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Fast transitions between different types of power density spectra (PDS) happening over time-scales of several tens of seconds are rare phenomena in black hole X-ray binaries. In this paper, we report a broad-band spectral-timing analysis of the fast transitions observed in the 2021 outburst of GX 339−4 using NICER and Insight-HXMT observations. We observe transitions between band-limited noise-dominated PDS and type-B quasi-periodic oscillations (QPOs), and their rapid appearance or disappearance. We also make a detailed comparison between the fast transitions in GX 339−4 with those seen in MAXI J1820+070 and MAXI J1348−630. By comparing the spectra of the periods with and without type-B QPOs, we find that the spectral ratios above 10 keV are nearly constant or slightly decreasing, and the values are different between sources. Below 10 keV, the flux change of the Comptonization component is inversely proportional to the flux change of the thermal component, suggesting that the appearance of type-B QPOs is associated with a redistribution of the accretion power between the disc and the Comptonizing emission region. The spectral ratios between the periods with type-B QPO and those with broad-band noise are significantly different from that with type-B QPO and without type-B QPO, where the ratios (type-B QPO/broad-band noise) show a maximum at around 4 keV and then decrease gradually towards high energies. Finally, we discuss the possible change of the geometry of the inner accretion flow and/or jet during the transitions.

Here we present a detailed study of the broadband noise in the power density spectra of the black hole X-ray binary MAXI J1820+070 during the hard state of its 2018 outburst, using Hard X-ray Modulation Telescope observations. The broadband noise shows two main humps, which might separately correspond to variability from a variable disk and two Comptonization regions. We fitted the two humps with multiple Lorentzian functions and studied the energy-dependent properties of each component up to 90–150 keV and their evolution with spectral changes. The lowest-frequency component is considered as the subharmonic of the quasiperiodic oscillation component and shows a different energy dependence compared with other broadband noise components. We found that although the fractional rms of all the broadband noise components mainly decreases with the energy, their rms spectra are different in shape. Above ∼20–30 keV, the characteristic frequencies of these components increase sharply with the energy, meaning that the high-energy component is more variable on short timescales. Our results suggest that the hot inner flow in MAXI J1820+070 is likely to be inhomogeneous. We propose a geometry with a truncated accretion disk and two Comptonization regions.

In this study, a sustainable water resources management (WRM) model with scenario-based mixed fuzzy-stochastic method with Green Z-score criterion method (SFGZ) is developed for coordinatin...

To elucidate whether miRNA-27a-3p can promote osteogenic differentiation of hMSCs by targeting ATF3, thus alleviating osteoporosis symptoms.The serum levels of miRNA-27a-3p in osteoporosis patients (n=20) and normal controls (n=20) were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Human bone marrow mesenchymal stem cells (hMSCs) were subjected to osteogenic differentiation for 1, 3 and 7 days. Subsequently, mRNA levels of miRNA-27a-3p, ALP, and Bglap in hMSCs were determined by qRT-PCR. The regulatory effects of miRNA-27a-3p levels and the mRNA levels of ALP, Bglap, and Runx2 were detected. After the overexpression or knockdown of miRNA-27a-3p, we evaluated the changes in the osteogenic differentiation by alizarin red staining and ALP staining. Through Dual-Luciferase Reporter Gene Assay, we verified the binding relationship between miRNA-27a-3p and ATF3. Rescue experiments were finally conducted to prove whether miRNA-27a-3p regulated the osteogenic differentiation by targeting ATF3.The serum level of miRNA-27a-3p remained lower in osteoporosis patients relative to controls. With the prolongation of osteogenic differentiation, the mRNA levels of miRNA-27a-3p, ALP, and Bglap gradually increased. The overexpression of miRNA-27a-3p upregulated mRNA and the protein levels of osteogenesis-related genes, increased ALP activity, and enhanced mineralization capacity. The knockdown of miRNA-27a-3p obtained the opposite trends. MiRNA-27a-3p could target ATF3, and the overexpression of ATF3 reversed the promotive effects of miRNA-27a-3p on osteogenic differentiation.MiRNA-27a-3p promotes the differentiation of hMSCs into osteoblasts by targeting ATF3, thus alleviating osteoporosis symptoms.

The thermal conductivity of a representative endothermic hydrocarbon aviation kerosene fuel RP-3 was accurately measured using the classical transient hot-wire method at sub- and supercritical pressures. The measured data cover a temperature range of 285 K to 513 K and a pressure range of 0.1 MPa to 5 MPa. The expanded uncertainty of the experiment was less than 3.0 % based on an uncertainty analysis. Furthermore, the measured data were correlated using a polynomial equation to analyze the deviations; 97.6 % of the measured data were within a 2 % error band. The average absolute deviation (AAD) and maximum absolute deviation (MAD) of the fitted thermal-conductivity data were 0.209 % and 2.31 % for all values, respectively.

