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A femtosecond laser induced photofragmentation fluorescence (fs-LIPF) scheme for the sensitive detection and imaging of water vapor is presented. Two photons of 244.3 nm excite water to the DÌ state and produce hydroxyl radicals in the fluorescing à state. Two more photons promote electrons from the DÌ state to a neutral Rydberg state of the (1b2)-1 ionic core through a 2 + 2 doubly resonant process. The resulting high-lying Rydberg state undergoes neutral dissociation, and the energetic hydrogen fragments are detected from their Balmer series fluorescence. These channels (in the low-pressure limit) have detection sensitivities around 1012 molecules per cubic centimeters, orders of magnitude more sensitive than laser-induced fluorescence based approaches, allowing for sensitive non-invasive detection and imaging of water density for many important processes.
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PURPOSE: We assessed long-term renal function, morbidities and mortality in 50 patients who had undergone primary gastrocystoplasty at our institution. MATERIALS AND METHODS: We retrospectively reviewed patients 21 years or younger who had undergone primary gastrocystoplasty between 1984 and 2004. Patients who underwent secondary gastrocystoplasty or primary composite augmentation or had cloacal exstrophy were excluded. Primary outcome was progression to end-stage renal disease. Secondary outcomes included mortality, bladder malignancy, hematuria-dysuria syndrome, electrolyte abnormalities and surgical revisions. RESULTS: Of 50 patients who had undergone gastrocystoplasty 35 met inclusion criteria. Median age was 9.4 years and 60% of the patients were male. Median followup was 19 years (IQR 11 to 25). Of the 35 patients 15 (43%) had normal preoperative estimated glomerular filtration rate and 5 (14%) had stage 2, 10 (29%) stage 3 and 5 (14%) stage 4 chronic kidney disease. Five of the 15 patients with stage 3 or 4 chronic kidney disease improved to normal estimated glomerular filtration rate, 1 remained with stage 3 disease and 9 progressed to end-stage renal disease. In 1 patient with normal estimated glomerular filtration rate end-stage renal disease developed following an episode of septic shock due to osteomyelitis. Seven patients in the cohort (20%) died, with 1 each dying of ventriculoperitoneal shunt infection, pneumonia, end-stage renal disease, complications of pregnancy and unknown cause, and 2 patients dying of septic shock due to urinary tract infection. There were no bladder malignancies. Hematuria-dysuria syndrome developed in 9 patients (24%). Eight patients (23%) underwent surgical revision. CONCLUSIONS: The majority of patients had preserved or improved renal function after gastrocystoplasty. There were no deaths attributable to gastric augmentation and no bladder malignancies. Approximately a fourth of patients required surgical revision.
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Rim/fisiologia , Estômago/transplante , Doenças da Bexiga Urinária/cirurgia , Bexiga Urinária/cirurgia , Adolescente , Criança , Feminino , Humanos , Testes de Função Renal , Masculino , Complicações Pós-Operatórias/epidemiologia , Insuficiência Renal/epidemiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
Background: Human kidney stones form via repeated events of mineral precipitation, partial dissolution, and reprecipitation, which are directly analogous to similar processes in other natural and manmade environments, where resident microbiomes strongly influence biomineralization. High-resolution microscopy and high-fidelity metagenomic (microscopy-to-omics) analyses, applicable to all forms of biomineralization, have been applied to assemble definitive evidence of in vivo microbiome entombment during urolithiasis. Methods: Stone fragments were collected from a randomly chosen cohort of 20 patients using standard percutaneous nephrolithotomy (PCNL). Fourier transform infrared (FTIR) spectroscopy indicated that 18 of these patients were calcium oxalate (CaOx) stone formers, whereas one patient formed each formed brushite and struvite stones. This apportionment is consistent with global stone mineralogy distributions. Stone fragments from seven of these 20 patients (five CaOx, one brushite, and one struvite) were thin sectioned and analyzed using brightfield (BF), polarization (POL), confocal, super-resolution autofluorescence (SRAF), and Raman techniques. DNA from remaining fragments, grouped according to each of the 20 patients, were analyzed with amplicon sequencing of 16S rRNA gene sequences (V1-V3, V3-V5) and internal transcribed spacer (ITS1, ITS2) regions. Results: Bulk-entombed DNA was sequenced from stone fragments in 11 of the 18 patients who formed CaOx stones, and the patients who formed brushite and struvite stones. These analyses confirmed the presence of an entombed low-diversity community of bacteria and fungi, including Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria, and Aspergillus niger. Bacterial cells approximately 1 µm in diameter were also optically observed to be entombed and well preserved in amorphous hydroxyapatite spherules and fans of needle-like crystals of brushite and struvite. Conclusions: These results indicate a microbiome is entombed during in vivo CaOx stone formation. Similar processes are implied for brushite and struvite stones. This evidence lays the groundwork for future in vitro and in vivo experimentation to determine how the microbiome may actively and/or passively influence kidney stone biomineralization.
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Oxalato de Cálcio , Cálculos Renais , Bactérias/genética , Oxalato de Cálcio/análise , Fosfatos de Cálcio , Fungos , Humanos , Cálculos Renais/química , RNA Ribossômico 16S , EstruvitaRESUMO
A novel transparent touch sensor was fabricated with a drop-on-demand inkjet printing technique on borosilicate glass and flexible polyethylene terephthalate (PET) substrates. Conductive poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) ( PEDOT: PSS) and dielectric poly(methylsiloxane) were deposited on a desired area to form a capacitive touch sensor structure. The properties of the printed sensors (optical transparency, electrical resistance and touch sensing performance) were investigated with varying PEDOT: PSS printing passes. A novel transparent touch sensor fabricated with an all-inkjet-printing method is demonstrated for the first time. This process holds industrially viable potential to fabricate transparent touch sensors with an inkjet printing technique on both rigid and flexible substrates for a wide range of applications.