BACKGROUND & AIMS: OBJECTIVE:Provoked deep venous thrombosis (DVT) is precipitated by a specific event. This paper compares the characteristics of provoked DVT in patients with transient risk (TR) factors and patients with continuous risk (CR) factors. METHODS:A retrospective review of records of all consecutive patients diagnosed with DVT between January 2013 and August 2014 was performed. Patients with provoked DVT were included in the TR group if the provoking event resolved in 2 weeks and they did not have ongoing risk of thrombosis. Patients in the CR group had a provoked DVT with ongoing risk of thrombosis due to individual factors deemed to be ongoing risks of thrombosis, such as cancer, hypercoagulable disorder, and prolonged immobilization. Demographics, risk factors, association with pulmonary embolism (PE) and its severity, risk of recurrent venous thromboembolism (VTE), and mortality were compared between the two groups. RESULTS:A total of 838 patients were diagnosed with DVT, and 50.7% (425) were provoked. There were 127 (29.9%) patients with TR and 298 (70.1%) with CR. TR patients were younger (60.4 ± 16.3 vs 65.9 ± 16.0; P = .001). TR was more likely to be provoked by surgery (70.9% vs 55.4%; P = .003), whereas CR was more likely to be provoked by immobilization (21.5% vs 12.6%; P = .032). CR patients were affected by cancer (48.7%) and hypercoagulable disorders (4.4%). TR patients were more likely to have calf DVTs (36.2% vs 26.2%; P = .047). There was a trend toward lower association with PE on presentation in TR (17.3% vs 21.1%; P = .072), but that did not reach statistical significance. However, TR factors were more likely to be associated with low-risk PE compared with CR factors (30.2% vs 54.6%; P = .040). After mean follow-up of 7.2 months, CR had higher risk of recurrent VTE (14.0% vs 6.8%; P = .045) and mortality (23.5% vs 7.1%; P < .0001). CONCLUSIONS:Provoked DVT with CR factors affects older patients and is associated with high recurrence of VTE and mortality compared with provoked DVT with TR factors.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The purpose of this study was to describe a new modification for big-bubble deep anterior lamellar keratoplasty (DALK) using pneumatic pressure to detach Descemet membrane (DM) via air injection followed by ophthalmic viscoelastic device (OVD) injection. METHODS:After failure of big-bubble formation after air injection, OVD was injected from a different site other than the previous air injection using a 27-gauge cannula to detach DM, called air-visco bubble (AVB) DALK technique. The technique was used in 7 human corneoscleral rims that were investigated with anterior segment optical coherence tomography and histopathology and in 69 eyes that underwent DALK surgeries. RESULTS:Big-bubble formation was noted in 4 of 7 of the donor corneoscleral rims. The anterior segment optical coherence tomography showed big-bubble formations together with intrastromal OVD accumulation. The histology of the donor corneas showed microdetachments at the DM in the periphery, deep intrastromal separation, and big-bubble formation filled with OVD. One hundred forty-one of 210 eyes (67%) underwent successful DALK with only air injection, and 69 of 210 eyes (33%) underwent AVB technique when a big bubble was not achieved with only air injection. All the corneas showed a clear interface with good wound healing when DM was bared with the AVB DALK technique. CONCLUSIONS:Additional OVD injection to detach DM may be useful in cases where air injection fails. Also, creating small DM detachments with air injection may facilitate the formation of a big bubble with further OVD injection.

背景与目标：

BACKGROUND & AIMS: :A 51-year-old human immunodeficiency virus (HIV)-positive male patient (CDC stage 3C) had had a painful nodule on his external ankle joint for 10 months. A biopsy suggested bacillary angiomatosis, but Kaposi's sarcoma could not be excluded. Rods were detectable in lesional skin by a Warthin-Starry stain. A 298 base pair (bp) gene fragment specific for Bartonella species was amplified from lesional skin and direct nucleotide sequence analysis of the amplification product clearly identified Bartonella quintana. Kaposi's sarcoma-associated herpes virus specific DNA was not amplifiable by polymerase chain reaction (PCR) in our patient, suggesting that the lesion represented bacillary angiomatosis alone, despite clinical and histopathological features which suggested the coexistence of bacillary angiomatosis and Kaposi's sarcoma. The lesion regressed after erythromycin was prescribed. However, 4 and 9 weeks after initiation of therapy, PCR still yielded a positive result in material obtained by a swab. After complete healing, following 12 weeks of antibiotic therapy, PCR became consistently negative. The optimal length of antibiotic treatment in HIV-positive patients with bacillary angiomatosis is not yet known and inadequate therapy may be followed by disseminated disease and a fatal outcome. PCR-based monitoring of the success of treatment is valuable for determining the duration of treatment resulting in a cure.

