Edema agudo pulmonar Postextubación / Edema agudo pulmonar Postextubación

El edema pulmonar agudo posextubación constituye un evento poco frecuente en la práctica anestésica. Cuando ocurre es necesario administrar tratamiento adecuado, ya que las complicaciones del mismo pueden traducirse en mayor estancia hospitalaria y lesiones serias del aparato respiratorio, como edema pulmonar intersticial, elevación de la presión hidrostática capilar y aumento de la presión transmural de las cámaras cardiacas, lo que puede conducir a fallo del aparato cardiovascular y a la muerte subsecuente del paciente. Se presenta el caso de un paciente con clasificación del estado físico ASA (American Society of Anesthesiologist) II, sin patología pulmonar previa, quien al momento de la emersión anestésica presenta un episodio agudo de dificultad respiratoria, con evidencia de edema pulmonar posextubación confirmado por clínica e imágenes con ulterior resolución satisfactoria.

Post-extubation acute pulmonary edema is a rare event in anesthetic practice. When it occurs, it requires adequate treatment, since its complications may result in longer hospital stay and serious respiratory system lesions, such as interstitial pulmonary edema, increased capillary hydrostatic pressure and increased transmural pressure of the cardiac chambers, which may progress to cardiopulmonary arrest and death of the patient. We present the case of a patient who was classified with the (American Society of Anesthesiologist (ASA) II physical status, without a history of pulmonary disease, who upon emergence of general anesthesia developed an acute episode of respiratory distress, with evidence of post-extubation pulmonary edema confirmed by clinical and imaging findings with subsequent satisfactory resolution.

Analysis of adhesive bond strength under simulated pulpal pressure during laser irradiation on different dentin thicknesses / Análise da resistência adesiva sob pressão pulpar simulada durante irradiação laser em diferentes espessuras de dentina

Objective: Evaluate the microtensile bond strength (µTBS) in different dentin thicknesses, under simulated pulpal pressure (SPP), submitted to an adhesive technique using laser irradiation. Material and methods: Forty sound human molars were sectioned and randomly divided into two groups (n=20): Group 1 ­ 1 mm of dentin thickness; Group 2 ­ 2 mm of dentin thickness. Each group was divided into two subgroups (n=10): Subgroup A ­ Absence of SPP; Subgroup P ­ Presence of SPP (15 cm H2 O). The samples were sequentially treated with: 37% phosphoric acid, adhesive system (Adper Single Bond 2), Nd:YAG laser irradiation (60 s, 1064 nm, 10 Hz) using 60 and 100 mJ/pulse energy parameters and photopolymerization (10 s). A composite resin block (Filtek Z350) was built up onto the irradiated area. After 30 days stored in water, the samples were sectioned and submitted to microtensile test (10 kgf load cell, 0.5mm/min). Data were analyzed by twoway ANOVA and Tukey tests. Results: Two-way ANOVA revealed no significant differences for SPP on bond strength. The laser energy parameters indicated that 100 mJ showed greater µTBS means compared to the group irradiated with 60 mJ. The presence of SPP reduced the mean µTBS values. Conclusions: Simulated pulpal pressure did not affect the µTBS using 60 mJ of laser energy parameter. At 100 mJ, the presence of SPP negatively influenced the bond strength, regardless of dentin thickness (AU)

Objetivo: O objetivo deste estudo foi avaliar a resistência adesiva (RA) em diferentes espessuras de dentina, associada à pressão pulpar simulada (PPS), quando submetidos à técnica adesiva por irradiação laser. Material e Métodos: Quarenta molares humanos hígidos foram seccionados e divididos aleatoriamente em dois grupos (n=20): Grupo 1 ­ 1 mm de espessura de dentina; Grupo 2 ­ 2 mm de espessura de dentina. As amostras foram divididas em 2 subgrupos (n=10): Subgrupo A ­ ausência de PPS; Subgrupo P ­ presença de PPS (15 cm de H2 O). As amostras foram tratadas seqüencialmente com: ácido fosfórico 37%, sistema adesivo (Adper Single Bond 2), irradiação com Nd:YAG laser (60 s, 1064 nm, 10 Hz) nos parâmetros de energia de 60 e 100 mJ/pulso e fotopolimerização (10 s). Um bloco de resina composta (Filtek Z350, 3M ESPE) foi confeccionado sobre a área irradiada. Após 30 dias armazenados em água, os espécimes foram seccionados e submetidos ao teste de microtração (carga de 10 kgf, 0.5mm/min). Os dados foram analisados pelos testes ANOVA sob 2 fatores e Tukey (p<0.05). Resultados: ANOVA mostrou que não houve diferenças significativas para PPS na RA. Para os parâmetros de energia do laser, 100 mJ apresentou maiores médias de RA quando comparado ao grupo irradiado à 60 mJ. A presença da PPS reduziu as médias de RA. Conclusão: Pressão pulpar simulada não afetou os valores de resistência adesiva para o grupo irradiado com 60 mJ. Para 100 mJ, a presença da pressão pulpar influenciou negativamente na resistência adesiva, independente das espessuras de dentina.(AU)

