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1.
Sci Rep ; 14(1): 15638, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38977807

RESUMEN

We present a method for modification of silicon nitride (Si3N4) waveguide resonators using femtosecond laser annealing. The quality (Q) factor of the waveguide resonators can be improved by approximately 1.3 times after annealing. Notably, waveguides that originally had a high Q value maintained their quality after the annealing process. However, those with a lower initial Q value experienced a noticeable improvement post-annealing. To characterize the annealing effect, the surface morphologies of Si3N4 films, both pre- and post-annealing, were analyzed using atomic force microscopy. The findings suggest a potential enhancement in surface refinement. Furthermore, Raman spectroscopy confirmed that the Si3N4 film's composition remains largely consistent with its original state within the annealing power range of 0.6-1.6 W. This research underscores the potential of femtosecond laser annealing as an efficient, cost-effective, and localized technique for fabricating low-loss integrated photonics.

2.
Rev Sci Instrum ; 95(1)2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38214591

RESUMEN

An economical and stable single-shot pulse picker design without dispersion, nonlinear effect, and limitation on wavelength is proposed. This design is composed of a periodic pulse blocker (PPB), a control unit, and a mechanical shutter. It has successfully been applied to the commercial high-fluence femtosecond laser with 11-mm beam diameter, 2-mJ pulse energy, and 1-kHz repetition rate. Significantly, by incorporating commercial optical choppers equipped with custom-designed chopper blades in the PPB, this design can accommodate lasers with fluences reaching 610 mJ/cm2 and the standard 1 kHz repetition rate typical of high-fluence lasers. Furthermore, the proposed design provides a cost-effective substitute compared to using electro-optic modulators or acousto-optic modulators.

3.
Clin Exp Immunol ; 215(2): 137-147, 2024 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-37708215

RESUMEN

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease caused by intrahepatic bile duct injuries, resulting in fibrosis, cirrhosis, and eventually liver failure. T helper (Th) 17 cells are proposed to involve in the pathogenesis of PBC. However, how and which Th17 cell-derived cytokines affect PBC remains unclear. In this study, we investigated the effects of Th17 effector cytokines, including interleukin (IL)-17A, IL-17F, and IL-21 in PBC using a xenobiotic-induced mouse model of autoimmune cholangitis (inducible chemical xenobiotic models of PBC) treated with cytokine-expressing adeno-associated virus. Our results showed that administration of IL-17A, the well-known main cytokine produced by Th17 cells, did not augment liver inflammation or fibrosis. In contrast, we noted IL-17A-treated mice had lower hepatic Th1 cell numbers and higher hepatic CD11b+Ly6G+ polymorphonuclear myeloid-derived suppressor cell numbers. IL-17F did not alter liver inflammation or fibrosis. However, the administration of IL-21 exacerbated liver inflammatory responses and portal cell infiltration. IL-21 markedly increased the numbers of activated CD8+ T cells and liver tissue-resident memory CD8+ T cells. Moreover, IL-21 aggravates liver fibrosis in mice with autoimmune cholangitis. These results emphasized that not IL-17A but IL-21 in Th17 cell-derived cytokines affected the pathogenesis of PBC. IL-21 enhanced liver inflammation and progression to fibrosis by enhancing the numbers and effector activities of CD8+ T cells. Delineation of the effects of different Th17 effector cytokines in PBC offers clues for developing new therapeutic approaches.


Asunto(s)
Enfermedades Autoinmunes , Colangitis , Cirrosis Hepática Biliar , Animales , Ratones , Interleucina-17 , Xenobióticos , Interleucinas , Citocinas , Colangitis/patología , Fibrosis , Cirrosis Hepática , Enfermedades Autoinmunes/patología , Inflamación
4.
J Biophotonics ; 17(1): e202300285, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37738103

RESUMEN

The trade-off between high-quality images and cellular health in optical bioimaging is a crucial problem. We demonstrated a deep-learning-based power-enhancement (PE) model in a harmonic generation microscope (HGM), including second harmonic generation (SHG) and third harmonic generation (THG). Our model can predict high-power HGM images from low-power images, greatly reducing the risk of phototoxicity and photodamage. Furthermore, the PE model trained only on normal skin data can also be used to predict abnormal skin data, enabling the dermatopathologist to successfully identify and label cancer cells. The PE model shows potential for in-vivo and ex-vivo HGM imaging.


