261 research outputs found

    Soil quality in a pecan agroforestry system is improved with intercropped kura clover

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    Paper presented at the 11th North American Agroforesty Conference, which was held May 31-June 3, 2009 in Columbia, Missouri.In Gold, M.A. and M.M. Hall, eds. Agroforestry Comes of Age: Putting Science into Practice. Proceedings, 11th North American Agroforestry Conference, Columbia, Mo., May 31-June 3, 2009.Intercropping alleys of agroforestry systems provides an income source until the tree crop produces harvestable yields. However, cultivation of annual crops soil organic matter and increases soil erosion, especially on sloping landscapes. Perennial crops maintain a continuous soil cover, maximize water infiltration, minimize soil erosion, and improve overall soil quality. The objective of this on-farm study was to assess the effects of a perennial legume, kura clover (Trifolium ambiguum), on various soil quality parameters in a recently established pecan (Carya illinoinensis) orchard. The pecan-kura clover agroforestry system was established on deep loess soils of the Missouri River hills. These silt loams are on 3 to 10 [percent] slopes and can be highly erosive. Kura clover, intercropped eight years after pecan planting, was selected based on its perennial growth habit, nitrogen-fixing ability, winter hardiness, high forage quality, and soil conservation properties. Kura clover was seeded in 2002 and harvested for hay annually beginning 2003. During this period soil organic matter and activities of selected soil enzymes have steadily increased compared with cultivated and grass pasture control soils. Water-stable aggregation improved by 50 [percent]. Results illustrate that kura clover as the interplanted component improved soil fertility and biological activity through increased organic matter and improved soil structure, and yielded high quality forage valuable for the cattle-feeding operation. Pecan trees thrive in this system partly because soil quality is maintained or improved and, unlike other "living mulch" systems in which cover crops may suppress the main crop, kura clover does not compete with tree growth.Robert J. Kremer (1) and Robert Kussman (2) ; 1. USDA, Agricultural Research Service, Cropping Systems & Water Quality Research Unit, 302 Natural Resources Bldg., University of Missouri, Columbia, MO 65211. 2. Kussman Pecan & Cattle Farm, Dalton, MO 65246.Includes bibliographical references

    Secondary recurrent multiple EGIST of the mesentary: A case report and review of the literature

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    AbstractINTRODUCTIONGastrointestinal stromal tumors (GISTs) are rare intra-abdominal tumors arising from mesenchymal stromal cells. EGISTs are mesenchymal tumors that originate outside the GI tract and tend to have similar characteristics to GISTs. To the best of our knowledge, few cases of long standing recurrent EGIST have been reported.PRESENTATION OF CASEWe present the case of a rare recurrent EGIST in the mesentery of a 39 year old female patient. The tumor was symptomatic at the time of complaint and measured 8.4cm×7.7cm×7.6cm. Histological analysis revealed a spindled pattern with fusiform cells arranged in long fascicles and little atypia. Immunochemistry showed positivity for CD117 and was negative for CD34, S-100, Desmin, and MSA. B-catenin was weakly positive. A Ki-67 staining shows approximately 5% positivity revealing a low proliferative rate. The patient was doing well postoperatively and was discharged on 400mg imanitib regimen.DISCUSSIONWhile GISTs are the most common tumors of the GI tract, recurrent EGISTs of the mesentery are extremely rare. Factors that indicate poor prognosis include tumor size greater than 5cm, mitotic rate greater than 1–5/10 HPF, presence of tumor necrosis or metastasis and most recently the c-kit mutation. Our patient had a very long time between recurrence of disease.CONCLUSIONThe current literature on EGISTs is limited. Our patient presents a very interesting case due to the time elapsed between disease recurrence and lack of metastasis or excessive growth

    Selected 2017 Highlights in Congenital Cardiac Anesthesia

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    This article is a review of the highlights of pertinent literature published during the 12 months of 2017, which is of interest to the congenital cardiac anesthesiologist. Following a search of the US National Library of Medicine PubMed database, several topics emerged where significant contributions were made in 2017, and that the authors of this manuscript felt were noteworthy to be summarized in this review: Training in pediatric cardiac anesthesia, the costs of congenital heart disease (CHD), catheter versus surgical intervention for CHD, cerebral oxygen saturation in CHD, and mechanical circulatory support in children