The first-principles ultra-soft pseudopotential plane wave based on density functional theory is used to calculate the electronic structure and photoelectric properties of zinc blende GaN and zinc blende In x Ga1- x N with different In doping concentrations (x=0, 0.125, 0.25, 0.375, 0.5). It is shown that zinc blende GaN and its In-doped system are all direct bandgap semiconductor materials. With the increase of In doping concentration, the lattice constant of InxGa1-xN increases and the band gap decreases, the absorption spectrum shift to the red region. Therefore, it can be inferred that by adjusting the doping concentration of In, the light absorption range of In x Ga1- x N can cover the entire solar spectrum, which means that InxGa1-xN can be worthy to fabricate photovoltaic devices such as full-spectrum solar cells.

Guided by simulations using SIMION 8.1, a series of modifications were made to an experimental version of an Isobar Separator for Anions (ISA). The resulting improved version of the ISA provides a means of re-energizing the ions after they are cooled by gas collisions as they pass through the gas-filled radiofrequency quadrupoles (RFQ), and also provides higher transmission efficiencies. Reinvestigation of the separation of CaF3− and KF3− with this refined apparatus resulted in a better balance between isobar suppression and analyte transmission. KF3− was attenuated at eV energies by 4 orders of magnitude while 40% transmission of CaF3− was retained, for a 20keV CaF3− beam of Φ2mm and ±12mr. These results advance the possibility of an efficient small ISA-AMS system for both cosmogenic and medical applications of 41Ca.

The pillared derivatives from δ-layered sodium disilicate were investigated by intercalation of bisoctyl dimethyl ammonium chloride and dioctadecyl dimethyl ammonium chloride. The influence of various parameters such as water content, pH of the mixture, and time were examined. The resultant samples were characterized by X-ray powder diffraction, Fourier transform infrared, and thermal gravimetric observation. The experimental results showed that δ-layered sodium disilicate was first transformed to kanemite (NaHSi2O4(OH)2 · 2H2O), and subsequently kanemite was pillared with bisoctyl dimethyl ammonium chloride or dioctadecyl dimethyl ammonium chloride. The tribological properties of typical samples then were investigated by point contact test. The results show that the pillared derivatives have good load-carrying capacity and friction-reducing property.

Objective: Chromosome segregation during mitosis requires a physically large proteinaceous structure called the kinetochore to generate attachments between chromosomal DNA and spindle microtubules. It is essential for kinetochore components to be carefully regulated to guarantee successful cell division. Depletion, mutation or dysregulation of kinetochore proteins results in mitotic arrest and/or cell death. HEC1 (high expression in cancer) has been reported to be a kinetochore protein, depletion of which, by RNA interference, results in catastrophic mitotic exit. Materials and methods and results: To investigate how HEC1 protein is controlled post-translation, we analysed the role of anaphase-promoting complex/cyclosome (APC/C)-Cdh1 in degradation of HEC1 protein. In this study, we show that HEC1 is an unstable protein and can be targeted by endogenous ubiquitin-proteasome system in HEK293T cells. Results of RNA interference and in vivo ubiquitination assay indicated that HEC1 could be ubiquitinated and degraded by APC/C-hCdh1 E3 ligase. The evolutionally conserved D-box at the C-terminus functioned as the degron of HEC1, destruction of which resulted in resistance to degradation mediated by APC/C-Cdh1. Overexpression of non-degradable HEC1 (D-box destroyed) induced accumulation of cyclin B protein in vivo and triggered mitotic arrest. Conclusion: APC/C-Cdh1 controls stability of HEC1, ensuring normal cell cycle progression.

This paper investigated the interaction of α-Na2Si2O5 and β-μNa2Si2O5 with surfactants sodium dodecylbenzene sulfonate (LAS), sodium lauryl sulfate (K12), alkyl polyglycol ether-9 (AEO-9) and α-olefin hydrocarbon sulfonate (AOS) under condition approximating the detergent spray drying process. The interaction samples were characterized by XRD and TG. The experimental results showed that α-Na2Si2O5 and β-Na2Si2O5 sustained their phases after interacted with surfactants. The relative crystallinity of α-Na2Si2O5 had little change after interacting with surfactants exception of AOS because it had better adsorbable effect on the surface of α-Na2Si2O5 than LAS, K12 and AEO-9. At the same conditions, the amount of H2O and surfactants were both important factors on the relative crystallinity of β-μNa2Si2O5. It also was proved that the temperature had little influence on the relative crystallinity of both α-Na2Si2O5 and β-Na2Si2O5. Compared with Al-δ-Na2Si2O5, α-Na2Si2O5 and β-μNa2Si2O5 were more stable than Al-δ-Na2Si2O5 after interacted with surfactants.