Asunto(s)
Aprendizaje Profundo , Microscopía
5.
Clin Exp Immunol ; 215(3): 225-239, 2024 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-37916967

RESUMEN

Primary biliary cholangitis (PBC) is a chronic autoimmune disease characterized by immune-mediated destruction of intrahepatic small bile ducts. CD8 T cells play a critical role in biliary destruction. However, regulatory T cells (Tregs) have also been identified in the portal tracts of PBC patients. This study tested the hypothesis that hepatic Tregs in PBC were dysfunctional in suppressing immune responses in disease by using our human PBC-like autoimmune cholangitis (AIC) mouse model induced by 2-octynoic acid-conjugated ovalbumin (2-OA-OVA). Our results showed that female and male mice immunized with 2-OA-OVA developed AIC; however, female AIC mice had more severe liver inflammation and fibrosis than male AIC mice. Levels of functional effector CD8 T cells and their chemoattractants, CXCL9 and CXCL10, in the liver were markedly elevated in female AIC mice than in male AIC mice. These results reinforce that CD8 T cells are the primary effector cells in PBC. The number of hepatic Tregs in AIC mice was also higher than in saline-treated mice, but there was no difference between male and female AIC mice. The suppressive function of AIC Tregs was evident despite a discrepancy in the changes in their co-inhibitory receptors and inhibitory cytokines. However, the expansion of hepatic Tregs by low-dose IL-2 treatment did not reduce immune responses to AIC, which may be due to the dysfunction of Tregs in inhibiting T cells. In conclusion, the function of Tregs in the inflamed liver of PBC was insufficient, and low-dose IL-2 treatment could not restore their function to suppress pathological immune responses. Transferring normal Tregs or directly targeting effector CD8 T cells may be beneficial for treating PBC.


Asunto(s)
Enfermedades Autoinmunes , Colangitis , Cirrosis Hepática Biliar , Humanos , Masculino , Femenino , Ratones , Animales , Linfocitos T Reguladores , Interleucina-2 , Hígado , Colangitis/patología
6.
Opt Lett ; 48(16): 4245-4248, 2023 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-37582003

RESUMEN

We present an unsupervised learning denoising method, RepE (representation and enhancement), designed for nonlinear optical microscopy images, such as second harmonic generation (SHG) and two-photon fluorescence (TPEF). Addressing the challenge of effectively denoising images with various noise types, RepE employs an encoder network to learn noise-free representations and a reconstruction network to generate denoised images. It offers several key advantages, including its ability to (i) operate without restrictive statistic assumptions, (ii) eliminate the need for clean-noisy pairs, and (iii) requires only a few training images. Comparative evaluations on real-world SHG and TPEF images from esophageal cancer tissue slides (ESCC) demonstrate that our method outperforms existing techniques in image quality metrics. The proposed method provides a practical, robust solution for denoising nonlinear optical microscopy images, and it has the potential to be extended to other nonlinear optical microscopy modalities.

7.
Life (Basel) ; 13(2)2023 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-36836716

RESUMEN

BACKGROUND: Orf, or ecthyma contagiosum, is a zoonosis caused by Parapoxvirus that infects sheep and goats. Human transmission typically occurs in persons in contact with the infected animals or contaminated fomites and environment. In humans, it generally occurs as solitary or multiple skin lesions on the hands or fingers. Involvement of the head region has rarely been reported. CASE PRESENTATION: We report an unusual case with multiple orf lesions on the scalp of a middle-aged woman, along with a review of previously reported Orf cases on the head region. CONCLUSIONS: Although Orf infection rarely happens on the head region, it should be considered in the differential diagnosis of cases with relevant animal exposure.

