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Directional fragment ejection from a tetrahedral molecule CH4 in linearly polarized two-color (ω and 2ω) asymmetric intense laser fields (50 fs, 1.4 × 1014 W cm-2, 800 nm and 400 nm) has been studied by three-dimensional ion coincidence momentum imaging. The H+ fragment produced from dissociative ionization, CH4 â H+ + CH3 + e-, is preferentially ejected on the larger amplitude side of the laser electric fields. Comparison with theoretical predictions by weak-field asymptotic theory shows that the observed asymmetry can be understood by the orientation selective tunneling ionization from the triply degenerated highest occupied molecular orbital (1t2) of CH4. A similar directional ejection of H+ was also observed for the low kinetic energy components of the two-body Coulomb explosion, CH4 â H+ + CH3+ + 2e-. On the other hand, the fragment ejection in the opposite direction were observed for the high energy component, as well as H2+ produced from the Coulomb explosion CH4 â H2+ + CH2+ + 2e-. Possible origins of the characteristic fragmentation are discussed.
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Dissociative tunneling ionization of tetrafluoromethane (CF4) in circularly polarized ultrashort intense laser fields (35 fs, 0.8 × 1014 W cm-2, 1035 nm), CF4 â CF4+ + e- â CF3+ + F + e-, has been studied by three-dimensional electron-ion coincidence momentum imaging. The photoelectron angular distribution in the recoil frame revealed that the dissociative tunneling ionization occurs efficiently when the laser electric field points from F to C. The obtained results are qualitatively consistent with the theoretical predictions by the weak-field asymptotic theory (WFAT) for tunneling ionization from the highest and next-highest occupied molecular orbitals, HOMO (1t1), and HOMO-1 (4t2), respectively. On the other hand, the angular distribution shows clear dependences on the polarization helicity, indicating that the breaking of the C-F bonds is sensitive to the helicity of the multicycle circularly polarized laser fields.
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BACKGROUND: Recent studies have indicated the potential benefit of intraoperative near-infrared fluorescence imaging (NIR-FI) with indocyanine green in reducing early anastomotic leakage in colorectal surgery. Nonetheless, whether NIR-FI is effective in reducing structural sequelae of anastomotic leakage (SSAL) remains unclear. The aim of the present study was to investigate the impact of NIR-FI on SSAL after laparoscopic intersphincteric resection (ISR) of malignant rectal tumors. METHODS: This study was a retrospective single-center cohort study. A total of 293 consecutive patients who underwent elective laparoscopic ISR from May 2010 to August 2017 were included. Patients were divided into 2 groups; those who underwent elective laparoscopic ISR with lymphadenectomy for malignant rectal tumors using NIR-F (NIR-FI group) and those who underwent elective laparoscopic ISR with lymphadenectomy for malignant rectal tumors without using NIR-FI (control group). Thirty were excluded from the analyses (13 died, 7 had pelvic recurrence, and 10 were lost to follow-up). The primary endpoint was the rate of SSAL within 2 years after the primary resection, whereas the secondary endpoint was the rate of natural defecation via the anus at 2 years after the primary resection. Using various statistical analyses, such as propensity score matching, the rate of SSAL was compared between groups. RESULTS: A total of 263 patients were analyzed [177 males and 86 females, median age 61 (27-84) years]. Prior to propensity score matching (n = 263), NIR-FI was performed in 70 patients (26.6%) The rates of SSAL were 1.4% (1/70) in the NIR-FI group and 10.4% (20/193) in the control group (p = 0.02). After propensity score matching (n = 163), the rates of SSAL were 1.5% (1/66) in the NIR-FI group and 11.7% (12/103) in the control group (p = 0.02). Propensity score analyses, as well as simple regression analyses, revealed that NIR-FI was associated with a significantly lower risk of SSAL (OR 0.10-0.13; p = 0.03-0.05). CONCLUSIONS: NIR-FI is useful in reducing the rate of SSAL after laparoscopic ISR.
