BACKGROUND & AIMS: :Balloon kyphoplasty (BKP) sometimes fails to improve patients' outcomes, with revision surgery, using anterior or posterior reconstruction, being required. The purpose of this study was to investigate the radiological risk factors of failure after BKP in the treatment of osteoporotic vertebral fractures (OVFs). This case-control study included 105 patients treated with single BKP and 14 patients  who required revision BKP. We evaluated radiological findings differentiating both groups, using plain radiography and computed tomography, before BKP. Angular flexion-extension motion was significantly greater in the revision than BKP group. While the frequency of pedicle fracture and posterior wall injury was not different between the groups, a split type fracture was more frequent in the revision group. Split type fracture had the highest adjusted odds ratio (OR) for revision (16.5, p = 0.018). Angular motion ≥14° increased the risk for revision surgery by 6-fold (p = 0.013), with endplate deficit having an OR of revision of 5.0 (p = 0.032). The revision rate after BKP was 3.8%, with split type fracture, greater angular motion and large endplate deficit being risk factors for revision. Treatment strategies for patients with these risk factors should be carefully evaluated, considering the inherent difficulties in performing revision surgery after BKP.

背景与目标： 球囊后凸成形术 (BKP) 有时无法改善患者的预后，需要使用前或后重建进行翻修手术。目的探讨BKP治疗骨质疏松性椎体骨折 (OVFs) 后失败的放射学危险因素。这项病例对照研究包括105例接受单一BKP治疗的患者和14例需要修订BKP的患者。在BKP之前，我们使用普通放射线照相和计算机断层扫描评估了区分两组的放射学发现。修订中的角度屈伸运动明显大于BKP组。虽然椎弓根骨折和后壁损伤的发生率在两组之间没有差异，但翻修组的劈裂型骨折更为常见。劈裂型骨折的修正优势比 (OR) 最高 (16.5，p   =   0.018)。角运动 ≥ 14 ° 将翻修手术的风险增加6倍 (p   =   0.013)，终板缺陷具有5.0的OR (p   =   0.032)。BKP后的翻修率为3.8%，劈裂型断裂，较大的角运动和较大的端板缺陷是翻修的危险因素。考虑到BKP后进行翻修手术的固有困难，应仔细评估具有这些危险因素的患者的治疗策略。

BACKGROUND & AIMS: OBJECTIVES:Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas encompasses a spectrum of neoplasms with both morphological and immunohistochemical variations of mucin glycoproteins. Recently, a consensus nomenclature and criteria were histologically defined for classifying these variants of IPMNs into gastric, intestinal, pancreatobiliary, and oncocytic types. The purpose of this study was to determine associations between the histological types and clinicopathological features in patients with IPMN. METHODS:Sixty-one patients with IPMN operated upon at Tohoku University Hospital between 1988 and 2006 were retrospectively analyzed. RESULTS:Our series included 27 gastric-, 29 intestinal-, 4 pancreatobiliary-, and 1 oncocytic-type IPMNs. Statistically, the types of IPMN were significantly associated with the histological diagnoses, macroscopic types, and survival of the patients. Characteristically, the gastric-type IPMNs were likely to be diagnosed as benign, to be confined to branch ducts, and to have fair prognoses. On the other hand, the intestinal-type IPMNs were likely to be diagnosed as malignant, occupy the main duct, and have poor prognoses. Because of the small number of pancreatobiliary-type IPMNs and only 1 case of oncocytic-type IPMN, we were unable to determine any of their clinicopathological characteristics in our series. CONCLUSIONS:Evaluation of the histological types of IPMN may help to predict the clinical course of patients with IPMN and to design improved clinical management for these patients.

背景与目标：

BACKGROUND & AIMS: :Of the multiple murine models of autoimmunity, the three most closely resembling human systemic lupus erythematosus (SLE) are the MRL/lpr, New Zealand Black/White F(1), and male BXSB. Although these strains share many disease characteristics, no common cellular defect has previously been found in prediseased mice from all these strains. We show in this study that macrophages from prediseased mice of all three SLE-prone strains, as well as macrophages from mice whose genomes contribute to the development of SLE (MRL/+, New Zealand White, New Zealand Black, female BXSB, and LG/J), have an identical and profound defect in cytokine expression that is triggered by apoptotic cells. Strikingly, none of 13 nonautoimmune strains tested exhibited this defect. Given that apoptotic Ags have been increasingly recognized as the target of autoantibodies, a defect in cytokine expression that is triggered by apoptotic cells has broad potential to upset the balance between tolerance and immunity.

