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1.
Materials (Basel) ; 17(13)2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38998178

RESUMEN

Replacing the flammable liquid electrolytes with solid ones has been considered to be the most effective way to improve the safety of the lithium batteries. However, the solid electrolytes often suffer from low ionic conductivity and poor rate capability due to their relatively stable molecular/atomic architectures. In this study, we report a composite solid electrolyte, in which polyethylene oxide (PEO) is the matrix and Li6.4La3Zr1.45Ta0.5Mo0.05O12 (LLZTMO) and Li6.4La3Zr1.4Ta0.6O12 (LLZTO) are the fillers. Ta/Mo co-doping can further promote the ion transport capacity in the electrolyte. The synthesized composite electrolytes exhibit high thermal stability (up to 413 °C) and good ionic conductivity (LLZTMO-PEO 2.00 × 10-4 S·cm-1, LLZTO-PEO 1.53 × 10-4 S·cm-1) at 35 °C. Compared with a pure PEO electrolyte, whose ionic conductivity is in the range of 10-7~10-6 S·cm-1, the ionic conductivity of composite solid electrolytes is greatly improved. The full cell assembled with LiFePO4 as the positive electrode exhibits excellent rate performance and good cycling stability, indicating that prepared solid electrolytes have great potential applications in lithium batteries.

2.
Int J Surg ; 110(6): 3230-3236, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38348893

RESUMEN

IMPORTANCE: Patients with pathological complete response (pCR) of rectal cancer following neoadjuvant treatment had better oncological outcomes. However, reliable methods for accurately predicting pCR remain limited. OBJECTIVE: To evaluate whether transrectal ultrasound-guided tru-cut biopsy (TRUS-TCB) adds diagnostic value to conventional modalities for predicting pathological complete response in patients with rectal cancer after neoadjuvant treatment. DESIGN, SETTING, AND PARTICIPANTS: This study evaluated data of patients with rectal cancer who were treated with neoadjuvant treatment and reassessed using TRUS-TCB and conventional modalities before surgery. This study is registered with ClinicalTrials.gov. MAIN OUTCOMES AND MEASURES: The primary outcome was accuracy, along with secondary outcomes including sensitivity, specificity, negative predictive value, and positive predictive value in predicting tumour residues. Final surgical pathology was used as reference standard. RESULTS: Between June 2021 and June 2022, a total of 74 patients were enroled, with 63 patients ultimately evaluated. Among them, 17 patients (28%) exhibited a complete pathological response. TRUS-TCB demonstrated an accuracy of 0.71 (95% CI, 0.58-0.82) in predicting tumour residues. The combined use of TRUS-TCB and conventional modalities significantly improved diagnostic accuracy compared to conventional modalities alone (0.75 vs. 0.59, P =0.02). Furthermore, TRUS-TCB correctly reclassified 52% of patients erroneously classified as having a complete clinical response by conventional methods. The occurrence of only one mild adverse event was observed. CONCLUSIONS AND RELEVANCE: TRUS-TCB proves to be a safe and accessible tool for reevaluation with minimal complications. The incorporation of TRUS-TCB alongside conventional methods leads to enhanced diagnostic performance.


Asunto(s)
Terapia Neoadyuvante , Neoplasias del Recto , Humanos , Neoplasias del Recto/patología , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/terapia , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Biopsia Guiada por Imagen/métodos , Adulto , Ultrasonografía Intervencional , Recto/patología , Recto/cirugía , Recto/diagnóstico por imagen , Valor Predictivo de las Pruebas , Resultado del Tratamiento
3.
BMC Cancer ; 23(1): 315, 2023 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-37020199

