Pancreas transplantation for diabetic patients in Hawaii.

Diabetes mellitus is a common disease affecting a large population in Hawaii. Over the past 20 years, pancreas transplantation has evolved into a viable therapeutic option for selected patients with diabetes mellitus. This report describes the first combined pancreas-kidney transplant performed in Hawaii on June 28, 1993 on a patient with juvenile-onset diabetes mellitus and diabetic nephropathy. The patient has remained off insulin and off dialysis since the transplant. The history, indications, techniques, and potential complications related to this procedure are discussed

Structure of a lectin from Canavalia gladiata seeds: new structural insights for old molecules

<p>Abstract</p> <p>Background</p> <p>Lectins are mainly described as simple carbohydrate-binding proteins. Previous studies have tried to identify other binding sites, which possible recognize plant hormones, secondary metabolites, and isolated amino acid residues. We report the crystal structure of a lectin isolated from <it>Canavalia gladiata </it>seeds (CGL), describing a new binding pocket, which may be related to pathogen resistance activity in ConA-like lectins; a site where a non-protein amino-acid, α-aminobutyric acid (Abu), is bound.</p> <p>Results</p> <p>The overall structure of native CGL and complexed with α-methyl-mannoside and Abu have been refined at 2.3 Å and 2.31 Å resolution, respectively. Analysis of the electron density maps of the CGL structure shows clearly the presence of Abu, which was confirmed by mass spectrometry.</p> <p>Conclusion</p> <p>The presence of Abu in a plant lectin structure strongly indicates the ability of lectins on carrying secondary metabolites. Comparison of the amino acids composing the site with other legume lectins revealed that this site is conserved, providing an evidence of the biological relevance of this site. This new action of lectins strengthens their role in defense mechanisms in plants.</p

Stress factors and stress management interventions: the heuristic of “bottom up” an update from a systematic review

Organizations have increasingly sought to adopt innovative interventions to prevent stress-related issues. In the field of manufacturing, however, the effectiveness of these interventions remains unclear because a systematic and specific review of existing primary evidence has not been undertaken. The present systematic literature review sought to address the foregoing limitation in the literature by summarizing the main source of stress and effectiveness of stress management interventions as grounded in the context of manufacturing. Our review was limited to only randomized clinical trials (RCTs) and quasi-experimental studies and concerned employees from the manufacturing sector. Twenty-two studies on primary, secondary and tertiary interventions across four continents (Asia, Europe, USA and South America) were selected and analyzed in terms of stress factors, methodological properties and outcomes. Most of these were RCT studies (68% Vs 32%) with a majority of secondary interventions (N = 11, 50%), followed by primary (N = 5, 22%), tertiary (N = 3, 13%), and two (9%) mixed interventions. The main outcomes included an improvement of psychological wellbeing, decreased stress reactivity and an increment of general health. There was a predominance of interventions utilizing skills programs and/or cognitive-behavioral techniques. The main source of stress reported related to professional identity, organizational deficiencies, interpersonal conflicts, physical complaints and poor work environment. Taken together, the findings provide important theoretical and practical implications for advancing the study of stress factors and the use of stress management interventions in the workplace. The prerequisite for a successful intervention is to address the real problems experienced by professionals and help them to cope with their difficult situations. The strategy of “bottom-up” offers a potential means of enhancing employees’ health and well-being; however, the most effective means of implementing these interventions needs to be understood better

Stable-isotope techniques to investigate sources of plant water

Stable isotopologues of water (mainly 1H216O, HD16O and 1H218O) have been used for decades as tracers of the Earth's water cycle. In this chapter, we briefly describe the theoretical background and state-of-the-art techniques of the use of water stable isotopes to investigate the sources of plant water. We aim to provide the basic understanding of stable isotope fractionation within the Earth's critical zone that is relevant for studies of plant water sources. We then present a practical guide of their most common applications in field studies and the most common and up-to-date laboratory procedures. We finally introduce the existing statistical approaches for estimating the relative contributions of water sources to plant transpiration. By acknowledging the advantages and limitations of each approach, we aim to provide an overview of the current techniques to researchers in the fields of plant ecophysiology, ecohydrology and forest ecology, so that they can make informed decisions when designing their experiments

Different work capacity impairments in patients with different work-anxieties

Purpose: Persons with work-anxieties are especially endangered for work-impairment and sick-leave. Work-impairment is not directly due to symptoms but due to illness-related capacity impairments. Work capacity impairments can be described on different dimensions (e.g. social interaction, decision making and judgment, endurance, mobility). Understanding the type of work capacity impairment is important for reintegration interventions This is the first study to investigate work capacity impairment in risk-patients with different work-anxieties. Methods: Two hundred forty four patients in inpatient rehabilitation suffering from work-anxieties were investigated concerning degree of work capacity impairment. Capacity impairment was described on 13 capacity dimensions according to the internationally evaluated observer-rating Mini-ICF-APP (impairment grades 0-4, grade 2 and higher indicating clinically relevant observable impairment). A physician´s rating on global work ability prognosis was obtained, and sick-leave duration during six months after assessment. Patients with different work-anxieties were compared concerning capacity impairments. Results: Patients with different work-anxieties were impaired in different capacity dimensions: work-related social anxiety went along with clinically relevant impairment in capacity of assertiveness (M=2.40), anxiety of insufficiency went along with impaired capacity of endurance (M=2.20), work-related generalized worrying was accompanied by impairment in the capacity for decision making (M=1.82). Specific capacity impairment dimensions were related with sick-leave duration, while a global work ability prognosis was not. Conclusions: The capacity approach is useful to describe work-impairment more precisely and beyond symptoms. On this basis reintegration-focusing interventions such as capacity training (e.g. social interaction training) or work adjustment (e.g. reducing exposure with interactional work tasks) can be initiated

The first non-heart-beating organ donor in Hawaii--medical and ethical considerations.

The shortage of organ donors remains a major obstacle in transplantation in Hawaii. Some patients die while waiting for a life-saving organ. Across the nation, "marginal" donors, including non-heart-beating donors are used. The authors describe the first successful non-heart-beating organ donor transplant in Hawaii, and include medical and ethical considerations

Laparoscopic donor nephrectomy in Hawaii.

Laparoscopic donor nephrectomy for transplant is a minimally invasive, effective, and safe operation that also provides less post-operative pain and earlier return to pre-donation activity. In review of the first 10 cases, no major complications occurred and mean hospital stay was 3.7 days. All recipients of these kidneys displayed excellent allograft function (mean creatinine--1.5 mg/dL) and no ureteral problems. Successful use of this procedure has also resulted in a steady increase in the number of living transplants performed in Hawaii and perhaps this will impact the 330 patients currently awaiting renal transplant

Liver transplantation in Hawaii.

The first liver transplant performed in Hawaii was on May 17, 1993 in a patient with end-stage liver disease caused by autoimmune hepatitis. Liver transplantation is a well-accepted treatment for end-stage liver disease with a 1-year patient survival of 80% to 85%. Early recognition of the appropriate candidate by primary care physicians and prompt referral to a liver transplant center are essential for optimal results. The indications, contraindications, organ procurement and allocation, complications, and results of liver transplantation are described. Finally, several controversial areas will be introduced, including liver transplant for alcoholic cirrhosis and hepatitis B, and use of transjugular intrahepatic portosystemic shunts (TIPS)