背景与目标： : 在自身免疫的多种鼠模型中，最类似于人类系统性红斑狼疮 (SLE) 的三种是MRL/lpr，新西兰黑/白F(1) 和雄性BXSB。尽管这些菌株具有许多疾病特征，但以前在所有这些菌株的患病小鼠中未发现常见的细胞缺陷。我们在这项研究中表明，来自所有三种SLE易患菌株的患病小鼠的巨噬细胞，以及来自其基因组有助于SLE发展的小鼠的巨噬细胞 (MRL/，新西兰白人，新西兰黑人，雌性BXSB和LG/J)，凋亡细胞触发的细胞因子表达具有相同且深刻的缺陷。令人惊讶的是，测试的13种非自身免疫菌株均未显示出这种缺陷。鉴于凋亡Ags已被越来越多地视为自身抗体的靶标，凋亡细胞触发的细胞因子表达缺陷具有破坏耐受性和免疫力之间平衡的广泛潜力。

BACKGROUND & AIMS: :The lives of recipients of peripheral blood progenitor cells (PBPC) depend upon the availability of PBPC. Rupture of stem cell bags does occur and can have devastating consequences. Each transplant center should agree on a rescue procedure and train its personnel to use it. We provide an example of such a procedure, and its update after the procedure was used for the first time.

背景与目标： : 外周血祖细胞 (PBPC) 接受者的生命取决于PBPC的可用性。干细胞袋确实会破裂，并可能造成毁灭性的后果。每个移植中心应就抢救程序达成一致，并培训其人员使用该程序。我们提供了这样一个过程的示例，以及该过程首次使用后的更新。

BACKGROUND & AIMS: :Early tracheal extubation in the operating room after atrial septal defect (ASD) surgery was recommended as part of a clinical practice guideline (CPG) established in the Cardiovascular Program at the Children's Hospital, Boston, MA. This retrospective review was undertaken to determine whether this practice was efficient without compromising patient care. The charts and hospital charges for 102 patients undergoing secundum ASD or sinus venosus defect surgery between March 1992 and July 1994 were reviewed; 36 patients (Group I) had surgery prior to introduction of the CPG, and 66 patients were managed according to the CPG. Of the latter, 25 patients (Group II) were tracheally extubated in the operating room (OR) and 41 patients (Group III) were extubated in the cardiac intensive care unit (CICU). Patients in all three groups were similar with respect to height, weight, and surgical conditions including cardiopulmonary bypass time, lowest esophageal temperature, hematocrit, total OR time, and the time from completion of bypass to leaving the OR. Patients in Group II received significantly less fentanyl during anesthesia, were more likely to have a respiratory acidosis on admission to the CICU, and had an increased frequency of vomiting in the CICU. There was no difference in duration of CICU stay among groups. The length of hospital stay was reduced in Groups II and III after introduction of the CPGs, but was not influenced by tracheal extubation in the OR. There was no difference among groups in the hospital charges for OR, anesthesia and CICU time. However, when the combined hospital charges for services provided both in the OR and CICU were included, patients in Group II were charged significantly less, and this primarily reflects the absence of postoperative mechanical ventilation charges. Tracheal extubation in the OR after ASD surgery in children can result in lower patient charges without significantly compromising patient care.