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Laparoscopia , Neoplasias Retais , Canal Anal/diagnóstico por imagem , Canal Anal/patologia , Canal Anal/cirurgia , Anastomose Cirúrgica , Fístula Anastomótica/diagnóstico por imagem , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Estudos de Coortes , Feminino , Humanos , Verde de Indocianina , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Imagem Óptica , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos RetrospectivosRESUMO
BACKGROUND: Placing a transanal endoscopic rectal purse-string suture (taEPS) is the crucial first component of transanal total mesorectal excision (taTME). However, no structured training is available to improve the procedure-specific skills for taEPS. The aim of this study was to create a performance rubric to improve taEPS skills and provide preliminary evidence for its validity. METHODS: A performance rubric was created based on technical considerations for taEPS, identified by consulting with taTME surgical and performance assessment experts. Ten independent, blinded raters assessed 10 videotaped taEPS procedures of consecutive taTME cases, at National Cancer Center Hospital East (NCCHE), Chiba, Japan, in January 2018-March 2019 using the rubric and the Global Operative Assessment of Laparoscopic Skills (GOALS). Internal consistency and inter-rater reliabilities were calculated. Videotaped taEPS procedures were timed and assessed by the rubric. Correlation between rubric scores and suturing times were analyzed. RESULTS: The rubric consists of four items: loading the needle (LN), atraumatic needle passage (AP), planned suture path (PS), and overall performance (OA). Videotaped performances were graded on a 3-point Likert scale; scores were calculated as sums of the points. Cronbach's α for internal consistency was 0.713. Inter-rater reliabilities were LN: 0.73, AP: 0.76, PS: 0.71, and OA: 0.70. Rubric and GOALS scores were strongly correlated (r = 0.964, p < 0.001). In 112 consecutive taEPS performances, rubric scores were strongly correlated with suturing time (r = - 0.69, p < 0.001). Surgeons' experience with taTME was associated with rubric scores and suturing time. CONCLUSIONS: This study provides preliminary validation for the taEPS skill performance rubric. The rubric's structured training may facilitate skill acquisition by providing trainees with critical clinical considerations.
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Laparoscopia , Protectomia , Neoplasias Retais , Cirurgia Endoscópica Transanal , Humanos , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Neoplasias Retais/cirurgia , Reto/cirurgia , Suturas , Cirurgia Endoscópica Transanal/métodosRESUMO
The number of elderly patients with esophageal cancer has increased in recent years. The use of thoracoscopic esophagectomy has also increased, and its minimal invasiveness is believed to contribute to postoperative outcomes. However, the short- and long-term outcomes in elderly patients remain unclear. This study aimed to elucidate the safety and feasibility of minimally invasive esophagectomy in elderly patients. This retrospective study included 207 patients who underwent radical thoracoscopic esophagectomy for thoracic esophageal squamous cell carcinoma at Kobe University Hospital between 2005 and 2014. Patients were divided into non-elderly (<75 years) and elderly (≥75 years) groups. A propensity score matching analysis was performed for sex and clinical T and N stage, with a total of 29 matched pairs. General preoperative data, surgical procedures, intraoperative data, postoperative complications, in-hospital death, cancer-specific survival, and overall survival were compared between groups. The elderly group was characterized by lower preoperative serum albumin levels and higher American Society of Anesthesiologists grade. Intraoperative data and postoperative complications did not differ between the groups. The in-hospital death rate was 4% in the elderly group, which did not significantly differ from the non-elderly group. Cancer-specific survival was similar between the two groups. Although overall survival tended to be poor in the elderly group, it was not significantly worse than that of the non-elderly group. In conclusion, the short- and long-term outcomes of minimally invasive esophagectomy in elderly versus non-elderly patients were acceptable. Minimally invasive esophagectomy is a safe and feasible modality for elderly patients with appropriate indications.
