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

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 need for organ donation in Hawaii.

Donor organ availability is the primary limiting factor in organ transplantation. The number of patients on the national organ waitlist has increased to more than 32,000, while the number of donors has remained fairly constant at approximately 4,500 per year. In Hawaii, there are 98 patients awaiting organ transplants, and for the past 5 years, the average number of donors per year was 15. The criteria for organ donation, brain death, approaches to donation request, and the management of the multiple organ donor are discussed

A VAN DER WAALS STATE OF MATRIX-ISOLATED Cr2Cr_{2}

Author Institution: Lash Miller Chemical Laboratory, University of Toronto; Laboratoire de la Spectroscopie Infrarouge, Universit\'{e} de Bordeaux I, 33405 Talence, FranceA van der Waals state of chromium dimers in an argon matrix has been detected via 458nm irradiation from an $Ar^{+}$ laser followed by an apparent intersystem crossing process. Resonance Raman study of this state with the 568nm line of a $Kr^{+}$ laser shows $w^{\prime \prime}_{e}=77.8cm^{-1}$ and $w^{\prime \prime}_{e}X^{\prime \prime}_{e}=0.01cm^{-1}$. Lifetime of this state is determined to be $\sim 0.5$ second, indicative of a spin-forbidden process involved in its relaxation

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)

Hepatic cryosurgery: early experience in Hawaii.

Liver cancer, both primary and metastatic, is often deemed hopeless and patients with advanced disease cannot be offered a treatment that is completely effective. Surgical resection is the treatment of choice, but less than 20% of patients are candidates for this treatment. Hepatic cryosurgery is a relatively new procedure in which the tumor is localized intraoperatively with ultrasound guidance and exposed to liquid nitrogen at -196 degrees C. Nine cases have been performed in Hawaii, and we present the first four cases here. Of these cases, there were no mortalities and only one patient required blood transfusion. All patients currently are alive with up to 11-month follow-up. Long-term studies will be necessary to assess the effectiveness of this modality

25 years of kidney transplantation in Hawaii.

The first kidney transplant in Hawaii was performed in August 1969. In the following 25 years, more than 433 kidney transplants were performed. The most common etiology leading to transplantation was chronic glomerulonephritis. Patient and graft survivals after a kidney transplant have progressively improved, particularly after the introduction of cyclosporine in 1984. The overall one-year patient and graft survival rates now are 96% and 85%, respectively; these results exceed the national averages