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Tubulointerstitial nephritis is a cardinal renal manifestation of leptospirosis. LipL32, a major lipoprotein and a virulence factor, locates on the outer membrane of the pathogen Leptospira. It evades immune response by recognizing and adhering to extracellular matrix components of the host cell. The crystal structure of Ca(2+)-bound LipL32 was determined at 2.3 A resolution. LipL32 has a novel polyD sequence of seven aspartates that forms a continuous acidic surface patch for Ca(2+) binding. A significant conformational change was observed for the Ca(2+)-bound form of LipL32. Calcium binding to LipL32 was determined by isothermal titration calorimetry. The binding of fibronectin to LipL32 was observed by Stains-all CD and enzyme-linked immunosorbent assay experiments. The interaction between LipL32 and fibronectin might be associated with Ca(2+) binding. Based on the crystal structure of Ca(2+)-bound LipL32 and the Stains-all results, fibronectin probably binds near the polyD region on LipL32. Ca(2+) binding to LipL32 might be important for Leptospira to interact with the extracellular matrix of the host cell.

Objective Partial face composite tissue allotransplantation was recently achieved in a human subject. However, the side effects of long-term immunosuppression and chronic rejection area still need concerning. This preliminary study investigated the reproducibility of swine hemi-facial transplantation for preclinical studies. Materials and methods Eleven out-bred miniature swine underwent hemi-facial transplant. The hemi-facial orthotopic transplant consisted of ear cartilage, auricular nerve, parotid gland and lymphoid tissue, muscle with surrounding hemi-facial skin paddle supplied by the carotid artery, and external jugular vein transplanted to recipient swine. Three different experimental designs were studied, as follows: group I ( n = 4): autologous hemi-facial transplantation as a normal control; group II ( n = 4): hemi-facial allotransplantation without treatment; group III ( n = 3): hemi-facial allotransplantation with cyclosporine-A treatment for 4 wk. The transplanted face was observed daily for signs of rejection. Biopsy of donor skin, gland lymphoid tissue, and cartilage were obtained at specified predetermined time (d 7, 14, 28), or at the time of clinically evident rejection. Results The results indicated the survival of group I following autologous hemi-facial transplant was 100% and indefinite until sacrifice. Group II without treatment as the controls revealed allograft rejection by d 7 to 28. The allograft with short-term cyclosporine-A treatment revealed delayed rejection by d 38 to 49 postoperatively. The histological examination in group I revealed abundant lymphocyte infiltration, especially in lymphoid gland and alloskin at 1 wk and sacrifice. In contrast, the cyclosporine treatment group showed no significant rejection signs in 4 wk posttransplants. These results demonstrated that lymphoid tissue and alloskin are both susceptible to early rejection. Conclusion The experimental results revealed this model is suitable to investigate the new strategies for preclinical facial allotransplantation studies. Monitoring and modulation of early rejection in alloskin and gland lymphoid tissue is a useful strategy to evaluate composite tissue allotransplantation survival.

Blue Cross and Blue Shield of Minnesota conducted a quality improvement project to quantify and improve the clinical and functional outcomes of low back pain and neck pain patients in a chiropractic network. Improved outcomes were encouraged through a financial incentive for implementation of standard clinical outcome measurement tools, quarterly feedback to individual practices, and a face-to-face meeting to share best practices. Although a large database on baseline neck pain and low back pain and functional disability was generated, and clinically and statistically significant improvements in outcomes were documented, progressive improvement in outcomes over the 4-year project period was not found.

Betanodaviruses cause massive mortality in marine fish species with viral nervous necrosis. The structure of a T = 3 Grouper nervous necrosis virus-like particle (GNNV-LP) is determined by the ab initio method with non-crystallographic symmetry averaging at 3.6 Å resolution. Each capsid protein (CP) shows three major domains: (i) the N-terminal arm, an inter-subunit extension at the inner surface; (ii) the shell domain (S-domain), a jelly-roll structure; and (iii) the protrusion domain (P-domain) formed by three-fold trimeric protrusions. In addition, we have determined structures of the T = 1 subviral particles (SVPs) of (i) the delta-P-domain mutant (residues 35−217) at 3.1 Å resolution; and (ii) the N-ARM deletion mutant (residues 35−338) at 7 Å resolution; and (iii) the structure of the individual P-domain (residues 214−338) at 1.2 Å resolution. The P-domain reveals a novel DxD motif asymmetrically coordinating two Ca2+ ions, and seems to play a prominent role in the calcium-mediated trimerization of the GNNV CPs during the initial capsid assembly process. The flexible N-ARM (N-terminal arginine-rich motif) appears to serve as a molecular switch for T = 1 or T = 3 assembly. Finally, we find that polyethylene glycol, which is incorporated into the P-domain during the crystallization process, enhances GNNV infection. The present structural studies together with the biological assays enhance our understanding of the role of the P-domain of GNNV in the capsid assembly and viral infection by this betanodavirus., Author Summary Betanodaviruses belong to the family Nodaviridae and cause the mortality of numerous larval-stage fish species. Here we report protein crystal structures of a piscine betanodavirus, the Grouper nervous necrosis virus (GNNV), in four different forms. Highlights are two structural features that contribute to the viral molecular mechanisms of the T = 3 and T = 1 capsid assembly: a calcium-associated protrusion domain and a functional arginine-rich motif. These results also shed insights into the structural basis for evolutionary lineage of the family Nodaviridae.

