Studying fast-ion populations using oscillations in solid-state neutral-particle analyzer signal and neutral-beam injection power

A method for determining the fast-ion population density in magnetically confined plasmas as a function of pitch-radius, (λ, R), using a solid-state neutral-particle analyzer (ssNPA) signal and neutral-beam injection (NBI) power-output data has been developed. Oscillations in the NBI power output are replicated only in the active part of the ssNPA signal, allowing this to be separated from the passive and background signals, which usually complicate data from this diagnostic. Results obtained using this method are compared with those from standard techniques using data from the Mega-Amp Spherical Tokamak Upgrade spherical tokamak.

Spectroscopy along Flerovium Decay Chains: Discovery of ^{280}Ds and an Excited State in ^{282}Cn

A nuclear spectroscopy experiment was conducted to study α-decay chains stemming from isotopes of flerovium (element Z=114). An upgraded TASISpec decay station was placed behind the gas-filled separator TASCA at the GSI Helmholtzzentrum für Schwerionenforschung in Darmstadt, Germany. The fusion-evaporation reactions ^{48}Ca+^{242}Pu and ^{48}Ca+^{244}Pu provided a total of 32 flerovium-candidate decay chains, of which two and eleven were firmly assigned to ^{286}Fl and ^{288}Fl, respectively. A prompt coincidence between a 9.60(1)-MeV α particle event and a 0.36(1)-MeV conversion electron marked the first observation of an excited state in an even-even isotope of the heaviest man-made elements, namely ^{282}Cn. Spectroscopy of ^{288}Fl decay chains fixed Q_{α}=10.06(1)  MeV. In one case, a Q_{α}=9.46(1)-MeV decay from ^{284}Cn into ^{280}Ds was observed, with ^{280}Ds fissioning after only 518  μs. The impact of these findings, aggregated with existing data on decay chains of ^{286,288}Fl, on the size of an anticipated shell gap at proton number Z=114 is discussed in light of predictions from two beyond-mean-field calculations, which take into account triaxial deformation.

P1247 Bilateral endogenous endophthalmitis as the initial presentation of hacek prosthetic valve infective endocarditis

Summary

A 75 year old lady with a prosthetic aortic valve (St Jude mechanical AVR) presented to ophthalmology with a one month history of black spots in the vision of her left eye with a further episode in her right eye two weeks later, leading to a diagnosis of bilateral endogenous endopthalmitis and was admitted to hospital. There was no history of trauma and the chest and abdominal examination was normal. The erythrocyte sedimentation rate (40) and C reactive protein (45.8) were elevated. She had several sets of blood cultures, which were positive for Aggregatibacter actinomycetemcomitans, a HACEK organism and was started on empirical Ceftriaxone. The transthoracic echocardiography was normal. However, the suspicion of Infective Endocarditis (IE) was high, therefore a transoesophageal echocardiography was performed and showed an aortic root abscess (Image 1). An urgent computerised aortogram was performed. Following a planned two week period of intravenous antibiotics the patient was taken to theatre to have a redo AV valve replacement and root repair. Following a prolonged period on intensive care and a six week course of pathogen directed antibiotic therapy she was then fit enough to be discharged.

Conclusion

We present the first case in the literature of a HACEK Prosthetic Valve endocarditis presenting with bilateral endogenous endophthalmitis.

Abstract P1247 Figure. TOE image of Absess

CD56(bright) natural killer cells and response to daclizumab HYP in relapsing-remitting MS

Objective:

To assess the relationship between CD56^bright natural killer (NK) cells and multiple sclerosis (MS) disease activity in patients with relapsing-remitting MS treated with daclizumab high-yield process (DAC HYP).

Methods:

Data were from patients enrolled in a 52-week randomized, double-blind, placebo-controlled study of DAC HYP and its extension study. Assessments included relationships of CD56^bright NK cell numbers (identified using fluorescence-activated cell sorting) at weeks 4 and 8 with the numbers of new or newly enlarging T2-hyperintense lesions between weeks 24 and 52 and the annualized relapse rate.

Results:

In DAC HYP–treated patients but not placebo-treated patients, the numbers of CD56^bright NK cells increased over 52 weeks of treatment, and their numbers at weeks 4 and 8 predicted the number of new or newly enlarging T2-hyperintense lesions between weeks 24 and 52 of treatment (p ≤ 0.005 for each comparison). Similar but nonsignificant trends were observed between CD56^bright NK cell counts and the annualized relapse rate in DAC HYP–treated patients. DAC HYP–treated patients who showed lower levels of expansion of CD56^bright NK cells still developed fewer new or newly enlarging T2-hyperintense lesions than placebo-treated patients during the first year of treatment.