背景与目标： : 建议将房间隔缺损 (ASD) 手术后在手术室进行早期气管拔管，作为马萨诸塞州波士顿儿童医院心血管计划中建立的临床实践指南 (CPG) 的一部分。进行这项回顾性审查是为了确定这种做法在不影响患者护理的情况下是否有效。回顾了1992年3月至1994年7月之间接受secundum ASD或鼻窦静脉缺损手术的102例患者的图表和住院费用; 36例患者 (I组) 在引入CPG之前进行了手术，66例患者根据CPG进行了治疗。在后者中，25例患者 (II组) 在手术室 (OR) 气管拔管，41例患者 (III组) 在心脏重症监护病房 (CICU) 拔管。三组患者的身高，体重和手术条件相似，包括体外循环时间，最低食管温度，血细胞比容，总或时间以及从旁路完成到离开OR的时间。第二组患者在麻醉期间接受的芬太尼明显减少，入院时更容易出现呼吸性酸中毒，并且在CICU中呕吐的频率增加。各组间CICU停留时间无差异。引入CPGs后，II组和III组的住院时间减少了，但不受OR中气管拔管的影响。两组之间的医院费用，麻醉和CICU时间没有差异。但是，如果将OR和CICU中提供的服务的合并医院费用包括在内，则II组患者的费用明显减少，这主要反映了术后没有机械通气费用。儿童ASD手术中或之后的气管拔管可降低患者费用，而不会显着影响患者的护理。

BACKGROUND & AIMS: :A cost-minimization analysis was performed to compare the direct costs of various neuromuscular blocking agents (NMBAs) in procedures of specific durations. Secondary objectives were to review the role of the NMBAs studied with respect to their place on our hospital formulary, and to develop a pharmacoeconomic methodology to be applied to other formulary decisions. Patients were stratified according to estimated length of surgical procedure; group 1 (55 patients) included surgeries estimated to take less than 2 hours, and group 2 (55 patients) included those estimated to be 2-4 hours long. Patients were then randomized to one of three intermediate-acting NMBAs: atracurium, vecuronium, or rocuronium. Anesthesia records were used to obtain all anesthetic agents administered in the operating room, and drug costs were calculated from hospital drug acquisition costs as of December 1994. Postanesthesia care unit (PACU) costs were estimated from patient charges and converted to costs using our hospital's cost-to-charge ratio. Costs that were common to all study treatments or unrelated to the use of NMBAs were excluded from the analysis. Two time-adjusted costs were calculated to determine the cost of neuromuscular blockade/hour and the total anesthesia drug costs/hour. In group 1 there were no statistical differences in NMBA cost/hour, anesthesia cost/hour, or PACU times or costs. In group 2, a significant difference was found in NMBA cost/case between atracurium ($54.23 +/- 41.26, mean +/- SD) and vecuronium ($31.95 +/- 15.33, p = 0.046). Atracurium was also significantly more costly than either vecuronium or recuronium/hour ($21.95 +/- 7.42 vs $14.39 +/- 7.02 and $16.07 +/- 8.15, respectively, p = 0.011) and anesthesia cost/hour ($28.77 +/- 7.43 vs $ 22.82 +/- 7.46 and $23.32 +/- 6.54, respectively, p = 0.03). There were no differences in PACU times or costs. Based on these results, vecuronium or rocuronium is preferred over atracurium in procedures with an estimated duration of 2-4 hours. In the patient population evaluated, there were no significant cost differences among the three NMBAs in surgeries with an estimated duration of less than 2 hours.

背景与目标： : 进行了成本最小化分析，以比较在特定持续时间内各种神经肌肉阻滞剂 (nmba) 的直接成本。次要目标是审查研究的nmba在我们医院处方集中的位置方面的作用，并开发可应用于其他处方集决策的药物经济学方法。根据估计的手术时间对患者进行分层; 第1组 (55例患者) 包括估计时间少于2小时的手术，第2组 (55例患者) 包括估计时间为2-4小时的手术。然后将患者随机分配到三种中效NMBAs之一: 阿曲库铵，维库溴铵或罗库溴铵。麻醉记录用于获取手术室中使用的所有麻醉剂，并根据1994年12月的医院药物获取成本计算药物成本。麻醉后护理单元 (PACU) 的费用是根据患者费用估算的，并使用我们医院的费用与费用比率转换为费用。所有研究治疗的共同费用或与使用NMBAs无关的费用被排除在分析之外.计算两个时间调整后的成本，以确定神经肌肉阻滞/小时的成本和总麻醉药物成本/小时。在第1组中，NMBA成本/小时，麻醉成本/小时或PACU时间或成本没有统计学差异。在第2组中，阿曲库铵 ($54.23/- 41.26，平均值/- SD) 和维库溴铵 ($31.95/- 15.33，p = 0.046) 之间的NMBA成本/案例存在显着差异。阿曲库铵的成本也明显高于维库溴铵或复发性/小时 (分别为 $21.95/- 7.42与 $14.39/- 7.02和 $16.07/- 8.15，p = 0.011) 和麻醉费用/小时 (分别为 $28.77/- 7.43 vs $22.82/- 7.46和 $23.32/- 6.54，p = 0.03)。PACU时间或费用没有差异。基于这些结果，在估计持续时间为2-4小时的程序中，维库溴铵或罗库溴铵比阿曲库铵更受欢迎。在评估的患者人群中，在估计持续时间少于2小时的手术中，三个nmba之间的成本没有显着差异。

