BACKGROUND & AIMS: OBJECTIVE:To present a case of selective arterial embolization for the treatment of placenta increta in a patient with subsequent pregnancy. DESIGN:Case report and literature review. SETTING:Community-based hospital. PATIENT(S):A 31-year-old G2P1 woman with placenta increta presenting with delayed postpartum hemorrhage. INTERVENTION(S):Selective uterine artery embolization. MAIN OUTCOME MEASURE(S):Cessation of uterine hemorrhage, future pregnancy. RESULT(S):The patient's uterine bleeding immediately resolved. She subsequently delivered a healthy neonate at term without recurrence of abnormal placentation. CONCLUSION(S):Arterial embolization is effective for treating placenta increta in women who wish to preserve fertility. A review of the literature demonstrates a 76.9% success rate and an 11% complication rate.

背景与目标：

BACKGROUND & AIMS: :Arteroportal fistula is a rare cause of prehepatic portal hypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding. Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the color-Doppler by a turbulent flow, and arterialization of portal vein flow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confirming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed. Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.

背景与目标： : 动脉门静脉瘘是肝前门静脉高压症的罕见原因。一名患有丙型肝炎病毒感染的44岁男性因急性静脉曲张出血而入院。内窥镜检查显示存在大的食管静脉曲张。超声显示胰头附近有肿块，在彩色多普勒处其特征是湍流和门静脉血流的动脉化。腹部ct扫描显示胃十二指肠动脉的大动脉瘤连通到肠系膜上静脉。以肝静脉压力梯度测量的正弦门静脉压力正常，证实了门静脉高压的肝前起源。建立了继发于动脉门静脉瘘的肝外门静脉高压症的诊断，并进行了经皮栓塞术。三个月后，内窥镜检查显示没有食管静脉曲张和腹水。目前，患者的临床状况良好，没有门静脉高压的迹象。

BACKGROUND & AIMS: BACKGROUND:Recent air travel recommendations suggest patients with precapillary pulmonary hypertension (PCPH) in New York Heart Association (NYHA) functional class 3 and 4 should have in-flight oxygen without the need for pre-flight testing. However it remains unclear as to how best to determine patients fitness to fly. METHODS:This study (i) investigates the effect of hypoxic challenge testing (HCT) on the arterial oxygen levels in a cohort of 36 patients with PCPH and (ii) compares the relative frequency with which FC and HCT predict the requirement for in-flight oxygen. RESULTS:The degree of arterial hypoxaemia induced by HCT (fall in partial pressure of oxygen in arterial blood (PaO(2)) 2.36 kPa, 95% CI 2.06-2.66 kPa) was similar to the drop observed in other published studies of chronic respiratory diseases. Following current air travel recommendations based on FC, 25 patients of the cohort would require in-flight oxygen whilst 10 subjects failed the HCT. Fourteen subjects had flown post-diagnosis. Of these, nine subjects should have had in-flight oxygen based on FC but were asymptomatic without. Also one who passed the HCT had developed symptoms during the flight whilst three who failed the HCT were asymptomatic flying without in-flight oxygen. CONCLUSIONS:Hypoxaemia induced by simulated air travel in patients with PCPH is similar to that seen in published studies of patients with other chronic respiratory diseases. HCT failed to predict correctly who had developed symptoms during an aircraft flight in a significant minority of the study subjects. Similarly guidelines based on functional class result in a major increase in the proportion of patients being advised to use oxygen, many of whom had been asymptomatic on previous flights without it. More work is required to improve prediction of need for in-flight oxygen in patients with PCPH.

背景与目标：

BACKGROUND & AIMS: :Affinity zones are defined as areas within which air quality displays consistent behaviour over space and time. Constructed using multivariate statistical techniques and physiographic and landscape variables reflecting underlying sources and spatial patterns of air pollution, affinity zones provide a spatial structure suited to exploring the representativity of monitoring networks and as a basis for air pollution mapping and exposure assessment. The affinity zone method is demonstrated using European air pollution monitoring sites, and environmental data compiled within a 1 km GIS. Organised into three main stages, this method involves: (i) indicator selection, using principal components analysis, (ii) zonation by cluster analysis to classify areas into distinct types, and (iii) site allocation, to confirm similarity within affinity zones in terms of monitored air pollution concentrations. Ten interpretable and coherent air pollution affinity zones were constructed for Europe, including two rural zones and eight related to different types of densely populated and built up environments. Concentrations between affinity zones differed significantly for NO(2) background and traffic sites and for PM(10) traffic sites only. Not all zones, however, were found to be sufficiently represented by monitoring sites, illustrating the importance of affinity zones in identifying deficiencies in monitoring networks. Spatial modelling within affinity zones is also demonstrated, showing that simple kriging of background NO(2) concentrations within zones (compared to kriging ignoring zones) produced a ca. 22% reduction in errors and increased R(2) by 0.25 at reserved validation monitoring sites. The affinity zone method developed here is a robust, statistical approach that can be used for evaluating the representativity of routine monitoring networks often used in continental level environmental and health risk assessments.

背景与目标： : 亲和区定义为空气质量在空间和时间上表现出一致行为的区域。亲和区使用多元统计技术以及反映空气污染的潜在来源和空间格局的地理和景观变量构建，提供了适合探索监测网络代表性的空间结构，并作为空气污染制图和暴露评估的基础。使用欧洲空气污染监测点以及在1千米GIS中汇编的环境数据演示了亲和区方法。该方法分为三个主要阶段，包括 :( i) 使用主成分分析进行指标选择，(ii) 通过聚类分析将区域划分为不同类型，以及 (iii) 站点分配，以确认亲和区域内的相似性。监测的空气污染浓度。为欧洲建造了十个可解释且连贯的空气污染亲和力区，包括两个农村地区和八个与不同类型的人口稠密和建筑环境有关的区域。对于NO(2) 背景和交通站点以及仅PM(10) 交通站点，亲和区域之间的浓度差异显着。然而，并非所有区域都被监测点充分代表，这说明了亲和力区域在识别监测网络缺陷方面的重要性。还证明了在亲和区域内的空间建模，表明区域内背景NO(2) 浓度的简单克里金化 (与克里金化忽略区域相比) 产生了约22% 的误差减少，并通过在保留的验证监测站点处的0.25增加了R(2)。此处开发的亲和区方法是一种强大的统计方法，可用于评估通常用于大陆水平环境和健康风险评估的常规监测网络的代表性。

BACKGROUND & AIMS: :The Grieshaber Air System was designed to maintain intraocular pressure during ophthalmologic surgery. It also has been used to maintain pressure in leaking endotracheal tube cuffs. It is a very useful device, especially if the intubation is difficult or the patient's position precludes replacement of the endotracheal tube. Two patients are presented in whom the system was used to maintain endotracheal tube cuff pressure.

背景与目标： : Grieshaber空气系统旨在在眼科手术期间保持眼内压。它也已用于维持气管导管袖口泄漏的压力。这是一种非常有用的设备，尤其是在插管困难或患者的位置无法更换气管插管的情况下。介绍了两名患者，其中该系统用于维持气管导管袖带压力。

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: 241 unselected cases of retinal detachment treated since 1971 with cryopexy and intravitreal air are discussed. The series is analysed according to the position of the retinal tears(s), and we describe briefly the surgical technique and evaluate the main complications.

背景与目标： 讨论了241例未选择的视网膜脱离病例，1971年用冷冻手术和玻璃体内空气治疗。根据视网膜撕裂的位置对该系列进行分析，我们简要描述了手术技术并评估了主要并发症。

BACKGROUND & AIMS: :The existence of a chest wall "steal" of blood away from the myocardium through patent internal mammary artery branches has been hypothesized as a cause of recurrent angina pectoris after coronary artery bypass grafting. Although some authors believe that such a steal is physiologically impossible because coronary flow occurs in diastole and chest wall flow in systole, we recently documented ischemia in the left anterior descending coronary artery distribution before embolization of a large left internal mammary artery first intercostal branch that had been left intact at the time of operation. After embolization of the branch, clinical and objective evidence of ischemia resolved.

