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We report the picosecond spin current generation from the interface between a heavy metal and a vicinal antiferromagnet insulator Cr_{2}O_{3} by laser pulses at room temperature and zero magnetic field. It is converted into a detectable terahertz emission in the heavy metal via the inverse spin Hall effect. The vicinal interfaces are apparently the source of the picosecond spin current, as evidenced by the proportional terahertz signals to the vicinal angle. We attribute the origin of the spin current to the transient magnetic moment generated by an interfacial nonlinear magnetic-dipole difference-frequency generation. We propose a model based on the in-plane inversion symmetry breaking to quantitatively explain the terahertz intensity with respect to the angles of the laser polarization and the film azimuth. Our work opens new opportunities in antiferromagnetic and ultrafast spintronics by considering symmetry breaking.
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Carrot (Daucus carota L.) is an economically important vegetable crop in China. In August 2008, a disease was observed on carrot in Inner Mongolia. The symptoms appeared as dry rot lesions on root surface, expressing light brown cankers with defined rounded or irregular shapes (1,3). The average disease incidence was up to 80% in Tuo Ke Tuo County. The disease has been a serious problem in these two counties since then, especially where consecutive carrot cropping was practiced. Carrot roots with typical dry rot symptoms were washed with tap water. Root tissues near the margin of necrotic lesions were excised, surface sterilized with 1% NaOCl for 3 min, and rinsed with sterile distilled water three times. The disinfected tissue was placed on potato dextrose agar (PDA) in a petri dish. Plates were incubated at 25 ± 1°C in the dark for 4 days. Fusarium single spore isolates were obtained from characteristic colonies (1). Three isolates (CF1, CF2, and CF3) were used for further study. The isolates were identified as Fusarium spp. on the basis of microscopic morphology on PDA. CF1 produced pink pigment, abundant falciform macroconidia of 14.7 to 38.2 × 4.5 to 5.7 µm with 2 to 3 septates, and elliptic microconidia of 7.5 to 15.1 × 3.3 to 5.4 µm with none or one septate. CF2 and CF3 produced light blue pigment, abundant falciform macroconidia of 16.4 to 34.4 × 4.0 to 6.1 µm with 2 to 3 septates, and elliptic microconidia of 6.7 to 10.7 × 3.0 to 4.9 µm with none or one septate. They were further identified and confirmed by PCR. The PCR involved amplifying the internal transcribed spacer (ITS) region of ribosomal DNA using genomic DNA as the template with universal primers ITS1 and ITS4 (2). The PCR products were sequenced. BLAST analysis of these sequences against the GenBank database determined the taxonomy of the isolates. The sequence of CF1 was 99% identical to F. oxysporum (Accession No. KC594035); sequences of CF2 and CF3 were 99% identical to F. solani (KC215123). To confirm the pathogenicity of the isolates, mature carrot roots (cv. Hong Ying 2) were inoculated with mycelial plugs (5 mm in diameter) cut from the margin of actively growing colonies on PDA plates. One mycelial plug was placed on each carrot root, with the mycelial side facing the root. PDA plugs were used for controls. Each treatment had five replicates. The inoculated roots were incubated in a humid chamber (90% RH) at 25°C. Four days after incubation, mycelia of the isolates developed and covered most of the surface of carrot roots, and brown rot lesions were observed on all inoculated roots, while the controls remained symptomless. This experiment was repeated. In another trial, carrot seeds (cv. Hong Ying 2) were sown in sterilized soil in pots (30 × 25 cm opening) with 15 seeds per pot. The soil was infested with either CF1, CF2, or CF3 by adding spore suspension to make the final concentration of 1 × 104 CFU/g soil. Plants grown in non-infested soil served as controls. There were three replicates per treatment. All the treated pots were placed in a field. After 13 weeks, the same symptoms of dry rot were observed as previously described. No symptoms were observed on the control plants. The trial was repeated. Symptomatic tissues from the inoculated roots were sampled and the pathogen was re-isolated, and identified using PCR. To our knowledge, this is the first report of F. oxysporum and F. solani causing dry rot of carrot in China. References: (1) H. Abe et al. Annual Report of the Society of Plant Protection of North Japan, 48:106-108, 1997. (2) X. Lu. Plant Dis. 97:991, 2013. (3) A. F. Sherf and A. MacNab. Pages 138-139 in: Vegetable Diseases and Their Control. John Wiley & Sons, Inc., 1986.