BACKGROUND & AIMS: :All adult BALB/c mice immunized with hen egg white lysozyme (HEL) or its dominant determinant, peptide (p)106-116, mount a T cell response using a "public" Vbeta8.2Jbeta1.5 T cell clone. Neonatal exposure to tolerance-inducing doses of antigen can drastically diminish responsiveness in the draining lymph nodes but not in the spleens of animals challenged as adults with the cognate antigen. To determine the role of T cell deletion or anergy within the mechanisms of observed neonatal "tolerance," we treated neonatal BALB/c mice with HEL and directly followed the characteristic public clone using complementarity determining region 3 length T cell repertoire analysis. Our results confirm that despite intraperitoneal injection of neonates with a high dose of HEL emulsified in incomplete Freund's adjuvant, a strong splenic proliferative response to HEL was observed upon recall. However, the adult splenic T cell response of these neonatally treated mice lacked the usual Vbeta8.2Jbeta1.5 public clone characteristic of HEL-primed BALB/c mice. After challenge with HEL-complete Freund's adjuvant as adults, immunoglobulin (Ig)G2a isotype antibody was drastically reduced, and IgG1 was found to be the predominant anti-HEL IgG isotype expressed, indicating a deviation of cytokine response toward T helper type 2. 5-wk-old mice, nasally instilled with tolerogenic doses of HEL p106-116, also showed significant inhibition of this public T cell expansion. These results demonstrate that during neonatal and adult nasal tolerance induction, deletion/anergy removes the public clone, exposing a response of similar specificity but that is characterized by the T helper type 2 phenotype and a splenic residence.

背景与目标： : 所有用鸡蛋清溶菌酶 (HEL) 或其主要决定簇肽 (p)106-116免疫的成年BALB/c小鼠，均使用 “公共” Vbeta8.2Jbeta1.5 T细胞克隆进行T细胞反应。新生儿暴露于诱导耐受剂量的抗原会大大降低引流淋巴结的反应性，但不会降低成年受到同源抗原攻击的动物脾脏的反应性。为了确定T细胞缺失或无反应性在观察到的新生儿 “耐受性” 机制中的作用，我们用HEL处理了新生BALB/c小鼠，并使用互补决定区域3长度的T细胞库分析直接跟踪了特征性的公共克隆。我们的结果证实，尽管在不完全弗氏佐剂中腹膜内注射了高剂量的HEL乳化新生儿，但在回忆时仍观察到对HEL的强烈脾脏增殖反应。然而，这些新生儿治疗的小鼠的成年脾T细胞反应缺乏HEL引发的BALB/c小鼠通常的Vbeta8.2Jbeta1.5公共克隆特征。成年后，用HEL-complete弗氏佐剂攻击后，免疫球蛋白 (Ig)G2a同种型抗体急剧减少，发现IgG1是表达的主要抗HEL IgG同种型，表明细胞因子对T辅助性2的反应存在偏差。5周龄小鼠，鼻腔滴注耐受剂量的HEL p106-116，也显示出显著抑制这种公共T细胞的扩增。这些结果表明，在新生儿和成人鼻耐受诱导期间，缺失/无反应性去除了公共克隆，暴露出类似特异性的反应，但其特征是T辅助2型表型和脾脏停留。

