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Background Controversy exists as to whether the threshold for blood pressure-lowering treatment should differ between people with and without type 2 diabetes. We aimed to investigate the effects of blood pressure-lowering treatment on the risk of major cardiovascular events by type 2 diabetes status, as well as by baseline levels of systolic blood pressure. Methods We conducted a one-stage individual participant-level data meta-analysis of major randomised controlled trials using the Blood Pressure Lowering Treatment Trialists' Collaboration dataset. Trials with information on type 2 diabetes status at baseline were eligible if they compared blood pressure-lowering medications versus placebo or other classes of blood pressure-lowering medications, or an intensive versus a standard blood pressure-lowering strategy, and reported at least 1000 persons-years of follow-up in each group. Trials exclusively on participants with heart failure or with short-term therapies and acute myocardial infarction or other acute settings were excluded. We expressed treatment effect per 5 mm Hg reduction in systolic blood pressure on the risk of developing a major cardiovascular event as the primary outcome, defined as the first occurrence of fatal or non-fatal stroke or cerebrovascular disease, fatal or non-fatal ischaemic heart disease, or heart failure causing death or requiring hospitalisation. Cox proportional hazard models, stratified by trial, were used to estimate hazard ratios (HRs) separately by type 2 diabetes status at baseline, with further stratification by baseline categories of systolic blood pressure (in 10 mm Hg increments from Findings We included data from 51 randomised clinical trials published between 1981 and 2014 involving 358 533 participants (58% men), among whom 103 325 (29%) had known type 2 diabetes at baseline. The baseline mean systolic/diastolic blood pressure of those with and without type 2 diabetes was 149/84 mm Hg (SD 19/11) and 153/88 mm Hg (SD 21/12), respectively. Over 4·2 years median follow-up (IQR 3·0–5·0), a 5 mm Hg reduction in systolic blood pressure decreased the risk of major cardiovascular events in both groups, but with a weaker relative treatment effect in participants with type 2 diabetes (HR 0·94 [95% CI 0·91–0·98]) compared with those without type 2 diabetes (0·89 [0·87–0·92]; pinteraction=0·0013). However, absolute risk reductions did not differ substantially between people with and without type 2 diabetes because of the higher absolute cardiovascular risk among participants with type 2 diabetes. We found no reliable evidence for heterogeneity of treatment effects by baseline systolic blood pressure in either group. In keeping with the primary findings, analysis using stratified network meta-analysis showed no evidence that relative treatment effects differed substantially between participants with type 2 diabetes and those without for any of the drug classes investigated. Interpretation Although the relative beneficial effects of blood pressure reduction on major cardiovascular events were weaker in participants with type 2 diabetes than in those without, absolute effects were similar. The difference in relative risk reduction was not related to the baseline blood pressure or allocation to different drug classes. Therefore, the adoption of differential blood pressure thresholds, intensities of blood pressure lowering, or drug classes used in people with and without type 2 diabetes is not warranted. Funding British Heart Foundation, UK National Institute for Health Research, and Oxford Martin School.

The stability of the gain of the photomultiplier (PMT) camera for the Fluorescence Detector (FD) of the Telescope Array experiment was monitored using an 241 Am loaded scintillator pulsers (YAP) and a diffused xenon flasher (TXF) for a selected set of 35 PMT-readout channels. From the monitoring of YAP pulses over four years of FD operation, we found slow monotonic drifts of PMT gains at a rate of −1.7~+1.7%/year. An average of the PMT gains over the 35 channels stayed nearly constant with a rate of change measured at −0.01±0.31(stat)±0.21(sys)%/year. No systematic decrease of the PMT gain caused by the night sky background was observed. Monitoring by the TXF also tracked the PMT gain drift of the YAP at 0.88±0.14(stat)%/year.

Given the amount of frenetic healthcare reform preparation occurring with accountable care organizations (ACOs), patient-centered medical homes (PCMHs), and bundling demonstrations, are we overlooking-or quietly ignoringmedical and surgical specialists and subspecialists in our planning? It may seem to specialists that they are off the healthcare radar screen for now.Yes, a few medical homes and ACOs are specialty based, and some commercial health plans and for-profit entities are creating accountable care scenarios with specialists in oncology, end-stage renal disease (ESRD), and a few other medical conditions. Bundled payment demonstration projects are frequently identified with specialists, but in reality these payment models currently fit some specialties better than others. Specialists account for the majority of U.S. physicians, but the actual number of physicians involved in these initiatives is only a small percentage of the specialty workforce. Most specialists are independent and are not hospital based or hospital employed. Even if the organizations where they practice are working with ACO, PCMH, or bundling models, they are not often directly involved. Over the years, healthcare executives have been careful not to rock the boat with specialists or disturb their productivity under hospital roofs. But aren't they a major part of healthcare reform strategies? Realize that they have a tremendous ability to change clinical costs and outcomes and to significantly affect local market dynamics.Specialists and their practice administrators have been asking what role they play in ACOs and PCMHs. They are not seeking alternatives to fee-for-service (FFS) but, at a minimum, want to be a player at the table for the new payment models to avoid losing future referrals. The Centers for Medicare & Medicaid Services has not developed a Medicare Shared Savings Program model for specialty care (although ESRD initiatives are in the works), which is understandable, given the significant risk and complexity associated with managing smaller pools of more vulnerable patient populations. Then how do ACO and PCMH referrals differ from routine patient visits? Currently, they don't. Unless the specialists are in a demonstration project or have an arrangement with a commercial insurer, specialty referrals generate FFS compensation, not a value-based payment.VALUE PROPOSITION OF SPECIALISTSSpecialists need to be part of the evaluation of care delivery processes. They and their specialty associations have been involved in research regarding clinical effectiveness and efficiencies related to the medical conditions they treat regularly. It makes sense for specialties to collaborate with primary care at an early stage in the management of high-risk patient populations in terms of preventive measures, early detection, and treatment choices. Additionally, specialists have hands-on experience in service line leadership and comanagement models. In their offices, clinics, and freestanding ambulatory facilities, they often have designed efficient patient flow and care models that garner high patient and staff satisfaction. Given their higher unit cost of care, specialties have a greater opportunity than primary care does to find significant cost savings in their diagnostic and treatment protocols.SPECIALTY TRENDS THAT COULD AFFECT HOSPITALSHealthcare executives should make careful note of the following trends, as they could translate to either new opportunities with specialists or unanticipated consequences for both hospitals and specialties.1. New carve-outs. The expansion of single-specialty groups can be seen in some areas of the country, and these entities could affect healthcare markets. For some specialties, consolidation and merger with similar practices is a viable strategy for dealing with the emerging challenges in healthcare. Similar to hospitals, practice mergers are developed with the hope of attaining economies of scale, group purchasing power, improved affordability of IT, increased market presence, and negotiating strength with payers. …

