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Pediatric critical procedures in the emergency department
Ashley Alexandra Foster,Matthew Adam Eisenberg 대한응급의학회 2020 Clinical and Experimental Emergency Medicine Vol.7 No.3
We have read the article by Cabalatungan et al. published in Clinical and Experimental Emergency Medicine with great interest. In this study, data from the National Hospital Ambulatory Medical Care Survey between 2010 and 2014 was used to identify adult and pediatric patients undergoing critical procedures in the emergency department (ED) and estimated a single emergency physician performed pediatric central line insertion, cardiopulmonary resuscitation, and endotracheal intubation once every 3.2, 5.2, and 2.8 years, respectively. The authors concluded that general emergency physicians perform these procedures at a significantly lower rate compared to the same critical procedures on adult patients. We agree that this article highlights a fundamentally important finding—the infrequency of pediatric critical procedures in the ED setting.
Sills, E. Scott,Obregon-Tito, Alexandra J.,Gao, Harry,McWilliams, Thomas K.,Gordon, Anthony T.,Adams, Catharine A.,Slim, Rima The Korean Society for Reproductive Medicine 2017 Clinical and Experimental Reproductive Medicine Vol.44 No.1
Objective: To describe in vitro development of human embryos derived from an individual with a homozygous pathogenic variant in NLRP7 (19q13.42) and recurrent hydatidiform mole (HM), an autosomal recessive condition thought to occur secondary to an oocyte defect. Methods: A patient with five consecutive HM pregnancies was genomically evaluated via next generation sequencing followed by controlled ovarian hyperstimulation, in vitro fertilization (IVF) with intracytoplasmic sperm injection, embryo culture, and preimplantation genetic screening. Findings in NLRP7 were recorded and embryo culture and biopsy data were tabulated as a function of parental origin for any identified ploidy error. Results: The patient was found to have a pathogenic variant in NLRP7 (c.2810+2T>G) in a homozygous state. Fifteen oocytes were retrieved and 10 embryos were available after fertilization via intracytoplasmic sperm injection. Developmental arrest was noted for all 10 embryos after 144 hours in culture, thus no transfer was possible. These non-viable embryos were evaluated by karyomapping and all were diploid biparental; two were euploid and eight had various aneuploidies all of maternal origin. Conclusion: This is the first report of early human embryo development from a patient with any NLRP7 mutation. The pathogenic variant identified here resulted in global developmental arrest at or before blastocyst stage. Standard IVF should therefore be discouraged for such patients, who instead need to consider oocyte (or embryo) donation with IVF as preferred clinical methods to treat infertility.
Benjamin Lopez-Jimena,Esther Garcia-Rosado,Kim Dawn Thompson,Alexandra Adams,Carlos Infante,Juan Jose Borrego,Maria del Carmen Alonso 대한수의학회 2012 JOURNAL OF VETERINARY SCIENCE Vol.13 No.4
The distribution of red-spotted grouper nervous necrosis virus (RGNNV) antigens was examined by immunohistochemistry in the nervous and non-nervous organs of juvenile European seabass (Dicentrarchus labrax) during the course of an intramuscular infection. Histological changes resulting from the infection were evaluated from 3 days to 2 months post-infection. The specific antibody response was also studied 2 months post-challenge. Viral proteins were present throughout the experimental period in the retina (inner nuclear layer, ganglion layer, outer limiting membrane, and outer plexiform layer), brain (cerebellum and tectum opticum), and liver (hepatocytes and endothelial cells). These proteins were also observed in the renal tubular cells, white pulp of spleen, and in fibroblasts and cartilage of caudal fin. This is the first report of RGNNV proteins appearing in these organs, where the immunostaining was only detected at certain sampling times after the onset of mortality. Brain and retina of virus-exposed fish showed high levels of vacuolation, while accumulation of fat vacuoles was observed in the liver. RGNNV infection also induced a specific antibody response as measured by an ELISA. In summary, this is the first study demonstrating the presence of viral proteins in cells of caudal fin, kidney and spleen of European seabass.