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Comparison of emergency surgical cricothyroidotomy and percutaneous cricothyroidotomy by experienced airway providers in an obese,in vivo porcine hemorrhage airway model

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Military Medical Research 2023年第4期10卷 421-430页

作者： Tomas Karlsson Andreas Brännström Mikael gellerfors Jenny gustavsson Mattias günther Department of Clinical Science and Education Section of Anesthesiology and Intensive CareKarolinska Institutet11883 StockholmSweden Department of Neuroscience Karolinska Institutet17177 StockholmSweden Department of Physiology and Pharmacology Section of Anesthesiology and Intensive CareKarolinska Institutet11883 StockholmSweden Department of Perioperative Medicine and Intensive Care Karolinska University Hospital17177 StockholmSweden Swedish Air Ambulance(SLA) 79291 MoraSweden Rapid Response Cars 18233 StockholmSweden.

Background: Emergency front-of-neck airway(eFONA) is a life-saving procedure in “cannot intubate, cannot oxygenate”(CICO). The fastest and most reliable method of eFONA has not been determined. We compared two of the most advocated approaches: surgical cricothyroidotomy and percutaneous cricothyroidotomy, in an obese, in vivo porcine hemorrhage model, designed to introduce real-time physiological feedback, relevant and high provider stress. The primary aim was to determine the fastest method to secure airway. Secondary aims were arterial saturation and partial pressure of oxygen, proxy survival and influence of ***: Twelve pigs [(60.3±4.1) kg] were anesthetized and exposed to 25%–35% total blood volume hemorrhage before extubation and randomization to Seldinger technique “percutaneous cricothyroidotomy”(n=6) or scalpelbougie-tube technique “surgical cricothyroidotomy”(n=6). Specialists in anesthesia and intensive care in a tertiary referral hospital performed the eFONA, simulating an actual ***: In surgical cricothyroidotomy vs. percutaneous cricothyroidotomy, the median(interquartile range, IQR) times to secure airway were 109(IQR 71–130) s and 298(IQR 128–360) s(P=0.0152), arterial blood saturation(SaO2) were 74.7(IQR 46.6–84.2)% and 7.9(IQR 4.1–15.6)%(P=0.0167), PaO_(2) were 7.0(IQR 4.7–7.7) kPa and 2.0(IQR 1.1–2.9) kPa(P=0.0667), and times of cardiac arrest(proxy survival) were 137–233 s, 190(IQR 143–229) s, from CICO. All six animals survived surgical cricothyroidotomy, and two of six(33%) animals survived percutaneous cricothyroidotomy. Years in anesthesia, 13.5(IQR 7.5–21.3), did not influence time to secure ***: eFONA by surgical cricothyroidotomy was faster and had increased oxygenation and survival, when performed under stress by board certified anesthesiologists, and may be an indication of preferred method in situations with hemorrhage and CICO, in obese patients.

关键词： Emergency front-of-neck airway “Cannot intubate cannot oxygenate”(CICO) Surgical cricothyroidotomy,Percutaneous cricothyroidotomy Porcine model

Anisotropic deformation for local shape control

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Computational Visual Media 2017年第4期3卷 305-313页

作者： Matteo Colaianni Christian Siegl Jochen Süвmuth Frank Bauer günther greiner Computer graphics group University Erlangen-Nuremberg Adidas Ag

We present a novel approach to mesh deformation that enables simple context sensitive manipulation of 3 D geometry. The method is based on locally anisotropic transformations and is extended to global control directions. This allows intuitive directional modeling within an easy to implement framework. The proposed method complements current sculpting paradigms by providing further possibilities for intuitive surface-based editing without the need for additional host geometries. We show the anisotropic deformation to be seamlessly transferable to free boundary parameterization methods, which allows us to solve the hard problem of flattening compression garments in the domain of apparel design.

