Infections in patients with cystic fibrosis following lung transplantation

BACKGROUND: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation. METHODS: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center. RESULTS: As of May 1996, 21 patients with CF underwent bilateral lung transplantation. The first patient died within 24 h of transplantation from sepsis due to Stenotrophomonas maltophilia. Of the remaining 20 patients, 17 (85%) are alive and in stable condition. The three deaths were related primarily to bronchiolitis obliterans at 4 and 18 months in two patients and to cytomegalovirus pneumonitis at 5 months in the other patient. The 17 surviving patients have been followed up for a mean of 13 months (range, 0.5 to 34 months). Most of them were colonized and infected with multidrug-resistant organisms before transplantation. Following transplantation, 11 patients had complications from infections. One patient had bacteremia due to a panresistant Burkholderia cepacia and was treated successfully. Two patients had bacteremia and wound infection due to Burkholderia gladioli, previously thought to be pathogenic only in plants. Both patients were treated successfully. Of the six patients with Aspergillus fumigatus isolated from cultures before transplantation, only one had invasive disease following transplantation and responded to treatment. CONCLUSION: The organisms present before transplantation were not the primary cause of mortality in our patient population. Our findings suggest that lung transplantation should be considered in CF patients infected with multidrug-resistant organisms.     

Influence of age and health on immune functions and trace elements

Apparently healthy elderly donors were screened according to a simple protocol that included clinical examination and the determination of hematological and biochemical values. This screening was performed to detect subclinical alterations which might interfere with immune responses and trace element status. The elderly were divided into two groups. The first group consisted of 22 (age 76 +/- 1 years) positively selected elderly (PSE), i.e. healthy subjects with no hematological and laboratory alterations, the second one comprised 13 (age 75 +/- 1 years) negatively selected elderly (NSE). Data were then compared with those obtained from 40 (age 35 +/- 2 years) healthy young controls. In both groups of elderly donors, plasma zinc levels were normal, while plasma copper concentrations were increased. Intracellular values of zinc and copper in mono- and polymorphonuclear cells from both groups of elderly were within reference limits. After in vitro activation, granulocyte chemiluminescence activity was impaired only in NSE. A decrement in the number of circulating CD3 lymphocytes and an increase in CD8d, CD57 cells were found in PSE, while NSE showed an increased number of CD3,DR cells and CD8d, CD57, CD8b,CD57 and CD16,CD56 positive cells. Our results indicate that only plasma copper levels were affected by age, whereas subclinical alterations in hematological or biochemical values appear to impair immune responses in the elderly.     

Physical and dosimetric aspects of a multileaf collimation system used in the dynamic mode for implementing intensity modulated radiotherapy

The use of a multileaf collimator in the dynamic mode to perform intensity modulated radiotherapy became a reality at our institution in 1995. Unlike treatment with static fields using a multileaf collimator, there are significant dosimetric issues which must be assessed before dynamic therapy can be implemented. We have performed a series of calculations and measurements to quantify head scatter for small fields, collimator transmission, and the transmission through rounded leaf ends. If not accounted for, these factors affect the delivered dose to the prostate by 5%-20% for a typical plan. Data obtained with ion chambers and radiographic film are presented for both 6 and 15 MV x-ray beams. The impact on the delivered dose of the mechanical accuracy of the multileaf collimator, achieved during leaf position calibration and maintained during dose delivery, is also discussed.     

Multimode parameter extraction for multiconductor transmissionlines via single-pass FDTD and signal-processing techniques

We present two approaches to extract the broadband multimode parameters of guided wave structures from a single-pass finite-difference time-domain (FDTD) simulation. They include a two-dimensional (2-D) Fourier transform (FT) algorithm and a super-resolution estimation of signal parameters via rotational invariance technique (ESPRIT) algorithm. Comparison is made to show the superiority of the super-resolution approach. As a typical application, a three-line coupled microstrip structure is studied. After a single-pass FDTD simulation, broadband multimode parameters such as propagation constants, modal-field templates, and modal impedances are extracted and verified against published data obtained by the spectral-domain method. The main feature of this parameter-extraction methodology is that it decouples the computational electromagnetics engine (in this case, the FDTD simulator) from the post-processing parameter-extraction algorithm, thus providing more flexibility and connectivity among the various simulation tools     

GIS技术与微机制图

地理信息系统（ＧＩＳ）随着信息社会的发展愈发显示出强大的生命力。本文简要叙述ＧＩＳ的重要作用及其发展进程中涌出出来的四个设计模型，总结了运用ＧＩＳ国产软件平台ＭＡＰＧＩＳ制作遥感地质构造解译图的工作步骤和技术方法。     

The human homologue of yeast CRM1 is in a dynamic subcomplex with CAN/Nup214 and a novel nuclear pore component Nup88

The oncogenic nucleoporin CAN/Nup214 is essential in vertebrate cells. Its depletion results in defective nuclear protein import, inhibition of messenger RNA export and cell cycle arrest. We recently found that CAN associates with proteins of 88 and 112 kDa, which we have now cloned and characterized. The 88 kDa protein is a novel nuclear pore complex (NPC) component, which we have named Nup88. Depletion of CAN from the NPC results in concomitant loss of Nup88, indicating that the localization of Nup88 to the NPC is dependent on CAN binding. The 112 kDa protein is the human homologue of yeast CRM1, a protein known to be required for maintenance of correct chromosome structure. This human CRM1 (hCRM1) localized to the NPC as well as to the nucleoplasm. Nuclear overexpression of the FG-repeat region of CAN, containing its hCRM1-interaction domain, resulted in depletion of hCRM1 from the NPC. In CAN-/- mouse embryos lacking CAN, hCRM1 remained in the nuclear envelope, suggesting that this protein can also bind to other repeat-containing nucleoporins. Lastly, hCRM1 shares a domain of significant homology with importin-beta, a cytoplasmic transport factor that interacts with nucleoporin repeat regions. We propose that hCRM1 is a soluble nuclear transport factor that interacts with the NPC.     

Serial cytological assay of micronucleus induction: a new tool to predict human cancer radiosensitivity

The role of the propeptide sequence and a disulfide bridge between sites 1 and 122 in chymotrypsin has been examined by comparing enzyme activities of wild-type and mutant enzymes. The kinetic constants of mutants devoid of the Cys1-Cys122 disulfide-linked propeptide show that this linkage is not important either for activity or substrate specificity. However this linkage appears to be the major factor in keeping the zymogen stable against non-specific activation. A comparison of zymogen stabilities showed that the trypsinogen propeptide is ten times more effective than the chymotrypsinogen propeptide in preventing non-specific zymogen activation during heterologous expression and secretion from yeast. This feature can also be transferred in trans to chymotrypsinogen; i.e. the chymotrypsin trypsin propeptide chimera forms a stable zymogen.     

低合金高强度钢的微观组织和疲劳裂纹扩展行为

用透射电镜观察了３０ＣｒＭｎＳｉＮｉ２Ａ钢等温的微观组织，疲劳裂纹扩展行为、裂纹尖端塑性区和位错结构，结果表明，等温状态组织由马氏体和贝氏体组成。在一个奥氏体晶粒内一般存在四个板条领域、裂纹尖端的塑性区内存在主位错带，疲劳断裂的基本组织单元为板条晶或板条束。裂纹遇到板条束界时方向发生较大偏斜。     

虚拟企业图纸数据传输

图纸数据是企业间合作需交换的一种重要的信息。本文分析了虚拟企业环境下企业之间交换图纸数据的要求，提出了一种具体的解决方案，并给出实例。