Conclusions:

CD56^bright NK cells appear to mediate some of the treatment-related effects of DAC HYP, but their numbers do not account for the full effect of DAC HYP on MS-related outcomes.

Shell-structure and pairing interaction in superheavy nuclei: rotational properties of the z=104 nucleus (256)rf

The rotational band structure of the Z=104 nucleus (256)Rf has been observed up to a tentative spin of 20ℏ using state-of-the-art γ-ray spectroscopic techniques. This represents the first such measurement in a superheavy nucleus whose stability is entirely derived from the shell-correction energy. The observed rotational properties are compared to those of neighboring nuclei and it is shown that the kinematic and dynamic moments of inertia are sensitive to the underlying single-particle shell structure and the specific location of high-j orbitals. The moments of inertia therefore provide a sensitive test of shell structure and pairing in superheavy nuclei which is essential to ensure the validity of contemporary nuclear models in this mass region. The data obtained show that there is no deformed shell gap at Z=104, which is predicted in a number of current self-consistent mean-field models.

Production and decay of element 114: high cross sections and the new nucleus 277Hs

The fusion-evaporation reaction 244Pu(48Ca,3-4n){288,289}114 was studied at the new gas-filled recoil separator TASCA. Thirteen correlated decay chains were observed and assigned to the production and decay of {288,289}114. At a compound nucleus excitation energy of E{*}=39.8-43.9  MeV, the 4n evaporation channel cross section was 9.8{-3.1}{+3.9}  pb. At E^{*}=36.1-39.5  MeV, that of the 3n evaporation channel was 8.0{-4.5}{+7.4}  pb. In one of the 3n evaporation channel decay chains, a previously unobserved α branch in 281Ds was observed (probability to be of random origin from background: 0.1%). This α decay populated the new nucleus 277Hs, which decayed by spontaneous fission after a lifetime of 4.5 ms.

Gamma-ray spectroscopy at the limits: first observation of rotational bands in 255Lr

The rotational band structure of 255Lr has been investigated using advanced in-beam gamma-ray spectroscopic techniques. To date, 255Lr is the heaviest nucleus to be studied in this manner. One rotational band has been unambiguously observed and strong evidence for a second rotational structure was found. The structures are tentatively assigned to be based on the 1/2-[521] and 7/2-[514] Nilsson states, consistent with assignments from recently obtained alpha decay data. The experimental rotational band dynamic moment of inertia is used to test self-consistent mean-field calculations using the Skyrme SLy4 interaction and a density-dependent pairing force.

Surgical risks and outcome of pancreas retransplants

BACKGROUND

The increased popularity of pancreas transplants has led to an increased number of potential candidates for retransplants after the initial graft has been lost to technical failure or rejection. We studied a group of recipients who underwent pancreas transplants at a single center to determine whether retransplant recipients were at higher risk of complications.

METHODS

Between June 1, 1994, and Dec 31, 1997, a total of 213 pancreas transplants were performed at the University of Minnesota. Of these, 187 were primary transplants and 26 were retransplants. Demographically, the two groups were not significantly different. We analyzed and compared the two groups with respect to incidence of surgical complications, graft survival rates, and patient survival rates.

RESULTS

Surgical complications such as bleeding and vascular thrombosis were slightly more common after retransplants, but this trend did not quite reach statistical significance. Infectious complications and leaks were equivalent between the two groups. The incidence of acute rejection was higher after retransplants (P =.02). At 3 years posttransplant, patient survival was no different between the two groups, but pancreas graft survival was lower after retransplants (P =.08). The incidence of early graft loss (by 6 months posttransplant) was significantly higher in retransplant recipients (27% vs 14%, P =.04).

CONCLUSIONS

Pancreas retransplants can be performed with a minimal increase in surgical complications. However, graft survival after retransplants is slightly inferior to that after primary transplants, probably for both immunologic and nonimmunologic reasons. Retransplants can be offered to suitable candidates, but they may require more aggressive monitoring for rejection.

Prolonged preservation increases surgical complications after pancreas transplants

BACKGROUND

Prolonged preservation of the donor organ may result in delayed graft function or nonfunction after most organ transplants. We studied whether or not prolonged preservation increases surgical complications after pancreas transplants.

METHODS

Between January 1, 1994, and September 30, 1998, a total of 294 recipients underwent cadaver pancreas transplants at our institution. Recipients were analyzed in 2 groups: those with pancreas preservation time < or = 20 hours (n = 211) versus > 20 hours (n = 83).

RESULTS

Demographic data were similar between the 2 groups, except that mean donor age in the prolonged preservation group was significantly lower. Despite use of younger donors, prolonged preservation was associated with an increased incidence of surgical complications, most notably leaks, thrombosis, and wound infections. Grafts with prolonged preservation were more often noted by the transplant surgeon to be edematous after reperfusion, although the incidence of hyperamylasemia posttransplant did not differ between the 2 groups. Graft and patient survival rates also did not differ between the 2 groups. The incidence of early graft loss (< 3 months) was, however, higher in the prolonged preservation group (20.5% versus 9.0%, P = .04).

