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INTRODUCTION: Although computed tomography (CT) is a useful tool for exploring occult infection in patients with sepsis in the emergency department, the potential nephrotoxicity of contrast media is a major concern. Our study aimed to investigate the association between use of contrast-enhanced CT and the risks of acute kidney injury and other adverse outcomes in patients with sepsis. METHODS: In total, 587 patients with sepsis who underwent CT scan (enhanced CT group: 105, non-enhanced CT group: 482) from January 2012 to December 2016 at a tertiary referral centre were enrolled in this retrospective analysis, and propensity score matching was performed to minimise the selection bias. The length of stay, incidences of acute kidney injury and emergent dialysis, and short-term mortality were compared between the two groups. RESULTS: Compared with patients in the non-enhanced CT group, patients in the contrast-enhanced CT group did not have increased risks of acute kidney injury (odds ratio [OR]=1.38, 95% confidence interval [CI]=0.55-3.43; P=0.489), emergent dialysis (OR=1.31, 95% CI=0.47-3.68; P=0.602), or short-term mortality (OR=0.90, 95% CI=0.48-1.69; P=0.751). In addition, there was no significant difference in the median length of hospital stay between survivors in the two groups (20 vs 19 days, P=0.742). CONCLUSIONS: Intravenous contrast administration during CT scanning was not associated with prolonged length of hospital stay in patients with sepsis in an emergency setting. Moreover, the use of contrast-enhanced CT was not associated with increased risks of acute kidney injury, emergent dialysis, or short-term mortality.
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Lesión Renal Aguda/epidemiología , Medios de Contraste/efectos adversos , Sepsis/diagnóstico por imagen , Lesión Renal Aguda/inducido químicamente , Administración Intravenosa , Anciano , Estudios de Cohortes , Medios de Contraste/administración & dosificación , Servicio de Urgencia en Hospital , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Estudios Retrospectivos , Factores de Riesgo , Taiwán/epidemiología , Tomografía Computarizada por Rayos XRESUMEN
Subwavelength resonators, ranging from single atoms to metallic nanoparticles, typically exhibit a narrow-bandwidth response to optical excitations. We computationally design and experimentally synthesize tailored distributions of silver nanodisks to extinguish light over broad and varied frequency windows. We show that metallic nanodisks are 2-10x more efficient in absorbing and scattering light than common structures, and can approach fundamental limits to broadband scattering for subwavelength particles. We measure broadband extinction per volume that closely approaches theoretical predictions over three representative visible-range wavelength windows, confirming the high efficiency of nanodisks and demonstrating the collective power of computational design and experimental precision for developing new photonics technologies.
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In patients with limited mouth opening, traditional laryngoscopy and videolaryngoscopes are not useful when performing nasotracheal intubation. Eighty patients with limited mouth opening who required nasotracheal intubation were randomly assigned to either fibreoptic intubation (n = 40) or the Trachway(®) (n = 40). Using the modified nasal intubation difficulty scale, 22 (55%) patients who received fibreoptic intubation were categorised as no difficulty compared with 40 (100%) patients in the Trachway group (p < 0.001). Mean (SD) total intubation time was 71.8 (23.3) s in patients who received fibreoptic intubation compared with 35.4 (9.8) s in the Trachway group (p < 0.001). We conclude that the Trachway technique for nasotracheal intubation is quicker and easier compared with fibreoptic intubation in patients with limited mouth opening.
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Intubación Intratraqueal/métodos , Grabación en Video/instrumentación , Adulto , Anciano , Femenino , Tecnología de Fibra Óptica , Humanos , Intubación Intratraqueal/instrumentación , Masculino , Persona de Mediana Edad , Boca , Factores de TiempoAsunto(s)
Apéndice , Neoplasias del Ciego , Resección Endoscópica de la Mucosa , Neoplasias , Apéndice/cirugía , HumanosRESUMEN
OBJECTIVE: Transforming growth factor-beta (TGF-ß) proteins are involved in epithelial keratinization. The major function of latent TGF-ß binding proteins (LTBPs) is modulating TGF-ß activity. However, whether LTBP-1 and LTBP-2 play roles in gingiva keratinization remains unclear. MATERIALS AND METHODS: Human keratinized gingiva and non-keratinized alveolar mucosa were processed for LTBP-1, LTBP-2, cytokeratin-1 (K1), cytokeratin-4 (K4), and TGF-ß immunohistochemical (IHC) staining. Porcine heterotopically transplanted connective tissues and newly grown epithelia were harvested for IHC staining. The expression levels of LTBP-1 and LTBP-2 were compared between differentiated and undifferentiated human normal oral keratinocytes (hNOK). The expression of LTBP-1 and LTBP-2 was knocked down in a cell line (OEC-M1) to evaluate the effects on the expression of K1, K4, and involucrin (INV). RESULTS: In human and porcine specimens, LTBP-2 expression patterns distinguished keratinized and non-keratinized oral epithelia. Western blotting results showed that K1, LTBP-1, and INV proteins were upregulated in differentiated hNOK. In OEC-M1 cells, LTBP-2 knockdown resulted in upregulated the expression of K1 and INV and downregulated the expression of K4. LTBP-1 knockdown resulted in opposite effects. CONCLUSION: The expression patterns of LTBP-2 differ in keratinized gingiva and non-keratinized mucosa. LTBP-1 and LTBP-2 are involved in the keratinization of oral epithelium; however, the underlying mechanism remains to be elucidated.
