Aminoglycoside-aminocyclitols including streptomycin, kanamycin, capreomycin and amikacin showed considerable activity against Mycobacterium tuberculosis, with MICs well below their Cmax and ...relatively low MBC/MIC ratios. Kanamycin, capreomycin and amikacin remained highly active against 'resistant' and 'multidrug-resistant' M. tuberculosis isolates except for some 'multidrug-resistant' isolates which showed complete cross-resistance between streptomycin and the selected 2-deoxystreptamines. Gentamicin displayed anti-tuberculous activity but was bacteriostatic only. Non-tuberculosis mycobacteria, in particular Mycobacterium chelonae and Mycobacterium avium-intracellulare, were more resistant than M. tuberculosis. Amikacin was inhibitory against Mycobacterium kanasii, Mycobacterium scrofulaceum and Mycobacterium fortuitum, but was bactericidal against M. scrofulaceum only. Kanamycin was also bactericidal against M. scrofulaceum. Growth of M. fortuitum was inhibited by amikacin and neomycin which was also inhibitory against M. tuberculosis and M. scrofulaceum. Although the application of neomycin has been limited by its high toxicity, this study suggested that this drug might be useful as a topical agent for cutaneous infections by M. fortuitum.
Rutherford backscattering/channeling spectrometry and synchrotron X-ray diffraction are employed to characterize the structural properties of the InAsPSb epilayer grown on the InAs substrate. The ...results indicate that a 975-nm thick InAs
0.668P
0.219Sb
0.113 layer has a quite good crystalline quality (
χ
min=6.1%). The channeling angular scan around an off-normal 〈1
1
1〉 axis in the (0
1̄
1) plane of the sample is used to determine the tetragonal distortion
e
T, which is caused by elastic strain in the layer. The results show that the InAsPSb layer is subjected to an elastic strain at the interfacial layer, and the strain decreases gradually moving towards the near-surface layer. It is expected that an epitaxial InAsPSb layer with the thickness of around 1700
nm will be fully relaxed (
e
T=0). The magnitude difference of
e
T deduced from angular scans and X-ray diffraction implies some structure (like dislocations) may play a role.
The Galileo spacecraft passed through an unexpectedly dense plasma and mass loading region near Io closest approach. This paper shows how the prodigious mass loading observed in this region can ...produce field‐aligned potential drops. For parameters appropriate to Io and consistent with Galileo measurements, this mechanism is shown to support up to two hundred volt, field‐aligned potential drops near Io and field‐aligned electron beams. The total power in these electron beams is less than ∼4×108 W, a small fraction of the total energy requirement for maintaining torus ultraviolet emissions. This mechanism may nevertheless be important for the Jupiter‐Io interaction, because it injects a seed population of energized electrons and ions into the Io flux tube with hundred volt parallel energies. A two step acceleration process may operate in the Io flux tube, in which a seed population of electrons with parallel energies above an eV is created, followed by field‐aligned acceleration in the Alfven wings.
Mechanical failure of π‐conjugated polymer thin films is unavoidable under cyclic loading conditions, due to intrinsic defects and poor resistance to crack propagation. Here, the first tear‐resistant ...and room‐temperature self‐healable semiconducting composite is presented, consisting of conjugated polymers and butyl rubber elastomers. This new composite displays both a record‐low elastic modulus (<1 MPa) and ultrahigh deformability with fracture strain above 800%. More importantly, failure behavior is not sensitive to precut notches under deformation. Autonomous self‐healing at room temperature, both mechanical and electronic, is demonstrated through the physical contact of two separate films. The composite film also shows device stability in the ambient environment over 5 months due to much‐improved barrier property to both oxygen and water. Butyl rubber is broadly applicable to various p‐type and n‐type semiconducting polymers for fabricating self‐healable electronics to provide new resilient electronics that mimic the tear resistance and healable property of human skin.
A mechanically durable and electronically stable semiconducting composite is engineered by introducing a blend of donor–acceptor polymer and butyl rubber elastomer. The composite exhibits ultralow modulus, ultrahigh deformability, tear resistance, and self‐healing performance, as well as ambient stable device stability. This method is widely applicable to different semiconducting polymers.
