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1.
The shortage of suitable liver donors for children has motivated the use of ABO-incompatible (ABO-I) grafts for transplantation in urgent situations. However, survival after ABO-I liver grafts has been reported at about 30% as compared with 80% in cases of ABO-identical or -compatible liver grafts. This difference has been attributed to antibody-mediated, hyperacute or chronic liver rejection, due to preformed ABO antibodies (alloantibodies). In this study, we report our results with ABO-I livers in children without alloantibodies at the time of transplantation. From January 1988 to June 1993, 143 OLT were performed in 122 children. Eight children received 8 ABO-I liver grafts. Of these, 7 patients were included in the study. All 7 were alloantibody free before OLT. Five children were spontaneously alloantibody free, while in 2 children, the plasma alloantibodies were eliminated before and after transplantation using intravenous infusion of specific blood group antigens of the donor blood group (soluble antigens). Immunosuppression consisted of a triple-drug treatment combining CsA, AZA, and steroids. The follow-up period was between 10 and 48 months. One child died from a surgical complication. Six children survived, but 1 died 10 months later from intestinal obstruction. There were no graft losses and no episodes of hyperacute or chronic rejection. The graft and patient survival rate was 71%. There was a 28% incidence of rejection, but all were mild (requiring steroid boluses only). Our results suggest that the absence of ABO alloantibodies at the time of and after transplantation can protect ABO-I liver grafts against antibody-mediated rejection, whether hyperacute or chronic, and that soluble antigens are effective in eliminating alloantibodies in children.  相似文献   
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While abundant clinical and angiographic data are available regarding features of acute or abrupt closure at the site of balloon angioplasty, little morphologic information is available. This study discusses morphologic-histologic causes for acute closure after angioplasty in 130 necropsy patients. Intimal-medial flaps, elastic recoil, and primary thrombosis were the three leading morphologic causes for closure. Data were subdivided into time categories: abrupt (< 1 day), acute (< 1 week), and early (< 1 month). Intimal-medial flaps remained the most common cause for angioplasty closure despite time from angioplasty to documented occlusion. Morphologic recognition of types and frequencies of angioplasty closure are discussed, and specific mechanical, pharmacologic, or combined treatments are reviewed.  相似文献   
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STUDY DESIGN: A case report of a patient in whom atlantoaxial instability developed secondary to repeat radiation therapy for recurrent nasopharyngeal carcinoma. OBJECTIVES: To illustrate a dramatic and previously unreported complication of local radiation to the posterior nasopharynx. SUMMARY OF BACKGROUND DATA: Nasopharyngeal carcinoma is an unusual tumor that usually is managed with local, external-beam radiation. It is not thought to involve the cervical spine directly, although local invasion of the skull base is common. METHODS: A review of the medical records and radiographs of the only patient known to develop this complication of radiation used to manage nasopharyngeal carcinoma. RESULTS: Atlantoaxial instability developed in a patient as a result of repeat radiation for a locally recurrent tumor. The instability was associated with intrusion of the anterior arch of C1 into the posterior nasopharynx and was managed successfully with a posterior stabilization using transarticular screws and supplemental wiring. CONCLUSIONS: Patients who have undergone local irradiation for nasopharyngeal carcinoma may be at risk for developing atlantoaxial instability.  相似文献   
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Explanation of diploidy have focused on advantages gained from masking deleterious mutations that are inherited. Recent theory has shown that these explanations are flawed. Indeed, we still lack any satisfactory explanation of diploidy in species that are asexual or that recombine only rarely. Here I consider a possibility first suggested by Efroimson in 1932, by Muller in 1964 and by Crow and Kimura in 1965: diploidy may provide protection against somatic, not inherited, mutations. I both compare the mean fitness of haploid and diploid populations that are asexual and investigate the invasion of "diploidy" alleles in sexual populations. When deleterious mutations are partially recessive and somatic mutation is sufficiently common, somatic mutation provides a clear advantage to diploidy in both asexual and sexual species.  相似文献   
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Pollution Buildup on Road Surfaces   总被引:1,自引:0,他引:1  