    Bronchial compression in an infant with isolated secundum atrial septal defect associated with severe pulmonary arterial hypertension

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    Symptomatic pulmonary arterial hypertension (PAH) in patients with isolated atrial septal defect (ASD) is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on the right side of heart and severe PAH (tricuspid regurgitation [TR] with a peak pressure gradient of 55 to 60 mmHg). The chest radiographs demonstrated severe collapse of both lung fields, and a computed tomography scan showed narrowing of the main bronchus because of an intrinsic cause, as well as a dilated pulmonary artery compressing the main bronchus on the left and the intermediate bronchus on the right. ASD patch closure was performed when the infant was 8 months old. After the repair of the ASD, echocardiography showed improvement of PAH (TR with a peak pressure gradient of 22 to 26 mmHg), and the patient has not developed recurrent respiratory infections while showing successful catch-up growth. In infants with symptomatic isolated ASD, especially in those with respiratory insufficiency associated with severe PAH, extrinsic airway compression should be considered. Correcting any congenital heart diseases in these patients may improve their symptoms

    Donor Killer Immunoglobulin Receptor Gene Content and Ligand Matching and Outcomes of Pediatric Patients with Juvenile Myelomonocytic Leukemia Following Unrelated Donor Transplantation

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    Natural killer (NK) cell determinants predict relapse-free survival after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia, and previous studies have shown a beneficial graft-versus-leukemia effect in patients with juvenile myelomonocytic leukemia (JMML). However, whether NK cell determinants predict protection against relapse for JMML patients undergoing HCT is unknown. Therefore, we investigated NK cell-related donor and recipient immunogenetics as determinants of HCT outcomes in patients with JMML. Patients with JMML (age 0 to 3 (HR, 0.52; 95% CI, 0.29 to 0.95; P = .032), centromeric A/B score (HR, 0.57; 95% CI, 033 to 0.98; P = .041), and telomeric A/B score (HR, 0.58; 95% CI, 0.34 to 1.00; P = .048). To our knowledge, this is the first study analyzing the association of NK cell determinants and outcomes in JMML HCT recipients. This study identifies potential benefits of donor KIR-B genotypes in reducing aGVHD. Our findings warrant further study of the role of NK cells in enhancing the graft-versus-leukemia effect via recognition of JMML blasts

    Airway obstruction by extrinsic tracheal compression during spinal surgery under prone position -A case report-

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    Tracheal compression by vascular anomalies in adults is uncommon and most related reports are of children. A 79-year-old woman without any respiratory history underwent a lumbar spine surgery under general anesthesia. She suddenly developed airway obstruction after a position change from supine to prone. A fiberoptic bronchoscopy showed the obstruction of endotracheal tube. The obstruction was relieved after we changed the depth of endotracheal tube and supported the patient's neck with a cotton roll. The surgery ended without any other event and the patient recovered safely. A computed tomography revealed the rightward tracheal deviation and tortuous innominate artery contact with trachea. The patient didn't manifest any respiratory related symptoms during postoperative period, and she was discharged without any treatment

    Multidetector row CT for imaging the paediatric tracheobronchial tree

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    The introduction of multidetector row computed tomography (MDCT) scanners has altered the approach to imaging the paediatric thorax. In an environment where the rapid acquisition of CT data allows general hospitals to image children instead of referring them to specialist paediatric centres, it is vital that general radiologists have access to protocols appropriate for paediatric applications. Thus a dramatic reduction in the delivered radiation dose is ensured with optimal contrast bolus delivery and timing, and inappropriate repetition of the scans is avoided. This article focuses on the main principles of volumetric CT imaging that apply generically to all MDCT scanners. We describe the reconstruction techniques for imaging the paediatric thorax and the low-dose protocols used in our institution on a 16-slice detector CT scanner. Examples of the commonest clinical applications are also given

    The Impact of Contact Isolation on the Quality of Inpatient Hospital Care

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    Background: Contact Isolation is a common hospital infection prevention method that may improve infectious outcomes but may also hinder healthcare delivery. Methods: To evaluate the impact of Contact Isolation on compliance with individual and composite process of care quality measures, we formed four retrospective diagnosis-based cohorts from a 662-bed tertiary-care medical center. Each cohor
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