背景与目标： : 假设存在胸壁通过未闭的乳内动脉分支从心肌 “窃取” 血液，这是冠状动脉旁路移植术后再发心绞痛的原因。尽管一些作者认为这种偷窃在生理上是不可能的，因为冠状动脉血流发生在舒张期，胸壁血流发生在收缩期，但我们最近记录了左前降支在栓塞大的左乳内动脉第一肋间分支之前的缺血。在手术时保持完整。分支栓塞后，缺血的临床和客观证据得以解决。

BACKGROUND & AIMS: OBJECTIVE:The objective of our study was to evaluate whether 0.3-second cine CT can be used to detect air trapping in the lungs of young children. SUBJECTS AND METHODS:In 30 children (mean age, 25 months), 0.3-second cine CT was performed at six levels during 3 seconds of quiet breathing. The study population was divided into an air trapping group (n = 24) and a no-air trapping group (n = 6). Lung density was measured at an abnormal area (with or without air trapping) and an adjacent normal area on inspiratory and expiratory phase images. Lung density differences between inspiration and expiration were calculated and compared in abnormal areas (with or without air trapping) and in normal areas. Their percentages were calculated and compared between the two groups. In addition, lung density differences between abnormal and adjacent normal areas were calculated and compared between the two groups. RESULTS:Lung density differences between inspiration and expiration were smaller in areas with air trapping (mean +/- SD, -19 +/- 34 H) than in abnormal areas without air trapping (138 +/- 36 H) (p < 0.001) or in normal areas (111 +/- 49 H) (p < 0.001). Their percentages were smaller in the group with air trapping (-27% +/- 54%) than in the group with no air trapping (120% +/- 87%) (p < 0.001). In the group with air trapping, lung density differences were larger at the expiratory phase (260 +/- 77 H) than at the inspiratory phase (129 +/- 69 H) (p < 0.001), but did not change through the respiratory cycle in the group with no air trapping (p > 0.05). CONCLUSION:Air trapping can be accurately detected in the lungs of free-breathing young children using 0.3-second cine CT.

背景与目标：

BACKGROUND & AIMS: CONTEXT:Fine particulate matter (PM) air pollution has been associated with alterations in circulating endothelial progenitor cell (EPC) levels, which may be one mechanism whereby exposures promote cardiovascular diseases. However, the impact of coarse PM on EPCs is unknown. OBJECTIVE:We aimed to determine the effect of acute exposure to coarse concentrated ambient particles (CAP) on circulating EPC levels. METHODS:Thirty-two adults (25.9 ± 6.6 years) were exposed to coarse CAP (76.2 ± 51.5 μg m(-3)) in a rural location and filtered air (FA) for 2 h in a randomized double-blind crossover study. Peripheral venous blood was collected 2 and 20 h post-exposures for circulating EPC (n = 21), white blood cell (n = 24) and vascular endothelial growth factor (VEGF) (n = 16-19) levels. The changes between exposures were compared by matched Wilcoxon signed-rank tests. RESULTS:Circulating EPC levels were elevated 2 [108.29 (6.24-249.71) EPC mL(-1); median (25th-75th percentiles), p = 0.052] and 20 h [106.86 (52.91-278.35) EPC mL(-1), p = 0.008] post-CAP exposure compared to the same time points following FA [38.47 (0.00-84.83) and 50.16 (0.00-104.79) EPC mL(-1)]. VEGF and white blood cell (WBC) levels did not differ between exposures. CONCLUSIONS:Brief inhalation of coarse PM from a rural location elicited an increase in EPCs that persisted for at least 20 h. The underlying mechanism responsible may reflect a systemic reaction to an acute "endothelial injury" and/or a circulating EPC response to sympathetic nervous system activation.

