RESUMEN
The nuclear shell structure, which originates in the nearly independent motion of nucleons in an average potential, provides an important guide for our understanding of nuclear structure and the underlying nuclear forces. Its most remarkable fingerprint is the existence of the so-called magic numbers of protons and neutrons associated with extra stability. Although the introduction of a phenomenological spin-orbit (SO) coupling force in 1949 helped in explaining the magic numbers, its origins are still open questions. Here, we present experimental evidence for the smallest SO-originated magic number (subshell closure) at the proton number six in 13-20C obtained from systematic analysis of point-proton distribution radii, electromagnetic transition rates and atomic masses of light nuclei. Performing ab initio calculations on 14,15C, we show that the observed proton distribution radii and subshell closure can be explained by the state-of-the-art nuclear theory with chiral nucleon-nucleon and three-nucleon forces, which are rooted in the quantum chromodynamics.
RESUMEN
The isospin character of p-n pairs at large relative momentum has been observed for the first time in the ^{16}O ground state. A strong population of the J,T=1,0 state and a very weak population of the J,T=0,1 state were observed in the neutron pickup domain of ^{16}O(p,pd) at 392 MeV. This strong isospin dependence at large momentum transfer is not reproduced by the distorted-wave impulse approximation calculations with known spectroscopic amplitudes. The results indicate the presence of high-momentum protons and neutrons induced by the tensor interactions in the ground state of ^{16}O.
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Electrocardiografía , Corazón Fetal/diagnóstico por imagen , Síndrome de QT Prolongado/diagnóstico por imagen , Taquicardia Ventricular/diagnóstico por imagen , Ultrasonografía Doppler , Adulto , Antiarrítmicos/administración & dosificación , Cesárea , Femenino , Humanos , Síndrome de QT Prolongado/tratamiento farmacológico , Sulfato de Magnesio/administración & dosificación , Embarazo , Resultado del Embarazo , Diagnóstico Prenatal , Taquicardia Ventricular/tratamiento farmacológicoRESUMEN
Various types of piperidinium ionic liquids (ILs) equipped with an oxygen atom-containing alkyl side chain on the positively charged nitrogen atom were systematically synthesized and their physical properties investigated. The thermal stability, viscosity, electrochemical window, and ion conductivity were influenced significantly by changing the position of the oxygen atom in the alkyl chain. Although the lowest viscosity was recorded for 1-((2-methoxyethoxy)methyl)-1-methylpiperidin-1-ium bis(trifluoromethylsulfonyl)amide ([PP1MEM][Tf2N]), 1-methyl-1-(2-propoxyethyl)piperidin-1-ium bis(trifluoromethylsulfonyl)amide ([PP1PE][Tf2N]) can be recommended as the best IL as an electrolyte due to its low viscosity and high thermal and electrochemical stability among the seven ILs tested.
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WHAT IS KNOWN AND OBJECTIVE: Anticoagulation therapy with warfarin requires periodic monitoring of prothrombin time-international normalized ratio (PT-INR) and adequate dose adjustments based on the data to minimize the risk of bleeding and thromboembolic events. In our hospital, we have developed protocol-based pharmaceutical care, which we called protocol-based pharmacotherapy management (PBPM), for warfarin therapy. The protocol requires pharmacists to manage timing of blood sampling for measuring PT-INR and warfarin dosage determination based on an algorithm. This study evaluated the efficacy of PBPM in warfarin therapy by comparing to conventional pharmaceutical care. METHODS: From October 2013 to June 2015, a total of 134 hospitalized patients who underwent cardiovascular surgeries received post-operative warfarin therapy. The early series of patients received warfarin therapy as the conventional care (control group, n=77), whereas the latter received warfarin therapy based on the PBPM (PBPM group, n=68). These patients formed the cohort of the present study and were retrospectively analysed. RESULTS: The indications for warfarin included aortic valve replacement (n=56), mitral valve replacement (n=4), mitral valve plasty (n=22) and atrial fibrillation (n=29). There were no differences in patients' characteristics between both groups. The percentage time in therapeutic range in the first 10 days was significantly higher in the PBPM group (47.1%) than that in the control group (34.4%, P<.005). The average time to reach the steady state was significantly (P<.005) shorter in the PBPM group compared to the control group (7.3 vs 8.6 days). WHAT IS NEW AND CONCLUSION: Warfarin therapy based on our novel PBPM was clinically safe and resulted in significantly better anticoagulation control compared to conventional care.