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Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Idoso , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia/efeitos adversos , Estudos de Viabilidade , Mortalidade Hospitalar , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: The complement cascade, especially the alternative pathway of complement, has been shown in basic research to be associated with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). We aimed to elucidate relationships between serum complement components and clinical characteristics in AAV. METHOD: In a nationwide prospective cohort study (RemIT-JAV-RPGN), we measured the serum levels of C1q, C2, C3, C3b/iC3b, C4, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, mannose-binding lectin, and properdin in 52 patients with microscopic polyangiitis (MPA) and 39 patients with granulomatosis with polyangiitis (GPA). RESULTS: The properdin level of MPA and GPA was significantly lower than that of healthy donors. The properdin level was negatively correlated with the Birmingham Vasculitis Activity Score (BVAS) (ρ = -0.2148, p = 0.0409). The factor D level at 6 months was significantly positively correlated with the Vasculitis Damage Index (VDI) at 6, 12, and 24 months (ρ = 0.4207, 0.4132, and 0.3115, respectively). Patients with a higher ratio of C5a to C5 had higher neutrophil percentage and serum immunoglobulin G levels, and significantly lower creatinine levels. Cluster analysis divided the MPA and GPA patients into three subgroups. A principal component (PC) analysis aggregated 15 types of complements into alternative pathway-related PC 1 and complement classical pathway and common pathway-related PC 2. CONCLUSIONS: The serum levels of properdin and factor D were correlated with the BVAS and the VDI in MPA and GPA, respectively. Our analyses suggested the pathological heterogeneity of MPA and GPA from the aspect of complement components.
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Proteínas do Sistema Complemento/metabolismo , Granulomatose com Poliangiite/sangue , Poliangiite Microscópica/sangue , Idoso , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Análise por Conglomerados , Feminino , Granulomatose com Poliangiite/tratamento farmacológico , Granulomatose com Poliangiite/etiologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Poliangiite Microscópica/tratamento farmacológico , Poliangiite Microscópica/etiologia , Pessoa de Meia-Idade , Análise de Componente Principal , Estudos Prospectivos , Recidiva , Indução de RemissãoRESUMO
At the Earth's low-latitude magnetopause, clear signatures of the Kelvin-Helmholtz (KH) waves have been frequently observed during periods of the northward interplanetary magnetic field (IMF), whereas these signatures have been much less frequently observed during the southward IMF. Here, we performed the first 3-D fully kinetic simulation of the magnetopause KH instability under the southward IMF condition. The simulation demonstrates that fast magnetic reconnection is induced at multiple locations along the vortex edge in an early nonlinear growth phase of the instability. The reconnection outflow jets significantly disrupt the flow of the nonlinear KH vortex, while the disrupted turbulent flow strongly bends and twists the reconnected field lines. The resulting coupling of the complex field and flow patterns within the magnetopause boundary layer leads to a quick decay of the vortex structure, which may explain the difference in the observation probability of KH waves between northward and southward IMF conditions.
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While vorticity defined as the curl of the velocity has been broadly used in fluid and plasma physics, this quantity has been underutilized in space physics due to low time resolution observations. We report Magnetospheric Multiscale (MMS) observations of enhanced electron vorticity in the vicinity of the electron diffusion region of magnetic reconnection. On 11 July 2017 MMS traversed the magnetotail current sheet, observing tailward-to-earthward outflow reversal, current-carrying electron jets in the direction along the electron meandering motion or out-of-plane direction, agyrotropic electron distribution functions, and dissipative signatures. At the edge of the electron jets, the electron vorticity increased with magnitudes greater than the electron gyrofrequency. The out-of-plane velocity shear along distance from the current sheet leads to the enhanced vorticity. This, in turn, contributes to the magnetic field perturbations observed by MMS. These observations indicate that electron vorticity can act as a proxy for delineating the electron diffusion region of magnetic reconnection.
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AIM: The hepatic microenvironment, which may include chronic inflammation and fibrosis, is considered to contribute to the pathogenesis of liver metastases of colorectal cancer. A similar mechanism is anticipated for pulmonary metastases, although no reports are available. Smoking causes pulmonary inflammation and fibrosis. Thus, we hypothesized that smokers would be especially affected by pulmonary metastases of colorectal cancer. In this study, we attempted to clarify the impact of smoking on pulmonary metastasis of colorectal cancer. METHOD: Between September 2005 and December 2010 we reviewed 567 patients with pathological Stage I, II or III colorectal cancer, whose clinicopathological background included a preoperative smoking history, pack-year history from medical records. Univariate and multivariate analyses using the Cox proportional hazard model were performed to determine the independent prognostic factors for pulmonary metastasis-free survival. RESULTS: Pulmonary metastases occurred in 39 (6.9%) patients. The smoking histories revealed 355 never smokers, 119 former smokers and 93 current smokers among the subjects. Multivariate analysis revealed that being a current smoker (hazard ratio = 2.72, 95% CI 1.18-6.25; P = 0.02) was an independent risk factor for pulmonary metastases. CONCLUSION: Smoking may be a risk factor for pulmonary metastasis of colorectal cancer. Cessation of smoking should be recommended to prevent pulmonary metastasis, although further basic and clinical studies are required.