8.
J Transl Autoimmun ; 6: 100182, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36619656

RESUMEN

Primary biliary cholangitis (PBC) is a female-predominant liver autoimmune disease characterized by the specific immune-mediated destruction of the intrahepatic small bile duct. Although apoptosis of biliary epithelial cells (BECs) and alterations in gut microbiota are observed in patients with PBC, it is still unclear whether these events happen in the early stage and cause the breakdown of tolerance in PBC. In this study, we examined the early events in the loss of tolerance in our well-defined 2-OA-OVA-induced murine autoimmune cholangitis (AIC) model. We report herein that apoptosis of BECs was notable in the early stage of murine AIC. An altered gut microbiota, in particular, an increased percentage of gram-positive Firmicutes in AIC mice was also observed. BECs in AIC mice expressed adhesion molecule ICAM-1, cytokines/chemokines TNF-α, CCL2, CXCL9, CXCL10, and toll-like receptor (TLR) 2. Moreover, BECs treated with TLR2 ligand had elevated apoptosis and CXCL10 production. These data collectively suggest a new mechanism of tolerance breakdown in AIC. Altered gut microbiota induces apoptosis of BECs through TLR2 signaling. BECs secrete chemokines to recruit CD8 T cells to damage BECs further.

9.
Artículo en Inglés | MEDLINE | ID: mdl-36141483

RESUMEN

The purpose of this study was to examine the differences in biomechanical parameters and sports-specific performance of lower limbs between arch support insoles (ASI) and flat insoles (FLI) when performing net strides. After installing the MVN IMU system, 18 college badminton team members were asked to take the following tests: (1) Consecutive net stride tests; (2) Six-point footwork tests; (3) Retrieve/stroke the ball at the left and right net; (4) Smash and retrieve/stroke the ball at the net; (5) Smash at the front and back crossover step. The joint angle of the lower limbs and ground reaction force during the support phase was collected. The results demonstrated that the peak right hip flexion angle was significantly greater with ASI than FLI (63.09 ± 10.70; 60.08 ± 13.82; p = 0.028), while the peak right foot inversion angle was significantly smaller with ASI than FLI (20.68 ± 7.87; 23.85 ± 8.11; p = 0.013). The principal conclusion was that the arch support insole avoids the decrease in the hip flexion angle and the increase in the foot inversion angle during the net stride tests.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Ortesis del Pié , Deportes de Raqueta , Accidente Cerebrovascular , Fenómenos Biomecánicos , Humanos , Articulación de la Rodilla , Zapatos
10.
Biomedicines ; 9(8)2021 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-34440235

RESUMEN

Primary biliary cholangitis (PBC) is a chronic liver autoimmune disease with augmented T helper (Th) 1 and corresponding cytokine IFN-γ immune responses. Using 2-octynoic acid (2-OA) coupled to OVA (2-OA-OVA)-induced mouse models of autoimmune cholangitis (inducible chemical xenobiotic models of PBC), our previous study demonstrated that overexpression of IFN-γ in the model mice enhanced liver inflammation upon disease initiation, but subsequently led to the suppression of chronic inflammation with an increase in interleukin-30 (IL-30) levels. In this study, we investigated whether IL-30 had an immunosuppressive function and whether it could be part of an immune therapeutic regimen for PBC, by treating model mice with murine IL-30-expressing recombinant adeno-associated virus (AAV-mIL-30). We first defined the effects of AAV-mIL-30 in vivo by administering it to a well-known concanavalin A (ConA)-induced hepatitis model of mice and found that AAV-mIL-30 reduced the numbers of activated CD25+CD4+ T cells and the levels of serum IFN-γ and IL-12. In autoimmune cholangitis, decreased numbers of activated CD4+ T cells and Foxp3+ regulatory T cells were noted in the mice treated with AAV-mIL-30 at 3 weeks after the 2-OA-OVA immunization. Treatment with IL-30 did not change the features of autoimmune cholangitis including autoantibodies, cell infiltration, and collagen deposition in the liver at 11 weeks of examination. However, increased levels of cytokines and chemokines were observed. These results suggest that IL-30 suppresses not only CD4+ T cells but also regulatory T cells. Additionally, the administration of IL-30 did not suppress liver inflammation in the murine model of PBC.