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Objective: To investigate the effect of volatile organic compounds (VOCs) exposure in the atmosphere on the risk of daily death from stroke in Guangzhou. Methods: Daily average concentrations of twelve atmospheric VOCs, meteorological factors, and daily deaths for stroke and its subtypes (including ischemic and hemorrhagic stroke) in Guangzhou from 2020 to 2021 were collected. The time-series Poisson generalized additive model was established to analyze the relationship between daily average concentrations of atmospheric VOCs and daily mortality from a stroke on different lag days. The season, gender, and age group further performed stratification analysis. Results: Toluene and n-pentane were associated with a higher mortality risk from stroke and its subtypes. For each interquartile range (IQR) increment in toluene concentration at lag0- 1 days, the RRs for mortality from stroke and hemorrhagic stroke were 1.060 (95%CI: 1.036-1.085) and 1.071 (95%CI: 1.030-1.113), respectively. For each IQR increment in n-pentane concentration, the RR for mortality from ischemic stroke was 1.064 (95%CI: 1.030-1.099). The effect estimates of VOCs may be higher during the cold season and among women and people aged ≥75 years. For each IQR increment in toluene concentration, the RRs for mortality risk of stroke in the cold season and women were 1.099 (95%CI: 1.056-1.143) and 1.085 (95%CI: 1.050-1.120), respectively. For n-pentane, the RR for death risk of stroke in people aged ≥75 years old was 1.072 (95%CI: 1.036-1.109). Results of sensitivity analysis showed that the effect estimates fluctuated less when PM2.5 and O3 were separately introduced for the two-pollutant model, as well as changing the degrees of freedom for covariates. Conclusions: This study suggests that VOCs may be an independent risk factor for daily mortality from stroke. Moreover, Toluene presented the most significant health impact.
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Acidente Vascular Cerebral Hemorrágico , Acidente Vascular Cerebral , Compostos Orgânicos Voláteis , Feminino , Humanos , Idoso , ToluenoRESUMO
Objective: To investigate the prognostic value of preoperative inflammatory and nutritional condition detection in the postoperative survival, and establish a prognostic model for predicting the survival of patients with gastric cancer. Methods: The clinicopathological data of 1123 patients with gastric cancer who had undergone radical gastrectomy in Tianjin Medical University Cancer Institute & Hospital from January 2005 to December 2014 were retrospectively analyzed. Patients with history of other malignancy, with history of gastrectomy, who had received preoperative treatment, who died during the initial hospital stay or first postoperative month, and missing clinical and pathological information were excluded. Cox univariate and multivariate analyses were used to identify independent clinicopathological factors associated with the survival of these gastric cancer patients. Cox univariate analysis was used to identify preoperative inflammatory and nutritional indexes related to the survival of patients with gastric cancer after radical gastrectomy. Moreover, the Cox proportional regression model for multivariate survival analysis (forward stepwise regression method based on maximum likelihood estimation) was used. The independent clinicopathological factors that affect survival were incorporated into the following three new prognostic models: (1) an inflammatory model: significant preoperative inflammatory indexes identified through clinical and univariate analysis; (2) a nutritional model: significant preoperative nutritional indexes identified through clinical and univariate analysis; and (3) combined inflammatory/nutritional model: significant preoperative inflammatory and nutritional indexes identified through clinical and univariate analysis. A model that comprised only pT and pN stages in tumor TNM staging was used as a control model. The integrated area under the receiver operating characteristic curve (iAUC) and C-index were used to evaluate the discrimination of the model. Model fitting was evaluated by Akaike information criterion analysis. Calibration curves were used to assess agreement between the predicted probabilities and actual probabilities at 3-year or 5-year overall survival (OS). Results: The study cohort comprised 1 123 patients with gastric cancer. The mean age was 58.9±11.6 years, and 783 were males. According to univariate analysis, age, surgical procedure, extent of lymph node dissection, tumor location, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, and nerve invasion were associated with 5-year OS after radical gastrectomy for gastric cancer (all P<0.050). Multivariate analysis further identified age (HR: 1.18, 95%CI: 