Digital ischemia and gangrene due to red blood cell aggregation induced by acquired dysfibrinogenemia

Digital gangrene was observed in a patient who had angiographic findings of digital arterial occlusion. The patient's blood showed a marked red blood cell aggregation with rouleaux formation in long chains, which could not be dispersed at shear rates up to 200 sec-1. Studies of the patient's blood revealed the presence of an abnormal fibrinogen capable of aggregating normal red blood cells. This fibrinogen was found by Raman spectroscopy to have an increased alpha-helical content, whereas the beta-sheet content was decreased. Defibrinogenation therapy with ancrod resulted in a dramatic symptomatic relief. The disappearance of the abnormal fibrinogen 6 months later and an absence of a family history indicate that this dysfibrinogenemia was acquired.     

Surgical strategy for patients with pancreaticobiliary maljunction without choledocal dilatation

Theory-driven investigations are necessary for generalization of findings and development of health care policy. Within the environments where nurses practice, however, there often is insufficient time to develop a theory base that supports practice changes or the investigation of their effects. Theories that support such investigations need to incorporate elements associated with both the structure and the process of care delivered as well as the outcomes expected. These same theories also need to specify the focal level of interest for research questions. Incorporating a research template to guide practice investigations facilitates decision making and collection of data.     

Estimating the burden of acute gastroenteritis and foodborne illness caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus by using population-based telephone survey data, Miyagi Prefecture, Japan, 2005 to 2006

Most cases of acute gastroenteritis and foodborne disease are not ascertained by public health surveillance because the ill person does not always seek medical care and submit a stool sample for testing, and the laboratory does not always test for or identify the causative organism. We estimated the total burden of acute gastroenteritis in Miyagi Prefecture, Japan, using data from two 2-week cross-sectional, population-based telephone surveys conducted in 2006 and 2007. To estimate the number of acute gastroenteritis illnesses caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Miyagi Prefecture, we determined the number of cases for each pathogen from active laboratory-based surveillance during 2005 to 2006 and adjusted for seeking of medical care and submission of stool specimens by using data from the population-based telephone surveys. Monte Carlo simulation was used to incorporate uncertainty. The prevalence of acute gastroenteritis in the preceding 4 weeks was 3.3% (70 of 2,126) and 3.5% (74 of 2,121) in the winter and summer months, yielding an estimated 44,200 episodes of acute gastroenteritis each year in this region. Among people with acute gastroenteritis, the physician consultation rate was 32.0%, and 10.9% of persons who sought care submitted a stool sample. The estimated numbers of Campylobacter-, Salmonella-, and V. parahaemolyticus -associated episodes of acute gastroenteritis were 1,512, 209, and 100 per 100,000 population per year, respectively, in this region. These estimates are significantly higher than the number of reported cases in surveillance in this region. Cases ascertained from active surveillance were also underrepresented in the present passive surveillance, suggesting that complementary surveillance systems, such as laboratory-based active surveillance in sentinel sites, are needed to monitor food safety in Japan.     

Isolation and analysis of lipase-overproducing mutants of Serratia marcescens

We have isolated a lipase-overproducing mutant, GE14, from Serratia marcescens 8000 after three rounds of N-methyl-N'-nitro-N-nitrosoguanidine mutagenesis. The mutant GE14 produced 95 kU/ml of extracellular lipase in the lipase medium, which was about threefold higher than that of produced by the original strain 8000. Enzymatic characteristics including specific activity of purified lipases from culture supernatants of GE14 and 8000 were almost same. The lipase gene (lipA) of GE14 contained two base substitutions; one in the promoter region and another in the N-terminal region of the lipA gene without an amino acid substitution. Promoter analysis using lipA-lacZ fusion plasmids revealed that these substitutions were responsible for the increase in the lipA expression level, independently. In contrast, no base substitution was found in the genes encoding the lipase secretion device, the Lip system. In addition, the genes coding for metalloprotease and the cell surface layer protein which are both secreted through the Lip system and associated with extracellular lipase production, also contained no base substitution. The strain GE14 carrying a high-copy-number lipA plasmid produced a larger amount of the extracellular lipase than the recombinant strains of 8000 and other mutants also did, indicating that GE14 was not only a lipase-overproducing strain, but also an advantageous host strain for overproducing the lipase by a recombinant DNA technique. These results suggest that the lipase-overproducing mutant GE14 and its recombinant strains are promising candidates for the industrial production of the S. marcescens lipase.     