We present a measurement of the energy spectrum of ultra-high-energy cosmic rays performed by the Telescope Array experiment using monocular observations from its two new FADC-based fluorescence detectors. After a short description of the experiment, we describe the data analysis and event reconstruction procedures. Since the aperture of the experiment must be calculated by Monte Carlo simulation, we describe this calculation and the comparisons of simulated and real data used to verify the validity of the aperture calculation. Finally, we present the energy spectrum calculated from the merged monocular data sets of the two FADC-based detectors, and also the combination of this merged spectrum with an independent, previously published monocular spectrum measurement performed by Telescope Array’s third fluorescence detector [T. Abu-Zayyad et al., The energy spectrum of Telescope Array’s middle drum detector and the direct comparison to the high resolution fly’s eye experiment, Astroparticle Physics 39 (2012) 109-119, http://dx.doi.org/10.1016/j.astropartphys.2012.05.012 , Available from: ]. This combined spectrum corroborates the recently published Telescope Array surface detector spectrum [T. Abu-Zayyad, et al., The cosmic-ray energy spectrum observed with the surface detector of the Telescope Array experiment, ApJ 768 (2013) L1, http://dx.doi.org/10.1088/2041-8205/768/1/L1 , Available from: ] with independent systematic uncertainties.

An antiphase boundary (APB)-like structure of the B19′ martensite in Ti–Ni alloy was investigated by transmission electron microscopy. The APB-like structure shows atomic shifts on both the (0 1 0)B19′ plane along the c-axis and the (0 0 1)B19′ plane along the b-axis; a kind of ledge-and-step structure on the b–c plane, in addition to a displacement along the a-axis. The displacement vector can be expressed as R = 〈−0.1648 1/2 0.4328〉 in terms of the conventional atomic coordinates of Ti and Ni in the B19′ martensite. The APB-like structure is not inherited from APB in the B2 parent phase. We conclude that the APB-like structure is developed by accidental impingement of differently nucleated martensitic domains during the transformation. This structure is defined as a kind of stacking fault with an APB-like contrast.

Bone cement consisting of polymethylmethacrylate (PMMA) powder and methylmethacrylate (MMA) liquid is clinically used for fixation of implants such as artificial hip joints. However, it does not show bone-bonding ability, i.e., bioactivity. The lack of bioactivity would be one of factors which cause loosening between the cement and the implant. The present authors recently showed the potential of bioactive PMMA-based bone cement through modification with gamma-methacryloxypropyltrimethoxysilane (MPS) and calcium acetate. In this study, the effects of the kinds of PMMA powder on setting time, apatite formation and compressive strength were investigated in a simulated body fluid (Kokubo solution). The cement modified with calcium acetate calcined at 220 degrees C could set within 15 min when the PMMA powder had an average molecular weight of 100,000 or less. The addition of calcium acetate calcined at 120 degrees C in the PMMA powder required a much longer period for setting. The modified cements formed an apatite layer after soaking in the Kokubo solution within 1 day for cement starting from PMMA powder with a molecular weight of 100,000 or less. Compressive strengths of the modified cements were more than 70 MPa for cements starting from 100,000 and 56,000 in molecular weight. After soaking in Kokubo solution for 7 days, the modified cement consisting of PMMA powder of 100,000 in molecular weight showed a smaller decrease in compressive strength than that consisting of 56,000 in molecular weight. These results indicate that bioactive PMMA cement can be produced with appropriate setting time and mechanical strength when PMMA powders with a suitable molecular weight are used. Such a type of design of bioactive PMMA bone cement leads to a novel development of bioactive material for bone substitutes.