1.03-1.36, P=0.019), maximum tumor size (HR: 1.19, 95%CI: 1.03-1.38, P=0.022), number of examined lymph nodes (HR: 0.79, 95%CI: 0.68-0.92, P=0.003), pT stage (HR: 1.40, 95%CI: 1.26-1.55, P<0.001) and pN stage (HR: 1.28, 95%CI: 1.21-1.35, P<0.001) as independent prognostic factors for OS of gastric cancer patients. Additionally, according to univariate survival analysis, the preoperative inflammatory markers of neutrophil count, percentage of neutrophils, neutrophil/lymphocyte ratio, platelet/neutrophil ratio and preoperative nutritional indicators of serum albumin and body mass index were potential prognostic factors for gastric cancer (all P<0.05). On the basis of the above results, three models for prediction of prognosis were constructed. Variables included in the three models are as follows. (1) Inflammatory model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, percentage of neutrophils, and neutrophil-lymphocyte ratio; (2) nutritional model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, and serum albumin; and (3) combined inflammatory/nutritional model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, percentage of neutrophils, neutrophil-lymphocyte ratio, and serum albumin. We found that the predictive accuracy of the combined inflammatory/nutritional model, which incorporates both inflammatory indicators and nutrition indicators (iAUC: 0.676, 95% CI: 0.650-0.719, C-index: 0.698),was superior to that of the inflammation model (iAUC: 0.662, 95% CI: 0.673-0.706;C-index: 0.675), nutritional model (iAUC: 0.666, 95% CI: 0.642-0.698, C-index: 0.672), and TNM staging control model (iAUC: 0.676, 95% CI: 0.650-0.719, C-index: 0.658). Furthermore, the combined inflammatory/nutritional model had better fitting performance (AIC: 10 762) than the inflammatory model (AIC: 10 834), nutritional model (AIC: 10 810), and TNM staging control model (AIC: 10 974). Conclusions: Preoperative percentage of neutrophils, NLR, and BMI have predictive value for the prognosis of gastric cancer patients. The inflammatory / nutritional model can be used to predict the survival and prognosis of gastric cancer patients on an individualized basis.
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Neoplasias Gástricas , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Estadiamento de Neoplasias , Gastrectomia , Albumina SéricaRESUMO
We propose a promising electron entanglement detector consisting of two quantum spin Hall systems weakly coupled to a superconductor. The detection of electron spins along various polarization directions, which is a prerequisite for testing Bell's inequality on solid state spins, can be achieved in an all-electrical-controlled manner utilizing the helical edge states. It is found that the violation of Bell's inequality exists in a large range of the tunneling parameters, which can be realized in mercury telluride quantum wells.
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Multiphoton excitation laser scanning microscopy, relying on the simultaneous absorption of two or more photons by a molecule, is one of the most exciting recent developments in biomedical imaging. Thanks to its superior imaging capability of deeper tissue penetration and efficient light detection, this system becomes more and more an inspiring tool for intravital bulk tissue imaging. Two-photon excitation microscopy including 2-photon fluorescence and second harmonic generated signal microscopy is the most common multiphoton microscopic application. In the present review we take diverse ocular tissues as intravital samples to demonstrate the advantages of this approach. Experiments with registration of intracellular 2-photon fluorescence and extracellular collagen second harmonic generated signal microscopy in native ocular tissues are focused. Data show that the in-tandem combination of 2-photon fluorescence and second harmonic generated signal microscopy as two-modality microscopy allows for in situ co-localization imaging of various microstructural components in the whole-mount deep intravital tissues. New applications and recent developments of this high technology in clinical studies such as 2-photon-controlled drug release, in vivo drug screening and administration in skin and kidney, as well as its uses in tumourous tissues such as melanoma and glioma, in diseased lung, brain and heart are additionally reviewed. Intrinsic emission two-modal 2-photon microscopy/tomography, acting as an efficient and sensitive non-injurious imaging approach featured by high contrast and subcellular spatial resolution, has been proved to be a promising tool for intravital deep tissue imaging and clinical studies. Given the level of its performance, we believe that the non-linear optical imaging technique has tremendous potentials to find more applications in biomedical fundamental and clinical research in the near future.