RESUMEN

BACKGROUND: DNA methylation is one of the most promising biomarkers in predicting the prognosis of colorectal cancer (CRC). We aimed to develop a DNA methylation biomarker that could evaluate the prognosis of CRC. METHODS: A promising DNA methylation biomarker was developed by hypermethylated genes in cancer tissue that were identified from Illumina EPIC methylation arrays. A cohort comprising 30 pairs of snap-frozen tumor tissue and adjacent normal tissue was used for correlation analysis between the methylation and expression status of the marker. The other cohort comprising 254 formalin-fixed paraffin-embedded (FFPE) tumor tissue from 254 CRC patients was used for prognosis analysis. RESULTS: Regulating synaptic membrane exocytosis 2 (RIMS2) was hypermethylated and lowly expressed in CRC comparing to adjacent normal tissue. Hypermethylation of RIMS2 in CRC was correlated with less frequent KRAS mutant and high differentiation. RIMS2 promoter methylation showed independent predictive value for survival outcome (P = 0.015, HR 1.992, 95% CI [(1.140-3.48)]), and a combination of RIMS2 methylation with KRAS status could predict prognosis better. CONCLUSIONS: RIMS2 is frequently hypermethylated in CRC, which can silence the expression of RIMS2. RIMS2 methylation is a novel biomarker for predicting the prognosis of CRC.


Asunto(s)
Neoplasias Colorrectales , Humanos , Estadificación de Neoplasias , Neoplasias Colorrectales/patología , Proteínas Proto-Oncogénicas p21(ras)/genética , Pronóstico , Metilación de ADN , Carcinogénesis/genética , Transformación Celular Neoplásica/genética , Biomarcadores de Tumor/genética , Regulación Neoplásica de la Expresión Génica
4.
EBioMedicine ; 90: 104496, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36863257

RESUMEN

BACKGROUND: More than ten randomized clinical trials are being tested to evaluate the efficacy, effectiveness and safety of a fasting-mimicking diet (FMD) combined with different antitumor agents. METHODS: UMI-mRNA sequencing, Cell-cycle analysis, Label retention, metabolomics, Multilabeling et al. were used to explore mechanisms. A tandem mRFP-GFP-tagged LC3B, Annexin-V-FITC Apoptosis, TUNEL, H&E, Ki-67 and animal model was used to search for synergistic drugs. FINDINGS: Here we showed that fasting or FMD retards tumor growth more effectively but does not increase 5-fluorouracil/oxaliplatin (5-FU/OXA) sensitivity to apoptosis in vitro and in vivo. Mechanistically, we demonstrated that CRC cells would switch from an active proliferative to a slow-cycling state during fasting. Furthermore, metabolomics shows cell proliferation was decreased to survive nutrient stress in vivo, as evidenced by a low level of adenosine and deoxyadenosine monophosphate. CRC cells would decrease proliferation to achieve increased survival and relapse after chemotherapy. In addition, these fasting-induced quiescent cells were more prone to develop drug-tolerant persister (DTP) tumor cells postulated to be responsible for cancer relapse and metastasis. Then, UMI-mRNA sequencing uncovered the ferroptosis pathway as the pathway most influenced by fasting. Combining fasting with ferroptosis inducer treatment leads to tumor inhibition and eradication of quiescent cells by boosting autophagy. INTERPRETATION: Our results suggest that ferroptosis could improve the antitumor activity of FMD + chemotherapy and highlight a potential therapeutic opportunity to avoid DTP cells-driven tumor relapse and therapy failure. FUNDING: A full list of funding bodies can be found in the Acknowledgements section.


Asunto(s)
Antineoplásicos , Neoplasias Colorrectales , Ferroptosis , Animales , Recurrencia Local de Neoplasia/tratamiento farmacológico , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Oxaliplatino/farmacología , Fluorouracilo/farmacología , Fluorouracilo/uso terapéutico , Apoptosis , Ayuno , Línea Celular Tumoral , ARN Mensajero/uso terapéutico , Neoplasias Colorrectales/patología
5.
J Natl Compr Canc Netw ; 21(2): 133-142.e3, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36791752

