Linear equations with random variables

A system of linear equations is presented where the unknowns are unobserved values of random variables. A maximum likelihood estimator assuming a multivariate normal distribution and a non-parametric proportional allotment estimator are proposed for the unobserved values of the random variables and for their means. Both estimators can be computed by simple iterative procedures and are shown to perform similarly. The methods are illustrated with data from a national nutrition survey in Japan.     

The potent role of graft-derived NKR-P1+TCRalphabeta+ T (NKT) cells in the spontaneous acceptance of rat liver allografts

BACKGROUND: The mechanism involved in the spontaneous acceptance of liver allografts in some rat strain combinations remains unclear. Immunoregulatory NKR-P1TCRalphabetaT (NKT) cells primarily produce IL-4 and IFN-gamma, and enhance the polarization of immune responses to Th2 and Th1, respectively. The aim of this study was to clarify the role of graft-derived NKT cells in inducing the spontaneous acceptance of rat orthotopic liver transplantation (OLTx) METHODS: The experimental groups were divided as follows: Group 1, BN to LEW "low responder (acceptor)" combination; Group 2, DA to LEW "high responder (rejector)" combination; na?ve BN (Group 3) or LEW recipients (Group 4) with liver allografts from irradiated BN donors. The recipients had liver allografts from irradiated donors reconstituted from the following cell populations 24 hr before harvesting, spleen cells (SPCs, Group 5), IgSPCs (Group 6), IgNKR-P1SPCs (Group 7), and IgTCRabSPCs (Group 8) RESULTS: In Group 1, the percent of graft-derived NKT cells harvested on day 7 posttransplant were significantly higher than in Group 2. In the case of BN liver allografts that had been irradiated and reconstituted with cell populations including NKT cells (Groups 5 and 6), the mean graft survival (MST) was extended to 39.2+/-5.7 and 38.8+/-8.0 days, respectively. In contrast, when NKT cells were excluded (Groups 7 and 8), the grafts were acutely rejected within MST of 17.8+/-4.0 and 18.8+/-7.7 days, respectively. The concentrations of IL-10 and TGF-beta, but not IL-4 in IgGICs culture supernatants were predominant in the acceptor, whereas those with IFN-gamma predominated in the rejector. CONCLUSIONS: Graft-derived NKT cells might be responsible for spontaneous acceptance in the rat OLTx.     

Is High Flexion Following Total Knee Arthroplasty Safe?: Evaluation of Knee Joint Loads in the Patients During Maximal Flexion

The purpose of this study was to indicate the mechanical loads and the flexion angle at the knee during rise from maximal flexion following total knee arthroplasty (TKA). Twenty three knees were evaluated using skin marker-based motion analysis system during four different activities of daily living. The average maximum flexion was 90 degrees (34 degrees less than passive flexion) and all subjects required support for their weight to rise from maximal flexion. The external moments and the external forces at the knee during the maximal flexion were smaller than those during the stair descending activity. The results indicate that capable flexion angle for the patients following TKA is approximately 90 degrees which has smaller mechanical loads at the knee than the stair descending activity.     

Colonic stricture secondary to hemolytic uremic syndrome caused by Escherichia coli O-157

Shiga toxin-producing Escherichia coli (E. coli) is known to be one of the main causes of hemolytic uremic syndrome (HUS). Of the secondary complications of HUS, colonic stricture is relatively rare. We herein report on a Japanese girl that demonstrated sigmoid colon stricture secondary to HUS caused by an infection of E. coli O-157. Severe HUS occurred after the E. coli O-157 infection, so hemodialysis was performed due to renal failure. However, 1 month after recovery from HUS, abdominal symptoms occurred. A contrast study in the colon revealed a sigmoid colon stricture. The stricture was operatively resected. Thereafter, her postoperative course was uneventful. We also review the occurrence of this complication secondary to HUS in the literature.     

Factors associated with frequent remission of microalbuminuria in patients with type 2 diabetes

To estimate the frequency of remission/regression of microalbuminuria and to identify factors affecting such outcomes in Japanese patients with type 2 diabetes, we observed 216 patients with type 2 diabetes and microalbuminuria enrolled during an initial 2-year evaluation period for the next 6 years. Remission was defined as shift to normoalbuminuria and regression as a 50% reduction in urinary albumin excretion rate (AER) from one 2-year period to the next. Reduction of urinary AER was frequent, with a 6-year cumulative incidence of 51% (95% CI 42-60) for remission and 54% (45-63) for regression, whereas the frequency of progression to overt proteinuria was 28% (19-37). Microalbuminuria of short duration, the use of renin-angiotensin system-blocking drugs, and lower tertiles for HbA(1c) (<6.95%) and systolic blood pressure (<129 mmHg) were independently associated with remission or regression in the pooled logistic regression analysis. The results indicate that reduction in urinary AER occurs frequently in Japanese patients with type 2 diabetes. Early detection of microalbuminuria and a multifactorial control may result in improved outcomes for diabetic nephropathy and cardiovascular events.     

Clinical outcomes and problems in laparoscopic radical prostatectomy

We evaluated the clinical outcome and problem of laparoscopic radical prostatectomy (LRP) for 115 prostate cancer patients. Mean (+/- SD) operative time was 294 +/- 57.5 min. and mean blood loss was 409.5 +/- 336.4 g. Mean duration of urethral catheter indwelling was 4 +/- 4.9 days and mean postoperative hospital stay was 8 +/- 4.6 days. Fifty one and 83% of the patients recovered urinary continence one month and 3 months after surgery in the latest procedure, respectively. Positive surgical margin was seen in 18 patients (15.7%) in total, but in 6 patients (6.6%) with pT2 > or = disease. Chemical relapse was seen in 14 patients (14.4%). Although oncological results of LRP are compatible to those of RRP, delay of early recovery of urinary continence is still the problem.     

Morphological Observations of Peripheral Nerves by the Scanning Electron Microscope

Abstract: In order to observe a normal peripheral nerve and a changed peripheral nerve by means of a scanning electron microscope, the present study was carried out. In the changed nerve fibers, they were enveloped by many processes of hypertrophied Schwann cells, and the processes of the Schwann cells seemed to make a pseudosyntitium-like structure with each other. From this finding, it was speculated that these Schwann cells seemed to follow the reverse process in the development of normal peripheral nerve fibers.