Pressure measurements in a low-density nozzle plume for code verification

Measurements of Pitot pressure were made in the exit plane and plume of a low-density, nitrogen nozzle flow. Two numerical computer codes were used to analyze the flow, including one based on continuum theory using the explicit MacCormack method, and the other on kinetic theory using the method of direct-simulation Monte Carlo (DSMC). The continuum analysis was carried to the nozzle exit plane and the results were compared to the measurements. The DSMC analysis was extended into the plume of the nozzle flow and the results were compared with measurements at the exit plane and axial stations 12, 24 and 36 mm into the near-field plume. Two experimental apparatus were used that differed in design and gave slightly different profiles of pressure measurements. The DSMC method compared well with the measurements from each apparatus at all axial stations and provided a more accurate prediction of the flow than the continuum method, verifying the validity of DSMC for such calculations

New England Medical Center Posterior Circulation Stroke Registry: I. Methods, Data Base, Distribution of Brain Lesions, Stroke Mechanisms, and Outcomes

Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs. Embolism was the commonest stroke mechanism accounting for 40% of cases (24% cardiac origin, 14% arterial origin, 2% had potential cardiac and arterial sources). In 32%, large artery occlusive lesions caused hemodynamic brain infarction. Stroke mechanisms in the posterior and anterior circulation are very similar. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes), while the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Infarcts that included the distal territory were twice as common as those that included the proximal or middle territories. Most distal territory infarcts were attributable to embolism. Thirty day mortality was low (3.6%). Embolic stroke mechanism, distal territory location, and basilar artery occlusive disease conveyed the worst prognosis

Anticoagulant-Related Intracerebral Hemorrhage

Twenty-Four Patients Had Intracerebral Hemorrhage While They Were Being Treated with Anticoagulants. Hypertension Was Present in 67% of the Cases, Head Trauma Was an Uncommon Preceding Event, and Simultaneous Bleeding in Other Organs Occurred in Only One Instance. Neurologic Abnormalities Progressed for Several Hours in 58%. Seizures Occurred at Onset in 12.5%. the Location of the Hemorrhage Was as Follows: Cerebellum (Nine Cases), Lobar White Matter (Six), Basal Ganglia (Five), Thalamus (Two), and Hemisphere, Unspecified (Two). in 61%, the Hemorrhages Occurred within 6 Months of Therapy. in 75%, the Prothrombin Time Was Beyond 1½ Times the Control Value. Mortality Was 62.5%. Survivors Had Smaller Hematomas Than Did Patients with Fatal Hemorrhage. © 1985 American Academy of Neurology

Selection-free genome editing of the sickle mutation in human adult hematopoietic stem/progenitor cells.

Genetic diseases of blood cells are prime candidates for treatment through ex vivo gene editing of CD34+ hematopoietic stem/progenitor cells (HSPCs), and a variety of technologies have been proposed to treat these disorders. Sickle cell disease (SCD) is a recessive genetic disorder caused by a single-nucleotide polymorphism in the β-globin gene (HBB). Sickle hemoglobin damages erythrocytes, causing vasoocclusion, severe pain, progressive organ damage, and premature death. We optimize design and delivery parameters of a ribonucleoprotein (RNP) complex comprising Cas9 protein and unmodified single guide RNA, together with a single-stranded DNA oligonucleotide donor (ssODN), to enable efficient replacement of the SCD mutation in human HSPCs. Corrected HSPCs from SCD patients produced less sickle hemoglobin RNA and protein and correspondingly increased wild-type hemoglobin when differentiated into erythroblasts. When engrafted into immunocompromised mice, ex vivo treated human HSPCs maintain SCD gene edits throughout 16 weeks at a level likely to have clinical benefit. These results demonstrate that an accessible approach combining Cas9 RNP with an ssODN can mediate efficient HSPC genome editing, enables investigator-led exploration of gene editing reagents in primary hematopoietic stem cells, and suggests a path toward the development of new gene editing treatments for SCD and other hematopoietic diseases

New England Medical Center Posterior Circulation registry.

Among 407 New England Medical Center Posterior Circulation registry patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs then strokes, and 16% had only TIAs. Embolism was the commonest stroke mechanism (40% of patients including 24% cardiac origin, 14% intraarterial, 2% cardiac and arterial sources). In 32% large artery occlusive lesions caused hemodynamic brain ischemia. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes); the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Severe occlusive lesions (\u3e50% stenosis) involved more than one large artery in 148 patients; 134 had one artery site involved unilaterally or bilaterally. The commonest occlusive sites were: extracranial vertebral artery (52 patients, 15 bilateral) intracranial vertebral artery (40 patients, 12 bilateral), basilar artery (46 patients). Intraarterial embolism was the commonest mechanism of brain infarction in patients with vertebral artery occlusive disease. Thirty-day mortality was 3.6%. Embolic mechanism, distal territory location, and basilar artery occlusive disease carried the poorest prognosis. The best outcome was in patients who had multiple arterial occlusive sites; they had position-sensitive TIAs during months to years