A bronchiolitis obliterans szindróma pathomechanizmusa = Pathomechanism of bronchiolitis obliterans syndrome

Tüdőtranszplantált betegek légúti infekciója során a kilégzett nitrogén monoxid (NO) szint megemelkedik. A teszt specificitása magas, szenzitivitása alacsony. A bronchiolitis obliterans szindrómában (BOS) szenvedő transzplantált betegekben az NO szint emelkedik, de csak előrehaladott stádiumban. A kilégzett szén-monoxid (CO) szintek és a transzplantáltakban előforduló pulmonális szövődmények (rejekció, infekció, BOS) között összefüggést nem találtunk. Protein microarray technikát használva a BOS-ban szenvedő betegek kondenzátumának citokin mintázata eltér a BOS-mentes betegekéhez viszonyítva. Stabil tüdőtranszplantált betegek kilégzett levegő kondenzátumának pH-ja és ennek variabilitása megegyezik az egészséges nem-transzplantált emberekével. A renin-angiotenzin rendszer (RAS) gátlása ACE-inhibitorokkal és az endothelin rendszer gátlása receptor antagonistákkal hasonló mértékben csökkentik az obliteratív légúti betegség kialakulását az experimentalis BO-ban patkányokban. A két farmakon együttes adása során az obliteratív folyamat még jobban visszaszorul. A kedvező hatásokat a transforming growth factor (TGF)-beta1 és platelet-derived growth factor (PDGF)-A és -B növekedési faktorok alacsonyabb mRNS expressziója kíséri. A donor és a recipiens neme vagy az ischaemiás idő nem befolyásolta az obliteratív légúti betegség kialakulását ebben az állatmodellben. | Pulmonary infections increase exhaled nitric oxide (NO) in lung transplant recipients. The test has high specificity and low sensitivity. With regard to bronchiolitis obliterans syndrome (BOS), we demonstrated increased NO levels; however, only in the advanced status. Exhaled carbon-monoxide (CO) levels were not associated with pulmonary complications (infection, rejection and BOS) in lung transplant recipients. Using the protein microarray method BOS patients have distinct exhaled breath condensate (EBC) cytokine pattern compared to BOS-free recipients. EBC pH and its variability are similar in stable lung transplant recipients compared to healthy non-transplant subjects. Inhibition of the renin-angiotensin system (RAS) with angiotensin-converting enzyme (ACE) inhibitors prevents the development of experimental BO to a similar extent as the blockade of endothelin system with receptor antagonists in rats. Interruption of both pathways provides superior graft protection. Beneficial effects of these drugs are associated with decreased intragraft transforming growth factor (TGF)-beta1 and platelet-derived growth factor (PDGF)-A and -B mRNA expressions. Donor or recipient gender and the ischemic time did not influence the development of obliterate airways disease in this animal model

Everything Matters in Programmable Packet Scheduling

Programmable packet scheduling allows the deployment of scheduling algorithms into existing switches without need for hardware redesign. Scheduling algorithms are programmed by tagging packets with ranks, indicating their desired priority. Programmable schedulers then execute these algorithms by serving packets in the order described in their ranks. The ideal programmable scheduler is a Push-In First-Out (PIFO) queue, which achieves perfect packet sorting by pushing packets into arbitrary positions in the queue, while only draining packets from the head. Unfortunately, implementing PIFO queues in hardware is challenging due to the need to arbitrarily sort packets at line rate based on their ranks. In the last years, various techniques have been proposed, approximating PIFO behaviors using the available resources of existing data planes. While promising, approaches to date only approximate one of the characteristic behaviors of PIFO queues (i.e., its scheduling behavior, or its admission control). We propose PACKS, the first programmable scheduler that fully approximates PIFO queues on all their behaviors. PACKS does so by smartly using a set of strict-priority queues. It uses packet-rank information and queue-occupancy levels at enqueue to decide: whether to admit packets to the scheduler, and how to map admitted packets to the different queues. We fully implement PACKS in P4 and evaluate it on real workloads. We show that PACKS: better-approximates PIFO than state-of-the-art approaches and scales. We also show that PACKS runs at line rate on existing hardware (Intel Tofino).Comment: 12 pages, 12 figures (without references and appendices

Active Individual Nanoresonators Optimized for Lasing and Spasing Operation

Plasmonic nanoresonators consisting of a gold nanorod and a spherical silica core and gold shell, both coated with a gain layer, were optimized to maximize the stimulated emission in the near‐field (NF‐c‐type) and the outcoupling into the far‐field (FF‐c‐type) and to enter into the spasing operation region (NF‐c*‐type). It was shown that in the case of a moderate dye concentra-tion, the nanorod has more advantages: smaller lasing threshold and larger slope efficiency and larger achieved intensities in the near‐field in addition to FF‐c‐type systems’ smaller gain and out-flow threshold, earlier dip‐to‐peak switching in the spectrum and slightly larger far‐field outcou-pling efficiency. However, the near‐field (far‐field) bandwidth is smaller for NF‐c‐type (FF‐c‐type) core–shell nanoresonators. In the case of a larger dye concentration (NF‐c*‐type), although the slope efficiency and near‐field intensity remain larger for the nanorod, the core–shell nanoresonator is more advantageous, considering the smaller lasing, outflow, absorption and extinction cross‐section thresholds and near‐field bandwidth as well as the significantly larger internal and external quantum efficiencies. It was also shown that the strong‐coupling of time‐competing plasmonic modes accompanies the transition from lasing to spasing occurring, when the extinction cross‐section crosses zero. As a result of the most efficient enhancement in the forward direction, the most uni-form far‐field distribution was achieved. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

A gastrointestinalis traktusból migrált, lenyelt idegen testek esetei = Cases of migration of swallowed foreign bodies from the gastrointestinal tract

Absztrakt: A lenyelt idegen test gastrointestinalis traktusból való kilépése és migrációja az idegentest-nyelések számához képest ritka jelenség. Bemutatott két esetünkben a súlyos szeptikus állapot sürgős sebészeti beavatkozást igényelt. Az egyik esetben a máj állományába és a retroperitoneumba, a másik esetben a máj bal lebenyén keresztül a pericardiumba hatoltak a hónapokkal korábban lenyelt drótdarabok. Első esetünknél a retroperitoneumban, majd a femoralis régióban, a második esetnél a máj és pericardium területén észleltünk a feltárás során suppurativ szövődményt. Az extrakció után első esetünkben ismételt műtétre kényszerültünk a retroperitonealis phlegmonének a femoralis régióra terjedése miatt. A tályogrendszerek kiürítése után mindkét esetben gyógyulást sikerült elérnünk. Az esetek diagnosztikus problémái tanulságosak a mindennapi gyakorlat számára. Orv Hetil. 2019; 160(42): 1677–1681. | Abstract: Migration of swallowed foreign bodies from the gastrointestinal tract is a rare phenomenon compared with the total number of ingestions. In the reported two cases, the serious septic condition indicated urgent surgical intervention. We found a piece of wire swallowed a few months earlier in the right lobe of the liver and the retroperitoneum in case one, and a piece of wire in the pericardium, which migrated from the stomach through the left lobe of the liver, in case two. Abscesses and phlegmonae were found in the retroperitoneum and then in the femoral region requiring a reoperation in case one, and in the liver and pericardium in case two. After the evacuation of abscesses, both patients made full recovery. Diagnostic difficulties and therapeutic challenges served the reasons to present these cases. Orv Hetil. 2019; 160(42): 1677–1681

Az emlőrák patológiai diagnosztikája, feldolgozása és kórszövettani leletezése. Szakmai útmutatás a III. Emlőrák Konszenzus Konferencia alapján

There have been relevant changes in the diagnosis and treatment of breast cancer to implement the updating of the 2010 recommendations made during the 2nd national consensus conference on the disease. Following a wide interdisciplinary consultation, the present recommendations have been finalized after their public discussion at the 3rd Hungarian Consensus Conference on Breast Cancer. The recommendations cover non-operative and intraoperative diagnostics, the work-up of operative specimens, the determination of prognostic and predictive markers and the content of the cytology and histology reports. Furthermore, it touches some special issues such as the current status of multigene molecular markers, the role of pathologists in clinical trials and prerequisites for their involvement, some relevant points about the future