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Neoplasias Colorretais/patologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/secundário , Fumar/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Metástase Neoplásica , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Microambiente TumoralRESUMO
BACKGROUND: One of the potential advantages of laparoscopic compared with open colorectal surgery is a reduction in postoperative bowel obstruction events. Early reports support this proposal, but accumulated evidence is lacking. METHODS: A systematic review and meta-analysis was performed of randomized clinical trials and observational studies by searching the PubMed and Cochrane Library databases from 1990 to August 2015. The primary outcomes were early and late postoperative bowel obstruction following laparoscopic and open colorectal surgery. Both ileus and bowel obstruction were defined as a postoperative bowel obstruction. Subgroup and sensitivity analyses were performed, and a random-effects model was used to account for the heterogeneity among the studies. RESULTS: Twenty-four randomized clinical trials and 88 observational studies were included in the meta-analysis; 106 studies reported early outcome and 12 late outcome. Collectively, these studies reported on the outcomes of 148 392 patients, of whom 58 133 had laparoscopic surgery and 90 259 open surgery. Compared with open surgery, laparoscopic surgery was associated with reduced rates of early (odds ratio 0·62, 95 per cent c.i. 0·54 to 0·72; P < 0·001) and late (odds ratio 0·61, 0·41 to 0·92; P = 0·019) postoperative bowel obstruction. Weighted mean values for early postoperative bowel obstruction were 8 (95 per cent c.i. 6 to 10) and 5 (3 to 7) per cent for open and laparoscopic surgery respectively, and for late bowel obstruction were 4 (2 to 6) and 3 (1 to 5) per cent respectively. CONCLUSION: The reduction in postoperative bowel obstruction demonstrates an advantage of laparoscopic surgery in patients with colorectal disease.
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Colo/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Obstrução Intestinal/prevenção & controle , Intestino Delgado , Laparoscopia , Complicações Pós-Operatórias/prevenção & controle , Reto/cirurgia , Humanos , Obstrução Intestinal/etiologia , Modelos Estatísticos , Complicações Pós-Operatórias/etiologiaRESUMO
OBJECTIVES: To understand the differences and similarities between immunocompetent and immunodeficient mice as ectopic transplantation animal models for bone tissue engineering. MATERIALS AND METHODS: Osteogenic cells from mouse leg bones were cultured, seeded on ß-TCP granules, and transplanted onto the backs of either immunocompetent or immunodeficient nude mice. At 1, 2, 4, and 8 weeks postoperatively, samples were harvested and evaluated by hematoxylin-eosin staining, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemical staining and quantitative PCR. RESULTS: In immunocompetent mice, inflammatory cell infiltration was evident at 1 week postoperatively and relatively higher expression of TNF-α and IL-4 was observed. In immunodeficient mice, new bone area and the number of TRAP-positive cells were larger at 4 weeks than in immunocompetent mice. The volume of new bone area in immunodeficient mice was reduced by 8 weeks. CONCLUSIONS: Bone regeneration was feasible in immunocompetent mice. However, some differences were observed between immunocompetent and immunodeficient mice in the bone regeneration process possibly due to different cytokine expression, which should be considered when utilizing in vivo animal models.
