Safety and efficacy of blood exchange transfusion for priapism complicating sickle cell disease.

BACKGROUND: Priapism is unwanted painful penile erection that affects about 36% of boys and men with sickle cell disease (SCD) most of whom have sickle cell anemia. Clinically, priapism could be stuttering, minor, or major. The first two types are mild, last \u3c 4 h, are usually treated at home, have good prognosis with normal sexual function. The major type of priapism lasts \u3e4 h, associated with severe pain, requires hospitalization; often does not respond to medical treatment and may require shunt surgery. Untreated major priapism and surgical intervention often cause impotence. In this study, we report our 15-year experience in treating adult patients with SCD and major priapism with blood exchange transfusion after being refractory to other medical therapies. METHODS: Adult male African Americans patients with SCD and major priapism were enrolled in this study and followed for 15 years. A Haemonitics V-50 machine was initially used for whole blood exchange and was later replaced with Cobe Spectra machine for RBC exchange. RESULTS: We used 239 blood exchanges requiring 1,136 RBC units. We maintained a post-exchange hemoglobin level of about 10 g/dL and hemoglobin S level \u3c 30%. None of the patients had any neurological complications such as headache, seizures, neurological deficits, or obtundation post-exchange. CONCLUSION: Together, the data indicate that blood exchange transfusion for the treatment of patients with SCD and major priapism is efficacious and safe

Frequency Selective Surfaces as Near Infrared Electro-Magnetic Filters for Thermophotovoltaic Spectral Control

Frequency selective surfaces (FSS) effectively filter electromagnetic radiation in the microwave band (1 mm to 100 mm). Interest exists in extending this technology to the near infrared (1 {micro}m to 10 {micro}m) for use as a filter of thermal radiation in thermophotovoltaic (TPV) direct energy conversion. This paper assesses the ability of FSS to meet the strict spectral performance requirements of a TPV system. Inherent parasitic absorption, which is the result of the induced currents in the FSS metallization, is identified as a significant obstacle to achieving high spectral performance

Monte Carlo analysis of a monolithic interconnected module with a back surface reflector

Recently, the photon Monte Carlo code, RACER-X, was modified to include wave-length dependent absorption coefficients and indices of refraction. This work was done in an effort to increase the code`s capabilities to be more applicable to a wider range of problems. These new features make RACER-X useful for analyzing devices like monolithic interconnected modules (MIMs) which have etched surface features and incorporates a back surface reflector (BSR) for spectral control. A series of calculations were performed on various MIM structures to determine the impact that surface features and component reflectivities have on spectral utilization. The traditional concern of cavity photonics is replaced with intra-cell photonics in the MIM design. Like the cavity photonic problems previously discussed, small changes in optical properties and/or geometry can lead to large changes in spectral utilization. The calculations show that seemingly innocuous surface features (e.g., trenches and grid lines) can significantly reduce the spectral utilization due to the non-normal incident photon flux. Photons that enter the device through a trench edge are refracted onto a trajectory where they will not escape. This leads to a reduction in the number of reflected below bandgap photons that return to the radiator and reduce the spectral utilization. In addition, trenches expose a lateral conduction layer in this particular series of calculations which increase the absorption of above bandgap photons in inactive material

Interface Reactions and Electrical Characteristics of Au/GaSb Contacts

The reaction of Au with GaSb occurs at a relatively low temperature (100 C). Upon annealing, a AuSb{sub 2} compound and several Au-Ga phases are produced. Phase transitions occur toward higher Ga concentration with increasing annealing temperatures. Furthermore, the depth of the contact also increases with increased annealing temperature. They found that the AuSb{sub 2} compound forms on the GaSb surface, with the compound crystal partially ordered with respect to the substrate. The transition of Schottky- to ohmic-contact behavior in Au/n-type GaSb occurs simultaneously with the formation of the AuGa compound at about a 250 C annealing temperature. This ohmic contact forms without the segregation of dopants at the metallic compound/GaSb interface. Therefore it is postulated that transition from Schottky- to ohmic-contact behavior is obtained through a series of tunneling transitions of electrons through defects in the depletion region in the Au/n-type GaSb contacts. Contact resistivities of 6-7 x 10{sup -6} {Omega}-cm{sup 2} were obtained with the annealing temperature between 300 and 350 C for 30 seconds. In Au/p-type GaSb contacts, the resistivity was independent of the annealing temperature. This suggested that the carrier transport in p-type contact dominated by thermionic emission