An overview of steady state tokamak studies in TRIAM-1M (R0 = 0.8 m, a × b = 0.12 m × 0.18 m and B = 8 T) is presented. The current ramp-up scenario without using centre solenoid coils is reinvestigated with respect to controllability of the current ramp-up rate at the medium density region of (1–2) × 1019 m−3. The plasma is initiated by ECH (fundamental o-mode at 170 GHz with 200 kW) at B = 6.7 T, and the ramp-up rate below the technical limit of 150 kA s−1 for ITER can be achieved by keeping the LH power less than 100 kW during the current ramp-up phase. The physics understanding of the enhanced current drive (ECD) mode around the threshold power level has progressed from a viewpoint of transition probability. A transition frequency, ftrans, for the ECD transition is determined as a function of PCD. At ~70 kW no transition occurs for an ftrans value of ~0.017 Hz, meaning almost zero transition probability. With increasing PCD > Pth, ftrans increases up to 10 Hz, and the transition tends to occur with high probability. The record value of the discharge duration is updated to 3 h 10 min in a low and low power (

For a profitable use of Pu, Japan Atomic Energy Research Institute has been promoting researches for once-through type fuels. The strategy consists of stable rock-like oxide fuel fabrication in conventional fuel facilities followed by almost complete Pu burning in LWR and disposal of chemically stable spent fuel without further processing. Because leach rates of hazardous nuclides, such as TRU and β-emitters, that have long half-lives, are very important for the evaluation of geological safety, leaching tests in deionized water at 363 K were performed with reference to the MCC-1 method. Five irradiated fuel pellets, a single phase fuel of a yttria-stabilized zirconia (YSZ) containing UO2 (U-YSZ), two fuels of U-YSZ particle dispersed in MgAl2O4 (SPI) or Al2O3 (COR) matrix, two homogeneous-blended fuels of U-YSZ and SPI or COR powders, were submitted to the tests. Stainless steel containers with Au coating and ethylene propylene diene monomer were used as leaching vessels and packing, respectively. The evaluated normalized leach rates of Zr, U and Pu were obviously lower than those of the other important elements and nuclides. Americium, Np and especially Y showed unexpectedly high evaluated normalized leach rates. The volatile elements, Cs and I, showed enhanced leaching within particle-dispersed type fuels because of crack formation around the particle.

Five kinds of rock-like oxide fuels were prepared and irradiated using 20% enriched U instead of Pu. The microstructure analyses for irradiated fuel pellets were carried out by ceramography and electron probe microanalysis (EPMA). For MgAl 2 O 4 (spinel)-based fuel, decomposition of the spinel and vaporization of MgO (magnesia) was observed. For Al 2 O 3 (corundum)-based fuels, significant appearance changes were not observed under the irradiation condition of sufficiently high fuel temperature. Fission product (FP) distributions were also analyzed by EPMA. The distributions of Nd and Ba were similar with those of U and Zr. Mo and Pd were found as fine inclusions in the yttria-stabilized zirconia (YSZ) phase. A part of Cs and Xe migrated to the periphery of YSZ particles and to pores in YSZ. The FP distributions of spinel-based fuel were almost similar to corundum-based fuel.

We search for ultra-high energy photons by analyzing geometrical properties of shower fronts of events registered by the Telescope Array surface detector. By making use of an event-by-event statistical method, we derive upper limits on the absolute flux of primary photons with energies above ${10}^{19}$, ${10}^{19.5}$, and ${10}^{20}\text{ }\text{ }\mathrm{eV}$ based on the first three years of data taken.

To evaluate the contribution of hepatic veins to the dual blood supply in the liver under temporary hepatic venous occlusion.Selected hepatic veins in 23 patients with liver tumors were temporarily occluded with a balloon catheter. Computed tomography (CT) arteriography, CT during arterial portography (CTAP), or both were performed with a spiral technique with and without temporary occlusion of a hepatic vein.After hepatic vein occlusion, a well-demarcated, wedge-shaped area of hypoattenuation was seen at CTAP and/or hyperattenuation was seen at CT arteriography in the following regions: left lobe (left hepatic vein), ventral part of the anterior segment and the medial segment except for the ventromedial part (middle hepatic vein), dorsal part of the anterior segment and the ventral part of the posterior segment (right hepatic vein), and dorsocaudal part of the right lobe (inferior right hepatic veins).After hepatic venous occlusion, the portal veins become draining veins and the occluded area is supplied with arterial blood alone.

To determine if chemiluminescence can be used in an enzyme immunoassay (EIA) format to test for hepatitis C virus (HCV) antibody and to compare sensitivity and specificity of chemiluminescence to a licensed anti-HCV EIA method, random volunteer donor samples were evaluated. One thousand and seventy-four random volunteer donor samples were collected during a 2-week period. Two aliquots of each sample were tested for anti-HCV. One aliquot was tested using a licensed anti-HCV 2.0 EIA test. The second aliquot was tested using the research anti-HCV chemiluminescence assay. Confirmatory testing was done using Recombinant Immuno Blot Assay (RIBA) 2.0 HCV and HCV RNA. Of the 1074 samples, eight were found to be reactive for anti-HCV. Seven were positive by the anti-HCV 2.0 EIA and the chemiluminescence system. The eighth sample was chemiluminescence reactive, but EIA negative; when tested by an unlicensed EIA 3.0 HCV test, RIBA 3.0 HCV test and an HCV-RNA assay, the sample was still negative. The same sample was also tested by RIBA 2.0 HCV and showed a reactive band to SOD. The chemiluminescence assay has a 100% sensitivity and 99.9% specificity compared to EIA and can be used as an alternative to EIA for detecting antibodies to HCV.

PURPOSE: To describe the features of congenital ossification of the stapedius tendon at thin-section computed tomography (CT). MATERIALS AND METHODS: Thin-section CT scans, clinical records, and surgical findings were retrospectively evaluated in nine ears of five patients with surgically proved congenital ossification of the stapedius tendon. Thin-section CT scans of 50 control ears were also reviewed. RESULTS: On thin-section CT scans, a linear area of soft-tissue attenuation was demonstrated between the monopod stapes and the pyramidal eminence (nine ears), as well as thickening of the stapes footplate (two ears). In the 50 control ears, the normal stapes tendon was not clearly seen on thin-section CT scans. CONCLUSION: At CT, a linear area of soft-tissue attenuation that extends from the pyramidal eminence to the monopod stapes is suggestive of congenital ossification of the stapedius tendon or a bony bar adjacent to it.