RESUMEN

BACKGROUND: Immune checkpoint inhibitor (ICI) treatment in patients with microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) tumors holds promise in reshaping organ preservation in rectal cancer. However, the benefits are accompanied by distinctive patterns of response, introducing a dilemma in the response evaluation for clinical decision-making. PATIENTS AND METHODS: Patients with locally advanced rectal cancer with MSI-H/dMMR tumors receiving neoadjuvant ICI (nICI) treatment (n=13) and matched patients receiving neoadjuvant chemoradiotherapy (nCRT; n=13) were included to compare clinical response and histopathologic features. RESULTS: Among the 13 patients receiving nICI treatment, in the final radiologic evaluation prior to surgery (at a median of 103 days after initiation of therapy), progressive disease (n=3), stable disease (n=1), partial response (n=7), and complete response (n=2) were observed. However, these patients were later confirmed as having pathologic complete response, resulting in pseudoprogression and pseudoresidue with incidences of 23.1% (n=3) and 76.9% (n=10), respectively, whereas no pseudoprogression was found in the 13 patients receiving nCRT. We further revealed the histopathologic basis underlying the pseudoprogression and pseudoresidue by discovering the distinctive immune-related regression features after nICI treatment, including fibrogenesis, dense lymphocytes, and plasma cell infiltration. CONCLUSIONS: Pseudoprogression and pseudoresidue were unique and prevalent response patterns in MSI-H/dMMR rectal cancer after nICI treatment. Our findings highlight the importance of developing specific strategies for response evaluation in neoadjuvant immunotherapy to identify patients with a good response in whom sphincter/organ-preserving or watch-and-wait strategies may be considered.


Asunto(s)
Neoplasias Colorrectales , Neoplasias del Recto , Humanos , Inhibidores de Puntos de Control Inmunológico/farmacología , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Terapia Neoadyuvante , Neoplasias del Recto/terapia , Neoplasias del Recto/patología , Neoplasias Colorrectales/tratamiento farmacológico , Inestabilidad de Microsatélites , Reparación de la Incompatibilidad de ADN
6.
Chemosphere ; 286(Pt 2): 131770, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34364234

RESUMEN

Antibiotic compounds have caused serious environmental concerns. In this study, we developed an effective technology for treatment of chlortetracycline (CTC), a widely used antibiotic compound. A natural heteroatom-doped spent tea leaves-based biochar (STLB) with excellent adsorption and catalytic property was prepared by simple thermal treatment. An adsorption-promoted persulfate-based advanced oxidation process (PS-AOP) using STLB was studied for CTC removal. The results showed that the as-prepared STLB presented favorable adsorption affinity towards CTC with the maximum adsorption capacity of 627 mg g-1. Meanwhile, CTC enriched on the surface of STLB was good for in-situ decomposition of CTC and nearly 97.4 % of CTC was removed within 30 min of pre-adsorption and 60 min of subsequent degradation. The STLB had excellent recyclability and wide pH tolerance range of 3.0-9.0 in combined pre-adsorption and PS-AOP. Reactive oxygen species analysis confirmed that CTC degradation was mainly due to non-radical (singlet oxygen, 1O2) and radicals (SO4- and OH). This study suggests that STLB is a promising adsorption-enhanced PS activator for the treatment of refractory wastewater and also provides a strategy of waste control by spent tea leaves.


Asunto(s)
Clortetraciclina , Contaminantes Químicos del Agua , Adsorción , Carbón Orgánico , Hojas de la Planta/química , , Agua , Contaminantes Químicos del Agua/análisis
7.
Cancer Med ; 10(24): 8924-8933, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34786881

RESUMEN

OBJECTIVE: We conducted this multicenter cohort study to evaluate the current tumor-node-metastasis staging system and treatment modality by analyzing the survival outcomes of patient groups with stage III and IV colon cancer. PATIENTS AND METHODS: Stage III and IV colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database (SEER cohort) and prospectively maintained Sun Yat-sen University (SYSU) cohort were included in this study. Kaplan-Meier method was used to estimate the cumulative rate of overall survival (OS) between patient groups, and the inverse probability weighting method was used to calculated age and sex-adjusted survival curves. The Cox regression model was used to identify the risk factors for OS. RESULTS: A total of 17,911 and 1135 stage III-IV cases were included in the SEER and SYSU cohorts, respectively. Among them, 1448 and 124 resectable stage IV cases underwent curative-intent treatment in the SEER and SYSU cohorts, respectively. The T4N2b group showed a significantly worse survival outcome compared with the M1a subset receiving curative-intent treatment (HR, 1.46; p < 0.001). This finding was validated in the SYSU cohort, in which the T4N2 group had a worse outcome than that of the M1 group receiving curative-intent treatment (HR, 2.44; p < 0.001). These findings were confirmed in the adjusted survival analysis. In the multivariate analysis, the right-side tumor, poor-undifferentiated tumor, and age over 60 years were identified as independent risk factors for T4N2b patients. Based on this multivariate model, the high-risk T4N2b subgroup had a worse survival outcome compared with resectable M1b patients (HR, 1.24; p = 0.03). CONCLUSION: By comparing stage III with stage IV colon cancer patients, we identified a subgroup of stage III patients at a higher risk of death than more advanced stages, implying that current cancer care modalities are not sufficient for these high-risk substages.