背景与目标： : 一名51岁的人类免疫缺陷病毒 (HIV) 阳性男性患者 (CDC阶段3C) 的外踝关节结节疼痛10个月。活检提示细菌性血管瘤病，但不能排除卡波西氏肉瘤。通过Warthin-Starry染色在病变皮肤中可检测到杆。从病变皮肤扩增出针对巴尔通体物种的298碱基对 (bp) 基因片段，并对扩增产物的直接核苷酸序列分析清楚地鉴定出了巴尔通体。在我们的患者中，与卡波西氏肉瘤相关的疱疹病毒特异性DNA无法通过聚合酶链反应 (PCR) 扩增，这表明该病变仅代表细菌性血管瘤病，尽管临床和组织病理学特征表明细菌性血管瘤病和卡波西氏肉瘤并存。开药红霉素后病变消退。然而，在开始治疗后4周和9周，PCR仍在拭子获得的材料中产生阳性结果。完全愈合后，经过12周的抗生素治疗，PCR始终呈阴性。对于HIV阳性的细菌性血管瘤病患者，抗生素治疗的最佳时间尚不清楚，治疗不足可能会导致传播性疾病和致命后果。基于PCR的治疗成功监测对于确定导致治愈的治疗持续时间很有价值。

BACKGROUND & AIMS: BACKGROUND:The relative importance of previous diagnosis and hereditary prothrombotic risk factors for cerebral venous thrombosis (CVT) in children in determining risk of a second cerebral or systemic venous thrombosis (VT), compared with other clinical, neuroimaging, and treatment variables, is unknown. METHODS:We followed up the survivors of 396 consecutively enrolled patients with CVT, aged newborn to 18 years (median 5.2 years) for a median of 36 months (maximum 85 months). In accordance with international treatment guidelines, 250 children (65%) received acute anticoagulation with unfractionated heparin or low-molecular weight heparin, followed by secondary anticoagulation prophylaxis with low-molecular weight heparin or warfarin in 165 (43%). RESULTS:Of 396 children enrolled, 12 died immediately and 22 (6%) had recurrent VT (13 cerebral; 3%) at a median of 6 months (range 0.1-85). Repeat venous imaging was available in 266 children. Recurrent VT only occurred in children whose first CVT was diagnosed after age 2 years; the underlying medical condition had no effect. In Cox regression analyses, non-administration of anticoagulant before relapse (hazard ratio [HR] 11.2 95% CI 3.4-37.0; p<0.0001), persistent occlusion on repeat venous imaging (4.1, 1.1-14.8; p=0.032), and heterozygosity for the G20210A mutation in factor II (4.3, 1.1-16.2; p=0.034) were independently associated with recurrent VT. Among patients who had recurrent VT, 70% (15) occurred within the 6 months after onset. CONCLUSION:Age at CVT onset, non-administration of anticoagulation, persistent venous occlusion, and presence of G20210A mutation in factor II predict recurrent VT in children. Secondary prophylactic anticoagulation should be given on a patient-to-patient basis in children with newly identified CVT and at high risk of recurrent VT. Factors that affect recanalisation need further research.