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Transplante Ósseo/métodos , Osso e Ossos/fisiologia , Engenharia Tecidual/métodos , Animais , Regeneração Óssea , Osso e Ossos/imunologia , Células Cultivadas , Citocinas/biossíntese , Imunocompetência , Hospedeiro Imunocomprometido , Interleucina-4/biossíntese , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Camundongos SCID , Osteoblastos/citologia , Osteoblastos/transplante , Osteoclastos/citologia , Osteoclastos/transplante , Osteogênese/fisiologia , Fator de Necrose Tumoral alfa/biossínteseRESUMO
OBJECTIVE: Lipo-prostaglandin E1 (lipo-PGE1) is a well-known potent vasodilator that increases peripheral blood flow. However, the effects of this agent on wound bed microcirculation still remain unclear. The present study aims to improve the experimental model which our group developed to visualise wound bed microcirculation and to evaluate acute stimulation by lipo-PGE1. METHOD: The superficial stratum of the Wistar rat's ear skin was microsurgically excised preserving the subdermal vascular plexus. The preserved vessels, the wound bed microcirculation, were visualised under an intravital microscope-video-computer system. Animals were divided into three groups, a control group in which animals received vehicle control, a medium-dose group (6 µg/2 ml/kg lipo-PGE1) and a high-dose group (10 µg/2 ml/kg lipo-PGE1). The blood velocity and diameter of individual venules were measured from the recorded microcirculatory images, and the blood flow of the venule in the wound bed was evaluated. RESULTS: A significant increase in the wound bed blood flow was seen 10 minutes after lipo-PGE1 injection (p<0.05). This was approximately fourfold the baseline values. The increase was greatest in the medium-dose group. Extravasation and accumulation of lipo-PGE1 in the wound bed was observed. CONCLUSION: Lipo-PGE1 effectively increased wound bed microcirculation blood flow at the optimal dose. DECLARATION OF INTEREST: There is no conflict of interest.
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Alprostadil/farmacologia , Orelha/irrigação sanguínea , Orelha/lesões , Microcirculação/efeitos dos fármacos , Fluxo Sanguíneo Regional/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Alprostadil/administração & dosagem , Animais , Emulsões Gordurosas Intravenosas , Masculino , Modelos Animais , Ratos , Ratos WistarRESUMO
Two new species of Syphacia (Nematoda: Oxyuridae) are described from endemic murids of Sulawesi, Indonesia: Syphacia (Syphacia) taeromyos sp. n. and S. (S.) paruromyos sp. n. parasitic in the caecum of Taeromys celebensis and Paruromys dominator, respectively. They are readily distinguished from all of the congeners recorded from Indonesia-Australian regions by having a round cephalic plate, vesicular lateral alae in the male, posteriorly positioned excretory pore in the male, and/or lacking cervical alae. Syphacia (S.) paruromyos differs from S. (S.) taeromyos by having a whip-like tail appendage in the male, longer relative distance between excretory pore and vulva, and larger eggs. The round cephalic plate in both sexes and developed vesicular lateral alae in the male are morphological traits common in endemic Syphacia species hitherto known from Sulawesi murids, suggesting that they have derived from a common ancestor and evolved with their hosts in the isolated insular environment.
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Murinae/parasitologia , Oxyuroidea/classificação , Oxyuroidea/isolamento & purificação , Animais , Ceco/parasitologia , Feminino , Indonésia , Masculino , Camundongos , Oxyuroidea/anatomia & histologiaRESUMO
OBJECTIVE: Despite its efficacy and minimal invasiveness, the clean-contaminated nature of endoscopic transnasal surgery (ETS) may be susceptible to central nervous system surgical site infections (CNS-SSIs), especially when involving intradural exposure. However, the profiles of ETS-associated CNS-SSIs are not fully elucidated. METHODS: The institutional ETS cases performed between May 2017 and March 2023 were retrospectively analysed. The incidences of CNS-SSIs were calculated, and their risk factors examined. RESULTS: The incidence of CNS-SSIs was 2.3% (7/305) in the entire cohort and 5.0% (7/140) in ETSs with intradural exposure. All the CNS-SSIs were meningitis and developed following ETS with intradural exposure. The incidences were 0%, 5.6% and 5.8% in ETSs with Esposito grade 1, 2 and 3 intraoperative cerebrospinal fluid leakage, respectively. Among the pre- and intra-operative factors, body mass index (unit odds ratio (OR), 0.62; 95% confidence interval (CI), 0.44-0.89; P<0.01), serum albumin (unit OR, 0.03; 95% CI, 0.0007-0.92; P=0.02), and American Society of Anesthesiologists physical status score (unit OR, 20.7; 95% CI, 1.65-259; P<0.01) were significantly associated with CNS-SSIs. Moreover, postoperative cerebrospinal fluid leakage was also significantly associated with CNS-SSIs (OR, 18.4; 95% CI, 3.55-95.0; P<0.01). CONCLUSIONS: The incidence of ETS-associated CNS-SSIs is acceptably low. Intradural exposure was a prerequisite for CNS-SSIs. Malnutrition and poor comorbidity status should be recognized as important risks for CNS-SSIs in ETS.