背景与目标：

BACKGROUND & AIMS: CONCLUSIONS:Routine embolization of the ipsilateral facial artery (FA) is effective because of the high success rate. The use of different embolic materials for the internal maxillary artery (IMA) and the FA was considered safe because of the absence of major complications. OBJECTIVE:To evaluate outcomes of routine embolization of the FA as well as the IMA ipsilateral to the bleeding site for intractable epistaxis, and outcomes using different embolic materials for the FA and the IMA. PATIENTS AND METHODS:Twenty-two patients with intractable epistaxis who underwent superselective embolization were retrospectively analyzed with a mean follow-up of 7 months. The FA and the IMA ipsilateral to the bleeding site were embolized. Two embolic materials, gelatin sponge and microcoils, were used for the IMA and the FA, respectively. RESULTS:The short-term success rate within the first 7 days was 77.3% (17/22). The long-term success rate was 95.5% (21/22). There were no major complications in 22 cases. Minor complications occurred in 13 cases (59%). These minor complications usually did not last more than a week and most resolved within a day.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas. MATERIALS AND METHODS:Thirty-eight women with symptomatic adenomyosis with or without uterine leiomyomas were treated with UAE with calibrated tris-acryl gelatin microspheres. Based on MR findings, women were categorized as having pure adenomyosis (group A; n = 15), adenomyosis dominance with fibroid tumors (group B; n = 14), or fibroid tumor dominance with adenomyosis (group C; n = 9). RESULTS:Heavy menstrual bleeding, pain, and bulk-related symptoms at last follow-up at a median of 16.5 months (range, 3-38 months) were compared with baseline symptoms. With follow-up MR imaging at a median of 12 months (range, 3-36 months), changes in uterine volume, leiomyoma volume, junctional zone thickness, and contrast enhancement of adenomyosis were assessed. After embolization, adenomyosis infarction could be depicted on contrast medium-enhanced MR in 44.1% of cases. Median reductions of uterine volume, fibroid tumor volume, and junctional zone thickness were 44.8%, 77.1%, and 23.9%, respectively. In group A, three patients needed additional surgery after UAE, in addition to two in group B and one in group C. In the remaining 32 patients, except for one patient in group C, all preexisting symptoms (eg, bleeding, pain, bulk-related symptoms) improved or resolved after UAE. Overall, 84.2% of women were satisfied with the results of UAE. CONCLUSION:In this study, midterm results (at a median of 16.5 months) showed that UAE in symptomatic adenomyosis with or without uterine leiomyomas is effective. Hysterectomy was avoided in the vast majority of patients. MR imaging showed reduction of uterine volume and junctional zone thickness.

背景与目标：

BACKGROUND & AIMS: :A review of literature focused on (129)I determination in air is provided. (129)I analysis in the environment represents a vital tool for tracing transport mechanisms, distribution pathways, safety assessment and its application as environmental tracer. To achieve that, specific chemical extraction methods and high sensitivity analytical techniques have been developed. This paper is intended to give an overview about the sample collection, extraction and distribution of (129)I in the air. Sensitivity of available measurement techniques for the determination of (129)I is compared. The article also provides the summary of current worldwide distribution of (129)I in air and respective radiation exposure of man.

背景与目标： : 提供了有关 (129)I在空气中的测定的文献综述。(129)I环境分析是追踪运输机制，分配途径，安全评估及其作为环境示踪剂应用的重要工具。为此，已经开发了特定的化学萃取方法和高灵敏度分析技术。本文旨在概述 (129)I在空气中的样品收集，提取和分布。比较了用于确定 (129)I的可用测量技术的灵敏度。本文还概述了 (129)I在空气中的当前全球分布以及人类各自的辐射暴露。

BACKGROUND & AIMS: A raw, pepperoni batter (75% porkH7 (> or = 2 x 10(7) cfu/g), mixed with non-meat ingredients, and then hand-stuffed into 55 mm fibrous casings to form sticks. The numbers of the pathogen were determined before stuffing, after fermentation, after drying/slicing, and after periods of storage. For storage, slices were packaged under air, vacuum or CO2 and stored at -20, 4 and 21 degrees C. Sticks were fermented at 36 degrees C and 85% relative humidity (RH) to < or = pH 4.8 and then dried at 13 degrees C and 65% RH to a moisture/protein ratio (M/Pr) of < or = 1.