背景与目标：

BACKGROUND & AIMS: :The incidence of thromboembolism is higher in mitral regurgitation. Mean platelet volume (MPV), which is calculated automatically in the complete blood count tests, indicates platelet production, function and activation. Elevated MPV levels in cardiovascular diseases and some heart valve diseases have been shown before. We aimed to investigate the relationship between MPV and mitral regurgitation, and to evaluate the MPV levels according to the presence of atrial fibrillation or left atrial appendage thrombus in patients with mitral regurgitation for the first time. The study included 57 patients who had undergone transthoracic and transesophageal echocardiography for the classic symptoms and diagnosed with primary (organic) mitral regurgitation. The control group was composed of 46 age, sex and BMI-matched healthy individuals who had undergone transthoracic echocardiography and obtained normal findings. Echocardiographic evaluation was performed according to the recommendations of the American Echocardiography Society. Mean MPV values in patients with mitral regurgitation were significantly higher than the control group (P < 0.001). MPV levels and the thrombus risk were correlated with the severity of the disease. When the patients with mitral regurgitation were classified according to the presence of atrial fibrillation and left atrial appendage thrombus, patients with atrial fibrillation had higher MPV levels compared to patients with normal sinus rhythm (P < 0.001). In addition, highest MPV levels were found in patients with both atrial fibrillation and thrombosis (P < 0.001). In conclusion, measurement of MPV may be considered as a quick and reliable guide in the assessment of mitral regurgitation and thrombus, without any cost or any advanced expensive technology.

背景与目标： : 二尖瓣反流中血栓栓塞的发生率较高。在整个血液计数测试中自动计算的平均血小板体积 (MPV) 表示血小板的产生，功能和激活。以前已显示心血管疾病和某些心脏瓣膜疾病中的MPV水平升高。本研究旨在探讨MPV与二尖瓣反流的关系，并根据首次发生二尖瓣反流的患者是否存在心房颤动或左心耳血栓来评估MPV水平。该研究包括57例经胸和经食管超声心动图检查经典症状并被诊断为原发性 (器质性) 二尖瓣反流的患者。对照组由46名年龄，性别和BMI相匹配的健康人组成，他们接受了经胸超声心动图检查并获得了正常的发现。根据美国超声心动图学会的建议进行超声心动图评估。二尖瓣反流患者的平均MPV值明显高于对照组 (p  <  0.001)。MPV水平和血栓风险与疾病的严重程度相关。根据是否存在心房颤动和左心耳血栓对二尖瓣关闭不全患者进行分类时，心房颤动患者的MPV水平高于窦性心律正常患者 (p  <  0.001)。此外，房颤和血栓形成患者的MPV水平最高 (p  <  0.001)。总之，MPV的测量可以被认为是评估二尖瓣反流和血栓的快速可靠的指南，而无需任何成本或任何先进的昂贵技术。

BACKGROUND & AIMS: PREMISE OF STUDY:The mechanisms by which plants tolerate water deficit are only just becoming clear. One key factor in drought tolerance is the ability to maintain the capacity to conduct water through the leaves in conditions of water stress. Recent work has shown that a simple feature of the leaf xylem cells, the cube of the thickness of cell walls divided by the lumen width (t/b)(3), is strongly correlated with this ability. METHODS:Using ecologically, phylogenetically, and anatomically diverse members of Proteaceae, we tested the relationships between (t/b)(3) and climate, leaf mass per unit area, leaf area, and vein density. To test relationships at high phylogenetic levels (mostly genus), we used phylogenetic and nonphylogenetic single and multiple regressions based on data from 50 species. We also used 14 within-genus species pairs to test for relationships at lower phylogenetic levels. KEY RESULTS:All analyses revealed that climate, especially mean annual precipitation, was the best predictor of (t/b)(3). The variation in (t/b)(3) was driven by variation in both lumen diameter and wall thickness, implying active control of these dimensions. Total vein density was weakly related to (t/b)(3) but unrelated to either leaf area or climate. CONCLUSIONS:We conclude that xylem reinforcement is a fundamental adaptation for water stress tolerance and, among evergreen woody plants, drives a strong association between rainfall and xylem anatomy. The strong association between (t/b)(3) and climate cannot be explained by autocorrelation with other aspects of leaf form and anatomy that vary along precipitation gradients.