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Anticoagulantes/administración & dosificación , Procedimientos Quirúrgicos Cardíacos/métodos , Servicio de Farmacia en Hospital/organización & administración , Warfarina/administración & dosificación , Anciano , Anciano de 80 o más Años , Algoritmos , Anticoagulantes/efectos adversos , Estudios de Cohortes , Relación Dosis-Respuesta a Droga , Monitoreo de Drogas/métodos , Femenino , Hemorragia/inducido químicamente , Humanos , Relación Normalizada Internacional , Masculino , Administración del Tratamiento Farmacológico/organización & administración , Persona de Mediana Edad , Farmacéuticos/organización & administración , Tiempo de Protrombina , Estudios Retrospectivos , Tromboembolia/prevención & control , Factores de Tiempo , Warfarina/efectos adversosRESUMEN
The biology, clinical phenotype and progression rate of chronic myelomonocytic leukemia (CMML) are highly variable due to diverse initiating and secondary clonal genetic events. To determine the effects of molecular features including clonal hierarchy in CMML, we studied whole-exome and targeted next-generation sequencing data from 150 patients with robust clinical and molecular annotation assessed cross-sectionally and at serial time points of disease evolution. To identify molecular lesions unique to CMML, we compared it to the related myeloid neoplasms (N=586), including juvenile myelomonocytic leukemia, myelodysplastic syndromes (MDS) and primary monocytic acute myeloid leukemia and discerned distinct molecular profiles despite similar pathomorphological features. Within CMML, mutations in certain pathways correlated with clinical classification, for example, proliferative vs dysplastic features. While most CMML patients (59%) had ancestral (dominant/co-dominant) mutations involving TET2, SRSF2 or ASXL1 genes, secondary subclonal hierarchy correlated with clinical phenotypes or outcomes. For example, progression was associated with acquisition of new expanding clones carrying biallelic TET2 mutations or RAS family, or spliceosomal gene mutations. In contrast, dysplastic features correlated with mutations usually encountered in MDS (for example, SF3B1 and U2AF1). Classification of CMML based on hierarchies of ancestral and subclonal mutational events may correlate strongly with clinical features and prognosis.
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Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Genómica , Leucemia Mielomonocítica Crónica/genética , Anciano , Anciano de 80 o más Años , Alelos , Aberraciones Cromosómicas , Evolución Clonal , Hibridación Genómica Comparativa , Estudios Transversales , Femenino , Frecuencia de los Genes , Genómica/métodos , Humanos , Cariotipo , Leucemia Mielomonocítica Crónica/diagnóstico , Leucemia Mielomonocítica Crónica/mortalidad , Masculino , Persona de Mediana Edad , Mutación , Polimorfismo de Nucleótido Simple , Pronóstico , Secuenciación del ExomaAsunto(s)
Mutación de Línea Germinal , Factor de Transcripción Ikaros/genética , Síndromes de Inmunodeficiencia/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Animales , Progresión de la Enfermedad , Femenino , Humanos , Síndromes de Inmunodeficiencia/patología , Lactante , Ratones , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patología , Receptor Notch1/genéticaAsunto(s)
Dexametasona/administración & dosificación , Neoplasias Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Activación de Macrófagos/efectos de los fármacos , Niño , Dexametasona/análogos & derivados , Femenino , Neoplasias Hematológicas/complicaciones , Humanos , Enfermedades del Sistema Inmune/inducido químicamente , Enfermedades del Sistema Inmune/tratamiento farmacológico , Enfermedades del Sistema Inmune/etiología , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , Masculino , Palmitatos/uso terapéutico , Trasplante Homólogo/efectos adversos , Resultado del TratamientoRESUMEN
Differential cross sections of isoscalar and isovector spin-M1 (0(+)â1(+)) transitions are measured using high-energy-resolution proton inelastic scattering at E(p)=295 MeV on (24)Mg, (28)Si, (32)S, and (36)Ar at 0°-14°. The squared spin-M1 nuclear transition matrix elements are deduced from the measured differential cross sections by applying empirically determined unit cross sections based on the assumption of isospin symmetry. The ratios of the squared nuclear matrix elements accumulated up to E(x)=16 MeV compared to a shell-model prediction are 1.01(9) for isoscalar and 0.61(6) for isovector spin-M1 transitions, respectively. Thus, no quenching is observed for isoscalar spin-M1 transitions, while the matrix elements for isovector spin-M1 transitions are quenched by an amount comparable with the analogous Gamow-Teller transitions on those target nuclei.