Asunto(s)
Neoplasias del Colon/terapia , Anciano , Indicadores de Enfermedades Crónicas , Estudios de Cohortes , Neoplasias del Colon/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Análisis de Supervivencia
8.
Medicine (Baltimore) ; 98(24): e15961, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31192934

RESUMEN

INTRODUCTION: Right-sided native endocarditis is a difficult case with fewer cardiac symptoms and fewer classic signs of cutaneous vascular lesions compared with left-sided endocarditis. PATIENT CONCERNS: A 68-year-old Taiwanese man with a history of gouty arthritis, hyperlipidemia, and adrenal insufficiency presented to our ED and complained dyspnea and low back pain for 1 month. DIAGNOSIS ASSESSMENT: The PE showed bilateral crackles on chest auscultation and a palpable fluctuant mass over the anterior chest wall. The chest and abdominal CT scan showed multiple abscess formations involving pulmonary, sternal, and paraspinal areas. The TEE being performed and an oscillating mass over the anterior and septal leaflets of the tricuspid valve and moderate tricuspid regurgitation. INTERVENTIONS: Only pharmacologic treatment without surgical interventions. OUTCOMES: Deceased, patient expired on day 4 after ED visit. CONCLUSION: This case arose as a sequela of staphylococcal endocarditis associated with persistent bacteremia and immunological dysregulation. The diagnosis of right-sided endocarditis is easily missing, multidisciplinary approach should be triggered as soon as possible, which might lead to a better outcome. Right-sided IE is still an important public health issue in southern Taiwan.


Asunto(s)
Absceso/diagnóstico por imagen , Endocarditis Bacteriana/diagnóstico , Válvula Tricúspide/diagnóstico por imagen , Absceso/etiología , Anciano , Ecocardiografía Transesofágica , Resultado Fatal , Humanos , Masculino , Taiwán
9.
Biomater Sci ; 5(11): 2337-2346, 2017 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-29034380

RESUMEN

Implant-associated infections in orthopaedic surgeries are very critical as they may hinder bone healing, cause implant failure and even progress to osteomyelitis. Drug-eluting implants for local delivery of antibiotics at surgical sites are thought to be promising in preventing infections. Herein, the antibiotic vancomycin was encapsulated in a poly(ethylene glycol) (PEG)-based hydrogel film that was covalently bound to Ti implants and subsequently covered by a PEG-poly(lactic-co-caprolactone) (PEG-PLC) membrane. Additionally, crosslinked starch (CSt) was mixed with the hydrogel because its porous microstructure is able to inhibit hydrogel swelling and thus slow down drug release. The release behavior could be regulated by the drug loading and the coating thickness. The vancomycin-loaded Ti implants showed no initial burst release, offering a sustained drug release for nearly 3 weeks in vitro and more than 4 weeks in vivo. In a rabbit model of S. aureus infection, the implants with a 4 mg vancomycin loading significantly reduced the inflammatory reaction and exhibited a good antimicrobial capability. The immobilization of the antibiotic-loaded polymeric coatings on orthopaedic implants can offer a sustainable drug release with no initial burst release and maintain an effective concentration for a longer time, so it is expected to be an effective strategy to treat and prevent local bone infections.


Asunto(s)
Antibacterianos/química , Portadores de Fármacos/química , Polietilenglicoles/química , Prótesis e Implantes/efectos adversos , Infecciones Relacionadas con Prótesis/prevención & control , Titanio/química , Vancomicina/química , Animales , Antibacterianos/farmacología , Huesos/efectos de los fármacos , Huesos/microbiología , Liberación de Fármacos , Articulaciones/efectos de los fármacos , Articulaciones/microbiología , Cinética , Masculino , Conejos , Almidón/química , Vancomicina/farmacología
13.
Am J Emerg Med ; 31(1): 8-15, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22795429

RESUMEN

PURPOSES: Outcome prediction for out-of-hospital cardiac arrest (OHCA) is of medical, ethical, and socioeconomic importance. We hypothesized that blood ammonia may reflect tissue hypoxia in OHCA patients and conducted this study to evaluate the prognostic value of ammonia for the return of spontaneous circulation (ROSC). METHODS: This prospective, observational study was conducted in a tertiary university hospital between January 2008 and December 2008. The subjects consisted of OHCA patients who were sent to the emergency department (ED). The primary outcome was ROSC. The prognostic values were calculated for ammonia levels and the partial pressure of ammonia (pNH(3)), and the results were depicted as a receiver operating characteristics curve with an area under the curve. RESULTS: Among 119 patients enrolled in this study, 28 patients (23.5%) achieved ROSC. Ammonia levels and pNH(3) in the non-ROSC group were significantly higher than those in the ROSC group (167.0 µmol/L vs 80.0 µmol/L, P < .05; 2.61 × 10(-5) vs 1.67 × 10(-5) mm Hg, P < .05, respectively). The predictive capacity of area under the curve for ammonia and pNH(3) for non-ROSC was 0.85 (95% confidence interval, 0.75-0.95) and 0.73 (95% confidence interval, 0.61-0.84), respectively. The multivariate analysis confirmed that ammonia and pNH(3) are independent predictors of non-ROSC. The prognostic value of ammonia was better than that of pNH(3). The cutoff level for ammonia of 84 µmol/L was 94.5% sensitive and 75.0% specific for predicting non-ROSC with a diagnostic accuracy of 89.9%. CONCLUSIONS: Hyperammonemia on ED arrival is independently predictive of non-ROSC for OHCA patients. The findings may offer useful information for clinical management.


Asunto(s)
Amoníaco/sangre , Paro Cardíaco Extrahospitalario/sangre , Anciano , Anciano de 80 o más Años , Análisis de los Gases de la Sangre , Reanimación Cardiopulmonar , Distribución de Chi-Cuadrado , Servicio de Urgencia en Hospital , Femenino , Humanos , Hipoxia/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Paro Cardíaco Extrahospitalario/terapia , Presión Parcial , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad
14.
J Hypertens ; 30(4): 787-93, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22241137

RESUMEN

OBJECTIVE: Postsystolic shortening is associated with hypertensive heart disease, and the degree of postsystolic shortening can be measured by postsystolic strain index (PSI) of the left ventricle (LV) derived from speckle tracking echocardiography. We studied the association between PSI with delayed diastolic lengthening and diastolic dysfunction in hypertension. METHODS: This study recruited 46 patients (mean age 56 ±â€Š13 years, 24 men) with untreated hypertension, and 26 normal individuals (mean age 55 ±â€Š11 years, 9 men) as controls. Hypertension patients were further divided into two groups based on the presence of diastolic dysfunction. PSI was calculated as [(postsystolic peak longitudinal strain - end-systolic strain)/end-systolic strain] × 100%. Timing of left-ventricular diastolic lengthening was determined by measurements of time to onset of early diastolic mitral annulus lengthening by tissue Doppler imaging. RESULTS: Total PSI was significantly higher in patients with diastolic dysfunction (252 ±â€Š257 vs. 98 ±â€Š72%, P = 0.002). After multivariate analysis, PSI was independently associated with diastolic dysfunction in hypertension [every 10% increment of PSI, odds ratio (OR) 1.13, 95% confidence interval (CI) 1.01-1.27, P = 0.036]. PSI was independently correlated with serum procollagen type I carboxyterminal propeptide (beta = 0.382, P = 0.028) after multivariable analysis, and time delay from onset of early mitral inflow to onset of early diastolic medial (beta = 0.405, P = 0.004) or lateral (beta = 0.582, P < 0.001) annulus lengthening. CONCLUSIONS: Increased PSI was associated with increased procollagen type I carboxyterminal propeptide and diastolic dysfunction in hypertension. Postsystolic shortening was associated with delayed diastolic lengthening which contributed to diastolic dysfunction in hypertension.