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Pesquisa Biomédica/métodos , Microscopia de Fluorescência/métodos , Encéfalo/ultraestrutura , Química Encefálica , Glioma/química , Glioma/ultraestrutura , Humanos , Rim/química , Rim/ultraestrutura , Pulmão/química , Pulmão/ultraestrutura , Melanoma/química , Melanoma/ultraestrutura , Miocárdio/química , Miocárdio/ultraestrutura , Esclera/química , Esclera/ultraestrutura , Pele/química , Pele/ultraestruturaRESUMO
BACKGROUND: The varying point at which the spinal cord terminates in the lumbar spinal canal may affect the incidence of spinal cord injuries associated with needle insertion for spinal anaesthesia, especially in patients with vertebral body or intervertebral disc disease. This is a complication which has been frequently reported when spinal needle insertion was performed at higher lumbar spinal levels. METHODS: We retrospectively reviewed magnetic resonance images of the spine in 1047 Chinese patients to determine the conus medullaris terminus (CMT) in patients with and without vertebral disorders. Patients with tumours in and around the spine and those with congenital spinal anomalies were excluded from the study. Patients with mixed vertebral disorders were also excluded. RESULTS: Our data demonstrate that patients with thoracic vertebral compression fractures had lower ending points of the CMT than those without (P<0.05), while patients with lumbar compression fractures did not demonstrate such a correlation. With regard to this difference, females were significantly at higher risk for a lower CMT than males. Conversely, lumbar disc disorders such as intervertebral disc extrusion, herniation, or bulging did not have any significant influence on the level of CMT. Moreover, patients with spondylolisthesis or scoliosis did not demonstrate an abnormal CMT location. CONCLUSIONS: When performing spinal anaesthesia, anaesthesiologists should be aware of potential differences of the CMT location, particularly in female patients with thoracic vertebral compression fractures, who may have a lower CMT than normal, extending to the level of L2. Performing spinal anaesthesia at the L2-L3 interspace would seem to be ill-advised in this patient population.
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Raquianestesia/efeitos adversos , Vértebras Lombares/patologia , Doenças da Coluna Vertebral/complicações , Adolescente , Adulto , Distribuição por Idade , Idoso , Raquianestesia/métodos , Criança , Feminino , Fraturas por Compressão/complicações , Fraturas por Compressão/patologia , Humanos , Deslocamento do Disco Intervertebral/complicações , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Doenças da Coluna Vertebral/patologia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/patologiaRESUMO
Two new stereoisomers of laurane-derived brominated sesquiterpenes, 4-bromolaur-11-en-1,10alpha-diol (1) and 4-bromolaur-11-en-1,10beta-diol (2), one new natural product, laur-11-en-1,10alpha-diol (3), together with 11 known compounds (4-14) were isolated and identified from the organic extract of the marine red alga Laurencia tristicha. Their structures and relative stereochemistry were established by analysis of mass and NMR spectroscopic techniques.
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Laurencia/química , Sesquiterpenos/isolamento & purificação , Sesquiterpenos/químicaRESUMO
We propose to realize adiabatic topological spin and valley pumping by using silicene, subject to the modulation of an in-plane ac electric field with amplitude Ey and a vertical electric field consisting of an electrostatic component and an ac component with amplitudes and . By tuning and , topological valley pumping or spin-valley pumping can be achieved. The low-noise valley and spin currents generated can be useful in valleytronic and spintronic applications. Our work also demonstrates that bulk topological spin or valley pumping is a general characteristic effect of two-dimensional topological insulators, irrelevant to the edge state physics.
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OBJECTIVE: The prevalence of hemorrhagic transformation (HT) after acute ischemic infarction varies greatly. Risk factors of HT include ageing, severity of stroke, baseline hypertension, high NIH Stroke Scale (NIHSS) scores, hyperglycemia and cardioembolic infarction and low levels of low-density lipoprotein (LDL). We investigated the relationship between LDL, lipid profile and HT after acute ischemic infarction and suggested precautions for HT management. PATIENTS AND METHODS: Three hundred and forty-eight patients with acute infarction were included in the study. Fasting lipid profile was examined on the next morning following hospitalization. Either MRI GRE-T2*WI or CT was performed, one week after hospitalization to detect any cerebral microbleed (CMB) and hemorrhagic transformation. The lipid profiles examined included total cholesterol (TCH), triglyceride (TG), LDL and high-density lipoprotein (HDL). RESULTS: Among all the patients, HT was noted in 35 patients and non-HT in 313. As compared with non-HT group, HT group had lower levels of TCH, HDL and LDL, lower rates of leukoaraiosis and CMB, but higher scores of NIHSS, higher rates of diabetes mellitus, atrial fibrillation and urokinase thrombolysis. The multivariate binary logistic regression showed that cardioembolic infarction, infarction with undetermined etiology, high scores of NIHSS and diabetes were the risk factors of HT, while the protective factor was LDL (OR=0.654, 95% CI: 0.430-0.996, p=0.048). CONCLUSIONS: Low level of LDL is likely associated with increased HT after acute ischemic infarct, so for those patients with low level of LDL, high scores of NIHSS and cardioembolic infarction at admission, aggressive lipid- lowering treatment should be prescribed cautiously to prevent the incidence of HT.