BACKGROUND & AIMS: :Phenylketonuria (PKU) is an important error of amino acid metabolism which results in most patients from phenylalanine hydroxylase (PAH) deficiency. PKU displays a marked genotypic heterogeneity both within and between different populations. The aim of this study was to establish the genotypic spectrum of PKU in eastern Germany, and to compare this to the distribution of mutations in western Germany. The study population included 302 patients in 290 families who were followed at treatment centers in Berlin, Leipzig and Jena. The study showed marked genotypic variability with a total of 75 mutations, including 15 that have so far not been described (eleven missense mutations, one splicing mutation, and three small deletions). One of these novel mutations, E183Q, occurred in cis to a R408W mutation. In the non-immigrant eastern German population, the frequency of R408W accounted for 40.1% of the PKU alleles. In the immigrant Turkish population of the former West Berlin, the most prevalent mutation was IVS10-11G>A (57%). There was a marked difference of the genotypic spectrum between the population studied here and the data reported from the western part of the country.

背景与目标： : 苯丙酮尿症 (PKU) 是氨基酸代谢的重要错误，导致大多数患者的苯丙氨酸羟化酶 (PAH) 缺乏症。PKU在不同人群内部和之间显示出明显的基因型异质性。这项研究的目的是建立德国东部PKU的基因型谱，并将其与德国西部的突变分布进行比较。研究人群包括290个家庭的302名患者，他们在柏林，莱比锡和耶拿的治疗中心接受了随访。该研究显示了显着的基因型变异性，共有75个突变，其中15个迄今尚未描述 (11个错义突变，1个剪接突变和3个小缺失)。这些新突变之一E183Q发生在顺式R408W突变中。在东德非移民人群中，R408W的频率占PKU等位基因的40.1%。在前西柏林的土耳其移民人口中，最普遍的突变是IVS10-11G>A (57%)。此处研究的人群与该国西部地区报告的数据之间的基因型谱存在显着差异。

BACKGROUND & AIMS: :A two-stage continuous system in combination with a temperature-sensitive expression system were used as model systems to maximize the productivity of a cloned gene and minimize the problem associated with the plasmid instability for a high-expression recombinant. In order to optimize the two-stage fermentation process, the effects of such operational variables as temperature and dilution rate on productivity of cloned gene were studied using the model systems and a recombinant, Escherichia coli K12 DeltaH1 Deltatrp/pPLc23trp A1. When the expression of cloned gene is induced by raising the operating temperature above 38 degrees C, a significant decrease in the colony-forming-units (CFU) of the plasmid-harboring cell was observed, and the decrease was related to the product concentration. In order to describe this phenomenon, a new kinetic parameter related to the metabolic stress (metabolic stress factor) was introduced. It is defined as the ratio of the rate of change of pheno-type from colony-forming to non-colony-forming cells to the product accumulation per unit cell mass. At a fixed temperature of 40 degrees C, the varying dilution rate D in the range of 0.35-0.90 h(-1) did not affect the metabolic stress factor significantly. At a fixed dilution rate of D = 0.35 h(-1), this factor remained practically constant up to 41 degrees C but increased rapidly beyond 41 degrees C. The effects of temperature and dilution rate in the second stage on the specific production rate were also studied while maintaining the apparent specific growth rate (mu(2) (app)) of the second stage constant at or near mu(2) (app) = 0.26 h(-1). Under a constant dilution rate, D(2) = 0.35 h(-1), the maximum specific production rate obtained was about q(p, max) = 38 units TrpA/mg cell/h at 41 degrees C. At a constant temperature, T(2) = 40 degrees C, specific production rate increased with decreasing dilution rate with in the dilution rate range of D(2) = 0.35-0.90 h(-1). Based on the results of our study, the optimal operating conditions found were dilution rate D(2) = 0.35 h(-1) and operating temperature T(2) = 41 degrees C at the apparent specific growth rate of 0.26 h(-1). Under the optimal operating conditions, about threefold increase in productivity was achieved compared to the best batch culture result. In addition, the fermentation period could be extended for more than 100 h.

