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1.
J Postgrad Med ; 67(3): 171-173, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33835057

RESUMEN

Chest pain complicated with electrocardiographic changes is not an uncommon scenario in emergency departments, which should be examined cautiously. We describe a 51-years-old man with a myocardial bridge of coronary artery presenting with simultaneous Mobitz type I atrioventricular block on electrocardiography. Echocardiography excluded valvular abnormality and systolic/diastolic dysfunction. Coronary angiography confirmed the diagnosis of a myocardial bridge at the middle segment of the left anterior descending artery, involving the most dominant septal perforator branch with marked systolic compression. The patient underwent coronary artery bypass grafting surgery and was followed up uneventfully at the outpatient department with medical treatment of diltiazem and clopidogrel. The present case is being reported to highlight that clinicians should be alert to such a congenital abnormality as a potential cause of repeated myocardial infarction and conduction abnormality.


Asunto(s)
Bloqueo Atrioventricular/diagnóstico , Puente Miocárdico/diagnóstico por imagen , Infarto del Miocardio/diagnóstico por imagen , Bloqueo Atrioventricular/complicaciones , Angiografía Coronaria , Ecocardiografía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico
2.
Hong Kong Med J ; 26(2): 120-126, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32285804

RESUMEN

PURPOSE: Among patients in paediatric intensive care units (PICUs), death is sometimes inevitable despite advances in treatment. Some PICU patients may have irreversible cessation of all brain function, which is considered as brain death (BD). This study investigated demographic and clinical differences between PICU patients with BD and those with cardiopulmonary death. METHODS: All children who died in the PICU at a university-affiliated trauma centre between October 2002 and October 2018 were included in this retrospective study. Demographics and clinical characteristics were compared between patients with BD and patients with cardiopulmonary death. RESULTS: Of the 2784 patients admitted to the PICU during the study period, 127 died (4.6%). Of these 127 deaths, 22 (17.3%) were BD and 105 were cardiopulmonary death. Length of PICU stay was shorter for patients with cardiopulmonary death than for patients with BD (2 vs 8.5 days, P=0.0042). The most common mechanisms of injury in patients with BD were hypoxic-ischaemic injury (40.9%), central nervous system infection (18.2%), and traumatic brain injury (13.6%). The combined proportion of accident and trauma-related injury was greater in patients with BD than in patients with cardiopulmonary death (27.3% vs 3.8%, P<0.001). Organ donation was approved by the families of four of the 22 patients with BD (18.2%) and was performed successfully in three of these four patients. CONCLUSIONS: These findings emphasise the importance of injury prevention in childhood, as well as the need for education of the public regarding acceptance of BD and support for organ donation.


Asunto(s)
Muerte Encefálica/diagnóstico , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Adolescente , Lesiones Traumáticas del Encéfalo/epidemiología , Reanimación Cardiopulmonar/estadística & datos numéricos , Causas de Muerte , Infecciones del Sistema Nervioso Central/epidemiología , Niño , Preescolar , Femenino , Hong Kong/epidemiología , Mortalidad Hospitalaria , Humanos , Lactante , Recién Nacido , Tiempo de Internación/estadística & datos numéricos , Masculino , Estudios Retrospectivos , Donantes de Tejidos/estadística & datos numéricos , Centros Traumatológicos
3.
Clin Radiol ; 73(3): 231-236, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29167015

