Liver failure occurring as a component of exertional heatstroke.

An unusual case of an exertional heatstroke in a healthy 25-year-old man is presented. Initially, the patient was deeply comatose and developed severe rhabdomyolysis and massive hepatic necrosis. Subsequently, he received a liver transplant with remarkable improvement in his mental status, although the rhabdomyolysis continued. The patient died 41 days after the transplant due to a complicating infection. Providing that infections can be effectively controlled, liver transplants might be a promising therapeutic alternative for the few patients who survive the initial neurological consequences of this unusual event

Cytomegalovirus infection of the upper gastrointestinal tract following liver transplantation—incidence, location, and severity in cyclosporine- and FK506-treated patients

One hundred and forty randomly selected liver transplant recipients were studied before and after primary orthotopic liver transplantation for the presence or absence of CMV enteritis. Following OLTx, 65 patients were treated with cyclosporine A and 75 were treated with FK506. The two groups were similar with regard to the incidence, location, and outcome of their upper gastrointestinal CMV infection. Prior to OLTx, only one patient had evidence of enteric CMV infection. The incidence of CMV enteritis post-OLTx was 27.7% in the CsA-treated group and 20% in the FK-treated group. During the first posttransplant month, no patient in the FK-treated group developed CMV enteritis, compared with 11.5% of the patients who were treated with CsA (P<0.05). Gastric CMV was found in over 80% of those positive for any organ in either group. In addition to CMV infection of the upper gastrointestinal tract, clinically evident CMV disease involved more nonenteric organs in the CsA-treated group than in the FK-treated group. In the CsA-treated group, CMV-negative patients had a statistically higher 1-year survival rate (100%) than CMV-positive patients (77.8%) (P<0.05). In the FK-treated group, no difference in survival was observed between CMV-positive or CMV-negative cases at 1 year. Of the patients on CsA, 20% received OKT3 for persistent rejection, as compared with 13% in the FK-treated group. The patients receiving both CsA and OKT3 had a higher rate of upper gastrointestinal CMV infection than did FK-treated patients who also received OKT3 therapy (38.5% versus 20%, respectively). Based upon these data, it can be concluded that (1) patients receiving FK have a lower incidence of enteric CMV infection; (2) following OLTx, upper gastrointestinal CMV infection presents later in FK-treated patients; (3) the stomach is the most frequently involved organ in the UGIT; (4) FK-treated liver recipients have less severe enteric CMV infection than do CsA-treated patients; (5) enteric CMV is not a major cause of mortality in liver trans lant recipients; and (6) in patients receiving FK, those who require OKT3 therapy do not appear to be at a greater risk for the development of CMV enteritis than those who do not. © 1992 by Williams & Wilkins

The Halting Process of Democratization in the Arab World: Current Challenges and Prospects

Following the uprisings that began in 2010, a number of scholars leaped to hasty conclusions about the end of “Arab exceptionalism” in regard to democracy. More than half a decade later, however, the outcomes have generally been negative and disappointing, as some Arab countries have plunged into civil war and internal conflict that threaten their very existence as political entities. In other cases, the ruling elites have taken tentative steps on the path of political reform in an effort to divert the winds of change; alternatively, democratization has at times been considered a low priority in the face of perceived security and development challenges. All of these responses represent attempts by ruling regimes to modernize authoritarianism rather than to engage in genuine democratization. The aim of this chapter is to account for the most significant political and democratic trends in the Arab world in the wake of the Arab Spring and to analyze the current challenges facing the process of democratization

Disease recurrence and rejection following liver transplantation for autoimmune chronic active liver disease

Autoimmune chronic active liver disease (ACALD), a major indication for liver transplantation, is associated strongly with antigenic determinants HLA-B8 and DR3. A retrospective analysis of 43 patients who underwent OLTx for putative ACALD and who, as well as their tissue organ donors, were typed, was performed. Disease recurrence and graft rejection episodes were determined by chart review and histopathological review of all material available. Disease recurrence was histologically documented in 11 (25.6%) of these 43 cases. Graft rejection episodes occurred in 24 (66.8%). All recurrences were in recipients of HLA-DR3-negative grafts. Nine of the recurrences were in HLA-DR3-poeitive recipients (odds ratio: 6.14, P<0.03). Two of 11 cases of disease recurrence were in recipients who were HLA-DR3-negative. Nine of these 11 had received HLA-DR3-negative grafts. Rejection occurred in 13 HLA-B8-positive recipients, 12 of whom received HLA-B8-negative grafts. Eleven HLA-B8-negative recipients experienced at least one rejection episode and 9 of these had received HLA-B8-negative grafts. Based upon these data we conclude: 1) that recurrence of putative ACALD is more likely to occur in HLA-DR3-positive recipients of HLA-DR3-negative grafts; (2) that recurrences were not seen in recipients of HLA-DR3-positive grafts; (3) that BXA-B8 status does not affect disease recurrence; and (4) that neither the HLA-B8 nor the DR3 status of the graft or recipient has an effect on the observed frequency of rejection. ©1992 by Williams & Wilkins

