Pulmonary vascular disease and operative indications in complete atrioventricular canal defect in early infancy

Pulmonary vascular disease was morphometrically analyzed in 67 patients (mean age, 19 months) with isolated complete atrioventricular canal defect. Complete obstruction of the small pulmonary arterial lumen resulting from acute fibrous proliferation and atrophy of the peripheral arterial media, which were considered absolute operative contraindications, were characteristic in six patients with Down's syndrome. Morphometric analysis of medial thickness revealed that thinning of the media of the small pulmonary arteries is generally observed at around 6 months of age in patients with complete atrioventricular canal defect and that the media in patients who have complete atrioventricular canal defect and Down's syndrome was thinner than that in such patients without Down's syndrome. These results suggest that thinning of the media as a result of two factors--Down's syndrome and aging--facilitates the rapid occurrence of fibrous intimal proliferation. Therefore intracardiac repair is desirable within 6 months of life, before medial thinning, in patients with complete atrioventricular canal defect and Down's syndrome. Excluding patients with absolute operative contraindications, the scores of the index of pulmonary vascular disease in operative survivors were below 2.0 and death occurred when scores were more than 2.2. The pulmonary vascular resistances measured in room air and by the oxygen inhalation and tolazoline tests in patients with operative contraindications were more than 7.3, 3.8, and 6.6 units.m2, respectively. We thus conclude that lung biopsy should be undertaken for patients in whom pulmonary vascular resistance is beyond these values to determine the appropriateness of surgical intervention.     

Westernized food habits and concentrations of serum lipids in the Japanese

It has recently been reported that there exists a new 'RING-finger' protein family among the zinc-finger (Zf) proteins. Previously, we had isolated the mouse Mel-18 cDNA (mMel-18) encoding the nuclear RING-finger protein that exhibits an ability to bind to a nonspecific DNA column. Here, we have isolated and characterized the human Mel-18 cDNA (hMel-18) using the mMel-18 cDNA as a probe. The deduced hMel-18 protein contains 344 amino acids (38 kDa) with a RING-finger motif, a helix-loop-helix (HLH)-like structure and a Pro/Ser-rich region. The hMel-18 gene is conserved among vertebrates. Its mRNA is highly expressed in placenta, lung and kidney, but the level is low in liver, pancreas and skeletal muscle. Using in situ hybridization, we mapped hMel-18 to band q22 of chromosome 12. It is possible that the Mel-18/bmi-1 gene family represents a mammalian homologue of the Drosophila polycomb gene group.     

Hot-carrier-injected oxide region in front and back interfaces inultra-thin (50 nm), fully depleted, deep-submicron NMOS andPMOSFET's/SIMOX and their hot-carrier immunity

The hot-carrier-injected oxide region in the front and back interfaces is systematically clarified for fully depleted surface-channel nMOSFET's and surface-channel and buried-channel pMOSFET's fabricated on an ultra-thin (50 nm)-film SIMOX wafer. Based on these results, the influence of these injected carriers on front-channel properties is investigated. NMOSFET degradation is shown to be caused by hot-carriers injected into the drain side of the front oxide and pMOSFET degradation by hot-electrons injected into the drain side of both the front oxide and the back oxide. Additionally, it is shown experimentally that these fully depleted devices with effective channel lengths between 0.1-0.2 μm have fairly high hot-carrier immunity, even for single-drain structures     

NiCoFe/C cathode electrocatalysts for direct ethanol fuel cells

A direct ethanol fuel cell (DEFC), which is less prone to ethanol crossover, is reported. The cell consists of PtRu/C catalyst as the anode, Nafion^® 117 membrane, and Ni–Co–Fe (NCF) composite catalyst as the cathode. The NCF catalyst was synthesized by mixing Ni, Co, and Fe complexes into a polymer matrix (melamine-formaldehyde resins), followed by heating the mixture at 800 °C under inert atmosphere. TEM and EDX experiments suggest that the NCF catalyst has alloy structures of Ni, Co and Fe. The catalytic activity of the NCF catalyst for the oxygen reduction reaction (ORR) was compared with that of commercially available Pt/C (CAP) catalyst at different ethanol concentrations. The decrease in open circuit voltage (V_oc) of the DEFC equipped with the NCF catalysts was less than that of CAP catalyst at higher ethanol concentrations. The NCF catalyst was less prone to ethanol oxidation at cathode even when ethanol crossover occurred through the Nafion^®117 film, which prevents voltage drop at the cathode. However, the CAP catalyst did oxidize ethanol at the cathode and caused a decrease in voltage at higher ethanol concentrations.     

An approach to integrating intelligentdiagnostics and supervision of machine tools

Arguments are presented for the necessity of integrating diagnostics and supervision in technological machines. An example of integrated diagnostics and supervision of the machine tool main drive, based on an expert system and neural network, is shown. Problems of intelligent thermal displacement supervision and questions related to practical supervision of machining centres are presented.     

Demonstration of a fully spatial coherent X-ray laser at 13.9 nm

We have recently reported the successful development of a fully coherent X-ray laser (XRL) at 13.9 nm by an oscillator-amplifier configuration with two targets. In the experiment, a seed XRL beam from the first target is injected into a plasma amplifier at the second target. The observed XRL beam has full spatial coherence and 0.2 mrad of nearly diffraction-limited divergence. In order to improve the output fluence, the amplification properties of the XRL beam have been investigated using various plasma lengths of the second amplifier target. The output energy has been improved by a factor of ten, increasing the length of the gain region to 10 mm, resulting in about 0.2 /spl mu/J of output energy.     

The effect of sheet processing on the microstructure, tensile, and creep behavior of INCONEL alloy 718

The grain size, grain boundary character distribution (GBCD), creep, and tensile behavior of INCONEL alloy 718 (IN 718) were characterized to identify processing-microstructure-property relationships. The alloy was sequentially cold rolled (CR) to 0, 10, 20, 30, 40, 60, and 80 pct followed by annealing at temperatures between 954 °C and 1050 °C and the traditional aging schedule used for this alloy. In addition, this alloy can be superplastically formed (IN 718SPF) to a significantly finer grain size and the corresponding microstructure and mechanical behavior were evaluated. The creep behavior was evaluated in the applied stress (σ _a ) range of 300 to 758 MPa and the temperature range of 638 °C to 670 °C. Constant-load tensile creep experiments were used to measure the values of the steady-state creep rate and the consecutive load reduction method was used to determine the values of backstress (σ₀). The values for the effective stress exponent and activation energy suggested that the transition between the rate-controlling creep mechanisms was dependent on effective stresses (σ _e =σ _a σ₀) and the transition occurred at σ _e ≅ 135 MPa. The 10 to 40 pct CR samples exhibited the greatest 650 °C strength, while IN 718SPF exhibited the greatest room-temperature (RT) tensile strength (>1550 MPa) and ductility (ε _f >16 pct). After the 954 °C annealing treatment, the 20 pct CR and 30 pct CR microstructures exhibited the most attractive combination of elevated-temperature tensile and creep strength, while the most severely cold-rolled materials exhibited the poorest elevated-temperature properties. After the 1050 °C annealing treatment, the IN 718SPF material exhibited the greatest backstress and best creep resistance. Electron backscattered diffraction was performed to identify the GBCD as a function of CR and annealing. The data indicated that annealing above 1010 °C increased the grain size and resulted in a greater fraction of twin boundaries, which in turn increased the fraction of coincident site lattice boundaries. This result is discussed in light of the potential to grain boundary engineer this alloy. INCONEL is a registered trademark of Special Metals Corp., Huntington, WV. This article is based on a presentation made in the symposium entitled “Processing and Properties of Structural Materials,” which occurred during the Fall TMS meeting in Chicago, Illinois, November 9–12, 2003, under the auspices of the Structural Materials Committee.     

