991 resultados para Transplantação de Rim


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With an extension of > 40 km**2 the recently discovered Campeche cold-water coral province located at the northeastern rim of the Campeche Bank in the southern Gulf of Mexico belongs to the largest coherent cold-water coral areas discovered so far. The Campeche province consists of numerous 20-40 m-high elongated coral mounds that are developed in intermediate water depths of 500 to 600 m. The mounds are colonized by a vivid cold-water coral ecosystem that covers the upper flanks and summits. The rich coral community is dominated by the framework-building Scleractinia Enallopsammia profunda and Lophelia pertusa, while the associated benthic megafauna shows a rather scarce occurrence. The recent environmental setting is characterized by a high surface water production caused by a local upwelling center and a dynamic bottom-water regime comprising vigorous bottom currents, obvious temporal variability, and strong density contrasts, which all together provide optimal conditions for the growth of cold-water corals. This setting - potentially supported by the diel vertical migration of zooplankton in the Campeche area - controls the delivering of food particles to the corals. The Campeche cold-water coral province is, thus, an excellent example highlighting the importance of the oceanographic setting in securing the food supply for the development of large and vivid cold-water coral ecosystems.

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In order to test the sensitivity of marine primary productivity in the midlatitude open ocean North Atlantic to changes in the Atlantic Meridional Overturning Circulation (AMOC), we investigated two spliced sediment cores from a site south of the Azores Islands at the northern rim of the North Atlantic subtropical gyre. For this purpose we analyzed coccolithophore assemblages, diatom abundances, alkenones and conducted X-ray fluorescence (XRF) core scanning. During times of reduced AMOC, especially during Heinrich event 1 (H1) and the Younger Dryas, we observe a strong increase in productivity as evidenced by high coccolith accumulation rates, high alkenone concentrations/accumulation rates, high Ba/Ti-ratios, high abundances of diatoms and low abundances ofF. profunda. The increased productivity is partly caused by a more southern position of the Azores Front (AzF), and hence by a less northward extension of the subtropical gyre, as deduced from high abundances of the temperate coccolithophore species G. muellerae and low abundances of subtropical species (Oolithotus spp., Umbellosphaera spp., Umbilicosphaeraspp.). However, to explain the full range of the observed productivity increase, other factors like increased westerly winds and advection of nutrient-rich surface waters have also to be considered. Because this pattern can also be observed in other sediment cores from the midlatitude North Atlantic, we propose that during times of reduced AMOC there has been a band of strongly increased productivity across the North Atlantic at the northern rim of the contracted subtropical gyre, which partly counteracts the decreased organic carbon pump in the high northern latitudes.

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Tourmaline from a gem-quality deposit in the Grenville province has been studied with X-ray diffraction, visible-near infrared spectroscopy, Fourier transform infrared spectroscopy, scanning electron microscopy, electron microprobe and optical measurements. The tourmaline is found within tremolite-rich calc-silicate pods hosted in marble of the Central Metasedimentary Belt. The crystals are greenish-greyish-brown and have yielded facetable material up to 2.09 carats in size. Using the classification of Henry et al. 2011 the tourmaline is classified as a dravite, with a representative formula shown to be (Na0.73Ca0.2380.032)(Mg2+2.913Fe2+0.057Ti4+0.030) (Al3+5.787Fe3+0.017Mg2+0.14)(Si6.013O18)(BO3)3(OH)3((OH,O)0.907F0.093). Rietveld analysis of powder diffraction data gives a = 15.9436(8) Å, c = 7.2126(7) Å and a unit cell volume of 1587.8 Å3. A polished thin section was cut perpendicular to the c-axis of one tourmaline crystal, which showed zoning from a dark brown core into a lighter rim into a thin darker rim and back into lighter zonation. Through the geochemical data, three key stages of crystal growth can be seen within this thin section. The first is the core stage which occurs from the dark core to the first colourless zone; the second is from this colourless zone increasing in brown colour to the outer limit before a sudden absence of colour is noted; the third is a sharp change from the end of the second and is entirely colourless. These events are the result of metamorphism and hydrothermal fluids resulting from nearby felsic intrusive plutons. Scanning electron microscope, and electron microprobe traverses across this cross-section revealed that the green colour is the result of iron present throughout the system while the brown colour is correlated with titanium content. Crystal inclusions in the tourmaline of chlorapatite, and zircon were identified by petrographic analysis and confirmed using scanning electron microscope data and occur within the third stage of formation.