关键词： anisotropy modeling as-rigid-aspossible(ARAP) deformation parameterization

Triggers of histologically suspected drug-induced colitis

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World Journal of gastroenterology 2019年第8期25卷 967-979页

作者： Thorsten Brechmann Katharina günther Matthias Neid Wolff Schmiegel Andrea Tannapfel Department of gastroenterology and Hepatology Ruhr-University BochumBerufsgenossenschaftliches Universitatsklinikum Bergmannsheil gGmbHBochum 44789Germany Institute of Pathology Ruhr-University BochumBochum 44789Germany Department of Internal Medicine University Hospital KnappschaftskrankenhausRuhr-University BochumBochum 44892Germany

BACKgROUND Drug toxicity is a common and even serious problem in the gastrointestinal tract that is thought to be caused by a broad spectrum of *** withdrawal of the causative agent would cure the disease knowledge is scarce and mostly derives from case reports and *** To investigate potential triggers of drug-induced colitis(DiC).METHODS We conducted a retrospective,observational case control *** were assigned to DiC or one of two age-and gender-matched control groups(noninflammatory controls and inflammatory colitis of another cause)based on histopathological *** was reassessed in a subset of patients(28 DiC with atherosclerosis,DiC without atherosclerosis and ischaemic colitis each)for validation *** history was collected from the electronic database and patient *** analysis included chi-squared test,t-test,logistic and multivariate regression *** Drug-induced colitis was detected in 211 endoscopically sampled biopsy specimens of the colon mucosa(7%of all screened colonoscopic biopsy samples);a total of 633 patients were included equally matched throughout the three groups(291 males,mean age:62.1±16.1 years).In the univariate analysis,DiC was associated with diuretics,dihydropyridines,glycosides,ASS,platelet aggregation inhibitors,nonsteroidal anti-inflammatory drugs(NSAIDs),statins and fibrates,and with atherosclerosis,particularly coronary heart disease,and *** parameters did not show substantial *** the multivariate analysis only fibrates[odds ratio(OR)=9.1],NSAIDs(OR=6.7)and atherosclerosis(OR=2.1)proved to be associated with *** DiC reassessment groups presented milder inflammation than ischaemic *** DiC patients with atherosclerosis exhibited histological features from both DiC without atherosclerosis and ischaemic *** Several drugs indicated for the treatment of cardiovascular and related disea

关键词： Drug toxicity Drug-induced colitis Ischaemic colitis Drug-associated gastrointestinal disease Atherosclerosis Colonic ischaemia Nonsteroidal antiinflammatory drugs Fibrates

Triacylglycerol lipases of the yeast

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Frontiers in Biology 2011年第3期6卷 219-230页

作者： Karlheinz gRILLITSCH günther DAUM ACIB gmbH–Austrian Centre of Industrial Biotechnology Institute of Biochemistry and Graz University of TechnologyGraz 8010Austria

All eukaryotes including the yeast contain a lipid storage compartment which is named lipid particle,lipid droplet or oil *** accumulating in this subcellular fraction serve as a depot of energy and building blocks for membrane lipid *** the yeast,the major storage lipids are triacylglycerols(Tgs)and steryl esters(SEs).An important step in the life cycle of these non-polar lipids is their mobilization from their site of storage and channeling of their degradation components to the appropriate metabolic pathways.A key step in this mobilization process is hydrolysis of Tg and SE which is accomplished by lipases and *** this review,we describe our recent knowledge of Tg lipases from the yeast based on biochemical,molecular biological and cell biological *** report about recent findings addressing the versatile role of Tg lipases in lipid metabolism,and discuss non-polar lipid homeostasis and its newly discovered links to various cell biological processes in the yeast.