Production data on 0.55 eV InGaAs thermophotovoltaic cells

Low bandgap 0.55 eV (2.25 {micro}m cutoff wavelength) indium gallium arsenide (In{sub 0.72}Ga{sub 0.28}As) thermophotovoltaic (TPV) cells use much more of the long wavelength energy emitted from low temperature (< 1,200 C) thermal sources than either Si or GaSb cells. Data are presented on a statistically significant number (2,500) of these TPV cells, indicating the performance obtainable in large numbers of cells. This data should be useful in the design and modeling of TPV system performance. At 1.2 A/cm{sup 2} short-circuit current, an average open-circuit voltage of 283 mV is obtained with a 60% fill factor. The peak external quantum efficiency for uncoated cells is 65% and is over 50% from 1.1 to 2.2 {micro}m. Internal quantum efficiency is over 76% in this range assuming an estimated 34% reflectance loss

Recent progress in InGaAsSb/GaSb TPV devices

AstroPower is developing InGaAsSb thermophotovoltaic (TPV) devices. This photovoltaic cell is a two-layer epitaxial InGaAsSb structure formed by liquid-phase epitaxy on a GaSb substrate. The (direct) bandgap of the In{sub 1{minus}x}Ga{sub x}As{sub 1{minus}y}Sb{sub y} alloy is 0.50 to 0.55 eV, depending on its exact alloy composition (x,y); and is closely lattice-matched to the GaSb substrate. The use of the quaternary alloy, as opposed to a ternary alloy--such as, for example InGaAs/InP--permits low bandgap devices optimized for 1,000 to 1,500 C thermal sources with, at the same time, near-exact lattice matching to the GaSb substrate. Lattice matching is important since even a small degree of lattice mismatch degrades device performance and reliability and increases processing complexity. Internal quantum efficiencies as high as 95% have been measured at a wavelength of 2 microns. At 1 micron wavelengths, internal quantum efficiencies of 55% have been observed. The open-circuit voltage at currents of 0.3 A/cm{sup 2} is 0.220 volts and 0.280 V for current densities of 2 A/cm{sup 2}. Fill factors of 56% have been measured at 60 mA/cm{sup 2}. However, as current density increases there is some decrease in fill factor. The results to date show that the GaSb-based quaternary compounds provide a viable and high performance energy conversion solution for thermophotovoltaic systems operating with 1,000 to 1,500 C source temperatures

Hydroxyurea and sickle cell anemia: effect on quality of life

BACKGROUND: The Multicenter Study of Hydroxyurea (HU) in Sickle Cell Anemia (MSH) previously showed that daily oral HU reduces painful sickle cell (SS) crises by 50% in patients with moderate to severe disease. The morbidity associated with this disease is known to have serious negative impact on the overall quality of life(QOL) of affected individuals. METHODS: The data in this report were collected from the 299 patients enrolled in the MSH. Health quality of llife (HQOL) measures were assessed in the MSH as a secondary endpoint to determine if the clinical benefit of HU could translate into a measurable benefit perceptible to the patients. HQOL was assessed with the Profile of Mood States, the Health Status Short Form 36 (SF-36), including 4-week pain recall, and the Ladder of Life, self-administered twice 2-weeks apart pre-treatment and every 6 months during the two-year, randomized, double-blind, treatment phase. The effects of factors including randomized treatment, age, gender, pre-treatment crises frequency, Hb-F level mean, daily pain from 4-week pre-treatment diaries, and 2-year Hb-F response level (low or high) were investigated. RESULTS: Over two years of treatment, the benefit of HU treatment on QOL, other than pain scales, was limited to those patients taking HU who maintained a high HbF response, compared to those with low HbF response or on placebo. These restricted benefits occurred in social function, pain recall and general health perception. Stratification according to average daily pain prior to treatment showed that responders to HU whose average daily pain score was 5–9 (substantial pain) achieved significant reduction in the tension scale compared to the placebo group and to non-responders. HU had no apparent effect on other QOL measures. CONCLUSION: Treatment of SS with HU improves some aspects of QOL in adult patients who already suffer from moderate-to-severe SS

Extending the cutoff wavelength of lattice-matched GaInAsSb/GaSb thermophotovoltaics devices

This paper reports the growth, materials characterization, and device performance of lattice-matched GaInAsSb/GaSb thermophotovoltaic (TPV) devices with cutoff wavelength as long as 2.5 {micro}m. GaInAsSb epilayers were grown lattice matched to GaSb substrates by organometallic vapor phase epitaxy (OMVPE) using all organometallic precursors including triethylgallium, trimethylindium, tertiarybutylarsine, and trimethylantimony with diethyltellurium and dimethylzinc as the n- and p-type dopants, respectively. The growth temperature was 525 C. Although these alloys are metastable, a mirror-like surface morphology and room temperature photoluminescence (PL) are obtained for alloys with PL peak emission at room temperature as long as 2.5 {micro}m. In general, however, a trend of decreasing material quality is observed as the wavelength increases. Both the surface roughness and PL full width at half-maximum increase with wavelength. In spite of the dependence of material quality on PL peak emission wavelength, the internal quantum efficiency of TPV devices with cutoff wavelengths of 2.3 to 2.5 {micro}m is as high as 86%