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Research on women’s employment has proliferated over recent decades, often under a perspective that conceptualizes female labour market activity as independent of male presences and absences in the productive and reproductive spheres. In the face of these approaches, the article argues the need to focus on the couple as the unit of analysis of work-life articulation. After referring to the main theoretical arguments that, from a gender perspective within labour studies, have pointed out the relevance of placing the household as the central space for the analysis of the sexual division of labour, the article reviews different empirical contributions that have incorporated such perspective in the international literature. Next, the state of the art in the Spanish literature is presented, before arguing the desirability of applying such framework of analysis to the study of employment and care work in Spanish households, which are at present undergoing major transformations.

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Angiotensin-converting enzyme (EC3.4.15. I; ACE), isa membrane-bounddipeptidyl carboxypeptidase that mediates the cleavage of the C-terminal dipeptide His-Leu of the decapeptide angiotensin, generating the most powerful endogenous vaso-constricting angiotensin.
Some ACE inhibitors, such as Captopril, have been used as anti-hypertensive drugs. Moreover in recent years, large quantities of ACE inhibitors have been identijied and isolated from peptides derivedfrom food material such as casein, soy protein, jish protein and so on. Functional food with hypotensive effect has been developed on the basis of these works.
Typicalprocedures for screening hypotensive peptides offood origins are separationof products of peptic and tryptic digestion of proteins followed by inhibitory activitydetermination of each fraction. A method developed by Cushman has been the mostwidely used, in which ACE activity is determined by the amount of hippuric acid
generated as a product of enzymatic reaction of ACE with tripeptide of hippuryl-Lhistidyl-L-leucine. Hippuric acid is determined spectrophotometrically at 228 nm after its isolation from the reaction system by ethylacetate extraction, which not only requires alarge quantity of reagent but also results in large error.
An improved method based on Cushman ’s method is proposed in this paper. In this method, an enzymatic reaction system is based on Cushman’s method, while isolation and determination of hippuric acid is performed by medium perjormance gel chromatography on a Toyopearl HW-40s column. Due to the size exclusion nature of the column with somewhat hydrophobic properties, complete separation of four existing fractions in the reaction system is obtained within a smallfraction of the time necessary in Cushman’s method, with ideal reproducibility.

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Solving microkinetics of catalytic systems, which bridges microscopic processes and macroscopic reaction rates, is currently vital for understanding catalysis in silico. However, traditional microkinetic solvers possess several drawbacks that make the process slow and unreliable for complicated catalytic systems. In this paper, a new approach, the so-called reversibility iteration method (RIM), is developed to solve microkinetics for catalytic systems. Using the chemical potential notation we previously proposed to simplify the kinetic framework, the catalytic systems can be analytically illustrated to be logically equivalent to the electric circuit, and the reaction rate and coverage can be calculated by updating the values of reversibilities. Compared to the traditional modified Newton iteration method (NIM), our method is not sensitive to the initial guess of the solution and typically requires fewer iteration steps. Moreover, the method does not require arbitrary-precision arithmetic and has a higher probability of successfully solving the system. These features make it ∼1000 times faster than the modified Newton iteration method for the systems we tested. Moreover, the derived concept and the mathematical framework presented in this work may provide new insight into catalytic reaction networks.