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Antiarrítmicos/administración & dosificación , Cardiotocografía , Digoxina/administración & dosificación , Taquicardia Atrial Ectópica/diagnóstico por imagen , Cesárea , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Resultado del Embarazo , Taquicardia Atrial Ectópica/tratamiento farmacológico , Taquicardia Atrial Ectópica/embriología , UltrasonografíaRESUMEN
Hybrid CT/angiography (angiography) system and C-arm cone beam CT provide cross-sectional imaging as an adjunct to angiography. Current interventional oncological procedures can be conducted precisely using these two technologies. In this article, several cases using a hybrid CT/angiography system are shown first, and then the advantages and disadvantages of the hybrid CT/angiography and C-arm cone beam CT are discussed with literature reviews.
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Angiografía/métodos , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/terapia , Tomografía Computarizada por Rayos X/métodos , Artefactos , Carcinoma Hepatocelular/irrigación sanguínea , Circulación Colateral , Tomografía Computarizada de Haz Cónico , Fluoroscopía/métodos , Humanos , Neoplasias Hepáticas/irrigación sanguínea , Masculino , Persona de Mediana Edad , Radiografía Intervencional/métodosRESUMEN
Reconstruction following pharyngolaryngectomy with total esophagectomy is a challenging surgery to perform. Between April 2008 and August 2012, three types of modified gastric pull-up reconstruction procedures, including a gastric tube creation combined with a free jejunal transfer (n = 7), elongated gastric tube creation with vascular anastomoses (n = 2) and pedunculated gastric tube creation with Roux-en-Y anastomosis (n = 5), were performed after pharyngolaryngectomy with total esophagectomy. To clarify feasibility of these reconstructive methods, we retrospectively analyzed the short-term outcomes. There were no graft failures. Salivary fistulae were observed in two cases after high pharyngoenteral anastomoses due to oropharyngeal extension of hypopharyngeal cancers. Overall morbidity rate was 21.4%, and no deaths occurred. Although the operation time was shortest for pedunculated gastric tube reconstructions, morbidity rates were similar among all methods. All three types of modified gastric pull-up reconstruction procedures can be performed safely. We can choose one of these methods according to the tumor status and the patient condition, understanding advantages and disadvantages of each procedure.
