ABDOMINAL FASCIAL TRANSPLANTS—Physiological and Psychological Benefits

Even when they cannot restore the ability of a paralyzed patient to walk, fascial transplanting operations to stabilize the trunk, to give firmness to the abdominal wall and to improve the posture can be of great benefit. Well designed and well executed operations can greatly improve respiratory, circulatory and eliminatory function. Often the ability to talk or even to sing is restored. Even the ability to cough effectively can sometimes be a boon.The rewards in improved physical health and in morale can make the pain and the expense of operation well worth while to the patient.     

Algorithm of hair restoration surgery in children

Hair is an inseparable element of external appearance of every human being. Although various fashion trends come and go, the lack of hair is for many a major aesthetic and psychological problem. Even if men's balding can be accepted as a natural phenomenon, hair loss in children is considered to be a condition demanding correction. During an 18-year period, 8440 hair restoration operations were performed at the Hair Clinic Poznan, in Poznan, Poland. Most patients were men treated for androgenic alopecia. Among the patients were 57 children in whom hair loss resulted from hereditary factors, perinatal traumas, radiotherapy, and mechanical, thermal, and chemical damage. Methods of restoration were adjusted to type of hair loss, patient age, and ability to cooperate with the surgeon. In cases of single massive scars, skin flap correction was usually used. The flaps were prepared with the use of expanders. In cases of numerous scattered defects or considerable thinning of the scalp, the method of choice was hair transplantation. The "four-hand stick-and-place" technique developed by the authors enabled the surgeon to quickly and precisely carry out the procedure. Application of varied surgery techniques in scalp reconstruction procedures in children gave very good aesthetic results with a minimal complication rate.     

Actue Cholecystitis Following Unrelated Surgery

In a series of 26 cases of acute cholecystitis occurring after an operation for an unrelated condition, 88% of the patients were over 50 years of age and males outnumbered females by 2 to 1. In some of the cases diagnosis was difficult and delay was responsible for the death of one patient. Acalculous cholecystitis occurred in 20% of the cases and in these gangrene or perforation supervened early in the course of the disease.Efforts should be directed to ensuring adequate hydration after operation; resumption of a diet low in fat may be important. Even in the absence of a history of biliary disease, there is a place for the radiological study of the biliary tract before major elective operations are performed. If gallstones are discovered on the occasion of the initial surgery, cholecystectomy should be performed whenever it is feasible. In any patient with postoperative cholecystitis early operation is generally indicated.     

POSTOPERATIVE BILE PERITONITIS

Bile peritonitis may occur after open operations on the biliary tract or following needle biopsy of the liver.Usually it is secondary to rupture of the common duct caused by overlooked common duct stone.Sterile intraperitoneal bile collections may be tolerated fairly well for long periods.Placing drains in the abdomen after biliary tract operations helps prevent dangerous accumulations of bile.Patients with extensive bile peritonitis should be operated upon as soon as possible. Ideally, the operation should include drainage of the abdomen and repair of any underlying pathological cause, but the condition of the patient may be so poor that only drainage can be carried out at the moment.     

Major Operations on Patients with Poliomyelitic Impairment

Pertinent data on operations (other than orthopedic) carried out in 39 patients who had residual impairment from poliomyelitis were reviewed with a view to appraising what additional operative risk there may be for such patients.For a large proportion of the patients, equipment to aid respiration was needed and a large proportion of the operations were urologic procedures as might be expected in a group with generally restricted physical activity. Also, the occurrence of complications was higher than for an ordinary surgical service. Even so, the experience indicated that residual impairment from poliomyelitis ought not be considered a contraindication even of elective, let alone emergency operations.     

Optimizing Semantic Pointer Representations for Symbol-Like Processing in Spiking Neural Networks

The Semantic Pointer Architecture (SPA) is a proposal of specifying the computations and architectural elements needed to account for cognitive functions. By means of the Neural Engineering Framework (NEF) this proposal can be realized in a spiking neural network. However, in any such network each SPA transformation will accumulate noise. By increasing the accuracy of common SPA operations, the overall network performance can be increased considerably. As well, the representations in such networks present a trade-off between being able to represent all possible values and being only able to represent the most likely values, but with high accuracy. We derive a heuristic to find the near-optimal point in this trade-off. This allows us to improve the accuracy of common SPA operations by up to 25 times. Ultimately, it allows for a reduction of neuron number and a more efficient use of both traditional and neuromorphic hardware, which we demonstrate here.     

