Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature

Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients.     

An architecture to support scalable distributed virtual environment systems on grid

A Distributed Virtual Environment (DVE) system offers a computer-generated virtual world in which individuals located at different places in the physical world can interact with one another. In order to achieve real-time response for a large user base, DVE systems need to have a scalable architecture. In this paper, we present the design of a grid-enabled service oriented framework for facilitating the construction of scalable DVE systems on computing grids. A service component called “gamelet” is proposed, whose distinctive mark is its high mobility for supporting dynamic load sharing. We propose a gamelet migration protocol which can ensure the transparency and efficiency of gamelet migration, and an adaptive gamelet load-balancing (AGLB) algorithm for making gamelet redistribution decisions at runtime. The algorithm considers both the synchronization costs of the DVE system and network latencies inherent in the grid nodes. The activities of the users and the heterogeneity of grid resources are also considered in order to carry out load sharing more effectively. We evaluate the performance of the proposed mechanisms through a multiplayer online game prototype implemented using the Globus toolkit. The results show that our approach can achieve faster response times and higher throughputs than some existing approaches. This research is supported in part by the China National Grid project (863 program) and the HKU Foundation Seed Grant 28506002.     

On-demand learning for a wireless campus

The current Internet and wireless networks are harsh environments for transporting high-bandwidth multimedia data. We examine the technical issues involved, and describe an end-to-end solution to support a Web-based learn-on-demand system that operates in a wireless campus environment.     

The band areas of proteins determined by fluorescent scanning in the commercial automated gel electrophoresis apparatus

An automated gel electrophoresis apparatus, recently available commercially, allows one to follow the band during electrophoresis in real time, and lends itself therefore to an evaluation of bandwidth as a function of migration time (the dispersion coefficient), resolution and band shape. These determinations assume the constancy of band area with migration time and at various gel concentrations. The purpose of the present study was to verify these assumptions. Representative proteins and sodium dodecyl sulfate (SDS)-proteins, either natively fluorescent or fluorescein carboxylate labeled, were found to exhibit band areas which approach constancy as a function of migration time in both agarose and polyacrylamide gel electrophoresis, provided that (i) the protein concentration under the band was low enough to obviate self-quenching of fluorescence; (ii) the separation of the protein of interest from contaminants had progressed sufficiently during the time at which band areas were measured; (iii) the baseline under the peak was sufficiently well defined. However, band areas decrease with increasing gel concentration. Protein peaks exhibited leading and trailing tails. The ratio of the combined tail area to total area appeared to be near-constant at varying migration times. However, that ratio increases with increasing gel concentration. The tail area does not appear to be an artifact of fluorometric detection since it is reproduced upon fluorimetric analysis of the protein eluted from gel slices after electrophoresis. However, it may be due to photochemical destruction under the conditions of repetitive fluorometric peak detection.     

Engagement of T cell receptor triggers its recruitment to low-density detergent-insoluble membrane domains

T-cell receptors (TCRs) upon binding to peptide-MHC ligands transduce signals in T lymphocytes. Tyrosine phosphorylations in the cytoplasmic domains of the CD3 (gammadeltaepsilon) and zeta subunits of the TCR complex by Src family kinases initiate the signaling cascades via docking and activation of ZAP-70 kinase and other signaling components. We examined the role of the low-density detergent-insoluble membranes (DIMs) in TCR signaling. Using mouse thymocytes as a model, we characterized the structural organization of DIMs in detail. We then demonstrated that TCR engagement triggered an immediate increase in the amount of TCR/CD3 present in DIMs, which directly involves the engaged receptor complexes. TCR/CD3 recruitment is accompanied by the accumulation of a series of prominent tyrosine-phosphorylated substrates and by an increase of the Lck activity in DIMs. Upon TCR stimulation, the DIM-associated receptor complexes are highly enriched in the hyperphosphorylated p23 zeta chains, contain most of the TCR/CD3-associated, phosphorylation-activated ZAP-70 kinases and seem to integrate into higher order, multiple tyrosine-phosphorylated substrate-containing protein complexes. The TCR/CD3 recruitment was found to depend on the activity of Src family kinases. We thus provide the first demonstration of recuitment of TCR/CD3 to DIMs upon receptor stimulation and propose it as a mechanism whereby TCR engagement is coupled to downstream signaling cascades.     

