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Excessive exposure of skin to UV-A (315–400 nm) and UV-B (280–315 nm) radiation causes premature skin aging, inflammation, and skin cancers. The harmful effects of solar radiation can be minimized ...

PurposeIn Japan, health-care systems have long been supported by physicians' long working hours. To solve this problem, there is an urgent need to improve the working environment for physicians while practicing patient-centered medicine and controlling health-care costs. This paper aims to examine the effect of task shifting to nurses and discuss its usefulness from the perspective of health-care value co-creation.Design/methodology/approachThis paper analyzes task shifting to nurses in acute care hospitals in Japan as a solution for the shortage of anesthesiologists. The authors discuss how the value was created from the perspective of the health-care ecosystem, with conceptual consideration of the value co-creation mechanism through patient-centered practices.FindingsThe study showed that task shifting initiatives in Japan can improve the motivation of nurses through human resource development while maintaining high quality. The study also suggested that task shifting from physicians to nurses may contribute to improving net income and maintaining the health-care system.Practical implicationsThe findings are highly reproducible and can be immediately applied to initiatives at other medical institutions in Japan. Furthermore, it is suggested that these findings might provide some perspective on the realignment of fragmented healthcare in the USA.Originality/valueIt was confirmed in practical terms that micro-level initiatives have an impact on the macro level as well. In addition, the academic presentation of the concept has contributed to the deepening of value research.

4-Coumaroyl-CoA ligase (4CL) is ubiquitous in the plant kingdom, and plays a central role in the biosynthesis of phenylpropanoids such as lignins, flavonoids, and coumarins. 4CL catalyzes the formation of the coenzyme A thioester of cinnamates such as 4-coumaric, caffeic, and ferulic acids, and the regulatory position of 4CL in the phenylpropanoid pathway renders the enzyme an attractive target that controls the composition of phenylpropanoids in plants. In this study, we designed and synthesized mechanism-based inhibitors for 4CL in order to develop useful tools for the investigation of physiological functions of 4CL and chemical agents that modulate plant growth with the ultimate goal to produce plant biomass that exhibits features that are beneficial to humans. The acylsulfamide backbone of the inhibitors in this study was adopted as a mimic of the acyladenylate intermediates in the catalytic reaction of 4CL. These acylsulfamide inhibitors and the important synthetic intermediates were fully characterized using two-dimensional NMR spectroscopy. Five 4CL proteins with distinct substrate specificity from four plant species, i.e., Arabidopsis thaliana, Glycine max (soybean), Populus trichocarpa (poplar), and Petunia hybrida (petunia), were used to evaluate the inhibitory activity, and the half-maximum inhibitory concentration (IC50) of each acylsulfamide in the presence of 4-coumaric acid (100 µM) was determined as an index of inhibitory activity. The synthetic acylsulfamides used in this study inhibited the 4CLs with IC50 values ranging from 0.10 to 722 µM, and the IC50 values of the most potent inhibitors for each 4CL were 0.10–2.4 µM. The structure–activity relationship observed in this study revealed that both the presence and the structure of the acyl group of the synthetic inhibitors strongly affect the inhibitory activity, and indicates that 4CL recognizes the acylsulfamide inhibitors as acyladenylate mimics.

VT CPMAS NMR measurements were carried out for a series of poly(alkyl l -glutamate)s (PALG) which have n-alkyl side chains with carbon numbers ranging from 2 to 12 in order to investigate the structure and mobility of the main and the side chains. From the temperature dependencies of the peak intensities for the PALGs, the relative mobilities of the main and side chains are discussed. For PG-2 and PG-4, the molecular motions of both the main and side chains are not very fast. From the amount ratio between the main and side chains, the main chain dominates the entire mobility of the polymer. As the side chain length increases, the side chain motion is drastically activated by a temperature change. In addition, the main chain motion is induced by the side chain motion. For PALGs with long alkyl side chains, the mobilities of the polymers are governed by the structure and mobility of the side chain.

