Effect of race on outcome after kidney and kidney-pancreas transplantation in type 1 diabetic patients

OBJECTIVE: The racial impact on graft outcome is not well defined in diabetic recipients. The purpose of this study is to analyze our experience with kidney-alone (A) and kidney-pancreas (KP) transplantation in type 1 diabetic recipients and evaluate the impact of racial disparity on outcome. RESEARCH DESIGN AND METHODS: The records of 217 kidney transplants (118 KA, 99 KP) performed on type 1 diabetic patients between 1985 and 1995 at the Medical University of South Carolina and the University of Texas Medical Branch were reviewed. RESULTS: A total of 53 (31%) white patients and 15 (33%) black patients experienced at least one episode of biopsy-proven acute rejection of the renal graft (NS). Patient survival at 1, 2, and 5 years was similar in white (92, 87, 69%) and black (91, 91, 69%) patients (NS). Kidney graft survival at 1, 2, and 5 years in the KA group was 72, 62, and 42% in blacks, compared with 79, 76, and 53% in whites (NS). Kidney graft survival at 1, 2, and 5 years in the KP group was 92, 92, and 74% in blacks, compared with 83, 77, and 58% in whites (NS). Pancreas graft survival at 1, 2, and 5 years was 81, 81, and 81% in blacks, compared with 81, 75, and 62% in whites (NS). Cox regression analysis revealed that donor age > or = 40 years increased the risk of renal graft failure 6.2-fold (P = 0.0001), whereas the addition of a pancreas transplant to a kidney and a living-related transplant decreased the risk of failure of the kidney graft 0.2 (P = 0.005) and 0.1 times (P = 0.005). CONCLUSIONS: Our results suggest that when compared with whites, there may be a trend toward an improved kidney and pancreas graft outcome in blacks undergoing KP transplants. These findings suggest that diabetes may override the risk factors that account for the pronounced disparity in outcome observed between nondiabetic white and black recipients.     

InxGa1−xAs (x=0.25–0.35) grown at low temperature

In_xGa_1−xAs (x=0.25–0.35) grown at low temperature on GaAs by molecular beam epitaxy is characterized by Hall effect, transmission electron microscopy, and ultrafast optical testing. As with low temperature (LT) GaAs, the resistivity is generally higher after a brief anneal at 600°C. High-resolution transmission electron microscopy shows all the as-grown epilayers to be heavily dislocated due to the large lattice mismatch (2–3%). When the layers are annealed, in addition to the dislocations, precipitates are also generally observed. As with LT-GaAs, the lifetime shortens as growth temperature is reduced through the range 300–120°C; also, the lifetime in LT-In_xGa_1−xAs is generally shorter in as-grown samples relative to annealed samples. Metal-semiconductor-metal photodetectors fabricated on the material exhibit response times of 1–2 picoseconds, comparable to results reported on GaAs grown at low temperature, and the fastest ever reported in the wavelength range of 1.0–1.3 μm.     

Ionic conductivity in poly(vinyl butyral) based polymeric electrolytes: Effect of solvents and salts

Li⁺ conductive solid polymeric electrolytes (SPEs) have been prepared by complexing Li salts LiX (X = I, SCN, CLO4, CF3SO3) with poly(vinyl butyral) (PVB) an amorphous polymer with a low T_g value and well known for its outstanding laminating properties. These self-supporting SPEs have been prepared by the solution cast technique using cyclohexanone, tetrahydrofuran, and n-butyl alcohol as solvents. The XRD and DSC investigations correlated to measured ionic conductivities have revealed that in addition to the amorphous nature of the resulting complex, its T_g value, the concentration and the values of the lattice energies of the complexing salts, the solvent used in making the SPEs also govern the value of ionic conductivity. Highest ionic conductivity values attained in SPEs made with n-butyl alcohol are explained in terms of the interception of the hydrogen bonding due to solvation.     

Cut off frequency and transit time analysis of lightly doped drain (LDD) MOSFETs

Analytical model for the transconductance, cut off frequency, transit time and fringing capacitance of LDD MOSFETs is presented with a simple approach. The analysis is carried out considering the LDD device as a conventional MOSFET with a series resistance [Z.-H. Liu et al., Threshold voltage model for submicrometer MOSFETs. IEEE Trans Electron Devices 1993; ED-40: 86–94] and a simple closed form expressions for cut off frequency and transit time is obtained. The total gate capacitance, i.e. the geometric and fringing capacitance, is calculated for both LDD and non-LDD devices and lower fringing capacitance is reported in LDD devices. Lower cut-off frequencies and higher transit time are reported in LDD devices for the same channel length.     

