of the blood pressure is still controversial. What is certain is that a lowering of blood pressure that is too rapid and too great can harm the patient with coronary or cerebral vascular stenoses. Better control of the blood pressure is enabled by the 24-hour blood pressure measurement by recording "office hypertension" or "office normotension", intermittent hypertensive or hypotensive phases and, in particular the nocturnal course of the blood pressure (no physiological dip/too pronounced dip).     

Noncompetitive enzyme immunoassay (hetero-two-site enzyme immunoassay) for gamma 2-melanocyte-stimulating hormone (gamma 2-MSH) and measurement of immunoreactive gamma 2-MSH in plasma of healthy subjects

A noncompetitive enzyme immunoassay (hetero-two-site enzyme immunoassay) for gamma 2-melanocyte-stimulating hormone (gamma 2-MSH) was developed. gamma 2-MSH (1-12) was biotinylated, trapped onto an anti-gamma 2-MSH (1-12) IgG-coated polystyrene bead, eluted at pH 1 after washing to eliminate other biotinylated substances, and measured using two streptavidin-coated polystyrene beads and affinity-purified anti-gamma 2-MSH (1-12) Fab'-peroxidase conjugate. The detection limit of gamma 2-MSH (1-12) was 10-30 amol (16-48 fg)/assay and 130-400 fmol (210-630 pg)/L of plasma. There was little or only slight cross reaction with alpha-MSH, beta-MSH, and gamma 1-MSH. By this immunoassay, the concentration and molecular size of immunoreactive gamma 2-MSH in plasma of healthy subjects were examined, and the results were compared with those by competitive enzyme immunoassay. Immunoreactive gamma 2-MSH measured by competitive enzyme immunoassay was a mixture of substances with high molecular weights (100-500 kDa), and its concentration was calculated to be 50-60 pmol/L using gamma 2-MSH (1-12) as standard. Immunoreactive gamma 2-MSH detected by the noncompetitive enzyme immunoassay after removal of high molecular weight substances was not homogeneous and smaller than gamma 2-MSH (1-12), and its concentration was approximately 1 pmol/L. The exact nature of these immunoreactive gamma 2-MSHs remains to be elucidated. gamma 2-MSH (1-12) added to plasma was degraded rapidly, and the concentration of gamma 2-MSH (1-12) was very low, if any, in plasma of healthy subjects.     

Modeling and measurement of the notched strength of gamma titanium aluminides under monotonic loading

A substantial concern with gamma titanium aluminides is their limited ductility and, in particular, the consequences of limited ductility at stress concentrators. In this study, the notched strength of a cast Ti-47.9Al-2.0Cr-2.0Nb alloy is considered under monotonic tensile loading at room temperature. Efforts are further focused on the alloy’s behavior under conditions of plane stress and on cases where notch radii are large relative to grain size. Finite element predictions for notched tensile specimens and the Neuber design criterion are used to quantify relationships between tensile ductility, the ability to reduce local stress concentrations through plastic flow, and ultimate failure loads in notched components. Results from the testing of two modeled configurations are presented, and the numerical models are used to interpret the test results. Two major issues are addressed in this work. The first is how much plastic deformation is needed to blunt stress concentrations in gamma TiAl components under monotonic loading. For values of elastic stress concentrations commonly encountered in components, it is demonstrated that a total strain at failure as low as 1 pct (corresponding to a plastic strain at failure of 0.8 pct) is sufficient to essentially achieve the maximum reduction in stress concentration due to plastic flow. Second, the relationship between continuum-theory predictions of notched component failure (made using uniaxial tensile test strains at failure) and failure loads observed in notched specimens is explored. It is shown that, on average, continuum-theory predictions of notched strength based on unnotched specimen strains at failure act as conservative lower bounds on actual results. It is suspected that the notch strengthening observed in gamma TiAl is due to smaller volumes of highly strained material (a size effect) in the notched specimens.