RESUMEN

AIM: To quantitatively assess fat infiltration in the sacroiliac joints (SIJs) of patients with ankylosing spondylitis (AS) by measuring the fat/water signal ratios of periarticular bone marrow with iterative decomposition of water and fat with echo asymmetry and least square estimation (IDEAL). MATERIALS AND METHODS: Routine SIJ magnetic resonance imaging (MRI) and IDEAL were performed on 40 patients with AS and 30 healthy subjects. The fat infiltration regions (FIRs) and normal-appearing regions (NARs) of patients were measured based on the fat/water signal intensity on IDEAL. RESULTS: AS patients had higher fat/water signal ratios on FIRs and NARs (65.4-85.4%, p<0.05, and 44.1-70.7%, p<0.05, respectively) compared to healthy controls (38.3-43.3%). After treatment, the fat/water signal ratios of FIRs and NARs decreased (42.1-53.7% and 41.5-50.3%, respectively), but they remained higher than in the healthy controls (p<0.05). The fat infiltration was detected more effectively with a fat fraction map of the IDEAL sequence (95%) than other sequences, including the T1-weighted sequence (65%), and the fat/water signal ratios of the sacrum and ilium between the left and right sides of SIJs were approximately the same. CONCLUSION: The findings of this study suggest that IDEAL may be useful as a quantitative and objective method for evaluating the fat infiltration in the periarticular bone marrow of SIJs with AS; additionally, the sensitivity of IDEAL is better than that of routine sequences in detecting micro-fat infiltration of SIJs, and IDEAL can be used to quantitatively measure the adipose content and monitor patient follow-up after AS treatment.


Asunto(s)
Tejido Adiposo/patología , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Articulación Sacroiliaca/diagnóstico por imagen , Espondilitis Anquilosante/diagnóstico por imagen , Adolescente , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Análisis de los Mínimos Cuadrados , Masculino , Persona de Mediana Edad , Articulación Sacroiliaca/patología , Espondilitis Anquilosante/patología
4.
Eur J Dent Educ ; 22(3): e573-e581, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29665243

RESUMEN

PURPOSE: This research aimed to evaluate the students' usage and perceptions of using smartphones in their general dental education and learning tooth preparation with the individually designed virtual 3D instructional models in the pre-clinical removable partial denture course. MATERIALS AND METHODS: Second-year dental students were asked to voluntarily participate in a survey to investigate their demographic information, general usages of smartphones, perception of smartphones usage in dental education (construct 1) and perception of individually designed virtual 3D instructional models (construct 2). Students' responses of general usages of the smartphones were compared with their demographic and educational backgrounds using nonparametric Kruskal-Wallis test (for age) and Fisher's exact test (for sex, race and educational background). The sums of scores of the construct 1 and construct 2 were tested for associations with student's demographic and educational backgrounds using the Pearson product-moment correlation (for age), t test (for sex and educational background) or one-way ANOVA F test (for race) (α = .05). RESULTS: A 75% response rate (N = 90) was achieved in this study, and all 90 participants owned smartphones. Students' responses to general usages of the smartphones were not significantly influenced by their demographic background. For the construct 1, more than 73% of participants responded either agree or strongly agree to the usage of smartphones in general dental education and pre-clinical setting; however, only 49% of participants responded the same way in the clinical setting. For the construct 2, 48 of 90 participants viewed the 3D models, and more than 73% of these 48 participants responded either agree or strongly agree to the usage of the 3D models in the pre-clinical course. Student's demographic background did not have significant influence on the sums of scores of the construct 1 and construct 2. CONCLUSIONS: Within the limitations of this study, high usages and ownerships of smartphones were found amongst the students surveyed. The individually designed virtual 3D instructional models as supplemental teaching materials in the pre-clinical course were perceived positively by the students.


Asunto(s)
Educación en Odontología/métodos , Educación en Odontología/estadística & datos numéricos , Modelos Anatómicos , Utilización de Procedimientos y Técnicas/estadística & datos numéricos , Teléfono Inteligente/estadística & datos numéricos , Estudiantes de Odontología/estadística & datos numéricos , Materiales de Enseñanza , Preparación del Diente , Realidad Virtual , Dentadura Parcial Removible , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
5.
Eur J Dent Educ ; 21(3): 200-205, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26960967