Asunto(s)
Ecocardiografía Doppler/métodos , Hipertensión/fisiopatología , Disfunción Ventricular Izquierda/fisiopatología , Velocidad del Flujo Sanguíneo , Diástole/fisiología , Femenino , Fibrosis/complicaciones , Fibrosis/patología , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertensión/complicaciones , Hipertensión/patología , Masculino , Persona de Mediana Edad , Miocardio/patología , Fragmentos de Péptidos/sangre , Procolágeno/sangre , Sístole/fisiología , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/patología
15.
J Am Soc Echocardiogr ; 24(5): 513-9, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21353469

RESUMEN

BACKGROUND: The objective of this study was to investigate myocardial deformation of the left atrium (LA) assessed by two-dimensional speckle tracking echocardiography in patients with permanent atrial fibrillation (AF) and its value for risk stratification for stroke. METHODS: We recruited 66 consecutive patients with permanent AF who were referred to our echocardiography laboratory for evaluation. These patients were divided into two groups according to the presence of previous stroke or not. RESULTS: Peak positive longitudinal strain (LASp) during atrial filling, peak strain rate in the reservoir phase of LA (LASRr), and peak strain rate in the conduit phase (LASRc) were identified from LA strain and strain rate curves. The ratio of peak early filling velocity (E) of mitral inflow to early diastolic annulus velocity (E') of the medial annulus (E/E') was calculated. LASp (10.44% ± 4.2% vs. 15.69% ± 5.1%, P < .001), LASRr (1.09 ± 0.27 1/s vs. 1.37 ± 0.32 1/s, P = .001), and LASRc (-1.28 ± 0.38 1/s vs. -1.62 ± 0.43 1/s, P = .002) were significantly lower in patients with AF with stroke than those without stroke. By multivariate analysis controlling for age, LA volume index, and left ventricular ejection fraction, LASp (OR 0.787, 95% CI, 0.639-0.968, P = .023) and LASRr (OR 0.019, 95% CI, 0.001-0.585, P = .023) were independently associated with stroke but not LASRc, E', and E/E' ratio. CONCLUSION: Decreased LASp and LASRr were independently associated with stroke in patients with permanent AF.


Asunto(s)
Fibrilación Atrial/patología , Función del Atrio Izquierdo , Atrios Cardíacos/patología , Accidente Cerebrovascular/patología , Anciano , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/diagnóstico por imagen , Intervalos de Confianza , Diástole , Femenino , Atrios Cardíacos/diagnóstico por imagen , Frecuencia Cardíaca , Humanos , Masculino , Análisis Multivariante , Oportunidad Relativa , Pronóstico , Curva ROC , Medición de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/diagnóstico por imagen , Volumen Sistólico , Ultrasonografía , Función Ventricular Izquierda
16.
Am J Nephrol ; 33(1): 84-90, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21178338

RESUMEN

BACKGROUND: The impact of chronic kidney disease (CKD) and hemodialysis on heart function is not fully understood. We aimed to investigate the influence of different stages of CKD and maintenance hemodialysis on heart function. METHODS: One hundred fifty-three patients were categorized into 3 subgroups [56 without CKD as controls; 37 with moderate-advanced CKD, stages 3, 4 or 5, and 60 with end-stage renal disease (ESRD) undergoing maintenance hemodialysis]. Left ventricular (LV) function was assessed by conventional echocardiography and 2-dimensional speckle-tracking echocardiography with strain analysis (2D strain analysis). RESULTS: There was no significant difference of gender, age and LV ejection fraction among groups. Compared with controls, global peak systolic longitudinal strain (GS(l)), circumferential strain and strain rate were decreased in the CKD group. Along with the decline of renal function, GS(l) deteriorated. Moreover, compared with moderate-advanced CKD patients, GS(l), circumferential strain and strain rate were better in ESRD group receiving maintenance hemodialysis. CONCLUSIONS: Worsening renal function was associated with a reduction of systolic function, and could be quantified by 2D strain analysis. The hemodialysis patients have better LV systolic function than the moderate-advanced CKD patients.