2000年の当院麻酔科管理症例のぅち,20歳未満と心臓大血管手術症例を除いた3,432例を対象とし,高血圧の頻度,術前治療の有無と方法,周術期血圧の関連を検討した.高血圧合併頻度は18%,このうち術前治療群は66%であった.治療群の入院時血圧は収縮期140±18mmHg,拡張期80±13mmHgで,両値とも非治療群より有意に低かった.臓器障害/心血管病合併率は治療群が非治療群より有意に高かった.全身麻酔症例では,降圧薬1剤投与群は非治療群より手術室入室時拡張期血圧が有意に低かったが,術中血圧変動や降圧薬投与には差はなかった.高血圧患者の麻酔では,術前治療のいかんにかかわらず,その術中血圧管理に細心の注意を要すると考えられた.

To evaluate optimal catheter position for PreSep central venous oximetry catheter, we inserted the catheter through a sheath introducer with contamination shield and conducted its in vivo calibration in twenty-eight patients. In the event of calibration failure due to unstable signals, the catheter was advanced until calibration became possible. If SQI rose to 3 or 4 during surgery, we readjusted the catheter position to resume reliable monitoring. At the conclusion of surgery, the catheter position was checked radiologically and the distance between the catheter tip and the upper border of the clavicle was measured.In 70% of the patients, calibration was performed successfully when the catheter was inserted for 12-14 cm from the top of the groove between the sternal and clavicular heads of the sternocleidomastoid muscle, which led to positioning of the catheter tip 5-7 cm from the upper border of the clavicle. However, there was a considerable variation within the total patient sample and no definite correlation was found between catheter positions and patient's height. In 30% of the patient, readjustment of the catheter was required during surgery.Use of a sheath introducer with contamination shield seems to be useful for positioning the PreSep catheter.

われわれは冠動脈バイパス術後に虚血性腸疾患を合併した3症例を経験した.いずれの症例も重症糖尿病,悪性高血圧など末梢循環不全をきたし得る重篤な基礎疾患を合併した慢性透析の患者であった.3症例とも術直後の経過は順調であり早期にlCU退室となったが,その後腸管虚血をきたして緊急手術が施行された.うち2症例は広範囲にわたる腸管壊死を認め,壊死腸管を切除したにもかかわらず多臓器不全にて死亡した.慢性腎不全を合併した冠動脈バイパス術患者は末梢循環不全をきたしやすく,循環動態の安定化や経口摂取の開始時期等その周術期管理に特に注意を払うことにより,腸管虚血の発症予防と増悪回避に努める必要があると考えられた.

頬部から舌根・中咽頭周囲組織に広がる海綿状血管腫を有する13歳,女性に対し,intratumoral ligation法による頬部血管腫圧迫形成術が行われ,術後出血に対してタイオーバー法による圧迫止血術が追加施行された.術後舌根から中咽頭周囲にかけての血管腫残存部に著しい腫脹がみられ,遷延性の気道狭窄を引き起こしたため,15日間にわたって気管挿管による気道確保を余儀なくされた.頬部手術創のタイオーバーを解除したところ,気道狭窄は速やかに改善し抜管可能となった.中咽頭部気道の可逆性狭窄をきたしたメカニズムとして,頬部海綿状血管腫の圧迫により血管腫内の血流分布が中咽頭周辺部へ著しく偏り,同部の腫脹を引き起こした可能性が考えられた.

Ferrite electromagnetic wave absorbers are widely used for electromagnetic half reflectionless rooms for EMC measurement and anechoic chambers. If gaps exist between the ferrite tiles, the return loss characteristics are substantially degraded in the low-frequency region between 30 and 200 MHz. In this article, the effects of the gap in ferrite tiles on the return loss characteristics are studied for grid-type ferrite absorbers and planar ferrite absorbers. From the numerical simulations, it is found that the degradation of the characteristics due to the gaps is smaller in the grid-type ferrite absorbers than in the planar ferrite absorbers at low frequencies. This finding is also confirmed by model experiments. Further, filling of the gaps with ferrite powder is studied as a means of reducing the degradation of the characteristics by the gaps. © 2000 Scripta Technica, Electron Comm Jpn Pt 2, 83(2): 52–60, 2000