Intervenciones no farmacológicas para la disminución del dolor en cistoscopia / Non-Pharmacological Interventions to Reduce Pain in Cystoscopy

Objetivo Generar una aproximación a las terapias no farmacológicas que disminuyan el dolor durante la realización de la cistoscopia. Métodos Se realizó una búsqueda de la literatura para identificar artículos relevantes con respecto al tópico, utilizando como palabras clave: cistoscopia, dolor, terapia no farmacológica en cistoscopia y terapias alternativas. La búsqueda se hizo a través de Medline y Embase. Se realizó una revisión narrativa. Resultados Aunque la cistoscopia flexible aumenta la tolerancia, especialmente en pacientes masculinos, el dolor sigue siendo inevitable durante la misma. Se han estudiado diferentes intervenciones no farmacológicas orientadas a disminuir el dolor y la ansiedad durante la cistoscopia, entre las que se encuentran: escuchar música, tomar la mano del paciente, ver el procedimiento en tiempo real, el aumento de la presión hidrostática, insuflación con aire y la hipnosis. Conclusión Esas intervenciones podrían ser usadas como adyuvantes en la disminución del dolor y la ansiedad durante la cistoscopia, principalmente la masculina. Sin embargo, se requieren más estudios que comprueben su uso clínico apropiado.

Objective To generate an approach to non-pharmacological therapies that reduce pain during cystoscopy. Methods We searched the literature to identify relevant articles regarding the topic, using as keywords: cystoscopy, pain, non-pharmacological therapy in cystoscopy and alternative therapies. The search was made through Medline and Embase. A narrative review was made. Results Although flexible cystoscopy increases tolerance, especially in male patients, pain remains unavoidable during it. Different non-pharmacological interventions aimed at reducing pain and anxiety during cystoscopy have been studied, among which are: listening to music, taking the patient's hand, seeing the procedure in real time, increasing hydrostatic pressure, insufflation with air and hypnosis. Conclusion These interventions could be used as adjuvants in the reduction of pain and anxiety during cystoscopy, mainly male. However, more studies are required to prove their appropriate clinical use.

Perirenal fat thickness is associated with metabolic risk factors in patients with chronic kidney disease

BACKGROUND: Adipose tissue accumulation in specific body compartments has been associated with diabetes, hypertension and dyslipidemia. Perirenal fat (PRF) may lead to have direct lipotoxic effects on renal function and intrarenal hydrostatic pressure. This study was undertaken to explore the association of PRF with cardiovascular risk factors and different stages of chronic kidney disease (CKD). METHODS: We studied 103 patients with CKD of different stages (1 to 5). PRF was measured by B-mode renal ultrasonography in the distal third between the cortex and the hepatic border and/or spleen. RESULTS: The PRF thickness was greater in CKD patients with impaired fasting glucose than in those with normal glucose levels (1.10 ± 0.40 cm vs. 0.85 ± 0.39 cm, P < 0.01). Patients in CKD stages 4 and 5 (glomerular filtration rate [GFR] < 30 mL/min/1.73 m²) had the highest PRF thickness. Serum triglyceride levels correlated positively with the PRF thickness; the PRF thickness was greater in patients with triglyceride levels ≥ 150 mg/dL (1.09 ± 0.40 cm vs. 0.86 ± 0.36 cm, P < 0.01). In patients with a GFR < 60 mL/min/1.73 m², uric acid levels correlated positively with the PRF thickness (P < 0.05). CONCLUSION: In CKD patients, the PRF thickness correlated significantly with metabolic risk factors that could affect kidney function.