Samples of sediment found on an urban road in Aberdeen (Scotland) were collected by washing designated surfaces. This method, called the “wet” method, was capable of collecting sediment of the smallest particle size range that is normally left behind by traditional sampling techniques using dry vacuuming. Over 17 months (mainly on a weekly basis), 66 samples were collected and analyzed for sediment loading, particle size distribution, concentration of heavy metals (Zn, Cu, Pb, Cd) in four sediment size fractions, and several dissolved pollutants in the effluent collected from washing (NO3?,?SO42?,?PO43?,?Cl?,?F?,?NH4+, total organic carbon, total carbon). Standard statistical methods, including multiple regressions, were used to determine relationships amongst different sediment characteristics. It was found that sediment loading, as well as concentrations of Cl? and SO42?, were highest in the winter months, especially when snow was present on the road surface. It was observed that 66% of total road sediment loading was found within a 0.5 m strip next to the curb. The average sediment particle sizes found were smaller than those previously recorded in the literature. As expected, the concentrations of heavy metals were highest in the smallest particle size fraction analyzed (<63?μm), and this occurred during the summer months when less sediment was available on the street surface. The antecedent dry weather period had a very weak and negative influence on the loading rate of the smallest particle size fraction next to the curb.  相似文献   
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An integrated remote sensing/field ecology project linked the use of synthetic aperture radar (SAR) and aerial photography to studies of landscape spatial heterogeneity and bird community ecology. P-, L-, and C-band SAR data, collected over a section of Kakadu National Park in Australia's Northern Territory during the Joint NASA/Australia DC-8 data acquisition campaign, were analyzed in light of field data integrating vegetation structure and floristics with bird abundances across a heterogeneous study site. Results indicate that SAR data are able to discern structural differences relevant to bird habitat quality within floristically homogeneous stands, while multispectral sensors successfully identified floristic differences among habitat types. Simplifying indices of bird diversity showed ambiguous changes across the site; however, the abundances of individual species were observed to change significantly across both floristic and structural gradients. These results suggest that efforts to map bird diversity should focus on species-specific habitat relationships and that some measure of vegetation structure is needed to understand bird habitat. The approach employed here advances the use of SAR data in the three-dimensional mapping of animal habitats from remotely sensed data, and extends current capabilities for mapping and modeling large-scale patterns in the distribution of biological diversity.  相似文献   
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In recent years there has been a shift from traditional methods of investigating dental materials to a fracture mechanics approach. Fracture toughness (KIC) is an intrinsic material property which can be considered to be a measure of a material's resistance to crack propagation. Glass-ionomer cements are biocompatible and bioactive dental restorative materials, but they suffer from poor fracture toughness and are extremely susceptible to dehydration. The main objective of this study was to evaluate the fracture toughness of three types of commercially available dental cements (polyacid-modified composite resin, resin-modified and conventional glass ionomer) using a short-rod chevron-notch test and to investigate and interpret the results by means of fractography using scanning electron microscopy. Ten specimens of each cement were fabricated according to manufacturers' instructions, coated in varnish, and stored at ambient laboratory humidity, 100 per cent relative humidity, or in water at 37 degrees C for 7 days prior to preparation for testing. Results indicated that significant differences existed between each group of materials and that the fracture toughness ranged from 0.27 to 0.72 MN/m3/2. It was concluded that the resin-modified glass-ionomer cement demonstrated the highest resistance to crack propagation. Fractographs clearly showed areas of stable and unstable crack growth along the fractured surfaces for the three materials examined.  相似文献   
10.
The paper describes a computer program for analysis and simulation of large-scale water distribution networks. The simulation facility enables the evaluation of system hydraulic and cost operation over extended time periods. An efficient user interface has been provided which allows interactive operation with graphical displays. The program computations use well established network solution techniques together with a range of specially developed models. With these features, the program has now been accepted as a powerful tool with a number of practical applications throughout the water industry.  相似文献   
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