On the macroscopic optimization of multicell wireless systems with multiuser detection and multiple antennas - uplink analysis

In this paper, we consider a system with K single-antenna client users, n/sub B/ base stations (each base station has n/sub R/ antennas), as well as a centralized controller. A client user could be associated with a single base station at any time. All the base stations operate at the same frequency and have optimal multiuser detection per base station which cancels intracell interference only. We consider a general problem of uplink macroscopic resource management where the centralized controller dynamically determines an appropriate association mapping of the K users with respect to the n/sub B/ base stations over a macroscopic time scale. We propose a novel analytical framework for the above macroscopic scheduling problems. A simple rule is to associate a user with the strongest base station (camp-on-the-strongest-cell), and this has been widely employed in conventional cellular systems. However, based on the optimization framework, we found that this conventional approach is in fact not optimal when multiuser detection is employed at the base station. We show that the optimal macroscopic scheduling algorithm is of exponential complexity, and we propose a simple greedy algorithm as a feasible solution.     

Gastrointestinal autonomic nerve tumour presenting as small bowel volvulus: a rare disease with a rare presentation

A 78-year-old Chinese woman presented with recurrent postprandial abdominal pain. Computerised tomography revealed a small bowel tumour causing volvulus of a segment of the small bowel. Laparotomy confirmed an extraluminal ileal tumour with partial volvulus of the involved small bowel segment. Small bowel resection was done. Histological and ultrastructural studies confirmed a gastrointestinal autonomic nerve tumour. We review the medical literature on this rare tumour.     

Pass-transistor adiabatic logic with NMOS pull-down configuration

A new low power adiabatic logic family, pass-transistor adiabatic logic with NMOS pull-down configuration, is presented. For a 2:1 multiplexer, a power saving of ~800% is achieved, compared to a 2N-2N2P logic circuit at 20 MHz. Compared to pass-transistor adiabatic logic using single power-clock supply (PAL), the `tri-state' problem is solved, while power consumption is comparable. A four phase sinusoidal clock power supply is employed in the new logic family, which facilitates pipelining hence leading to higher throughput, compared to PAL     

Effect of angiotensin-converting enzyme inhibitors on the progression of nondiabetic renal disease: a meta-analysis of randomized trials. Angiotensin-Converting-Enzyme Inhibition and Progressive Renal Disease Study Group

BACKGROUND: The effect of angiotensin-converting enzyme (ACE) inhibitors in slowing the decline in renal function in nondiabetic renal disease varies among studies. PURPOSE: To use meta-analysis to assess the effect of ACE inhibitors on the development of end-stage renal disease caused by factors other than diabetes. DATA SOURCES: The English-language medical literature, identified by a MEDLINE search and unpublished studies. STUDY SELECTION: All randomized studies that compared ACE inhibitors with other antihypertensive agents and had at least 1 year of planned follow-up were selected. Studies of diabetic renal disease and renal transplants were excluded. A total of 1594 patients in 10 studies was included. DATA EXTRACTION: Data on end-stage renal disease, death, drop out, and blood pressure were extracted. Study investigators confirmed results and provided additional data. DATA SYNTHESIS: Among 806 patients receiving ACE inhibitors, 52 (6.4%) developed end-stage renal disease and 17 (2.1%) died; in the 788 controls, the respective values were 72 (9.1%) and 12 (1.5%). The pooled relative risks were 0.70 (95% CI, 0.51 to 0.97) for end-stage renal disease and 1.24 (CI, 0.55 to 2.83) for death; the studies were not significantly heterogeneous. The decreases in weighted mean systolic and diastolic blood pressures during follow-up were 4.9 and 1.2 mm Hg greater, respectively, in the patients who received ACE inhibitors. CONCLUSIONS: Angiotensin-converting enzyme inhibitors are more effective than other antihypertensive agents in reducing the development of end-stage nondiabetic renal disease, and they do not increase mortality. It could not be determined whether this beneficial effect is due to the greater decline in blood pressure or to other effects of ACE inhibition.