Induction of Chondrogenic Differentiation in Human Mesenchymal Stem Cells Cultured on Human Demineralized Bone Matrix Scaffold under Hydrostatic Pressure

BACKGROUND: Articular cartilage damage is still a troublesome problem. Hence, several researches have been performed for cartilage repair. The aim of this study was to evaluate the chondrogenicity of demineralized bone matrix (DBM) scaffolds under cyclic hydrostatic pressure (CHP) in vitro. METHODS: In this study, CHP was applied to human bone marrow mesenchymal stem cells (hBMSCs) seeded on DBM scaffolds at a pressure of 5 MPa with a frequency of 0.5 Hz and 4 h per day for 1 week. Changes in chondrogenic and osteogenic gene expressions were analyzed by quantifying mRNA signal level of Sox9, collagen type I, collagen type II, aggrecan (ACAN), Osteocalcin, and Runx2. Histological analysis was carried out by hematoxylin and eosin, and Alcian blue staining. Moreover, DMMB and immunofluorescence staining were used for glycosaminoglycan (GAG) and collagen type II detection, respectively. RESULTS: Real-time PCR demonstrated that applying CHP to hBMSCs in DBM scaffolds increased mRNA levels by 1.3-fold, 1.2-fold, and 1.7-fold (p < 0.005) for Sox9, Col2, and ACAN, respectively by day 21, whereas it decreased mRNA levels by 0.7-fold and 0.8-fold (p < 0.05) for Runx2 and osteocalcin, respectively. Additionally, in the presence of TGF-β1 growth factor (10 ng/ml), CHP further increased mRNA levels for the mentioned genes (Sox9, Col2, and ACAN) by 1.4-fold, 1.3-fold and 2.5-fold (p < 0.005), respectively. Furthermore, in histological assessment, it was observed that the extracellular matrix contained GAG and type II collagen in scaffolds under CHP and CHP with TGF-β1, respectively. CONCLUSION: The osteo-inductive DBM scaffolds showed chondrogenic characteristics under hydrostatic pressure. Our study can be a fundamental study for the use of DBM in articular cartilage defects in vivo and lead to production of novel scaffolds with two different characteristics to regenerate both bone and cartilage simultaneously.

Nasal polyposis: more than a chronic inflammatory disorder-a disease of mechanical dysfunction - the São paulo position

Introduction: The importance of our study lies in the fact that we have demonstrated the occurrence ofmechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective: To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data: Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion: The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP (AU)

Morphometry of the cervical spine of emu using the hydrostatic method / Morfometría de la columna cervical de emu usando el método hidrostático

The study aimed at estimating the values of basic metric traits of emu cervical vertebrae. The study was conducted on the vertebrae of 6 male and 10 female emus being fourteen years old. Osteometric measurements were performed with electronic callipers, while the hydrostatic method was used to assess the density and volume of each vertebra. The sex of birds was considered a source of variation. The cervical spine had 17 vertebrae. Dimorphism was found in basic metric traits between analogous emu vertebrae of both sexes. The female vertebrae were characterised by significantly (P≤0.05 and P≤0.01) greater length, breadth and height than the male ones. No dimorphic differences were found in the volume of bone mass for vertebrae 1 to 8, whereas female vertebrae 9 to 17 had greater (P≤0.05) volume compared to the male ones. Correlation coefficients for body weight, vertebra volume and spinal canal capacity were weak. The sum of the length of vertebral bodies determining the length of neck showed significantly (P≤0.01) longer necks in female emus. No narrowing and extensions of the vertebral canal for the spinal cord running in it was found throughout the whole cervical spine.

Este estudio tuvo como objetivo la estimación de los valores de los rasgos métricos básicos de las vértebras cervicales del Emu. El estudio se realizó en vértebras de 6 machos y 10 hembras Emu de catorce años. Las mediciones osteométricas se realizaron con pinzas electrónicas, mientras que el método hidrostático se usó para evaluar la densidad y el volumen de cada vértebra. El sexo de las aves se consideró como una variación. La columna cervical contaba con 17 vértebras. Se encontró dismorfismo en rasgos métricos básicos entre vértebras análogas de ambos sexos. Las vértebras de las hembras se caracterizaron por una longitud, ancho y altura significativamente mayor (P≤0,05 y P≤0,01) a las de los machos. No se encontraron diferencias dismórficas en el volumen de masa ósea para las vértebras 1 a 8, mientras que las vértebras de las hembras 9 a 17 tuvieron un volumen mayor (P≤0,05) en comparación con los machos. Los coeficientes de correlación para el peso corporal, el volumen de la vértebra y la capacidad del canal espinal fueron débiles. La suma de la longitud de los cuerpos vertebrales que determina la longitud del cuello mostró significativamente (P≤0.01) cuellos más largos en las hembras. No se observaron estrechamientos y extensiones del canal vertebral para la médula espinal que se encuentra en toda la columna cervical.