(1995). Predicting Muscular Strength in Women: A Preliminary Study. Research Quarterly for Exercise and Sport: Vol. 66, No. 2, pp. 168-172.

SUMMARY. We have compared two different second-generation (2.O) enzyme-linked immunosorbent assays (ELISA) for the presence of antibodies to hepatitis C virus (anti-HCV) in blood from volunteer, unpaid donors. At two separate blood centres, a total of 21431 donor samples were tested with Abbott Anti-HCV 2.0 ELISA and Ortho Anti-HCV 2.0 ELISA. Samples found to be repeatedly reactive were tested by supple-mental/investigational assays, MATRIX HCV (Abbott) and anti-HCV RIBA II (Ortho/Chiron), to ‘confirm’ the presence of anti-HCV. Discordant ELISA samples were additionally tested by the polymerase chain reaction (PCR) for the presence of HCV RNA. The Abbott anti-HCV assay had a repeatedly reactive rate of 0.59% (127/21431) and the Ortho anti-HCV assay 0.51% (110/21431). Overall agreement between assays was 99.76%. 72/127 (56.7%) of Abbott repeatedly reactive samples confirmed on MATRIX and 61/127 (48.0%) on RIBAII; 70/110 (63.6%) of Ortho repeatedly reactivate samples confirmed on MATRIX and 61/110 (55.5%) on RIBA II. Discordant ELISA samples tested by PCR yielded negative results. Hence the two ELISA had equal sensitivity, as defined by detection of true positive samples: the slightly lower specificity of the Abbott Anti-HCV 2.0 ELISA may be owing to culling of donors with a false positive test by Ortho's Anti-HCV 1.0 and 2.0 ELISA tests (the routine tests in place at each blood centre). A sample found to be repeatedly reactive by two different ELISA tests for anti-HCV is likely to be a true positive and may not require further ‘confirmatory’ testing.

We conducted a cross-sectional study of elderly outpatients with hypertension to examine the relationship between quality of life (QOL) scores and social background factors. The subjects consisted of 516 outpatients (267 females), age of 60 or over, at nine clinics of major hospitals which participated in the National Cardiovascular Center Research Project. The perceived QOL was evaluated by the QOL scale originally based on Japanese patients with cardiovascular diseases. The scale consisted of the following 5 subscales; difficulty due to disease, psychological stability, independence, satisfaction in daily living and vitality. The background factors included family structure, socioeconomic factors and work status, and physical activity of daily living (ADL). After adjusting for age, sex, administered drugs and complicating conditions such as ischemic heart disease and/or apoplexy, a significant odds ratio of a low score of difficulty due to disease, psychological stability, satisfaction in daily living and vitality was found in the impaired physical ADL group with low socioeconomic class, and a significant odds ratio of low score of independence were found in the impaired physical ADL group who had lost jobs due to illness and had no children.

The Telescope Array (TA) experiment, located in the western desert of Utah, USA, is designed for the observation of extensive air showers from extremely high energy cosmic rays. The experiment has a surface detector array surrounded by three fluorescence detectors to enable simultaneous detection of shower particles at ground level and fluorescence photons along the shower track. The TA surface detectors and fluorescence detectors started full hybrid observation in March, 2008. In this article we describe the design and technical features of the TA surface detector. © 2012 Elsevier B.V., 0, SCOPUS: ar.j, info:eu-repo/semantics/published

When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

The specificities of four assays for hepatitis C virus (HCV) were compared by using units from volunteer blood donors. Upon Food and Drug Administration licensure of the first immunoassay for anti-HCV, EIA-1, units previously deemed acceptable for transfusion and all subsequent blood donations were screened. EIA-1 repeat-reactive (RR) units were tested for HCV by a second-generation enzyme-linked immunoassay (EIA-2) and by a four-antigen recombinant immunoblot assay (RIBA II) and for HCV RNA by reverse transcriptase polymerase chain reaction. All HCV RNA-positive samples were reactive by both RIBA II and EIA-2. All RIBA II-reactive sera were EIA-2 RR. In EIA-1, 0.45% of the prescreened units and 0.59% of the prospectively screened donors were RR. Of these, 52.5 and 54%, respectively, were EIA-2 RR, 71.4 and 69% of the EIA-2 RR units were reactive on RIBA II, and 93 and 88% of the RIBA II-reactive samples were HCV RNA positive. When the sample/cutoff ratio for EIA-2 was greater than 5, 91% of the samples were RIBA II reactive and 82% of the samples were HCV RNA positive. None of EIA-2 RR units with a sample/cutoff ratio of < 5 was RIBA II reactive or HCV RNA positive. In conclusion, RIBA II and RT PCR results are highly concordant. A sample/cutoff ratio of > 5 in EIA-2 is a good discriminator for the likelihood of a true HCV infection on the basis of RT PCR and RIBA II assays.

An abrupt decrease of the anomalously large dielectric constant at about 100 K in the ferroelectric phase, called domain freezing, was observed in monoclinic CsH2PO4 in compatible with tetragonal KH2PO4. It was found that the low frequency relaxational dispersion plays a major role in the domain freezing of CsH2PO4.