パラチオンを服毒した慢性透析患者において,持続的血液透析(continuous venovenous hemodialysis,CVVHD)下におけるpralidoxime(2-PAM)薬物動態を検討しえた。症例は67歳の男性で,週3回の血液透析を受けていた。自殺企図にてパラチオン15mlを服毒し,アトロピン,2-PAMを併用した心肺蘇生に成功の後,ICUに収容した。筋攣縮や縮瞳などの症状の改善を目安にCVVHD施行下で2-PAM0.1g・hr-1を約20時間持続投与し,血中ならびに透析廃液中の2-PAM濃度を経時的に測定してCVVHDによる排泄と薬物動態を検討した。その結果,持続投与中の血中濃度は22～23mg・ml-1と高値であり,CVVHDによるクリアランスは約8.1ml・min-1と極めて小さく,半減期が健常人の1.1時間に比べ40時間と著明に延長することが判明した。有機リン中毒に対しCVVHD施行下で2-PAMを投与する場合,体外排泄の遅延による過剰投与に十分注意する必要があると考えられた。

This paper describes the optical circuit that enables to extract address from a transmitted cell in an all-optical manner. Nonlinear optical loop mirrors (NOLM's) are used as all-optical switches in order to confirm the operation of the proposed circuit. The control pulses synchronized with address bits are generated from the transmitted cell. The address bits are successfully extracted without any electronic control circuit. The factors that limit an attainable bit rate are discussed. If we use NOLM composed of a 2-km-long fiber, 110 Gb/s is attainable for the 4 ps FWHM input pulse with RZ format.

Mode coupling theory describes light propagation characteristics in coupled systems composed of several waveguides. It becomes possible to determine light propagation characteristics by solving differential equations called coupled equations. For determination of the propagation constant and coupling coefficients which are elements of the coupled equations, waveguide parameters and light wavelength must be given. Therefore, when the refractive index and wavelength are changed, different coupled equations must be solved. In this paper, a normalized scale is introduced which takes the refractive index and wavelength into account, and the coupled equations are derived in such a (normalized) coordinate system. It is shown that even if the wavelength and refractive indices are changed, the coupling characteristics of the coupled systems with the same configuration in normalized space can be determined from the same coupled equations. © 1997 Scripta Technica, Inc. Electron Comm Jpn Pt 2, 80(3): 60–68, 1997

A novel diagram which describes the condition of 3 dB coupler is proposed. Using the proposed diagram, the design of a wavelength-flattened 3 dB directional coupler composed of a uniform coupled waveguide is investigated. Normalized waveguide parameters are introduced to characterize a five-layer planar waveguide. This enables us to generalize the discussion and to reduce the number of parameters required for characterizing a coupled waveguide. A broadband 3 dB coupler having 50/spl plusmn/5% coupling ratio over a wavelength range of 1.1-1.7 /spl mu/m is designed.

No detailed analysis has been available on the return loss characteristics of a pyramidal electromagnetic wave absorber. Therefore, an approximate analysis method for the pyramidal absorber has not been established in a rigorous sense. In this paper, the return loss characteristics for the normal incident on the pyramidal absorber are derived by the numerical simulation based on the spatial network method. Also, as an approximate method for the wave absorber that can approximate the obtained results well, a method called the synthesized capacitance model is proposed. By comparison of the numerical results by the two methods, it is found that the approximate results by the synthesized capacitance model provide more accurate results than those by the previous approximate models. Further, by means of the synthesized capacitance model for the normal incidence, the oblique incidence characteristics of the TE wave were computed and the results agreed well with the measured data.

To investigate the possibility of improving the crystal quality of a GaInSb layer grown on a Gd3Ga5O12 substrate by metal organic chemical vapor deposition (MOCVD), experimental studies were carried out on the effect of the total reactor pressure. The lattice constant was affected by the pressure. The effect of reducing the pressure was dependent on the growth temperature. In a low-temperature regime, the lattice constant increased, and at high temperature it decreased, as the pressure was reduced. The growth rate increased as the pressure was reduced in both temperature regimes. Upon reduction of the pressure, the range of growth conditions which gives a preferentially (111)-oriented GaInSb layer became narrow.