Thermodynamic and kinetic analysis was performed in order to study the interfacial reaction mechanism of cubic boron nitride (CBN) abrasive grains and Ti activated Ag–Cu filler alloy during high temperature brazing. Meanwhile, microstructure of the interfacial layer was experimentally detected using scanning electron microscope (SEM), energy dispersion spectrometer (EDS) and X-ray diffraction (XRD) in the present paper. The results indicate that according to the thermodynamic theory, the interfacial reaction has been proved feasible, and during brazing the special active element Ti concentrated to and reacted with the CBN abrasive to form TiB2 and TiN, which joined hard the abrasive grain and steel substrate. Furthermore, the diffusion activation energy of the growing process in the interfacial reaction layer has discovered that the layer growth largely depends on the new formed TiN under conditions of 1153–1193 K and 5–30 min.

Cubic AlN (c-AlN) films were deposited on MgO (100) substrates by laser molecular beam epitaxy (LMBE) technique. The crystal structure and surface morphology of deposited films with various laser pulse energy and substrate temperature were investigated. The results indicate that c-AlN films exhibit the (200) preferred orientation, showing a good epitaxial relationship with the substrate. The surface roughness of c-AlN films increases when the laser pulse energy and substrate temperature increase. The film grown at laser pulse energy of 150 mJ and substrate temperature of 700 °C shows the best crystalline quality and relatively smooth surface.

This paper summarizes our studies on transport and biodegradation of azo dyes in aerobic biofilms. Three lab-scale rotating drum biofilm reactors (RDBRs) were used to culture the biofilms. synthetic, municipal-type wastewater, spiked with several azo dyes, was continuously fed into the RDBRs. The study has revealed that Acid Orange 7 (AO7) and Acid Orange 8 (AO8) can be degraded aerobically in an efficient and effective manner under properly controlled operating conditions. The other dyes tested, however, are essentially non-degradable in an aerobic reactor. Microelectrodes and a microslicing technique have been used to elucidate changes in the structure of biofilms with depth and to determine the influence of these changes on mass transport and transformation processes. The results show that biofilms are non-homogeneous and highly stratified. Accordingly, biofilm is usually characterized by aerobic and anaerobic zones, with the anaerobic part used to break the azo bond and the aerobic surface layer to achieve the mineralization of anaerobically recalcitrant intermediates. Results concerning the inhibition effect of azo dyes on biofilm COD removal and respiration rate are also presented in this paper.

Direct measurement of unsteady-state variation of oxygen concentrations inside deactivated biofilm at intervals of 100 μm was conducted with oxygen microelectrodes. The diffusivity of each layer was estimated using an explicit finite-difference method. The results show that the distribution of the biofilm effective oxygen diffusivity varies from 25% Dw at the substratum of the biofilm to 90% Dw at the surface of the biofilm. This information provides experimental evidence necessary for biofilm modelling that could not be approached in the past, and will create a new dimension for evaluation of biofilm processes.

Competitions in biofilms for substrate and space have been studied by using a microelectrode technique and a microslicing technique. Three different kinds of biofilms, cultured by laboratory-scale rotating drum biofilm reactors (RDBR) with synthetic wastewater, have been used as test materials. Oxygen, ammonium-nitrogen, nitrate-nitrogen, and pH concentration profiles in the biofilms were measured using microelectrodes. Experimental results showed that: 1) an increase of organic loading rate would result in a decrease of DO concentration in the biofilm. However, after the organic loading rate exceeded a certain value, the oxygen profiles within the biofilm did not change any more; 2) Heterotrophs competed for oxygen with nitrifiers, which resulted in the inhibition of nitrification because of the shortage of oxygen. Glucose itself, however, did not inhibit the nitrification processes; and 3) The competition for substrate in biofilms resulted in a stratified biofilm structure. Experiments showed that competition in biofilms resulted in non-uniform spatial distributions of bacterial populations and metabolically active bacteria. The spatial distributions of biotic and abiotic components in turn affected the substrate transfer and substrate competition within the biofilm. Traditional biofilm modelling will fail in many cases if they are based on substrate removal kinetics and uniform distributions of biofilm properties.

An inhibition study showed that toxic compounds caused two responses when present at low concentration. One is stimulation of the biomass by simply serving as an energy source; this caused an increase in the total respiration rate. The other is inhibition of the reaction. AR14 was more toxic than AO7 for biofilm from reactors fed with a primary substrate. However, AO7 demonstrated inhibition for biofilm from reactors fed with AR14 and primary substrate, and AR14 could serve as a carbon source for the same film.

