It is well known that disorders of coagulation and fibrinolysis play a major role in the development of organ dysfunction during sepsis. Furthermore, the importance of the early initiation of anticoagulation therapy for severe cases has been emphasized based on the success of recent clinical trials. The purpose of this study is to search for useful markers for predicting organ dysfunction. Plasma samples were prospectively collected from 78 patients within 48 h after the onset of sepsis. Hemostatic markers and endothelial damage markers were compared between the patients with and without organ dysfunction. The WBC and platelet counts were not different between the groups. In contrast, fibrin/fibrinogen degradation products, D-dimer, thrombin-antithrombin complex, plasmin alpha2-antiplasmin complex, soluble fibrin, and total plasminogen activator inhibitor-1 were significantly higher, and the antithrombin activity and protein C levels were lower in the patients with organ dysfunction. Thus, the changes in the hemostatic molecular markers were associated with organ dysfunction from an early stage of sepsis, and antithrombin and protein C activities were found to be the most reliable markers.

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SUMMARYThis paper presents an alternative choice for the construction of integration cells and an additional Lagrange-multiplier mesh in computations using the eXtended finite element method (X-FEM) with the Lagrange-multiplier. The proposed computational target is flow simulations with the Dirichlet boundary conditions on a non-boundary-fitted mesh. The methods studied in this paper make use of a high-order Gaussian quadrature to relax the complexity in implementing the X-FEM with the Lagrange-multiplier. The first of these is the straightforward employment of the Gaussian quadrature as a numerical integration scheme for enriched fluid elements. The second makes use of free Lagrange-multipliers that are not placed at crossing points between fluid elements and the Dirichlet boundary. This method considers the scalability of fluid-structure and fluid-thin object interactions. A unique benchmark problem in which a computational fluid domain is partitioned into two physical domains with the Lagrange-multipliers is introduced to validate the proposed method. Numerical results show that this method is applicable in practice with acceptable numerical accuracy.

This paper presents a non-interface-fitted mesh method for fluid-thin structure interactions. The key components are the Lagrangian Lagrange-multiplier (LLM) method and the extended finite element method (X-FEM). The LLM couples fluid and thin structure through the Lagrangian nodes of the structure element. The X-FEM gives flow discontinuity to the fluid elements intersected by the structure element. The combination method is verified through applications to flow with a domain-partitioning boundary and flow-induced flapping of a flexible filament. We discuss how the discontinuities at the interface enhance the simulation results, how the lack of the discontinuities affects the results, and identify some effects of these discontinuity enrichments.

The signal transduction system of erythropoietin (Epo) and the accompanying molecular control mechanism of proliferation and differentiation of erythroid progenitors remains largely unknown. In this study, the effect of Epo on the expression of nuclear oncogenes was investigated in two murine cell lines which respond to the hormone in different ways: ELM-I-1 cells proliferate independently of Epo, but differentiate in response to the hormone, while the growth of DA-1ER cells is absolutely dependent on Epo or interleukin (IL) 3. The cell lines were stimulated with Epo or IL-3, and total RNA was extracted. Then expression of nuclear proto-oncogenes (c-myc, c-fos and c-myb) was analyzed by northern blotting. The change in c-fos expression observed during the first two h following stimulation with either stimulant were common to both cell lines; a rapid and temporary increment. Before stimulation, c-myc and c-myb were strongly expressed in both lines. No apparent change in c-myc expression was observed during the first two h of stimulation, while c-myb expression in ELM-I-1 cells was slightly reduced 1 h after stimulation with Epo but not with IL-3. Three days after stimulation with Epo, but not with IL-3, only ELM-I-1 produced hemoglobin and expressed a lower amount of c-myb mRNA. These data suggest the importance of c-fos in the early signaling system of Epo, and the involvement of c-myb in erythroid differentiation but not in proliferation.