背景与目标：

BACKGROUND & AIMS: :A strictly aerobic, Gram-stain positive, slightly halophilic strain, designated SCSIO 04524(T), was isolated from a deep sea sediment sample collected from the northern South China Sea at a depth of 3415 m. The isolate slightly embedded into the medium after 72 h incubation at 30 °C. Growth was found to occur on media with 0-10 % NaCl but extremely weak growth occurred without supplying NaCl. The predominant menaquinone was determined to be MK-7. The major cellular fatty acid identified was iso-C15:0. The diagnostic polar lipids were determined to be diphosphatidylglycerol, phosphatidyl methylethanolamine, phosphatidylethanolamine and phosphatidylglycerol. The genomic DNA G+C content was determined to be 38 mol%. 16S rRNA gene sequences analysis showed that this strain had the highest similarities with Bacillus carboniphilus JCM 9731(T) (94.7 %) and Bacillus endophyticus 2DT(T) (94.3 %). Phylogenetic analysis revealed that strain SCSIO 04524(T) formed a distinct lineage with Bacillus chungangensis CAU 348(T) and B. carboniphilus JCM 9731(T). Physiological characteristics including utilization of sole nitrogen and carbon sources, and chemotaxonomic properties of cellular fatty acids and polar lipids could readily distinguish strain SCSIO 04524(T) from its most closely related species. Based on this polyphasic taxonomic data, a new species, Bacillus oceani sp. nov., is proposed, with the type strain SCSIO 04524(T) (=DSM 26213(T) = KCTC 33077(T)).

背景与目标： : 从从南海北部收集的深度为3415 m的深海沉积物样品中分离出严格需氧，革兰氏染色阳性，轻度嗜盐菌株，命名为SCSIO 04524(T)。在30 °C孵育72小时后，该分离物略微嵌入培养基中。发现在具有0-10% NaCl的培养基上发生生长，但是在不提供NaCl的情况下发生极弱的生长。主要的menaquinone被确定为MK-7。所鉴定的主要细胞脂肪酸为iso-C15:0。诊断极性脂质被确定为二磷脂酰甘油，磷脂酰甲基乙醇胺，磷脂酰乙醇胺和磷脂酰甘油。确定基因组DNA G C含量为38 mol %。16S rRNA基因序列分析表明，该菌株与碳酸芽孢杆菌JCM 9731(T) (94.7%) 和内生芽孢杆菌2DT(T) (94.3%) 具有最高的相似性。系统发育分析表明，菌株SCSIO 04524(T) 与重庆芽孢杆菌CAU 348(T) 和B. carboniphilus JCM 9731(T) 形成了独特的谱系。生理特性，包括唯一的氮和碳源的利用，以及细胞脂肪酸和极性脂质的化学分类特性，可以很容易地将SCSIO 04524(T) 菌株与其最密切相关的物种区分开。基于这一多相分类学数据，提出了一种新的物种，11月芽孢杆菌，其类型为SCSIO 04524(T) (= DSM 26213(T) = KCTC 33077(T))。

BACKGROUND & AIMS: :We studied the involvement of deep cortical layer neurons in processing callosal information in the rat. We observed with electron microscopy that both parvalbumin (PV)-labeled profiles and unlabeled dendritic spines of deep cortical layer neurons receive synapses from the contralateral hemisphere. Stimulation of callosal fibers elicited monosynaptic excitatory postsynaptic currents in both layer VI pyramidal neurons and gamma-aminobutyric acidergic (GABAergic) interneurons immunopositive for the vesicular GABA transporter and PV. Pyramidal cells had intrinsic electrophysiological properties and synaptic responses with slow kinetics and a robust N-metyhl-D-aspartate (NMDA) component. In contrast, GABAergic interneurons had intrinsic membrane properties and synaptic responses with faster kinetics and a less pronounced NMDA component. Consistent with these results, the temporal integration of callosal input was effective over a significantly longer time window in pyramidal neurons compared with GABAergic interneurons. Interestingly, callosal stimulation did not evoke feedforward inhibition in all GABAergic interneurons and in the majority of pyramidal neurons tested. Furthermore, retrogradely labeled layer VI pyramidal neurons of the contralateral cortex responded monosynaptically to callosal stimulation, suggesting interconnectivity between callosally projecting neurons. The data show that pyramidal neurons and GABAergic interneurons of deep cortical layers receive interhemispheric information directly and have properties supporting their distinct roles.

