Herpesvirus saimiri has a gene specifying a homologue of the cellular membrane glycoprotein CD59.

Herpesvirus saimiri (HSV) is a T-lymphotropic tumor virus that causes fulminant lymphomas and leukemias in various New World primates other than its natural host, the squirrel monkey (Saimiri sciureus). In the course of completing the nucleotide sequence of its genome, we identified an open reading frame of 363 nucleotides, designated HVS-15, that has no detectable homology to any other viral sequences to date. HVS-15 encodes a 121-amino-acid protein which shows significant similarities to human CD59, a phosphatidyl-inositol-glycan-anchored glycoprotein involved in T-cell activation and restriction of complement-mediated lysis. The predicted HVS-15 gene product is more similar to human CD59 than to the related murine Ly-6 antigens. A nucleotide sequence identity of 64% was found between HVS-15 and the CD59 reading frame, and a 48% identity exists between the corresponding protein sequences. The comparison of the amino acid sequences revealed a number of conserved structural features such as a similar pattern of hydrophobic termini and an identical cysteine skeleton.     

Body composition measures from underwater weighing and dual energy X-ray absorptiometry in black and white girls: A comparative study

The purpose of this study was to compare estimates of body composition in two ethnic groups, 31 black and 38 white girls 10 through 16 years of age, to establish accurate and precise laboratory standards for field measures of body composition in the NHLBI Growth and Health Study HC 55025. The dual energy X-ray absorptiometry (DXA) measures of fat free mass (FFM) and % body fat (%BF) were made using Hologic QDR-1000/W. Corresponding values of FFM and %BF from underwater weighing (UWW) were determined using the two-component model of Siri, and these were corrected using the model of Lohman for white girls only. In the comparison of the different models and methods, the two-component model overestimated FFM compared to estimates from DXA for black girls, as did the corrected Lohman model for white girls. The two-component model significantly overestimated %BF in both white and black girls compared to corresponding estimates from DXA. The ratio of bone mineral content (BMC)/FFM affected the degree of %BF differences in black girls but not in white girls. Also, as the density of FFM increased or approached adult status in black girls (BMC/FFM increased), differences between the two-component model and estimates from DXA decreased. In both groups of girls, the relationship of %BF from UWW and DXA are a function of the level of body fatness. DXA values of %BF are greater than those from UWW under about 24% body fat, but the converse occurs above 25% body fat. The inability of UWW using the two-component model to account for the body composition in these girls can be corrected in part by measuring the variables for a multicomponent model or more easily by using DXA estimates of body composition. © 1994 Wiley-Liss, Inc.     

Sensory-feedback system compatible with myoelectric control

Progress in the development of a system to provide sensory feedback of the pinch force of an artificial hand is described. Design criteria relating to electrocutaneous stimulation and compatibility with myoelectric control are discussed. Details of a practical system, presently in use by two amputees prior to full-scale clinical evaluation, are presented.     

Surgical palliation of unresectable carcinoma of the pancreas

The results of palliative surgery for pancreatic carcinoma were reviewed in over 10,000 patients from the English-language literature from 1965 to 1983. This collected series suggests that biliary-enteric bypass relieves the sequelae of chronic extrahepatic biliary obstruction, prolongs survival, and provides symptomatic palliation. The more easily constructed loop cholecystojejunostomy is preferred over choledochojejunostomy unless malignant obstruction of the cystic duct is imminent. Chronic percutaneous internal biliary drainage offers reasonable palliation in the poor-risk patient who is not a candidate for surgery. Routine concomitant gastroenterostomy is recommended in all patients with a reasonable life expectancy since operative mortality is unaffected, and the incidence of future duodenal obstruction is at least 16%. Intraoperative chemical splanchnicectomy is easily performed and appears beneficial in relief of pain related to advanced pancreatic carcinoma.

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Resumen Se revisaron los resultados de la cirugía paliativa para carcinoma pancreático en más de 10.000 pacientes de la literatura inglesa desde 1965 hasta 1983. Esta serie colectiva sugiere que la derivación bilio-entérica alivia las secuelas de la obstrucción biliar extrahepática crónica, prolonga la supervivencia y provee paliación sintomática. Se prefiere la colecisto-yeyunostomía, que es la de más fácil realización, a menos que la obstrucción neoplásica del canal cístico sea inminente. El drenaje biliar percutáneo crónico ofrece una paliación razonable en el paciente de alto riesgo que no sea candidato para cirugía. Se recomienda la gastroenterostomía concomitante como rutina en todos los pacientes con una razonable expectativa de vida, puesto que la mortalidad operatoria no resulta afectada y la incidencia de futura obstrucción duodenal es de no menos de 16%. La esplacnicectomía química intraoperatoria es fácilmente realizable y es beneficiosa en el alivio del dolor asociado con el carcinoma pancreático avanzado.