Resveratrol, a phytopolyphenol compound found chiefly in grapes and wine, has been reported to have a variety of anti-inflammatory, anti-platelet, and anti-carcinogenic effects. However, little is known about the effects of resveratrol on ovarian development and oocyte apoptosis. We investigated the effects of resveratrol on ovarian development in rats with different ages [from post-natal day (PD) 1 to 15 months], as well as on oocyte apoptosis in PD1 and PD2 rat ovaries. We show that: a) ip injection of resveratrol (20 mg/kg/day) increased the percentage of unassembled follicles and the total number of oocytes in PD1 and PD2 rat ovaries. Similar results were obtained when mothers were treated with resveratrol (20 mg/kg/day) by intragastric administration from day 11, after the detection of vaginal plug, until delivery. In PD4 rat ovaries, the total number of oocytes was significantly increased in the groups treated with resveratrol. Moreover, more unassembled follicles and fewer primary follicles were present in the groups treated with resveratrol than in the controls; b) in 15-month-old rat ovaries, resveratrol increased the number of resting follicles and total oocytes, and decreased the number of developing follicles and atretic follicles; 3) the percentage of TUNEL-positive oocytes decreased in PD1 and PD2 rat ovaries after resveratrol treatment, and the number of oocytes positive for Foxo3a, Bim, and p27KIP1 in PD2 rat ovaries was lower in the resveratrol treatment group than in controls. These results suggest that resveratrol may delay oocyte nest breakdown and inhibit both the primordial-to-developing-follicle transition and apoptosis by decreasing the activation of Foxo3a, Bim, and p27KIP1, thus augmenting the resting follicle reserves, maintaining regular estrous cycles of early aged rats and delaying climacterium.

Objective: Chromosome segregation during mitosis requires a physically large proteinaceous structure called the kinetochore to generate attachments between chromosomal DNA and spindle microtubules. It is essential for kinetochore components to be carefully regulated to guarantee successful cell division. Depletion, mutation or dysregulation of kinetochore proteins results in mitotic arrest and/or cell death. HEC1 (high expression in cancer) has been reported to be a kinetochore protein, depletion of which, by RNA interference, results in catastrophic mitotic exit. Materials and methods and results: To investigate how HEC1 protein is controlled post‐translation, we analysed the role of anaphase‐promoting complex/cyclosome (APC/C)‐Cdh1 in degradation of HEC1 protein. In this study, we show that HEC1 is an unstable protein and can be targeted by endogenous ubiquitin‐proteasome system in HEK293T cells. Results of RNA interference and in vivo ubiquitination assay indicated that HEC1 could be ubiquitinated and degraded by APC/C‐hCdh1 E3 ligase. The evolutionally conserved D‐box at the C‐terminus functioned as the degron of HEC1, destruction of which resulted in resistance to degradation mediated by APC/C‐Cdh1. Overexpression of non‐degradable HEC1 (D‐box destroyed) induced accumulation of cyclin B protein in vivo and triggered mitotic arrest. Conclusion: APC/C‐Cdh1 controls stability of HEC1, ensuring normal cell cycle progression.

In tension lap splices, the benefit provided to the lap by stirrups placed to intercept longitudinal cracking due to bond splitting action is recognized by the American Concrete Institute code (ACI 318-89) and the design recommendations of ACI Committee 408, on which the American code provisions are partially based. However, a limit exists on the benefit that can be derived from this confinement. In Canada, Canadian Standards Association Standard CAN3 A23.3 M-84 does not directly recognize the confinement benefit provided by stirrups placed along a lap splice. The current study shows that the ACI limit of 1 bar diameter of equivalent concrete cover provided by the transverse reinforcement confinement is too restrictive under static loading. When the concrete cover is small, much larger transverse reinforcement confinement, up to 2-2.5 bar diameters of equivalent concrete cover, can be utilized, in lieu of requiring very long lap lengths. The tests also show that total confinement (actual concrete confinement plus equivalent concrete confinement provided by stirrups) is effective beyond the current limit of 3 main bar diameters, when stirrups are provided. Good performance was found with confinements of 4-4.5 bar diameters, and correspondingly shorter lap splice lengths. Key words: concrete, reinforcement, lap splices, beams, confinement, stirrups, tension, static loading.

Hydration reactions in the dioctadecyldimethylammonium chloride (DODMAC)-water system display an extremely wide dynamic range (about 10 8 over a 15 o C temperature span) and occur by a one-step process. The rate of hydration is usually determined by the kinetics of diffusion of water through a surface layer of the hydration product phase, but hydration of the dry crystal X is anomalously fast. Hydration of the monohydrate crystal X-W is accelerated by heating this phase for a short time to just above its peritectoid temperature, but the hydration product is a metastable crystal phase X-2Wm

In the present paper, a detailed analysis is given for the study of antihydrogen formation inP +Ps collisions in the presence of a purely monochromatic, linearly polarized laser field. The dressing effects are considered by the treatment of the dipole approximation and the perturbation approach up to first order. The angular distributions have been calculated for a few typical cases. It is shown that laser fields can produce significant modifications on the angular distributions.