We investigated the corrosion defects of TbFeCo films in magneto-optical disks. There were two types of corrosion defects (A-type and B-type) which arose from the oxides. The A-type defect grew rapidly and became a large corrosion site. The main centre of the A-type defect was a pin-hole with large dust grains in the film. This should be prevented because it seriously degrades media life. The B-type defect was small and it was presumed to break out at the boundary between the substrate and the film. By eliminating the large dust grains, the centres of the A-type growth, we can obtain from the fabrication process highly reliable disks whose median life is estimated to be 336 y.

Twelve serum samples from French blood donors that were uniformly reactive in tests for antibody to human immunodeficiency virus type 2 (anti-HIV-2) also were reactive in 92 to 100 percent of tests with three anti-HIV type 1 (anti-HIV-1) enzyme-linked immunoassays currently in widespread use for donor screening in the United States. Supplemental tests for anti-HIV-1 on these anti-HIV-2-reactive samples differed in their responses. All samples reacted in a licensed anti-HIV-1 Western blot, but there was an atypical band near the p41 position, which could be a clue to the fact that this result was a cross-reaction with anti-HIV-2. A recombinant immunoblot gave an indeterminate result for anti-HIV-1 in all 12 samples. A local immunofluorescence assay for anti-HIV-1 reacted with 92 percent of the samples, but a commercial one detected only 58 percent.

An enzyme-linked immunosorbent assay (ELISA) was developed by using a synthetic polypeptide (SP) whose sequence was derived from the structural region of hepatitis C virus (HCV). Results of several coded panels of sera obtained from volunteer blood donors and patients with apparent non-A, non-B hepatitis and/or hepatitis B virus used in this ELISA were compared with those of a commercially available first-generation C-100 ELISA (using nonstructural HCV antigens), an experimental second-generation C-200/C-22 ELISA (using both structural and nonstructural HCV antigens), and recombinant immunoblot assays RIBA-I and RIBA-II. In the majority of cases, the results obtained with the HCV-SP ELISA correlated well with those obtained by RIBA-II and C-200/C-22 ELISA. In contrast, many samples that were repeatedly reactive in the C-100 ELISA results were nonreactive with RIBA and HCV-SP ELISA. In addition, HCV-SP detected HCV-specific antibody that appeared within a month of infection and coincided with the earliest increase in alanine aminotransferase. In summary, we have developed an ELISA based on a structural HCV synthetic polypeptide, HCV-SP, that has high specificity and sensitivity and is capable of detecting specific antibodies in the acute phase of HCV infection.

Blood samples from 2000 accepted blood donors and 343 deferred donors with antibody to hepatitis B core antigen (anti-HBc) and/or an alanine aminotransferase (ALT) elevation were evaluated for antibody to hepatitis C virus (anti-HCV). Sixteen (0.8%) of the 2000 sera initially reacted on enzyme-linked immunosorbent assay (ELISA); 12 (0.6%) were repeatably reactive. One repeatably reactive sample had an elevated ALT; two reacted on anti-HBc testing and had ALT elevations. When the repeatably reactive ELISA samples were tested by an immunoblot assay, four reacted, three were indeterminate, and five did not react. Among the 343 deferred donors, HCV antibodies were detected in 8 (3.8%) of 210 anti-HBc-reactive samples, 12 (11.8%) of 104 elevated-ALT samples, and 15 (52%) of 29 combined elevated-ALT and anti-HBc-reactive samples; 25 of 28 reacted on immunoblot. The anti-HBc-reactive sera were subdivided into groups according to strength of anti-HBc reactivity (weak or strong) and antibody to hepatitis B surface antigen status and then were compared for anti-HCV reactivity rates. The group of samples showing the greatest frequency of anti-HCV had strong anti-HBc reactivity. For blood donors, the anti-HCV test correlates with the surrogate tests for non-A, non-B hepatitis (anti-HBc and ALT); however, most anti-HCV-reactive units remain undetected by surrogate tests, so that implementation of anti-HCV screening should further reduce the transmission of HCV via transfusion.

A clinicopathological analysis of myocardial infarction with an onset of stroke-like symptoms was carried out on 30 autopsy cases at the Tokyo Metropolitan Geriatric Hospital. The cases were classified into four groups according to the types of brain lesions, I: embolism (n = 17), II: thrombosis (n = 9), III: bleeding (n = 2), and IV: no remarkable focal lesion (n = 2). Classification was made based on clinical findings, and pathological features. The characteristic clinical findings were conciousness disturbance, no elevation of blood pressure at the onset of stroke, hemiplegia and shock. However, the typical anginal chest pain was found in only 17% of cases. The underlying diseases and complications were hypertension, atrial fibrillation (Af), disseminated intravascular coagulation (DIC), renal failure, malignant neoplasma, and diabetes mellitus. The incidences of Af, DIC, mural thrombus, non-bacterial thrombotic endocarditis (NBTE) were significantly higher in the group with cerebral embolism than in the group with cerebral thrombosis. The coronary stenotic index was also smaller in the group with cerebral embolism. Therefore, the major etiology of cardio-cerebral apoplexy was a simultaneous embolism to the brain and heart due to Af, NBTE or, DIC.