Advanced Surface Polishing For Accelerator Technology Using Ion Beams

Surface erosion problems are common in the development of TeV accelerators, fusion and fission reactors, semiconductor, optical and magnetic storage devices, and Extreme Ultra-Violet (EUV) lithography devices. We have reviewed various erosion mechanisms of ion interactions with the surfaces studied by experiment and computer simulation. Nanoscale surface roughness in rf-linacs and contamination cause field emission of electrons, field evaporation of ions and fragments, plasma formation, and lead to high-gradient rf vacuum breakdown of electrodes which is a limiting factor in the development of high-gradient rf technology for future TeV accelerators. A few mechanisms of nanoscale surface fracture under a high-gradient electric field were developed and will be discussed. A Gas Cluster Ion Beam (GCIB) technology was successfully applied to surface treatment of Cu, Stainless steel, Ti and Nb samples and to Nb rf-cavities by using accelerated cluster ion beams of Ar, O2, N2, and NF3, and combinations of them, with accelerating voltages up to 35 kV. DC field emission (dark current) measurements and electron microscopy were used to investigate metal surfaces treated by GCIB. The experimental results showed that GCIB technique can significantly reduce the number of field emitters and also change the structure of the Nb oxide layer on the surface. The RF tests on the GCIB treated Nb rf-cavities showed improvement of the quality factor Q at 4.5 K. The superconducting gap was also enhanced by using the oxygen GCIB irradiation exposure. GCIB may become a standard technique to modify and control the oxygen content on the surface and a promising surface treatment technique for Nb SRF cavities in particle accelerators. Computer simulation of bombardment of Nb surfaces with Ar and O2 clusters by molecular dynamics and phenomenological surface dynamics equations confirms experimental results

Effect of Dual Ion Beam Irradiation (Helium and Deuterium) on Tungsten–Tantalum Alloys Under Fusion Relevant Conditions

The selection of tungsten (W) as a divertor material in ITER is based on its high melting point, low erosion, and strong mechanical properties. However, continued investigation has shown W to undergo severe morphology changes in fusion-like conditions. Recent literature suggests alloying W with other ductile refractory metals, viz. tantalum (Ta) may resolve some of these issues. These results provide further motivation for investigating W–Ta alloys as a plasma-facing component (PFC) for ITER and future DEMO reactors. Specifically, how these alloy materials respond to simultaneous He+ and D+ ion irradiation, and what is the effect on the surface morphology when exposed to fusion relevant conditions. In the present study, the surface morphology changes are investigated in several W–Ta targets (pure W, W-1%Ta, W-3%Ta, and W-5% Ta) due to simultaneous He+ and D+ ion irradiations. This comprehensive work allows for deeper understanding of the synergistic effects induced by dual ion irradiation on W and W–Ta alloy surface morphology. Pure W and W–Ta alloys were irradiated simultaneously by 100 eV He+ and/or D+ ions at various mixture ratios (100% He+, 60% D+ + 40% He+, 90% D+ + 10% He+ ions and 100% D+ ions), having a total constant He fluence of 6 × 1024 ion m−2, and at a target temperature of 1223 K. This work shows that slight changes in materials composition and He/D content have significant impact on surface morphology evolution and performance. While both the pure W and W–Ta alloys exhibit very damaged surfaces under the He+ only irradiations, there is a clear suppression of the surface morphology evolution as the ratio of D+/He+ ions is increased

Binary mixture sorption of basic dyes onto wheat straw

Simultaneous adsorption of Basic Blue 3 (BB 3) and Basic Red 18 (BR 18) onto wheat straw (WS) from a binary system was studied and compared with a single dye system in a batch mode. The single-component Langmuir and Freundlich isotherm models were applied to the adsorption equilibrium data for single-component and binarycomponent systems. The equilibrium adsorption for the binary system was also analyzed by using multi-component modified Langmuir and Sheindorf-Rebuhn-Sheintuch (SRS) models. Equilibrium data of BB 3 in single and binary systems fitted more adequately to the Freundlich adsorption isotherm. For BR 18, the Langmuir model was the best one for fitting the adsorption equilibrium in single and binary systems. The pseudo-first order and pseudo-second order models were employed to fit the experimental data for the adsorption kinetics of BB 3 and BR 18 on WS from singleand binary-component systems. The pseudo-second-order model provided better correlation for the adsorption process in single-and binary-component systems. Adsorption results from the binary system indicated the competitive adsorption between dyes. The maximum adsorption capacities of WS for BB 3 and BR 18 dyes in single solution system were found as 90.91 mg g -1 and 142.86 mg g -1 , respectively, while in binary mixture they decreased to 76.92 mg g -1 and 111.11 mg g -1 , respectively, as a result of their antagonistic behavior

Analysis of Chemical and Microbial Change During Storage of Overripe Tempeh Powder as Seasoning Material

Tempeh and other soy-derived products are historically and currently some of the most important foods in the Asian region where diets remain predominantly plant-based. Overripe tempeh (tempe semangit) is a term used for over-fermented tempeh with pungent odor and darkening appearance commonly used in Javanese cuisine. Unique taste and odor of overripe tempeh lead to the exploration of its potencies as condiment, which may add the nutritional, safety and economic values of tempeh. In this research, overripe tempeh is made into powder for better appearance and availability. Oven drying at 60oC and freeze drying were applied to the overripe tempeh until it reached moisture content below 5%, followed by subsequent crushing into powder using electric grinding machine. As seasoning material, the tempeh powder and overripe tempeh powder were then analyzed for their stability. Observations in chemical and microbial changes during storage were also applied to selected product during storage. Parameters observed during the research are: moisture content, protein content, acid content, total microbial count and total coliform. Oven dried overripe tempeh (S60) has higher moisture content but lower in acid content, total microbial count and total coliform compared to freeze dried overripe tempeh (SFD)