关键词： triacylglycerol lipase fatty acid acyltransferase lipid droplet/particles yeast

Characterization of a Powertrain Test Bed in the Context of Virtual Validation of Drivability

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同济大学学报（自然科学版） 2024年第S01期52卷 9-19页

作者： Schmidt HENRIK Prokop gÜnther Department of Automotive Engineering Technische Universität Dresden01069 DresdenGermany

Technological trends in the automotive industry toward a software-defined and autonomous vehicle require a reassessment of today’s vehicle development *** validation process soaringly shapes after starting with hardware-in-the-loop testing of control units and reproducing real-world maneuvers and physical interaction ***,the road-to-rig approach offers a vast potential to reduce validation time and costs *** present research study investigates the maneuver reproduction of drivability phenomena at a powertrain test *** drivability phenomena occur in the frequency range of most up to 30∙Hz,the design and characteristics substantially impact the test setup’s *** utilization of modal analysis,the influence of the test bed on the mechanical characteristic is ***,the sensitivity of the natural modes of each component,from either specimen or test bed site,is *** contrast,the uncertainty of the deployed measurement equipment also affects the *** of an accuracy class indication,we apply the ISO/IEC guide 98 to the measurement equipment and the test bed setup to increase the fidelity of the validation *** conclusion,the present paper contributes to a traceable validity determination of the road-to-rig approach by providing objective metrics and methods.

关键词： powertrain test bed virtual validation modal analysis powertrain-hardware-in-the-loop drivability measurement uncertainty

Physical activity,COVID-19,and respiratory comorbidities:The good,the bad,and the ugly

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Journal of Sport and Health Science 2023年第2期12卷 216-218页

作者： Anh-Tuan Dinh-Xuan Thõng Hua-Huy Sven günther Lung Function&Respiratory Physiology Units Department of Respiratory Physiology and Sleep MedicineAssistance Publique-Hôpitaux de ParisCochin&George Pompidou HospitalsUniversity Paris CitéParis 75006France

Almost 3 years after the outbreak of the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)responsible for the coronavirus disease 2019(COVID-19)that has caused more than 6 million deaths worldwide,1the pandemic persists and hampers our daily *** are at least 2 main reasons explaining why we still struggle to terminate this ***,novel variants of concern of SARS-CoV-2unceasingly emerge despite almost 12 billion doses of vaccinebeing administered to date.

关键词： respiratory doses acute

Latent HIV-1 TAR Regulates 7SK-responsive P-TEFb Target genes and Targets Cellular Immune Responses in the Absence of Tat

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genomics, Proteomics & Bioinformatics 2017年第5期15卷 313-323页

作者： Sebastian Eilebrecht bernd-Joachim Benecke Arndt g. Benecke CNRS UMR8246 Université Pierre et Marie Curie Paris 75005 France ACSIOMA gmbH Technologiezentrum Ruhr Bochum 44799 Germany Center for Innate Immunity and Immune Disease University of Washington School of Medicine Seattle WA 98195 USA

The transactivating response element （TAR） structure of the nascent HIV-1 transcript is critically involved in the recruitment of inactive positive transcription elongation factor b （P-TEFb） to the promoter proximal paused RNA polymerase II. The viral transactivator Tat is responsible for subsequent P-TEFb activation in order to start efficient viral transcription elongation. In the absence of the viral transactivator of transcription （Tat）, e.g., during latency or in early stages of HIV tran- scription, TAR mediates an interaction of P-TEFb with its inhibitor hexamethylene bis-aeetamide- inducible protein 1 （HEXIM1）, keeping P-TEFb in its inactive form. In this study, we address the function of HIV-1 TAR in the absence of Tat by analyzing consequences of HIV-1 TAR overexpres- sion on host cellular gene expression. An RNA chimera consisting of Epstein-Barr virus-expressed RNA 2 （EBER2） and HIV-1 TAR was developed to assure robust overexpression of TAR in HEK293 cells. The overexpression results in differential expression of more than 800 human genes. A significant proportion of these genes is involved in the suppression of cellular immune responses, including a significant set of 7SK-responsive P-TEFb target genes. Our findings identify a novel role for HIV-1 TAR in the absence of Tat, involving the interference with host cellular immune responses by targeting 7SK RNA-mediated gene expression and P-TEFb inactivation.