Elimination of background in film-based applications

Erase-It Background Eliminator is a solution used directly on processed film to remove background or improve data resolution. Traditional methods, such as optimization of the scientific protocol or better estimation of exposure time, are tedious and uncertain. Nevertheless, autoradiography continues to be a simple, effective method to visualize data. Therefore, we evaluated the ability of Erase-It Working Solution to help solve background and resolution issues. To demonstrate the efficiency of the Background Eliminator, we analyzed the product's ability to remove signal evenly, performance on several brands of film, and usefulness with various detection methods. Even reduction of signal was demonstrated by performing densitometric analysis on film generated from a dot blot with serial dilutions of analyte. In addition, overexposed films from various suppliers were effectively treated to remove background and visualize data. Autoradiographs, generated with 32P-labeled probes, and chemiluminescent substrate were also processed resulting in clearer images. Our results demonstrate that film data can be treated quickly and conveniently without fear of artificial enhancement. We show the Background Eliminator to be a universal and timesaving tool to visualize results that otherwise may be difficult to interpret.     

Anesthesia for eye operations in the aged

Aged persons appear to fear eye operations. Hence both patient and surgeon are more at ease with the use of a general anesthetic, particularly if the anesthetist has visited the patient before the operation and reassured him. Early ambulation, ordinarily so desirable in the aged, is curtailed in most eye operations because the head and eyes must be completely quiet. Since barbiturates are not well tolerated by aged patients, Dramamine is used instead preoperatively. Dramamine adequately sedates but does not cause depression or hallucinations. Morphine is contraindicated because of its pupillary action; Demerol is the drug of choice for preoperative medication. Xylocaine applied directly to the pyriform fossa and vocal cords prevents laryngospasm, coughing and straining. Then, following induction with Pentothal, a Guedel airway is introduced into the oropharynx and through it a continuous flow of oxygen is maintained throughout the procedure. Relaxation of the eyelids is aided by the use of various muscle relaxants, succinylcholine being the relaxant of choice because it is rapidly eliminated. By administering narcotics intravenously during the course of the operation the amount of Pentothal needed can be held to a minimum. To prevent any slowing of the respiration, Nalline is administered in conjunction with the narcotic. In dealing with debilitated patients, Nalline is usually given in conjunction with the preoperative narcotic. Any latent slowing of the respiration can be promptly relieved by an additional dose of Nalline.     

Quantifying life cycle inventories of agricultural field operations by considering different operational parameters

Purpose

The ability to estimate fuel and lubricant consumption as well as depreciated weight of agricultural machinery used for field operations is very useful for energy and environmental analyses. In this study, life cycle inventory data of agricultural field operations were established by considering different parameters of such operations.

Methods

Agricultural operations considered in this study include tillage, cultivation, planting, harvesting and post-harvest operations. For these operations, the fuel and lubricant consumption as well as depreciated weight of tractors, combine harvesters and agricultural implements was estimated by considering different operational parameters such as tractor power, field condition, depth of operation, soil condition, tractor type, operational capacity of machine, width of operation and speed. Technical standards were used to estimate different types of power required for most agricultural operations (drawbar power, rotary power and motion power). The standards were then used to evaluate the variability of the fuel and lubricant consumption as well as depreciated weight of the implements by varying the aforementioned parameters.

Results and discussion

The results were compared to those that can be calculated with other approaches for life cycle inventory analysis of agricultural operations. Such comparison indicates that by using different parameters, representing the diverse local conditions of different field operations, a great variability of the results is obtained. For instance, diesel fuel consumption of tillage operations ranges from 12.6 to 76.0 L ha^?1, with an average of 34.15 L ha^?1 and standard deviation of 11.7 L ha^?1. Such representativeness of the different conditions of each field operation cannot be modelled with other tools or via the use of standard LCI datasheets.

Conclusions

The final result of this study is a novel approach for the life cycle inventory analysis of agricultural operations, in terms of fuel and lubricant consumption and of depreciated weight of the machines, which are estimated by simply selecting the operational parameters which best represent the effect of local conditions.

     

基于分子信标的DNA计算

DNA计算是解决一类难以计算问题的一种新方法,这种计算随着问题的增大可以呈指数增长．迄今为止,许多研究成果已经成功地提高了它的性能和增加了它的可行性,本文在基于表面的DNA计算中采用了分子信标编码策略,并对分子信标在与对应的补链杂交形成双链时的受力进行分析,给出3-SAT问题的另一种解法．这种方法比现有的方法更有效,更具发展前景．因为它具有编码简单;耗材底;操作时间短;技术先进等优点．本文尝试了分子生物学,光学和力学的结合．这一工作为DNA计算能解决NP一完全问题提供了更有力的依据．     

The preparation of the factors IX, II, and X concentrate by means of DEAE cellulos and its therapeutic effectiveness.