Le diagramme d'equilibre de phases du systeme eau-chlorure de dioctadecyldimethylammonium est determine a 80 o C

Background: Epidemics of enterovirus 71 infection have caused the death of many children throughout the world. Rhombencephalitis, brain stem encephalitis, and heart failure were present in all of the fatal cases. However, no evidence of myocarditis was noted in the heart specimens, and the mechanism of heart failure remains unknown. Aims: To characterise the presentation of cardiac complications in children with enterovirus rhombencephalitis and discuss its pathogenesis. Methods: Ninety one consecutive patients with enterovirus rhombencephalitis underwent echocardiography. Of these, 17 patients (nine male, eight female; median age 14 months, range 4–57 months) with left ventricular dysfunction were studied. Results: Tachycardia was noted in all patients and systemic hypertension in 12. Muscle-brain fraction of creatine kinase was >5% in 14 patients. Plasma norepinephrine and epinephrine levels were significantly raised in the three patients in whom these were analysed. Electrocardiographic abnormalities were noted in eight patients. Pulmonary oedema was complicated in 15 patients. The initial ejection fraction of the left ventricle was 22–58% (mean 37%, SD 11%). All patients deteriorated to hypotensive shock within 12 hours and 13 died. Heart specimens from seven patients showed no evidence of myocarditis, but significant coagulative myocytolysis, myofibrillar degeneration, and cardiomyocyte apoptosis were observed. Conclusions: Acute heart failure was noted in 19% of patients with enterovirus rhombencephalitis, which had a fatality rate of 77%. It was not caused by myocarditis but possibly by neurogenic cardiac damage.

A rare case of spontaneous femoral neck fracture complicating a healed subtrochanteric fracture was encountered in an 85-year-old female. The subtrochanteric fracture was caused by a minor trauma with no other combined injury. Patient received close reduction and internal fixation two days later and the fracture healed in three months. Six months after operation, spontaneous ispilateral femoral neck fracture occurred without trauma. Although there were some reports about subcapital fracture or femur neck fracture complication after operation, this is the first case of spontaneous femoral neck fracture after healed subtrochanteric fracture which was treated with a 95 degrees dynamic condylar screw (DCS) and side plate previously without technical error.

Kawasaki disease is a common acquired heart disease in children. Only a few reports have been published concerning Kawasaki disease in infants. This study was performed to assess the clinical spectrum of Kawasaki disease in infants.Between January 1989 and December 1998, a total of 48 consecutive Kawasaki patients less than one year of age were enrolled and studied retrospectively. Coronary artery dilation was defined as the internal diameter of a coronary artery larger than 3 mm. All cases received 2 gm/Kg of intravenous immunoglobulin. We divided the patients into two groups; group I; coronary artery dilation (+) and group II; coronary artery dilation (-), and compared the clinical and laboratory data.Of 273 patients with Kawasaki disease, 48 (17.5%) were less than one year of age. Among these patients (1 year old), the median age was 7.8 +/- 2.8 months (range 2 months to 12 months), and the male to female ratio was 1.52:1. The incidence of atypical Kawasaki disease was 31.2% (compared with an incidence of atypical Kawasaki disease among patient more than one year of age of 7.5%; p0.001), and that of coronary artery dilation was 35.4%. Clinical manifestations included fever 100%, extremity change 91.6%, skin rash 89.6%, conjunctivitis 89.6%, oral mucosa change 89.6%, and cervical lymphadenopathy 0%. Laboratory data revealed white blood cell count: 15,403 +/- 6,282/mm3, hemoglobin: 10.1 +/- 1.0 gm/dl, neutrophil: 59.2 +/- 13.7%, lymphocytes: 30.6 +/- 13.1%, platelet count: 456,3000 +/- 216,4000/mm3, and C-reactive protein 8.2 +/- 5.6 mg/dl. Patients with coronary artery dilation had a longer duration of diagnosis, higher incidence of atypical presentation, lower incidence of conjunctivitis, lower incidence of skin rash, lower incidence of extremity change, and lower C-reactive protein. The predictive value of coronary artery dilation based on the combination of atypical presentation, duration of diagnosis, and C-reactive protein was 81.2%.Kawasaki disease in infants is associated with a high incidence of atypical presentation and increased risk of coronary artery dilation. We suggest that in an infant with insufficient diagnostic criteria for Kawasaki disease, care should be taken to avoid missing atypical Kawasaki disease. Echocardiography is an important tool for diagnosis of atypical Kawasaki disease.

