Lawsonhamann4147

Intraoperative transesophageal echocardiography (TEE) has commonly been used for evaluating cardiac function and monitoring hemodynamic parameters during complex surgical cases. Anesthesiologists may be dissuaded from using TEE in orthotopic liver transplantation (OLT) out of concern about rupture of esophageal varices. Complications associated with TEE in OLT were evaluated.

We retrospectively reviewed charts and TEE videos of all OLT cases from January 2003 through December 2013 at Mayo Clinic (Jacksonville, Florida).

Of the 1811 OLTs performed, we identified 232 patients who underwent intraoperative TEE. Esophageal variceal status was documented during presurgical esophagogastroduodenoscopy in 230 of the 232 patients. Of these, 69 (30.0%), had no varices; 113 (49.1%), 41 (17.8%), and 7 (3.0%) had grades I, II, and III varices, respectively. Two patients (0.9%) had no EGD performed because of acute liver failure. During OLT, 1 variceal rupture (0.4%) occurred after placement of an oral gastric tube and TEE probe; the patient required intraoperative variceal banding. Most patients had preexisting coagulopathy at the time of probe placement. The mean (SD) laboratory test results were as follows prothrombin time, 21.7 (6.6) seconds; international normalized ratio, 1.9 (1.3); partial thromboplastin time, 43.8 (13.3) seconds; platelet, 93.7 (60.8)×1000/μL; and fibrinogen, 237.8 (127.6) mg/dL.

TEE was a relatively safe procedure with a low incidence of major hemorrhagic complications in patients with documented esophagogastric varices and coagulopathy undergoing OLT. It appeared to effectively disclose cardiac information and allowed rapid reaction for proper patient management.

TEE was a relatively safe procedure with a low incidence of major hemorrhagic complications in patients with documented esophagogastric varices and coagulopathy undergoing OLT. It appeared to effectively disclose cardiac information and allowed rapid reaction for proper patient management.Previous studies that used carotid ultrasound have been largely conflicting in regards to whether or not patients after Kawasaki disease (KD) have a greater carotid intima-media thickness (CIMT) than controls. To test the hypothesis that there are significant differences between the values of CIMT expressed as absolute values and standard deviation scores (SDS) in children and adolescents after KD and controls, we reviewed 12 published articles regarding CIMT on KD patients and controls. The mean ± SD of absolute CIMT (mm) in the KD patients and controls obtained from each article was transformed to SDS (CIMT-SDS) using age-specific reference values established by Jourdan et al. (J n = 247) and our own data (N n = 175), and the results among these 12 articles were compared between the two groups and the references for comparison of racial disparities. There were no significant differences in mean absolute CIMT and mean CIMT-SDS for J between KD patients and controls (0.46 ± 0.06 mm vs. 0.44 ± 0.04 mm, p = 0.133, and 1.80 ± 0.84 vs. read more 1.25 ± 0.12, p = 0.159, respectively). However, there were significant differences in mean CIMT-SDS for N between KD patients and controls (0.60 ± 0.71 vs. 0.01 ± 0.65, p = 0.042). When we assessed the nine articles on Asian subjects, the difference of CIMT-SDS between the two groups was invariably significant only for N (p = 0.015). Compared with the reference values, CIMT-SDS of controls was within the normal range at a rate of 41.6 % for J and 91.6 % for N. These results indicate that age- and race-specific reference values for CIMT are mandatory for performing accurate assessment of the vascular status in healthy children and adolescents, particularly in those after KD considered at increased long-term cardiovascular risk.We measured chlorophyll (chl) concentration and chl a/b ratio in Sphagnum balticum, S. jensenii, and S. lindbergii, sampled after 7 and 8 years of ultraviolet-B (UVB) and temperature manipulation in an open field experiment in Finnish Lapland (68°N). We used plastic filters with different transmittance of UVB radiation to manipulate the environmental conditions. The plants were exposed to (1) attenuated UVB and increased temperature, (2) ambient UVB and increased temperature and (3) ambient conditions. Chlorophyll was extracted from the capitula of the mosses and the content and a/b ratio were measured spectrophotometrically. Seasonal variation of chlorophyll concentration in the mosses was species specific. Temperature increase to 0.5-1 °C and/or attenuation of solar UVB radiation to ca. one fifth of the ambient (on average 12 vs. 59 uW/cm(2)) had little effect on the chlorophyll concentration or its seasonal variation. In the dominant S. lindbergii, UVB attenuation under increased temperature led to a transient decrease in chlorophyll concentration. Altogether, species-specific patterns of seasonal chlorophyll variation in the studied Sphagna were more pronounced than temperature and UVB treatment effects.A procedure to regenerate cassava (Manihot esculenta Crantz) cultivars from Cameroon via somatic embryogenesis (SE) was developed. Shoot apical meristems and immature leaf lobes were used as explants on Murashige and Skoog (MS) basal medium containing 33 or 50 µM of the auxins Picloram (Pic), 2,4-Dichlorophenoxyacetic acid (2,4-D), Dicamba (Dic), and α-Naphthalene acetic acid. Cultivar performance was assessed using SE and number of somatic embryos produced. Overall, the frequency of primary somatic embryogenesis (PSE) and the mean number of somatic embryos produced varied considerably with genotype, type of auxin and concentration tested. For example, cultivar (cv.) Ngan Mbada showed the best performance on MS medium supplemented with 50 µM Pic with a SE frequency of 40 % and an average number of somatic embryos of 90. The second best performance was recorded in cv. Local Red on MS medium supplemented with 33 µM 2,4-D, where the SE frequency was 40 % and an average number of somatic embryos of 60.5. Cultivar Ekona Red recorded the best performance on medium supplemented with 50 µM Pic showing a SE frequency of 47 % and an average number of somatic embryos of 45. We further examined secondary and cyclic somatic embryogenesis (SSE, CSE) and both were also observed to vary with genotype, however, both exhibited significantly higher frequencies of SE compared with PSE. SE started to decline at the fourth cycle of embryogenesis. Examination of organogenesis showed that shoot bud induction from green cotyledons varied across cultivars and benzylaminopurine was shown to outperform Thidiazuron in the ability to induce organogenesis. Furthermore, the frequencies of bud induction were identical under light and dark conditions. Finally, regenerated plants grew easily in the greenhouse with 90-100 % survival rate and did not display detectable variation in morphology.