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Isquemia Encefálica/sangue , Isquemia Encefálica/diagnóstico , Hemorragia Cerebral/sangue , Hemorragia Cerebral/diagnóstico , LDL-Colesterol/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Isquemia Encefálica/epidemiologia , Hemorragia Cerebral/epidemiologia , Infarto Cerebral/sangue , Infarto Cerebral/diagnóstico , Infarto Cerebral/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologiaRESUMO
Free TRAM flap transfer is now routinely offered to patients requiring breast reconstruction. This study compares results of conventional superior-pedicled TRAM flaps and free TRAM flaps in bilateral breast reconstructions. A total of 92 breasts were reconstructed in 46 patients. Eighteen patients had free TRAM flap reconstructions, and 28 patients were reconstructed with conventional TRAM flaps. Comparison of average operative blood loss and average operative time for the two techniques showed blood loss of 575 cc and an operative time of 9.6 hours for the free TRAM reconstructions and a blood loss of 313 cc and an operative time of 6.6 hours for the conventional TRAM reconstructions. For free TRAM flap reconstructions, both blood loss and operative time decreased significantly between the first and second group of nine patients: from 819 to 360 cc of blood loss and from 10.5 to 8.9 hours of operative time. Partial flap loss (skin and fat necrosis) and fat necrosis only occurred in 13 and 7 percent, respectively, of conventional TRAM flaps, but neither occurred in free TRAM flaps. However, early in the series, three free flaps were lost in two patients, requiring implant placement. Bilateral breast reconstruction using the free TRAM flap may offer a lower complication rate than the conventional TRAM flap by virtue of improved blood supply and less abdominal wall disruption. Surgeons, however, are forewarned that this procedure has a steep learning curve, and surgeons lacking microsurgical expertise may be better served by the conventional TRAM flap.
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Mamoplastia/métodos , Retalhos Cirúrgicos/métodos , Perda Sanguínea Cirúrgica , Feminino , Humanos , Tempo de Internação , Mamoplastia/efeitos adversos , Mastectomia/reabilitação , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de TempoRESUMO
One purported advantage of the free transverse rectus abdominis musculocutaneous (TRAM) flap for breast reconstruction is that, compared with the conventional TRAM flap, it has a better blood supply and therefore a lower incidence of fat necrosis. We tested this claim by reviewing the incidence of fat necrosis, both clinically and mammographically, in a group of 110 patients with 116 TRAM flap breast reconstructions who had undergone mammography of their reconstructed breasts. Of the 49 breasts reconstructed with free TRAM flaps, 4 (8.2 percent) had clinically evident fat necrosis, and 1 (2.0 percent) had fat necrosis that was detectable by mammography. Of the 67 breasts reconstructed with conventional TRAM flaps, 18 (26.9 percent) had clinically detectable fat necrosis, and 9 (13.4 percent) had fat necrosis that was detectable mammographically. Both of these differences were statistically significant (p = 0.0113 for clinical fat necrosis; p = 0.031 for mammographic fat necrosis). Fat necrosis was more common in patients who were obese or had a history of smoking, but neither association was statistically significant. We conclude that the use of the free TRAM flap reduces the incidence of fat necrosis in the reconstructed breast.