The metacarpal-like hand is a severe hand injury, never addressed before. It describes a hand that has lost a significant degree of prehension through a wide array of amputations, involving all ...digits proximal to the functional length except in one finger or in two digits, including the thumb. The thumb condition can be used to differentiate between two types. In type I, the thumb is intact or amputated at or distal to the interphalangeal joint (functional length); therefore, the reconstruction is focused mainly on fingers. In type II, the thumb is amputated proximal to the interphalangeal joint; therefore, the reconstruction is focused on both the thumb and fingers. Thumb amputation level, integrity of the first basal joint, and functionality of the thenar muscles can be used to subdivide type II. Functional reconstruction should consider the patient's desire and vocational needs. The finger left with adequate functional length is assessed for its location, level of amputation, and joint motion, especially the proximal interphalangeal joint. The goal is to use the reliable techniques of toe-to-hand surgery to reconstruct more opposable units, at least two fingers, whether adjacent to each other or not, and the thumb, when needed, to achieve a functionally and aesthetically better hand instead of a functionally adequate hand, with a more acceptable to ideally natural hand cascade. Strategic, individualized toe transfer(s) is the key element in fulfilling the goals of this operation whether single or multiple toes are transplanted.
Small cell lung cancer (SCLC) is a highly aggressive and lethal type of cancer in humans. SCLC is sensitive to chemotherapy and radiotherapy, but long-term survival is low and the majority of ...patients eventually develop progressive disease. With the success of imatinib mesylate in the treatment of gastrointestinal stromal tumors expressing c-kit, its use in SCLC serves as a novel molecular therapeutic approach. The activity of imatinib mesylate is correlated with the mutation of c-kit gene exons 9 and 11 in gastrointestinal stromal tumors. The incidence of epidermal growth factor receptor mutation in non-small cell lung cancer is higher in China than in the United States of America and European countries. There may be also differences in the incidence of c-kit mutation between China and European countries. At present, no study examining imatinib mesylate treatment for SCLC in China is available. To investigate the expression and mutation of c-kit and the correlation with prognosis of SCLC in China, immunohistochemistry was used to detect the expression of c-kit, and a pyrosequencing assay was used to detect mutations in c-kit exons 9 and 11 of 36 SCLC patients who received surgical treatment at the Zhejiang Cancer Hospital, Hangzhou, China, between 1998 and 2010. All 36 patients were followed up to analyze the correlation between prognosis and expression and mutation of c-kit. The incidence of c-kit-positive expression was 83.3%, including 25.0% weak staining, 22.2% moderate staining and 36.1% strong staining. The overall survival of patients with c-kit strong staining was shorter compared to patients with c-kit not strong staining. No mutation in c-kit exons 9 and 11 was detected. In conclusion, the findings showed that the expression of c-kit is high, and strong staining is a prognostic factor for worse survival.
The present study aimed to identify the risk factors influencing the survival of patients with hepatocellular carcinoma (HCC) affected by portal vein tumor thrombus (PVTT), following hepatic ...resection, and to establish a prognostic model. Between March 2001 and May 2008, 234 cases of HCC with PVTT that underwent hepatic resection were randomly divided into experimental or validation groups. The association between the clinicopathological factors and disease-free survival (DFS) and overall survival (OS) was analyzed, and the significant factors involved were used to establish a prognostic model, which was then validated. Tumor rupture, number of tumors and macroscopic vascular invasion were observed to be independent risk factors of DFS and OS. In the prognostic model, the DFS and OS of low-, medium- and high-risk patients in the experimental group were observed to be significantly different, compared to those in the validation group. In conclusion, the present study established a prognostic model for patients with HCC affected by PVTT following hepatectomy, and demonstrated that the model may be used to guide the treatment of these patients and predict their prognosis.
The adequate presence of silicon (Si) in rice plants can enhance their yield and improve their tolerance to various biotic and abiotic stresses. In this study Si uptake abilities were compared ...between the japonica rice cultivar (cv.) Kinmaze and the indica rice cv. DV85 under three Si concentrations (0.16, 0.4, and 1.6mM) at different time points from 1 to 12h. The results showed that the phenotypic values of two traits—Si uptake by individual plants (SP, Si uptake by all roots of a plant) and Si uptake per unit root dry weight (SR=SP/root dry weight)—of Kinmaze were significantly higher than those of DV85 (P<0.01). Meanwhile, a kinetic study indicated that the Si transporters in Kinmaze and DV85 had the same affinity for silicic acid, but with different Vmax values, indicating that Kinmaze had more Si transporters in the roots than DV85. This may be the main reason for the difference in Si uptake ability between Kinmaze and DV85. In addition, a mapping population consisting of 81 recombinant inbred lines (RILs) derived from the cross between Kinmaze and DV85 was used to detect quantitative trait loci (QTLs) underlying SP and SR. The RILs follow a continuous one-peak distribution and show transgressive segregation in both directions for SP, SR, and root dry weight (RDW). Three QTLs for SP, four for SR, and three for RDW were detected. This can explain 7.16–17.15% of the phenotypic variation (PVE). Thus, the results obtained in this study provide a better understanding of the mechanism of rice Si uptake ability and the basis for fine-mapping the genes involved.