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There is ample evidence for magnetic reconnection in the solar system, but it is a nontrivial task to visualize, to determine the proper approaches and frames to study, and in turn to elucidate the physical processes at work in reconnection regions from in-situ measurements of plasma particles and electromagnetic fields. Here an overview is given of a variety of single- and multi-spacecraft data analysis techniques that are key to revealing the context of in-situ observations of magnetic reconnection in space and for detecting and analyzing the diffusion regions where ions and/or electrons are demagnetized. We focus on recent advances in the era of the Magnetospheric Multiscale mission, which has made electron-scale, multi-point measurements of magnetic reconnection in and around Earth's magnetosphere.
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BACKGROUND AND STUDY AIMS: Acute colorectal obstruction (ACO) often accompanies colorectal cancer (CRC) and requires urgent treatment, but achieving elective laparoscopy-assisted colectomy (LAC) is difficult in this setting. The aim of the current study was to assess the clinical outcomes of a transanal tube (Dennis colorectal tube [DCT]) for CRC with ACO, focusing in particular on the impact of the DCT on subsequent elective LAC. PATIENTS AND METHODS: Among 1142 patients who underwent surgery for CRC between January 2007 and December 2011, 92 patients with ACO were identified retrospectively. Of these 92 patients, the DCT procedure was performed in 66 patients who fulfilled the indications for DCT, and these patients were included in the study. RESULTS: All 66 patients presented with complete obstruction. Technical and clinical success rates for DCT were 93.9 % and 86.4 %, respectively. Perforation after DCT occurred in 4.5 % and the mortality rate was 1.5 %. The rate of LAC was 48.5 %, and the rate of primary stoma was 13.6 %. For curative stage II/III CRC with ACO, DCT resulted in a primary stoma rate of 13.6 %, a one-stage surgery rate of 90.9 %, a LAC rate of 50.0 %, and a 3-year survival rate of 73.1 %. For stage II/III CRC cases with clinical success by DCT, the one-stage surgery rate was 97.4 % and the LAC rate was 56.4 %. CONCLUSIONS: DCT achieved a high rate of clinical success and enabled safe one-stage surgery and LAC for CRC with ACO. DCT followed by LAC is proposed as a promising non-invasive strategy for CRC with ACO.
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Neoplasias Colorretais/cirurgia , Drenagem/métodos , Obstrução Intestinal/cirurgia , Perfuração Intestinal/etiologia , Intubação Gastrointestinal/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Canal Anal , Colectomia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/patologia , Colostomia , Drenagem/instrumentação , Feminino , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/patologia , Intubação Gastrointestinal/efeitos adversos , Estimativa de Kaplan-Meier , Laparoscopia , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Estudos Retrospectivos , Estatísticas não Paramétricas , Adulto JovemRESUMO
A 37-year-old male with systemic lupus erythematosus (SLE) presented with high fever, subcutaneous indurations, anemia, thrombocytopenia, elevated liver enzymes and hyperferritinemia. Skin biopsy revealed hemophagocytic histiocytes in the adipose tissues. The patient was diagnosed with SLE with cytophagic histiocytic panniculitis (CHP). Treatment with high-dose glucocorticoids and cyclosporine A induced remission of SLE and CHP. CHP is generally a systemic disorder affecting subcutaneous adipose tissues with a high mortality rate. However, based on the present and previously reported cases, we believe that intensive immunosuppression can ameliorate CHP that occurs as a skin manifestation of SLE.
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Ciclosporina/uso terapêutico , Glucocorticoides , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Paniculite/tratamento farmacológico , Adulto , Histiócitos/patologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/patologia , Masculino , Paniculite/complicações , Paniculite/patologiaRESUMO
The gullet worm (Gongylonema pulchrum) has been recorded from a variety of mammals worldwide, including monkeys and humans. Due to its wide host range, it has been suggested that the worm may be transmitted locally to any mammalian host by chance. To investigate this notion, the ribosomal RNA gene (rDNA), mainly regions of the internal transcribed spacers (ITS) 1 and 2, and a cytochrome c oxidase subunit I (COI) region of mitochondrial DNA of G. pulchrum were characterized using parasites from the following hosts located in Japan: cattle, sika deer, wild boars, Japanese macaques, a feral Reeves's muntjac and captive squirrel monkeys. The rDNA nucleotide sequences of G. pulchrum were generally well conserved regardless of their host origin. However, a few insertions/deletions of nucleotides along with a few base substitutions in the ITS1 and ITS2 regions were observed in G. pulchrum from sika deer, wild boars and Japanese macaques, and those differed from G. pulchrum in cattle, the feral Reeves's muntjac and captive squirrel monkeys. The COI sequences of G. pulchrum were further divided into multiple haplotypes and two groups of haplotypes, i.e. those from a majority of sika deer, wild boars and Japanese macaques and those from cattle and zoo animals, were clearly differentiated. Our findings indicate that domestic and sylvatic transmission cycles of the gullet worm are currently present, at least in Japan.
