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Thoracotomy in the emergency department for resuscitation of the mortally inj.red

Chinese j.urnal of Traumatology 2017年第3期20卷 141-146页

作者： j. christopher DiGiacomo L.D. George Angus Long Island Comprehensive Trauma Center Department of Surgery Nassau University Medical Center. East Meadow NY 11554 USA

Purpose： Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room. Methods： A retrospective review of all patients at a suburban level I trauma center who underwent emergency department resuscitative thoracotomy as an adj.nct to the resuscitation efforts normally delivered in the trauma receiving area over a 22 year period was performed. Survival of emergency department resuscitative thoracotomy was defined as restoration of vital signs and transport out of the trauma resuscitation area to the operating room. Results： Sixty-eight patients were identified, of whom 27 survived the emergency department resusci- tative thoracotomy and were transported to the operating room. Review of pre-hospital and initial hospital data between these potential long term survivors and those who died in the emergency department failed to demonstrate trends which were predictive of survival of emergency department resuscitative thoracotomy. The only subgroup which failed to respond to emergency department resuscitative thoracotomy was patients without signs of life at the scene who arrived to the treatment facility without signs of life. Conclusion： The patient population of the ＂potential survivor＂ has been expanded due to advances in critical care practices, technology, and surgical technique and every opportunity for survival should be provided at the outset. Emergency department resuscitative thoracotomy is warranted for any patient with thoracic or subdiaphragmatic trauma who presents in extremis with a history of signs of life at the scene or or

关键词： Emergencies Thoracotomy Inj.ries Resuscitation

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Male fertility following childhood cancer: current conceptsand future therapies

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Asian j.urnal of Andrology 2003年第4期5卷 325-337页

作者： Mark F. H. Brougham christopher j. H.Kelnar Richard M.Sharpe W.Hamish B.Wallace Royal Hospital for Sick Children Edinburgh United KingdomRoyal Hospital for Sick Children Edinburgh United KingdomMRC Human Reproductive Sciences Unit Centre for Reproductive Biology University of Edinburgh United KingdomRoyal Hospital for Sick Children Edinburgh United Kingdom

Prepubertal boys treated for cancer may exhibit impaired fertility in later life. A number of chemotherapeu tic agents have been identified as being gonadotoxic, and certain treatment regimens, such as that used for Hodgkin's disease, are particularly associated with subsequent infertility. Radiotherapy may also cause gonadal damage, most notably following direct testicular irradiation or total body irradiation. Because of the varied nature of the cytotoxic insult, it can be difficult to predict the likelihood of infertility in later life. Currently it is not possible to detect gonadal damage early due to the lack of a sensitive marker of gonadal function in the prepubertal age *** cryopreservation is currently the only method of preserving fertility in patients receiving gonadotoxic therapy. This is only applicable to postpubertal patients and can be problematic in the adolescent age group. At present there is no provision for the prepubertal boy, although there are a number of experimental methods currently being investigated. By harvesting testicular tissue prior to gonadotoxic therapy, restoration of fertility could be achieved following treatment, either by germ cell transplantation or by in vitro maturation of the germ cells harvested. Alternatively, rendering the testes quiescent during cytotoxic treatment may protect the germ cells from subsequent damage. In addition to the many scientific and technical issues to be overcome prior to clinical application of these techniques, a number of ethical and legal issues must also be addressed to ensure a safe and realistic prospect for future fertility in these patients.

关键词： infertility childhood cancer semen cryopreservation germ cell transplantation In vitro germ cell maturation assisted reproductive techniques

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Progress and Challenges for Live-cell Imaging of Genomic Loci Using CRISPR-based Platforms

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Genomics, Proteomics & Bioinformatics 2019年第2期17卷 119-128页

作者： Xiaotian Wu Shiqi Mao Yachen Ying christopher j.Krueger Antony K. Chen Department of Biomedical Engineering College of Engineering Peking University Beijing 100871 China School of Life Sciences Peking University Beijing 100871 China Wallace H Coulter Department of Biomedical Engineering Georgia Institute of Technology Atlanta GA 30332 USA

Chromatin conformation,localization,and dynamics are crucial regulators of cellular behaviors. Although fluorescence in situ hybridization-based techniques have been widely utilized for investigating chromatin architectures in healthy and diseased states,the requirement for cell fix-ation precludes the comprehensive dynamic analysis necessary to fully understand chromatin activ-ities. This has spurred the development and application of a variety of imaging methodologies for visualizing single chromosomal loci in the native cellular context. In this review,we describe currently-available approaches for imaging single genomic loci in cells,with special focus on clus-tered regularly interspaced short palindromic repeats (CRISPR)-based imaging approaches. In addition,we discuss some of the challenges that limit the application of CRISPR-based genomic imaging approaches,and potential solutions to address these challenges. We anticipate that,with continued refinement of CRISPR-based imaging techniques,significant understanding can be gained to help decipher chromatin activities and their relevance to cellular physiology and pathogenesis.

关键词： CRISPR Cas9 dCas9 Genomic imaging sgRNA

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Deletion or underexpression of the Y-chromosome genes CDY2 and HSFY is associated with maturation arrest in American men with nonobstructive azoospermia

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Asian j.urnal of Andrology 2012年第5期14卷 676-682页

作者： Peter j.Stahl Anna N Mielnik christopher E Barbieri Peter N Schlegel Darius A Paduch Department of Urology Weill Cornell Medical CollegeNew York Presbyterian HospitaI-CornellNew YorkNY 10065USA

Maturation arrest （MA） refers to failure of germ cell development leading to clinical nonobstructive azoospermia. Although the azoospermic factor （AZF） region of the human Y chromosome is clearly implicated in some cases, thus far very little is known about which individual Y-chromosome genes are important for complete male germ cell development. We sought to identify single genes on the Y chromosome that may be implicated in the pathogenesis of nonobstructive azoospermia associated with MA in the American population. Genotype-phenotype analysis of 132 men with Y-chromosome microdeletions was performed. Protein-coding genes associated with MA were identified by visual analysis of a genotype-phenotype map. Genes associated with MA were selected as those genes within a segment of the Y chromosome that, when completely or partially deleted, were always associated with MA and absence of retrievable testicular sperm. Expression of each identified gene transcript was then measured with quantitative RT-PCR in testicular tissue from separate cohorts of patients with idiopathic MA and obstructive azoospermia. Ten candidate genes for association with MA were identified within an 8.4-Mb segment of the Y chromosome overlapping the AZFb region. CDY2and HSFYwere the only identified genes for which differences in expression were observed between the MA and obstructive azoospermia cohorts. Men with obstructive azoospermia had 12-fold higher relative expression of CDY2transcript （1.33__.0.40 vs. 0.11＋_0.04; P=O.O003） and 16-fold higher expression of HSFYtranscript （0.78__.0.32 vs. 0.05_0.02; P=O.O005） compared to men with MA. CDY2 and HSFYwere also underexpressed in patients with Sertoli cell only syndrome. These data indicate that CDY2and HSFYare located within a segment of the Y chromosome that is important for sperm maturation, and are underexpressed in testicular tissue derived from men with MA. These observations suggest that impairments in CDY2 or HSFYexpression could be impli

关键词： CDY1 protein CDY2 protein genetics histology HSFY human make infertility nonobstructive azoospermia spermato-genesis sperm maturation

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A critical examination of compound stability predictions from machine-learned formation energies

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npj.Computational Materials 2020年第1期6卷 858-868页

作者： christopher j.Bartel Amalie Trewartha Qi Wang Alexander Dunn Anubhav j.in Gerbrand Ceder Department of Materials Science&Engineering University of CaliforniaBerkeleyBerkeleyCA 94720USA Energy Technologies Area Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA Materials Sciences Division Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA

Machine learning has emerged as a novel tool for the efficient prediction of material properties,and claims have been made that machine-learned models for the formation energy of compounds can approach the accuracy of Density Functional Theory(DFT).The models tested in this work include five recently published compositional models,a baseline model using stoichiometry alone,and a structural *** testing seven machine learning models for formation energy on stability predictions using the Materials Proj.ct database of DFT calculations for 85,014 unique chemical compositions,we show that while formation energies can indeed be predicted well,all compositional models perform poorly on predicting the stability of compounds,making them considerably less useful than DFT for the discovery and design of new *** critically,in sparse chemical spaces where few stoichiometries have stable compounds,only the structural model is capable of efficiently detecting which materials are *** nonincremental improvement of structural models compared with compositional models is noteworthy and encourages the use of structural models for materials discovery,with the constraint that for any new composition,the ground-state structure is not known a *** work demonstrates that accurate predictions of formation energy do not imply accurate predictions of stability,emphasizing the importance of assessing model performance on stability predictions,for which we provide a set of publicly available tests.

关键词： stability critical solids

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Cooperation in an asymmetric volunteer's dilemma game with relatedness

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Chinese Science Bulletin 2012年第16期57卷 1972-1981页

作者： HE j.nZhou WANG RuiWu christopher X j.j.nsen LI YaoTang LI ChaoQian School of Mathematics and Statistics Yunnan UniversityKunming 650091China State Key Laboratory of Genetic Resources and Evolution Kunming Institute of ZoologyChinese Academy of SciencesKunming 650223China Department of Mathematics and Science School of Liberal Arts and SciencesPratt Institute200 Willoughby AvenueBrooklynNY 11205USA

What motivates some members of a social group to voluntarily incur costs in order to provide for the common good? This question lies at the heart of theoretical and empirical studies of cooperative behavior. This is also the question that underlies the classic volunteer's dilemma model, which has been previously explored in scenarios where group members are related or interact asym- metrically. Here we present a model that combines asymmetry and relatedness, showing that the probability of volunteerism in such systems depends closely on both the degree of asymmetry and level of relatedness between interacting individuals. As has been shown in previous volunteer's dilemma models, the payoff ratio and overall group size also influence the probability of volunteerism. The probability of volunteerism decreases with increasing group size or decreasing cost-to-benefit ratio of the coplayers; in the presence of asymmetrical interactions, subordinate players were more likely to offer public goods than the dominant player. More asymmetrical interactions decrease the probability of volunteerism of the dominant player; overall volunteerism increases with increasing relatedness.

关键词：不对称性志愿者关联性合作游戏相互作用社会团体关联程度

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Sensitivity Analysis of Computations of the Vapor-Liquid Equilibria of Methane + Methanol or Glycols at Gas Hydrate Formation Conditions

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Modeling and Numerical Simulation of Material Science 2019年第1期9卷 1-15页

作者： christopher E. Ozigagu Anthony j. Duben Department of Chemistry and Biochemistry Stephen F. Austin State University Nacogdoches TX USA

The Soave-Redlich-Kwong (SRK-EOS) and Peng-Robinson (PR-EOS) equations of state are used often to describe the behavior of pure substances and mixtures despite difficulties in handling substances, like water, with high polarity and hydrogen bonding. They were employed in studying the binary vapor-liquid equilibria (VLE) of methane + methanol, monoethylene glycol (MEG), and triethylene glycol (TEG). These liquids are used to inhibit the formation of gas hydrates. The investigation focused on the conditions at which methane-water clathrates can form 283.89?K to 323.56?K and 5.01?MPa to 18.48?MPa. The pressure of methane in methanol is overestimated by a factor of two by either the SRK-EOS or the PR-EOS. In the methane + MEG system, the predicted pressures for both equations of state are generally less than experimental pressure except for the highest concentration of methane in MEG calculated by the SRK-EOS. In the methane + TEG system, the predictions of both models are close and trend similarly. Because of the comparative lack of extensive experimental methane + TEG data, the similarity of the methane + TEG computed results can be used as a basis for further study of this system experimentally.

关键词： Vapor-Liquid Equilibrium Cubic Equations of State Clathrate Glycols

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Predictors of a Cerebrovascular Accident in a Population of Systemic Sclerosis Patients Followed at a Large Academic Center with a Dedicated Scleroderma Center

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Open j.urnal of Rheumatology and Autoimmune Diseases 2020年第2期10卷 45-56页

作者： christopher j. Inserra Chris T. Derk Department of Medicine Creighton University Omaha NE USA Division of Rheumatology University of Pennsylvania Philadelphia PA USA

Aim: The aim of this study is to describe the clinical characteristics of patients with a diagnosis of systemic sclerosis who later suffer a stroke and to identify associations for this relationship. Background: Prior studies have showed an increased risk of cardiovascular disease among patients with chronic inflammatory disorders, with chronic inflammation leading to atherosclerosis believed to be the culprit. Systemic sclerosis (SSc) is a chronic inflammatory disease characterized by diffuse fibrosis of the skin and internal organs. Previous studies have suggested a possible link between systemic sclerosis and macrovascular complications such as stroke. Methods: This is a retrospective chart review of patients treated within the University of Pennsylvania Health System from October 2015 to April 2019 with a diagnosis of SSc. Using ICD10 codes, we identified a cohort of SSc patients who suffered a stroke. Information regarding demographics and stroke risk factors were gathered from the charts of patients with a diagnosis of both SSc plus stroke and compared to a control group of randomly selected patients with SSc who never suffered a stroke. Continuous variables were conveyed using a mean plus a standard deviation. A two-sample t-test was used to compare the two groups of patients. Qualitative variables were compared using a two-tailed Fisher’s exact test. Results: Based on a large cohort of SSc patients (n = 2080) followed between October 2015 and April 2019, we identified 36 SSc patients who developed a subsequent stroke (1.7% of cohort). When looking at risk factors for stroke in SSc patients, we identified hypertension and atrial fibrillation to be associated with the diagnosis of stroke in such patients. Specifically, 28 of the 36 patients with both SSc and stroke also had a diagnosis of hypertension while in the control group, only 17 of 36 patients had hypertension. Atrial fibrillation was seen in 9 of 36 patients with both SSc and CVA while it was seen in

关键词： Systemic Sclerosis Scleroderma Stroke Cerebrovascular Accident Atrial Fibrillation Hypertension

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Encapsulating peritoneal sclerosis

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World j.urnal of Gastroenterology 2018年第28期24卷 3101-3111页

作者： christopher j.Danford Steven C Lin Martin P Smith j.cqueline L Wolf Division of Gastroenterology and Hepatology Beth Israel Deaconess Medical Center Harvard Medical School Department of Radiology Beth Israel Deaconess Medical Center Harvard Medical School

Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease.

关键词： Abdominal cocoon Sclerosing encapsulating peritonitis Peritoneal sclerosis Peritonectomy Enterolysis Peritoneal dialysis Tamoxifen Corticosteroids

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Liver Fibrosis Helps to Distinguish Autoimmune Hepatitis from DILI with Autoimmune Features: A Review of Twenty Cases

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j.urnal of Clinical and Translational Hepatology 2019年第1期7卷 21-26页

作者： christopher A.Febres-Aldana Sarah Alghamdi Kritika Krishnamurthy Robert j.Poppiti Department of Pathology and Laboratory Medicine Mount Sinai Medical CenterMiami BeachFLUSA Herbert Wertheim College of Medicine Florida International UniversityMiamiFLUSA

Background and Aims:Drug-induced liver inj.ry with autoimmune features(AI-DILI)mimics the clinical presentation,and laboratory and pathologic features of idiopathic autoimmune hepatitis(AIH).We aimed to identify histopathologic hallmarks to differentiate these ***:All liver biopsies archived for the past 10 years were reviewed retrospectively to identify cases of recently detected liver inj.ry associated with predominantly lymphoplasmacytic interphase hepatitis,positive markers for liver autoimmunity,and negative tests for viral *** cases were divided into AIH(n=12)or AI-DILI(n=8)*** qualitative evaluation of necroinflammatory changes and liver fibrosis were performed according to the Scheuer scoring *** densities were determined using Imagej.V1.51t,National Institutes of Health,Bethesda,MD,USA).Fibrosis was assessed on Masson trichrome-stained slides,and collagen deposition was estimated following a protocol of color ***:Necroinflammatory changes as well as densities(portal and lobular)of neutrophils and eosinophils,intracellular cholestasis,and regenerative changes did not differ between the two groups(P≥0.05).Neutrophil densities but not eosinophils showed a positive correlation with the severity of hepatocellular damage(r=0.6and 0.58,*** aminotransferase,P<0.05).Ceroidladen macrophages but not histiocytic aggregates appeared to be more common in AI-DILI(P<0.05).AIH patients presented more often with evidence of chronic damage,including higher scores of fibrosis and collagen deposition,in comparison to AI-DILI(P<0.05).Conclusions:Although there is no histologic feature pathognomonic for AI-DILI or AIH,advanced stages of liver fibrosis can be used to support the diagnosis of AIH in some *** diagnosis of AI-DILI requires follow-up and demonstration of complete remission after drug withdrawal with no need for immunosuppression.

关键词： DILI Autoimmune hepatitis Liver fibrosis Digital pathology

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