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Carcinoma/cirugía , Neoplasias Esofágicas/cirugía , Esofagoplastia/métodos , Neoplasias Hipofaríngeas/cirugía , Yeyuno/trasplante , Laringoplastia/métodos , Neoplasias Primarias Múltiples/cirugía , Faringe/cirugía , Fístula de las Glándulas Salivales/etiología , Estómago/cirugía , Anciano , Anastomosis en-Y de Roux/efectos adversos , Esofagectomía/efectos adversos , Esofagoplastia/efectos adversos , Supervivencia de Injerto , Humanos , Neoplasias Hipofaríngeas/complicaciones , Laringectomía/efectos adversos , Laringoplastia/efectos adversos , Masculino , Persona de Mediana Edad , Tempo Operativo , Faringectomía/efectos adversos , Estudios Retrospectivos , Factores de TiempoRESUMEN
Dyskeratosis congenita (DC) is a rare inherited multisystem disorder caused by mutations in seven genes involved in telomere biology, with approximately 20% of cases having pulmonary complications. DKC1 mutations exhibit a severe disease phenotype of DC that develops in early childhood. Here, we report a unique case of DC with pulmonary fibrosis diagnosed at the age of 46. A novel missense mutation(p.Arg65Lys) of DKC1 was detected, and predicted to show a weak mutagenic effect. In spite of the steroid and immunosuppressive treatment, he died of an acute exacerbation seven months after the initial visit. This case suggests that mutation subtypes can cause heterogeneity in DC and pulmonary fibrosis.
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Disqueratosis Congénita , Mutación Missense , Humanos , Fenotipo , Fibrosis Pulmonar , TelómeroRESUMEN
We developed a 2(nd) generation suprachoroidal transretinal stimulation (STS) system with a 49 channel electrode array and implanted in 2 dogs. One month after surgery, all electrodes were functioning and the ocular fundus was normal in both dogs. The results indicate the 2(nd) generation STS retinal prosthesis is feasible and can be considered for clinical use.
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Coroides/fisiología , Estimulación Luminosa , Retina/fisiología , Prótesis Visuales , Animales , Artefactos , Perros , Electrodos Implantados , Electrorretinografía , Potenciales Evocados Visuales , Estudios de Factibilidad , Fondo de Ojo , Masculino , Implantación de PrótesisRESUMEN
AIMS: Increasing evidences suggest a similarity in the pathophysiological mechanisms of neuronal cell death in amyotrophic lateral sclerosis (ALS) and myofibre degeneration in sporadic inclusion body myositis (sIBM). The aim of this study is to elucidate the involvement of ALS-causing proteins in the pathophysiological mechanisms in sIBM. METHODS: Skeletal muscle biopsy specimens of five patients with sIBM, two with oculopharyngeal muscular dystrophy (OPMD), three with polymyositis (PM), three with dermatomyositis (DM), three with neurogenic muscular atrophy, and three healthy control subjects were examined. We analysed the expression and localization of familial ALS-causing proteins, including transactive response DNA binding protein-43 (TDP-43), fused in sarcoma/translocated in liposarcoma (FUS/TLS), Cu/Zn superoxide dismutase (SOD1) and optineurin (OPTN) by immunohistochemistry. RESULTS: TDP-43, OPTN and, to a lesser extent, FUS/TLS were more frequently accumulated in the cytoplasm in patients with sIBM and OPMD than in patients with PM, DM, neurogenic muscular atrophy, or healthy control subjects. SOD1 was accumulated in a small percentage of myofibres in patients with sIBM and OPMD, and to a very small extent in patients with PM and DM. Confocal microscopy imaging showed that TDP-43 proteins more often colocalized with OPTN than with FUS/TLS, p62 and phosphorylated Tau. CONCLUSIONS: These findings suggest that OPTN in cooperation with TDP-43 might be involved in the pathophysiological mechanisms of skeletal muscular degeneration in myopathy with rimmed vacuoles. Further investigation into these mechanisms is therefore warranted.