Asunto(s)
Insuficiencia Cardíaca/terapia , Ventrículos Cardíacos/fisiopatología , Fallo Renal Crónico/fisiopatología , Diálisis Renal/métodos , Disfunción Ventricular Izquierda/terapia , Anciano , Cardiología/métodos , Ecocardiografía/métodos , Femenino , Insuficiencia Cardíaca/complicaciones , Humanos , Fallo Renal Crónico/complicaciones , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Vena Cava Inferior/patología , Disfunción Ventricular Izquierda/complicaciones
17.
J Am Soc Echocardiogr ; 23(11): 1183-9, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20833507

RESUMEN

BACKGROUND: The aim of this study was to investigate the role of segmental longitudinal strain for the diagnosis of coronary artery disease (CAD) assessed by automated function imaging. METHODS: One hundred fifty-two subjects (mean age, 63 ± 12 years; 77 men) referred for assessment of cardiac function under suspicion of CAD were recruited for this study. Patients with left ventricular dysfunction or with acute coronary syndromes were excluded. RESULTS: Peak systolic global longitudinal strain (GLS) was significantly decreased in patients with CAD. Peak segmental longitudinal strain difference (LSD) and its ratio to peak systolic GLS were significant higher in patients with CAD. The areas under receiver operating characteristic curves for the diagnosis of CAD were 0.813 for peak systolic GLS, 0.851 for the number of abnormal segments, 0.805 for peak segmental LSD, and 0.862 for the ratio of peak segmental LSD to peak systolic GLS. Using 1.0 as a cutoff point for the ratio of peak segmental LSD to peak systolic GLS, sensitivity was 77.3% and specificity 79.2%. CONCLUSIONS: This study suggests that it may be possible to assess CAD with strain by automated function imaging, but further larger scale studies are needed to confirm this.


Asunto(s)
Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Reconocimiento de Normas Patrones Automatizadas/métodos , Anciano , Estudios de Casos y Controles , Intervalos de Confianza , Enfermedad de la Arteria Coronaria/fisiopatología , Circulación Coronaria/fisiología , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valores de Referencia , Reproducibilidad de los Resultados , Medición de Riesgo , Volumen Sistólico/fisiología , Disfunción Ventricular Izquierda/fisiopatología
18.
Heart Vessels ; 25(5): 386-91, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20676960

RESUMEN

Coexistence of hypertension and diabetes mellitus (DM) increases the risk of cardiovascular disease. However, factors associated with future development of DM have not been well elucidated in patients already having essential hypertension. This study prospectively included 168 patients (mean age 41 +/- 7 years, 112 men) with essential hypertension. All patients did not have DM and vascular or renal complications initially. Baseline demographic data, blood pressure, body mass index, and antihypertensive agents were carefully evaluated and serum high-sensitivity C-reactive protein (hsCRP) was measured at the beginning of the study. All of the patients were followed for at least 6 months. The study endpoint was occurrence of new DM. After a mean follow-up period of 32 +/- 10 months, 22 subjects (13.1%) developed new DM. Patients with new DM had higher baseline glucose (105.2 +/- 11.8 vs 94.2 +/- 8.0 mg/dl, P < 0.001), triglyceride level (213.7 +/- 112.4 vs 155.6 +/- 83.2 mg/dl, P = 0.04), log hsCRP (0.31 +/- 0.44 vs 0.19 +/- 0.25 mg/dl, P = 0.016), and lower high-density lipoprotein (40.2 +/- 7.8 vs 46.6 +/- 14.4 mg/dl, P = 0.045). Total cholesterol, low-density lipoprotein, homeostasis model assessment index, and adiponectin were not different in patients with or without new DM. Among antihypertensive agents, only use of beta-blocker was significantly associated with new DM (P = 0.008). Multivariate Cox regression analysis showed log hsCRP (hazard ratio [HR] 9.77, 95% confidence interval [CI] 2.97-32.10, P < 0.001), age (HR 1.21, 95% CI 1.06-1.38, P = 0.004), and baseline glucose level (HR 1.11, 95% CI 1.06-1.15, P < 0.001) to be independent predictors for occurrence of new DM. High-sensitivity CRP was an independent factor for future development of DM in essential hypertensive patients. Increased inflammation might have a key role in the pathogenesis of DM in hypertension.