11.
Front Psychol ; 10: 497, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30941071

RESUMEN

Dynamic vision is crucial to not only animals' hunting behaviors but also human activities, and yet little is known about how to enhance it, except for extensive trainings like athletics do. Exposure to blue light has been shown to enhance human alertness (Chellappa et al., 2011), perhaps through intrinsically photosensitive retinal ganglion cells (ipRGCs), which are sensitive to motion perception as revealed by animal studies. However, it remains unknown whether blue light can enhance human dynamic vision, a motion-related ability. We conducted five experiments under blue or orange light to test three important components of dynamic vision: eye pursuit accuracy (EPA, Experiment 1), kinetic visual acuity (KVA, Experiment 1 and 2), and dynamic visual acuity (DVA, Experiment 3-5). EPA was measured by the distance between the position of the fixation and the position of the target when participants tracked a target dot. In the KVA task, participants reported three central target numbers (randomly chosen from 0 to 9) moving toward participants in the depth plane, with speed threshold calculated by a staircase procedure. In the DVA task, three numbers were presented along the meridian line on the same depth plane, with motion direction (Experiment 3) and difficulty level (Experiment 4) manipulated, and a blue light filter lens was used to test the ipRGCs contribution (Experiment 5). Results showed that blue light enhanced EPA and DVA, but reduced KVA. Further, DVA enhancement was modulated by difficulty level: blue light enhancement effect was found only with hard task in the downward motion in Experiment 3 and with the low contrast target in Experiment 4. However, this blue light enhancement effect was not caused by mechanism of the ipRGCs, at least not in the range we tested. In this first study demonstrating the relationship between different components of dynamic vision and blue light, our findings that DVA can be enhanced under blue light with hard but not easy task indicate that blue light can enhance dynamic visual discrimination when needed.

12.
Gerontology ; 65(4): 441-450, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30844813

RESUMEN

BACKGROUND: With global aging, robots are considered a promising solution for handling the shortage of aged care and companionships. However, these technologies would serve little purpose if their intended users do not accept them. While the socioemotional selectivity theory predicts that older adults would accept robots that offer emotionally meaningful relationships, selective optimization with compensation model predicts that older adults would accept robots that compensate for their functional losses. OBJECTIVE: The present study aims to understand older adults' expectations for robots and to compare older adults' acceptance ratings for 2 existing robots: one of them is a more human-like and more service-oriented robot and the other one is a more animal-like and more companion-oriented robot. METHODS: A mixed methods study was conducted with 33 healthy, community-dwelling Taiwanese older adults (age range: 59-82 years). Participants first completed a semi-structured interview regarding their ideal robot. After receiving information about the 2 existing robots, they then completed the Unified Theory of Acceptance and Use of Technology questionnaires to report their pre-implementation acceptance of the 2 robots. RESULTS: Interviews were transcribed for conventional content analysis with satisfactory inter-rater reliability. From the interview data, a collection of older adults' ideal robot characteristics emerged with highlights of humanlike qualities. From the questionnaire data, respondents showed a higher level of acceptance toward the more service-oriented robot than the more companion-oriented robot in terms of attitude, perceived adaptiveness, and perceived usefulness. From the mixed methods analyses, the finding that older adults had a higher level of positive attitude towards the more service-oriented robot than the more companion-oriented robot was predicted by higher expectation or preference for robots with more service-related functions. CONCLUSION: This study identified older adults' preference toward more functional and humanlike robots. Our findings provide practical suggestions for future robot designs that target the older population.