Negative pressure pulmonary edema may present as acute left ventricular failure: a case report

Negative pressure pulmonary edema [NPPE] also known as post obstructive pulmonary edema is a potentially life threatening condition with a multifocal pathogenesis. Type 1 NPPE is due to forceful inspiratory effort in the context of an acute airway obstruction, while Type 2 NPPE occurs after relief of a chronic partial upper airway obstruction. Once developed, it impairs gas exchange and causes hypoxemia and if not treated promptly may lead to respiratory failure. The diagnosis of negative pressure pulmonary edema is usually made on the basis of a history of a precipitating incident and symptoms. However, it is basically a diagnosis of exclusion. We present here a case of negative pressure pulmonary edema, which presented as acute left ventricular failure. The cause was eventually found to be acute airway obstruction due to an obstructive goiter precipitated by an upper respiratory tract infection

The effects of daily bathing on symptoms of patients with bronchial asthma

BACKGROUND: The influence of bathing in asthma patients is not yet fully known. OBJECTIVE: We conducted an observational study to investigate changes in symptoms and their degree by bathing in asthmatic patients. METHODS: A questionnaire focusing on ever experienced bathing-induced symptom changes and their degree, as well as contributing factors, was designed and administered to asthmatic patients in the outpatient department of our institute between January 2012 and November 2013. RESULTS: Two hundred fifteen cases were recruited. In 60 cases (27.9%), asthmatic symptoms appeared, including 20 cases of chest discomfort (33.3%), 19 cases of cough (31.7%), and 21 cases of wheezing (35.0%). The triggering factors included vapor inhalation (32 cases, 53.3%), hydrostatic pressure on the thorax due to body immersion in the bathtub (26 cases, 43.3%), and sudden change of air temperature (16 cases, 26.7%). Thirty-eight cases (17.7%) experienced improvement in active asthmatic symptoms by bathing. Vapor inhalation was the most common contributing factor (34 cases, 89.5%), followed by warming of the whole body (13 cases, 34.2%). There was no relationship between asthma severity and the appearance of bathing-induced symptoms or improvement of active asthmatic symptoms by bathing. CONCLUSION: The effects of bathing in asthmatic patients widely differed from patient to patient and their etiology includes several factors. For those who suffer from bathing-induced asthma symptoms, preventive methods, such as premedication with bronchodilators before bathing, should be established. This study is registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan with the registration number UMIN000015641.

Inhibition on Apoptosis Induced by Elevated Hydrostatic Pressure in Retinal Ganglion Cell-5 via Laminin Upregulating β1-integrin/Focal Adhesion Kinase/Protein Kinase B Signaling Pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glaucoma is a progressive optic neuropathy characterized by degeneration of neurons due to loss of retinal ganglion cells (RGCs). High intraocular pressure (HIOP), the main risk factor, causes the optic nerve damage. However, the precise mechanism of HIOP-induced RGC death is not yet completely understood. This study was conducted to determine apoptosis of RGC-5 cells induced by elevated hydrostatic pressures, explore whether laminin is associated with apoptosis under pressure, whether laminin can protect RGCs from apoptosis and affirm the mechanism that regulates the process of RGCs survival.</p><p><b>METHODS</b>RGC-5 cells were exposed to 0, 20, 40, and 60 mmHg in a pressurized incubator for 6, 12, and 24 h, respectively. The effect of elevated hydrostatic pressure on RGC-5 cells was measured by Annexin V-fluorescein isothiocyanate/propidium iodide staining, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and Western blotting of cleaved caspase-3 protein. Location and expression of laminin were detected by immunofluorescence. The expression of β1-integrin, phosphorylation of focal adhesion kinase (FAK) and protein kinase B (PKB, or AKT) were investigated with real-time polymerase chain reaction and Western blotting analysis.</p><p><b>RESULTS</b>Elevated hydrostatic pressure induced apoptosis in cultured RGC-5 cells. Pressure with 40 mmHg for 24 h induced a maximum apoptosis. Laminin was declined in RGC-5 cells after exposing to 40 mmHg for 24 h. After pretreating with laminin, RGC-5 cells survived from elevated pressure. Furthermore, β1-integrin and phosphorylation of FAK and AKT were increased compared to 40 mmHg group.</p><p><b>CONCLUSIONS</b>The data show apoptosis tendency of RGC-5 cells with elevated hydrostatic pressure. Laminin can protect RGC-5 cells against high pressure via β1-integrin/FAK/AKT signaling pathway. These results suggest that the decreased laminin of RGC-5 cells might be responsible for apoptosis induced by elevated hydrostatic pressure, and laminin or activating β1-integrin/FAK/AKT pathway might be potential treatments to prevent RGC loss in glaucomatous optic neuropathy.</p>