背景与目标： : 我们研究了深皮质层神经元在处理大鼠call骨信息中的参与。我们用电子显微镜观察到，浅白蛋白 (PV) 标记的轮廓和深皮质层神经元的未标记的树突棘均从对侧半球接收突触。Call骨纤维的刺激在VI层锥体神经元和 γ-氨基丁酸 (GABA能) 中间神经元中均引起单突触兴奋性突触后电流，对囊泡GABA转运蛋白和PV免疫呈阳性。锥体细胞具有内在的电生理特性和突触反应，动力学缓慢，并且具有强大的N-metyhl-D-天冬氨酸 (NMDA) 成分。相反，gaba能中间神经元具有内在的膜特性和突触反应，其动力学更快，NMDA成分不那么明显。与这些结果一致，与gaba能中间神经元相比，在锥体神经元中，call骨输入的时间整合在明显更长的时间窗口内有效。有趣的是，在所有gaba能中间神经元和大多数测试的锥体神经元中，call刺激并未引起前馈抑制。此外，对侧皮层的逆行标记的第VI层锥体神经元对call骨刺激单突触反应，表明call骨投射神经元之间的相互连接。数据表明，皮层深层的锥体神经元和gaba能中间神经元直接接收半球间信息，并具有支持其独特作用的特性。

BACKGROUND & AIMS: OBJECTIVES:To describe the 15-year incidence of retinal vein occlusion (central retinal vein occlusion and branch retinal vein occlusion) and associated risk factors. METHODS:A population-based study where branch retinal vein occlusion and central retinal vein occlusion were detected at baseline (n = 4068, 1988-1990) and three 5-year follow-up examinations by grading 30 degrees color fundus photographs. RESULTS:The 15-year cumulative incidences of branch retinal vein occlusion and central retinal vein occlusion were 1.8% and 0.5%, respectively. Using a generalized estimating equation model, incident retinal vein occlusion was related to baseline age (odds ratio [OR] per 10 years, 1.70; 95% confidence interval [CI], 1.36-2.12), history of barbiturate use (OR, 5.30; 95% CI, 2.28-12.31), focal retinal arteriolar narrowing (OR, 2.45; 95% CI, 1.29-4.66), glaucoma (OR, 3.17; 95% CI, 1.50-6.69), serum ionized calcium level (OR per 0.4 mg/dL, 0.43; 95% CI, 0.23-0.79), serum phosphorus level (OR per 0.3 mg/dL, 1.15; 95% CI, 1.01-1.30), and serum creatinine level (OR for > or = 1.4 vs < 1.4 mg/dL, 1.61; 95% CI, 1.00-2.59). Migraine headache history was associated with branch retinal vein occlusion (OR, 1.99; 95% CI, 1.08-3.67). Diabetes history was associated with central retinal vein occlusion (OR, 6.35; 95% CI, 1.90-21.27). CONCLUSIONS:Incident retinal vein occlusion is not infrequent in the population, especially after age 65 years. The relationships of barbiturate use, serum creatinine level, serum ionized calcium level, and serum phosphorus level with incident retinal vein occlusion require further assessment in other large population-based studies.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The purpose of this study was to evaluate the safety and efficacy of transorbital puncture for the retreatment of previously embolized cavernous sinus dural arteriovenous fistulas (DAVFs) via a superior ophthalmic vein (SOV) approach. MATERIALS AND METHODS:During a 12-year period, 9 consecutive patients with previously embolized cavernous sinus DAVFs underwent retreatment via the transorbital SOV approach. RESULTS:All of the nine cases of previously embolized cavernous sinus DAVFs were successfully embolized. Clinical follow-ups were conducted in all nine cases at the duration of 17-141 months (61.22 ± 39.13 months). No recanalization occurred during the follow-up period. A subtle ptosis appeared in two patients and disappeared in one of the two cases after a 4-year follow-up. One patient suffered from paroxysmal positional vertigo and bruit for nearly 2 years after the treatment, but the follow-up angiography demonstrated no recurrence. One patient had persistent visual impairment caused by the initial venous stasis retinopathy. One patient with a history of a procedure-related transient decrease in visual acuity had it return to the normal level. The remaining four cases had clear improvement in the ocular symptoms and became completely asymptomatic during the follow-up period. No patient worsened or developed new symptoms. CONCLUSION:The approach of surgical cannulation of the SOV for the retreatment of previously embolized cavernous sinus DAVFs was proved feasible and efficient, especially when the transarterial and transfemoral venous approaches were inaccessible. However, if the SOV is not dilated enough or is located deeply in the orbit, transorbital venous puncture access may not be possible.