One hundred consecutive patients with acute suppurative cholangitis were randomized in a prospective, controlled clinical trial to receive either ciprofloxacin (200 mg bd iv) or triple therapy ...comprising ceftazidime (1 g bd iv), ampicillin (500 mg qds iv) and metronidazole (500 mg tds iv); 46 and 44 patients in the ciprofloxacin and triple therapy groups respectively were suitable for inclusion in the analysis of efficacy. In two-thirds of the patients biliary obstruction was caused by ductal calculi and in one-third by malignant or benign strictures of the biliary tract. Bacteraemia was documented in 38% of patients in the ciprofloxacin group and in 34% of patients in the triple therapy group, while bile cultures were positive in 87% and 92% of patients in the ciprofloxacin and triple therapy groups respectively. Escherichia coli, Klebsiella spp. and Enterococcus spp. were the most common biliary isolates. Eighty-five per cent of evaluable patients in the ciprofloxacin group and 77% of those in the triple therapy group responded to therapy. The mean durations of fever, septicaemic shock and hospitalization were also similar in the two treatment groups. Six (13%) patients in the ciprofloxacin group and seven (16%) in the triple therapy group required urgent endoscopy or surgery for uncontrolled infection. Recurrence of fever after an initial response was documented in one (2%) patient receiving ciprofloxacin and in three (7%) patients receiving triple therapy. The incidences of mortality were 4% in the ciprofloxacin group and 2% in the triple therapy group. The results of this study suggest that ciprofloxacin alone is adequate empirical therapy for patients with cholangitis.
Unrecognized obstructive sleep apnea increases cardiovascular risks in the general population, but whether obstructive sleep apnea poses a similar risk in the perioperative period remains uncertain.
...To determine the association between obstructive sleep apnea and 30-day risk of cardiovascular complications after major noncardiac surgery.
Prospective cohort study involving adult at-risk patients without prior diagnosis of sleep apnea and undergoing major noncardiac surgery from 8 hospitals in 5 countries between January 2012 and July 2017, with follow-up until August 2017. Postoperative monitoring included nocturnal pulse oximetry and measurement of cardiac troponin concentrations.
Obstructive sleep apnea was classified as mild (respiratory event index REI 5-14.9 events/h), moderate (REI 15-30), and severe (REI >30), based on preoperative portable sleep monitoring.
The primary outcome was a composite of myocardial injury, cardiac death, heart failure, thromboembolism, atrial fibrillation, and stroke within 30 days of surgery. Proportional-hazards analysis was used to determine the association between obstructive sleep apnea and postoperative cardiovascular complications.
Among a total of 1364 patients recruited for the study, 1218 patients (mean age, 67 SD, 9 years; 40.2% women) were included in the analyses. At 30 days after surgery, rates of the primary outcome were 30.1% (41/136) for patients with severe OSA, 22.1% (52/235) for patients with moderate OSA, 19.0% (86/452) for patients with mild OSA, and 14.2% (56/395) for patients with no OSA. OSA was associated with higher risk for the primary outcome (adjusted hazard ratio HR, 1.49 95% CI, 1.19-2.01; P = .01); however, the association was significant only among patients with severe OSA (adjusted HR, 2.23 95% CI, 1.49-3.34; P = .001) and not among those with moderate OSA (adjusted HR, 1.47 95% CI, 0.98-2.09; P = .07) or mild OSA (adjusted HR, 1.36 95% CI, 0.97-1.91; P = .08) (P = .01 for interaction). The mean cumulative duration of oxyhemoglobin desaturation less than 80% during the first 3 postoperative nights in patients with cardiovascular complications (23.1 95% CI, 15.5-27.7 minutes) was longer than in those without (10.2 95% CI, 7.8-10.9 minutes) (P < .001). No significant interaction effects on perioperative outcomes were observed with type of anesthesia, use of postoperative opioids, and supplemental oxygen therapy.
Among at-risk adults undergoing major noncardiac surgery, unrecognized severe obstructive sleep apnea was significantly associated with increased risk of 30-day postoperative cardiovascular complications. Further research would be needed to assess whether interventions can modify this risk.
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