Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for >1 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient=-5.550, P=0.02 and coefficient=-0.268, P=0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P=0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT.

Immunoglobulin prophylaxis against cytomegalovirus infection in patients at high risk of infection following allogeneic hematopoietic cell transplantation

Reports on the efficacy of intravenous immunoglobulin (IVIG) prophylaxis against cytomegalovirus (CMV) infection after allogeneic hematopoietic cell transplantation (HCT) have often sparked controversy. In addition, we are not aware of any study that has examined whether prophylaxis with IVIG affects the incidence of CMV infection in high-risk patients--those who are elderly or have received human leukocyte antigen (HLA) mismatched HCT. In the present open-label, phase II study, we addressed this question. We enrolled 106 patients in the study. The cumulative incidences of CMV infection at 100 days after HCT were similar in the intervention and the control groups (68% and 64%, P=.89; 89% and 87%, P=.79, respectively, for patients 55 years or older and those who received HLA-mismatched HCT). In those who received HLA-mismatched HCT, 1-year overall survival after HCT was 46% in the intervention group and 40% in the control group (P=.31); for age≥55 years, the corresponding values were 46% and 40% (P=.27). Our data showed that prophylaxis with regular polyvalent IVIG did not affect the incidence of CMV infections or survival among older patients or those who receive HLA-mismatched HCT.

Determination of radial location of rotating magnetic islands by use of poloidal soft x-ray detector arrays in the STOR-M tokamak

A technique is presented for determining the radial location of the rotating magnetic islands in the STOR-M tokamak by use of soft x-ray (SXR) detector arrays. The location is determined by examining the difference in the integrated SXR emission intensities through two adjacent lines of sight. A model for calculating dependence of the line integrated SXR emission intensity on the radius, the mode numbers and the magnetic island geometry, has been developed. The SXR difference signal shows phase inversion when the impact parameter of the line of sight sweeps across the magnetic islands. Experimentally, the difference SXR signals significantly reduce noise and suppress the influence of background plasma fluctuations through common mode rejection when a dominant mode exists in the STOR-M tokamak. The radial locations of the m = 2 magnetic islands have been determined under several experimental conditions in the STOR-M discharges. With the decrease in the tokamak discharge current and thus the increase of the safety factor at the edge, the radial location of the m = 2 magnetic islands has been found to move radially inward.

Levothyroxine replacement therapy and refractory hypotension out of transitional period in preterm infants

BACKGROUND

Recent studies suggest that refractory hypotension from causes other than septicaemia or cardiac failure is common in extremely preterm infants even out of the transitional period. Marked response to low-dose cortisol suggests underlying adrenal insufficiency, although the exact mechanism remains unknown.

METHODS

To investigate potential triggers for and related short-term outcomes of early-onset (<Day 7) and late-onset (≥Day 7) refractory hypotension, clinical data for 70 infants <30 weeks gestation were assessed.

RESULTS

The incidence of early-onset refractory hypotension (n=7) was correlated with younger gestational ages <26 weeks (P < 0.05), whereas the incidence of late-onset refractory hypotension (n=14) was correlated with younger gestational ages and levothyroxine supplementation (P<0.05 and 0.01, respectively). The incidence of both early- and late-onset refractory hypotension was correlated with risks of short-term adverse outcomes such as prolonged mechanical ventilation and hospital stay.

CONCLUSIONS

Levothyroxine supplementation was identified as an independent variable correlated with an increased incidence of refractory hypotension out of the transitional period; as seen in hypothyroidism with Addison's disease, the immature hypothalamic-pituitary-adrenal axis may not respond properly to the increased demand for cortisol, which may precipitate premature infants into refractory hypotension. Following the administration of levothyroxine, preterm infants may have to be carefully monitored for early signs of refractory hypotension.

A compact and continuously driven supersonic plasma and neutral source

A compact and repetitively driven plasma source has been developed by utilizing a magnetized coaxial plasma gun (MCPG) for diagnostics requiring deep penetration of a large amount of neutral flux. The system consists of a MCPG 95mm in length with a DN16 ConFlat connection port and an insulated gate bipolar transistor (IGBT) inverter power unit. The power supply consists of an array of eight IGBT units and is able to switch the discharge on and off at up to 10 kV and 600 A with a maximum repetitive frequency of 10 kHz. Multiple short duration discharge pulses maximize acceleration efficiency of the plasmoid. In the case of a 10 kHz operating frequency, helium-plasmoids in the velocity range of 20 km/s can be achieved.

Chemical reactions and applications of the reductive surface of porous silicon

The chemical reactivity of freshly prepared porous silicon is similar to that of a reducing agent on the surface of the nanocrystallites. Ag+ spontaneously reduces to form Ag0 granular coatings on the surface of porous silicon at the expense of the oxidation of silicon hydride and silicon. Atomic Force Microscopy shows that the thickness and topography of the Ag0 coating depend on the concentration of Ag+ with the porous silicon surface being the limiting reagent. In-situ Raman Spectroscopy shows an Ag layer on the silicon and Si:O layer immediately after etching and exposure to Ag+ and O2 respectively. Ag0 coated on the surface and in the pores of the porous silicon proves to be an excellent material for Surface Enhanced Raman Spectroscopy and the natural low electron affinity on the surface of porous silicon replaces the need for a negative bias to prepare very stable diamond coatings on the surface of silicon.

Ultrathin W-Al dual interlayer approach to depositing smooth and adherent nanocrystalline diamond films on stainless steel

The adherence of diamond coated on steel is commonly low and needs to be strengthened with thick intermediate layers. In this paper, a nanoscale W-Al dual metal interlayer has been applied on SS304 substrates to facilitate deposition of continuous, adherent and smooth diamond thin films. During the microwave plasma-enhanced chemical vapor deposition process, the Al inner layer 30 nm thick diffuses into steel surface inhibiting carbon diffusion and graphitization. The W outer layer 20 nm thick is transformed into W carbides, both preventing carbon diffusion and enhancing diamond nucleation. The diamond films synthesized are of high purity and have smooth surfaces and dense structures. Indentation and shear deformation tests indicate high delaminating tolerance of the diamond films.

Retarding field energy analyzer for the Saskatchewan Torus-Modified plasma boundary

The retarding field energy analyzer (RFA) is a simple and reliable diagnostic technique to measure the ion temperature in the scrape-off layer and edge of magnetic fusion devices. Design and operation features of a single-sided (facing the ion flow) RFA for ion temperature measurements in the Saskatchewan Torus-Modified (STOR-M) tokamak are described. Its compact size (21 x 15 x 20 mm3) allows RFA measurements without perturbing plasma significantly. Both ion and electron temperature have been measured by RFA in the STOR-M tokamak. A method is proposed to correct the effects of ion flow on the ion temperature using the simultaneously measured Mach number. The measured electron temperature is consistent with the previously reported Langmuir probe data. Abnormal behavior of the RFA has been observed in both ion and electron modes when RFA is inserted deep into the plasma.

Brain-type natriuretic peptide at birth reflects foetal maturation and antenatal stress

AIM

Antenatal stress, maturation and other foetal conditions affect the postnatal cardiovascular function. Atrial- (ANP) and brain-type natriuretic peptide (BNP) play important roles in regulating extracellular fluid volume and blood pressure, which may surrogate the foetal cardiovascular condition. The aim of this study was to investigate the dependence of serum ANP and BNP at birth on antenatal variables in high-risk infants.

METHODS

Plasma ANP and BNP levels in the umbilical cord blood were compared with antenatal clinical information in 280 infants.

RESULTS

High levels of ANP and BNP were associated with multiple pregnancy, antenatal magnesium sulphate and foetal distress. Caesarean section (CS) was paradoxically associated with low ANP and high BNP; low ANP was related with CS before labour whereas high BNP was related with CS after the commencement of labour. High BNP levels further correlated with younger gestational age and intrauteral growth restriction. With regard to short-term postnatal variables, high BNP levels were associated with low Apgar scores and respiratory failure whereas high ANP only correlated with the latter.

CONCLUSION

High natriuretic peptide levels were associated with prematurity at birth, uteral contraction and antenatal stress: cord blood ANP and BNP may be a useful surrogate marker for hidden antenatal stress.

Design and initial operation of multichord soft x-ray detection arrays on the STOR-M tokamak

Two miniature pinhole camera arrays for spatially and temporally resolved measurements of soft x-ray emission have been designed and installed on the STOR-M tokamak. Each array consists of a photodiode array, with one array viewing vertically and one viewing horizontally through a plasma cross section. Preamplifiers with fixed gains of 10(5) VA and custom built amplifiers with variable gains are used for signal amplification. Digitizers with 14 bit resolution and 3 MSs sampling rate are used for data acquisition. In the initial operation, an Al foil with a thickness of 1.8 microm installed for one array and Be filter of 7.6 microm installed for the other array are used to test signal strength. Initial tests have identified sawtooth oscillations and 20 kHz fluctuations, which are also detected by Mirnov coils, superimposed on the sawtooth oscillations.

Serum lipid effects of a monounsaturated (palmitoleic) fatty acid-rich diet based on macadamia nuts in healthy, young Japanese women

1. Recent studies have identified potential beneficial effects of eating nuts, most of which have substantial amounts of monounsaturated fatty acids (MUFA). Macadamia nuts consist of 75% fat by weight, 80% of which is MUFA (palmitoleic acid). 2. To examine variations in serum lipid levels in response to a high-MUFA diet based on macadamia nuts, 3 week interventions of macadamia nuts, coconuts and butter were determined in young, healthy Japanese female students. 3. After 3 weeks intervention, serum concentrations of total cholesterol and low-density lipoprotein-cholesterol were significantly decreased in the macadamia nut and coconut diets and bodyweight and body mass index were decreased in the group fed macadamia nuts, although there were no statistically significant changes in the group fed butter.

Performance of the university of saskatchewan compact torus injector with curved acceleration electrodes

The first vertical compact torus (CT) injection experiment has been performed in the Saskatchewan Torus Modified (STOR-M) tokamak [Nucl. Fusion 46, 104 (2006)]. To increase the kinetic energy density of the injected CTs for deeper penetration, the University of Saskatchewan Compact Torus Injector (USCTI) was further modified by attaching a 90 degrees curved inner electrode coaxial with the outer electrode. The modification extended the original CT acceleration section from 60 to 114 cm. Effects of the curved acceleration electrodes on the velocity and magnetic field of the CT are reported in this paper. It has been found that the CTs, injected horizontally, were deflected to vertical direction and CT velocity measured at the curved acceleration section increased to 180 kms, representing a 40% increase compared with the case without the curved inner electrode in a previous experiment. At a higher acceleration bank voltage of 16 kV, this velocity increased to about 270 kms. In addition, amplification of the CT magnetic field in the curved acceleration section has also been observed.

A case of partial 14q- with facial features of holoprosencephaly and hydranencephaly

We report a rare case of facial features of holoprosencephaly associated with hydranencephaly, with a de novo proximal interstitial deletion of the long arm of chromosome 14, specifically, del(14)(q13q21). She was born at 37 weeks of gestation and transferred to our institution at 3 years of age. The patient had midline facial anomalies consisting of cleft palate, defective nasal septum, and hypotelorism, together with endocrine abnormalities such as diabetes insipidus and hypothyroidism. Cranial computed tomography revealed the near-total loss of all cerebral tissue, with a frontal part of the cerebral falx lacking. None of the few reports of holoprosencephaly with 14q- chromosomal abnormality describe holoprosencephaly in association with hydranencephaly. The partial deletion of chromosome 14, del(14)(q13q21), may underlie the association of facial features of holoprosencephaly and hydranencephaly.

Pediatric susceptibility to 18 industrial chemicals: A comparative analysis of newborn with young animals

We comprehensively re-analyzed the toxicity data for 18 industrial chemicals from repeated oral exposures in newborn and young rats, which were previously published. Two new toxicity endpoints specific to this comparative analysis were identified, the first, the presumed no observed adverse effect level (pNOAEL) was estimated based on results of both main and dose-finding studies, and the second, the presumed unequivocally toxic level (pUETL) was defined as a clear toxic dose giving similar severity in both newborn and young rats. Based on the analyses of both pNOAEL and pUETL ratios between the different ages, newborn rats demonstrated greater susceptibility (at most 8-fold) to nearly two thirds of these 18 chemicals (mostly phenolic substances), and less or nearly equal sensitivity to the other chemicals. Exceptionally one chemical only showed toxicity in newborn rats. In addition, Benchmark Dose Lower Bound (BMDL) estimates were calculated as an alternative endpoint. Most BMDLs were comparable to their corresponding pNOAELs and the overall correlation coefficient was 0.904. We discussed how our results can be incorporated into chemical risk assessment approaches to protect pediatric health from direct oral exposure to chemicals.