Has risk associated with smoking increased? Results from the Copenhagen Center for Prospective Population Studies

BACKGROUND: Two recent much cited publications have raised the concern that risk associated with cigarette smoking has so far been underestimated. In this study we wish to determine whether excess all-cause mortality associated with smoking has increased during the last 20-30 years in a study population representative of the general Danish population and whether any such changes relate to changes in smoking behaviour. METHODS: Pooled data from three prospective population studies conducted in Copenhagen with detailed information on smoking habits. A total of 31,194 subjects, 17,669 males and 13,525 females, initially examined between 1964 and 1992 with examinations repeated at intervals from 1-10 years, were followed until 1995 for all-cause mortality. Relative mortality risk in smokers versus never-smokers was calculated within periods of five calendar years and compared throughout the study period. RESULTS: Male smokers' exposure did not change during the study period whereas female smokers' exposure to tobacco increased in terms of age at smoking onset, quantity smoked and depth of inhalation. During follow-up 5744 males and 2900 females died. In males, death rate ratios (comparing continuous smokers with never-smokers) did not change in the study period. In females, ratios increased from 1964-1978 to 1979-1994 by a factor of 1.3 (95% confidence interval 1.0-1.8). CONCLUSIONS: In agreement with the observed changes in smoking habits, excess mortality in male smokers did not increase whereas excess mortality in female smokers increased slightly.     

The limit of viability--neonatal outcome of infants born at 22 to 25 weeks' gestation

BACKGROUND: With improved survival of preterm infants, questions have been raised about the limit of viability. To provide better information and counseling for parents of infants about to be delivered after 22 to 25 weeks' gestation, we evaluated the mortality and neonatal morbidity of preterm infants born at these gestational ages. METHODS: We studied retrospectively all 142 infants born at 22 to 25 weeks' gestation (as judged by best obstetrical estimate) from May 1988 through September 1991 in a single hospital. Mortality in the first six months, including stillbirths, and neonatal morbidity (i.e., the presence of intracranial pathologic conditions, chronic lung disease, and retinopathy of prematurity) were analyzed. RESULTS: Fifty-six infants (39 percent) survived for six months. Survival improved with increasing gestational age; none of 29 infants born at 22 weeks' gestation survived, as compared with 6 of 40 (15 percent) born at 23 weeks, 19 of 34 (56 percent) born at 24 weeks, and 31 of 39 (79 percent) born at 25 weeks. There were seven stillbirths at 22 weeks' gestation and four stillbirths at 23 weeks. The more immature the infant, the higher the incidence of neonatal complications as determined by the number of days of mechanical ventilation, the length of the hospital stay, and the presence of retinopathy of prematurity, periventricular or intraventricular hemorrhage, or periventricular leukomalacia. Only 2 percent of infants born at 23 weeks' gestation survived without severe abnormalities on cranial ultrasonography, as compared with 21 percent of those born at 24 weeks and 69 percent of those born at 25 weeks. CONCLUSIONS: We believe that aggressive resuscitation of infants born at 25 weeks' gestation is indicated, but not of those born at 22 weeks. Whether the occasional child who is born at 23 or 24 weeks' gestation and does well justifies the considerable mortality and morbidity of the majority is a question that should be discussed by parents, health care providers, and society.     

Quantitation of Cefaclor in Pharmaceutical Dosage Forms Using High Performance Liquid Chromatography

A stability-indicating high-performance liquid chromatography for the quantitation of cefaclor in pharmaceutical dosage forms has been developed. The method is accurate and precise with a percent relative standard deviation of 1.2 based on 5 readings. A number of inactive ingredients present in the capsules and suspensions did not interfere with the assay procedure. The extraction procedure from the dosage forms is very simple. The recovery from the synthetic mixtures was quantitative. The capsules which had expired 3 years ago lost only 3% of the potency. The drug appears to be very sensitive to strong acids or bases since a 5 minute boiling caused 100% degradation of drug in both the solutions.     

Radiation-Induced graft copolymerization of methacrylic acid onto polypropylene fibers. V. Mechanical properties

Mechanical properties of polypropylene-g-poly(methacrylic acid) fibers, prepared by graft copolymerization of methacrylic acid onto polypropylene fiber using simultaneous gamma ray irradiation technique, were evaluated. In general, an improvement in the mechanical behavior of the polypropylene fiber by grafting was observed. Denier and initial modulus of the fiber showed a linear increase with the percent graft, and elongation showed an opposite trend. The results have been explained in terms of reinforcing effect of poly(methacrylic acid) grafts and reduction in the segmental mobility of the polymeric chains. Tenacity also increases up to certain graft level, beyond which a sharp decrease occurs, probably due to the influence on the compactness of the macromolecular chains with the further grafting.     

Microstructural Investigation on Failure of Internal Drive Shaft

17-4 PH stainless steel is used as internal drive shaft material in liquid engine pumps. One of the drive shafts failed during operation. The shaft pieces were in contact for short duration after failure, which has resulted in abrasion of fractured surfaces. Samples from the location of failure were taken, and investigation of the failure was carried out using optical and scanning electron microscopy. The microstructural analysis of the material and fractographic analysis of the fractured surface show that the failure was caused by excessive torsion.