Systolic anterior motion of the anterior mitral leaflet and asymmetric septal hypertrophy (ASH) are characteristic features of hypertrophic obstructive cardiomyopathy (HOCM) on an echocardiogram. Among 9,670 patients over 60 years old examined by echocardiography from January, 1984 to October, 1990, 55 patients showed systolic anterior motion of the anterior mitral leaflet and/or the chordae tendinae (SAM). We investigated clinical features and morphological features of the left ventricle on an echocardiogram in the 55 patients with SAM. They were classified into three groups according to the degree of SAM. Thirty eight cases (group I) had no mitral and/or chordal-septal contact, 10 (group II) had brief contact (less than 30% on the echocardiographic systole) and 7 (group III) had prolonged contact (greater than or equal to 30%). Ages ranged from 60 to 99 with a mean age of 78.2 years. There were 19 males and 36 females and there was a predominance of females in each group. Thirty five cases had hypertension and 34 left ventricular hypertrophy on electrocardiograms. One case of group I, 3 of group II and 7 of group III had a clinical diagnosis of HOCM. In comparison with each group, the incidence of LVH (SV1 + RV5 greater than or equal to 35 mm) was 52% in group I, 90% in group II and 83% in group III and that of LVH (SV1 + RV5 greater than or equal to 70 mm) was 29%, 20% and 67%, respectively. On echocardiographic examination, the diastolic descent rate of the anterior mitral leaflet in the 3 groups was 36.1 +/- 13.1 mm/sec, 19.4 +/- 13.1 mm/sec and 10.7 +/- 11.8 mm/sec (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

This paper describes the multi-class zone ITS communication scheme considering real-time and short periodical communications for vehicle safety in intersections. In our proposed scheme, an area near an intersection is categorized into the nearest area and the quasi-nearest area. Vehicles communicate with a base station every 20 ms in the nearest area. In the quasi-nearest area, vehicles communicate with the base station for safety, and also make reservations for the communication for the nearest area. For performance evaluation, a microscopic traffic flow simulator is constructed and simulation of the scheme is carried out. We assume large intersections in Japan. First, simulation results show the required frequency bandwidth for realization of the scheme. The results show that the required frequency for vehicle safety in intersections is 12.9 MHz. Second, the performance evaluation considering shadowing effects is carried out. Though the frequency bandwidth is expanded, some vehicles can not communicate periodically because of shadowing effects. Using only half of the required frequency bandwidth causes lack of the number of communication slots. As the result, vehicles which can not communicate every 20 ms come into existence.

As the result of developments in computer technology in recent years, the calculation, simulation and analysis of the stress environment for the artificial hip prosthesis and the femur have been made possible. In order to perform an exact calculation, three-dimensional modeling with the hip prosthesis and femur is required. The modeling of a femur is done by reconstructing the femoral outline data from CT images using three-dimensional CAD. The outline extraction work is performed by the experience and subjectivity of the operator, and the reliability of the data and working efficiency is low. In this paper, algorithms that extract the femur outline from CT images automatically are proposed.

In this study the effect of porosity in /spl beta/-FeSi/sub 2/ on structural and thermoelectric properties was investigated for the large-scale thermoelectric power generation with porous FeSi/sub 2/ thermoelectric devices prepared by thermal spraying and sintering. In order to acquire high porosity in the silicide by sintering, an organic compound such as polyethylene glycol, sodium lauryl sulfate and polymethyl methacrylate was mixed with 1.4-/spl mu/m FeSi/sub 2/ particles, and then the mixture was sintered. The effects of the organic compounds and their amount on structural and thermoelectric properties of /spl beta/-FeSi/sub 2/ were evaluated based on SEM observation of the surface as well as on measurements of density, thermal and electric conductivity, and Seebeck coefficient. It was found that the porosity of the silicide increased up to 0.5 by adding the organic compounds, while the maximal porosity prepared by thermal spraying was at most 0.2. The heat conductivity of the porous material was found to significantly decrease down to one-tenth of that prepared by thermal spraying. Seebeck coefficient of the sintered FeSi/sub 2/ was found to be larger than that of the thermal-sprayed silicide. The pore size at the surface of the porous silicide was found to depend on the organic compounds.

Surface acoustic wave (SAW) filters using ZnO thin films are discussed. These films have a low dielectric constant and low temperature coefficients, but stability and producibility of the films are a concern. Some fabrication techniques for the films are described, and packaging and reliability of the filters are discussed. SAW filters with 1.5 to 2 GHz center frequency are reported. >

In marine rescue, the detection of the target such as life rafts depends on the visual search by man as yet. However, human eyes are sometimes inadequate owing to a long flight and wide views. In order to carry out the prompt rescue of human life, development of the searching system in place of the human eyes is surely required. This paper deals with a new search method for detection of the rescue target using image processing techniques. To detect the small target in the wide views over the sea, we have proposed a new method including the image processing techniques based on the color information and the composite image sensor which increases about the measurement accuracy and the image processing speed at actual field. At the first step of the study, we attempt to extract the image data of the rescue target with the orange color in an experimental sea. >

A novel design of large size thermoelectric module and the application of thermal spraying technology to the module processing were presented for a thermoelectric power generation system utilizing waste heat. Using the thermal spraying process a layer of semiconducting iron disilicides, FeSi/sub 2/, was directly deposited on the heat transfer surface of the heat exchanger to form a thermoelectric device with large area and high porosity. /spl beta/-FeSi/sub 2/ was formed by heat treatment. The thermoelectric properties of /spl beta/-FeSi/sub 2/ prepared by thermal spraying were investigated. In addition, porous FeSi/sub 2/ thermoelectric devices were fabricated by sintering under various conditions. The effect of porosity on thermoelectric properties was studied.

We have fabricated a distributed-feedback laser diode (DFB-LD) with monolithically integrated electroabsorption modulator (EAM), which has small chirp characteristics (effective /spl alpha/ parameter =0.2). 2.5 Gbps-700 km penalty-free transmission without any intentional pre-biasing or self phase modulation effect is successfully demonstrated using the EAM-LD.

