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Clinical application of concentrated bone marrow aspirate in orthopaedics:A systematic review

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World Journal of Orthopedics 2017年第6期8卷 491-506页

作者： Arianna l Gianakos li Sun Jay N Patel Donald M Adams frank A liporace Division of Orthopedic Surgery Department of Orthopedic SurgeryJersey City Medical Center-RWJ Barnabas Health

AIM To examine the evidence behind the use of concentrated bone marrow aspirate(c BMA) in cartilage, bone, and tendon repair; establish proof of concept for the use of cB MA in these biologic environments; and provide the level and quality of evidence substantiating the use of cB MA in the clinical *** We conducted a systematic review according to PRISMA guidelines. EMBASE, MEDlINE, and Web of Knowledge databases were screened for the use of cB MA in the repair of cartilage, bone, and tendon repair. We extracted data on tissue type, cB MA preparation, cB MA concentration, study methods, outcomes, and level of evidence and reported the results in tables and *** A total of 36 studies met inclusion/exclusion criteria and were included in this review. Thirty-one of 36(86%) studies reported the method of centrifugation and preparation of cB MA with 15(42%) studies reporting either a cell concentration or an increase from baseline. Variation of c BMA application was seen amongst the studies evaluated. Twenty-one of 36(58%) were level of evidence Ⅳ, 12/36(33%) were level of evidence Ⅲ, and 3/36(8%) were level of evidence Ⅱ. Studies evaluated full thickness chondral lesions(7 studies), osteochondral lesions(10 studies), osteoarthritis(5 studies), nonunion or fracture(9 studies), or tendon injuries(5 studies). Significant clinical improvement with the presence of hyaline-like values and lower incidence of fibrocartilage on T2 mapping was found in patients receiving cB MA in the treatment of cartilaginous lesions. Bone consolidation and time to bone union was improved in patients receiving cB MA. Enhanced healingrates, improved quality of the repair surface on ultrasound and magnetic resonance imaging, and a decreased risk of re-rupture was demonstrated in patients receiving cB MA as an adjunctive treatment in tendon repair. CONClUSION The current literature demonstrates the potential benefits of utilizing c BMA for the repair of cartilaginous lesions, bo

关键词： Concentrated bone marrow aspirate Bone Cartilage Osteochondral lesion Osteoarthritis Tendon

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肢体无力的男性患者一例

英国医学杂志中文版 2021年第1期24卷 59-60页

作者： Shing Fung lee Pui lam yip frank Chi Sing Wong 毛晨晖(译) Department of Clinical Oncology Tuen Mun HospitalNew Territory West Cluster Hospital AuthorityHong Kong 中国医学科学院北京协和医院神经科

58岁男性,以进行性右侧肢体无力和头痛一周就诊。他每周饮酒约7个单位,20年前戒烟(既往吸烟10包/年)。近期无头外伤史,未服用药物或毒品。神志清楚,无发热、体重下降或盗汗等症状。体格检查一般情况好,无发热,无脑膜炎体征或视乳头水肿... 详细信息

58岁男性,以进行性右侧肢体无力和头痛一周就诊。他每周饮酒约7个单位,20年前戒烟(既往吸烟10包/年)。近期无头外伤史,未服用药物或毒品。神志清楚,无发热、体重下降或盗汗等症状。体格检查一般情况好,无发热,无脑膜炎体征或视乳头水肿,右侧上下肢肌力4级,左侧肌力5级1。血常规、肝功能、电解质、C反应蛋白正常。颅脑钆增强磁共振成像(MRI)如图所示(图1)。

关键词：下肢肌力视乳头水肿 C反应蛋白体格检查脑膜炎体重下降外伤史血常规

Forecasting the effects of EU policy measures on the nitrate pollution of groundwater and surface waters

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Journal of Environmental Sciences 2010年第6期22卷 872-877页

作者： Ralf Kunkel Peter Kreins Bjrn Tetzlaff frank Wendland Research Centre Jülich Institute of Chemistry and Dynamics of the Geosphere Institute of Rural Studies Federal Agricultural Research Centre