Operative videothoracoscopy in the surgical treatment of penetrating firearms wounds of the chest

We prospectively analyzed our experience with operative videothoracoscopy (OVT) performed in a field military hospital in cases of penetrating firearms wounds of the thorax (PFAWT) sustained in Chechnya. From February to April 1996, we treated 206 wounded patients, of whom 37 (18.0%) had sustained chest injuries. PFAWT were present in 23 soldiers, accounting for 62.2% of all chest injuries. Twelve injuries were confined to the thorax, eight patients had associated injuries, and three soldiers had thoracoabdominal injuries. Nineteen patients had pleural drainage performed during medical evacuation. The thoracic injuries were right-sided (17), involved bullets or shell splinters (23); were through and through (16), represented solitary wounds (19), and were associated with internal organ injuries (21). Fifteen patients had indications for OVT when they were delivered from the battle-field 1.5 to 22 hours after injury. All patients manifested signs of hemorrhagic shock and hemodynamic instability. Indications for OVT were ongoing intrapleural bleeding (6), clotted hemothorax (6), or marked air leakage (3) preventing lung inflation with the OP-02 apparatus (field modification). OVT revealed 12 lung wounds, nine of which were multiple wounds, pleural bleeding in 6 patients, clotted hemothorax in 11 patients, and foreign bodies in 5 patients. Two patients underwent thoracotomy, one for suspicion of heart injury and the second because we could not adequately visualize and control bleeding revealed at OVT to be from the intercostal artery in the left costovertebral angle. Eight of 23 patients had no indication for operative videothoracoscopy and were managed with continued pleural aspiration and drug therapy. Wedge resection of the lung using an Endo-GIA-30 stapler was necessary in two patients because of parenchymal destruction and bleeding. Evacuation of clotted blood by fragmentation and aspiration was satisfactory in all cases. Satisfactory manual suturing of selected lung injuries was obtained largely with intracorporeal knot tying. The duration of the procedures ranged from 40 to 90 minutes. No morbidity nor mortality was encountered in patients undergoing OVT. Postoperative pain was minimized by using OVT placement of catheters in the chest wall soft tissue with local administration of 2% Trimecain. Patients were able to stand in 10 to 12 hours and to walk by the end of the first postoperative day. All patients who underwent OVT were evacuated without drains by the third or fourth postoperative day, all tolerating sitting and standing positions. We conclude that early OVT in the military field hospital for continued bleeding, clotted hemothorax, and continued major air leakage has several advantages in military patients with PFAWT: early definition and management of organ injury; identification and control of bleeding in most instances; earlier and more accurate assessment for thoracotomy; vigorous lavage and removal of projectiles such as bone fragments and evacuation of clotted hemothorax; early debridement with suture closure of the thoracic wall canal; and minimal postoperative pain with dramatically reduced suppurative sequelae and bronchopleural fistulae.     

Effects of scatter and attenuation correction on quantitative assessment of regional cerebral blood flow with SPECT

The pyruvate dehydrogenase complex (PDC) plays a key role in the anaerobic mitochondrial metabolism of the parasitic nematode Ascaris suum. A cDNA coding for an A. suum pyruvate dehydrogenase kinase (APDK) has been cloned and sequenced from poly(A)+ RNA isolated from adult A. suum muscle.2 APDK exhibited significant sequence identity to mammalian PDKs. Nucleotide sequence analysis of the APDK cDNA revealed a 22-nucleotide spliced leader, characteristic of many nematode mRNAs, a 5'-UTR of 6 nucleotides, an open reading frame of 1197 nucleotides, and a 3'-UTR of 101 nucleotides that included a putative polyadenylation signal. The open reading frame predicted a protein of 399 amino acids with a molecular weight of 45,402 that included a putative 18-aminoacid leader peptide. Recombinant APDK (rAPDK) was functionally expressed in Escherichia coli with a his tag at its N-terminus and purified to apparent homogeneity on Ni-NTA-agarose. Recombinant APDK was a dimer and was not autophosphorylated and its activity was stimulated in the presence of APDK-deficient adult A. suum muscle PDC presumably by the binding of APDK to the dihydrolipoyl transacetylase (E2) core of the complex. After binding to the core, rAPDK activity was stimulated by elevated NADH/NAD+ and acetyl CoA/CoA ratios within the same ranges as observed for the native APDK. Immunoblotting suggested that native APDK focused as a series of 43-kDa spots (pI 6.1-6.8) on two-dimensional gels of the purified adult A. suum muscle PDC.