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Proteínas de Unión al ADN/fisiología , Miositis por Cuerpos de Inclusión/genética , Miositis por Cuerpos de Inclusión/patología , Proteinopatías TDP-43/genética , Proteinopatías TDP-43/patología , Factor de Transcripción TFIIIA/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Esclerosis Amiotrófica Lateral/genética , Esclerosis Amiotrófica Lateral/patología , Biopsia , Proteínas de Ciclo Celular , Proteínas de Unión al ADN/genética , Dermatomiositis/genética , Dermatomiositis/patología , Femenino , Humanos , Inmunohistoquímica , Masculino , Proteínas de Transporte de Membrana , Persona de Mediana Edad , Atrofia Muscular/genética , Atrofia Muscular/patología , Distrofia Muscular Oculofaríngea/genética , Distrofia Muscular Oculofaríngea/patología , Polimiositis/genética , Polimiositis/patología , Proteína FUS de Unión a ARN/metabolismo , Superóxido Dismutasa/metabolismo , Superóxido Dismutasa-1 , Factor de Transcripción TFIIIA/genéticaAsunto(s)
Anticuerpos Monoclonales de Origen Murino/administración & dosificación , Antineoplásicos/administración & dosificación , Trasplante de Médula Ósea , Hepatitis Autoinmune/tratamiento farmacológico , Leucemia Mieloide Aguda/terapia , Donante no Emparentado , Animales , Femenino , Hepatitis Autoinmune/etiología , Humanos , Lactante , Rituximab , Trasplante HomólogoAsunto(s)
Anemia Aplásica/terapia , Enfermedades Óseas Metabólicas/terapia , Trasplante de Células Madre , Acondicionamiento Pretrasplante , Anemia Aplásica/diagnóstico por imagen , Anemia Aplásica/genética , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/genética , Médula Ósea/anomalías , Médula Ósea/diagnóstico por imagen , Calcinosis , Humanos , Recién Nacido , Masculino , Radiografía , Retina/diagnóstico por imagen , Trasplante HomólogoRESUMEN
A benchmark experiment on (208)Pb shows that polarized proton inelastic scattering at very forward angles including 0° is a powerful tool for high-resolution studies of electric dipole (E1) and spin magnetic dipole (M1) modes in nuclei over a broad excitation energy range to test up-to-date nuclear models. The extracted E1 polarizability leads to a neutron skin thickness r(skin) = 0.156(-0.021)(+0.025) fm in (208)Pb derived within a mean-field model [Phys. Rev. C 81, 051303 (2010)], thereby constraining the symmetry energy and its density dependence relevant to the description of neutron stars.
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Alpha-hydroxy acids (AHAs), primarily glycolic and lactic acids, are widely used in cosmetics to alleviate dyspigmentation, photodamage, and other aging skin conditions and as pH adjusters. Glycolic acid reportedly enhances skin damage after repeated ultraviolet light exposure, e.g., increased sunburn cell formation. This study assessed potential in vitro skin penetration of lactic acid and malic acid incorporated into rinse-off personal care products, compared with rinse-off and leave-on exposures to glycolic acid (10%, pH 3.5) in a reference lotion. Radiolabeled AHA-fortified shampoo, conditioner, and lotion were evenly applied as single doses to human epidermal membranes mounted in static diffusion cells (not occluded). Exposures were 1-3 min (rinse-off) or 24 h (leave-on). Epidermal penetration of malic acid and lactic acid from the rinse-off shampoo and conditioner, respectively, was negligible, with >99% removed by rinsing, a negligible portion remaining in the stratum corneum (≤0.15%), and even less penetrating into the viable epidermis (≤0.04%). Glycolic acid penetration from the leave-on reference lotion was 1.42 µg equiv./cm2/h, with total absorbable dose recovery (receptor fluid plus epidermis) of 2.51%, compared to 0.009%, 0.003%, and 0.04% for the rinse-off reference lotion, shampoo (malic acid), and conditioner (lactic acid) exposures, respectively. Dermal penetration of AHAs into human skin is pH-, concentration-, and time-dependent. Alpha-hydroxy acids in rinse-off shampoos and conditioners are almost entirely removed from the skin within minutes by rinsing (resulting in negligible epidermal penetration). This suggests that ultraviolet radiation-induced skin effects of AHA-containing rinse-off products are negligible.