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2.
Iran J Vet Res ; 24(3): 242-246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38269008

RESUMO

Background: With the increasing use of cementless total hip arthroplasty (THA), stem subsidence has emerged as one of the primary complications. Although electron beam melting (EBM)-manufactured stems have been demonstrated to prevent subsidence, there has been limited investigation into the comparative biomechanical impact of collarless and collared EBM cementless stems on stem subsidence in veterinary medicine. Aims: This study aimed to compare the stem implant resistance and failure mechanical properties between collarless and collared EBM-manufactured stems. Methods: Seven pairs of femurs were harvested from canine cadavers. In each pair of femurs, the left femur was implanted with a collarless, and the right femur with a same-sized collared cementless stem. Specimen constructs were mounted to the loading frame of a testing machine and load was transferred to the femoral stem parallel to the longitudinal axis of the femur until the stem subsided 5 mm. Load and stem displacement data acquired during the tests were used to generate load-displacement curves and obtain stiffness, yield, and failure data for each specimen construct. Yield and failure energies were calculated as the areas under the load-displacement curves to the respective points. The effects of implant type and load during subsidence were analyzed using paired t-tests. Results: The yield and failure loads for the collared stems were approximately 40% greater than for the collarless stems (156.39 ± 43.63 kgf vs. 112.01 ± 59.83 kgf, P<0.05). Conclusion: This study supported the advantages of collared EBM stems, including subsidence prevention and better initial stability for early osteointegration.

3.
Eur Rev Med Pharmacol Sci ; 25(1): 263-272, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33506915

RESUMO

OBJECTIVE: The importance of continuous monitoring of fasting blood sugar (FBS) levels of diabetic patients has been established. MATERIALS AND METHODS: An observational prospective study was conducted. Our analysis included 1,700,796 individuals from the nationwide South Korean National Health Insurance System cohort. FBS variability was measured by standard deviation (SD). RESULTS: Kaplan-Meier curves demonstrated elevated disease probability in the higher FBS fluctuation group compared with the lower FBS fluctuation group. After adjusting for confounding variables, Cox proportional hazards analysis showed that the hazard ratios of 411 individuals in the highest quartile of SD variation of FBS were 1.77 (95% confidence interval 1.37-2.28, p<0.001) compared with the lowest quartile of SD variation of FBS. The impact of FBS fluctuation on the risk of cardiovascular diseases (CVDs), cerebrovascular diseases, CVD mortality and all-cause mortality in the highest quartiles of diabetic and non-diabetic individuals was statistically significant. CONCLUSIONS: Visit-to-visit FBS variability has prognostic value for predicting micro- and macrovascular disease, cardiovascular mortality, and all-cause mortality.


Assuntos
Glicemia/análise , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/mortalidade , Jejum/sangue , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Fatores de Risco
4.
Iran J Vet Res ; 21(1): 61-64, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32368228

RESUMO

BACKGROUND: Aortic thrombosis (ATh) is an uncommon problem in dogs. Although the pathogenesis of hypertrophic osteopathy (HO) is unknown, it is thought this can be due to blood flow disorder. In this case, removal of aortic thromboembolism (ATE) resulted in periosteal proliferation. CASE DESCRIPTION: A 4.8-kg, 3-year-old, intact female Maltese was referred with a bite wound showing pneumomediastinum, pneumothorax, and subcutaneous emphysema. After adequate treatment, the dog had recovered well and was discharged. FINDINGS/TREATMENT AND OUTCOME: Acute non-painful paraparesis suddenly developed 5 days after discharge. An abdominal ultrasound showed ATE at the level of 1 cm proximal to the external iliac arterial bifurcation. Based on clinical sign, physical exam, neurologic exam, and ultrasonography, ATh was diagnosed. Arterial thrombectomy was performed to remove the thrombus. Twenty-four days after surgery, the dog had pain and soft tissue swelling of both stifles due to HO. After rehabilitation, the dog finally started to ambulate, and the dorsal pedal arteries pulse was normal. Hypertrophic osteopathy also resolved completely. CONCLUSION: This report suggests the relationship between HO and ATh, for the first time in veterinary medicine.

5.
Clin Radiol ; 74(8): 651.e1-651.e6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31202566

RESUMO

AIM: To investigate whether the use of metformin during computed tomography (CT) with radiocontrast agents increases the risk of contrast-induced nephropathy (CIN) and metabolic acidosis after CT in type 2 diabetes patients with mild to moderate renal failure. MATERIALS AND METHODS: Patient records from January 2015 to December 2017 were reviewed retrospectively. A total of 374 patients were included in the final analysis. Of them, 157 patients received metformin, and 217 patients were taking other oral hypoglycaemic agents (OHAs) during radiocontrast administration. RESULTS: No significant difference in CIN incidence was observed between the metformin use group and the other OHAs group (p=0.085). Metabolic acidosis after CT was seen in 91 (58%) patients who used metformin and 141 (65%) patients who were taking other OHAs. There was no relationship between metabolic acidosis after CT and the use of metformin (p=0.195). Metabolic acidosis after radiocontrast agent exposure was associated with malignant disease, low serum albumin level, and low serum total CO2 level at baseline. CONCLUSION: These data show that other factors, but not metformin use, are associated with metabolic acidosis after radiocontrast agent exposure in patients with reduced renal function. These data support current recommendations that there is no need to discontinue metformin before CT using radiocontrast agents in patients with mild to moderate renal failure.


Assuntos
Acidose/induzido quimicamente , Meios de Contraste/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/efeitos adversos , Metformina/efeitos adversos , Insuficiência Renal/induzido quimicamente , Administração Oral , Idoso , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Incidência , Masculino , Metformina/administração & dosagem , Metformina/uso terapêutico , Intensificação de Imagem Radiográfica/métodos , Tomografia Computadorizada por Raios X/métodos
6.
Poult Sci ; 97(9): 3058-3062, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29788438

RESUMO

This study evaluated the preventive effect of the spontaneous oxidation of ß-carotene (OxC-beta) in broiler chickens with necrotic enteritis by Clostridium perfringens taking into consideration various parameters including clinical signs, body weight, intestinal lesion severity, and bacterial enumeration. The mean body weight of the OxC-beta treatment groups increased significantly (P < 0.05) compared to that of the C. perfringens challenge group. Intestinal lesion scores due to C. perfringens infection were significantly alleviated by OxC-beta treatment (P < 0.05), and the number of clostridial bacteria in intestine was reduced by OxC-beta in a dose-dependent manner. OxC-beta in feed contributes to the prevention of necrotic enteritis in commercial broiler chicken, and has a positive effect in improving productivity.


Assuntos
Galinhas , Infecções por Clostridium/veterinária , Clostridium perfringens/efeitos dos fármacos , Enterite/veterinária , Polímeros/metabolismo , Doenças das Aves Domésticas/tratamento farmacológico , beta Caroteno/metabolismo , Ração Animal/análise , Animais , Galinhas/crescimento & desenvolvimento , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/microbiologia , Dieta/veterinária , Suplementos Nutricionais/análise , Enterite/tratamento farmacológico , Enterite/microbiologia , Oxirredução , Polímeros/química , Doenças das Aves Domésticas/microbiologia , Provitaminas/administração & dosagem , Provitaminas/química , Provitaminas/metabolismo , beta Caroteno/administração & dosagem , beta Caroteno/química
7.
Comput Biol Med ; 97: 74-82, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29709716

RESUMO

In this study, we propose a modification to a single-grid phase-contrast x-ray imaging (PCXI) system using a Fourier domain analysis technique to extract absorption, scattering, and differential phase-contrast images. The proposed modification is to rotate the x-ray grid in the image plane to achieve spectral separation between the desired information and the moiré artifact, which is introduced by the superposition of the periodic image of the grid shadow and the periodic sampling by the detector. In addition, we performed some system optimization by adjusting distances between source, object, grid, and detector to further improve image quality. This optimization aimed to increase the spectral spacing between the primary spectrum (lower frequency) and the harmonics of the spectrum (higher frequency) used to extract the various image contrasts. The table-top setup used in the experiment consisted of a focused-linear grid with a 200-lines/inch strip density, a microfocus x-ray tube with a 55-µm focal spot size, and a CMOS flat-panel detector with a 49.5-µm pixel size. The x-ray grid was rotated at 27.8° with respect to the detector and the sample was placed as close as possible to the x-ray tube. Our results indicated that the proposed method effectively eliminated the PCXI artifacts, thus improving image quality.


Assuntos
Artefatos , Análise de Fourier , Intensificação de Imagem Radiográfica/métodos , Animais , Desenho de Equipamento , Peixes , Modelos Biológicos
8.
Bone Joint Res ; 6(3): 137-143, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28258117

RESUMO

OBJECTIVES: We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. METHODS: We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet PC. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resection with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. RESULTS: The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p < 0.05, one-way analysis of variance). The probabilities of a surgeon obtaining a 10 mm surgical margin with a 3 mm tolerance were 90.2% in AR-assisted resections, and 70.7% in conventional resections. CONCLUSION: We demonstrated that the accuracy of tumour resection was satisfactory with the help of the AR navigation system, with the tumour shown as a virtual template. In addition, this concept made the navigation system simple and available without additional cost or time.Cite this article: H. S. Cho, Y. K. Park, S. Gupta, C. Yoon, I. Han, H-S. Kim, H. Choi, J. Hong. Augmented reality in bone tumour resection: An experimental study. Bone Joint Res 2017;6:137-143.

9.
Phys Med ; 32(1): 213-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26494155

RESUMO

In this work, we propose a practical method that can combine the two functionalities of dental panoramic and cone-beam CT (CBCT) features in one by using a single panoramic detector. We implemented a CS-based reconstruction algorithm for the proposed method and performed a systematic simulation to demonstrate its viability for 3D dental X-ray imaging. We successfully reconstructed volumetric images of considerably high accuracy by using a panoramic detector having an active area of 198.4 mm × 6.4 mm and evaluated the reconstruction quality as a function of the pitch (p) and the angle step (Δθ). Our simulation results indicate that the CS-based reconstruction almost completely recovered the phantom structures, as in CBCT, for p≤2.0 and θ≤6°, indicating that it seems very promising for accurate image reconstruction even for large-pitch and few-view data. We expect the proposed method to be applicable to developing a cost-effective, volumetric dental X-ray imaging system.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional/métodos , Boca/diagnóstico por imagem , Radiografia Dentária/métodos , Algoritmos , Simulação por Computador , Análise Custo-Benefício , Compressão de Dados , Humanos , Modelos Teóricos , Imagens de Fantasmas , Interpretação de Imagem Radiográfica Assistida por Computador , Reprodutibilidade dos Testes , Dente/diagnóstico por imagem , Raios X
10.
Tissue Antigens ; 86(4): 255-66, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26381046

RESUMO

The genetic diversity of the major histocompatibility complex (MHC) class I molecules of pigs has not been well characterized. Therefore, the influence of MHC genetic diversity on the immune-related traits of pigs, including disease resistance and other MHC-dependent traits, is not well understood. Here, we attempted to develop an efficient method for systemic analysis of the polymorphisms in the epitope-binding region of swine leukocyte antigens (SLA) class I genes. We performed a comparative analysis of the last 92 bp of the 5' untranslated region (UTR) to the beginning of exon 4 of six SLA classical class I-related genes, SLA-1, -2, -3, -4, -5, and -9, from 36 different sequences. Based on this information, we developed a genomic polymerase chain reaction (PCR) and direct sequencing-based comprehensive typing method for SLA-2. We successfully typed SLA-2 from 400 pigs and 8 cell lines, consisting of 9 different pig breeds, and identified 49 SLA-2 alleles, including 31 previously reported alleles and 18 new alleles. We observed differences in the composition of SLA-2 alleles among different breeds. Our method can be used to study other SLA class I loci and to deepen our knowledge of MHC class I genes in pigs.


Assuntos
Variação Genética , Genoma/imunologia , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Suínos/genética , Regiões 5' não Traduzidas , Alelos , Animais , Sequência de Bases , Cruzamento , Linhagem Celular , Impressões Digitais de DNA , Éxons , Loci Gênicos , Técnicas de Genotipagem , Antígenos de Histocompatibilidade Classe I/classificação , Antígenos de Histocompatibilidade Classe I/imunologia , Antígenos de Histocompatibilidade Classe II/classificação , Antígenos de Histocompatibilidade Classe II/imunologia , Íntrons , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Suínos/imunologia
11.
Nutr Metab Cardiovasc Dis ; 25(7): 677-85, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26026212

RESUMO

BACKGROUND AND AIMS: Low bilirubin and high gamma-glutamyltransferase (GGT), which are endogenous markers of oxidative stress, confer a higher risk of cardiovascular disease (CVD). We investigated associations between serum concentrations of bilirubin, GGT and coronary atherosclerosis. METHODS AND RESULTS: A cross-sectional analysis was performed on 1520 subjects who underwent multidetector computed tomography scans. Coronary atherosclerosis was assessed by coronary artery calcium score (CACS) and obstructive coronary artery disease (OCAD), was defined as the presence of coronary artery stenosis of ≥50%. Total bilirubin (TB) level was negatively correlated with CACS and coronary stenosis whereas GGT level was positively correlated with CACS in men. However, there was no correlation between TB, GGT levels and either CACS or coronary artery stenosis in women. In a multivariate-adjusted model, TB level was inversely associated with a CACS > 100 [odds ratio (OR) per log standard deviation (SD), 0.67; 95% confidence interval (CI), 0.52-0.87], and OCAD (OR per log SD, 0.77; 95% CI, 0.62-0.95) in men. By contrast, GGT level was positively associated with a CACS > 100 (OR per log SD, 1.35; 95% CI, 1.05-1.73) but not with OCAD. Adding TB and GGT to the conventional risk factors increased predictive accuracy for CACS > 100 (net reclassification improvement index [NRI] = 13.1%, P = 0.026; integrated discrimination index [IDI] = 0.024, P = 0.001) and for OCAD (NRI = 12.6%, P = 0.026; IDI = 0.010, P = 0.013). CONCLUSIONS: Low TB and high GGT levels were concomitantly associated with coronary atherosclerosis in Korean men. Future studies are needed to elucidate the causal associations of TB and GGT with CVD.


Assuntos
Bilirrubina/sangue , Doença da Artéria Coronariana/sangue , gama-Glutamiltransferase/sangue , Adulto , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Estudos Transversais , Fígado Gorduroso/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Caracteres Sexuais , Calcificação Vascular/sangue , Calcificação Vascular/patologia
12.
Bone Joint J ; 97-B(1): 121-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25568425

RESUMO

Cancellous allograft bone chips are commonly used in the reconstruction of defects in bone after removal of benign tumours. We investigated the MRI features of grafted bone chips and their change over time, and compared them with those with recurrent tumour. We retrospectively reviewed 66 post-operative MRIs from 34 patients who had undergone curettage and grafting with cancellous bone chips to fill the defect after excision of a tumour. All grafts showed consistent features at least six months after grafting: homogeneous intermediate or low signal intensities with or without scattered hyperintense foci (speckled hyperintensities) on T1 images; high signal intensities with scattered hypointense foci (speckled hypointensities) on T2 images, and peripheral rim enhancement with or without central heterogeneous enhancements on enhanced images. Incorporation of the graft occurred from the periphery to the centre, and was completed within three years. Recurrent lesions consistently showed the same signal intensities as those of pre-operative MRIs of the primary lesions. There were four misdiagnoses, three of which were chondroid tumours. We identified typical MRI features and clarified the incorporation process of grafted cancellous allograft bone chips. The most important characteristics of recurrent tumours were that they showed the same signal intensities as the primary tumours. It might sometimes be difficult to differentiate grafted cancellous allograft bone chips from a recurrent chondroid tumour.


Assuntos
Neoplasias Ósseas/patologia , Transplante Ósseo/métodos , Condrossarcoma/patologia , Imageamento por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/patologia , Procedimentos Ortopédicos/métodos , Adulto , Aloenxertos , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/cirurgia , Transplante Ósseo/efeitos adversos , Condrossarcoma/mortalidade , Condrossarcoma/cirurgia , Estudos de Coortes , Curetagem/métodos , Erros de Diagnóstico , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Procedimentos Ortopédicos/efeitos adversos , Estudos Retrospectivos , Medição de Risco , Taxa de Sobrevida , Resultado do Tratamento
13.
J Clin Pharm Ther ; 39(3): 328-30, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24612195

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Febuxostat is now recommended as the first-line pharmacological urate-lowering therapy for gout in the American College of Rheumatology guidelines. There is no case of rhabdomyolysis associated with febuxostat among reported side effects of the drug. Our objective is to report on a case of rhabdomyolysis associated with initiation of febuxostat in a patient with chronic kidney disease (CKD). CASE SUMMARY: A 73-year-old male patient visited our emergency room due to progressive weakness in both lower extremities starting 3 days earlier. Ten days before presentation, his primary physician had changed his prescription from allopurinol to febuxostat (80 mg) because of poor control of uric acid levels. There was tenderness in both thighs. Initial creatinine kinase (CK) was 7652 U/L (0-170 U/L), and a bone scan using (99m) Tc-HDP revealed strong uptake in soft tissues in both thighs and buttocks. Electromyography (EMG) and nerve conduction velocity (NCV) showed abnormal spontaneous activities (ASA), suggesting myopathy, not nerve damage. On day 7 of admission, after conservative management and febuxostat withdrawal, he could walk on the ward. He is being followed in our clinic as an outpatient with no sequelae. WHAT IS NEW AND CONCLUSION: This report is first case of rhabdomyolysis associated with initiation of febuxostat. Febuxostat should be withdrawn when rhabdomyolysis is confirmed.


Assuntos
Supressores da Gota/efeitos adversos , Hiperuricemia/tratamento farmacológico , Insuficiência Renal Crônica/epidemiologia , Rabdomiólise/induzido quimicamente , Tiazóis/efeitos adversos , Idoso , Febuxostat , Gota/tratamento farmacológico , Gota/epidemiologia , Humanos , Masculino
14.
Reprod Domest Anim ; 49(3): 370-7, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24592966

RESUMO

The reactive oxygen species (ROS) generated during the in vitro maturation of oocytes affect oocyte maturation and subsequent embryonic development. Bovine follicular fluid (bFF) has an effective antioxidant capacity. This study was conducted to investigate the effects of supplementing oocyte maturation media with bFF from different size classes (3-8 and 9-13 mm) on the glutathione (GSH) and ROS levels of oocytes. Embryonic development and apoptosis, as well as the relative abundance of INFτ, BAX, BCL2 and HSP70 transcripts in blastocysts, were also monitored. Oocytes collected from ovaries were matured in TCM-199 with FBS (control) and 10% 3-8 mm (M), 9-13 mm (L) or a mixture of 3-8 mm and 9-13 mm (M + L) bFF. Glutathione and ROS levels in oocytes after 24 h were assessed by Cell Tracker Blue CMF2HC and DCHFDA staining, respectively. Apoptosis in day-8 blastocysts was assessed by TUNEL staining. The relative abundance of BAX, BCL2, HSP70 and INFτ transcripts was assessed using quantitative real-time polymerase chain reaction (PCR). The GSH level was significantly higher in the L group compared to the other groups (p < 0.05), while the ROS levels in the M group were significantly higher than in the other groups (p < 0.05). The apoptosis levels of blastocysts in the FBS group were significantly higher than those in the M + L group (p < 0.05), although the embryonic development did not differ between the groups. The HSP70 and INFτ expression levels in group M were significantly greater than in the controls (p < 0.05). There was no significant difference in BAX expression between the groups. Supplementation with bFF from various sizes of follicles into the maturation medium was capable of supporting oocyte cytoplasmic maturation by decreasing the ROS. Moreover, bFF subsequently affected antioxidative gene expression, increasing HSP70 and INFτ expressions.


Assuntos
Blastocisto/citologia , Bovinos/embriologia , Líquido Folicular/fisiologia , Glutationa/análise , Oócitos/fisiologia , Espécies Reativas de Oxigênio/análise , Animais , Antioxidantes , Apoptose/genética , Blastocisto/metabolismo , Células Cultivadas , Meios de Cultura , Desenvolvimento Embrionário/fisiologia , Feminino , Fertilização in vitro/veterinária , Expressão Gênica , Marcação In Situ das Extremidades Cortadas , Técnicas de Maturação in Vitro de Oócitos/métodos , Técnicas de Maturação in Vitro de Oócitos/veterinária , Oócitos/química , Reação em Cadeia da Polimerase em Tempo Real
15.
Anaesthesia ; 68(9): 931-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23841798

RESUMO

We evaluated the effects of three airway manipulation manoeuvres: (a) conventional (single-handed chin lift); (b) backward, upward and right-sided pressure (BURP) manoeuvre; and (c) modified jaw thrust manoeuvre (two-handed aided by an assistant) on laryngeal view and intubation time using the Clarus Video System in 215 patients undergoing general anaesthesia with orotracheal intubation. In the first part of this study, the laryngeal view was recorded as a modified Cormack-Lehane grade with each manoeuvre. In the second part, intubation was performed using the assigned airway manipulation. The primary outcome was the time to intubation, and the secondary outcomes were the modified Cormack-Lehane grade, the number of attempts and the overall success rate. There were significant differences in modified Cormack-Lehane grade between the three airway manipulations (p < 0.0001). Post-hoc analysis indicated that the modified jaw thrust improved the laryngeal view compared with the conventional (p < 0.0001) and the BURP manoeuvres (p < 0.0001). The BURP worsened the laryngeal view compared with the conventional manoeuvre (p = 0.0132). The time to intubation in the modified jaw thrust group was shorter than with the conventional manoeuvre (p = 0.0004) and the BURP group (p < 0.0001). We conclude that the modified jaw thrust is the most effective manoeuvre at improving the laryngeal view and shortening intubation time with the Clarus Video System.


Assuntos
Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Gravação em Vídeo/instrumentação , Análise de Variância , Desenho de Equipamento/métodos , Feminino , Tecnologia de Fibra Óptica , Humanos , Arcada Osseodentária , Laringoscópios , Laringoscopia/instrumentação , Laringoscopia/métodos , Masculino , Pessoa de Meia-Idade , Postura , Pressão , Tempo
16.
Transplant Proc ; 45(5): 1916-9, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23769072

RESUMO

INTRODUCTION: Mixed venous saturation (SvO2) reflects the balance between oxygen delivery and consumption throughout the body. A multifunction pulmonary artery catheter (PAC) can monitor continuous SvO2 after in vitro calibration (CSvO2), obviating the need for in vivo calibration with pulmonary arterial blood. In critically ill patients CSvO2 has shown a good correlation with measured SvO2 of pulmonary arterial blood using co-oximetry (MSvO2). The aim of this study was to compare CSvO2 and MSvO2 in liver transplantation (OLT) recipients. METHODS: We enrolled 44 OLT recipients for comparison with 24 coronary artery bypass graft (CABG) controls free of end-stage liver disease. After anesthetic induction, the PAC was inserted after in vitro calibration and CSvO2 and MSvO2 simultaneously measured. In OLT recipients, additional measurements of CSvO2 and MSvO2 were performed at anhepatic and postreperfusion phases. Pearson's correlation analysis was used to evaluate the correlation between the 2 measurements. A Bland-Altman analysis was used to determine precision of and bias between the 2 measurements. With ±3% regarded to be interchangeable. RESULTS: Cardiac output and intrapulmonary shunt in CABG patients were lower than among OLT recipients. OLT recipients, showed a significant correlation between CSvO2 and MSvO2, but the coefficients were different during the three phases of OLT (r = 0.597, 0.753, and 0.756). In addition, bias values between the two measurements were 6.0%, 6.4%, and 2.9% for the preanhepatic, anhepatic, and postreperfusion phases, respectively, with 29.5%, 31.8%, and 50% of them being interchangeable. In contrast CABG patients showed bias in -0.17% with 75% of measurements interchangeable. CONCLUSION: While in vitro calibration of the PAC can be used in CABG patients, MSvO2 is higher than CSvO2 in OLT recipients. Therefore, in vivo calibration with pulmonary arterial blood is necessary for accurate monitoring of SvO2 in OLT recipients.


Assuntos
Catéteres/normas , Transplante de Fígado , Doadores Vivos , Oxigênio/sangue , Artéria Pulmonar , Idoso , Calibragem , Ponte de Artéria Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
J Bone Joint Surg Br ; 94(10): 1414-20, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23015571

RESUMO

We evaluated the oncological and functional outcome of 18 patients, whose malignant bone tumours were excised with the assistance of navigation, and who were followed up for more than three years. There were 11 men and seven women, with a mean age of 31.8 years (10 to 57). There were ten operations on the pelvic ring and eight joint-preserving limb salvage procedures. The resection margins were free of tumour in all specimens. The tumours, which were stage IIB in all patients, included osteosarcoma, high-grade chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma of bone, and adamantinoma. The overall three-year survival rate of the 18 patients was 88.9% (95% confidence interval (CI) 75.4 to 100). The three-year survival rate of the patients with pelvic malignancy was 80.0% (95% CI 55.3 to 100), and of the patients with metaphyseal malignancy was 100%. The event-free survival was 66.7% (95% CI 44.9 to 88.5). Local recurrence occurred in two patients, both of whom had a pelvic malignancy. The mean Musculoskeletal Tumor Society functional score was 26.9 points at a mean follow-up of 48.2 months (22 to 79). We suggest that navigation can be helpful during surgery for musculoskeletal tumours; it can maximise the accuracy of resection and minimise the unnecessary sacrifice of normal tissue by providing precise intra-operative three-dimensional radiological information.


Assuntos
Neoplasias Ósseas/cirurgia , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Técnicas Estereotáxicas , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
18.
Anaesthesia ; 67(1): 19-22, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21972884

RESUMO

We investigated the forces required to remove thoracic epidural catheters to determine the effect of patient position on removal. Eighty-four patients undergoing open thoracotomy and thoracic patient-controlled epidural analgesia were enrolled. Catheterisation was performed under fluoroscopic guidance before surgery, and the patients were allocated to one of three position groups for removal: prone; sitting; and lateral. On the third postoperative day, the peak tension during withdrawal in the assigned position was measured. No differences in mean (SD) forces were found between groups: prone 1.61 (0.39) N, supine 1.62 (0.61) N and lateral 1.36 (0.56) N (p = 0.140). The withdrawal forces required to remove thoracic epidural catheters were not affected by the position. Thus, the position for removal can be determined by patient's choice and clinical judgement.


Assuntos
Analgesia Epidural/métodos , Anestesia Epidural/métodos , Posicionamento do Paciente , Postura/fisiologia , Adulto , Fatores Etários , Idoso , Analgesia Epidural/instrumentação , Analgesia Controlada pelo Paciente , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Anestesia Epidural/instrumentação , Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Estatura/fisiologia , Índice de Massa Corporal , Bupivacaína/administração & dosagem , Bupivacaína/uso terapêutico , Cateterismo , Catéteres , Remoção de Dispositivo , Espaço Epidural/diagnóstico por imagem , Feminino , Fluoroscopia , Humanos , Hidromorfona/administração & dosagem , Hidromorfona/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Decúbito Ventral/fisiologia , Estudos Prospectivos , Tamanho da Amostra , Fatores Sexuais , Vértebras Torácicas
19.
J Synchrotron Radiat ; 18(Pt 4): 658-70, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21685684

RESUMO

BioCARS, a NIH-supported national user facility for macromolecular time-resolved X-ray crystallography at the Advanced Photon Source (APS), has recently completed commissioning of an upgraded undulator-based beamline optimized for single-shot laser-pump X-ray-probe measurements with time resolution as short as 100 ps. The source consists of two in-line undulators with periods of 23 and 27 mm that together provide high-flux pink-beam capability at 12 keV as well as first-harmonic coverage from 6.8 to 19 keV. A high-heat-load chopper reduces the average power load on downstream components, thereby preserving the surface figure of a Kirkpatrick-Baez mirror system capable of focusing the X-ray beam to a spot size of 90 µm horizontal by 20 µm vertical. A high-speed chopper isolates single X-ray pulses at 1 kHz in both hybrid and 24-bunch modes of the APS storage ring. In hybrid mode each isolated X-ray pulse delivers up to ~4 × 10(10) photons to the sample, thereby achieving a time-averaged flux approaching that of fourth-generation X-FEL sources. A new high-power picosecond laser system delivers pulses tunable over the wavelength range 450-2000 nm. These pulses are synchronized to the storage-ring RF clock with long-term stability better than 10 ps RMS. Monochromatic experimental capability with Biosafety Level 3 certification has been retained.


Assuntos
Síncrotrons , Cristalografia por Raios X
20.
Waste Manag ; 31(3): 475-80, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21144726

RESUMO

The biodegradability and the biodegradation rate of two kinds biodegradable polymers; poly(caprolactone) (PCL)-starch blend and poly(butylene succinate) (PBS), were investigated under both aerobic and anaerobic conditions. PCL-starch blend was easily degraded, with 88% biodegradability in 44 days under aerobic conditions, and showed a biodegradation rate of 0.07 day(-1), whereas the biodegradability of PBS was only 31% in 80 days under the same conditions, with a biodegradation rate of 0.01 day(-1). Anaerobic bacteria degraded well PCL-starch blend (i.e., 83% biodegradability for 139 days); however, its biodegradation rate was relatively slow (6.1 mL CH(4)/g-VS day) compared to that of cellulose (13.5 mL CH(4)/g-VS day), which was used as a reference material. The PBS was barely degraded under anaerobic conditions, with only 2% biodegradability in 100 days. These results were consistent with the visual changes and FE-SEM images of the two biodegradable polymers after the landfill burial test, showing that only PCL-starch blend had various sized pinholes on the surface due to attack by microorganisms. This result may be use in deciding suitable final disposal approaches of different types of biodegradable polymers in the future.


Assuntos
Reatores Biológicos , Butileno Glicóis/metabolismo , Poliésteres/metabolismo , Polímeros/metabolismo , Amido/metabolismo , Aerobiose , Anaerobiose , Biodegradação Ambiental , Butileno Glicóis/química , Metano/biossíntese , Microscopia Eletrônica de Varredura , Poliésteres/química , Polímeros/química , Amido/química , Fatores de Tempo
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