背景与目标： : 将两阶段连续系统与温度敏感表达系统结合用作模型系统，以最大程度地提高克隆基因的生产率并最大程度地减少与高表达重组体的质粒不稳定性相关的问题。为了优化两阶段发酵工艺，使用模型系统和重组大肠杆菌K12 DeltaH1 Deltatrp/pPLc23trp a1研究了温度和稀释率等操作变量对克隆基因生产率的影响。当通过将操作温度提高到38 ℃ 以上来诱导克隆基因的表达时，观察到载体细胞的集落形成单位 (CFU) 显着降低，并且降低与产物浓度有关。为了描述这种现象，引入了与代谢应激 (代谢应激因子) 有关的新动力学参数。定义为酚型从集落形成细胞到非集落形成细胞的变化率与每单位细胞质量的产物积累之比。在40 ℃ 的固定温度下，在0.35-0.90 h(-1) 范围内变化的稀释率D对代谢应激因子的影响不显著。在D = 0.35 h(-1) 的固定稀释率下，该因子实际上保持恒定，直到41 ℃，但迅速增加超过41 ℃。还研究了第二阶段中的温度和稀释率对比生产率的影响，同时将第二阶段的表观比增长率 (mu(2) (app)) 保持为或接近mu(2) (app) = 0.26 h(-1)。在恒定的稀释率下，D(2) = 0.35 h(-1)，在41 ℃ 下获得的最大比产率约为q(p，max) = 38单位TrpA/mg细胞/h。在恒定温度下，T(2) = 40 ℃，在D(2) = 0.35-0.90 h(-1) 的稀释率范围内，比生产率随着稀释率的降低而增加。根据我们的研究结果，发现的最佳操作条件是稀释率D(2) = 0.35 h(-1) 和操作温度T(2) = 41 ℃，表观比生长速率为0.26 h(-1)。在最佳操作条件下，与最佳分批培养结果相比，生产率提高了约三倍。此外，发酵时间可以延长超过100小时。

BACKGROUND & AIMS: :The intracellular rate-limiting capability of phosphofructokinase in baker's yeast (Saccharomyces cerevisiae) fermentation is investigated using the reaction path analysis discussed by Liao and Lightfoot in a previous article. It is found that the yeast cells under our experimental conditions indeed exhibit the characteristic behavior, and the characteristic reaction path on the G6P-ATP phase plot is determined for cells fed with different sugars, cells of different strains, and cells in the transition period following rehydration. Results suggest that phosphofructokinase does not limit the CO(2) production rate of the cells under investigation. However, it is not present in a great excess either: ca. 80% of phosphofructokinase activity is utilized by the glycolytic pathway of the cell under investigation.

背景与目标： : 使用Liao和Lightfoot在上一篇文章中讨论的反应路径分析，研究了面包酵母 (Saccharomyces cerevisiae) 发酵中磷酸果糖激酶的细胞内限速能力。发现在我们的实验条件下，酵母细胞确实表现出了特征行为，并且确定了G6P-ATP相图上的特征反应路径，用于喂食不同糖的细胞，不同菌株的细胞以及处于复水后过渡期的细胞。结果表明，磷酸果糖激酶不会限制所研究细胞的CO(2) 产生速率。然而，它也不存在很大的过量: 大约80% 的磷酸果糖激酶活性被所研究的细胞的糖酵解途径利用。

BACKGROUND & AIMS: :This article reports on a patient who needed intensive care treatment because of multiple trauma. The patient had no preexisting liver disease but developed secondary sclerosing cholangitis and finally died. The etiology, diagnosis and therapeutic options of this clinical picture are discussed and a review of the literature is presented.

背景与目标： : 本文报道了一名因多重创伤而需要重症监护治疗的患者。该患者没有先前存在的肝脏疾病，但发生了继发性硬化性胆管炎，并最终死亡。讨论了该临床图片的病因，诊断和治疗选择，并对文献进行了回顾。

BACKGROUND & AIMS: :In a search for features predictive of ventricular arrhythmias in myocardial ischemia, the body surface potential maps of 17 dogs with coronary artery occlusion were studied. Ventricular tachycardia occurred in 9 (53%) of the 17 dogs. Multiple distribution of the abnormal potential minimum was found in 6 (67%) of the 9 dogs with (group A) and none of the 8 dogs without ventricular tachycardia (group B). The difference was statistically significant (p less than 0.01). The abnormal "early reversal" phenomenon of potential distribution was observed in 6 (67%) of group A and 7 (88%) of group B. The difference was not statistically significant (p greater than 0.05). The area of abnormal negative potential was 28.0 +/- 8.5 cm2 for group A and 14.5 +/- 5.5 cm2 for group B (p less than 0.001). The abnormal negative potential lasted for 25.4 +/- 3.5 ms in group A and 10.1 +/- 5.1 ms in group B (p less than 0.001). The abnormally early appearance of potential minimum lasted for 24.2 +/- 5.1 ms in group A and 10.5 +/- 5.4 ms in group B (p less than 0.001). The data suggest that the distribution, area, and duration of the abnormal negative potential of the body surface potential map are useful in the prediction of ventricular tachycardia associated with coronary artery occlusion.