Asunto(s)
Actividades Cotidianas , Actitud , Robótica , Apoyo Social , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Teoría Psicológica , Investigación Cualitativa , Taiwán , Tecnología
13.
Eur J Emerg Med ; 26(3): 224-227, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29280900

RESUMEN

OBJECTIVES: Fishbone ingestion is a common problem worldwide, and the first step for managing this condition is to locate the fishbone precisely. However, until now, no study has analysed the true location of fishbone and its associated factors. Thus, this study identified the factors predicting the true location of fishbone and subsequently attempted to provide a management algorithm for fishbone ingestion. PATIENTS AND METHODS: This retrospective study was carried out at St Martin De Porres Hospital, Taiwan, between January 2015 and January 2016. All patients were diagnosed as having fishbone ingestion within the pharynx and underwent fishbone removal. RESULTS: This study included 198 consecutive patients with a mean age of 43.1 years (range: 1-84 years). The sensitivity of lateral neck radiography in the diagnosis of fishbone in the pharynx was only 22%. The fishbone locations were as follows: the tonsil in 72 (36.4%) patients, the tongue base / vallecula in 112 (56.6%) and the hypopharynx in 14 (7.0%). Multiple logistic regression analysis showed that patient age and fishbone length were significant independent risk factors associated with the true location of fishbone ingestion. Among all patients, fishbone was removed transorally under direct vision in 73 (36.9%) patients and using flexible nasopharyngoscopy in 125 (63.1%) patients. CONCLUSION: Patient age and fishbone length are important independent factors associated with the location of ingested fishbone. Lateral neck radiography is not beneficial for diagnosing fishbone ingestion within the pharynx. Flexible nasopharyngoscopy, by contrast, is an important method for the diagnosis and treatment of fishbone ingestion within this location.


Asunto(s)
Cuerpos Extraños/diagnóstico , Cuerpos Extraños/terapia , Laringoscopía/métodos , Faringe , Sistema de Registros , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Ingestión de Alimentos , Femenino , Hospitales Generales , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Taiwán , Resultado del Tratamiento , Adulto Joven
14.
J Autoimmun ; 95: 159-170, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30274824

RESUMEN

The immunomodulatory effect of IL-10 as an immunosuppressive and anti-inflammatory cytokine is well known. Taking advantage of our established mouse model of autoimmune cholangitis using 2-octynoic acid conjugated ovalbumin (2-OA-OVA) induction, we compared liver pathology, immune cell populations and antimitochondrial antibodies between IL-10 knockout and wild type mice immunized with 2-OA-OVA. At 10 weeks post immunization, portal inflammation and fibrosis were more severe in 2-OA-OVA immunized IL-10 knockout mice than in wild type mice. This was accompanied by significant higher levels of collagen I and III expression, T, NK and NKT subsets in liver and IgG anti-mitochondrial autoantibodies (AMAs) compared to 2-OA-OVA immunized wild type mice, suggesting that endogenous IL-10 is necessary for the maintenance of immune tolerance in primary biliary cholangitis (PBC). Further, we investigated whether administration of exogenous IL-10 could prevent PBC by administration of IL-10 expressing recombinant adeno-associated virus (AAV-IL-10) either 3 days before or 3 weeks after the establishment of liver pathology. Interestingly, administration of AAV-IL-10 resulted in increased liver inflammation and fibrosis, accompanied by increases in IFN-γ in liver CD4+ T cell, granzyme B, FasL, and CD107a in liver CD8+ T and NKT cells, and granzyme B and FasL in liver NK cells of AAV-IL-10 administered mice compared with control mice. Furthermore, administration of AAV-IL-10 significantly increased levels of proinflammatory cytokines and chemokines (IFN-γ, TNF-α, CXCL9 and CXCL10) and collagen I and III production in naïve mice, together with increase in immune cell infiltration and collagen deposition in the liver, suggesting a role of IL-10 in fibrosis. In conclusion, our data demonstrate that endogenous IL-10 is critical in the maintenance of immune tolerance but exogenous administration of IL-10 exacerbates liver inflammation and fibrosis. Furthermore, the distinctive presence of inflammatory immune cell populations and collagen expression in AAV-IL-10 treated naïve mice cautions against the clinical use of exogenous IL-10 in patients with autoimmune cholangitis.