6:1. Fermentation and drying resulted in the numbers of the pathogen decreasing by about 2 log10 units. During storage, the temperature rather than the atmosphere had the greater effect on pathogen numbers. The greatest reductions in numbers were observed during storage at 21 degrees C, when numbers decreased to about 2 and 3.8 log10 cfu/g within 14 days in product stored under air and vacuum, respectively, and a 5 log10 reduction was observed for both atmospheres within 28 days. Regardless of the storage atmosphere, numbers did not decrease below 3.6 or 3.7 log10 cfu/g after 90 days of storage at -20 or 4 degrees C, respectively. These data confirm that fermentation and drying are sufficient to eliminate only about 2 log10 cfu/g of E.

coli O157:H7 from fermented sausage, and that additional strategies, such as storage for at least 2 weeks at ambient temperature in air, are required to achieve a 5 to 6 log10 reduction in the numbers of the pathogen in sliced pepperoni.

背景与目标： 生的意大利辣香肠面糊 (75% porkH7 (> 或 = 2x10(7) cfu/g)，与非肉类成分混合，然后手工填充到55毫米的纤维肠衣中，形成木条。在填充前，发酵后，确定病原体的数量。干燥/切片后，以及储存一段时间后。为了储存，切片在空气、真空或二氧化碳下包装，储存在-20，4和21 ℃。将棒在36 ℃ 和85% 相对湿度 (RH) 下发酵至 <或 = pH 4.8，然后在13 ℃ 和65% ℃ 下干燥至水分/蛋白质比 (M/Pr) <或 = 1。
<强> 6:1.发酵和干燥导致病原体数量减少约2 log10单位。在储存期间，温度而不是大气对病原体数量的影响更大。在21摄氏度的储存期间观察到数量的最大减少，当在空气和真空下储存的产品在14天内数量分别降低到约2和3.8 log10 cfu/g时，并且在28天内观察到两个大气压的5 log10减少。不管储存气氛如何，在-20或4摄氏度下储存90天后，数字没有低于3.6或3.7 log10 cfu/g，这些数据分别证实，发酵和干燥足以消除发酵香肠中仅约2 log10 cfu/g的大肠杆菌。例如，在环境温度下在空气中至少保存2周，以使切成薄片的意大利辣香肠中的病原体数量减少5至6 log10。

BACKGROUND & AIMS: OBJECTIVES:This study aimed to evaluate the associations between ambient air pollutants, obesity, and kidney function. SUBJECTS/METHODS:We enrolled 3345 people who had undergone health checkups at Seoul National University Hospital. We recorded the annual average concentrations of ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), in each subject's residential area. Various obesity traits, such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue areas, were measured by quantified computerized tomography (CT), and kidney function was assessed in relation to estimated glomerular filtration rate as an indicator of kidney function. RESULTS:High PM10, NO2, SO2, and CO concentrations were significantly associated with decreased kidney function (β = -2.39 and standard error = 0.32, -1.00 and 0.31, -1.23 and 0.28, and -1.32 and 0.29, respectively), and with the prevalence of chronic kidney disease (CKD). The association between air pollutant concentrations and decreased kidney function, including CKD, was stronger among those with high abdominal adiposity, as defined by CT measurement. For example, the association between increased concentrations of air pollutants and the prevalence of CKD was stronger in the group with greater visceral adiposity than in the group with less visceral adiposity (aORs = 1.29 vs 1.16 for PM10, 1.42 vs 1.21 for SO2, and 1.27 vs 1.11 for CO). CONCLUSIONS:Long-term exposure to higher concentrations of air pollutants was unfavorably associated with kidney function and CKD prevalence, especially in people with abdominal obesity. This may indicate a high susceptibility to air pollutants in obese people.

背景与目标：