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Résumé Les résultats de la chirurgie palliative pour cancer du pancréas ont été étudiés dans la littérature anglaise de 1965 à 1983. Ils concernent 10.000 malades et permettent de suggérer que les interventions de dérivation assurent la disparition des symptômes de la rétention biliaire et l'allongement du temps de survie.La simple cholécystojéjunostomie est préférable à la cholédocojéjunostomie dès lors que le canal cystique n'est pas envahi. Le drainage percutané et transhépatique apporte une solution au problème de la rétention biliaire chez le malade en mauvais état général et incapable de subir une intervention chirurgicale. La gastro-entérostomie associée est recommandée chez tous les malades dont l'espoir de vie est de durée raisonnable car la mortalité n'est pas augmentée et le taux d'obstruction duodénale atteint 16%. La splanchnicectomie chimique au cours de l'intervention est facile à pratiquer et permet d'atténuer la douleur en cas de cancer avancé.

     

Frequency dependence of magnetic resonance spin-lattice relaxation of protons in biological materials

The frequency dependence of spin-lattice (T1) relaxation times of protons in tissues and other macromolecular solutions was investigated. This dependence can be principally assigned to reduced mobility of water molecules "hydrated" on the surface of macromolecular structures. The T1 relaxation time of "hydration water" was found to increase linearly with frequency in the range from 5 to 100 MHz (T1 = 1.83 f + 25.0). It is assumed that the remainder of water in the tissue has a relaxation rate that is independent of frequency, as is characteristic of bulk tap water. Variations occur in the fraction of water hydrated or bound from one organ to the next. As the observed relaxation rate is a weighted average of the two rates as described by the fast exchange model, the above empirical relationship can be used to take a tissue T1 relaxation time measured at one frequency and then calculate the tissue T1 relaxation time that would be expected at another frequency. Good agreements were obtained between such calculated tissue T1 values and the T1 values actually measured at the second frequency. Variations between the calculated and measured T1 values in some classes of tissues indicate that there are also less important secondary factors such as lipid content.     

实施员工关爱计划保障医务人员职业安全与健康

医务人员的身心健康和执业满意度直接影响医疗服务质量。复旦大学附属华山医院从员工需求切入,建立并实施员工关爱计划:横向包括身心健康、社会支持、个人成长与职业生涯发展等;纵向贯彻危机前、危机中、危机后三级援助体系。实践后,员工满意度、社会支持水平、幸福感有所提升,职业倦怠阳性率有所下降。员工关爱计划在管理理念、方案完善、人才培养等方面还有待进一步改进。     

脑卒中肺部感染危险因素及血清免疫炎性因子的预测价值

目的基于主成分分析(PCA)-决策树模型分析脑卒中肺部感染的危险因素及血清免疫炎性因子的预测价值。方法回顾性分析2014年12月-2019年12月江西省上饶市人民医院确诊的176例脑卒中患者,根据是否发生肺部感染,分为感染组40例和未感染组136例。记录患者临床特征,检测血白细胞(WBC)计数、血清C-反应蛋白(CRP)、降钙素原(PCT)和可溶性白细胞介素-2受体(SIL-2R)水平。采用Logistic回归和卡方自动交叉检验(CHAID)模型分析影响脑卒中后肺部感染的危险因素;受试者工作特征曲线(ROC)分析血WBC、CRP、PCT、SIL-2R预测肺部感染的价值。结果脑卒中肺部感染与患者年龄、卒中类型、是否合并糖尿病、吸烟史、吞咽困难、意识障碍、侵入性操作有关(P<0.05);感染组患者血WBC、CRP、PCT和SIL-2R水平高于未感染组(P<0.05);糖尿病、侵入性操作、CRP和PCT均为影响脑卒中患者肺部感染的独立危险因素(P<0.05);PCA-ROC分析显示,血WBC、CRP、PCT、SIL-2R和联合预测主成分1(PC1)的曲线下面积(AUC)分别为0.670、0.816、0.854、0.686、0.918;PCA-卡方自动交互检测(CHAID)模型分析显示,WBC、CRP、PCT、SIL-2R和PC1预测肺部感染的准确率为77.33%、84.72%、86.90%、79.02%和89.24%。结论血清PCT水平可用于预测脑卒中患者肺部感染的发生,临床可重点关注合并糖尿病、意识障碍和侵入性操作的患者。     

卵巢子宫内膜异位症和卵巢良性肿瘤患者血清CA125和唾液酸测定的临床意义

目的 探讨血清CA125和唾液酸（SA）对卵巢子宫内膜异位症及卵巢良性肿瘤的诊断价值。方法 对30例卵巢巧克力囊肿、30例卵巢良性肿瘤和15例正常妇女采用放免法测定血清CA125值,比色法测定血清SA值。结果 卵巢巧克力囊肿组血清CA125均值明显高于良性肿瘤组及正常对照组（P＜0．01）,而血清SA增值三组间无显著性差异（P＞0．05）。结论 血清CA125测定对巧克力囊肿有辅助诊断价值,且有助于与卵巢良性肿瘤的鉴别。     

The changing face of reoperative parathyroidectomy: a single-centre comparison of 147 parathyroid reoperations

IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes.