RESUMO
1. The objectives of this study were to use principal component analysis (PCA) to analyse the variability of the three instrumental and 14 descriptive sensory properties of chicken breast meat. The meat was cooked until the internal temperature reached 85°C and further cooked for 0, 20, and 40 min. The second objective was to identify the most critical variables for assessing meat juiciness.2. Cooking loss and moisture content exhibited high correlation with sensorial moisture release and mouth feel.3. The distribution of objects on the axes of the first two principal components (PCs) enabled the identification of three groups undergoing different cooking durations. The four major PCs explained 80.0% of the total variability.4. Cooking loss, moisture content, water-holding capacity, sensorial moisture release and mouth feel were demonstrated as the most effective variables for the first two PCs. PCA with instrumental and sensory analyses proved an effective procedure for systematically and comprehensively judging chicken meat juiciness.
Assuntos
Galinhas , Culinária , Animais , Culinária/métodos , Carne/análise , Análise de Componente Principal , TemperaturaRESUMO
This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM). A total of 647 T2DM were included. Among them, 20.9% patients were IA positive, who were elder and had a longer duration, lower BMI, a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test. More patients were treated with insulin in IA positive group than in IA negative group (65.9% vs 41.0%, P=0.000). Fasting serum insulin level was associated with occurrence of IA in all patients (OR=1.02, P=0.001) and insulin treated patients (OR=1.033, P=0.002). The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1%, specificity 89.0%). Exogenous insulin use is associated with the presence of IA. Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.
Assuntos
Autoanticorpos/sangue , Diabetes Mellitus Tipo 2/imunologia , Glutamato Descarboxilase/imunologia , Diabetes Mellitus Tipo 1/imunologia , Humanos , Insulina/sangue , Fatores de TempoRESUMO
The efficacy of an "allergen-gene immunization" protocol in altering allergic response was examined. Intramuscular injection of rats with a plasmid DNA encoding a house dust mite allergen into the muscle results in its long-term expression and the induction of specific immune responses. Significantly, this approach prevents the induction of immunoglobulin E synthesis, histamine release in bronchoalveolar fluids, and airway hyperresponsiveness in rats challenged with aerosolized allergen. Furthermore, this suppression is persistent and can be transferred into naive rats by CD8+ T cells from gene-immunized rats. These findings suggest that allergen-gene immunization is effective in modulating allergic responses, and may provide a novel therapeutic approach for allergic diseases.
Assuntos
DNA Recombinante/uso terapêutico , Glicoproteínas/uso terapêutico , Imunoglobulina E/biossíntese , Hipersensibilidade Respiratória/prevenção & controle , Vacinação , Animais , Antígenos de Dermatophagoides , Líquido da Lavagem Broncoalveolar , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/transplante , Glicoproteínas/genética , Glicoproteínas/imunologia , Histamina/metabolismo , Imuno-Histoquímica , Masculino , Ratos , Hipersensibilidade Respiratória/imunologiaRESUMO
BACKGROUND: It is unknown whether neural drive is comparable in constant rate and incremental exercise tests. Few data have previously been available to address this question because of the lack of reliable methods to assess neural respiratory drive in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: The aims of this study are to determine whether neural respiratory drive during constant rate exercise differs from that during incremental exercise and to determine whether neural respiratory drive was maximal at the end of exhaustive exercise tests. METHODS: We studied sixteen patients with moderate-severe COPD (mean ± SD FEV(1) 29 ± 10%). Both diaphragmatic electro-myogram (EMG) and transdiaphragmatic pressure were recorded with a combined multipair electrode balloon catheter during incremental and constant (80% of maximal oxygen consumption derived from a prior incremental exercise test) treadmill exercise. Minute ventilation and oxygen uptake were also measured. RESULTS: Root mean square (RMS) of the diaphragmatic EMG increased gradually without a plateau during incremental exercise, whereas the RMS increased initially and reached a plateau during constant work rate exercise. The RMS of the diaphragmatic EMG at the end of exercise was similar for both incremental and constant work rate exercise (176 ± 42 µV vs. 184 ± 39 µV); these values were 70 and 73% of maximal values recorded over the study. CONCLUSIONS: The pattern of increase in neural respiratory drive during incremental exercise is different to that observed during constant work rate exercise, but both exercise protocols are terminated when the patients achieve a similar but submaximal drive.
Assuntos
Diafragma/fisiopatologia , Teste de Esforço , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Respiração , Eletromiografia , Feminino , Capacidade Residual Funcional , Humanos , Inalação , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Capacidade Pulmonar TotalRESUMO
Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional (3D) deformity, and the plane of maximum curvature (PMC) is proposed to reflect these clinical features, which refers to a vertical plane presenting the maximum projected spinal curvature and its parameters include the PMC Cobb and orientation (angle between PMC and sagittal planes). This study aimed to develop a computational method (CM) for PMC estimation. Twenty-nine patients with AIS and computed tomography (CT) images were recruited. For CT, PMC was determined by rotating a vertical plane about its vertical axis with 5° increment until the maximum Cobb angle was measured. For CM, PMC was estimated via identifying the eight points (the corner points of the superior and inferior endplates of the upper and lower end-vertebrae respectively) in the coronal and lateral CT images. Two experienced raters repeated the PMC estimation three times with one-week interval. The intra-class correlation coefficient (ICC) and Bland-Altman method were used for statistical analysis. Twenty-seven right thoracic curves (RTs) (mean Cobb: 46.1°±12.4°) and 23 left thoracolumbar/lumbar (LTLs/LLs) (mean Cobb: 30.6°±11.1°) were analysed. The intra- and inter-rater ICC values were >0.91 and 0.84 in RTs and LTLs/LLs, respectively. The PMCs obtained from the CM and CT were showed good agreement was also observed between the PMCs obtained from the two methods according to ICC (>0.90) and Bland-Altman method assessments. This purpose-design computational method could provide reliable and valid estimation of PMCs for AIS, which has potential to be used as an alternative for 3D assessment.
Assuntos
Escoliose , Adolescente , Previsões , Humanos , Escoliose/diagnóstico por imagem , Coluna Vertebral , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Recently, numerous studies have yielded inconsistent results regarding the effect of metformin on esophageal cancer risk in type 2 diabetes mellitus patients. The purpose of this study is to systematically assess this effect using meta-analysis. METHODS: We searched clinical studies on metformin and esophageal cancer risk in PubMed, Embase, and the Cochrane Library. After literature screening, a series of meta-analyses were conducted using RevMan 5.3 software. The pooled hazard ratio (HR) and the corresponding 95% confidence interval (CI) were used as the effect size. RESULTS: Five eligible studies (four cohort studies and one case-control study) were included for our meta-analysis using a random-effect model. The analysis showed that metformin could not reduce esophageal cancer risk in type 2 diabetes mellitus patients (HR 0.88, 95% CI 0.60-1.28, P > 0.05). Subgroup analyses by geographic location showed that metformin significantly reduced esophageal cancer risk in Asian patients with type 2 diabetes mellitus (HR 0.59, 95% CI 0.39-0.91, P = 0.02), without heterogeneity between studies (P = 0.80 and I2 = 0%). CONCLUSIONS: Overall, our systematic review and meta-analysis demonstrate that metformin does not reduce esophageal cancer risk in type 2 diabetes mellitus patients. However, a significant reduction in esophageal cancer risk in Asian populations remains to be clarified.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Neoplasias Esofágicas/prevenção & controle , Hipoglicemiantes/farmacologia , Metformina/farmacologia , Povo Asiático , Estudos de Casos e Controles , Intervalos de Confiança , Diabetes Mellitus Tipo 2/etnologia , Neoplasias Esofágicas/etnologia , Humanos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Viés de Publicação , Estudos Retrospectivos , RiscoRESUMO
Objective: To analyze the effect of intervention programs and influencing factors regarding the community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL). Methods: A total of 12 community health service centers from Shanxi province, Jiangsu province, and Ningxia Hui autonomous region were selected as intervention group and control group, by stratified cluster sampling method. "5+1" model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up. Data was collected through a questionnaire on demographic and disease-related information, while the QOL was measured with SF-36. Multiple linear regression and conducted by SAS 9.4. Results: A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service. After intervention programs being implemented, the net effect of PCS score between the intervention and the control groups was 13.6, with the net effect of MCS score as 29.8. Results from the multiple linear regression showed that the main factors affecting PCS scores included age, type of medical insurance, baseline PCS score and regions of residency. Main factors related to MCS score included age, type of medical insurance, baseline MCS score, hypertension, and region of residency. Conclusion: Community "5+1" staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
Assuntos
Serviços de Saúde Comunitária/organização & administração , Diabetes Mellitus Tipo 2/terapia , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Diabetes Mellitus Tipo 2/psicologia , Humanos , Hipertensão , Autocuidado , Autogestão , Inquéritos e QuestionáriosRESUMO
This study evaluated the efficacy of slightly acidic electrolyzed water (SAEW) for the inactivation of Salmonella Enteritidis and Escherichia coli on shelled eggs as well as studied the shelf life and internal quality attributes (i.e., weight loss, Haugh unit, yolk index, albumen pH, and yolk pH) of eggs during storage at 25°C. The decontamination test egg samples (freshly laid) were inoculated and immersed for 1, 2, 3, and 4 min in each treatment (i.e., SAEW, acidic electrolyzed water, NaClO solution, and sterile deionized water) at available chlorine concentrations (ACCs) of 10, 18 and 26 mg/L. The storage test eggs (freshly laid) were immersed for 3 min in 4 treatments (i.e., SAEW, acidic electrolyzed water, NaClO solution, and no treatment) and stored for 30 D at 25°C. The effects of the SAEW on microbiological qualities and freshness parameters were investigated. Decontamination of eggs with SAEW showed an equivalent or higher bactericidal effect compared to other treatments. A complete inactivation of S. Enteritidis and E. coli on the surface of shelled egg samples resulted from treatment with SAEW at an ACC of 26 mg/L for 3 and 4 min, respectively. Almost all of the egg quality parameters investigated in the present study were significantly (P < 0.05) affected by the storage time. As storage time increased, the yolk index and Haugh unit value decreased, and weight loss, albumen pH, and yolk pH increased. However, SAEW treatment minimized weight loss (5.52%) and preserved the albumen and yolk quality better than no treatment at 25°C. Relative to acidic electrolyzed water and NaClO solution, the advantages of SAEW are reduced corrosion of egg surfaces and potentially less water and CO2 escaping from eggshell pores. The results highlight the promising use of SAEW to enhance the microbial safety and to extend the shelf life of shelled eggs. Future combined methods with SAEW and other treatments are also needed.
Assuntos
Desinfetantes/farmacologia , Ovos/microbiologia , Escherichia coli/efeitos dos fármacos , Óvulo/química , Salmonella enteritidis/efeitos dos fármacos , Água/farmacologia , Eletrólise , Concentração de Íons de Hidrogênio , Óvulo/efeitos dos fármacos , Água/químicaRESUMO
For a given neural drive, oesophageal pressure during apnoeic episodes may differ from that during airflow, since inspiratory airflow and increased lung volume both reduce pressure generation. It was, therefore, hypothesised that diaphragm electromyography (EMG) may provide additional data to oesophageal pressure when used for the assessment of neural drive in patients with obstructive sleep apnoea, whose breathing is associated with variable airflow and changes in lung volume. Neural respiratory drive was assessed using diaphragm EMG recorded from multipair oesophageal electrodes in 12 patients with obstructive sleep apnoea. Oesophageal pressure was also recorded. The mean+/-sd inspiratory oesophageal pressure swing was 11.0+/-3.7 cmH(2)O during wakefulness, 38.2+/-15.7 cmH(2)O at the end of the apnoea and reduced to 28.5+/-10.4 cmH(2)O at the beginning of arousal. The mean peak inspiratory diaphragm EMG signal was 21.8+/-6.5 muV during wakefulness, 38.6+/-14.0 muV at the end of the apnoea and further increased to 59.6+/-32.0 muV at the beginning of arousal. It was concluded that the pattern of neural drive assessed by oesophageal pressure differs from that measured by diaphragm electromyography during apnoeic events and, therefore, that diaphragm electromyography may be a useful adjunct to measurement of oesophageal pressure for the assessment of neural drive in patients with obstructive sleep apnoea.
Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Eletromiografia/métodos , Polissonografia/métodos , Síndromes da Apneia do Sono/fisiopatologia , Trabalho Respiratório/fisiologia , Adulto , Cimicifuga , Diafragma/fisiologia , Esôfago/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pressão , Sistema Respiratório/inervação , Sistema Respiratório/fisiopatologiaRESUMO
BACKGROUND: Peroxisome proliferator-activated receptor-gamma (PPARgamma) is expressed in atherosclerotic plaques and in endothelial cells. The possible effects of PPARgamma activators on endothelial activation and inflammatory response within the plaque are currently unknown. METHODS AND RESULTS: We tested the hypothesis that PPARgamma activators inhibit vascular cell adhesion molecule (VCAM-1) and intercellular adhesion molecule (ICAM-1) expression in cultured endothelial cells (evaluated by flow cytometry) and homing of monocyte/macrophages to atherosclerotic plaques in vivo. In endothelial cells, the PPARgamma agonists troglitazone at 100 micromol/L and 15-deoxy-(Delta12,14)-prostaglandin J(2) (15d-PGJ2) at 20 micromol/L markedly attenuated the tumor necrosis factor-induced expression of VCAM-1 and ICAM-1. A significant inhibition of VCAM-1 expression was also evident at 5 and 10 micromol/L 15d-PGJ2 and 20 micromol/L troglitazone. Expression of E-selectin and PECAM-1 was not altered. To confirm the biological relevance of these results, we assessed the effects of troglitazone on monocyte/macrophage homing to atherosclerotic plaques in apoE-deficient mice. A 7-day treatment with troglitazone (400 mg/kg) significantly reduced monocyte/macrophage homing to atherosclerotic plaques (236+/-77 versus 177+/-43 macrophages, P=0.03); an even more striking inhibition was found at 3200 mg/kg troglitazone (344+/-76 versus 172+/-83 macrophages, P=0.005). CONCLUSIONS: PPARgamma activators inhibit expression of VCAM-1 and ICAM-1 in activated endothelial cells and significantly reduce monocyte/macrophage homing to atherosclerotic plaques. These findings suggest that PPARgamma activators, currently used in treatment of type II diabetes, may have beneficial effects in modulating inflammatory response in atherosclerosis.
Assuntos
Arteriosclerose/tratamento farmacológico , Molécula 1 de Adesão Intercelular/fisiologia , Receptores Citoplasmáticos e Nucleares/efeitos dos fármacos , Tiazolidinedionas , Fatores de Transcrição/efeitos dos fármacos , Molécula 1 de Adesão de Célula Vascular/fisiologia , Vasculite/tratamento farmacológico , Animais , Movimento Celular/efeitos dos fármacos , Células Cultivadas , Cromanos/uso terapêutico , Endotélio Vascular/efeitos dos fármacos , Humanos , Molécula 1 de Adesão Intercelular/análise , Macrófagos/efeitos dos fármacos , Macrófagos/fisiologia , Camundongos , Monócitos/efeitos dos fármacos , Monócitos/fisiologia , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Tiazóis/uso terapêutico , Troglitazona , Molécula 1 de Adesão de Célula Vascular/análiseRESUMO
Asymmetric dimethylarginine (ADMA), a compound detectable in human plasma, is an endogenous inhibitor of NO synthase. Endothelial dysfunction is an early event in atherogenesis, and large-vessel atherosclerosis is a major cause of morbidity and mortality in patients with type 2 diabetes mellitus. Fifty patients with type 2 diabetes mellitus were studied at baseline and 5 hours after ingestion of a high-fat meal. Plasma ADMA measured by using high-performance liquid chromatography increased from 1.04+/-0.99 to 2.51+/-2.27 micromol/L (P:<0.0005). Brachial arterial vasodilation after reactive hyperemia, a NO-dependent function, measured by high-resolution ultrasound, decreased from 6.9+/-3.9% at baseline to 1.3+/-4.5% (P:<0.0001). These changes occurred in association with increased plasma levels of triglycerides and very low density lipoprotein triglycerides, with reduced low density lipoprotein cholesterol and high density lipoprotein cholesterol, and with no changes in total cholesterol. The increase in plasma ADMA in response to a high-fat meal was significantly and inversely related to the decrease in percent vasodilation. In 10 of the subjects studied with a similar protocol on another day, no significant changes in the brachial artery flow responses or in plasma ADMA were observed 5 hours after ingestion of a nonfat isocaloric meal. The data suggest that ADMA may contribute to abnormal blood flow responses and to atherogenesis in type 2 diabetics.
Assuntos
Arginina/análogos & derivados , Arginina/sangue , Diabetes Mellitus Tipo 2/sangue , Gorduras na Dieta/farmacologia , Endotélio Vascular/efeitos dos fármacos , Adulto , Idoso , Endotélio Vascular/fisiologia , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue , Vasodilatação/efeitos dos fármacosRESUMO
BACKGROUND: Currently, functional assessment to monitor therapeutic response in feline lower airway disease (FLAD) has limited application. OBJECTIVES: To evaluate if expiratory indices derived from pseudo-tidal breathing flow-volume loop (pTBFVL) representing lower airway obstruction would decrease after clinical improvement and to investigate the correlation between functional phenotype and inflammatory cell type in bronchoalveolar lavage (BAL) fluid. ANIMALS: Nineteen client-owned cats with FLAD. METHODS: Prospective observational study. Functional assessment with pTBFVL indices (eg, peak to mid-expiratory flow; PEF/EF50) and conventional barometric whole body plethysmography (BWBP) parameters (eg, enhanced pause) was carried out before receiving treatment. BAL was performed to analyze inflammatory cell types. Signs were assessed by scoring. The cats were treated with glucocorticoids daily and functional testing was repeated. RESULTS: Loop indices PEF/EF50 and PEF/EF25 were significantly decreased after treatment (P < .001). Conventional BWBP parameters were not significantly different before and after treatment. Cats with PEF/EF50 > 1.51 before treatment had a significantly higher granulocyte (eosinophil plus neutrophil) percentage in BAL fluid (P = .014). Granulocyte percentage in BAL fluid was strongly correlated with PEF/EF25 (P = .001, rs = 0.74) and moderately correlated with PEF/EF50 (P = .022, rs = 0.57), whereas eosinophil or neutrophil percentage alone had no significant correlation with functional parameters. CONCLUSIONS AND CLINICAL IMPORTANCE: Functional parameters including PEF/EF50 and PEF/EF25 can be used for monitoring therapeutic response. The presence of airflow limitation during mid- to late expiration is affected by the overall extent of granulocyte infiltration.
Assuntos
Líquido da Lavagem Broncoalveolar/citologia , Doenças do Gato/patologia , Inflamação/veterinária , Pneumopatias/veterinária , Androstadienos/uso terapêutico , Animais , Anti-Inflamatórios/uso terapêutico , Doenças do Gato/terapia , Gatos , Fluticasona , Inflamação/patologia , Pneumopatias/tratamento farmacológico , Pneumopatias/patologia , Prednisolona/uso terapêutico , Terapia RespiratóriaRESUMO
Because repeat sternotomies are becoming much more prevalent with repeat coronary bypass operations, prevention of direct adhesions of the heart and grafts to the back of the sternum by use of synthetic or xenograft material to close the pericardiotomy has become a matter for investigation. In this study bovine and equine glutaraldehyde-processed xenografts were implanted bilaterally in dogs for implant intervals of 6 weeks and 3, 6, 9, and 12 months. The bovine and equine xenografts both performed well in resisting the adhesion of the heart to their inner surfaces and less well in resisting adhesion of the lung and chest wall to their outer surfaces. The bovine xenograft had a higher percentage of adhesion-free surface on all the surfaces evaluated; however, one of our 12-month bovine pericardial xenograft implants exhibited significant multifocal calcific degeneration. Although pericardial xenografts generally have performed well when implanted in the dog, Gallo, Artiñano, and Duran recently expressed concern about their performance in humans. Along with our finding of calcification, their concern suggests a cautious approach to clinical application.
Assuntos
Cardiopatias/prevenção & controle , Pericárdio/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Esterno , Animais , Bioprótese , Bovinos , Cães , Seguimentos , Próteses Valvulares Cardíacas , Pericárdio/patologia , Fatores de Tempo , Aderências Teciduais/prevenção & controleRESUMO
Eighty patients with roentgenographic evidence of mediastinal abnormalities were examined with ultrasonography. Fifty-four lesions were malignant, and 26 lesions were benign. The histologic diagnoses were confirmed by ultrasonically guided fine needle aspiration/cutting needle (Tru-Cut) biopsy, surgical specimens, or transbronchial biopsy. There were no unique ultrasonographic features for diagnosis of specific tumors. Ultrasonically guided aspiration biopsies (UGAB) were performed in 44 of the malignant lesions and in 14 of the benign lesions (nine of the noncystic lesions and five of the cystic lesions). Cytologic diagnosis of malignancies was obtained in 34 (77 percent) of these 44 malignancies; however, accurate histologic classifications of malignancies were achieved in only 24 (55 percent). Accurate diagnoses were achieved in only three (33 percent) of the nine noncystic benign lesions. Ultrasonically guided cutting biopsies (UGCB) were performed in 24 malignant and five benign lesions. All attempts yielded satisfactory specimens for histologic diagnosis. Using UGAB and UGCB together, a positive diagnosis was achieved in 89 percent (39/44) of the malignancies, and accurate histologic diagnosis was achieved in 89 percent and 78 percent (7/9) in malignant and benign noncystic lesions, respectively. Correct histologic diagnosis with UGAB alone is lower in thymoma (55 percent [6/11]) and lymphoma (30 percent [3/10]) but higher in lung cancer (67 percent [8/12]) and metastatic cancer (78 percent [7/9]). There were no complications in this series. We conclude that ultrasonography with UGAB has a high diagnostic yield in diagnosing mediastinal tumors, and UGCB is necessary for thymic tumors, lymphoma, and benign lesions.
Assuntos
Biópsia por Agulha/métodos , Neoplasias do Mediastino/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/instrumentação , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Cateterismo/instrumentação , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/patologia , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/secundário , Pessoa de Meia-Idade , Punções/instrumentação , Punções/métodos , UltrassonografiaRESUMO
Long-term follow-up data from several leading centers concerning patients undergoing coronary artery bypass clearly demonstrate the superiority of the internal mammary artery (IMA) with patency rates of 83 to 94% at 7 to 12 years compared with the saphenous vein and its patency rates of 41 to 53%. Our experimental studies provide a biological basis for understanding this difference. Thin-walled arterial autografts undergo no histological change after being implanted in the arterial system, while venous autografts undergo major changes with an initial scattered loss of endothelium and marked thickening due to a proliferative reaction. The challenge to the cardiac surgeon is to revascularize the entire left ventricle with the IMAs. We have found this possible in most patients with advanced three-vessel disease by using both IMAs either as in situ grafts or free grafts with as many sequential anastomoses as necessary to achieve full revascularization. Our use of the term in situ refers to the graft's origin from the subclavian artery as opposed to a free IMA graft arising from another site.
Assuntos
Ponte de Artéria Coronária/métodos , Artéria Torácica Interna/transplante , Artérias Torácicas/transplante , Grau de Desobstrução Vascular , Cicatrização , Idoso , Animais , Pressão Sanguínea , Artérias Carótidas/patologia , Artérias Carótidas/cirurgia , Ponte de Artéria Coronária/efeitos adversos , Vasos Coronários/cirurgia , Cães , Feminino , Seguimentos , Oclusão de Enxerto Vascular/prevenção & controle , Humanos , Veias Jugulares/patologia , Veias Jugulares/cirurgia , Masculino , Artéria Torácica Interna/patologia , Pessoa de Meia-Idade , Veia Safena/patologia , Veia Safena/cirurgia , Fatores de TempoRESUMO
A total of 122 patients with pulmonary consolidation on chest radiographs underwent color Doppler ultrasonography to evaluate hemodynamic change in regional pulmonary artery in pulmonary consolidation due to various causes. The diseases underlying pulmonary consolidation included 66 simple pneumonia, 37 obstructive pneumonia, 13 tumor consolidation and 6 pulmonary infarctions. Blood flow signals in consolidation were detected by color-flow mapping. The degree of reactive vasoconstriction was evaluated from analysis of the spectral waveform of the blood flow in the segmental pulmonary artery by several vessel resistance-indicating Doppler ultrasound (US) indices, including pulsativity index (PI), resistive index (RI), and acceleration time (AT). The results showed that reactive vasoconstriction was most marked in obstructive pneumonia, followed by simple pneumonia, and least in tumor consolidation (p < 0.001, Kruskal-Wallis test and p < 0.001, Dunn's test for comparison of PI, RI and AT values between different groups of pulmonary consolidation). No flow was detected in pulmonary infarction. We conclude that color Doppler US is a useful tool for evaluating reactive vasoconstriction in pulmonary consolidation. The different degrees of reactive vasoconstriction may be helpful in exploring the possible etiology of pulmonary consolidation.