We used the interdisciplinary model network REGFlUD to predict the actual mean nitrate concentration in percolation water at the scale of the Weser river basin （Germany） using an area differentiated （100 m × 100 m） approach. REGFlUD combines the agro-economic model RAUMIS for estimating nitrogen surpluses and the hydrological models GROWA/DENUZ for assessing the nitrate leaching from the soil. For areas showing predicted nitrate concentrations in percolation water above the European Union （EU） groundwater quality standard of 50 mg NO3-N/l, effective agri-environmental reduction measures need to be derived and implemented to improve groundwater and surface water quality by 2015. The effects of already implemented agricultural policy are quantified by a baseline scenario projecting the N-surpluses from agricultural sector to 2015. The REGFlUD model is used to estimate the effects of this scenario concerning groundwater and surface water pollution by nitrate. From the results of the model analysis the needs for additional measures can be derived in terms of required additional N-surplus reduction and in terms of regional prioritization of measures. Research work will therefore directly support the implementation of the Water Framework Directive of the European Union in the Weser basin.

关键词： catchment management diffuse source pollution mitigation methods river basin management Water Framework Directive

Determination of nitrogen reduction levels necessary to reach groundwater quality targets in Slovenia

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Journal of Environmental Sciences 2014年第9期26卷 1806-1817页

作者： Miso Andelov Ralf Kunkel Jo?e Uhan frank Wendland Slovenian Environment Agency Hydrogeological Analysis DivisionVojkova 1bSI-1000 LjubljanaSlovenia Forschungszentrum Jülich (FZJ) Institute of Bio- and Geosciences (IBG)Institute 3: Agrosphere52425 JuelichGermany

Within a collaborative project between Slovenian Environment Agency （ARSO） and Research Center Jfilich （FZJ）, nitrogen reduction levels necessary to reach groundwater quality targets in Slovenia were assessed. For this purpose the hydrological model GROWA- DENUZ was coupled with agricultural N balances and applied consistently to the whole territory of Slovenia in a spatial resolution of 100 x 100 m. GROWA was used to determine the water balance in Slovenia for the hydrologic period 1971-2000. Simultaneously, the displaceable N load in soft was assessed from agricultural Slovenian N surpluses for 2011 and the atmospheric N deposition. Subsequently, the DENUZ model was used to assess the nitrate degradation in soil and, in combination with the percolation water rates from the GROWA model, to determine nitrate concentration in the leachate. The areas showing predicted nitrate concentrations in the leachate above the EU groundwater quality standard of 50 mg NO3/l have been identified as priority areas for implementing nitrogen reduction measures. For these ＂hot spot＂ areas DENUZ was used in a backward mode to quantify the maximal permissible nitrogen surplus levels in agriculture to guarantee a nitrate concentration in percolation water below 50 mg NO3/l. Model results indicate that additional N reduction measures should be implemented in priority areas rather than area-covering. Research work will directly support the implementation of the European Union Water Framework Directive in Slovenia, e.g., by using the maximal permissible nitrogen surplus levels as a framework for the derivation of regionally adapted and hence effective nitrogen reduction measures.

关键词： EU Water Framework DirectiveGroundwater quality targetsNitrate pollutionReactive nitrate transport modeling

Characterization of novel Brown midrib 6 mutations affecting lignin biosynthesis in sorghum

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Journal of Integrative Plant Biology 2016年第2期58卷 136-149页

作者： Erin D. Scully Tammy Gries Deanna l. Funnell-Harris Zhanguo Xin frank A. Kovacs Wilfred Vermerris Scott E. Sattler Grain Forage and Bioenergy Research Unit USDA-ARS Lincoln NE 68583 USA Department of Agronomy and Horticulture University of Nebraska-Lincoln Lincoln NE 68583 USA Department of Plant Pathology University of Nebraska-Lincoln Lincoln NE 68583 USA Plant Stress and Germplasm Development Unit USDA-ARS Lubbock TX 79414 USA Department of Chemistry University of Nebraska-Kearney Kearney NE 68849 USA Department of Microbiology & Cell Science and UF Genetics Institute University of Florida Gainesville FL 32610 USA