Shear-induced pre-crystallization structures of long chain branched polypropylene under steady shear flow near the melting temperature

Shear-induced crystallization of a long chain hyper-branched polypropylene (LCB-PP, denoted PP-3) was carried out at a relatively high temperature of 170 °C, close to its melting temperature of 158 °C. Small-angle X-ray scattering (SAXS) showed that the intensity ratio of the normal to the perpendicular to the shear (V/H) was always larger than 1 for PP-3, indicating that shish-like structures were predominately formed and further growth to kebab was suppressed in PP-3. The crystallization behavior of PP-3 can be explained by the nature of PP-3 that there were a large amount of crystallization nuclei due to their branching points, and the point-like precursors formed from these nuclei were arrayed linearly along the shear direction and transformed into thread-like precursors or premature shishs; however, owing to the large amount of branching, further progress in crystallization was suppressed.     

Natural convection heat transfer from a horizontal cylinder in liquid sodium: Part 2: generalized correlation for laminar natural convection heat transfer

Rigorous numerical solution of natural convection heat transfer, from a horizontal cylinder with uniform surface heat flux or with uniform surface temperature, to liquid sodium was derived by solving the fundamental equations for laminar natural convection heat transfer without the boundary layer approximation. It was made clear that the local and average Nusselt numbers experimentally obtained and reported in part 1 of this paper were described well by the numerical solutions for uniform surface heat fluxes, but that those for uniform surface temperatures could not describe the angular distribution of the local Nusselt numbers and about 10% underpredicted the average Nusselt numbers. Generalized correlation for natural convection heat transfer from a horizontal cylinder with a uniform surface heat flux in liquid metals was presented based on the rigorous theoretical values for a wide range of Rayleigh numbers. It was confirmed that the correlation can describe the authors’ and other workers’ experimental data on horizontal cylinders in various kinds of liquid metals for a wide range of Rayleigh numbers. Another correlation for a horizontal cylinder with a uniform surface temperature in liquid metals, which may be applicable for special cases such as natural convection heat transfer in a sodium-to-sodium heat exchanger etc. was also presented based on the rigorous theoretical values for a wide range of Rayleigh numbers. These correlations can also describe the rigorous numerical solutions for non-metallic liquids and gases for the Prandtl numbers up to 10.     

Monolithic four-channel photodiode/amplifier receiver array integrated on a GaAs substrate

A four-channel optoelectronic integrated receiver array operating at the wavelength near 850 nm has been fabricated on a single GaAs substrate by using metal-semiconductor-metal (MSM) photodiodes (PD's) and metal-semiconductor field-effect transistors (MESFET's). The largest integration scale for a monolithic receiver and uniform characteristics among circuit channels have been achieved due to the structural simplicity and the process-compatibility of this array. Also, an extremely small capacitance of MSM-PD, 0.10 pF, has lead us to obtain a high-speed operation up to a bit rate of 1.5 Gbit/s, NRZ, and a low noise characteristic exhibiting an equivalent input noise current as small as 5 pA/Hz^1/2. These results have indicated the suitability of MSM-PD/MESFET's circuits for large-scale multichannel optoelectronic integration of receivers.     

Relationship between weight change in young adulthood and the risk of NIDDM. The Sotetsu Study

OBJECTIVE: To investigate the independent effect of weight change in young adulthood on the risk of prevalent NIDDM among middle-aged Japanese men. RESEARCH DESIGN AND METHODS: A case-control study was carried out in 895 male employees aged > or = 30 years of a railway company located in the vicinity of Tokyo. Adjusted odds ratios (ORs) were calculated for prevalent diabetes in each category of weight change (obtained from subjects' medical records) in young adulthood and adulthood. Adjustment for current age, initial BMI, and weight change in each age stratum was performed by the Mantel-Haenszel method or multiple logistic regression analysis. RESULTS: Weight change between 20 years of age and the age at maximum weight was not associated with the risk of NIDDM. Weight gain between 20 and 25 years of age was significantly and positively associated with the risk of NIDDM (OR 3.87 for gains > or = 10.0 kg, 2.53 for gains of 5.0-9.9%, and 3.73 for gains > or = 10.0%). On the other hand, moderate weight gain after 30 years of age was significantly inversely associated with NIDDM (OR 0.44 for gains of 5.0-9.9 kg, 0.15 for gains of 10.0-19.9%, and 0.38 for gains of 20.0-29.9%). CONCLUSIONS: Extreme weight gain between 20 and 25 years of age is a significant predictor of NIDDM, independent of current age, BMI at 20 years of age, and weight change within other age strata.