This paper presents a CMOS programmable gain amplifier (PGA) with 3dB bandwidth greater than 290MHz. The PGA can provide 50dB gain with 20dB gain control range, and the gain step is ldB with -0.4 to +0.4dB gain error. The minimal acceptable input signal is -52dBm and the 1dB compression point is -6dBm. It consumes 4 mA in core stage from IV supply voltage. This PGA is fabricated in 90nm CMOS one-poly nine-metal digital process and the core area is 0.2x0.15 mm2.

The development and performance of construction industry are strongly relative with citizens' living quality in each country. Such is meaning that the life cycle management (LCM) and life cycle assessment (LCA) are important issues to each construction project. In this 21s t century, information technology (IT) is an important issue for economic growth. The professional knowledge of IT and construction are key factors to develop high-tech industry. The constructional characteristics of high-tech projects are such as the location, size, main construction method, team organization, and the construction management techniques applied in planning, design, procurement, construction, and maintenance phases. This paper will introduce algorithms of LCA and LCM, investigates and illus trates s everal practice high-tech construction projects including retrieved from the expert interviews. Based on the collected sample information, a database retrieving system is developed for supporting management in understanding the performance of the historical projects with similar high-tech project characteristics.

This paper proposes an LC-NOR-ring quadrature voltage controlled oscillator (QVCO). Applied to the direct frequency synthesizer used in the frequency-hopped MB-OFDM UWB system, the ring is designed to enhance quadrature phase accuracy. To prevent from the inactive equilibrium state in an even-numbered delay-stage ring, the QVCO comprises four stages of NMOS-NOR gates that stimulate oscillation and equip with low-voltage operation capability. Inductor loads are used in accompany with the varactors to reduce the power consumption. Realized in a 0.18-mum 1P6M CMOS process, the circuit draws 27-mA current from a 1-V supply. The core circuit occupies an area of 1.012 times 0.35mm2 . The measured oscillation frequency shows that the QVCO has the range of 9.7GHz to 10.6GHz. The phase noise performance is above -90dBc/Hz from 10-kHz offset in the wideband sense

Background Although the determination of the correct ganglion under direct vision through thoracoscopy by an experienced surgeon is almost unerring, there is still a 4.3% rate of clipping at the unintended level. Methods Through the review of the most recent patients (N = 117) with various sympathetic disorders undergoing thoracoscopic sympathetic interruption over different ganglions by clipping, we found that 5 cases were clipped at the unplanned level. The immediate manifestations were the different outcomes between both sides of the face, trunk, and extremities. The postoperative chest radiographs demonstrated the error. Results All patients received a second operation in which the unintended clip was removed, and a new one was applied to the appropriate ganglion. The results were satisfactory. Conclusions Although the authors in this study have the experience of more than 1000 cases of hyperhidrosis, such an error is still inevitable. Luckily, by using the clipping method, the error is detectable and amendable.