The presence of lignin reduces the quality of lignocellulosic biomass for forage materials and feedstock for biofuels. In C4 grasses, the brown midrib phenotype has been linked to mutations to genes in the monolignol biosynthesis pathway. For example, the Bmr6 gene in sorghum （Sorghum bicolor） has been previously shown to encode cinnamyl alcohol dehydrogenase （CAD）, which catalyzes the final step of the monolignol biosynthesis pathway. Mutations in this gene have been shown to reduce the abundance of lignin, enhance digestibility, and improve saccharification efficiencies and ethanol yields. Nine sorghum lines harboring five different bmr6 alleles were identified in an EMS-mutagenized TIllING population. DNA sequencing of Bmr6 revealed that the majority of the mutations impacted evolutionarily conserved amino acids while three-dimensional structural modeling predicted that all of these alleles interfered with the enzyme＇s ability to bind with its NAPPH cofactor. All of the new alleles reduced in vitro CAD activity levels and enhanced glucose yields following saccharification. Further, many of these lines were associated with higher reductions in acid detergent lignin compared to lines harboring the previously characterized bmr6-ref allele. These bmr6 lines represent new breeding tools for manipulating biomass composition to enhance forage and feedstock quality.

关键词： Cinnamyl alcohol dehydrogenase (CAD) EMS mutagenesis biofuels C4 grass forage

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渗透测试技术在计算机网络安全中的应用

安防科技 2003年第3期 58-59页

作者： frank lam ,朴辉

一位著名的犯罪学家曾经这样讲过:如果要了解罪犯的想法,最好是用罪犯的思维去思考问题。这个原则用在计算机安全上面的话,就衍生出所谓的渗透测试技术。现在一些公司经常雇佣一些计算机专家对自己公司的网络进行善意的攻击,及时发现问... 详细信息

一位著名的犯罪学家曾经这样讲过:如果要了解罪犯的想法,最好是用罪犯的思维去思考问题。这个原则用在计算机安全上面的话,就衍生出所谓的渗透测试技术。现在一些公司经常雇佣一些计算机专家对自己公司的网络进行善意的攻击,及时发现问题并采取措

关键词：渗透测试计算机小组密码用户名邮件服务器目标网络域名远程系统

Disagreement in middle ear volume estimation between tympanometry and three-dimensional volume reconstruction in the context of tympanic membrane perforation

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Journal of Otology 2017年第2期12卷 74-79页

作者： David J.Carpenter Debara l.Tucci David M.Kaylie Dennis O.frank-Ito Division of Head and Neck Surgery&Communication Sciences Department of SurgeryDuke University Medical CenterDurhamNCUSA Computational Biology&Bioinformatics PhD Program Duke UniversityDurhamNCUSA Department of Mechanical Engineering and Materials Science Duke UniversityDurhamNCUSA

Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni ***: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p les(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.

关键词： Middle ear volume Tympanometry Three-dimensional volume reconstruction Tympanic membrane perforation

The anatomic determinants of conductive hearing loss secondary to tympanic membrane perforation

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Journal of Otology 2017年第3期12卷 125-131页

作者： David J.Carpenter Debara l.Tucci David M.Kaylie Dennis O.frank-Ito Division of Head and Neck Surgery & Communication Sciences Department of Surgery Duke University Medical Center Durham NC USA Computational Biology & Bioinformatics PhD Program Duke University Durham NC USA Department of Mechanical Engineering and Materials Science Duke University Durham NC USA