Asunto(s)
Autoanticuerpos/sangre , Enfermedades Autoinmunes/genética , Tolerancia Inmunológica , Interleucina-10/inmunología , Cirrosis Hepática Biliar/inmunología , Animales , Enfermedades Autoinmunes/sangre , Enfermedades Autoinmunes/patología , Quimiocina CXCL10/genética , Quimiocina CXCL10/inmunología , Colágeno Tipo I/genética , Colágeno Tipo I/inmunología , Colágeno Tipo III/genética , Colágeno Tipo III/inmunología , Dependovirus/genética , Dependovirus/inmunología , Modelos Animales de Enfermedad , Proteína Ligando Fas/genética , Proteína Ligando Fas/inmunología , Femenino , Regulación de la Expresión Génica , Vectores Genéticos/administración & dosificación , Vectores Genéticos/química , Vectores Genéticos/inmunología , Granzimas/genética , Granzimas/inmunología , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Interferón gamma/genética , Interferón gamma/inmunología , Interleucina-10/administración & dosificación , Interleucina-10/deficiencia , Interleucina-10/genética , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/patología , Hígado/inmunología , Hígado/patología , Cirrosis Hepática Biliar/sangre , Cirrosis Hepática Biliar/genética , Cirrosis Hepática Biliar/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Transducción de Señal , Linfocitos T/inmunología , Linfocitos T/patología , Factor de Necrosis Tumoral alfa/genética , Factor de Necrosis Tumoral alfa/inmunología
15.
Int. braz. j. urol ; 43(3): 481-488, May.-June 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-840858

RESUMEN

ABSTRACT Introduction A randomized trial was conducted prospectively to evaluate the efficacy, related complications, and convalescence of emergency percutaneous nephrolithotomy compared to percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with large uretero-pelvic junction stone impaction. Materials and Methods The inclusion criteria included a WBC count of 10.000/mm3 or more and/or a temperature of 38°C or higher. Besides, all enrolled patients should maintain stable hemodynamic status and proper organ perfusions. A total of 113 patients with large, obstructive uretero-pelvic junction stones and clinical signs of sepsis completed the study protocol. Of those, 56 patients were placed in the emergency percutaneous nephrostomy group, while the other 57 patients were part of the percutaneous nephrolithotomy group. The primary end point was the time until normalization of white blood cells (WBC) at a count of 10.000/mm3 or less, and a temperature of 37.4°C or lower. The secondary end points included the comparison of analgesic consumption, length of stay, and related complications. Statistical analysis was performed using SPSS® version 14.0.1. The Mann-Whitney U test, chi-square test, and Fisher’s exact test were used as appropriate. Results The length of hospital stays (in days) was 10.09±3.43 for the emergency percutaneous nephrostomy group and 8.18±2.72 for the percutaneous nephrolithotomy group. This set of data noted a significant difference between groups. There was no difference between groups in regard to white blood cell count (in mm3), time to normalization of white blood cell count (in days), body temperature (in ºC), time to normalization of body temperature (in days), C-reactive proteins (in mg/dL), time taken for C-reactive proteins to decrease over 25% (in days), procalcitonin (in ng/mL), or complication rates. Conclusions This study confirms that emergency percutaneous nephrolithotomy may be as safe as early percutaneous nephrolithotomy in a selected low risk patients with sepsis-associated large, obstructive stone.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Anciano de 80 o más Años , Obstrucción Ureteral/cirugía , Obstrucción Ureteral/epidemiología , Nefrostomía Percutánea/métodos , Sepsis/cirugía , Sepsis/epidemiología , Complicaciones Posoperatorias , Taiwán/epidemiología , Nefrostomía Percutánea/efectos adversos , Estadísticas no Paramétricas , Urgencias Médicas , Pelvis Renal/cirugía , Tiempo de Internación , Persona de Mediana Edad
16.
Int Braz J Urol ; 43(3): 481-488, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28128911