Changes in Choroidal Thickness in Branch Retinal Vein Occlusion

PURPOSE: To compare the choroidal thickness of a branch retinal vein occlusion (BRVO) lesion and that of other areas in the eyes. METHODS: Patients who visited the Ophthalmologic Clinic of Inje University Sanggye Paik Hospital for BRVO between March 2015 and October 2015 were reviewed retrospectively. We performed basic ophthalmologic exam and enhanced depth imaging optical coherence tomography in 48 eyes of 24 patients with BRVO. The choroidal thickness was compared in a total of 4 places, the branch retinal vein occlusion lesion, the symmetric site in the same eye, and the equivalent sites in the fellow eye by paired t-test. All measurements were performed by 2 independent observers. RESULTS: Choroidal thickness had strong inter-observer correlation. Choroidal thickness of the BRVO lesion was significantly thicker than that in the symmetric site of same eye, the equivalent site of lesion, and the equivalent site of the symmetric site to lesion in the fellow eye. CONCLUSIONS: Choroidal thickness in acute BRVO lesions was thicker than choroidal thickness in other areas of the eyes. It is thought that both hydrostatic pressure and the effects of vascular endothelial growth factor influence choroidal thickness in the acute phase of BRVO.

Influencia de 2 dentífricos con agentes desensibilizantes en la conductabilidad hidráulica dentinaria / Influence of two agents desensitizing toothpastes in hydraulic conductance dentin

El objetivo del estudio fue determinar in vitro los efectos de agentes desensibilizantes de dentífricos sobre la conductancia hidráulica de la dentina. Se seleccionaron 60 terceros molares humanos sanos, recientemente extraídos, sin contacto oclusal, de pacientes entre 15-30 años, los cuales fueron limpiados, desinfectados (Tymol 0,1% durante 24 h) y conservados a temperatura ambiente en solución HBSS. Las coronas fueron seccionadas perpendicular al eje dentario mayor bajo abundante refrigeración, obteniendo un disco de 1 mm ± 0,1 mm de espesor por cada corona. Se trataron ambas superficies del disco con ácido ortofosfórico al 35% por 15 segundos. Los discos se separaron en los siguientes 3 grupos de tratamiento, de 20 discos cada uno: los que fueron cepillados (cepillo eléctrico Oral-B® Pro Salud Power) durante 2 minutos solo por su cara oclusal con a) Colgate® Sensitive Pro Alivio con tecnología pro arginina (Colgate-Palmolive, Estados Unidos); b) Sensodyne® Rápido Alivio (GlaxoSmitheKline, Reino Unidio), y c) agua destilada como control negativo. Los datos fueron analizados estadísticamente por medio de las pruebas de Kruskall-Wallis y Mann-Whitney. Los resultados expresados en µl*cm−2*min−1cm*H²O−1 como medias, separados por grupo fueron: a) 0,00650 (± 0,00384); b) 0,00800 (± 0,00472), y c) 0,03649 (± 0,03042). Con el estudio se pudo concluir que los 2 agentes desensibilizantes dentinarios presentan significativa disminución de la conductabilidad hidráulica en dentina. Se encontraron diferencias estadísticamente significativas entre el grupo control y Sensodyne® Rápido Alivio (p = 0,000) y entre el grupo control y Colgate® Sensitive Pro Alivio (p = 0,000). No se observó diferencia entre las 2 pastas dentales (p = 0,317).