Poorly controlled hypertension was incidentally cured after performing an endoscopic sympathetic block (ESB) in a patient with hyperhidrosis craniofacialis (HHC). A survey of the literature indicated that 30% to 40% of essential hypertension is of sympathetic origin. Patients with facial sweating associated with hypertension were then studied to determine whether blood pressure is lowered after performing ESB. Between November 2002 and July 2003, 17 hypertensive patients (13 males and 4 females) ranging in age from 22 to 62 years underwent ESB solely for HHC at the Department of Surgery of Kaohsiung Medical University, Taiwan. Their preoperative systolic blood pressure (SBP) values ranged from 170 +/- 6 to 200.7 +/- 7.6 mmHg, and their diastolic blood pressure (DBP) values ranged from 94.7 +/- 6.1 to 120.3 +/- 5.7 mmHg. Their heart rates were between 92.67 +/- 2.28 and 119.67 +/- 5.13 beats per minute (bpm). They were refractory to aggressive medical treatment, including lifestyle modifications and antihypertensive medications. Their postoperative blood pressure, heart rate and surgical outcomes were recorded. After performing ESB, HHC was cured in all 17 patients. Based on the reductions in blood pressure and heart rate, the patients could be divided into two groups, one showing high-level reductions (Group T) and one showing low-level reductions (Group S). The blood pressure of Group T (ten patients) was reduced to the range of 120.2 +/- 6.9 to 131.6 +/- 3.5 mmHg SBP and 74.8 +/- 3.1 to 85.4 +/- 4.5 DBP, and the heart rate of this group was reduced to the range of 65.36 +/- 4.63 to 85 +/- 3.60 bpm, while the blood pressure and heart rate of Group S (seven other patients) were reduced to the ranges of 145.9 +/- 5.7 to 160.5 +/- 5.5 mmHg SBP, 90 +/- 4 to 100.7 +/- 3.2 mmHg DBP, and 80 +/- 4 to 90.83 +/- 3.53 bpm, respectively. The patients in Group S were well controlled at 119.8 +/- 5.5 to 130.6 +/- 8.0 mmHg SBP and 70.1 +/- 3.8 to 84.5 +/- 5.7 mmHg DBP with a daily low-dose of calcium channel blocker. The average follow-up periods of the two groups were 17.00 +/- 2.906 and 17.43 +/- 2.37 months, respectively. We named this surgically curable form of hypertension "Sympathetic Hypertensive Syndrome" (SHS), which we define by the presence of all three of the following: 1) stage II hypertension; 2) HHC or other sympathetic disorders; and 3) heart rateor = 100 bpm. If the patient is male the reductions of blood pressure after the surgery will be better, which might be due to the link with Y chromosome. Finally, we recommend that ESB should be performed in patients with SHS, although the female would respond less satisfactorily in terms of the blood pressure.

This paper proposes a subharmonic direct frequency synthesizer (SH-DFS) for the hopping carrier generation in mode-1 MB-OFDM based UWB system. The SH-DFS employs octet phases of 2.244-GHz from a VCO to synthesize and the deviations at 528-MHz and 1.056-GHz acquired from a divide-by-17 semi-dynamic divider. The output stage with the switched functionalities between a subharmonic single sideband (SH-SSB) mixer and an edge combiner generates the designated tone. Realized in 0.18-/spl mu/m CMOS technology, it occupies an active area of 1 /spl times/ 1 mm/sup 2/. The chip draws 34-mW power from a single supply at 1.8-V. The carrier output has the voltage swing larger than 700-mV/sub pp/ and the spurious tones are smaller than -20-dBc.

The paper presents a CMOS analog front-end (AFE) for a short range impulse radio system in low-band ultrawideband (UWB) based on 2 ns width PAM. The wideband amplifier provides 69 dB gain from 30 MHz to 1.2 GHz, realized by a limiting amplifier with an active-inductor load and a cross-coupled g/sub m/ gain-boosting cell in each gain stage. The received signal is digitized at 2 GHz sampling rate by 8 parallel 1-bit ADCs, each of which is composed of transmission-gate type sample-and-hold circuits and a dynamic differential comparator. A timing generator based on a 4-stage ring oscillator in a PLL is employed to provide 8-phase 250 MHz clocks. Realized in 0.18 /spl mu/m CMOS technology, the AFE occupies a 1.0/spl times/1.2 mm/sup 2/ active area with the 3/sup rd/ order loop filter integrated in the same die. This chip also includes an integrated pulse generator for loop-back self-testing purposes. The receiver AFE achieves 200 /spl mu/V sensitivity and consumes 15 mW from a 1.8 V supply.

This paper presents the design simulation, implement, and measurement of a 2.4 GHz omni-directional horizontally polarized planar printed antenna for WLAN application. The HFSS 3-D EM simulator is used for design simulation. The antenna is fabricated on a double-sided FR-4 printed circuit board. The antenna pattern measurements are performed for the antenna is alone in free space, printed on a PCMCIA card, and that inserted inside a notebook PC. In addition to be used alone for a horizontally polarized antenna, it can be also a part of a diversity antenna.

