RESUMEN
OBJECTIVE: To assess the changes in antimüllerian hormone (AMH) levels after ablation for symptomatic uterine fibroids and adenomyosis using ultrasound-guided high-intensity focused ultrasound (USgHIFU). DESIGN: A prospective study. SETTING: Gynaecological department in multiple hospitals in South Korea. POPULATION: Patients with uterus fibroids and adenomyosis. METHODS: Seventy-nine women with symptomatic uterine fibroids and adenomyosis who met the inclusion criteria were enrolled in our study between January 2014 and December 2014. All patients underwent USgHIFU ablations. Each patient was examined before and after treatment, and at 6 and 12 months after treatment by T2-weighted MRI imaging (T2WI) and T1-weighted MRI imaging (T1WI) with gadolinium injection. Symptom severity scores (SSS), Uterine Fibroid Symptom Quality of Life (UFS-QOL) questionnaire subscales, and reductions of treated volume were assessed. AMH levels before and 6 months after HIFU ablation were compared to determine whether USgHIFU ablation affected ovarian reserve. MAIN OUTCOME MEASURES: HIFU treatment did not affect the ovarian function. RESULTS: HIFU treatment time (mean ± standard deviation), HIFU ablation time, and treatment energy were 73.5 ± 25.6 minutes, 9994.7 ± 386.8 seconds, and 364 713.8 ± 156 350.7 Joules, respectively. AMH levels before and 6 months after HIFU ablation were 2.11 ± 2.66 and 1.84 ± 2.57 µg/l, respectively. There was no significant difference in AMH level between the two time points (P > 0.05). CONCLUSIONS: USgHIFU ablation for uterine fibroid and adenomyosis was effective without affecting ovarian reserve. TWEETABLE ABSTRACT: HIFU ablation is a safe and effective treatment for patients with uterine fibroids and adenomyosis that does not affect ovarian function.
Asunto(s)
Adenomiosis/cirugía , Hormona Antimülleriana/metabolismo , Ultrasonido Enfocado de Alta Intensidad de Ablación/métodos , Leiomioma/cirugía , Neoplasias Uterinas/cirugía , Adenomiosis/sangre , Adenomiosis/patología , Adulto , Biomarcadores/metabolismo , Femenino , Humanos , Leiomioma/sangre , Leiomioma/patología , Tempo Operativo , Carga Tumoral , Neoplasias Uterinas/sangre , Neoplasias Uterinas/patología , Adulto JovenRESUMEN
This paper describes the design of a telemedicine system based on next-generation wireless local area networks (WLANs) operating at 17 GHz. Seventeen gigahertz is proposed for next-generation WLAN services offering numerous advantages over traditional IEEE 802.11 networks that operate in the range of 2.4-5 GHz. Orthogonal polarization is often used to increase spectrum efficiency by utilizing signal paths of horizontal and vertical polarization. Radio waves exceeding 10 GHz are particularly vulnerable to signal degradation under the influence of rain which causes an effective reduction in isolation between polarized signal paths. This paper investigates the influence of heavy rain in a tropical region on wide-band microwave signals at 17 GHz using two links provided by a fixed broad-band wireless access system for two-way data exchange between paramedics attending an accident scene and the hospital via microwave equipment installed in the ambulance. We also study the effects of cross polarization and phase rotation due to persistent heavy rainfall in tropical regions.
Asunto(s)
Redes de Comunicación de Computadores/instrumentación , Medicina de Emergencia/instrumentación , Medicina de Emergencia/métodos , Microondas , Lluvia , Telemedicina/instrumentación , Telemedicina/métodos , Diseño de Equipo , Análisis de Falla de EquipoRESUMEN
OBJECTIVE: To evaluate changes in lung function in individuals before and after treatment for pulmonary tuberculosis (PTB) in relation to extent of disease. DESIGN: Using a retrospective cohort design, changes in and predictors of lung function were evaluated. RESULTS: A total of 41 patients were included in the final analysis. The median decline in annualised forced expiratory volume in 1 sec (FEV1) was 180.0 ml/year (95%CI 118.9-356.1) in advanced PTB and 94.7 ml/year (95%CI 33.4-147.3) in localised PTB (ΔFEV1% predicted/year 9.4%, 95%CI 4.4-14.0 vs. 3.8%, 95%CI 1.8-6.2). The median decline in annualised forced vital capacity (FVC) was 309.6 ml/year (95%CI 137.0-359.0) in advanced PTB and 101.1 ml/year (95%CI 30.3-219.6) in localised PTB (ΔFVC % predicted/year 7.3%, 95%CI 5.3-12.3 vs. 2.9%, 95%CI 0.9-6.5). CONCLUSIONS: As the sample size of our study was small, the conclusions could be biased. Nevertheless, our findings show that PTB causes a significant decline in lung function even in localised PTB, whereas advanced PTB was associated with excessive or even higher decline. This study suggests that early diagnosis and treatment of PTB is needed to preserve lung function.