RESUMEN

INTRODUCTION: A randomized trial was conducted prospectively to evaluate the efficacy, related complications, and convalescence of emergency percutaneous nephrolithotomy compared to percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with large uretero-pelvic junction stone impaction. MATERIALS AND METHODS: The inclusion criteria included a WBC count of 10.000/mm3 or more and/or a temperature of 38°C or higher. Besides, all enrolled patients should maintain stable hemodynamic status and proper organ perfusions. A total of 113 patients with large, obstructive uretero-pelvic junction stones and clinical signs of sepsis completed the study protocol. Of those, 56 patients were placed in the emergency percutaneous nephrostomy group, while the other 57 patients were part of the percutaneous nephrolithotomy group. The primary end point was the time until normalization of white blood cells (WBC) at a count of 10.000/mm3 or less, and a temperature of 37.4°C or lower. The secondary end points included the comparison of analgesic consumption, length of stay, and related complications. Statistical analysis was performed using SPSS® version 14.0.1. The Mann-Whitney U test, chi-square test, and Fisher's exact test were used as appropriate. RESULTS: The length of hospital stays (in days) was 10.09±3.43 for the emergency percutaneous nephrostomy group and 8.18±2.72 for the percutaneous nephrolithotomy group. This set of data noted a significant difference between groups. There was no difference between groups in regard to white blood cell count (in mm3), time to normalization of white blood cell count (in days), body temperature (in ºC), time to normalization of body temperature (in days), C-reactive proteins (in mg/dL), time taken for C-reactive proteins to decrease over 25% (in days), procalcitonin (in ng/mL), or complication rates. CONCLUSIONS: This study confirms that emergency percutaneous nephrolithotomy may be as safe as early percutaneous nephrolithotomy in a selected low risk patients with sepsis-associated large, obstructive stone.


Asunto(s)
Nefrostomía Percutánea/métodos , Sepsis/epidemiología , Sepsis/cirugía , Obstrucción Ureteral/epidemiología , Obstrucción Ureteral/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Urgencias Médicas , Femenino , Humanos , Pelvis Renal/cirugía , Tiempo de Internación , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea/efectos adversos , Complicaciones Posoperatorias , Estadísticas no Paramétricas , Taiwán/epidemiología
17.
Urolithiasis ; 44(5): 415-9, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26662171

RESUMEN

A randomized trial was conducted prospectively to evaluate the efficacy, related complications, and convalescence of emergent retrograde ureteroscopic management, instead of percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with ureteral stone obstruction. A total of 107 patients undergoing ureteroscopic stone manipulation for ureteral stones completed the study protocol, 53 patients in the percutaneous nephrostomy group, and 54 patients in the emergent retrograde ureteroscopic management group. The primary end point was the time to normalization of WBC of 10,000/mm or less and temperature of 37.4 °C or less. The second end point was the comparison analgesic consumption, length of stay, and related complications. Statistical analysis was performed using SPSS(®) version 14.0.1. The Mann-Whitney U test, Chi square test, and fisher's exact test was used as appropriate. The length of hospital stay (days) was 10.25 ± 3.53 and 8.24 ± 2.77 in the percutaneous nephrostomy group and emergent retrograde ureteroscopic management group, respectively, with significant difference (Table 2). However, patients in the emergent retrograde ureteroscopic management group had a significantly higher rate of s body temperature (°C). Meanwhile, the analgesic consumptions are 31.51 ± 11.16 and 40.00 ± 14.54 in the percutaneous nephrostomy group and emergent retrograde ureteroscopic management group, respectively, with significant difference. Our results show that it can be effectively and safely managed by retrograde ureteroscopic management combined with strong antibiotics in select clinical situations. Ureteroscopic management should no longer be considered a contraindication for the treatment of patients with sepsis associated with obstructing ureteral stones.