The nuclear factor of activated T cells (NFAT) regulates cytokine gene expression in T cells through cis-acting elements located in the promoters of cytokine genes. Here, we report the cDNA cloning, chromosomal localization, and initial characterization of a transcription factor related to NFATp and NFATc. The novel molecule, designated NFATx, exhibits in its middle a region very similar to the Rel homology domain in NFATc and NFATp. The amino-terminal region of NFATx also shows significant similarities to corresponding sequences in NFATc and NFATp and contains three copies of a conspicuous 17-residue motif of unknown function. We provide evidence showing that NFATx can reconstitute binding to the NFAT-binding site from the interleukin 2 promoter when combined with AP1 (c-Fos/c-Jun) polypeptides and that NFATx is capable of activating transcription of the interleukin 2 promoter in COS-7 cells when stimulated with phorbol ester and calcium ionophore. NFATx mRNA is preferentially and remarkably found in the thymus and at lower levels in peripheral blood leukocytes. The expression pattern of NFATx, together with its functional activity, strongly suggests that NFATx plays a role in the regulation of gene expression in T cells and immature thymocytes.

The bonding of InP/Gd3Ga5O12 and InP/GaInSb on Gd3Ga5O12 without glue is demonstrated. After chemical treatment, heat treatment in H2 ambient results in bonding of the samples. We have investigated the bonding conditions, mechanisms and the bonding durability against device fabrication processes. The bonding durability depends on the crystal orientation of the wafer, the heat-treatment temperature and GaInSb layer thickness. The samples bonded at higher temperature maintained bonding after typical device fabrication processes. The (111)-oriented InP is more susceptible to bonding than the (100)-oriented InP. The heat-treatment temperature is reduced by using appropriate chemical treatment and by applying pressure.

By combining a ferrite-type electromagnetic wave absorber and a lossy dielectric layer, an electromagnetic wave absorber with a super wideband characteristic can be realized. In this paper, a grid-type ferrite absorber and a rubber ferrite loaded ferrite multilayered absorber are treated as a ferrite-type absorber. When a lossy dielectric material is mounted in front of these ferrite-type wave absorbers, the thickness of a lossy dielectric layer necessary for realization of a return loss of more than 20 dB at any frequency above 30 MHz was computed. It was found that the thickness is much less than that for the lossy dielectric attached to a single layer ferrite. Further, by means of a model experiment in the coaxial tube, the thickness of the lossy dielectric layer was proven to be smaller if a lossy dielectric is combined with the grid-type ferrite absorber loaded with rubber ferrite.

Transesophageal echocardiography is an invaluable hemodynamic monitoring modality. Extended and anatomically based evaluation of cardiac function with transesophageal echocardiography is essential to prompt and accurate decision-making in anesthetic management during cardiac surgery. Fractional shortening and fractional area changes are indices widely used to assess the global systolic performance of the left ventricle. Monitoring regional function using semi-quantitative scoring has been demonstrated to be a more sensitive indicator of myocardial ischemia. Assessment of left ventricular diastolic function should be performed in a systematic way, measuring transmitral flow, pulmonary venous flow, transmitral color M-mode flow propagation velocity, and mitral annulus tissue Doppler imaging. The unique anatomical features of the right ventricle make echocardiographic evaluation complicated and therefore less frequently employed. Right ventricular fractional area change, tricuspid annular plane systolic excursion, maximal systolic tricuspid annular velocity with tissue Doppler imaging, and myocardial performance index are indices successfully incorporated into intraoperative right ventricular assessment. Left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve may develop after cardiac procedures. Transesophageal echocardiography plays a central role in prevention as well as diagnosis of systolic anterior motion. Transesophageal echocardiography is extremely useful not only for detecting and locating intracardiac air, but also for guiding and evaluating the procedures to remove air. Air is likely to persist in the right and left superior pulmonary vein, left ventricular apex, left atrium, right coronary sinus of Valsalva, and ascending aorta. Accurate evaluation of cardiac function depends on performing TEE examination properly and obtaining optimal images.

To assess the usefulness of ultrasound-guided sciatic nerve block in the popliteal fossa in the postoperative pain management after Achilles' tendon repair, we compared 15 patients managed by general anesthesia and sciatic nerve block (Group B) with 17 patients managed by general anesthesia alone (Group G). The time required for the nerve block was about 20 minutes on the average, and the success rate was 100%. No significant complication associated with the nerve block was observed. Fentanyl dosing for the postoperative analgesia was significantly smaller in the Group B. Although the postoperative analgesic requirement was comparable, the time to the first postoperative analgesic administration was significantly longer in the Group B. This retrospective study suggests that ultrasound-guided sciatic nerve block in the popliteal fossa provides safe and effective postoperative pain relief after Achilles' tendon repair.