The aim of the study was to determine the effects of agents toothpastes on the hydraulic conductance of dentin desensitizers "in vitro". We selected 60 third molars healthy humans, recently extracted without occlusal contact, of patients between 15-30 years, which were cleaned, disinfected (Tymol 0.1% per 24 hours) and preserved at T atmosphere solution for a maximum of 14 days. The crowns were sectioned perpendicular to the tooth axis under abundant refrigeration, obtaining a disc of 1 mm +/-0.1 mm. thickness for each Crown. Disks were separated into the following three groups of treatment, of 20 discs each, which were brushings (brush electrical Oral-B Pro health Power) for 2 minutes only by your face occlusal with; a) Colgate® Sensitive Pro relief with technology Pro arginine (Colgate-Palmolive, USA), b) Sensodyne® quick-relief (GlaxoSmitheKline, UK), and c) distilled water as a negative control. The data were statistically analyzed by Kruskall Wallis and Mann Whitney tests. The results expressed in µl*cm−2*min−1cm*H²O−1as stockings, separated by group were; a) 0,00650 (±0.00384), b) 0,00800 (±0,00472), c) 0 and 03649 (±0,03042). You could be concluded with the study that two dentin desensitizers agents present significant decrease in hydraulic conductance in dentin. Statistically significant differences were found between the group control and Sensodyne® fast relief (p = 0,000) and between group control and Colgate® Sensitive Pro relief (p = 0,000). There was no difference between the two toothpastes (p = 0,317).

Involvement of Smad pathway in proteoglycan 4 expression induced by hydrostatic pressure in temporomandibular synovial fibroblasts / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To examine the expression of proteoglycan 4 (PRG-4) induced by hydrostatic pressure in rat temporomandibular synovial fibroblasts and investigate the possible mechanism.</p><p><b>METHODS</b>The cultured rat temporomandibular synovial fibroblasts were subjected to 100 kPa magnitude intermittent hydrostatic pressure (IHP) at frequency of 4 h/day, and the static group served as control. The expressions of Smad pathway proteins and p38MAPK pathway proteins were analyzed by Western blot and immunofluorescence staining. Then the cells were incubated with SB431542, the inhibitor of transforming growth factor (TGF)-β receptor. Western blot and reverse transcription PCR were used to detect the PRG-4 expression after 72 h.</p><p><b>RESULTS</b>The expression of phosphorylated Smad-2 and phosphorylated Smad-3 were increased after 1 h of IHP, reaching a maximum after 2 h and 4 h of IHP, respectively.However, the protein content of phosphorylated p38 did not vary significantly. In addition, IHP induced nuclear translocation of Smad-2/-3, and the immunofluorescence staining signal intensity markedly increased (24.11 ± 4.70)(P < 0.05). The levels of PRG-4 mRNA were significantly increased by IHP (1.48 ± 0.08)(P < 0.05). Treatment of cells with SB431542 could decrease the expression of PRG-4 mRNA significantly after IHP (0.47 ± 0.05)(P < 0.05). In addition, SB431542 inhibited the expression of PRG-4 protein induced by IHP.</p><p><b>CONCLUSIONS</b>Smad signal acts as an essential signal pathway to regulate PRG-4 expression induced by IHP.</p>

The Effects of Substrates and Hydrostatic Pressure on Differentiation of Mesenchymal Stem Cell / 대한정형외과연구학회지

PURPOSE: This study investigated the potential of dual differentiation of stem cells into osteo- and chodrogenesis depending on scaffold type even in the same environment. MATERIALS AND METHODS: For the part of the cartilage tissue section, MSCs were suspended in alginate solution and bead droplets were made using 23G syringe. For the bone tissue section, PCL/HA scaffolds were made using the bio-plotting system followed by seeding mesenchymal stem cells (MSCs) onto the scaffolds. Scaffolds with MSCs were cultured in cocktail media containing osteogenic and chondrogenic growth factors for up to 21 days. To provide mechanical environments which articular cartilage experiences in-vivo, intermittent hydrostatic pressure (IHP) was engaged. Various cellular responses were assessed: the quantitative analysis of DNA contents, GAG contents, ALP activities and immunofluorescence. RESULTS: We found that IHP promoted MSCs differentiation into the targeted cell types. That is, MSCs in alginate scaffolds were able to be differentiated into chondrocytes, while those onto PCL/HA scaffolds were able to be differentiated into osteoblasts. CONCLUSION: Depending on the scaffold characteristics MSCs can be differentiated into bone cells or chondrocytes. This technique can provide a cue for the treatment of osteochondral defects utilizing tissue engineering.