CONCLUSIONS

Prolonged preservation of the donor organ increases the incidence of surgical complications after pancreas transplants. All attempts should be made to minimize preservation time, keeping it below 20 hours, if possible.

A panel of CAb antibodies recognize endogenous and ectopically expressed ING1 protein

Nine monoclonal antibodies (MAbs) against human and rodent ING1 protein have been generated using an IL6-secreting mouse myeloma line. These antibodies are all effective in recognizing ING1 protein in ELISAs, Western blot assays, and by indirect immunofluorescence. Combining different CAb monoclonal antibodies in a Western blot assay also allows detection of the very low levels of endogenous ING1 found in fibroblast cells in culture and the identification of at least two isoforms of ING1 in normal human diploid fibroblasts and established brain cancer cell lines.

Steroid withdrawal in pancreas transplant recipients

BACKGROUND

Numerous studies of steroid withdrawal have been carried out in kidney and liver transplant recipients, but only a few in pancreas transplant recipients. Yet, pancreas transplant recipients could have significant long-term benefits from steroid withdrawal.

METHODS

We performed a retrospective analysis to determine the feasibility of steroid withdrawal in pancreas transplant recipients.

RESULTS

Of 360 recipients who underwent a pancreas transplant between January 1, 1994 and June 30, 1998, 14 attempted steroid withdrawal (12 simultaneous pancreas-kidney [SPK]; 2 pancreas transplant alone [PTA]). Reasons for steroid withdrawal were bone fractures (n = 3), psychiatric disorders (n = 2), severe acne (n = 1), recurrent infections (n = 4), and problems with hypercholesterolemia or hypertension (n = 4). All 14 were maintained on tacrolimus and mycophenolate mofetil (MMF) immunosuppression, except for 1 who was on tacrolimus and azathioprine (AZA). Of the 14 recipients, 11 had no episodes of acute rejection before steroid withdrawal. The remaining 3 had one or more acute rejection episodes. Of the 14 recipients, 10 (72%) currently remain off steroids (mean follow-up 18 months, range 5-51 months). However, 4 recipients have resumed steroids: 2 after an acute rejection episode (at 2 and 21 months post-withdrawal) and 2 because of leukopenia (WBC < 3000) and an inability to tolerate full-dose MMF. Steroid withdrawal was unsuccessful in both PTA recipients and in 2 of the 12 SPK recipients. All 14 recipients currently have a functioning pancreas graft. However, 1 of the SPK recipients, in whom steroid withdrawal failed, has developed chronic kidney rejection and is now back on hemodialysis awaiting a retransplant.

CONCLUSION

Steroid withdrawal is possible in up to 70% of pancreas transplant recipients. Further studies are necessary to define ideal candidates for steroid withdrawal. Based on the results of this analysis, we have launched a prospective, randomized trial of steroid withdrawal in pancreas transplant recipients.

Hospital food hygiene: the application of Hazard Analysis Critical Control Points to conventional hospital catering

The Hazard Analysis Critical Control Point (HACCP) concept is a preventive approach to quality control. It is based on a logical, structured exploration of potential hazard points in a food operation and the introduction of control and monitoring measures. HACCP studies have been extensively applied to manufacturing systems. It has been difficult to extend this detailed systematic analysis to conventional catering, partly due to the wide range of foods being processed. We describe here the application of HACCP methods to a hospital department that uses conventional catering methods. Basic principles, based on the work flow and the range of products are established. The guidelines produced can be applied to any kitchen using similar catering methods. Examples of log charts used for monitoring are provided.

The distribution of perforin in normal tissues

We describe the production of monoclonal antibodies to murine and human forms of the lymphocyte pore-forming protein (perforin, PFP, or cytolysin), a major granule-localized cytolytic mediator of CTL and NK cells. Antibodies were raised against both murine perforin purified from a CTL line, and human perforin expressed in bacteria as a fusion protein with the Escherichia coli TrpE protein. Antibodies raised against either immunogen inhibited the hemolytic activity of murine perforin, and thus may enable us to identify the pore-forming or self-associative domain of perforin. One mAb, MP1, was used to study the distribution of perforin in murine tissues under physiological conditions. We found that perforin was expressed in the granular metrial gland (GMG) cells of the pregnant murine uterus, but not in other tissues examined. These results further support the view that perforin is induced only in activated cytolytic lymphocytes, and raise the question whether perforin-containing GMG cells represent an effector of a maternal immune response to the fetus.