A novel ferrite grid electromagnetic wave absorber composed of sintered ferrite is proposed. Based on the condition that the return loss should be above 20 dB at 30 MHz, its wideband characteristics for suppressing reflections compared to a single-layer absorber are demonstrated by computer simulation. Calculating the return loss by varying the geometrical parameters of the ferrite grid, an optimum structure is determined which gives the maximum frequency band. In addition, it is found that the return loss of the grid absorber is impaired by an air gap between the ferrite and conductor. Moreover, the operating characteristics of the grid absorber are demonstrated by experimental models.

Fin electromagnetic wave absorbers are proposed in which the sintered ferrite plates are placed in the direction perpendicular to the electric field of the incident electromagnetic field. By numerical calculations, it is shown that this structure has a broadband reflection suppressing characteristic. The characteristics of the absorbers in terms of the structural parameters of the absorber and ferrite permeability are shown, and it is found that the optimum structure of the absorber for a broadband operation depends on the permeability of the ferrite. Further, by means of the model experiment, the broadband characteristics of the proposed absorber are demonstrated.

Substantially decreased oxygen saturation levels were incidentally detected by pulseoxymetry in a patient with spherocytic hemolysis who was undergoing laparoscopic splenectomy. Molecular analysis revealed that he was carrying hemoglobin (Hb) Nishinomiya, a novel Hb variant [Leu-Gly-inserted between codons 69(E13) and 70(E14) of beta]. Amino acid substitutions around positions 70-73(E13-17) of the beta chain are likely to change stability and oxygen affinity, as has been demonstrated in several Hb variants including Hb Seattle. The apparent substitution of the amino acid residues in the heme pocket of the beta chain explains the decreased stability and oxygen affinity of Hb Nishinomiya.

We proposed to use a distributed feedback structure with a weighted coupling coefficient (W-DPB) in an all-optical bistable device in order to improve on-state transmittance and to reduce threshold intensity. Through numerical calculations, characteristics of the W-DPB structure were discussed compared with those of a conventional DPB structure. The W-DPB optical bistable device exhibits high on-state transmittance and low-threshold input intensity. Fabrication of the W-DPB structure with a periodicity of 169.8 nm is demonstrated on a CdS(x)Se(1-x)-doped glass substrate by means of holographic exposure with a double-coated photoresist and reactive ion etching in CHP(3).

A 91-year-old man underwent aortic valve replacement using a pulmonary artery catheter (PAC). Intraoperative hemodynamic monitoring with the PAC showed no abnormality except for bleeding from optical module connection port. In the intensive care unit, difficulty in withdrawing the PAC was noted. Surgical removal of the PAC was performed, revealing the PAC sutured to the right atrium. When bleeding from the PAC connection ports is noted, it is advisable to suspect that the PAC might have been sutured.