RESUMEN

INTRODUCTION: With increasing use of digital scanning with restorative procedures in the dental office, it becomes necessary that educational institutions adopt instructional methodology for introducing this technology together with conventional impression techniques. OBJECTIVE: To compare the time differences between instructing dental students on digital scanning (DS) (LAVA C.O.S. digital impression system) and a conventional impression technique (CI) (polyvinyl siloxane), and to compare students' attitudes and beliefs towards both techniques. MATERIALS AND METHODS: Volunteer sophomore dental students (n = 25) with no prior experience in clinical impressions were recruited and IRB consent obtained. Participants responded to a pre-and post-exposure questionnaire. Participants were instructed on the use of both DS and CI for a single tooth full coverage crown restoration using a consecutive sequence of video lecture, investigator-led demonstration and independent impression exercise. The time necessary for each step (minutes) was recorded. Statistical significance was calculated using dependent t-tests (time measurements) and 2-sample Mann-Whitney (questionnaire responses). RESULTS: The time spent teaching students was greater for DS than CI for video lecture (15.95 and 10.07 min, P = 0.0000), demonstration time (9.06 and 4.70 min, P = 0.0000) and impression time (18.17 and 8.59 min, P = 0.0000). Prior to the instruction and practice, students considered themselves more familiar with CI (3.96) than DS (1.96) (P = 0.0000). After the instruction and practice, participants reported CI technique proved significantly easier than expected (pre-instruction: 3.52 and post-instruction: 4.08, P = 0.002). However, overall participants' perception of ease of use for DS was not influenced by this instruction and practice experience (pre-instruction: 3.84 and post-instruction: 3.56, P = 0.106). Despite the results, 96% of participants expressed an expectation that DS will become their predominant impression technique during their careers. CONCLUSIONS: Dental students with no clinical experience have high expectations for digital scanning, and despite their initial difficulty, expect it to become their primary impression technique during their professional futures. The instructional time necessary for introducing DS into the curriculum is significantly greater than CI in both classroom (lecture) and clinical simulation settings (investigator-led demonstration).


Asunto(s)
Diseño Asistido por Computadora , Coronas , Materiales de Impresión Dental , Técnica de Impresión Dental , Educación en Odontología , Estudiantes de Odontología , Diente/diagnóstico por imagen , Actitud del Personal de Salud , Humanos , Maniquíes , Modelos Dentales , Polivinilos , Siloxanos , Encuestas y Cuestionarios , Diente/anatomía & histología
6.
Phys Chem Chem Phys ; 18(5): 3900-9, 2016 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-26766540

RESUMEN

This work describes an oxidation process of iron-iron oxide core-shell nanowires at temperatures between 100 °C and 800 °C. The studied nanomaterial was synthesized through a simple chemical reduction of iron trichloride in an external magnetic field under a constant flow of argon. The electron microscopy investigations allowed determining that the as-prepared nanowires were composed of self-assembled iron nanoparticles which were covered by a 3 nm thick oxide shell and separated from each other by a thin interface layer. Both these layers exhibited an amorphous or highly-disordered character which was traced by means of transmission electron microscopy and Mössbauer spectroscopy. The thermal oxidation was carried out under a constant flow of argon which contained the traces of oxygen. The first stage of process was related to slow transformations of amorphous Fe and amorphous iron oxides into crystalline phases and disappearance of interfaces between iron nanoparticles forming the studied nanomaterial (range: 25-300 °C). After that, the crystalline iron core and iron oxide shell became oxidized and signals for different compositions of iron oxide sheath were observed (range: 300-800 °C) using X-ray diffraction, Raman spectroscopy and Mössbauer spectroscopy. According to the thermal gravimetric analysis, the nanowires heated up to 800 °C under argon atmosphere gained 37% of mass with respect to their initial weight. The structure of the studied nanomaterial oxidized at 800 °C was mainly composed of α-Fe2O3 (∼ 93%). Moreover, iron nanowires treated above 600 °C lost their wire-like shape due to their shrinkage and collapse caused by the void coalescence.

7.
Genet Mol Res ; 14(2): 4381-90, 2015 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-25966211

RESUMEN

Rice (Oryza sativa L.) is one of the most important food crops in the world. In Taiwan, due to the warm climate, there are two harvests annually. However, the yield and quality of rice can vary between each crop season in any given year. Previous reports have shown that microRNAs (miRNAs) play a crucial role in many developmental and physiological processes in plants. In this study, the heading date characteristics of 167 rice cultivars from the second crop season were recorded, and 27 rice cultivars were selected for preliminary microarray analysis. A total of 14 miRNAs from different heading date characteristics in 21 cultivars were selected based on significant differences in their expression profiles. Using a correlation analysis between the heading date and selected miRNA expression obtained from real-time polymerase chain reaction (PCR) assays, we developed a heading date prediction model. The model includes nine miRNA genes with corresponding R2 values of 0.8. To confirm the model, a real-time PCR analysis was performed on an additional 27 rice cultivars and we found the model predicted the heading date with accuracy. Therefore, the developed prediction may be useful in further studies aimed at confirming the reliability of the use of miRNA in molecular breeding and to increase the selection efficiency of rice cultivars and breeding.


Asunto(s)
MicroARNs/metabolismo , Oryza/genética , Productos Agrícolas , Expresión Génica , Genes de Plantas , Modelos Genéticos , Análisis de Secuencia por Matrices de Oligonucleótidos , Oryza/crecimiento & desarrollo , Fitomejoramiento , Desarrollo de la Planta/genética , Sitios de Carácter Cuantitativo
8.
Eur J Dent Educ ; 19(2): 81-6, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25040313

RESUMEN

In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics.


Asunto(s)
Educación en Odontología/organización & administración , Educación del Paciente como Asunto , Odontología Preventiva/educación , Estudiantes de Odontología/psicología , Adulto , Competencia Clínica , Curriculum , Evaluación Educacional , Femenino , Humanos , Kentucky , Masculino
9.
Tissue Antigens ; 80(5): 431-6, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23020308

RESUMEN

Hashimoto disease (HD) is an autoimmune thyroid disease resulting from complex interactions between genetic and environmental factors. The human leukocyte antigen (HLA) gene has been established to be involved in the susceptibility to HD. We aim to investigate the associations between HLA-B alleles and Han Chinese children with HD by both case-control and family-based studies. A total of 108 unrelated children with HD, 380 unrelated healthy controls, 58 trios of affected patients and their parents, and 75 trios of unaffected siblings and their parents were recruited. HLA-B genotyping was performed by polymerase chain reaction and detected with a sequence-specific oligonucleotide probes system. We found that B*46:01 allele (OR = 2.31, 95% CI 1.60-3.34, P(c) = 9.99 × 10(-5)) and carrier (OR = 3.28, 95% CI 2.10-5.11, P(c) = 1.35 × 10(-6)) were associated with HD risk. Transmission/disequilibrium test further confirmed an overtransmission of the B*46:01 (OR 2.55, 95% CI 1.36-6.10, P = 6.5 × 10(-3)). The findings were similar in females when stratified by gender. In conclusion, our results clearly identify that HLA-B*46:01 confers susceptibility to HD in Han Chinese children. Further studies with larger children cohort are required to confirm the role of B*46:01 in the development of HD.


Asunto(s)
Pueblo Asiatico , Predisposición Genética a la Enfermedad , Antígenos HLA-B/genética , Enfermedad de Hashimoto/genética , Polimorfismo Genético , Adolescente , Adulto , Alelos , Estudios de Casos y Controles , Niño , Preescolar , Familia , Femenino , Frecuencia de los Genes , Antígenos HLA-B/inmunología , Haplotipos , Enfermedad de Hashimoto/inmunología , Prueba de Histocompatibilidad , Humanos , Desequilibrio de Ligamiento , Masculino , Persona de Mediana Edad , Hermanos
10.
Oper Dent ; 41(5): 552-562, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27689837