背景与目标：

BACKGROUND & AIMS: :Succinylation is a type of protein post-translational modification (PTM), which can play important roles in a variety of cellular processes. Due to an increasing number of site-specific succinylated peptides obtained from high-throughput mass spectrometry (MS), various tools have been developed for computationally identifying succinylated sites on proteins. However, most of these tools predict succinylation sites based on traditional machine learning methods. Hence, this work aimed to carry out the succinylation site prediction based on a deep learning model. The abundance of MS-verified succinylated peptides enabled the investigation of substrate site specificity of succinylation sites through sequence-based attributes, such as position-specific amino acid composition, the composition of k-spaced amino acid pairs (CKSAAP), and position-specific scoring matrix (PSSM). Additionally, the maximal dependence decomposition (MDD) was adopted to detect the substrate signatures of lysine succinylation sites by dividing all succinylated sequences into several groups with conserved substrate motifs. According to the results of ten-fold cross-validation, the deep learning model trained using PSSM and informative CKSAAP attributes can reach the best predictive performance and also perform better than traditional machine-learning methods. Moreover, an independent testing dataset that truly did not exist in the training dataset was used to compare the proposed method with six existing prediction tools. The testing dataset comprised of 218 positive and 2621 negative instances, and the proposed model could yield a promising performance with 84.40% sensitivity, 86.99% specificity, 86.79% accuracy, and an MCC value of 0.489. Finally, the proposed method has been implemented as a web-based prediction tool (CNN-SuccSite), which is now freely accessible at http://csb.cse.yzu.edu.tw/CNN-SuccSite/ .

背景与目标： : 琥珀酰化是蛋白质翻译后修饰 (PTM) 的一种，可以在多种细胞过程中发挥重要作用。由于从高通量质谱 (MS) 获得的位点特异性琥珀酰化肽的数量不断增加，因此已开发出各种工具来计算识别蛋白质上的琥珀酰化位点。但是，大多数这些工具都基于传统的机器学习方法来预测琥珀酰化位点。因此，这项工作旨在基于深度学习模型进行琥珀酰化位点预测。MS验证的琥珀酰化肽的丰度使得能够通过基于序列的属性 (例如位置特异性氨基酸组成，k间隔氨基酸对 (CKSAAP) 的组成和位置特异性评分矩阵 (PSSM)) 研究琥珀酰化位点的底物位点特异性。此外，通过将所有琥珀酰化序列分为几个具有保守的底物基序的组，采用最大依赖性分解 (MDD) 来检测赖氨酸琥珀酰化位点的底物特征。根据十倍交叉验证的结果，使用PSSM和信息性CKSAAP属性训练的深度学习模型可以达到最佳的预测性能，并且性能也优于传统的机器学习方法。此外，使用训练数据集中真正不存在的独立测试数据集将所提出的方法与六种现有的预测工具进行比较。测试数据集由218阳性和2621阴性实例组成，所提出的模型可以产生具有84.40% 灵敏度、86.99% 特异性、86.79% 准确性和0.489 MCC值的有希望的性能。最后，所提出的方法已实现为基于web的预测工具 (cnn-succsite)，现在可以在http://csb.cse.yzu.edu.tw/cnn-succsite/上自由访问。

BACKGROUND & AIMS: AIM/BACKGROUND:Treatment of DVT with LMWHs has been shown recently to be as effective as UFH with suggested lower costs. This study was conducted to determine and compare the cost of in-patient hospital treatment versus outpatient hospital treatment of patients with DVT. METHOD:All adult patients with acute proximal DVT referred to the Emergency Department of King Khalid University Hospital, Riyadh, Saudi Arabia between August 2009 and August 2010 were invited to the study. An economic analysis was performed to compare the cost impact of outpatients versus hospital treatment. RESULTS:Sixty-one patients were included in the study, 31 were followed in the outpatient setting and 30 as the control group (inpatients). There were no significant differences in the outcome between the outpatient and inpatient group; three patients (9.7%) in the outpatient group and four patients (13.3%) in the inpatient group had recurrent DVT. Mean nursing cost was $55 for the outpatient group and $215 for the inpatient group, mean laboratory monitoring cost was $638 for outpatient group and $1511 for the inpatient group. Hospital stay and doctor's fees amounted to a mean of $1000 for outpatient treatment and $2387 for inpatient treatment, p < 0.0001. The mean outpatient cost was significantly lower than the inpatient cost ($1750 vs. $4338, p < 0.0001). CONCLUSION:Outpatient treatment of patients with DVT using LMWHs is cost-effective with no significant differences in the outcome of patients. OPD treatment of DVT is feasible in Saudi Arabia provided there is enough logistic support from thrombosis clinics and those involved in DVT care.

