An Experimental Evaluation of Lake Flow Simulation

The global positioning system is utilized in lake flow analysis to facilitate experimental evaluation for numerical results of a lake flow simulation. In our lake flow experiment a float travels on the lake surface receiving the fluid resistance due to lake flow, while a global positioning system receiver keeps track of its position. A momentum equation is derived when the product of the float mass and its acceleration is set equal to the driving force. The temporal change in the position of the float can be simulated when numerical solutions of lake flow equations are given. A comparison of numerical results and experimental data leads to an evaluation of the numerical simulation of lake flow

Driving restrictions in patients with implantable cardioverter defibrillators and pacemakers

Implantable cardioverter-defibrillators (ICDs) improve the survival in patients at risk of sudden cardiac death. However, these patients have an ongoing risk of sudden incapacitation that may cause harm to individuals and others when driving. Considerable disagreement exists about whether and when these patients should be allowed to resume driving after ICD therapies. This information is critical for the management decisions to avoid future potentially lethal incidents and unnecessary restrictions for ICD patients. The cardiac implantable device committee of the Japanese Heart Rhythm Society reassessed the risk of driving for ICD patients based on the literature and domestic data. We reviewed the driving restrictions of ICD patients in various regions and here present updated Japanese driving restrictions

Polyunsaturated fatty acids-enriched lipid from reduced sugar alcohol mannitol by marine yeast Rhodosporidiobolus fluvialis Y2

Brown macroalgae is a promising marine biomass for the production of bioethanol and biodiesel fuels. Here we investigate the biochemical processes used by marine oleaginous yeast for assimilating the major carbohydrate found in brown macroalgae. Briefly, yeast Rhodosporidiobolus fluvialis strain Y2 was isolated from seawater and grown in minimal medium containing reduced sugar alcohol mannitol as the sole carbon source with a salinity comparable to seawater. Conditions limiting nitrogen were used to facilitate lipid synthesis. R. fluvialis Y2 yielded 55.1% (w/w) and 39.1% (w/w) of lipids, per dry cell weight, from mannitol in the absence and presence of salinity, respectively. Furthermore, mannitol, as a sugar source, led to an increase in the composition of polyunsaturated fatty acids, linoleic acid (C18:2) and linolenic acid (C18:3), compared to glucose. This suggests that oxidation of mannitol leads to the activation of NADH-dependent fatty acid desaturases in R. fluvialis Y2. Such fatty acid composition may contribute to the cold-flow properties of biodiesel fuels. Our results identified a salt-tolerant oleaginous yeast species with unique metabolic traits, demonstrating a key role as a decomposer in the global carbon cycle through marine ecosystems. This is the first study on mannitol-induced synthesis of lipids enriched with polyunsaturated fatty acids by marine yeast

Total arterial revascularization with composite skeletonized gastroepiploic artery graft in off-pump coronary artery bypass grafting

AbstractBackgroundTotal arterial revascularization in coronary artery bypass grafting has recently become of great interest to many surgeons. At the same time, off-pump coronary bypass grafting has also become a popular procedure because of its low morbidity and mortality. Here we report our recent series of off-pump coronary bypass grafting performed with a grafting technique we developed by using the skeletonized gastroepiploic artery and the radial artery composite graft to achieve total arterial revascularization.MethodsFrom September 2000 to April 2003, 98 patients underwent total arterial revascularization with the skeletonized gastroepiploic artery and radial artery composite graft on the beating heart. We used the gastroepiploic artery graft of choice in patients with a right coronary artery lesion. When multiple grafting was required in inferior, posterolateral, or lateral ventricular walls and the gastroepiploic artery graft was too short to cover these areas, we used the composite grafting technique.ResultsThere were no in-hospital deaths and there was no severe morbidity among the study patients. Postoperative angiography showed graft occlusion at the anastomosis site between the gastroepiploic and radial arteries. The patency rate of the gastroepiploic arterial composite graft was 98.3% (118/120 distal anastomoses).ConclusionsA composite graft with the skeletonized gastroepiploic artery and the radial artery ensured sufficient caliber size and length for myocardial revascularization on inferior, posterolateral, and lateral ventricular walls. This composite graft can be used safely and effectively even in off-pump coronary bypass surgery with excellent early clinical and angiographic outcome in selected patients, although longer follow-up periods are necessary to draw definitive conclusions

Successful low-energy cardioversion using a novel biodegradable gel pad: Feasibility of treating postoperative atrial fibrillation in animals