There is currently accumulating evidence for bidirectional communication between the neuroendocrine and immune systems. Various cytokines have been suggested to be involved in the stimulation of stress hormone secretion during the times of infection and inflammation. To assess the possible involvement and pathophysiologic significance of cytokines in the mechanisms responsible for the perioperative stress response of the hypothalamo-pituitary-adrenal axis, we observed the changes of plasma adrenocorticotropic hormone and cortisol levels together with those of plasma endotoxin and cytokine levels. In patients undergoing pancreatoduodenectomy, perioperative stimulation of adrenocorticotropic hormone and cortisol secretion was accompanied by a significant elevation of plasma cytokine levels. Application of epidural block up to the upper thoracic levels failed to suppress this stress response effectively. In patients undergoing unilateral total hip replacement, the response of plasma hormone levels was smaller and briefer with no significant increase of plasma cytokine levels. Application of epidural block up to the lower thoracic levels suppressed this hormonal response almost completely. In patients undergoing pancreatoduodenectomy, a significant elevation of plasma endotoxin level was followed by a gradual but significant elevation of plasma tumor necrosis factor alpha and interleukin-6 levels. It seems likely that the stimulatory effects of these cytokines on the secretion of adrenocorticotropic hormone and cortisol might be involved in the development of the greater and more prolonged stress response of hypothalamo-pituitary-adrenal axis. Our present study suggests that not only neural input from the surgical wound but also stimulation of cytokine production were responsible for the development of the stress response of the hypothalamo-pituitary-adrenal axis during and after upper abdominal surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Using specific antagonists to rat interleukin (IL)-1 alpha and IL-1 beta, the roles of these IL-1s in endotoxin-induced suppression of plasma gonadotropin levels in freely-moving rats were studied. In orchiectomized rats, recombinant rat IL-1 alpha and IL-1 beta administered into the lateral ventricles almost equipotently suppressed plasma LH levels. Twenty five micrograms of bacterial endotoxin or lipopolysaccharide (LPS) administered similarly showed a comparable effect as that of 1 microgram IL-1 alpha or IL-1 beta, and completely lowered plasma LH levels by 60 min after the injection. To examine the roles of endogenous IL-1 alpha and IL-1 beta, anti-rat IL-1 alpha antiserum (anti-IL-1 alpha) and a recombinant human IL-1 receptor antagonist (IL-1ra) were used as specific blockers for IL-1 alpha and IL-1 beta, respectively. Anti-IL-1 alpha (10 microliters) or IL-1ra (10 micrograms) administered intracerebroventricularly (icv) with 25 micrograms LPS, significantly attenuated the LPS-induced effect on plasma LH levels during the first 60 min after LPS infusion, but not during the second 60 min. LPS at a dose of 5 micrograms induced smaller but still significant changes in plasma LH levels compared with 25 micrograms LPS or 1 microgram IL-1 beta. IL-1ra (10 micrograms) completely blocked LH suppression induced by 1 microgram IL-1 beta, but did not completely reverse the changes of LH induced by 5 micrograms LPS. IL-1ra injected iv also significantly attenuated the early suppressive effect of iv administered LPS, but not its late effect on plasma LH levels. However, iv administered IL-1ra had no influence on the effects of icv administered LPS. These data indicate that at least a part of plasma LH suppression caused by icv administered LPS is mediated via IL-1 alpha and IL-1 beta synthesized within the brain, while factor(s) other than IL-1 also participate in the LPS-induced change, particularly during the later period. A similar mechanism may also work peripherally in the case of iv administered LPS-induced plasma LH suppression.

Activation of T cells is initiated by the recognition of antigen on antigen presenting cells to exert the effector functions in immune and inflammatory responses. Two types of helper T cell (Th) clones (Th1 and Th2) are defined on the basis of different patterns of cytokine (lymphokine) secretion. They determine the outcome of an antigenic response toward humoral or cell-mediated immunity. Although lymphokine genes are coordinately regulated upon antigen stimulation, they are regulated by the mechanisms common to all as well as those which are unique to each gene. For most lymphokine genes, a combination of phorbol esters (phorbol 12-myristate 13 acetate, PMA) and calcium ionophores (A23187) is required for their maximal induction. Yet phorbol ester alone or calcium ionophore alone produce several lymphokines. The production of the granulocyte-macrophage colony stimulating factor (GM-CSF) is completely dependent on the two signals. We have previously found a cis-acting region spanning the GM-CSF promoter region (positions -95 to +27) that confers inducibility to reporter genes in transient transfection assays. Further analysis identified three elements required for efficient induction, referred to as GM2, GC-box and conserved lymphokine element (CLE0). GM2 defines a binding site for protein(s) whose binding is inducible by PMA. One protein, NF-GM2 is similar to the transcription factor NF-kB. GC-box is a binding site for constitutively bound proteins. CLEO defines a binding site for protein(s) whose optimum binding is stimulated by PMA and A23187. Viral trans-activators such as Tax (human T cell leukemia virus-1, HTLV-1) and E2 (bovine papilloma virus, BPV) proteins are other agents which activate lymphokine gene expression by bypassing T cell receptor (TCR) mediated signaling. The trans-activation domain of E2 and Tax is interchangeable although they have no obvious sequence homology between them. The viral trans-activators appear to target specific DNA binding protein such as NF-kB and Sp1 to cis-acting DNA site and promote lymphokine gene expression without TCR-mediated stimulation.

A simple and accurate method for analyzing rectangular dielectric waveguides is proposed. By investigating some improved equivalent guide models, which can be defined by a successive perturbation feedback process, propagation constants of the original guides can be reasonably obtained with accuracy better than those obtained by applying current approximate approaches, especially when the modes exist at or around the weakly confined region. >

Regulatory mechanisms of the hypothalamo-pituitary-adrenal (H-P-A) axis during and after major abdominal surgery were studied in a group of patients who underwent upper abdominal surgery. We first examined the general profile of the changes of the H-P-A axis from the day before surgery to the seventh day after surgery. On the day of surgery, plasma levels of CRH, ACTH, and cortisol were all significantly elevated after skin incision (phase I). During the next 2 days, plasma cortisol levels remained significantly elevated, and the both plasma CRH and ACTH levels were suppressed below the control levels obtained on the day before surgery (phase II). Several additional studies, carried out to analyze the mechanism that maintains the high plasma cortisol levels, revealed the following features of the H-P-A axis during phase II. Plasma free cortisol levels in this phase were higher than those during the preoperative period. The exogenously administered hydrocortisone clearance rate in phase II did not differ from that observed on the day before surgery. Dexamethasone administration resulted in a decrease in plasma cortisol levels similar to that observed preoperatively. Conversely, the ACTH-stimulated cortisol increase was significantly greater in phase II than that observed preoperatively. These results suggest that during and after major surgical stress, the H-P-A axis undergoes a biphasic change in the pattern of the stress response and during the second phase, not the continuous hypothalamo-pituitary drive but the increased adrenal responsiveness to ACTH is responsible at least in part for maintaining the elevated plasma cortisol level.

An effective method for coupling optical signals from single-mode fibers to thin-film waveguides is proposed. The authors show that this method provides high coupling efficiency for connecting fibers of different core diameters to thin-film waveguides of different film thicknesses or refractive indexes. The authors summarize the theoretical treatment of the coupler. Examples of couplers designed for SiO/sub 2/-based materials as well as iron garnets are presented. Fabrication of the proposed coupler and its experimental results are described. >

A novel taper‐formed three‐guide coupler is presented. Its unique power coupling characteristics are experimentally demonstrated. By virtue of adopting the taper‐formed waveguide, the severe restrictions imposed on the device fabrication process are greatly relaxed. This makes the coupler advantageous to application in a variety of integrated optics, such as power splitters and combiners, and as constituent elements of devices like optical isolators.

The effects of interleukins on adrenal steroidogenesis and their mode of action were studied using cultured rat adrenal cells. The addition of rat interleukin-1 alpha (IL-1 alpha) or rat IL-2 increased corticosterone levels in the medium in a concentration-dependent manner during 24 h of incubation. The minimum, half-maximum, and maximum effective concentrations of both rat IL-1 alpha and rat IL-2 were almost same (approximately 3, 10, and 100 U/ml, respectively). After a latent period, the effect became apparent after 12 h of incubation. Human IL-1 beta and human IL-6 also showed a stimulatory effect on corticosterone production, whereas human IL-2 was inactive in this system. To clarify the cellular mechanism of these stimulatory effects, we measured the levels of prostaglandin E2 (PGE2) and cAMP in the cells and media as well as the corticosterone levels. Corticosterone production stimulated by IL-1 alpha or IL-2 was accompanied by intracellular and extracellular cAMP and PGE2 accumulation. Although the stimulation of both cAMP and corticosterone was observed only after 12 h of incubation, PGE2 levels increased during the first 4 h of incubation. Corticosterone, cAMP, and PGE2 production stimulated by ILs was almost completely blocked by the addition of 0.1 mM aspirin, a cyclooxygenase inhibitor. Lipoxygenase inhibitors, i.e. AA-861, nordihydroguaiaretic acid, and 5,8,11,14-eicosatetrynoic acid, did not abolish corticosterone production stimulated by ILs. Submaximal doses of IL-1 alpha and IL-2 synergistically stimulated PGE2 production, but did not have even additional effects on cAMP and corticosterone levels. On the other hand, submaximal doses of ACTH, which did not significantly affect PGE2 levels, acted synergistically with IL to increase cAMP and corticosterone levels in these cells. These results indicate that 1) IL-1 alpha and IL-2 directly stimulate glucocorticoid synthesis in a dose- and time-dependent manner; 2) a half-maximum effective concentration of ACTH acts synergistically with IL in stimulating glucocorticoidogenesis; 3) the stimulatory process initially requires PGs, followed by the activation of the adenylate cyclase system; 4) although the profiles of steroidogenic action of IL-1 alpha and IL-2 are quite similar, they may exert their effects through different mechanisms in their early steps of PGE2 production; and 5) the low effective concentrations of both cytokines suggest possible physiological or pathophysiological roles of circulating cytokines in the glucocorticoidogenesis under certain conditions.