The Effects of Substrates and Hydrostatic Pressure on Differentiation of Mesenchymal Stem Cell / 대한정형외과연구학회지

PURPOSE: This study investigated the potential of dual differentiation of stem cells into osteo- and chodrogenesis depending on scaffold type even in the same environment. MATERIALS AND METHODS: For the part of the cartilage tissue section, MSCs were suspended in alginate solution and bead droplets were made using 23G syringe. For the bone tissue section, PCL/HA scaffolds were made using the bio-plotting system followed by seeding mesenchymal stem cells (MSCs) onto the scaffolds. Scaffolds with MSCs were cultured in cocktail media containing osteogenic and chondrogenic growth factors for up to 21 days. To provide mechanical environments which articular cartilage experiences in-vivo, intermittent hydrostatic pressure (IHP) was engaged. Various cellular responses were assessed: the quantitative analysis of DNA contents, GAG contents, ALP activities and immunofluorescence. RESULTS: We found that IHP promoted MSCs differentiation into the targeted cell types. That is, MSCs in alginate scaffolds were able to be differentiated into chondrocytes, while those onto PCL/HA scaffolds were able to be differentiated into osteoblasts. CONCLUSION: Depending on the scaffold characteristics MSCs can be differentiated into bone cells or chondrocytes. This technique can provide a cue for the treatment of osteochondral defects utilizing tissue engineering.

A simple and effective pressure culture system modified from a transwell cell culture system

Mechanical pressure plays an important role in many physiological and pathological processes. Mimicking the mechanical pressure present in vitro is necessary for related research, but usually requires expensive and complicated equipment. In this study we created a simple pressure culture system based on the transwell culture system. By cutting off the top rim of the transwell insert, the cells were compressed between the insert membrane and the well floor. The new pressure culture system was proven effective in that it induced cell morphological change, integrin β1 upregulation, actin polymerization and growth change in rat retinal ganglion cells, human nasopharyngeal carcinoma cells and mice embryonic fibroblasts. Though the pressure value is immeasurable and inhomogeneous, the easily available culture system still provides a choice for the laboratories that do not have access to the better, but much more expensive pressure culture equipment.

Prediction of acid lactic-bacteria growth in turkey ham processed by high hydrostatic pressure

High hydrostatic pressure (HHP) has been investigated and industrially applied to extend shelf life of meat-based products. Traditional ham packaged under microaerophilic conditions may sometimes present high lactic acid bacteria population during refrigerated storage, which limits shelf life due to development of unpleasant odor and greenish and sticky appearance. This study aimed at evaluating the shelf life of turkey ham pressurized at 400 MPa for 15 min and stored at 4, 8 and 12 ºC, in comparison to the non pressurized product. The lactic acid bacteria population up to 10(7) CFU/g of product was set as the criteria to determine the limiting shelf life According to such parameter the pressurized sample achieved a commercial viability within 75 days when stored at 4 ºC while the control lasted only 45 days. Predictive microbiology using Gompertz and Baranyi and Roberts models fitted well both for the pressurized and control samples. The results indicated that the high hydrostatic pressure treatment greatly increased the turkey ham commercial viability in comparison to the usual length, by slowing down the growth of microorganisms in the product.