Asunto(s)
Nefrostomía Percutánea , Sepsis/etiología , Cálculos Ureterales/complicaciones , Cálculos Ureterales/terapia , Obstrucción Ureteral/complicaciones , Obstrucción Ureteral/terapia , Ureteroscopía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
18.
Pediatr Neonatol ; 56(3): 149-58, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25440779

RESUMEN

BACKGROUND: There are limited nationwide data relating to neonatal mortality rate in Taiwan. This study aims to provide updated national birth weight/gestational age-specific neonatal mortality reference rates. METHODS: We abstracted the birth registration database from the Ministry of Interior in Taiwan from 1998 to 2002 and linked the data to the death registration database from the Ministry of Health and Welfare in Taiwan between 1998 and 2003. We included 1,331,785 infants born between 20 weeks and 44 weeks of gestation and weighing within the median ± 2 interquartile ranges in their age group in this study. We calculated the birth weight/gestational age-specific neonatal mortality rates of different genders by birth weight increments of 250 g and at gestational age intervals of 1 week. A Poisson regression model was used in modeling the mortality data. RESULTS: A total of 4,169 deaths occurred within 28 days of life out of a total of 1,331,785 live births between 20 weeks and 44 weeks of gestation, giving a neonatal mortality rate (0-27 days) of 3.39 per 1000 live births for males and 2.80 per 1000 for females. The infant mortality rate remained higher in the male (5.91 per 1000) than the female (5.10 per 1000) population within the 1(st) year of life. Birth weight/gestational age-specific neonatal mortality rates were plotted with curves representing the 10(th) and 90(th) birth weight percentiles. The risk of an early neonatal death (0-6 days) does not exceed 50% except for female neonates < 500 g and ≤ 23 weeks, which implies that the limit of viability is now at 23 weeks for females. CONCLUSION: We have provided an easy-to-use birth weight/gestational age-specific neonatal mortality rate chart as a reference document that physicians and parents can use to make decisions based on ethical considerations relating to whether to give palliative care or further invasive management. The normative data are crucial for public health policies on neonatal care in Taiwan.


Asunto(s)
Peso al Nacer , Femenino , Edad Gestacional , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Masculino , Riesgo , Taiwán/epidemiología
19.
Opt Lett ; 39(7): 2060-3, 2014 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-24686674

RESUMEN

We demonstrate a 3 GHz repetition rate, femtosecond Raman soliton source with its wavelength tunable from 1.15 to 1.35 µm. We investigate the dependence of Raman soliton formation on different photonic-crystal fibers (PCFs), input powers, and fiber lengths. To produce a Raman soliton peaking at the same wavelength, shorter PCFs demand higher input average powers and consequently generate stronger Raman soliton pulses. Using 30 cm PCF NL-3.2-945, the resulting Raman soliton pulse at 1.35 µm has 0.9 W average power. The integrated relative intensity noise of the Raman soliton pulse at 1.35 µm generated from the 54-cm PCF NL-3.2-945 is as low as 0.33% from 100 Hz to 10 MHz.


Asunto(s)
Rayos Láser , Fibras Ópticas , Fotones , Factores de Tiempo
20.
Opt Lett ; 38(22): 4927-30, 2013 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-24322168

RESUMEN

We demonstrate a compact ultrafast source centered at 850 nm with >200 nm bandwidth (full width at half-maximum) based on a 3 GHz Yb-fiber master-oscillator-power-amplifier system. The output pulses (with up to 13 W average power) from the laser system are coupled into short (<50 mm) pieces of photonic crystal fibers to excite broadband fiber-optic Cherenkov radiation; the resulting broad phase-matching bandwidth due to short fiber length produces an upconverted spectrum spanning in the wavelength range of 750-950 nm with average power of 94, 184, and 380 mW for fiber length of 28, 37, and 48 mm, respectively. The spectrum generated from the 37 mm fiber is then dechirped by eight double-chirped mirrors, leading to compressed pulses ~14 fs in duration. Such an ultrafast source is a promising substitute of multigigahertz mode-locked Ti:sapphire lasers for applications in optical frequency metrology and multiphoton coherent microscopy.


Asunto(s)
Óxido de Aluminio/química , Tecnología de Fibra Óptica/instrumentación , Rayos Láser , Titanio/química , Iterbio/química , Transferencia de Energía , Diseño de Equipo , Análisis de Falla de Equipo
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