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Encía/química , Queratina-1/metabolismo , Queratina-4/metabolismo , Proteínas de Unión a TGF-beta Latente/análisis , Precursores de Proteínas/metabolismo , Animales , Diferenciación Celular , Línea Celular , Técnicas de Silenciamiento del Gen , Humanos , Queratinocitos/metabolismo , Proteínas de Unión a TGF-beta Latente/genética , Mucosa Bucal/química , PorcinosRESUMEN
We propose and demonstrate the feasibility of using all-optical orthogonal frequency division multiplexing (AO-OFDM) for the convergent optical wired and wireless access networks. AO-OFDM relies on all-optically generated orthogonal subcarriers; hence, high data rate (> 100 Gb/s) can be easily achieved without hitting the speed limit of electronic digital-to-analog and analog-to-digital converters (DAC/ADC). A proof-of-concept convergent access network using AO-OFDM super-channel (SC) is demonstrated supporting 40 - 100 Gb/s wired and gigabit/s 100 GHz millimeter-wave (MMW) ROF transmissions.
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We show that there are shape-independent upper bounds to the extinction cross section per unit volume of dilute, randomly arranged nanoparticles, given only material permittivity. Underlying the limits are restrictive sum rules that constrain the distribution of quasistatic eigenvalues. Surprisingly, optimally designed spheroids, with only a single quasistatic degree of freedom, reach the upper bounds for four permittivity values. Away from these permittivities, we demonstrate computationally optimized structures that surpass spheroids and approach the fundamental limits.
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Nanopartículas del Metal/química , Modelos QuímicosAsunto(s)
Angiografía con Fluoresceína/métodos , Complicaciones Intraoperatorias/diagnóstico por imagen , Isquemia/diagnóstico por imagen , Neoplasias del Recto/cirugía , Estomas Quirúrgicos/irrigación sanguínea , Anastomosis Quirúrgica , Humanos , Verde de Indocianina , Rayos Infrarrojos , Complicaciones Intraoperatorias/cirugía , Isquemia/etiología , Isquemia/cirugía , Laparoscopía/efectos adversos , Laparoscopía/métodos , Escisión del Ganglio Linfático/efectos adversos , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/cirugía , Masculino , Persona de Mediana Edad , Proctoscopía/métodosAsunto(s)
Adenocarcinoma/cirugía , Aorta , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/cirugía , Neoplasias del Recto/cirugía , Síndrome de Cascanueces Renal/complicaciones , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Femenino , Humanos , Hallazgos Incidentales , Laparoscopía , Ganglios Linfáticos/patología , Persona de Mediana Edad , Neoplasias del Recto/complicaciones , Neoplasias del Recto/patologíaAsunto(s)
Adenocarcinoma/terapia , Bevacizumab/efectos adversos , Neoplasias del Ciego/terapia , Neoplasias Colorrectales/terapia , Laparoscopía/métodos , Neoplasias Peritoneales/terapia , Fístula Vesicovaginal/cirugía , Adenocarcinoma/secundario , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Camptotecina/análogos & derivados , Camptotecina/uso terapéutico , Neoplasias del Ciego/patología , Quimioterapia Adyuvante , Colectomía , Neoplasias Colorrectales/patología , Femenino , Fluorouracilo/uso terapéutico , Humanos , Histerectomía , Leucovorina/uso terapéutico , Persona de Mediana Edad , Neoplasias Peritoneales/secundario , SalpingooforectomíaAsunto(s)
Angiomiolipoma/diagnóstico por imagen , Dolor en el Flanco/etiología , Hematoma/diagnóstico por imagen , Enfermedades Renales/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Sistemas de Atención de Punto , Rotura Espontánea/diagnóstico por imagen , Síndrome , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Primary sternal osteomyelitis (PSO) is a rare syndrome. In adults, it usually occurs with underlying predisposing factors, such as immunodeficiency, or intravenous (IV) drug abuse. The infecting organism in these patients is usually Staphylococcus aureus or Pseudomonas aeruginosa. Peptostreptococcus species are Gram-positive anaerobic cocci and are part of the normal flora of human mucocutaneous surfaces. Peptostreptococcus infection can occur in all body sites, including the central nervous system, head, neck, chest, abdomen, pelvis, skin, bone, joint, and soft tissue. Here, we report on a 32-year-old previously healthy Chinese man who was diagnosed with PSO and P. anaerobius was yielded in the bacterial culture. He was treated empirically with antibiotics, but these failed. After additional limited surgical intervention with debridement, the PSO was cured.
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Desbridamiento/métodos , Infecciones por Bacterias Grampositivas/microbiología , Osteomielitis/microbiología , Peptostreptococcus/aislamiento & purificación , Adulto , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Pueblo Asiatico , Ácido Clavulánico/uso terapéutico , Infecciones por Bacterias Grampositivas/terapia , Humanos , Masculino , Osteomielitis/terapia , Oxacilina/uso terapéutico , Esternón , Resultado del TratamientoRESUMEN
Growing InGaN quantum dots (QDs) at the apex of hexagonal GaN pyramids is an elegant approach to achieve a deterministic positioning of QDs. Despite similar synthesis procedures by metal organic chemical vapor deposition, the optical properties of the QDs reported in the literature vary drastically. The QDs tend to exhibit either narrow or broad emission lines in the micro-photoluminescence spectra. By coupled microstructural and optical investigations, the QDs giving rise to narrow emission lines were concluded to nucleate in association with a (0001) facet at the apex of the GaN pyramid.