Longitudinally extensive transverse myelitis is characterized by contiguous inflammatory lesion of spinal cord involving three or more spinal segments. It is a well-recognized but rare presentation of Mycobacterium tuberculosis infection.

We report a case of young boy diagnosed with multiple brain tuberculomas. He was on antitubercular drugs therapy for 2months and became asymptomatic. On 2-month followup visit, the patient complained of acute onset progressive sensorimotor, spastic paraparesis with bladder dysfunction. Magnetic resonance imaging of spine showed longitudinally extensive transverse myelitis extending from thoracic spinal segment T2 to T10 level. He was treated with high dose intravenous methylprednisolone therapy and continued on combination of first line four antitubercular drugs. At 6-month followup, patient was able to walk with support. In our patient, clinical features, previous history of brain tuberculoma and spinal neuroimaging confirmed the diagnosis of tuberculous myelitis. The n. Our case is unique because of paradoxical presentation of longitudinally extensive transverse myelitis in cranial tuberculomas, already on antitubercular treatment.The experimental cage culture was conducted at Shirati bay, Lake Victoria from February to August 2013, to investigate the impacts of the small scale cage culture on the environment. Three locations along the cages, at the intermediate and one in the offshore (control) were sampled for water quality parameters, phytoplankton and macro invertebrates. A notable increase in nutrient concentration was observed after the set of cages among the stations. However DO, pH, and water transparency showed no major changes and was within the recommended ranges. Cyanophytes an indicator of inorganic pollution dominated before and after the set of cages, an increase in phytoplankton numerical abundance was observed after stocking of fish in cages. In addition there was an increase in the invertebrate community especially bivalves and gastropods. In conclusion we found no consistent environmental change caused by cage culture, and therefore it can be allowed in Lake Victoria, Tanzania part, with close monitoring of its impacts.Graphical analysis and computer simulations have become the preferred tools to present Tilman's model of resource competition to new generations of ecologists. To really understand the full dynamic behaviour, a more rigorous mathematical analysis is required. We show that just a basic stability analysis is insufficient to describe the relevant dynamics of this deceptively simple model. To investigate realistic invasion and succession processes, not only the stable state is relevant, but also the time scales at which the system moves away from the unstable situation. We argue that the relative stability of saddle points is more important for the actual observed transient dynamics in realistic systems than the predicted asymptotic behaviour towards the stable equilibria. For the mathematical analysis this implies that not only the signs, but also the magnitudes of the eigenvalues of the Jacobi matrix at the stationary points, the rates at which the system evolves, must be considered. We present the underlying mathematics of the Tilman model in a way that should be accessible to any ecologist with a basic mathematical background.Adolphe Quetelet was one of the most prominent figures of the second half of the nineteenth century, yet in present-day histories of several social sciences the impact of his ideas is widely ignored. The first part consists of a sketch of his life and work. Astronomer and statistician, he sought to apply the mathematical tools of astronomy to create was has been called a 'mathematics of society'. In particular he demonstrated regularities in the incidence of various social phenomena, notably crime, whose implications were widely debated. In the second part the influence he exerted on some key figures in the then emerging social sciences is traced in some detail; these figures include Durkheim, Galton, Marx, and Tylor. He also advocated the wider use of statistics and his call had a powerful impact on the then emerging fields such as administration, economics, sociology and psychology. He influenced some of his most famous contemporaries, including Florence Nightingale, Karl Marx and Francis Galton.