Skinfold Parameter as Predictor of Body Density for Undergraduate Female Students in a Nigeria University Community

The purpose of this study was to determine if some selected skinfold parameters are visible in predicting body density (BD) of undergraduate female students of Obafemi Awolowo University; lie Ife.Methods: Seventy five non- athletic female students; age ranged from 18 to 30 years old from Obafemi Awolowo University (OAU) lie Ife; Nigeria participated in the study. Underwater weight was measured using Hydrostatic Weighing (HSW) equipment and skinfold was measured with Lange skinfold calipers using standard protocol at chest; biceps; triceps; forearm; mid axillar; subscapular; abdomen; supra illiac; thigh and lateral calf. Body density (BD) was calculated with underwater weight and skinfold measurement using some established equations. Descriptive statistics and Pearson Moment Correlation coefficient was used to analyze the data collected.Results: The result showed that BD by HSW had significant negative correlation with skinfold at chest (r = - .505; p .001); biceps (r

Invaginación intestinal recurrente secundaria a apéndice cecal invaginado: caso clínico / Recurrent intussusception secondary to invaginated cecal appendix. Case report

Introducción: La invaginación intestinal es una patología de causa idiopática en el 95 por ciento de los casos, encontrándose en el 5 por ciento restante algún factor desencadenante que la justifique. Las recurrencias se presentan en un 7 a 12 por ciento de los casos y se asocian a múltiples causas. El objetivo de este trabajo es presentar el caso de un paciente con invaginación intestinal recurrente y analizar la causa de la recurrencia. Caso clínico: Paciente de 1 año y 4 meses de edad, sexo masculino, con antecedente de primer episodio de Invaginación intestinal operado a los 4 meses de edad. Presenta segundo episodio de invaginación a los 9 meses de edad, la cual se trató con desinvaginación neumática y a los 16 meses de edad presentó su tercer episodio, manejandose con desinvaginación hidrostática. Ocho horas post procedimiento el paciente presentó nueva invaginación; se realizó reducción manual quirúrgica. Se encontró una invaginación ileocólica con un remanente apendicular intracecal actuando como cabeza invaginante. Se reseco remanente y se envió a biopsia. Conclusiones: La invaginación intestinal recurrente se asocia a factores anatómicos desencadenantes, por lo cual al presentar recurrencias se debe tener en consideración una posible causa orgánica, ante lo cual se recomienda el tratamiento quirúrgico.

Introduction: Intussusception is an idiopathic pathology that accounts for 95 percent of cases found; the remaining 5 percent is caused by some triggering events. Recurrences occur in 7 to 12 percent of cases and are associated with multiple causes. The aim of this research is to present the case of a patient with recurrent intussusception and analyze the cause of the recurrence. Case report: The patient was a 16 month-old male infant with a history of first episode of intussusception surgery at 4 months old. His second intussusception episode took place at 9 months of age, which was treated with pneumatic reduction process; at 16 months of age he presented his third episode, which was treated with hydrostatic reduction process. 8 hours post procedure, the patient had a new intussusception condition and surgical manual reduction was performed. Ileocolic intussusception was found with an appendiceal intrathecal remnant acting as the invaginating head. Remnant was removed and sent for biopsy. Conclusions: Recurrent intussusception is associated with triggering anatomical factors; therefore, in the case of recurrences, a possible organic cause should be considered and surgical treatment is recommended.

Performance of fixed-pressure valve with antisiphon device SPHERA® in hydrocephalus treatment and overdrainage prevention / Desempenho da válvula de pressão fixa com antissifão SPHERA® no tratamento da hidrocefalia e na prevenção da ocorrência de hiperdrenagem

Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA® in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H2O after tap test (40 mL), 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT) evidence of hypo or overdrainage, and no immediate early or late significant complications.

Pacientes com hidrocefalia e fatores de risco para hiperdrenagem podem ser submetidos ao implante de derivação ventricular (VS) com mecanismo antissifão. O objetivo deste trabalho foi avaliar prospectivamente os resultados clínicos e tomográficos do implante de válvulas de pressão fixa com antissifão SPHERA® em 35 pacientes adultos, com hidrocefalia e risco de hiperdrenagem, acompanhados por dois anos. Destes, 3 apresentavam hidrocefalia congênita em adulto, com ventrículos muito dilatados (índice de Evans >50%); 3 tinham hiperdrenagem sintomática pós-derivação ventricular prévia (hematoma subdural, higroma ou síndrome dos ventrículos colabados; 1 apresentava hematoma subdural crônico pregresso; 15 apresentavam hidrocefalia de pressão normal com pressão lombar final <5 cm H2O após tap test (40 mL); 6 apresentavam pseudotumor cerebral; e 7, devido a outras causas. A melhoria clínica foi detectada e sustentada em 94,3% dos pacientes no período de dois anos, sem indícios tomográficos de hipo ou hiperdrenagem e sem complicações significativas imediatas, precoces ou tardias.