Starting from a plasma used for producing cryoprecipitate a concentrate was gained by means of adsorption on DEAE cellulose, the factor IX activity of which was six to thirteen times higher than that of the original plasma. Even the factors X and II are enriched to the same extent approximately. In patients with haemophilia B the concentrate proved to be very efficient and compatible during surgical operations.     

Minimal model: perspective from 2005

The minimal model was proposed over 25 years ago. Despite (or because of) its simplicity it continues to be used today - both as a clinical tool and an approach to understanding the composite effects of insulin secretion and insulin sensitivity on glucose tolerance and risk for type 2 diabetes mellitus. The original assumptions of the model have led to an understanding of the kinetics of insulin in vivo, as well as the relative importance of beta-cell compensatory failure in the pathogenesis of diabetes. The disposition index (DI), a parameter emerging from the model, represents the ability of the pancreatic islets to compensate for insulin resistance. There is evidence that a locus on chromosome 11 codes for the DI, which has a significant heritability and can predict type 2 diabetes better than any known genetic locus. Even today, the model continues to be a subject of scientific discovery and discourse.     

Phenotypic assays for analyses of pluripotent stem cell–derived cardiomyocytes

Stem cell–derived cardiomyocytes (CMs) hold great hopes for myocardium regeneration because of their ability to produce functional cardiac cells in large quantities. They also hold promise in dissecting the molecular principles involved in heart diseases and also in drug development, owing to their ability to model the diseases using patient‐specific human pluripotent stem cell (hPSC)–derived CMs. The CM properties essential for the desired applications are frequently evaluated through morphologic and genotypic screenings. Even though these characterizations are necessary, they cannot in principle guarantee the CM functionality and their drug response. The CM functional characteristics can be quantified by phenotype assays, including electrophysiological, optical, and/or mechanical approaches implemented in the past decades, especially when used to investigate responses of the CMs to known stimuli (eg, adrenergic stimulation). Such methods can be used to indirectly determine the electrochemomechanics of the cardiac excitation‐contraction coupling, which determines important functional properties of the hPSC‐derived CMs, such as their differentiation efficacy, their maturation level, and their functionality. In this work, we aim to systematically review the techniques and methodologies implemented in the phenotype characterization of hPSC‐derived CMs. Further, we introduce a novel approach combining atomic force microscopy, fluorescent microscopy, and external electrophysiology through microelectrode arrays. We demonstrate that this novel method can be used to gain unique information on the complex excitation‐contraction coupling dynamics of the hPSC‐derived CMs.     

无饲养层和动物源蛋白的β-地中海贫血诱导多能干细胞系的建立

β-地中海贫血患者因无合适的造血干细胞供体来源从而不得不靠输血维持生命。诱导多能干细胞(iPS)技术为获得患者自身遗传背景的干细胞进行临床治疗开拓了新途径。目前,建立iPS细胞系的过程需要使用小鼠胚胎成纤维细胞作为饲养层和动物源的蛋白成分,因此建立的iPS细胞系存在病原体和动物源蛋白污染的可能性,不能应用于临床。采用目前商品化的TeSRTM2和StemAdhereTMDefined Matrix限定培养体系,利用Oct4、Sox2、Klf4、c-Myc 4个转录因子组装在同一表达载体的可切除的慢病毒感染人β-地中海贫血成纤维细胞,建立了5株无饲养层和动物源蛋白的β-地中海贫血iPS细胞系,这些iPS细胞系具有人胚胎干细胞典型的特征,表达人胚胎干细胞的多能性分子标记,如Oct4、Nanog、Tra-1-60等。在体外分化能够形成拟胚体,在体内分化能够形成含有3个胚层类型细胞的畸胎瘤。     

Clearing the smoke: the scientific rationale for tobacco abstention with plastic surgery

The use of tobacco is a significant contributor to preventable morbidity and mortality in the United States. A significant proportion of cardiovascular diseases, various oral and pulmonary neoplasms, nonmalignant respiratory diseases, and peripheral vascular disorders can be attributed to the use of cigarettes. Surgical outcomes can also be adversely affected as a result of cigarette smoking with intraoperative and postoperative pulmonary, cardiovascular, and cerebrovascular complications as well as increased wound healing complications. These are found across the entire spectrum of surgical specialties. Tissue ischemia and wound-healing impairment secondary to the influence of tobacco is particularly problematic for the plastic surgeon, especially during elective facial aesthetic procedures, cosmetic and reconstructive breast operations, abdominoplasty, free-tissue transfer, and replantation procedures. By educating and providing guidelines to those patients who smoke and by refusing to operate on individuals who fail to abstain, tobacco-associated surgical morbidity in the plastic and reconstructive surgery patient can be eliminated.     