A rare case of acute open dorsal perilunate dislocation of the left hand was encountered in a 30-year-old man with exposure of the lunate and distal radius. No other combined injury was identified except open dislocation and chip avulsion fracture of triquetrum. Open reduction was performed through a dorsal approach after debridement. Such a severe injury, to our knowledge, has not been reported previously.

The authors reported a patient with abductor pollicis brevis muscle fibrosis of the right thumb, stemming from a bowling injury that had occurred 6 years previously. At that time in the acute stage, a Chinese bonesetter treated the injury using manipulation, massage and herbal drugs. Abduction contracture of the patient's right thumb developed. She began to experience chronic pain at dorsal side of her right thumb and discovered that she could not move her thumb into a retro position. When she came into our hospital, physical examination revealed an abduction contracture of patient's right thumb, the angle of separation was 60 degrees, and the angle of circumduction was fixed at 90 degrees. In addition, a fibrotic band was palpable in abductor pollicis brevis muscle. The patient responded well to percutaneous release and physical therapy. As far as we know, this is an unusual case, which has not been reported before.

Congenital complete heart blocks (CCHB) are mostly related to the neonatal lupus syndrome. The purpose of this paper was to assess the clinical spectrum of CCHB in our hospital. Nine patients were retrospectively enrolled between 1994 and 1999. The birth history, electrocardiography, 24-hour Holter monitoring, pacemaker insertion and its complications, maternal disease, and maternal and infant autoantibody levels were studied. All nine cases were diagnosed prenatally. Hydrops fetalis was noted in five (55.6%). Six cases were live births and the other three were terminated. No anatomical heart defects were noted. Initial electrocardiography revealed the atrial rates ranged from 150 to 166 beats per minute. The minimal ventricular rates ranged from 46 to 80 beats per minute. VVI mode pacemakers were inserted through xyphoid approach in all live-birth infants. Complications were noted in three of them (50%). Antinuclear antibody and anti-SSA/Ro antibody were positive in all 8 mothers (100%). The anti-SSB/La antibody was positive in 6 of the eight mothers (75%). Five infants tested positive for anti-SSA/Ro antibody. None of the infants tested positive for anti-SSB/La antibody. In conclusion, all CCHBs in our series were associated with maternal autoantibodies. Because of high complication rate of permanent pacemaker insertion during the neonatal period, it should be restricted in certain conditions.

Tetralogy of Fallot (TOF) with subpulmonary ventricular septal defects (VSD) is relatively more common among Orientals than among Occidentals. This study assessed the influence of type of VSD on surgical results in children with TOF.Fifty-one patients with TOF (age range, 14 months to 11 years, mean 40.7 months, median 30 months, 29 boys, 22 girls) who underwent total correction by a single surgeon between January 1992 and December 1995 were retrospectively studied. Of the 51 patients, 17 patients with subpulmonary VSD were classified as group I. The remaining 34 patients with perimembranous VSD were classified as group II. All patients underwent a combined transatrial and transpulmonary surgical approach. Early postoperative results were evaluated 7 to 10 days after surgery and late postoperative results were evaluated 1 year after surgery.There were no statistically significant differences between the two groups in age, sex, body weight, pulmonary to systemic flow ratio, pulmonary to aortic annulus diameter ratio or preceding palliative shunt or balloon pulmonary valvuloplasty. Nevertheless, group I patients had better oxygen saturation preoperatively (84.2 +/- 4.4% vs 80.3 +/- 7.6%, p = 0.037). During surgery, the transannular patch rate was higher in group I (100% vs 73.5%, p = 0.003). The cardiopulmonary bypass time, postoperative stay in the intensive care unit, duration of chest tube placement, early postoperative residual VSD rate, and early and late postoperative residual pulmonary stenosis rate were not significantly different between the groups. However, late postoperative residual VSD rate was 33.3% in group I and 6.45% in group II, which was statistically significant (p = 0.029). There were no significant differences in arrhythmia between the two groups.Patients with TOF with subpulmonary VSD had a better preoperative oxygenation, higher transannular patch rate during surgery and a higher incidence of late residual VSD than those with TOF with perimembranous VSD.

