Oscillating thromboemboli within the extracranial internal carotid artery demonstrated by ultrasonography in patients with acute cardioembolic stroke

BACKGROUND: Gunshot wounds to the kidney have been managed traditionally by surgical exploration. Concerns over increased nephrectomy rates and unnecessary explorations have placed this method under scrutiny. Selective renal exploration based on solid clinical and radiographic criteria may be a safer alternative and deserves evaluation. METHODS: The medical records of 52 consecutive patients with renal gunshot wounds, who were managed between September 1994 and August 1995 by a protocol of selective exploration, were reviewed. Renal injuries were explored only if they involved the hilum or were accompanied by signs of continued bleeding. Main outcome measures were the numbers of kidneys lost, as well as the morbidity and mortality related to the management of the renal injury. RESULTS: Three patients died from associated injuries shortly after admission. Fifteen patients suffered complications but only two had complications directly associated with the renal injury. Thirty-two patients underwent renal exploration and 17 of them required nephrectomy for major renovascular or parenchymal trauma (grade IV and V). Renal exploration was successfully avoided in the remaining 20 patients. No kidneys were lost unnecessarily as a result of this policy. CONCLUSION: Mandatory exploration of all gunshot wounds to the kidney is not necessary. Injuries that produce stable peripheral haematomas do not require exploration.     

In vitro parathyroid hormone release in patients with secondary hyperparathyroidism

BACKGROUND: The purpose of this study was to determine the precise endocrine characteristics of parathyroid function in secondary hyperparathyroidism (sHPT). METHODS: We examined the effects of extracellular ionized calcium (Ca2+) varying from 0.5 to 2.0 mM on parathyroid hormone (PTH) release in parathyroid cell suspensions using a mid-regional PTH assay. Cells were obtained from 26 patients with sHPT who were divided into two groups according to the type of hyperplasia they exhibited, either nodular (n = 16) or diffuse (n = 10). For comparison, we also analyzed data from nine patients with primary hyperparathyroidism (pHPT; adenomas). RESULTS: Significant in vitro suppression of PTH release by Ca2+ was observed in the majority of subjects, regardless of the histologic abnormality. The pHPT group exhibited no significant relationship between clinical and in vitro data. In contrast, in the sHPT group (taken as a whole), suppression of PTH release by Ca2+ exhibited a plateau at a total serum calcium concentration of 2.5 mmol/L, and a parathyroid gland weight of 2 g. CONCLUSIONS: These findings suggest that there is a curvilinear relationship in sHPT, but not pHPT, between the in vitro calcium sensitivity of parathyroid cells and total serum calcium, as well as gland weight. The in vitro calcium sensitivity in sHPT remains constant when the total serum calcium concentration exceeds 2.5 mmol/L, or when the gland weight exceeds 2 g.     

Portal-hepatic venous shunt through a portal aneurysm complicated by hepatic encephalopathy and pulmonary hypertension

We report a rare case of portal-hepatic venous shunt through an enormous portal aneurysm complicated by pulmonary hypertension. A 66-year-old woman was admitted to our hospital for hepatic encephalopathy. Chest roentgenography revealed pulmonary hypertension. Computed tomography and ultrasound examination demonstrated a shunt between the portal and hepatic veins through an enormous portal aneurysm. The diagnoses of portal-hepatic venous shunt and pulmonary hypertension were confirmed by hepatic venous catheterization and cardiac catheterization. Pulmonary hypertension might result from the effects of vasoconstrictive agents, which should be metabolized by the liver in normal subjects, passing through the intrahepatic shunt into the lung.     

Continuous reactor system of monosized colloidal particles

A reactor system, which continuously hydrolysed the metal alkoxide in an alcohol solution, was designed using an electromagnetic stirrer and an ageing tube. Several monosized colloidal particles were produced by this reactor system, which had high reproducibility and reliability for long-term production. The relation between powder characteristics and experimental parameters such as reagent concentration, mixing rate, ageing time, temperature, was investigated. These parameters had an effect on the particle size, size distribution, morphology and state of agglomeration. It is possible to control the particle size to between 0.1 and 1.0 μm by varying the experimental conditions. A narrower size distribution of powders was obtained by using an electromagnetic stirrer with greater flow rate. Physical and chemical properties of monosized colloidal particles obtained by this reactor were comparable to those of monosized colloidal particles obtained by the batch process.     