This paper presents a dual-loop automatic gain control (AGC) employed in a 10 Mbps infrared communication system. The AGC is composed of an exponential-type variable-gain amplifier, a shaping filter, a gain/buffer stage, a noncoherent envelope detector, and a pair of integrators that provide dual loop bandwidths. The switch and two integrators are realized by a proposed switched integrator technique. The fast acquisition is accomplished by a 500 kHz loop bandwidth at the initial acquisition state and followed by a 50 kHz loop bandwidth at the steady state. The AGC is implemented in 0.6 /spl mu/m SPTM CMOS technology. According to the post-layout simulation, it achieves an acquisition time of 5 /spl mu/s and provides a constant output of 1V/sub pp/ at a 50 /spl Omega/ load for 20 dB input signal amplitude range. The dual-loop AGC consumes 88 mW power from a single 3.3 V supply and occupies 1.8/spl times/1.8 mm/sup 2/ area.

This paper presents a programmable filter with a self-tuning mechanism. Conformed with the DMT-VDSL (discrete multi-tone very-high-speed digital subscriber loop) system, the filter is configured as a 4-th order Chebyshev low-pass filter with programmable bandwidth in which the ripple is set to 0.5 dB. The cut-off frequencies are 1.104/spl times/2/sup n/ MHz, where n is 0, 1, 2, 3, 4, corresponding to different transmission rates. The filter is self-tuned by the proposed tuning mechanism that is based on the relation between DC and fundamental components of a filtered clock signal. Peak-and-valley detection is employed to observe the two frequency components in the time domain. Implemented in 0.35 /spl mu/m 1P4M digital CMOS technology, the circuit occupies an active area of 1.3/spl times/1.4 mm/sup 2/. According to the post-layout simulation, it achieves 55 dB THD using 2 V supply voltage while the output swing is 120 mV/sub pp/. The power consumption for the core filter is 2.8 mW, whereas the overall system, including the filter, the output buffer, and the tuning circuits, consumes 28 mW power.

This paper proposes a two-fold carrier recovery loop that possesses /spl plusmn/25000-ppm pull-in range and 7-ms acquisition time for 64-QAM blind adaptive system. The carrier recovery system contains a prior wide-band loop to acquire a coarse carrier frequency and a posterior narrow-band loop to achieve -82 dBc jitter suppression. It can be applied to a 4.035-MHz low-IF cable modem system with the /spl plusmn/100-kHz frequency offset tolerance requirement. The two-fold carrier recovery loop operates in consecutive three stages, which are Costas carrier phase estimation, DDML carrier phase estimation, and DD-MMSE carrier phase estimation. The proposed architecture is hardware efficient since the three-staged operation shares most of the circuit functions.

Although hyperhidrosis palmaris is a benign condition, it may cause considerable psychological, social, and occupational disturbances. There are many conservative measures used to treat hyperhidrosis, but surgical sympathectomy is the only permanent cure. Of the various surgical approaches to the upper thoracic sympathetic ganglia, one must select the approach that combines good functional results and a satisfactory cosmetic outcome with only minor complications. Twenty-one patients (10 men and 11 women) with hyperhidrosis palmaris underwent synchronous bilateral T2 sympathectomy between 1 October 1989 and 30 April 1990. These patients underwent a new method of thoracoscopic sympathectomy without preoperative pneumothorax. All were relieved of excessive sweating in their upper extremities immediately after the operation. In addition, the technique led to significant savings in operation and hospitalization time. We recommend thoracoscopic sympathectomy as the best approach for sympathectomy in cases of hyperhidrosis palmaris.

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The room-temperature nitric acid (HNO3) compensation method is introduced to effectively improve the dielectric quality of ultrathin aluminum oxide (Al2O3) gate dielectrics under low thermal budget consideration. The physical properties, electrical characteristics, and temperature response of Al2O3 metal-oxide-semiconductor (MOS) devices without and with HNO3 compensation are compared. The surface roughness and interface trap density are obviously decreased by utilizing HNO3 compensation. Under negative gate bias, the leakage current, hard breakdown characteristics, and temperature-dependent reliability of the Al2O3 MOS(p) capacitors are clearly improved by HNO3 compensation. Under positive gate bias, the highly temperature-dependent current is principally dominated by generation-recombination mechanism. However, the diodes without HNO3 compensation show irregular temperature response especially at temperature above 70 °C. From Frenkel-Poole emission analysis, the oxide traps in Al2O3 without HNO3 compens...