背景与目标： : 为了寻找心肌缺血中室性心律失常的预测特征，研究了17只患有冠状动脉闭塞的狗的体表电位图。17只狗中有9只 (53% 只) 发生了室性心动过速。在9只患有 (A组) 的狗中有6只 (67% 只) 和8只没有室性心动过速的狗 (B组) 中没有发现异常电位最小值的多重分布。差异有统计学意义 (p <0.01)。在A组的6 (67%) 和B组的7 (88%) 中观察到电位分布的异常 “早期逆转” 现象。差异无统计学意义 (p> 0.05)。A组异常负电位面积28.0 +/-8.5平方厘米，B组14.5 +/-5.5平方厘米 (p小于0.001)。A组异常负电位持续25.4 +/- 3.5 ms，B组10.1 +/- 5.1 ms (p小于0.001)。潜在最小值的异常早期出现在A组持续24.2 +/- 5.1 ms，在B组持续10.5 +/- 5.4 ms (p小于0.001)。数据表明，体表电位图异常负电位的分布，面积和持续时间可用于预测与冠状动脉闭塞相关的室性心动过速。

BACKGROUND & AIMS: :Burkitt's lymphoma (BL) is a highly malignant, aggressive non-Hodgkin's lymphoma derived from germinal center B cells. Recently, global gene expression profiling of patient samples led to a molecular definition of BL with lymphocyte enhancer-binding factor 1 (LEF1) as a signature gene. Herein, we report the expression of nucleic LEF1 in 15 of 18 patients with BL and the identification of LEF1 target genes. Germinal center B cells were devoid of detectable nuclear LEF1 expression, as were mantle cell lymphoma (0 of 5), marginal zone lymphoma (0 of 6), follicular lymphoma (0 of 12), and diffuse large B-cell lymphoma (1 of 31). Whole-genome gene expression profiling after transient knockdown of LEF1 in BL cell lines identified new LEF1 target genes; these LEF1 targets are enriched with genes associated with cancers. The expression of LEF1 and LEF1-regulated genes in primary BL suggests that LEF1 is not only aberrantly expressed but also transcriptionally active. This study supports a functionally important role for LEF1 and its target genes in BLs.

背景与目标： : 伯基特淋巴瘤 (BL) 是一种高度恶性，侵袭性的非霍奇金淋巴瘤，源自生发中心b细胞。最近，患者样本的全球基因表达谱导致了以淋巴细胞增强子结合因子1 (LEF1) 为特征基因的BL的分子定义。在此，我们报告了18例BL患者中的15例核酸LEF1的表达以及LEF1靶基因的鉴定。生发中心b细胞缺乏可检测的核LEF1表达，套细胞淋巴瘤 (5个中的0个)，边缘区淋巴瘤 (6个中的0个)，滤泡性淋巴瘤 (12个中的0个) 和弥漫性大b细胞淋巴瘤 (1个) 31)。在BL细胞系中瞬时敲除LEF1后，全基因组基因表达谱确定了新的LEF1靶基因; 这些LEF1靶富含与癌症相关的基因。LEF1和LEF1-regulated基因在初级BL中的表达表明LEF1不仅异常表达，而且转录活性高。这项研究支持LEF1及其靶基因在BLs中的功能重要作用。