The dependency of the crack growth rate on the loading pattern and temperature in stress corrosion cracking of strain-hardened 316L stainless steels in a simulated BWR environment

The stress corrosion cracking (SCC) growth rate of a warm-rolled (WR) 316L stainless steel contoured double cantilever (CDCB) specimen was measured in high purity water at various temperatures and under various loading patterns. An alternating current potential drop (ACPD) technique was used to monitor the crack growth kinetics throughout the tests. The fracture surface exhibited typical intergranular SCC characteristics. Depending on the test conditions, three kinds of crack growth kinetics, i.e., increasing with time then becoming steady, being constant during the whole period, decreasing with time then becoming steady, were identified and are described. The steady state crack growth rate (CGR) values are used to quantify the effects of the loading pattern and the environmental temperature. A moderate increase in the crack growth rate was encountered by employing periods of unloading and reloading to form a trapezoidal loading pattern and the enhancement factor was found to depend on the holding time and the times for unloading and reloading. It was found that the crack growth is thermally activated; however, the apparent activation energy is not constant but seems to be greater at higher temperatures. Several types of temperature-dependent crack growth kinetics are proposed based on the rate-determining step for the crack growth. The present experimental results can be rationalized by considering multiple element processes such as aqueous mass transport and solid-state mass transport in the crack growth. The cracking mode, the temperature dependence of the crack growth rate, and the transient crack growth behavior for WR 316L SS after changing the environmental temperature are quite similar to those for a cold-worked(CW) 316L SS tested in the same environment, despite their different absolute crack growth rate values. The effect of yield strength on CGR is more significant at lower temperatures and the apparent activation energy for the crack growth rate seems to be lower in the material with a higher yield strength. Time-lag crack growth behavior was found at points during several test steps on WR 316L SS, for example, just after in situ pre-cracking and after increasing or decreasing the temperature, which is quite consistent with the results obtained with CW 316L SS. The importance of in situ monitoring of the crack growth for obtaining steady state crack growth rates is emphasized, especially for those steps for which a nonlinear crack growth period occurs after changing the test condition.     

In situ measurement of lithium mass transfer during charging and discharging of a Ni–Sn alloy electrode

The charging (lithiation) and discharging (delithiation) of a Ni–Sn alloy electrode was examined by means of holographic interferometry and laser scanning confocal microscopy (LSCM). The developing concentration profile of Li⁺ ion during discharging (delithiation) of the Ni–Sn alloy electrode agreed reasonably well with the prediction based on transient diffusion theory, indicating that the cell configuration successfully suppressed natural convection due to the electrochemical reaction. The morphological variation of Ni–Sn alloy electrode during charge/discharge cycle could be observed very clearly by in situ LSCM. It was found that the contraction of active material during the discharge (delithiation) initiates cracks in the Ni–Sn alloy electrode.     

First-principles study of structure,vacancy formation,and strength of bcc Fe/V<Subscript>4</Subscript>C<Subscript>3</Subscript> interface

Voids are representative of the damage process in both creep and ductile fractures. Although the matrix/precipitate interface has been considered the preferential nucleation site for voids, the relationship between the atomic structure of this interface and the nucleation mechanism of a void has never been sufficiently investigated. In this study, the bcc Fe/V₄C₃ interface is selected as a model interface between a matrix and precipitate. The vacancy formation energy and intrinsic mechanical strength at this interface are investigated using a first-principles calculation because they should be related with the nucleation of creep and ductile voids, respectively. Within the considered interface, the Fe vacancy is found to be dominant. When the Baker–Nutting orientation relationship is satisfied at the interface, the calculated intrinsic mechanical strength of the interface is 23.8 GPa. However, when the geometric coherence at the interface is low as compared to that of the Baker–Nutting orientation relationship, it is found that the interfacial mechanical strength is significantly weakened. At each interface, it is found that the back-bond of the interface determined the interfacial strength because of the strongly bonded Fe–C on the interface. The nucleation mechanism of a void at the matrix/precipitate interface is discussed based on the present findings. It is suggested that local decohesion at the matrix/precipitate interface should be the origin of the nucleation of a ductile void.     

Structure-conductivity relationsihp in polymer electrolytes formed by network polymers from poly[dimethylsiloxane-g- poly(ethylene oxide)] and litegum perchlorate

The combination of LiClO₄ and network polymers from poly[dimethyl-siloxane-g-poly(ethylene oxide)] has been applied to polymer electrolytes as an Li⁺ ion conductor, and the structure/conductivity relationship has been investigated. The ionic conductivity is about 10⁻⁶ S cm⁻¹ at room temperature. The polymer electrolytes form a micro-heterogeneous structure from the constituent segments, and the incorporated LiClO₄ preferentially interacts with the poly(ethylene oxide) segments. The segmental motion of poly(ethylene oxide) appears to contribute to the ionic migration, while that of poly(dimethylsiloxane) does not. Not all of the incorporated LiClO₄ functions as carrier ions.