RESUMEN

OBJECTIVE: For some esthetic clinical situations, it is necessary to finish crown margins on direct restorative materials to preserve tissue integrity, bonding integrity, and biological width. The purpose of this research was to investigate microleakage at the interface between bonded lithium disilicate crowns and various direct restorative materials in a class III and class V position. METHODS AND MATERIALS: Class III or class V restorations were prepared on one side of extracted incisors with either Tetric EvoCeram, Tetric Evoceram Bulk, Fuji II LC, or Tetric Evoflow. The teeth were prepared for and received a lithium disilicate crown. After load fatiguing, the specimens were thermo-cycled with a fuchsin dye and sectioned. The depth and area of dye penetration were measured with a dimensional grid in micrometers using stereomicroscopy and reported as mean dye depth and area (µm) ± SD. The comparison of multiple categorical independent variables with ratio scale dependent variables was evaluated with an analysis of variance and Tukey's post hoc analysis. RESULTS: A statistically significant higher dye penetration was noted for all treatment groups compared with the positive control (side opposite the restoration after sagittal sectioning was used as positive control) regardless of material or placement area (p<0.05). In comparing treatment groups, the Tetric EvoFlow experienced a statistically higher dye penetration than did the other treatment groups regardless of material or placement area (p<0.05). There was no statistically significant difference between the Tetric EvoCeram, Tetric Evoceram Bulk, and Fuji II LC materials regardless of placement area (p>0.05). CONCLUSIONS: Within the limitations of this study, it can be concluded that flowable composite materials as finish lines that interact with resin cements could lead to exacerbated interfacial degradation. Finishing lithium disilicate all-ceramic crowns on flowable resin composite materials in the esthetic zone should be used with caution. If necessary, finishing lithium disilicate all-ceramic crowns on nanofilled resin composite or resin-modified glass ionomer materials seems to provide the least dye penetration depth and area.

11.
Circulation ; 102(1): 67-74, 2000 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-10880417

RESUMEN

BACKGROUND: The superior vena cava (SVC) has cardiac musculature extending from the right atrium. However, no previous study in humans has given details regarding the ectopic foci that initiate paroxysmal atrial fibrillation (PAF), which may originate from the SVC. METHODS AND RESULTS: A total of 130 patients with frequent attacks of PAF initiated by ectopic beats were included. Eight patients (6%) had spontaneous AF initiated by a burst of rapid ectopic beats from the SVC (located 19+/-7 mm above the junction of the SVC and right atrium), which was confirmed by multiplane angiographic and intracardiac echocardiographic visualization and was marked by a sharp SVC potential preceding atrial activity. During initial repetitive discharges, the group with SVC ectopy had a higher incidence of intravenous conduction block than the group with pulmonary vein ectopy (75% versus 37%; P=0.03). The activation time of the earliest intracardiac ectopic activities relative to ectopic P wave onset was significantly shorter in the SVC ectopy than the pulmonary vein ectopy group (37+/-15 versus 84+/-32 ms; P<0. 001). After 5+/-3 applications of radiofrequency energy, AF was eliminated. SVC angiography after ablation revealed a local indentation of the venous wall in one patient. Two patients manifested coexisting sinus rhythm and a "focal" fibrillating activity confined inside the SVC after radiofrequency ablation. During a follow-up period of 9+/-3 months, all 8 patients were free of antiarrhythmic drugs, without tachycardia recurrence or symptoms of SVC obstruction. CONCLUSIONS: Ectopic beats initiating PAF can originate from the SVC. A radiofrequency current delivered to eliminate these ectopies is a highly effective and safe way to prevent PAF.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Vena Cava Superior/fisiopatología , Adulto , Anciano , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Fibrilación Atrial/terapia , Angiografía Coronaria , Electrocardiografía Ambulatoria , Femenino , Humanos , Masculino , Venas Pulmonares/fisiopatología , Nodo Sinoatrial/fisiología , Resultado del Tratamiento
12.
Circulation ; 101(11): 1274-81, 2000 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-10725287