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Variação Genética , Infecções por Spirurida/veterinária , Spiruroidea/classificação , Spiruroidea/genética , Animais , Animais Selvagens , Bovinos , DNA Mitocondrial/química , DNA Mitocondrial/genética , DNA Ribossômico/química , DNA Ribossômico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Complexo IV da Cadeia de Transporte de Elétrons/genética , Feminino , Haplótipos , Japão , Masculino , Dados de Sequência Molecular , Mutagênese Insercional , RNA Ribossômico/genética , Análise de Sequência de DNA , Deleção de Sequência , Infecções por Spirurida/parasitologia , Spiruroidea/isolamento & purificaçãoRESUMO
We present in-depth analysis of three southward-moving meso-scale (ion-to magnetohydrodynamic-scale) flux transfer events (FTEs) and subsequent crossing of a reconnecting magnetopause current sheet (MPCS), which were observed on 8 December 2015 by the Magnetospheric Multiscale spacecraft in the subsolar region under southward and duskward magnetosheath magnetic field conditions. We aim to understand the generation mechanism of ion-scale magnetic flux ropes (ISFRs) and to reveal causal relationship among magnetic field structures, electromagnetic energy conversion, and kinetic processes in magnetic reconnection layers. Results from magnetic field reconstruction methods are consistent with a flux rope with a length of about one ion inertial length growing from an electron-scale current sheet (ECS) in the MPCS, supporting the idea that ISFRs can be generated through secondary reconnection in an ECS. Grad-Shafranov reconstruction applied to the three FTEs shows that the FTEs had axial orientations similar to that of the ISFR. This suggests that these FTEs also formed through the same secondary reconnection process, rather than multiple X-line reconnection at spatially separated locations. Four-spacecraft observations of electron pitch-angle distributions and energy conversion rate j·E'=j·E+ve×B suggest that the ISFR had three-dimensional magnetic topology and secondary reconnection was patchy or bursty. Previously reported positive and negative values of j·E', with magnitudes much larger than expected for typical MP reconnection, were seen in both magnetosheath and magnetospheric separatrix regions of the ISFR. Many of them coexisted with bi-directional electron beams and intense electric field fluctuations around the electron gyrofrequency, consistent with their origin in separatrix activities.
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Arsenic (As) contamination is an important environmental consequence in some parts of salinity-affected South (S) and South-East (SE) Asia. In this study, we investigated the individual and combined phytotoxicity of arsenic (As) [arsenate; As(V)] and salinity (NaCl) on early seedling growth (ESG) of saline-tolerant and non-tolerant rice varieties. Germination percentage (GP), germination speed (GS) and vigor index (VI) of both saline-tolerant and non-tolerant rice varieties decreased significantly (p > 0.01) with increasing As(V) and NaCl concentrations. The highest GP (91%) was observed for saline non-tolerant BRRI dhan28 and BRRI dhan49, while the lowest (62%) was for saline-tolerant BRRI dhan47. The ESG parameters, such as weights and relative lengths of plumule and radicle, also decreased significantly (p < 0.01) with increasing As(V) and NaCl concentrations. Relative radicle length was more affected than plumule length by As(V) and NaCl. Although VI of saline-tolerant and non-tolerant rice seedlings showed significant variation (p < 0.05), weights and lengths of plumule and radicle of different rice varieties did not show significant variation for As(V) and NaCl treatments. Results reveal that the combined phytotoxicity of As(V) and NaCl on rice seed germination and ESG are greater than their individual toxicities, and some saline-tolerant rice varieties are more resistant to the combined phytotoxicity of As(V) and NaCl than the saline non-tolerant varieties.