背景与目标：

BACKGROUND & AIMS: :Background and Objectives: Prior studies have identified a number of predictors for Atrial fibrillation (AF) ablation success, including comorbidities, the type of AF, and left atrial (LA) size. Ectopic foci in the initiation of paroxysmal AF are frequently found in pulmonary veins. Our aim was to assess how pulmonary vein anatomy influences the recurrence of atrial fibrillation after radiofrequency catheter ablation. Materials and Methods: Eighty patients diagnosed with paroxysmal or persistent AF underwent radiofrequency catheter ablation (RFCA) between November 2016 and December 2017. All of these patients underwent computed tomography before AF ablation. PV anatomy was classified according to the presence of common PVs or accessory PVs. Several clinical and imagistic parameters were recorded. After hospital discharge, all patients were scheduled for check-up in an outpatient clinic at 3, 6, 9, and 12 months after RFCA to detect AF recurrence. Results: A total of 80 consecutive patients, aged 53.8 ± 9.6 years, 54 (67.5%) men and 26 (32.5%) women were enrolled. The majority of patients had paroxysmal AF 53 (66.3%). Regular PV anatomy (2 left PVs, 2 right PVs) was identified in 59 patients (73.7%), a left common trunk (LCT) was detected in 15 patients (18.7%), an accessory right middle pulmonary vein (RMPV) was found in 5 patients (6.25%) and one patient presented both an LCT and an RMPV. The median follow-up duration was 14 (12; 15) months. Sinus rhythm was maintained in 50 (62.5%) patients. Age, gender, antiarrhythmic drugs, and the presence of cardiac comorbidities were not predictive of AF recurrence. The diagnosis of persistent AF before RFCA was more closely associated with an increase in recurrent AF after RFCA than after paroxysmal AF (p = 0.01). Longer procedure times (>265 minutes) were associated with AF recurrence (p = 0.04). Patients with an LA volume index of over 48.5 (mL/m2) were more likely to present AF recurrence (p = 0.006). Multivariate analysis of recurrence risk showed that only the larger LA volume index and variant PV anatomy were independently associated with AF recurrence. Conclusion: The study demonstrated that an increased volume of the left atrium was the most important predictive factor for the risk of AF recurrence after catheter ablation. Variant anatomy of PV was the only other independent predictive factor associated with a higher rate of AF recurrence.

背景与目标： 背景和目的: 先前的研究已经确定了心房颤动 (AF) 消融成功的许多预测因素，包括合并症，AF的类型和左心房 (LA) 大小。在肺静脉中经常发现阵发性房颤的异位灶。我们的目的是评估肺静脉解剖结构如何影响射频导管消融后房颤的复发。材料和方法: 80例确诊为阵发性或持续性房颤的患者在2016年11月和2017年12月之间进行了射频导管消融 (RFCA)。所有这些患者在AF消融前均接受了计算机断层扫描。根据常见PVs或辅助PVs的存在对PV解剖进行分类。记录了几个临床和影像学参数。出院后，所有患者都计划在RFCA后3、6、9和12个月在门诊进行检查，以检测AF复发。结果: 共纳入80例连续患者，年龄53.8 ± 9.6岁，54 (67.5%) 名男性和26 (32.5%) 名女性。大多数患者有阵发性AF 53 (66.3%)。在59例患者 (73.7% 例) 中发现了常规的PV解剖 (2例左PVs，2例右PVs)，在15例患者 (18.7% 例) 中发现了左主干 (LCT)，在5例患者 (6.25% 例) 中发现了右中肺静脉 (RMPV)，一名患者同时出现了LCT和RMPV。中位随访时间为14 (12; 15) 个月。50 (62.5%) 例患者维持窦性心律。年龄，性别，抗心律失常药物和心脏合并症的存在不能预测AF复发。与阵发性房颤相比，RFCA前持续性房颤的诊断与RFCA后复发性房颤的增加更密切相关 (p = 0.01)。较长的手术时间 (>265分钟) 与房颤复发相关 (p = 0.04)。LA体积指数超过48.5 (mL/m2) 的患者更有可能出现AF复发 (p = 0.006)。复发风险的多因素分析表明，只有较大的LA体积指数和变异的PV解剖结构与AF复发独立相关。结论: 研究表明，左心房体积增加是导管消融后房颤复发风险的最重要预测因素。PV的变异解剖结构是与更高的AF复发率相关的唯一其他独立预测因素。

