A unified approach to the surgical exposure of pancreatic and duodenal injuries

OBJECTIVE: It is necessary to have thorough knowledge of the survival of extreme low birth weight infants (ELBWI) in order to make it easier for obstetricians, neonatologists and the family to make a decision. PATIENTS AND METHODS: A revision of the 100 ELBWI in our service between 1988 and 1995, considering live births, those deceased in the same birthing room and those followed until their discharge from the hospital, was performed. The differences between the periods before and after the introduction of pulmonary surfactant in 1992 were analyzed. RESULTS: The total survival was 37% for those with a birth weight superior to 750 g or 26 weeks gestation. There were 44.2% males and 28.9% females. The total survival improved from 26.1% during 1988-1991 to 46.3% during the period of 1992-1995. During this period (1992-1995), the newborns weighing more than 750 g had a survival rate of 72.4% and for those of 26 weeks gestation it was 73.3%. Those born at 28 weeks gestation and those with 25 weeks of gestation and weighing more than 750 g, the total survival was 63% and the survival rate in the last four years was 75.9%. CONCLUSIONS: The mortality of the ELBWI descends in similar proportion to the remainder fo the ELBWI. In order to predict the prognosis, it would be necessary to carry out a correct ultrasound estimation of the gestational age and weight. It is necessary to offer a mother in the process of childbirth with a fetus of 28 weeks gestation or with 25 weeks gestation and a fetus with an ultrasound weight greater than 750 g, intrapartum fetal monitoring and to finish by Cesarean section in case of acute fetal distress, as well as intense and immediate neonatal attention as indicated by the index of survival reached in the group mentioned during the later years.     

Monoclonal antibodies to the alpha-subunit of the putative human H+,K+-ATPase encoded by the atp1al1 gene

The N-terminal fragment of ATP1AL1, the possible catalytic subunit of human ouabain-sensitive H+,K(+)-ATPase, was expressed in Escherichia coli cells as two recombinant proteins: the Ser14-Ile104 fragment or the same fragment containing His6 sequence at its N-end. The second protein was purified by metal-affinity chromatography and used as an antigen to construct two hybridoma lines producing antibodies of the IgM class. These monoclonal antibodies were shown to recognize not only the starting antigen but also the full-size recombinant ATP1AL1 protein and do not react with Na+,K(+)-ATPase.     

Effects of emoxipine and histochrome on lipid peroxidation and activity of serum MB-creatine phosphokinase in patients with ischemic heart disease during aortocoronary shunting]

Comparative study of the cardioprotective effect of antioxidants emoxipin and hystochrom was conducted in patients with chronic ICD during and after operation for aorto-coronary shunting. Both drugs effectively inhibited LPO activation and reduced the reperfusion damage to the myocardium recorded according to the release of MB-PCK into the blood. The new antioxidant hystochrom proved to be more effective. Its prevalent effect is associated with its higher antioxidant activity.     

A comparison of the association of helicopter and ground ambulance transport with the outcome of injury in trauma patients transported from the scene

INTRODUCTION: Comprehensive emergency medical services and helicopter aeromedical transport systems have been developed based on the principle that early definitive care improves outcome. The purpose of this study was to compare outcomes between patients transported by helicopter and those transported by ground. METHODS: Data were obtained from the North Carolina Trauma Registry for the period between 1987 and 1993 on all patients transported by helicopter and ground admitted to one of the eight state designated trauma centers. Study patients included only those who were transported directly from the scene of injury to the trauma center (interhospital transfers were excluded). Mortality (outcome) was compared after patient stratification by injury severity and transport time, using Cochran-Mantel-Haenszel statistics and logistic regression-derived probabilities of survival. RESULTS: One thousand three hundred forty-six patients (7.3% of the total) were transported from scene to trauma center by helicopter and 17,144 were transported by ground. In patients transported by helicopter, the mean Trauma Score was lower (12 +/- 3.6) versus 14.3 +/- 3.6 (p < 0.001) and the mean Injury Severity Score was higher (17 +/- 11.1) versus 10.8 +/- 8.4 (p < 0.001). A trend toward increased survival was observed among patients transported by helicopter with a higher Injury Severity Score. Statistical significance was achieved only for patients with a Trauma Score between 5 and 12 and Injury Severity Score between 21 and 30. CONCLUSION: The large majority of trauma patients transported by both helicopter and ground ambulance have low injury severity measures. Outcomes were not uniformly better among patients transported by helicopter. Only a very small subset of patients transported by helicopter appear to have any chance of improved survival based on their helicopter transport. This study suggests that further effort should be expended to try to better identify patients who may benefit from this expensive and risky mode of transport.     

Brazilian isolates of Trypanosoma cruzi from humans and triatomines classified into two lineages using mini-exon and ribosomal RNA sequences

Traditional molecular and biochemical methods, such as schizodeme analysis, karyotyping, DNA fingerprinting, and enzyme electrophoretic profiles, have shown a large variability among Trypanosoma cruzi isolates. In contrast to those results, polymerase chain reaction (PCR) amplification of sequences from the 24S alpha ribosomal RNA gene and from the mini-exon gene nontranscribed spacer indicated a dimorphism among T. cruzi isolates, which enabled the definition of two major parasite lineages. In the present study, 86 T. cruzi field stocks (68 isolated from humans with defined presentations of Chagas' disease and 18 from triatomines) derived from four Brazilian geographic areas were typed by the PCR assay based on the DNA sequences of the mini-exon and 24S alpha rRNA genes. These stocks were ordered into the two major T. cruzi lineages. Lineage 1 was associated mainly with human isolates and lineage 2 with the sylvatic cycle of the parasite.     

供应链管理基础浅析

文章阐述了主要对电子商务中的供应链管理基础，并对其进行了分析。     

Translation eukaryotic initiation factor 4G recognizes a specific structural element within the internal ribosome entry site of encephalomyocarditis virus RNA

A complex of eukaryotic initiation factors (eIFs) 4A, 4E, and 4G (collectively termed eIF4F) plays a key role in recruiting mRNAs to ribosomes during translation initiation. The site of ribosomal entry onto most mRNAs is determined by interaction of the 5'-terminal cap with eIF4E; eIFs 4A and 4G may facilitate ribosomal entry by modifying mRNA structure near the cap and by interacting with ribosome-associated factors. eIF4G recruits uncapped encephalomyocarditis virus (EMCV) mRNA to ribosomes without the involvement of eIF4E by binding directly to the approximately 450-nucleotide long EMCV internal ribosome entry site (IRES). We have used chemical and enzymatic probing to map the eIF4G binding site to a structural element within the J-K domain of the EMCV IRES that consists of an oligo(A) loop at the junction of three helices. The oligo(A) loop itself is not sufficient to form stable complexes with eIF4G since alteration of its structural context abolished its interaction with eIF4G. Addition of wild type or trans-dominant mutant forms of eIF4A to binary IRES.eIF4G complexes did not further alter the pattern of chemical/enzymatic modification of the IRES.