ObjectivePostoperative atrial fibrillation is one of the most frequent complications of cardiac surgery. We developed a novel biodegradable gel pad consisting of biopolymers that directly attach to the myocardium by electrostatic interaction. The present study examines the feasibility and effectiveness of low-energy internal cardioversion using these pads.MethodsThe hearts of 6 pigs were exposed through a median sternotomy under general anesthesia, and 2 monopolar pacing wires were placed on the left pulmonary veins (chest open group). Two biodegradable cardioversion gel pads were placed on the right appendage and the left atria without suturing. All wires were extruded through the skin and secured with a suture. Sustained atrial fibrillation was induced by burst-pacing from the pulmonary veins in continuous 20-ms cycles. Shock intensity started at 0.5 J, and the energy level was increased in 0.5-J increments until cardioversion occurred. This protocol was repeated 5 times per pig. In a second group of 6 pigs (chest closed group), the epicardial cardioversion electrode gel pads and pacing wire electrodes were positioned as described above. Shock intensity was started at 0.5 J. If the shock was unsuccessful, the energy level was increased in 0.5-J increments until 2 consecutive cardioversions were achieved at a single energy level. At postoperative days 1, 3, 5, and 7, the defibrillation threshold was determined with the chest closed. At postoperative day 10, the cardioversion wires were removed. At predetermined time intervals, the heart was reexposed and the extent of degradation in vivo was visually evaluated and histologically assessed after sacrifice.ResultsAll pigs with induced atrial fibrillation were cardioverted to sinus rhythm on the determined postoperative day. The mean energy and lead impedance in the chest open group were 0.65 ± 0.23 J and 97.6 ± 5.52 Ω, respectively, and the overall values of mean energy and lead impedance in the chest closed group were 1.67 ± 1.00 J and 75.9 ± 13.3Ω, respectively. No complications were observed after wire removal. The gel pads became degraded and decreased in thickness, and signs of mild inflammation were evident on the gel pad. However, the gel pads did not elicit significant severe inflammatory reactions according to both gross and histologic assessments at 1 month after the surgery.ConclusionAtrial cardioversion using novel biodegradable gel pads that are easily affixed may afford a straightforward and effective treatment for atrial fibrillation after cardiac surgery

Deep Knot Structure for Construction of Active Site and Cofactor Binding Site of tRNA Modification Enzyme

AbstractThe tRNA(Gm18) methyltransferase (TrmH) catalyzes the 2′-O methylation of guanosine 18 (Gua18) of tRNA. We solved the crystal structure of Thermus thermophilus TrmH complexed with S-adenosyl-L-methionine at 1.85 Å resolution. The catalytic domain contains a deep trefoil knot, which mutational analyses revealed to be crucial for the formation of the catalytic site and the cofactor binding pocket. The tRNA dihydrouridine(D)-arm can be docked onto the dimeric TrmH, so that the tRNA D-stem is clamped by the N- and C-terminal helices from one subunit while the Gua18 is modified by the other subunit. Arg41 from the other subunit enters the catalytic site and forms a hydrogen bond with a bound sulfate ion, an RNA main chain phosphate analog, thus activating its nucleophilic state. Based on Gua18 modeling onto the active site, we propose that once Gua18 binds, the phosphate group activates Arg41, which then deprotonates the 2′-OH group for methylation

International Consensus Diagnostic Criteria for Autoimmune Pancreatitis and Its Japanese Amendment Have Improved Diagnostic Ability over Existing Criteria

Objectives. The recent International Consensus Diagnostic Criteria (ICDC) for autoimmune pancreatitis (AIP) and its Japanese amendment developed by the Japanese Pancreas Society (JPS 2011) may have overcome the drawbacks of earlier criteria and achieved a higher diagnostic ability for AIP. The aim of the present study is to evaluate this possibility and identify the underlying causes of this change. Methods. We compared the diagnostic abilities of the ICDC and JPS 2011 with those of the Japanese diagnostic criteria 2006 (JPS 2006), Korean diagnostic criteria (Korean), Asian diagnostic criteria (Asian), and HISORt diagnostic criteria in 110 patients with AIP and 31 patients with malignant pancreatic cancer. Results. The ICDC achieved the highest diagnostic ability in terms of accuracy (95.0%), followed by JPS 2011 (92.9%), Korean (92.2%), HISORt (88.7%), Asian (87.2%), and JPS 2006 (85.1%). Nearly all criteria systems exhibited a high specificity of 100%, indicating that the enhanced diagnostic ability of the ICDC and JPS 2011 likely stemmed from increased sensitivity brought about by inclusion of diagnostic items requiring no endoscopic retrograde pancreatography. The diagnostic ability of JPS 2011 was nearly equivalent to that of the ICDC. Conclusions. The ICDC and JPS 2011 have improved diagnostic ability as compared with earlier criteria sets because of an increase in sensitivity.ArticleGASTROENTEROLOGY RESEARCH AND PRACTICE. 2013:456965 (2013)journal articl

The Utility of Serum IgG4 Concentrations as a Biomarker

IgG4-related disease is a new disease entity involving IgG4 in its clinical presentation and having 6 characteristic features: (1) systemic involvement; (2) solitary or multiple lesions showing diffuse or localized swelling, masses, nodules, and/or wall thickening on imaging; (3) high serum IgG4 concentration >135 mg/dL; (4) abundant infiltration of lymphoplasmacytes and IgG4-bearing plasma cells; (5) a positive response to corticosteroid therapy; and (6) complications of other IgG4-related diseases. To date, most IgG4-related diseases have been recognized as extrapancreatic lesions of autoimmune pancreatitis. This paper will discuss the utility of IgG4 as a biomarker of IgG4-related diseases, including in the diagnosis of autoimmune pancreatitis and its differentiation from pancreatic cancer, in the prediction of relapse, in the long-term follow-up of patients with autoimmune pancreatitis and normal or elevated IgG4 concentrations, and in patients with autoimmune pancreatitis and extrapancreatic lesions, as well as the role of IgG4 in the pathogenesis of IgG4-related disease