Asunto(s)
Proteína C-Reactiva/metabolismo , Diabetes Mellitus/etiología , Hipertensión/complicaciones , Antagonistas Adrenérgicos beta/uso terapéutico , Adulto , Antihipertensivos/uso terapéutico , Biomarcadores/sangre , Glucemia/metabolismo , Colesterol/sangre , LDL-Colesterol/sangre , Diabetes Mellitus/sangre , Diabetes Mellitus/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Hipertensión/sangre , Hipertensión/tratamiento farmacológico , Hipertensión/mortalidad , Estimación de Kaplan-Meier , Modelos Lineales , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Taiwán , Factores de Tiempo , Triglicéridos/sangre
19.
Am J Hypertens ; 23(10): 1069-73, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20634800

RESUMEN

BACKGROUND: Diabetes mellitus (DM) and hypertension (HT) frequently coexist. Increased central aortic pressures indexes are associated with HT; however, possible associations of these indexes with future development of DM have never been studied in HT. METHODS: We recruited 178 patients with uncomplicated nondiabetic HT in this study. Baseline glucose, insulin, lipid profiles, and central aortic pressure indexes obtained using applanation tonometry were measured at the beginning of the study. Patients were followed for new-onset DM. RESULTS: After a mean follow-up period of 31 ± 12 months, 22 patients (12.4%) developed new-onset DM. In multivariate regression analyses adjusted for age, sex, and mean blood pressure (BP) in model 1, we found that central systolic BP (CSBP; hazard ratio 1.24, 95% CI 1.10-1.41, P < 0.001), and augmentation index (AIx) corrected at heart rate 75/min (AIx(75); hazard ratio 1.58, 95% CI 1.11-1.58, P < 0.05) were independent predictors for new-onset DM. After adjustment for age, sex, mean BP, glucose concentration, and ß-blocker use in model 2, we found that CSBP (hazard ratio 1.36, 95% CI 1.19-1.55, P < 0.001) and AIx(75) (hazard ratio 1.71, 95% CI 1.16-2.52, P < 0.01) were independent predictors for new-onset DM. CONCLUSIONS: CSBP and AIx(75) were independent factors for future DM in essential hypertensive patients. Increased central pressure indexes were associated with risk of DM in essential hypertension.


Asunto(s)
Presión Sanguínea/fisiología , Diabetes Mellitus Tipo 2/complicaciones , Hipertensión/complicaciones , Antagonistas Adrenérgicos beta/uso terapéutico , Adulto , Aorta/fisiología , Análisis Químico de la Sangre , Glucemia/metabolismo , Arterias Carótidas/fisiología , Presión Venosa Central/fisiología , Femenino , Estudios de Seguimiento , Frecuencia Cardíaca/fisiología , Humanos , Hipertensión/tratamiento farmacológico , Resistencia a la Insulina , Masculino , Persona de Mediana Edad , Arteria Radial/fisiología , Flujo Sanguíneo Regional/fisiología , Análisis de Regresión , Análisis de Supervivencia
20.
J Hazard Mater ; 177(1-3): 668-75, 2010 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-20060215

RESUMEN

The templated crosslinked-chitosan microparticles prepared using the imprinting method with the Remazol Black5 (RB5) dye as a template, epichlorohydrin (ECH) as a crosslinker, and sodium hydroxide (NaOH) solution used for the microparticle formation showed the highest adsorption capacity for the RB5 dye compared with those that used other methods with or without a template, three crosslinkers, and two microparticle formations. The results showed that the adsorption of the RB5 dye on the microparticles was affected by the microparticle size, the initial dye concentration, the initial pH value, as well as the temperature. Both kinetics and thermodynamic parameters of the adsorption process were estimated. These data indicated an exothermic spontaneous adsorption process that kinetically followed the second-order adsorption process. Equilibrium experiments fitted well the Langmuir isotherm model, and the maximum monolayer adsorption capacity for the RB5 dye was 2941 mg/g. The competition study showed that the adsorption of the RB5 dye on the microparticles in the mixture solution was much less affected by the existence of the 3R dye than the other way around. Furthermore, the microparticles could be regenerated through the desorption of the dye in pH 10.0 of NaOH solution and could be reused to adsorb the dye again.


Asunto(s)
Quitosano/química , Naftalenosulfonatos/aislamiento & purificación , Contaminantes Químicos del Agua/aislamiento & purificación , Adsorción , Reactivos de Enlaces Cruzados , Concentración de Iones de Hidrógeno , Cinética , Tamaño de la Partícula , Soluciones , Temperatura , Termodinámica
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