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Analisar a associação estatística entre diagnósticos de enfermagem identifi cados nos pacientes transplantados renais e seus fatores sócio-econômicos. Estudo transversal realizado em um hospital universitário em Fortaleza-CE, no período compreendido entre dezembro de 2004 a abril de 2005. Foram identifi cados 38 diagnósticos de enfermagem. Dez diagnósticos apresentaram freqüências acima do percentil 75: Risco de infecção; percepção sensorial perturbada: visual; Padrão de sono perturbado; Nutrição desequilibrada: mais do que as necessidades corporais; Fadiga; Disfunção sexual; Percepção sensorial perturbada: audição; Dor aguda; Padrões de sexualidade inefi cazes; Risco de nutrição desequilibrada: mais do que as necessidades. O estudo sobre diagnósticos de enfermagem ajudou a expandir o conhecimento da realidade dos pacientes, o que é necessário para o estabelecimento de cuidados de enfermagem ao transplante renal, bem como para abordar os resultados que vierem a ser desenvolvidas com o objetivo de melhorar a qualidade de vida

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We intended to evaluate the influence of sex mismatch between donor and recipient, which is still under much debate, on survival and comorbidities after cardiac transplantation. From November 2003 to December 2013, a total of 258 patients were transplanted in our center. From these, 200 receptors were male (77.5%) and constituted our study population, further divided into those who received the heart from a female donor (Group A) - 44 patients (22%) and those who received it from a male donor (Group B) - 156 (78%). Median follow-up was 4.2 ± 3.0 years (1-10 years). The two groups were quite comparable with each other, except for body mass index, systolic pulmonary artery pressure, and transpulmonary gradient, which were significantly lower in Group A. A low donor/recipient weigh ratio (<0.8) was avoided whenever possible. Hospital mortality was not different in the two groups. During follow-up, global survival was similar, as was survival free from acute cellular rejection and cardiac allograft vasculopathy. However, patients in Group A had decreased survival free from serious infections and malignant tumors. Allocation of female donors to male receptors can be done safely, at least in receptors without pulmonary hypertension and when an adequate donor/recipient weigh ratio is ensured.

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BACKGROUND: Patients older than 65 years have traditionally not been considered candidates for heart transplantation. However, recent studies have shown similar survival. We evaluated immediate and medium-term results in patients older than 65 years compared with younger patients. METHODS: From November 2003 to December 2013, 258 patients underwent transplantation. Children and patients with other organ transplantations were excluded from this study. Recipients were divided into two groups: 45 patients (18%) aged 65 years and older (Group A) and 203 patients (81%) younger than 65 years (Group B). RESULTS: Patients differed in age (67.0 ± 2.2 vs. 51.5 ± 9.7 years), but gender (male 77.8 vs. 77.3%; p = 0.949) was similar. Patients in Group A had more cardiovascular risk factors and ischemic cardiomyopathy (60 vs. 33.5%; p < 0.001). Donors to Group A were older (38.5 ± 11.3 vs. 34.0 ± 11.0 years; p = 0.014). Hospital mortality was 0 vs. 5.9% (p = 0.095) and 1- and 5-year survival were 88.8 ± 4.7 versus 86.8 ± 2.4% and 81.5 ± 5.9 versus 77.2 ± 3.2%, respectively. Mean follow-up was 3.8 ± 2.7 versus 4.5 ± 3.1 years. Incidence of cellular/humoral rejection was similar, but incidence of cardiac allograft vasculopathy was higher (15.6 vs. 7.4%; p = 0.081). Incidence of diabetes de novo was similar (p = 0.632), but older patients had more serious infections in the 1st year (p = 0.018). CONCLUSION: Heart transplantation in selected older patients can be performed with survival similar to younger patients, hence should not be restricted arbitrarily. Incidence of infections, graft vascular disease, and malignancies can be reduced with a more personalized approach to immunosuppression. Allocation of donors to these patients does not appear to reduce the possibility of transplanting younger patients.