Asunto(s)
Progresión de la Enfermedad , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/fisiopatología , Capacidad Vital/fisiología , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado/fisiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Valores de Referencia , República de Corea , Pruebas de Función Respiratoria , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Tomografía Computarizada por Rayos X/métodosRESUMEN
The first ATP-dependent complex formed in pre-mRNA splicing is the prespliceosome, a 30 S complex. This reaction was investigated using partially purified fractions isolated from nuclear extracts of HeLa cells. Previous studies (Furneaux, H. M., Perkins, K. K., Freyer, G. A., Arenas, J., and Hurwitz, J. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 4351-4355) have shown that DEAE-cellulose chromatography of nuclear extracts yielded two fractions (fractions I and II, eluted at 0.2 and 1 M NaCl, respectively) which carried out pre-mRNA splicing only when combined. Fraction II, alone and in the presence of ATP, supported the formation of the 30 S complex. In this report, we have separated fraction II into ribonucleoprotein and protein-rich fractions by isopycnic banding in CsCl. The combination of these two fractions completely replaced fraction II in prespliceosome formation; when supplemented with fraction Ib (1 M NaCl Biorex fraction derived from fraction I), the preparations supported spliceosome formation; when supplemented with fraction I, they yielded spliced products. The CsCl fractions, like fraction II, efficiently converted pre-mRNA to the 30 S complex with high yields (30-70%). The 30 S complex was shown to contain pre-mRNA complexed to U2 small ribonucleoproteins and small amounts of U1 small ribonucleoproteins. The 30 S complex protected a 50-nucleotide region at the 3'-end of the intron from T1 RNase attack. This region included sequences spanning the branch site, the polypyrimidine stretch and the AG dinucleotide of the 3'-splice site. When the 30 S complex was first generated with partially purified fractions, followed by the addition of a large amount of poly(U) or unlabeled pre-mRNA, the 30 S complex could be chased into a 55 S spliceosome complex by the addition of fraction Ib. These results support the conclusion, initially derived from kinetic data, that the 30 S complex is a precursor of the 55 S complex.
Asunto(s)
Núcleo Celular/metabolismo , Precursores del ARN/genética , Empalme del ARN , Secuencia de Bases , Biotina , Centrifugación por Gradiente de Densidad , Cromatografía DEAE-Celulosa , Etilmaleimida/farmacología , Células HeLa/metabolismo , Humanos , Cinética , Datos de Secuencia Molecular , Plásmidos , Precursores del ARN/aislamiento & purificación , Ribonucleoproteínas/aislamiento & purificación , Ribonucleoproteínas Nucleares Pequeñas , Fracciones Subcelulares/metabolismoRESUMEN
To investigate the nitric oxide (NO) production and its signalling mechanism in TM4 Sertoli cells, the cells were treated with recombinant tumor necrosis factor-alpha (rTNF-alpha), recombinant interleukin-1 alpha (rIL-1alpha), or lipopolysaccharide (LPS), either alone or in combination with recombinant interferon-gamma (rIFN-gamma), and NO production was measured by using the Griess method. TM4 Sertoli cells produced a small amount of NO upon treatment with rIFN-gamma. The effect of rIFN-gamma was drastically increased by cotreatment with rTNF-alpha in a dose-dependent manner. However, combination of rIL-1alpha or LPS with rIFN-gamma did not synergize to activate cells. RIFN-gamma in combination with rTNF-alpha showed marked increase of the expression of iNOS protein. Protein kinase C inhibitors did not inhibit the production of NO induced by rIFN-gamma plus rTNF-alpha. These results suggest that the role of TNF-alpha is to provide TM4 Sertoli cells with the active cofactor for NO production and TNF-alpha-induced signaling for induction of NO synthesis is not dependent on protein kinase C activation.