Objectives: Recent studies have introduced middle ear volume(MEV) as a novel determinant of perforation-induced conductive hearing loss(CHl) in a mechanism driven by trans-tympanic membrane pressure differences. The primary aims of this preliminary report are to: 1) correlate CHl with perforation size; 2) describe the relationship between CHl and MEV; and 3) compare CHl across a range of cholesteatoma ***: A retrospective pilot study was performed in 31 subjects with audiometry indicative of conductive hearing loss, temporal bone CT scans,and no prior middle ear surgery. Perforation size and MEV were analyzed with respect to CHl in a cohort of 10 perforated ears with no cholesteatoma. CHls were compared in 3 groups defined by extent of cholesteatoma ***: Ears with large and small perforations showed mean ABG values of 32.0 ± 15.7 dB and 16.0 ± 16.4 dB, respectively. A direct relationship was observed between MEV and CHl for ears with large perforations across all frequencies, whereas this relationship for small perforations was frequency-dependent. Finally, a statistically significant increase in CHl was found across ears with increasing cholesteatoma involvement at 1000 Hz(X^2(2) = 9.786, p = 0.008),2000 Hz(x^2(2) = 8.455, p = 0.015),and 4000 Hz(x^2(2)= 8.253, p = 0.016).Conclusions: These pilot data suggest that greater perforation-induced conductive hearing losses may be associated with larger perforation sizes and cholesteatoma. The correlation between MEV and CHl may require additional study.

关键词： Perforation-induced hearing loss Conductive hearing loss Middle ear volume Three-dimensional volume reconstruction

Dietary stimulation of the endogenous somatotropic axis in weaner and growerfinisher pigs using medium chain triglycerides and cysteamine hydrochloride

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Journal of Animal Science and Biotechnology 2017年第2期8卷 405-416页

作者： David W.Miller Zoe Prosser Edward y.W.Chee Christian F.Hansen frank R.Dunshea Bruce P.Mullan John R.Pluske School of Veterinary and life Sciences Murdoch UniversityMurdochWA6150Australia Department of large Animal Sciences Faculty of Health and Medical SciencesUniversity of CopenhagenGroennegaardsvej 21870 Frederiksberg CDenmark Melbourne School of land and Environment University of MelbourneParkvilleVlC 3051Australia Department of Agriculture and Food Western Australia Bentley Delivery CenterLocked Bag4BentleyWA 6983Australia

Background： Three experiments were conducted to examine the overall hypothesis that addition of medium chain triglycerides（MCT） and cysteamine hydrochloride（CSH） into the diets of young and growing pigs would stimulate the endogenous somatotropic axis to improve growth and ***： In Experiment 1, weaner pigs were given either a 5 d dietary supplement of 5 % MCT（n = 8） or a control diet（n = 8）. MCT increased the plasma concentration of growth hormone（GH; P ＆lt; 0.05） and the GH secretagogue,ghrelin（P ＆lt; 0.05）. Additionally, the MCT treatment reduced scouring（P ＆lt; 0.05）, maintained villous height in the small intestine（P ＆lt; 0.05） and stabilised daily weight gain（P ＆lt; 0.05）, compared to the controls. Experiment 2compared the effects of 4 levels（0, 1, 3 and 6 % v/v） of MCT supplementation in grower-finisher male pigs, of approximately 35 kg live weight（n = 15 per treatment）. Blood samples taken after 7 wk of treatment showed that the MCT supplementation increased circulating ghrelin（P ＆lt; 0.001）, GH（P ＆lt; 0.01） and insulin（P ＆lt; 0.05）concentrations in a dose-dependent manner. Daily weight gain, feed intake and feed conversion ratio were not affected by the MCT diets. In Experiment 3, 64 female pigs of approximately 60 kg live weight were allocated to one of three dietary treatments： control（n = 20）; 6 % MCT（n = 21）; and 70 mg/kg CSH（n = 21）. After 3 wk of supplementation, the MCT treated pigs had a higher plasma concentration of ghrelin compared to the control and CSH pigs（P ＆lt; 0.05）. Plasma concentrations of GH and weight were not affected by any of the dietary ***： Evidence is provided in Experiment 1 to support the use of dietary MCT supplements, perhaps acting via stimulation of somatotropic endocrine pathways, to minimise weaning-associated disorders such as slowing of growth and diarrhoea. In Experiments 2 and 3, although there was no effect on weight gain or feed conversion ratio in either experiment, MCT and CSH incr

关键词： Ghrelin Growth Pig Somatotropin