To apply a thermoelectric device to power generation from waste heat from an incinerator or steel factory, large size thermoelectric device or module is required. Thermal spraying is the potential candidate as a processing tool for such a device because it enables a thick layer (to 5 mm or more) to be formed with a simple and short process on large plates or long pipes, which can be inserted directly within the furnace or heat exchanger. Co-doped n-type FeSi/sub 2/ powder was prepared, and a thermoelectric device was formed by plasma spraying with 43 kW plasma under inert atmosphere. FeSi/sub 2/ layer with the thickness of 3-5 mm was formed on a stainless steel (SUS430) plate (100/spl times/100 mm) and pipe (diameter: 25 mm). The properties, microstructure and performance of thermal sprayed beta-FeSi/sub 2/ thermoelectric device was evaluated.

This paper deals with the detection of the rescue target as a particular object from motion images under bad conditions. When shipwrecks occur, the search activities of rescue are done using an airplane. The detection of the rescue target such as a life raft depends on visual search of human eyes. To detect a small rescue target in the wide sea, the searcher man must monitor motion sights in nasty weather. In order to carry out the prompt rescue of human life, development of searching support system using image processing techniques in place of the human eye is required It is very difficult to process the motion images taken by the airplane, because these images are inferior due to shaking of the airplane, sunshine reflections and crest waves under bad conditions. We make a simulation experiment for detection of the rescue target from images. To get basic design data for development of the searching system in the case of a marine casualty, we propose motion image processing techniques using improved S/N ratio and dynamic range of the image data of the rescue target in the motion images under bad conditions

This paper deals with the detection of the rescue target as a particular object from motion images under bad weather conditions. When shipwrecks occur, the searching activities for rescue is done using an airplane. The detection of the rescue target such as life rafts depends on a visual search by human eyes. To detect a small rescue target in a wide sea area, the searching man must monitor motion sights under nasty weather. The human eyes sometimes loses its sight and the ability of detection fails owing to the long flight and the nasty weather. To support the searching activities in the case of a marine casualty, we propose motion image processing techniques using the improved S/N ratio and dynamic range of the image data of the rescue target in the motion images under bad conditions

Myelodysplastic syndrome (MDS) is a clonal disorder of hematopoietic stem cells. To investigate whether chromosomal instability and/or DNA repair defects are involved in the development of MDS, we measured the micronucleus (MN) frequency in peripheral blood lymphocytes exposed to various doses of X-rays, using a cytokinesis-block micronucleus assay. The spontaneous MN frequencies in RAEB and RAEB-T patients were significantly higher than those in normal individuals (P = 0.0224, P = 0.008, respectively). Also, the X-ray-induced MN frequencies in RA/RARS, RAEB, and RAEB-T patients were significantly higher than those in normal individuals (P = 0.007, P = 0.003, P = 0.003, respectively, at 2 Gy). In order to elucidate the cause of unusual radiosensitivity, we measured the expression levels of nucleotide excision repair (NER) genes in peripheral blood mononuclear cells using a RT-PCR method. Reduction of NER gene expression was found in only one of 10 patients with low risk MDS, but in four of 11 patients with high risk MDS. Our data suggest that chromosomal instability and DNA repair defects may be involved in the pathophysiology of disease progression of MDS.

The field‐effect transistor has been fabricated, where polythiophene works as a semiconductor and a couple of polypyrrole layers act as a source and/or a drain electrode. The modulation ratio of the channel current with gate voltages has reached ca. 105, which is the largest one among organic FETs. This large modulation has been attributed to the depression of the channel current at no gate bias. It has been elucidated that the depression is caused by the barrier against hole transport formed inside the polythiophene layer and near the interface with polypyrrole.

This study was undertaken to investigate the endocrine changes that occur in male Tig:Wistar rats with Leydig cell tumors, with special reference to immunoreactive inhibin (ir-inhibin) and its dimeric forms. Adult male rats from 2 to 28 months of age were used. Blood samples were taken to measure plasma concentrations of ir-inhibin, inhibin-A, inhibin-B, 17beta-estradiol (E2), testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Inhibin bioactivity in both peripheral plasma and testicular extracts was also measured. Rats aged 18 months and older had testicular Leydig cell tumor. Testicular tissue sections from 27-month-old rats examined immunohistochemically showed strong positive staining for all 3 inhibin subunits, in particular inhibin alpha and betaA subunits, in the tumor cells. Plasma concentrations of ir-inhibin began to rise significantly (P.05) at 18 months of age. High bioactivity of inhibin was detected not only in testicular extracts but also in peripheral plasma of aged rats. Thus, plasma concentrations of bioactive inhibin-A, but not inhibin-B, were significantly elevated with increasing age. The concentrations were significantly higher than those in normal male (P.01) or normal female (P.05) rats. Plasma concentrations of E2 were significantly (P.05) elevated only at 23-24 months of age. A marked reduction (P.05 to .001) in plasma LH and FSH concentrations was observed at 18 months of age and older. Plasma concentrations of testosterone were highest at 2 months of age and then decreased gradually and significantly (P.05 to .001) afterward. Significant (P.05 to .001) positive (testosterone vs LH) and negative (ir-inhibin vs FSH, ir-inhibin vs LH, and E2 vs FSH) correlations were observed. It is suggested that plasma inhibin-A levels are elevated in male Tig:Wistar rats with Leydig cell tumor, and thus inhibin-A may be used as a specific marker of testicular Leydig cell tumors. The present results also suggest that the age-related decline in plasma gonadotropins and thus testosterone levels in Tig:Wistar rats may be due to the development of tumors of the Leydig cells rather than to aging per se.