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Necrose Gordurosa/etiologia , Mamoplastia/efeitos adversos , Retalhos Cirúrgicos , Músculos Abdominais/cirurgia , Adulto , Necrose Gordurosa/diagnóstico por imagem , Feminino , Humanos , Modelos Logísticos , Mamografia , FumarRESUMO
This study compared nipple projection after nipple reconstruction (following breast mound reconstruction) with either the modified double-opposing tab flap or the star flap. Areolar reconstruction and pigmentation of the nipple were achieved with tattooing. Nipple projection for 153 nipples was measured at least 6 months after the reconstruction, when projection was believed to have become stable. Mean follow-up was 2.27 years. In the 106 nipples reconstructed with modified double-opposing tab flaps, the mean projection was 2.4292 mm, while in the 47 nipples reconstructed with star flaps, the mean projection was 1.9681 mm (p = 0.021). We conclude that although both methods are effective, the modified double-opposing tab flap has slightly more projection after approximately 2 years. It is not known, however, whether this is because of reduced flap atrophy or longer initial projection by the modified double-opposing tab flap; further studies are ongoing.
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Mamoplastia/métodos , Mamilos/cirurgia , Retalhos Cirúrgicos/métodos , Feminino , Seguimentos , HumanosRESUMO
In this study, the records of all patients at the University of Texas M. D. Anderson Cancer Center with T1 or T2 breast cancer who were treated between March of 1986 and November of 1990 with mastectomy followed by immediate breast reconstruction were reviewed for the presence of recurrent disease. Patients with in situ disease were not included. Patients were included in the study if a local recurrence occurred (regardless of the length of follow-up) or if a follow-up of 6 years or longer could be obtained. Patients were grouped according to the use or nonuse of skin-sparing mastectomy, by tumor stage, and by nuclear grade of the tumor. The series included 154 patients, of whom 114 had skin-sparing mastectomies and 40 had nonskin-sparing mastectomies. The local recurrence rate in the skin-sparing mastectomy group was 7.0 percent, whereas in the nonskin-sparing mastectomy group it was 7.5 percent. The sample size in the nonskin-sparing mastectomy group was too small for meaningful statistical analysis, but the data suggest that there is no clinically important difference in recurrence rates between the two groups. We conclude that the use of skin-sparing technique for early breast cancer patients does not significantly increase the risk of tumor recurrence after mastectomy.
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Neoplasias da Mama/cirurgia , Mastectomia Subcutânea , Recidiva Local de Neoplasia/epidemiologia , Neoplasias da Mama/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Mamoplastia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
The resource cost (cost to our hospital) of providing mastectomy plus breast reconstruction was calculated for 276 patients who had received both mastectomy and breast reconstruction at our institution. All patients had completed the entire reconstructive process, including reconstruction of the nipple. The resource costs of providing mastectomy with immediate breast reconstruction were compared with those of mastectomy with subsequent delayed reconstruction. We found that the mean resource cost for the 57 patients who had separate mastectomy followed by delayed breast reconstruction ($28,843) was 62 percent higher than that of mastectomy with immediate reconstruction ($17,801; n = 219, p < 0.001). Similar differences were found when patients were subgrouped by type of reconstruction (TRAM versus tissue expansion and implants), by laterality (unilateral versus bilateral), and by history of preoperative irradiation. We conclude that mastectomy with immediate breast reconstruction is significantly less expensive than mastectomy followed by delayed reconstruction and can potentially conserve resources.
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Custos Hospitalares , Mamoplastia/economia , Mastectomia/reabilitação , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Retalhos Cirúrgicos/economia , Fatores de TempoRESUMO
A series of 178 immediate reconstructions with regional or distant tissue for repair of oropharyngeal defects caused by treatment of head and neck cancer was reviewed to determine whether reconstruction with free flaps was more or less expensive than reconstruction with regional myocutaneous flaps. In this series, three types of flaps were used: the radial forearm free flap (n = 89), the rectus abdominis free flap (n = 56), and the pectoralis major myocutaneous flap (n = 33). Resource costs were determined by adding all costs to the institution of providing each service studied using salaried employees (including physicians). The two free-flap groups were combined to compare free flaps with the pectoralis major myocutaneous flap, a regional myocutaneous flap. Failure rates in the two groups were similar (3.0 percent for pectoralis major myocutaneous flap, 3.4 percent for free flaps). The mean costs of surgery were slightly higher for the free flaps, but the subsequent hospital stay costs were lower. Therefore, the total mean resource cost for the free-flap group ($28,460) was lower than the cost for the myocutaneous flap group ($40,992). The pectoralis major myocutaneous flap may have been selected for more patients with advanced disease and systemic medical problems, contributing to longer hospitalization and added cost. Nevertheless, this study suggests that free flaps are not more expensive than other methods and may provide cost savings for selected patients.