BACKGROUND & AIMS: BACKGROUND:Data is scarce on hemorrhagic and thrombotic complications in patients with ST-elevation myocardial infarction (STEMI) associated with out-of-hospital cardiac arrest (OHCA). METHODS:This is a monocentric, retrospective study conducted from January 2012 to December 2017 in a tertiary university hospital, which serves as a cardiac arrest center for a large urban area. Over the study period, all consecutive patients who were treated with stent implantation for STEMI with or without OHCA were included. Baseline characteristics, treatments, hemorrhagic and thrombotic events were compared between STEMI patients with and without OHCA. Univariate and multivariate analysis were performed in order to identify predictors of 30-day mortality, occurrence of major bleeding (MB), and early stent thrombosis (ST). RESULTS:A total of 549 patients treated for STEMI without OHCA and 146 patients for STEMI with OHCA were included. The incidence of definite ST and MB after coronary angioplasty was significantly higher in patients with OHCA (2.6% vs. 7.5%, p = 0.004 and 3.3% vs. 19.2%, p < 0.001, respectively). Independent predictors of MB in OHCA patients were anticoagulation therapy (HR = 3.11, 95%CI [1.22-7.98], p = 0.02) and the use of glycoprotein IIb/IIIa inhibitors (HR = 4.16, 95%CI [1.61-10.79], p = 0.003). Independent predictors of mortality in OHCA patients were age (HR = 1.05, 95%CI [1.02-1.09], p = 0.004) and ST (HR = 5.62, 95%CI [1.61-19.65], p = 0.007, with a protective effect of new anti-P2Y12 treatments (HR = 0.20, 95%CI [0.08-0.46], p < 0.001). CONCLUSION:Patients treated for STEMI associated with OHCA are at higher-risk of ST and MB than those who did not experience cardiac arrest. In this subset of patients, prospective studies are needed to better evaluate the balance of thrombosis and hemorrhage.

背景与目标：

BACKGROUND & AIMS: Background:Ingrowth-core method is a useful tool to determine fine root growth of standing crops by inserting root-free soil in mesh-bags for certain period of time. However, the root density observed by the method does not directly explain the nutrient uptake potential of crop plants as it varies over soil depth and incubation time. We have inserted an access-tube up to 4.2 m of soil depth with openings directly under crop plants, through which ingrowth-cores containing labelled soil with nutrient tracers were installed, called core-labelling technique (CLT). The main advantage of CLT would be its capacity to determine both root density and root activity from the same crop plants in deep soil layers. We tested the validity of the new method using a model crop species, alfalfa (Medicago sativa) against three depth-levels (1.0, 2.5 and 4.2 m), three sampling spots with varying distance (0-0.36, 0.36-0.72 and > 5 m from core-labelled spot), two sampling times (week 4 and 8), and two plant parts (young and old leaves) under two field experiments (spring and autumn). Results:Using CLT, we were able to observe both deep root growth and root activity up to 4.2 m of soil depth. Tracer concentrations revealed that there was no sign of tracer-leakage to adjacent areas which is considered to be advantageous over the generic tracer-injection. Root activity increased with longer incubation period and tracer concentrations were higher in younger leaves only for anionic tracers. Conclusions:Our results indicate that CLT can lead to a comprehensive deep root study aiming at measuring both deep root growth and root activity from the same plants. Once produced and installed, the access-tubes and ingrowth-cores can be used for a long-term period, which reduces the workload and cost for the research. Therefore, CLT has a wide range of potential applications to the research involving roots in deep soil layers, which requires further confirmation by future experiments.

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