The complication of coinfection

Infectious disease remains one of the largest burdens on humankind. Even with modern medical and public health standards, infectious disease remained the No. 1 killer worldwide at the turn of the century. Often, the most costly disease burdens come from multiple infections at once, i.e., coinfection. Influenza, an annual infection often considered relatively harmless, can increase susceptibility to both deadly bacterial pneumonia and childhood ear infections. Major health threat HIV rarely kills a patient on its own, but instead allows for opportunistic infections and re-emergence of infections such as tuberculosis. What generates these unique relationships is not well understood; herein, we examine in detail three types of coinfection and the unique interactions between infectious agents as well as with the host in each setting. We also begin to address how we may aid further understanding of coinfection and what questions need to be addressed to help direct future treatments.     

生物工程专业微生物学实验课的改革与学生创新能力培养

针对传统微生物实验教学中存在的问题,提出以创新能力培养为核心,调整微生物实验教学内容,改革实验教学环节,丰富教学方法和手段,加强师资队伍建设,从而建立微生物实验教学新体系,培养学生独立思考、创新思维和综合动手的能力.     

From complexation to computation: Recent progress in molecular logic

The new thrusts in molecular logic are gathered together in this short review, while paying attention to the seeds from which these developments have arisen. The original demonstration of a few basic logic operations has now been extended to cover many of the one- and two-input varieties and even some of the three-input types. Many kinds of inputs and outputs have emerged, including various chemical species and some physical properties. The latter can include heat, light and, arguably, polarity. Reconfigurable logic has grown up to include a range of examples. Even superposable logic has proved possible with molecular systems. Numerical processors have flowered in recent years with several diverse approaches being revealed in recent years. Photochemical concepts such as photoinduced electron transfer (PET), internal charge transfer (ICT) and electronic energy transfer (EET) can be discerned among the designs in the field.     

The application of 3D printing patient specific instrumentation model in total knee arthroplasty

The application of 3D printing patient specific instrumentation model in total knee arthroplasty was explored to improve the operative accuracy and safety of artificial total knee arthroplasty. In this study, a total of 52 patients who need knee replacement were selected as the study objects, and 52 patients were divided into experimental group and control group. First, the femoral mechanical-anatomical angle (FMAA), lateral femoral angle (LFA), hip-knee-ankle angle (HKA), femorotibial angle (FTA) of research objects in both groups were measured. Then, the blood loss during the operations, drainage volume after operations, total blood loss, hidden blood loss, and hemoglobin decrease of the experiment group and the control group were measured and calculated. Finally, the postoperative outcomes of patients who underwent total knee arthroplasty were evaluated. The results showed that before the operations, in the PSI group, the femoral mechanical-anatomical angle (FMAA) was (6.9 ± 2.4)°, the lateral femoral angle (LFA) was (82.4 ± 1.6)°, the hip-knee-ankle angle (HKA) was (166.4 ± 1.4)°, and the femorotibial angle (FTA) was (179.5 ± 7.3)°. In the CON group, the FMAA was (5.8 ± 2.4)°, the LFA was (81.3 ± 2.1)°, the HKA was (169.5 ± 1.9)°, and the FTA was (185.4 ± 5.4)°. The differences in these data between the two groups were not statistically significant (P > 0.05). After the operations, in the PSI group, the total blood loss, the hidden blood loss, and the hemoglobin (Hb) decrease were respectively (420.2 ± 210.5), (240.5 ± 234.5), and (1.7 ± 0.9); in the CON group, the total blood loss, the hidden blood loss, and the Hb decrease were respectively (782.1 ± 340.4), (450.9 ± 352.6), and (2.9 ± 1.0). These data of both groups were statistically significant (P < 0.05). Therefore, it can be seen that the 3D printing patient specific instrumentation model can effectively simulate the lower limb coronal force line and was highly consistent of the preoperative software simulation plan. In addition, the random interviews of patients who underwent total knee arthroplasty showed that the knees of patients had recovered well. The application of 3D printing patient specific instrumentation model in artificial total knee arthroplasty can effectively improve the operative accuracy and safety, and the clinical therapeutic effects were significant.     

Technology and patient safety: a two-edged sword

The Agency for Healthcare Research and Quality (AHRQ) is now the world's largest funder of patient safety research. Part of AHRQ's research focus is to examine evidence to help determine which technologies can be used to effectively minimize harm and improve patient safety. The report of the Institute of Medicine (IOM). To Err is Human stressed the importance of automating repetitive, time-consuming, and error-prone tasks through the use of technology. While automation holds substantial promise for improved safety, error experts caution that all technology introduces the potential for new and different errors. It is critical that any new automated system be tested in actual operational settings to determine what, if any, unanticipated failures exist. Field-based research is essential in the emerging field of patient safety to create the evidence as to which technologies actually improve patient safety and those that may well increase the potential for harm.