Assuntos
Pneumopatias/diagnóstico por imagem , Circulação Pulmonar/fisiologia , Ultrassonografia Doppler em Cores , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fluxo Pulsátil , Radiografia , Estatísticas não Paramétricas , VasoconstriçãoRESUMO
Lipoblastomatosis is a rare benign lipomatous tumour of childhood and infancy, classically showing high signal identical to fat on T1 weighted images. A case of histologically proven lipoblastomatosis in an infant is presented, in which MRI showed low signal on T1 weighted images identical to that of muscle instead of high signal. This appearance has not been previously reported.
Assuntos
Lipoma/diagnóstico , Ombro , Neoplasias de Tecidos Moles/diagnóstico , Feminino , Humanos , Lactente , Imageamento por Ressonância MagnéticaRESUMO
Six external velour (Bionit C. R. Bard, Inc.; Billerica, MA) and 11 double velour (Microvel Meadox Medicals, Inc.; Oakland, NJ) warp-knit Dacron grafts with lengths of 6 cm and diameters of 8 mm were implanted in the canine upper descending thoracic aorta for 56 days. Differences were observed: four of 11 double velour grafts developed major perigraft hematomas, while none of the external velour grafts exhibited this complication. Healing of the external velour grafts was virtually complete (average full wall healing and endothelial-like cell coverage of 97.0%, SD 5.9%) in contrast to the seven (of 11) double velour grafts that were free of perigraft hematoma (average full wall healing and endothelial-like cell coverage of 40.9%, SD 20.9%).
Assuntos
Aorta Torácica/cirurgia , Bioprótese , Prótese Vascular , Polietilenotereftalatos , Animais , Aorta Torácica/patologia , Bioprótese/efeitos adversos , Prótese Vascular/efeitos adversos , Cães , Hematoma/etiologiaRESUMO
The influence on healing of three materials for closure of interstices in a macroporous Dacron arterial prosthesis were evaluated by 56-day implantation in the canine descending thoracic aorta. The materials studied were: the nondenatured fibrin deposited as a result of a 4-step preclot with autogeneic blood (n = 6), heat-coagulated autogeneic blood deposited by autoclaving the blood-soaked prosthesis (n = 6), and cross-linked human albumin (n = 6). Healing of autogeneic fibrin was superior with little difference between the other two materials.
Assuntos
Aorta Torácica/cirurgia , Prótese Vascular , Sangue , Fibrina , Polietilenotereftalatos , Albumina Sérica , Cicatrização , Animais , Cães , HemostáticosRESUMO
BACKGROUND AND PURPOSE: The purpose of this study was to compare the cough threshold between people with and without spinal cord injury (SCI). The effect of smoking on cough threshold was also investigated. SUBJECTS: The participants were 26 people with SCI (15 smokers, 11 nonsmokers) and 18 people without SCI (9 smokers, 9 nonsmokers). METHODS: Aerosols of citric acid were delivered with incremental doubling concentration from 62.5 mmol to 2 mol. Cough threshold was defined as the first concentration of citric acid that induced at least 2 coughs, which is associated with large chest excursion and concurrently acoustic response. RESULTS: The mean cough thresholds of smokers and nonsmokers with SCI (209 and 417 mmol, respectively) were lower than those of smokers and nonsmokers without SCI (467 and 1,072 mmol, respectively). The mean citric acid cough thresholds decreased in smokers with and without SCI when compared with nonsmokers with and without SCI. CONCLUSION AND DISCUSSION: The cough sensitivity increased in subjects with SCI, and smoking could also increase the cough sensitivity. Training about the frequency and technique of cough in patients with SCI should be carefully monitored.