RESUMEN

BACKGROUND: Successful ablation of ectopic beats originating from the pulmonary veins (PV) could eliminate paroxysmal atrial fibrillation (PAF). However, information about the structure of the PV in patients with PAF that is initiated by PV ectopic beats has not been reported. METHODS AND RESULTS: We studied the morphology of the PVs and measured their diameters in 3 groups of patients. Group I included 52 patients (aged 66+/-14 years; 44 men) with focal atrial fibrillation (AF) from the PVs. Group II included 8 patients (aged 50+/-10 years; 3 men) with focal AF from the superior vena cava or cristal terminalis. Group III included 23 control patients (aged 55+/-16 years; 17 men). Of the control patients, 11 had AV node and 12 had AV reentrant tachycardia. After an atrial transseptal procedure, selective PV angiography using a biplane system with a right anterior oblique view of 30 degrees, a left anterior oblique view of 60 degrees, and a cranial angle of 20 degrees was performed. The ostial and proximal portions of the right and left superior PVs (RSPV and LSPV) were significantly dilated in group I patients compared with those in groups II and III. Furthermore, the ostia of the RSPV and LSPV were significantly dilated in group II compared with group III patients. However, the mean diameters of the inferior PVs were similar between the 3 groups. Comparisons of the individual PV diameters among the 3 subgroups of group I (which was divided according to where the ectopic focus was located) showed nonselective dilatation of the PV. CONCLUSIONS: Nonspecific dilatation of the ostia and proximal portion of superior PVs were found in patients with PAF initiated by ectopic beats from the superior PVs.


Asunto(s)
Fibrilación Atrial/diagnóstico por imagen , Fibrilación Atrial/etiología , Complejos Cardíacos Prematuros/complicaciones , Complejos Cardíacos Prematuros/fisiopatología , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Angiografía , Complejos Cardíacos Prematuros/cirugía , Ablación por Catéter , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Venas Pulmonares/cirugía , Valores de Referencia , Vasodilatación , Vena Cava Superior/fisiopatología
13.
Circulation ; 104(13): 1501-5, 2001 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-11571243

RESUMEN

BACKGROUND: The atrial musculature in the cavotricuspid isthmus is a part of posterior inputs to the AV node. In patients with typical atrial flutter, effects of radiofrequency ablation of this isthmus on AV node conduction are still unknown. METHODS AND RESULTS: This study included 16 patients with clinically documented typical atrial flutter. Group 1 had 8 patients without and group 2 had 8 patients with dual AV nodal pathway physiology. Electrical pacing from the interatrial septum and low right atrium was performed to evaluate antegrade AV node function before and after ablation of the cavotricuspid isthmus. In group 1, the AV node conduction properties were similar before and after ablation. In group 2, the AV node Wenckebach cycle length and maximal AH interval during low right atrium (356+/-58 versus 399+/-49 ms, P=0.008; 303+/-57 versus 376+/-50 ms, P=0.008) and interatrial septum (365+/-62 versus 393+/-59 ms, P=0.008; 324+/-52 versus 390+/-60 ms, P=0.008) pacing were significantly longer after ablation. Elimination of the slow pathway after ablation was noted in 2 patients, including 1 with AV nodal reentrant echo beats. CONCLUSIONS: Radiofrequency ablation of the cavotricuspid isthmus was effective in eliminating typical atrial flutter without injury of antegrade fast AV node conduction. The atrial musculature in the cavotricuspid isthmus significantly contributed to the slow AV node conduction.


Asunto(s)
Aleteo Atrial/cirugía , Nodo Atrioventricular/fisiopatología , Ablación por Catéter , Anciano , Aleteo Atrial/fisiopatología , Electrofisiología , Femenino , Sistema de Conducción Cardíaco , Humanos , Masculino , Persona de Mediana Edad
14.
J Am Coll Cardiol ; 36(3): 788-93, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10987601