TE-TM mode conversion based on the nonreciprocal Faraday effect for waveguides fabricated by liquid-phase epitaxially grown (YBiCa)/sub 3/Fe/sub 5/O/sub 12/ films is discussed. The phase mismatch is controlled by constructing a double-layer channel waveguide with an intermediate cladding layer of refractive index slightly lower than the core. Care must be taken to compensate any birefringence of materials, e.g. stress- and growth-induced birefringence. It is shown that such a structure is effective in decreasing the effect of waveguide shape deformation on the phase-matching degree. The analysis of the double-layered channel waveguide and experimental results are described. >

We examined the adrenocorticotropic hormone-releasing activities of several human interleukin-1 beta analogues that have markedly reduced pyrogenic activities in rats. Among the analogues tested, [Gly4]-, [Leu93]- and [1-148]-interleukin-1 beta increased the plasma adrenocorticotropic hormone level to almost that induced by authentic human interleukin-1 beta. Modifications of the N-terminus of the authentic molecule, i.e., [7-153]- and [Des-Ala1, Asp4]-interleukin-1 beta, significantly reduced the hormone-releasing activity. These data suggest that the adrenocorticotropic hormone-releasing activity of human interleukin-1 beta resides in the N-terminal structure of the authentic peptide and can be separated from its pyrogenic activity.

Optical coupling characteristics of a three-guide coupled system are discussed. Application of a taper-formed waveguide in the system is proposed. A theoretical analysis of the tapered waveguide system is presented by applying a modified coupled-mode theory, with the tapered guide being approximated by successive stepped small guide segments. Based on numerical examinations, particular coupling characteristics of the tapered guide system are demonstrated. An application of the tapered three-guide coupled system in a type of optical isolator is proposed. The main working principles of the isolator are presented. >

To assess the chronic effects of interleukin-1 (IL-1) and IL-2 on the hypothalamo-pituitary-adrenal axis in vivo, we administered recombinant human (rh) IL-1 alpha, rhIL-1 beta or rhIL-2 (2.0 micrograms/day) repetitively to adult male rats for 10 days. In rhIL-1 beta-treated rats, adrenocorticotropic hormone-like immunoreactivity (ACTH-LI) of the anterior pituitary appeared to increase first on day 3 followed by an increase of corticotropin-releasing hormone (CRH)-LI both in the hypothalamus and in the adrenal gland after day 7. At the end of the 10-day treatment, wet weights of the adrenal glands of rhIL-1 beta-treated rats increased significantly compared with those of control rats. Plasma ACTH levels in rhIL-1 beta-treated rats at the sampling time continued to be elevated throughout the experimental period. Under the same experimental design, rhIL-1 alpha increased plasma ACTH levels at the sampling time without changes in adrenal weight or in the peptide contents investigated. The same amount of rhIL-2 had no effect on these measured variables during the 10-day treatment. These data indicate that the repetitive administration of IL-1 beta resulted in chronic effects in the hypothalamo pituitary-adrenal axis to increase the activities in these organs during the treatment and, moreover, IL-1 possibly has a positive direct effect on the CRH-containing cells in the adrenal glands.

The coupling characteristics of parallel coupled waveguides are examined, with emphasis on the dependence of the output phase difference, by means of a simplified model. The phase relationship among the output waves for a 3-dB coupler is discussed. It is concluded that a magic-T can be realized by employing asymmetric coupled waveguides with a specific degree of asymmetry. >

Optical coupling characteristics between one uniform waveguide and one tapered waveguide are discussed. This coupling structure is analyzed by utilizing coupled-mode theory and system step approximation. Based on numerical investigation, various coupling characteristics are presented. It is shown that the proposed structure can be used as a waveguide-type optical power divider by selecting an appropriate taper slope for the tapered waveguide or by separating the coupled waveguides properly for a desired power-dividing ratio. >

An optical bistable device is realized by an optical feedback structure and the optical Kerr effect. We fabricated an optical distributed feedback waveguide in a GaInAsP-InP wafer. All-optical set-reset operation has been observed in the GaInAsP-InP waveguide at a wavelength of 1.56 /spl mu/m.