A 72-year-old woman, who has been administered prednisolone and azathioprine with diagnoses of idiopathic thrombocytopenic purpura (ITP) and autoimmune hepatitis (AIH), underwent a complete medical examination because of monoclonal gammopathy (IgG-kappa). Tumors were found in the ileum and descending colon. Pathological examination of biopsy specimens suggested a diagnosis of marginal zone B-cell lymphoma of the MALT type with a high-grade component. Flow cytometric analysis by two-color staining revealed that the neoplastic B cells expressed CD38, CD19, IgG and kappa, but not CD5 or CD10. There were no abnormal plasma cells in bone marrow smears. The patient achieved complete remission after receiving three cycles of THP-COP chemotherapy, which resulted in a decrease of the IgG level to within the normal range. These findings indicated that monoclonal IgG-kappa might be produced by lymphoma cells. However, the relationship of the immunosuppressive agents to the pathogenesis of the MALT lymphoma remains to be clarified.

Mycotic aneurysms of the subclavian artery are rare. This report describes an experience of 2 rare cases in which transcatheter embolization with metallic coils was performed for the management of these lesions alternative to surgery. Two patients who had been treated with chemotherapy for malignant neoplasms were diagnosed as having mycotic aneurysms of the left subclavian artery. The causes of these lesions were presumed to be the invasion of the arterial wall by the pulmonary abscess in case 1, and wound infection after placement of the reservoir for intraarterial chemotherapy in case 2. In both cases, proximal and distal sites of the aneurysm were embolized with metallic coils. In case 1, the vertebral artery was also embolized with Guglielmi detachable coils to avoid retrograde blood flow. Both aneurysms were completely occluded by a single embolization. In case 1, although weakness and paresthesia of the left hand remained, lethal hemoptysis due to aneurysmal fistulization to the lung parenchyma ceased. In case 2, no neurological deficit except for mild paresthesia in the left thumb had been observed. Both patients died of primary disease 10 and 5 months after the procedure. Transcatheter embolization is technically feasible and effective enough to treat the mycotic aneurysm of the subclavian artery even in the situation in which the surgical option seems to be difficult or risky.

We investigated the effect of long-term treatment with a calcium antagonist (nicardipine hydrochloride retard tablet) and a diuretic (trichlormethiazide) on quality of life (QOL) in elderly hypertensives in a multicenter, randomized, double-blind, comparative study (National Intervention Cooperative Study in Elderly Hypertensives Study Group). The percentage of patients who experienced side effects was 17.2% in the nicardipine group and 18.1% in the trichlormethiazide group and 2.9% and 4.3% of participants, respectively, withdrew due to those side effects. These results suggested that nicardipine was tolerated slightly better than trichlormethiazide. There were no significant differences between the two groups in terms of total QOL score or in degree of change (delta score) before and after calcium antagonist or diuretic administration. Lower score was seen in 3 categories (general symptoms, sleep scale, and sexual function) in the trichlormethiazide group (p0.05) and in one category (cognitive function) in the nicardipine group, but there was no significant difference in delta score in any of the individual items. In conclusion, the two anti-hypertensive agents had nearly equivalent effects on QOL in the long-term treatment of hypertension in the elderly and that neither resulted in a deterioration in QOL.

Vascular endothelial growth factor (VEGF) inhibits radiation-induced apoptosis in the leukemia cell line, CMK86 (O. Katoh et al., Cancer Res., 55: 5687-5692, 1995). To elucidate the molecular mechanisms underlying this inhibitory effect of VEGF, we attempted to identify a transcription factor involved in the cellular response to VEGF stimulation. We cloned the cDNA of a novel Kruppel-type zinc finger (ZNF) gene, ZK7, from a cDNA library constructed from the human leukemia cell line CMK86 after incubation with VEGF. This cDNA encoded a protein of 289 amino acids, which contained a Kruppel-associated box A-box domain at the NH2 terminus and seven ZNF motifs at the COOH terminus. These ZNF motifs were identical to those of HZF16 (M. Saleh et al., Am. J. Hum. Genet., 52: 192-203, 1993). ZK7 and HZF16 genes appear to be the splice variants transcribed from the same gene. Northern blotting and quantitative reverse transcription-PCR analysis revealed that expression of ZK7 mRNA in CMK86 cells and human hematopoietic progenitor cells was increased after VEGF stimulation, whereas that of HZF16 mRNA remained unchanged. To examine the function of ZK7 protein, we generated clones of a human monocytoid leukemia cell line, U937, which were stably transfected with ZK7 or HZF16 cDNA. Importantly, ZK7-overexpressing cells had lower sensitivity to ionizing radiation and the chemotherapeutic agent etoposide than U937 parent cells or HZF16-overexpressing cells. Therefore, ZK7 protein may be involved in the inhibitory effect of VEGF on apoptotic cell death in human hematopoietic cells.

Thermoelectric (TE) power generation from waste heat is recently attracted much attention as one of energy-saving technologies. In this paper, Co-doped n-type iron silicide semiconductor was plasma sprayed under various spray conditions to find the optimum spray-forming conditions. Then Co-doped iron silicide TE device with thickness ranging from 3 to 5 mm and the area of over 100 cm square was produced in the form of a plate or on tube. The paper examines the microstructure and evaluates thermal and electric properties. Paper includes a German-language abstract.