关键词： HIV-1 Latency TAR 7SK RNA Cellular immunity

Hypoplastic particle finite element model for cutting tool-soil interaction simulations:Numerical analysis and experimental validation

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Underground Space 2018年第1期3卷 61-71页

作者： Abdiel Ramon Leon Bal Ulrich Hoppe Thai Son Dang Klaus Hackl günther Meschke Inustitute for Structural Mechanics Ruhr-Uniuersitdit BochunGermany Inustitute of Mechanics of Materials Ruhr-Universitit BochunGermany

This study presents numerical and experimental models for the analysis of the excavation of soft soils by means of a cutting *** computational model is constructed using an Updated Lagrangean(UL)velocity-based Finite Element approach.A hypoplastic formu-lation is employed to describe the constitutive behavior of soft *** displacements and deformations of the ground resulting from the cutting tool-soil interaction are handled by means of the Particle Finite Element method,characterized by a global re-meshing strat-egy and a boundary identiﬁcation procedure called a-shape *** capabilities and performance of the proposed model are demonstrated through comparative analyses between experiments and simulations of cutting tool-soft soil *** experiments are performed using an excavation device at Ruhr-Universita¨t Bochum(RUB),*** main details concerning the setup and calibration and evolution of the measured draft forces are *** computational results characterizing the cutting tool-soft soil interaction including the topology of the free surface,void ratio distribution ahead of the tool,spatio-temporal evolution of the reaction forces and abrasive wear behavior are evaluated.

关键词： Velocity-basedﬁnite elements formulation Hypoplasticity Large deformations Particleﬁnite elements Cutting tool-soil interaction Excavation experiments

Cardiac diagnostics before oral propranolol therapy in infantile hemangioma: retrospective evaluation of 234 infants

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World Journal of Pediatrics 2018年第3期14卷 254-258页

作者： giovanni Frongia Ji-Oun Byeon Raoul Arnold Arianeb Mehrabi Patrick günther Division of Pediatric Surgery Department of GeneralVisceral and Transplantation SurgeryUniversity Hospital of HeidelbergIm Neuenheimer Feld 11069120 HeidelbergGermany Department of Pediatric Cardiology Center for Pediatrics and Adolescent MedicineUniversity Hospital of HeidelbergHeidelbergGermany Department of general Visceral and Transplantation SurgeryUniversity Hospital of HeidelbergHeidelbergGermany

Background The indication and extent of cardiac screening before oral propranolol therapy (OPT) in patients with infantile hemangioma (IH) has been challenged. In this study, we evaluated pre-OPT cardiac diagnostics in a pediatric IH cohort in our department. Methods Retrospective chart review of infants ≤ 12 months old with IH undergoing OPT. The diagnostics prior to OPT, occurrence of complications, and outcome were recorded. Results A total of 234 patients were evaluated. The mean age at the onset of OPT was 4.2 ± 0.3 months, the average dura-tion of OPT was 6.1 ± 0.1 months, and the average follow-up was 12.3 ± 0.7 months. Echocardiograms and electrocardio-grams were performed prior to OPT in all patients. One hundred and three (44.0%) echocardiograms revealed pathological findings, 19 (8.1%) of which were minor (including atrial septal defects, pulmonary stenosis, and patent ductus arteriosus). Pathological findings were observed in 17 (7.3%) of electrocardiograms, only one (0.4%) of which was minor (suspected cardiac arrhythmia, subsequently excluded by long-term electrocardiogram analysis). These findings did not contraindicate OPT and no severe adverse events associated with OPT occurred during the follow-up period. Conclusions Routine cardiac screening by electrocardiogram and echocardiogram before OPT is debatable and not routinely indicated in children with IH. Further studies are necessary to draw definite conclusions on the reasonable indication and extent of this diagnostic approach.

关键词： Cardiac diagnostics Echocardiogram Electrocardiogram Hemangioma Propranolol