An outbreak of hand-foot-and-mouth disease caused by enterovirus infection occurred in Taiwan in 1998 and more than 70 infants and children with fulminant courses died. We compared the cardiac manifestations of fatal cases with patients who survived the enterovirus infection.A total 187 patients with enterovirus infection were treated at Taichung Veterans General Hospital between April and June 1998. Enterovirus infection was diagnosed by history, clinical features, polymerase chain reaction study and/or viral culture. Cardiac examinations including complete physical examinations, electrocardiography and echocardiography were performed on seven cases (group I) with or without central nervous system (CNS) involvement, 30 patients with CNS involvement (group II), and 150 patients without CNS involvement (group III).There were no significant differences in sex distribution, days of fever, heart rate, systemic blood pressure or time from the onset of symptoms to hospital admission among the three groups. All group I patients had features of acute congestive heart failure, pulmonary edema and neurologic signs except one who presented with right-sided heart failure and neurologic signs. The echocardiographic findings of group I were a lower fractional shortening, lower ejection fraction, and more severe and higher incidence of mitral regurgitation (p0.01) than in groups II and III, but there were no significant differences in end-systolic wall stress, left ventricular end-diastolic internal dimension and incidence of pericardial effusion among the three groups.We conclude that seven infants and children (group I) died due to either severe cardiomyopathy or encephalopathy. The possible pathogenesis of enterovirus infection leading to death is reviewed and analyzed.

Total dislocation of talus from all its surrounding joints (tibiotalar, subtalar and talonavicular) is an extremely rare injury. Because of its rarity, only few case reports can be found in the literature. In the review of the literature, infection and AVN are the most commonly encountered complications that affect the outcome of these severe injuries. Herein we report two cases of open total talar dislocation. Immediate debridement, reduction of the talus, and primary skin closure was done followed by cast immobilization. After more than 2 years follow up, neither infection nor AVN was found. We conclude that reimplantation of the talus is preferable if the wound is relatively clean. Talectomy, or combined with tibiocalcaneal fusion should be reserved for later salvage procedure.

The principal viruses implicated in pericarditis are enteroviruses. Cytomegalovirus pericarditis is quite rare and has been reported in immunocompromised patients with acquired immunodeficiency syndrome, malignant neoplasm or organ transplantation. We report a three-month-old male infant who suffered from cough and rhinorrhea for two weeks. He developed shortness of breath for three days, and fever for one day, prior to admission. Physical examination revealed tachycardia, tachypnea, pale conjunctiva, hepatomegaly, and a muffled heart sound without significant murmur. Chest radiography showed marked enlargement of the cardiac silhouette. Echocardiography demonstrated a large amount of pericardial effusion with impaired diastolic ventricular function. After pericardial drainage and supportive treatment, the fluid gradually disappeared. Viral culture of the pericardial fluid and serologic data confirmed a cytomegalovirus infection. Cytomegalovirus pericarditis should be included in the differential diagnosis of pericardial effusion in a young infant.

Ankle arthrodesis is still considered to be the standard treatment for most disabling types of ankle arthritis, but fusion methods are varied. We report our experience of ankle arthrodesis and compare a group of 34 cases treated by Blair's non-compression arthrodesis to another group of 32 cases treated by internal compression arthrodesis using two crossed screws. The same surgeon performed all the operations. The Blair's non-compression arthrodesis group included 21 males and 13 females with an average age of 42 y/o (range 18-70 y/o) and an average follow up period of 38.6 months (range 26-62 months). The union rate was 91.2% and the average union time was 5.6 months (range 2-10 months). There were three cases of non-union. The cross-screw compression arthrodesis group included 20 males and 12 females with an average age of 45 y/o (range 20-86 y/o) and an average follow up period of 38.3 months (range 15-81 months). The union rate was 96.9% and the average union time was 2.7 months (range 1.5-4.4 months). There was one case of non-union. We conclude that our cross-screws compression arthrodesis with its shorter fusion time was found to be superior to the Blair's non-compression arthrodesis.

Since its introduction, percutaneous transluminal coronary angioplasty has become an alternative therapeutic modality to surgical and medical treatment for renovascular hypertension. We report the case of a nine-year-old boy who had hypertension caused by renal arterial stenosis. The patient's high blood pressure was 164/100 mmHg, which was discovered incidentally during a physical check-up. A selective renal angiography showed a severe short-segment stenosis with post-stenotic dilatation of the left renal artery. A 4-mm balloon catheter was advanced through the stenotic area and was inflated five times to dilate the stenosis. After the procedure, the selective renal angiography showed a significant increase in the diameter of the left renal artery. Blood pressure decreased to normal immediately after the procedure. During the one-year follow-up period, the patient remained normotensive without the use of antihypertensive drugs.

Early treatment for the neonate with pulmonary atresia and intact ventricular septum (PA-IVS) is important if a high mortality rate is to be avoided. The treatment includes prostaglandin administration, balloon atrial septostomy, pulmonary valvotomy, a shunting procedure and patch repair for the right ventricular outflow tract (RVOT). This study discusses the early treatment and risk factors of this disease that are essential for assessing the risk of surgery and predicting outcome.The medical records, echocardiograms, catheterization data and cineangiograms of 29 patients with PA-IVS diagnosed at our institution from 1987 to 1997 were reviewed retrospectively. Clinical manifestations including age, body weight, sex ratio, type of surgery and outcome were analyzed.Three of four patients with a right ventricular volume of less than 1 ml died, and all patients with a right ventricular volume of greater than 2 ml survived. Four of six patients with a tricuspid valvular area of between 0.25 and 0.5 cm2 died, but patients with an area of greater than 0.5 cm2 survived. One case with a monopartite right ventricle died. Patients with a bipartite or tripartite right ventricle had higher survival rates than those with a monopartite right ventricle. Patients with a the right ventricle dependent coronary sinusoid had a higher risk for mortality, even after surgery, than those with normal coronary circulation.A small right ventricular volume, the presence of a coronary sinusoid involving the right ventricle, a short linear length of the tricuspid valve and a small area of the tricuspid valve were the risk factors associated with a negative outcome in neonates with PA-IVS.

We report a rare complication of pancarditis in an extreme premature neonate with a peripheral inserted central venous catheter which was positioned in the right atrium. She showed a picture of sepsis, pulmonary embolism, and heart failure. This case emphasizes the need for careful monitoring of the neonate with a central venous catheter to eliminate possible sequel. Echocardiography may help in making an early diagnosis of endocarditis in neonates.

Sixty-five ankle arthrograms of the patients who underwent surgical reconstruction for their chronic ankle instability from 1987 to 1995 were studied retrospectively by comparing their operative findings. There were 15 cases (23.1%) with definite positive arthrographic findings. In the remaining 50 cases (76.9%), the arthrograms showed a "tear-drop" extravasation of dye beneath the fibular tip which we called "suspectable positive". Of these all but one, which had normal ligament, proved to correspond to the operative finding. As there was only one false positive finding among our surgical cases with both the "definite" and "suspectable" positive arthrograms, we concluded that ankle arthrography is relatively reliable and may be worth doing even in chronic cases if only for reference. Even when other diagnostic methods are negative, arthrography might help surgeons make surgical decisions in clinical symptomatic cases.

Coronary artery fistula is rare, but it is the most common congenital coronary artery anomaly with hemodynamic significance. It usually causes no symptoms in young patients but may be associated with symptoms and complications in older patients. Surgery has been the traditional treatment. In this report, a 7-year-old girl who had a coronary artery fistula from the left circumflex coronary artery to the right atrium was successfully treated by percutaneous transcatheter technique.

AZ31 magnesium alloys were galvanostatically anodized in an alkaline solution without and with the addition of phosphate and fluoride ions. The microstructure and composition of the anodic film were investigated using cross-sectional transmission electron microscopy. Results show that during anodizing at 10 mA cm 2 in the KOH solution, the potential of the cell was relatively low and sparks were absent throughout the anodization. Adding fluoride ions in the KOH solution resulted in a sharp increase in cell voltage during the early stages of anodizing and subsequent sparking commenced at 75 V. In contrast, phosphate ions in the solution hardly affected the potential response of the cell. The anodic film formed in the presence of fluoride ions consisted of a compact inner layer containing significant fluorine species, while that formed in the solution without fluoride ions comprised a highly porous inner layer. Sparking, which resulted from the dielectric breakdown of the compact inner layer, led to the formation of magnesium oxide layer. In contrast, the anodic film formed in the absence of sparks was primarily the magnesium hydroxide.

The interactions which occur between a homologous series (C10–C20) of 6-alkyldimethylammoniohexanoates (AHs) and large unilamellar vesicles of DSPC have been investigated. The major findings are: (1) That when the temperature is below Tc of the DSPC and for short times (

Recently, we found that rRNA synthesis in dissociated embryonic cells of Xenopus laevis is selectively inhibited by ammonium salts added to their surrounding medium. Similar effects were also observed in cells treated with amines. In this report, we analysed in more detail the effects of an ammonium salt and trimethylamine on rRNA synthesis in Xenopus embryonic cells cultured under several different conditions. Results obtained showed that ammonia and trimethylamine inhibit formation of 40S pre-rRNA, without inducing breakdown (wastage) or aberrant processing of the 40S pre-rRNA. Such inibitory effects were also shown not to be due to interference with cellular ATP level. Furthermore, we found that the effects of both ammonium salt and trimethylamine were completely abolished when Na+ in the culture medium of the testing cells was replaced by choline ions. These results favour the view that the inhibition of rRNA synthesis by ammonia and amine is realized at the transcriptional level or at the step before the formation of 40S pre-rRNA, most probably via a slight increase of intracellular pH, but not via an inhibition in energy-generating systems.