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Neoplasias de Cabeça e Pescoço/cirurgia , Custos Hospitalares , Músculos Peitorais/transplante , Retalhos Cirúrgicos/economia , Fatores Etários , Análise de Variância , Redução de Custos , Antebraço , Sobrevivência de Enxerto , Hospitalização/economia , Humanos , Tempo de Internação/economia , Pessoa de Meia-Idade , Doenças da Boca/etiologia , Doenças da Boca/cirurgia , Músculo Esquelético/transplante , Orofaringe/cirurgia , Doenças Faríngeas/etiologia , Doenças Faríngeas/cirurgia , Médicos/economia , Complicações Pós-Operatórias/cirurgia , Reto do Abdome/transplante , Estudos Retrospectivos , Salários e Benefícios , Transplante de Pele/economia , Retalhos Cirúrgicos/métodos , Fatores de TempoRESUMO
Audiograms were taken on 20 young men before and immediately after exposure to Fighter-6 ground running-up noise, and their course of recovery was followed. The sound levels at the engine hatch were 117-128 dB(A). The noise-induced temporary threshold shift was more than 13 dB. The maximum threshold shift occurred at 4 kHz. The shift in the low and speech frequencies recovers more rapidly and is completed in 30 min, whereas that in the high-frequency range recovers much more slowly, not returning to normal until 24 h later. High-frequency hearing loss is at risk in groundcrew. In order to prevent hearing damage, they ought to wear ear-protectors. We discovered that the V-shaped depression was not at 4 kHz but at 6 kHz. The former view concerning the pathogenesis of "4 kHz depression", therefore, is open to question. This interesting subject warrants further study.
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Aeronaves , Fadiga Auditiva , Ruído/efeitos adversos , Adolescente , Adulto , Audiometria , Dispositivos de Proteção das Orelhas , Perda Auditiva Provocada por Ruído/prevenção & controle , Humanos , MasculinoRESUMO
The reinforcing effect of transcutaneous acupoint electric stimulation (TAES) with enflurane anesthesia during craniotomy was studied. 110 neurosurgical patients were randomly divided into three groups. Anesthesia was maintained with enflurane in group A (n = 40); in group B, enflurane anesthesia was supplemented by TAES with Han's acupoint nerve stimulator (HANS) at Hegu, Yuyao and Fengchi points on the operated side (n = 40); in group C, enflurane anesthesia was supplemented by TAES and scalp infiltration with 0.5% procaine (n = 30). The results showed that the minimum alveolar concentration (MAC) of enflurane in group B and C decreased 37.8-47.0% and 42.1-66.1% respectively than that in group A. The hemodynamics was more stable during operation, and the patients recovered faster after operation in group B and C. It was concluded that TAES with HANS significantly potentiated the anesthetic effect and decreased the side effects of enflurane during operation, and that the triple combination of TAES, enflurane and scalp infiltration with procaine proved to be a better anesthetic method for craniotomy.
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Analgesia por Acupuntura , Anestesia por Inalação , Craniotomia , Enflurano , Adolescente , Adulto , Anestesia Local , Neoplasias Encefálicas/cirurgia , Eletroacupuntura , Feminino , Hemodinâmica , Humanos , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Pessoa de Meia-Idade , ProcaínaRESUMO
OBJECTIVE: Todd's paralysis is the most common complication after epileptic seizures, especially status epilepticus, but other disabilities deriving from the postictal state are poorly understood. There is relatively little information on the underlying parameters that affect clinical features of post-epileptic dysfunction. The aim of this paper is to investigate clinical features of special post-epileptic dysfunction persisting over 24 hours. PATIENTS AND METHODS: Seven patients with special syndromes of post-epileptic dysfunction were retrospectively analyzed and the related literature was reviewed. RESULTS: Six patients with post-epileptic dysfunction experienced status epilepticus. Of the seven patients, six had underlying structural brain lesions. Post-epileptic dysfunction has different syndromes, including post-epileptic paralysis, post-epileptic aphasia, cognitive disorder, gaze palsy and hemianopsia. The duration of the dysfunction in these patients lasted from 2 days to 3 months. CONCLUSIONS: The great majority of patients with post-epileptic dysfunction experience status epilepticus and have underlying structural brain lesions. Post-epileptic dysfunction includes various syndromes and can last from several days to 3 months with a good prognosis.