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BACKGROUND: Reconstruction of the distal femur after resection for malignant bone tumors in skeletally immature children is challenging. The use of megaprostheses has become increasingly popular in this patient group since the introduction of custom-made, expandable devices that do not require surgery for lengthening, such as the Repiphysis(®) Limb Salvage System. Early reports on the device were positive but more recently, a high complication rate and associated bone loss have been reported. QUESTIONS/PURPOSES: We asked: (1) what are the clinical outcomes using the Musculoskeletal Tumor Society (MSTS) scoring system after 5-year minimum followup in patients treated with this prosthesis at one center; (2) what are the problems and complications associated with the lengthening procedures of this implant; and (3) what are the specific concerns associated with revision of this implant? METHODS: At our institute, between 2002 and 2007, the Repiphysis(®) expandable prosthesis was implanted in 15 children (mean age, 8 years; range, 6-11 years) after distal femoral resection for malignant bone tumors. During this time, the general indication for use of this implant was resection of the distal femur for localized malignant bone tumors in pediatric patients. Alternative techniques used for this indication were modular prosthetic reconstruction, massive (osteoarticular or intercalary) allograft reconstruction, or rotationplasty. Age and tumor extension were the main factors to decide on the surgical indication. Of the 15 patients who had this prosthesis implanted during reconstruction surgery, five died with the implant in situ or underwent amputation before 5 years followup and the remaining 10 were evaluated at a minimum of 5 years (mean, 104 months; range, 78-140 months). No patients were lost to followup. These 10 patients were long-term survivors and underwent the lengthening program. They were included in our study analysis. The first seven lengthening procedures were attempted in an outpatient setting; however, owing to pain and burning sensations experienced by the patients, the procedures failed to achieve the desired lengthening. Therefore, other procedures were performed with the patients under general anesthesia. We reviewed clinical data at index surgery for all 15 patients. We further analyzed the lengthening procedures, implant survival, radiographic and functional results, for the 10 long-term survivors. Functional results were assessed according to the MSTS scoring system. Complications were classified according to the International Society of Limb Salvage (ISOLS) classification system. RESULTS: Nine of the 10 survivors underwent revision of the implant for mechanical failure. They had a mean MSTS score of 64% (range, 47%-87%) before revision surgery. At final followup the 10 long-term surviving patients had an average MSTS score of 81% (range, 53%-97%). In total, we obtained an average lengthening of 39 mm per patient (range, 17-67 mm). Exact expansion of the implant was unpredictable and difficult to control. Nine of 10 of the long-term surviving patients underwent revision surgery of the prosthesis-eight for implant breakage and one for stem loosening. At revision surgery, six patients had another type of expandable prosthesis implanted and three had an adult-type megaprosthesis implanted. In five cases, segmental bone grafts were used during revision surgery to compensate for loss of bone stock. CONCLUSIONS: We could not comfortably expand the Repiphysis(®) prosthesis in an outpatient setting because of pain experienced by the patients during the lengthening procedures. Furthermore, use of the prosthesis was associated with frequent failures related to implant breakage and stem loosening. Revisions of these procedures were complex and difficult. We no longer use this prosthesis and caution others against the use of this particular prosthesis design. LEVEL OF EVIDENCE: Level IV, therapeutic study.

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Cette recherche présente les résultats d'une étude portant sur les éléments de la performance à l'exportation de vingt-trois entreprises tunisiennes de confection, appréhendées par le niveau et la croissance de leurs ventes à l'exportation. Ce travail part de l'hypothèse que cette performance dépend d'une série de facteurs dont certains sont internes à la firme et d'autres appartiennent à son environnement externe. Un modèle, reliant plus de 74 variables indépendantes aux deux critères de la performance (le niveau des exportations et la croissance de celles-ci), a été élaboré. Il a permis de cerner l'influence de plusieurs variables inhérentes à la firme et à son preneur de décision sur les mesures de la performance. Il a pu également déceler l'impact d'un certain nombre de variables attitudinales et de perception sur la performance export. La collecte des données a eu lieu en Tunisie durant l'été 1990. Les résultats de l'étude montrent que des critères comme l'âge du preneur de décision, l'ancienneté de l'entreprise et l'expérience internationale de cette dernière affectent aussi bien le niveau que la croissance des exportations. La perception de l'activité d'exportation influe davantage sur la croissance que sur le niveau des exportations. Le choix de la stratégie marketing à l'export affecte considérablement le succès de celle-ci à l'échelle internationale. Les données recueillies traduisent également des divergences de profils entre les exportateurs performants et les exportateurs non-performants. La recherche autorise, par ailleurs, une meilleure compréhension des spécificités de la branche de la confection tunisienne. En dépit des difficultés rencontrées, la confection de cette thèse fut, pour nous, un travail passionnant. Nous invitons le lecteur, à venir partager notre intérêt et espérons pouvoir lui transmettre notre enthousiasme.

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