A patient with angina pectoris who had been successfully treated by thoracoscopic cardiac sympathectomy was scheduled to have scalp debridement under general anaesthesia for a scald burn. There were haemodynamic changes during and after the operation including anaesthetic induction, endotracheal intubation, maintenance, and early recovery period. The sympathetic denervated heart showed little chronotropic response to anaesthetic and surgical stimulation. On the contrary, the parasympathetic response was predominant. An episode of severe bradycardia occurred during endotracheal suctioning prior to extubation. The haemodynamic response to cardiac sympathetic denervation corresponded to the efferent effect of beta-receptor blockade

We proposed the concept of effective uniform area ratio (Keff) to evaluate the nonuniformity phenomena of SiO2 and HfO2 gate dielectrics below 3 nm. Keff can be considered as an indication of gate oxide uniformity. It is found that Keff increases with the thickness of SiO2, whereas decreases with increasing effective oxide thickness for HfO2. The reason for the observed phenomena is given in this work. The electrical and reliability characteristics were examined to check the feasibility of our concept. The tendency of Keff values was reconfirmed by the uniformity of leakage current and constant field stress test. It is believed that this methodology is useful for the future oxide quality test.

In this article, we report a novel high performance nanocomposite made from environmentally friendly and energy conserving solventless photocurable patternable resin system. The system contains a fluoroimide acrylate oligomer, acrylate monomer, photoinitiator and SiO2 nanoparticles. The fluoroimide acrylate oligomer was synthesized by reacting 2 mole equivalent of 4,4′-(hexafluoroisopropylidene) diphthalic anhydride (6FDA) with 4,4′-(hexafluoroisopropylidene) diamine (6FpDA) first to form fluoroimide dianhydride, and then further reacting with 2 moles of 2-hydroxy ethyl methacrylate (HEMA). The fluoroimide acrylate oligomer was specially designed with carboxylic acid functionality. As compared with bis-phenol A acrylate oligomer, the fluoroimide acrylate oligomer nanocomposite shows an improvement in both physical properties and chemical properties. This new nanocomposite exhibits good cross hatch adhesive strength (>95% on glass) and unusually high hydrophobicity (>140° contact angle). The nanocomposite also shows excellent transparency (>90% transmission at 400–800 nm for 100 μm film), high thermal stability and mechanical durability. The water absorption and the water vapor permeation of this nanocomposite are reduced to at least one quarter of those of the bis-phenol A acrylate nanocomposite. The chemical characteristics of the fluoroimide acrylate and the formation of nanodomains in the nanocomposite play major roles in providing the outstanding performance.

A new method of thoracoscopic T2-sympathectomy mentioned in a previous report was used on 36 cases of hyperhidrosis at Tainan Municipal Hospital in Taiwan between October 1, 1989 and July 31, 1990. To reduce the possibility of incomplete resection of sympathetic nerve tracts, including ganglions and their regeneration, the method was modified on August 1, 1990. Thereafter, routine total removal of T2 and T3 sympathetic ganglions, as well as wide lateral incisions of the pleura on the second, third, and fourth rib beds were performed for treatment of hyperhidrosis. This newly modified method, "extended thoracoscopic T2-sympathectomy," can be performed easily by thoracoscopic approach in the treatment of hyperhidrosis palmaris. From August 1, 1990 to May 31, 1991, 130 consecutive cases of hyperhidrosis (56 males and 74 females) ranging in age from 8 to 51 years underwent extended thoracoscopic T2-sympathectomy. In addition to a nearly 100% cure rate of hyperhidrosis palmaris, significant saving in operative time and hospital stay were achieved. High simultaneous cure rate (70.6%) and subjective improvement (17.4%) of excessive sweating of feet (hyperhidrosis plantaris) were also noted in the 109 cases followed up, and complications were minor. Extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective method in the treatment of hyperhidrosis. It is worthy of being propagated worldwide.

Carbon nanotubes (CNTs) with tunable density have been grown directly by inductively coupled plasma chemical vapor deposition (ICP-CVD) using anodic aluminum oxide (AAO) on silicon as a substrate. The density of CNTs (10 6 to 10 9 CNTs/cm 2 ) can be controlled by changing the length of catalytic Ni nanowires embedded in AAO. The one-dimensional CNTs-Ni nanowire heterojunction without observable defects by transmission electron microscopy characterization ensures good contact between the CNT and the Ni nanowire. The realization of combining AAO on silicon and controlling the density of carbon nanotubes by a plasma process is significant for application of CNTs as field emitters and nanoelectronic devices.

In this paper, we obtain some exact solutions of Derivative Reaction-Diffusion (DRD) system and, as by-products, we also show some exact solutions of DNLS via Hirota bilinearization method. At first, we review some results about two by two AKNS-ZS system, then introduce Hirota bilinearization method to find out exact N-soliton solutions of DNLS and exact N-dissipaton solutions of the Derivative Reaction-Diffusion system respectively.