BACKGROUND & AIMS: :Sludge production in wastewater treatment plants is nowadays a big concern due to the high produced amounts and their characteristics. Consequently, the study of techniques that reduce the sludge generation in wastewater treatment plants is becoming of great importance. In this work, four laboratory sequencing batch reactors (SBRs), which treated municipal wastewater, were operated to study the effect of adding the metabolic uncoupler 3,3',4',5-tetrachlorosalicylanilide (TCS) on the sludge reduction, the SBRs performance and the microbial hydrolytic enzymatic activities (MHEA). In addition, different operating conditions of the SBRs were tested to study the effect of the TCS on the process: two dissolved oxygen (DO) concentrations (2 and 9 mg L-1) and two F/M ratio (0.18 and 0.35 g COD·g MLVSS-1·d-1). The sludge production decreased under high DO concentrations. At the same time, the DNA and EPS production increased in the four SBRs. After these stress conditions, the performance of the reactors were recovered when DO was around 2 mg L-1. From that moment on, results showed that TCS addition implied a reduction of the adenosine triphosphate (ATP) production, which implied a decrease in the sludge production. In spite of this reduction, the SBRs performances did not decay due to the increase in the global MHEA. Additionally, the sludge reduction was enhanced by the increase of the F/M ratio, achieving 28% and 60% of reduction for the low and the high F/M ratio, respectively.

背景与目标： : 由于高产量及其特点，如今废水处理厂的污泥生产已成为人们关注的一个大问题。因此，研究减少废水处理厂污泥产生的技术变得非常重要。在这项工作中，运行了四个处理城市废水的实验室序批式反应器 (sbr)，以研究添加代谢解偶联剂3,3 '，4'，5-四氯水杨酰苯胺 (TCS) 对污泥减量，SBRs性能和微生物水解酶活性 (MHEA) 的影响。此外，测试了sbr的不同操作条件以研究TCS对该过程的影响: 两种溶解氧 (DO) 浓度 (2和9 mg L-1) 和两种F/M比 (0.18和0.35g COD·g MLVSS-1·d-1)。在高DO浓度下，污泥产量下降。同时，四个sbr的DNA和EPS产量增加。在这些应力条件之后，当DO为约2 mg L-1时恢复反应器的性能。从那时起，结果表明添加TCS意味着三磷酸腺苷 (ATP) 产量的减少，这意味着污泥产量的减少。尽管有所降低，但由于全球MHEA的增加，SBRs的性能并未下降。此外，通过增加F/M比来增强污泥的减少量，分别实现了低F/M比和高F/M比的减少量的28% 和60%。

BACKGROUND & AIMS: :By April 7, 2020, severe acute respiratory syndrome coronavirus 2 was responsible for 1,383,436 confirmed cases of Coronavirus disease 2019 (COVID-19), involving 209 countries around the world; 378,881 cases have been confirmed in the United States. During this pandemic, the urgent surgical requirements will not stop. As an example, the most recent Centers of Disease Control and Prevention reports estimate that there are 2.8 million trauma patients hospitalized in the United States. These data illustrate an increase in the likelihood of encountering urgent surgical patients with either clinically suspected or confirmed COVID-19 in the near future. Preparation for a pandemic involves considering the different levels in the hierarchy of controls and the different phases of the pandemic. Apart from the fact that this pandemic certainly involves many important health, economic, and community ramifications, it also requires several initiatives to mandate what measures are most appropriate to prepare for mitigating the occupational risks. This article provides evidence-based recommendations and measures for the appropriate personal protective equipment for different clinical and surgical activities in various settings. To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, emergency department consultation room, induction room, operating room, and recovery room) are reviewed.

背景与目标： : 根据2020年4月7日，新型冠状病毒负责1,383,436确诊病例的冠状病毒病2019新型冠状病毒肺炎)，涉及全球209个国家; 美国已确认378,881例。在这次大流行期间，紧急手术要求不会停止。例如，最新的疾病控制和预防中心报告估计，美国有280万名创伤患者住院。这些数据表明，在不久的将来，遇到临床疑似或确诊COVID-19的紧急手术患者的可能性增加。大流行的准备工作包括考虑控制层次结构中的不同级别和大流行的不同阶段。除了这一流行病肯定涉及许多重要的健康、经济和社区影响之外，它还需要采取几项举措来强制采取最合适的措施来为减轻职业风险做准备。本文为各种环境下的不同临床和手术活动提供了基于证据的建议和措施，以提供适当的个人防护设备。为降低疑似或确诊的COVID-19紧急骨科患者的职业风险，建议采取预防措施和预防措施 (分诊区、急诊科诊室、感应室、手术室和康复室)。