RESUMEN

OBJECTIVES: This study was aimed at evaluating the effects of phenylephrine infusion on the occurrence of focal atrial fibrillation (AF). BACKGROUND: Paroxysmal AF can be initiated by ectopic atrial beats originating in the pulmonary vein (PV) or superior vena cava (SVC). The effect of change in autonomic tone on this focal AF is unknown. METHODS: This study included 12 patients with frequent bursts of AF documented by 24-h Holter monitoring. The number and coupling interval of spontaneous ectopic activity and bursts of AF were evaluated for 1 min before and after phenylephrine (2 to 3 microg/kg) injection. RESULTS: After detailed mapping, four patients had a focus located in the left superior PV, six in the right superior PV and two in the SVC. In 10 patients with AF foci originating in the PVs, the frequency of ectopic activity (19.5 +/- 27.4 vs. 11.4 +/- 22.9 beats/min, p = 0.059) was reduced as well as AF bursts (14 +/- 3 vs. 1.8 +/- 2.7 bursts/min, p = 0.005) before versus after phenylephrine injection; the minimal coupling interval of ectopic activity and AF bursts became longer compared with baseline. The maximal percent increase in sinus cycle length after phenylephrine injection was significantly greater in patients with complete suppression of AF compared with those with partial suppression (43 +/- 19 vs. 14 +/- 5%, p = 0.01). However, no significant effect of phenylephrine on AF originating in the SVC was found. CONCLUSIONS: Change in autonomic tone induced by phenylephrine injection was effective in suppressing focal AF originating in the PVs but not in the SVC.


Asunto(s)
Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/fisiopatología , Cardiotónicos/uso terapéutico , Fenilefrina/uso terapéutico , Venas Pulmonares/fisiopatología , Vena Cava Superior/fisiopatología , Anciano , Fibrilación Atrial/cirugía , Complejos Cardíacos Prematuros/tratamiento farmacológico , Complejos Cardíacos Prematuros/cirugía , Ablación por Catéter , Electrofisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiocirugia
15.
Oper Dent ; 40(3): 241-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25706612

RESUMEN

Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.


Asunto(s)
Cerámica/uso terapéutico , Diseño Asistido por Computadora , Porcelana Dental/uso terapéutico , Coronas con Frente Estético , Adulto , Restauración Dental Permanente/métodos , Humanos , Masculino
16.
Oper Dent ; 40(4): 357-63, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25706616

RESUMEN

The purpose of this case report was to present the use of a contemporary digital photograph-assisted virtual smile design principle, an intraoral digital impression, and computer-aided design/computer-aided manufacture-fabricated lithium disilicate ceramic veneers to treat a patient with esthetic needs in the maxillary anterior region. By using the proposed digital restorative work flow, this case report demonstrated an effective communication pathway between the patient, clinician, and dental laboratory technician. Effective communication can help to achieve a more predictable and satisfactory esthetic outcome.


Asunto(s)
Diseño Asistido por Computadora , Reparación de Restauración Dental/métodos , Coronas con Frente Estético , Cerámica , Estética Dental , Femenino , Humanos , Persona de Mediana Edad , Fotografía Dental , Sonrisa , Programas Informáticos
17.
Arch Neurol ; 34(5): 310-2, 1977 May.
Artículo en Inglés | MEDLINE | ID: mdl-193474

RESUMEN

Sudden permanent blindness of cerebral origin, in addition to severe abdominal pain, hypertension, convulsions, and peripheral neuropathy developed in a 21-year-old woman, a victim of acute intermittent porphyria. Findings of the pathological examination of the brain showed extensive infarction in both occipital lobes. The pathological changes were consistent with anoxia. We discuss and review the literature of the possibility of "vasospasm" of both posterior cerebral arteries. Follow-up studies with serial EEG showed either focal epileptogenic activity or diffuse slow waves. The most consistent epileptic discharges were found in the occipital regions. The favorable response to the treatment of seizures with carbamazepine in this patient might encourage further clinical trials.


Asunto(s)
Ceguera/etiología , Enfermedades del Sistema Nervioso Periférico/etiología , Porfirias/complicaciones , Adulto , Encéfalo/patología , Carbamazepina/uso terapéutico , Electroencefalografía , Epilepsia/diagnóstico , Epilepsia/tratamiento farmacológico , Epilepsia/etiología , Femenino , Humanos , Hipertensión/complicaciones , Parálisis/etiología , Porfirias/patología , Parálisis de los Pliegues Vocales/etiología
18.
Food Chem Toxicol ; 24(12): 1309-13, 1986 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-3804133

RESUMEN

15-Acetyldeoxynivalenol (15-ADON), a biosynthetic precursor of deoxynivalenol (DON), was extracted from rice cultures of Fusarium graminearum R6576 and purified. Growing female B6C3F1 mice were fed semi-purified diets containing 0, 0.5, 2.0 and 5.0 ppm 15-ADON over 56 days and assessed for effects on feed intake, body-weight gain, terminal organ weights and blood clotting function. A significant reduction in feed intake was observed at the 5.0-ppm level after 44 days, whereas reduced rates of weight gain were found to occur at the 5.0-ppm level after only 16 days. Terminal liver, kidney and spleen weights were significantly lower in mice consuming the 5.0-ppm diet when compared with controls. Dietary 15-ADON at the 0.5- and 2.0-ppm levels did not show significant effects on weight gain, feed intake or organ weights. Although mice treated with 15-ADON had significantly decreased bleeding times, other measurements of clotting function indicated no differences between the control and treated groups. Results indicated that 15-ADON was only slightly less toxic than DON and that chronic manifestations of dietary 15-ADON were similar to those found previously for DON. Future risk assessments for DON should therefore include consideration of 15-ADON occurrence and toxicity.


Asunto(s)
Peso Corporal/efectos de los fármacos , Ingestión de Alimentos/efectos de los fármacos , Sesquiterpenos/farmacología , Tricotecenos/farmacología , Animales , Tiempo de Sangría , Coagulación Sanguínea/efectos de los fármacos , Ratones , Tamaño de los Órganos/efectos de los fármacos
19.
Food Chem Toxicol ; 25(11): 855-8, 1987 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-3692388

RESUMEN

The emetic activity of 15-acetyldeoxynivalenol (15-ADON), a deoxynivalenol (DON) precursor, was evaluated in swine over a dose range of 25-200 micrograms/kg body weight and found to be very similar to that of DON. The minimum effective oral doses for 15-ADON and DON were 75 and 50 micrograms/kg, respectively, with 3/15 of the 15-ADON- and 4/15 of the DON-treated pigs exhibiting emesis, over the total dose range. The minimum effective ip doses for 15-ADON and DON were also 75 and 50 micrograms/kg, respectively, with 9/15 pigs in each group exhibiting emesis, over the total dose range. For pigs receiving 15-ADON and DON ip, increased dosage was associated with decreased average time to vomition, increased duration of emesis and increased average number of vomitions.


Asunto(s)
Sesquiterpenos/toxicidad , Tricotecenos/toxicidad , Vómitos/inducido químicamente , Animales , Relación Dosis-Respuesta a Droga , Análisis de Regresión , Porcinos , Tricotecenos/metabolismo
20.
Food Chem Toxicol ; 25(2): 155-62, 1987 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-3557238

RESUMEN

The acute toxic effects of deoxynivalenol (DON) and 15-acetyldeoxynivalenol (15-ADON) were compared in the B6C3F1 female mouse after oral and intraperitoneal exposure. Using the abbreviated procedure of Lorke (Archs Toxicol. 1983, 54, 275), LD50 values for DON were estimated to be 78 mg/kg (oral) and 49 mg/kg (ip) whereas the LD50 values for 15-ADON were 34 mg/kg (oral) and 113 mg/kg (ip). Acute doses of these toxins resulted in extensive necrosis of the gastro-intestinal tract, bone marrow and lymphoid tissues, and focal lesions in kidney and cardiac tissue. The minimum doses required for these histopathological effects were consistent with LD50 estimations. The results indicate that 15-ADON was more or less toxic than DON depending on the route of administration. Risk assessments for DON should therefore consider the potential for 15-ADON occurrence and toxicity in food and feed.


Asunto(s)
Sesquiterpenos/toxicidad , Tricotecenos/toxicidad , Animales , Médula Ósea/efectos de los fármacos , Sistema Digestivo/efectos de los fármacos , Femenino , Riñón/efectos de los fármacos , Dosificación Letal Mediana , Tejido Linfoide/efectos de los fármacos , Ratones , Ratones Endogámicos , Tricotecenos/metabolismo
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