The Treatment Efficiency and Microbiota Analysis of Sapindus mukorossi Seed Oil on the Ligature-Induced Periodontitis Rat Model.

Periodontitis is a common oral disease mainly caused by bacterial infection and inflammation of the gingiva. In the prevention or treatment of periodontitis, anti-bacterial agents are used to inhibit pathogen growth, despite increasing levels of bacterial resistance. Sapindus mukorossi Gaertn (SM) seed oil has proven anti-bacterial and anti-inflammation properties. However, the possibility of using this plant to prevent or treat periodontitis has not been reported previously. The aim of this study was to evaluate the effects of SM oil on experimental periodontitis in rats by using micro-CT and microbiota analysis. The distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) on the sagittal micro-CT slide showed that total bone loss (TBL) was significantly lower in CEJ-ABC distances between SM oil and SM oil-free groups on Day 14. Histology data also showed less alveolar bone resorption, a result consistent result with micro-CT imaging. The microbiota analyzed at phylum and class levels were compared between the SM oil and SM oil-free groups on Day 7 and Day 14. At the phylum level, Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria were the dominant bacterium. Firmicutes in box plot analysis was significantly less in the SM oil group than in the SM oil-free group on Day 7. At the class level, Bacteroidia, Gammaproteobacteria, Bacilli, Clostridia, and Erysipelotrichia were the dominant bacteria. The bacteria composition proportion of Bacilli, Clostridiay, and Erysipelotrichia could be seen in the SM oil group significantly less than in t SM oil-free group on Day 7. Overall, the present results show that topical application of SM oil can reduce bone resorption and change bacteria composition in the ligature-induced periodontitis model. According to these results, it is reasonable to suggest SM oil as a potential material for preventing oral disease.

Myocardial Tissue Doppler Imaging Detects Right Ventricular Dysfunction after Percutaneous Angioplasty of Dysfunctional Hemodialysis Access in Uremic Patients.

BACKGROUND: Right ventricular dysfunction has been observed in uremic patients receiving percutaneous transluminal angioplasty (PTA). This prospective study focuses on the impact of tissue Doppler imaging echocardiographic parameters on assessing right ventricle function in uremic patients post PTA of dysfunctional hemodialysis access. METHODS: Sixty uremic patients were divided into two groups by angiographic findings: an occlusive group (26 patients) and a stenotic group (34 patients). All uremic patients underwent routine echocardiography with tissue Doppler imaging both before and immediately following PTA to assess the right ventricular (RV) function and pulmonary artery systolic pressure (PASP). The right ventricular (RV) myocardial performance index (MPI) was obtained during tissue Doppler imaging over the lateral tricuspid annulus. The M index was measured and defined as the peak early diastolic mitral inflow velocity divided by the RV MPI. The RV MPI, RV isovolumic relaxation time (IVRT) and M-index were used to evaluate RV function post-PTA. RESULTS: Immediately following PTA, PASP (31.6 ± 11.3 mmHg versus 42.6 ± 12.0 mmHg, p = 0.001), RV MPI (0.46 ± 0.08 versus 0.62 ± 0.13, p < 0.001) and IVRT (75.1 ± 12.9 versus 98.4 ± 27.7 ms, p < 0.001) increased significantly in the occlusive group. However, PASP and RV function did not change significantly in the stenotic group. In 42.3% patients from the occlusive group, the M-index fell below 112 and RV MPI rose above 0.55 post-PTA; this occurred in only 8.8% of the stenotic group. CONCLUSIONS: This prospective study demonstrated that there was a higher incidence of RV dysfunction in uremic patients with elevated PASP with totally occluded hemodialysis access than those with stenotic access post-PTA. KEY WORDS: Myocardial performance index; Percutaneous transluminal angioplasty; Pulmonary hypertension; Tissue Doppler image; Uremic.

Relationships of Borg's RPE 6-20 scale and heart rate in dynamic and static exercises among a sample of young Taiwanese men.

The objective of this study was to assess the relationship between the scores collected from Borg's rating of perceived exertion (RPE) scale and the heart rates (HR) of young Taiwanese men. Three exercises types (dynamic, partially dynamic, and static) were performed by 12 participants (six were familiar with Borg's scale and 6 were unfamiliar) under nine test conditions of three load levels for each exercise. The effect of familiarity on the relationship between RPE and HR was also examined. The results showed that the familiarity of the participants regarding the Borg's scale did not affect the scores. The relationship between Borg's RPE 6-20 scale and the HR values during dynamic exercise was described by the regression equation HR = 8.88 x RPE + 38.2 (beats/min). The HR had lower correlations with RPE values when the participants performed both partially dynamic and static exercises. The findings may serve as a reference when using Borg's RPE scale to evaluate the physical exertion of young Taiwanese men.

Left atrial distensibility and E/e' for estimating left ventricular filling pressure in patients with stable angina. -A comparative echocardiography and catheterization study-.

BACKGROUND: Although E/e' (the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity) is widely used to measure left ventricular filling pressure (LVFP), its accuracy is questionable in coronary artery disease patients. METHODS AND RESULTS: Echocardiograms and LVFP were obtained from 174 patients with stable angina (Canadian Cardiovascular Society angina grade I-II) who had received interventions for angiography-confirmed coronary stenosis. Compared with single-vessel groups, the multiple-vessel group exhibited lower mitral annular velocities, higher LVFP, and stronger correlations between E/regional e' and LVFP. Additionally, stronger correlations between E/regional e' and LVFP existed in patients with systolic dysfunction or lower variation of myocardial performance index (MPI) among anterior, inferior and lateral borders of mitral annulus. Average e' was not superior to any regional e' for assessing LVFP by the E/e' method. E/e' and left atrial (LA) ejection fraction (EF) correlated linearly with LVFP, but the correlation between LA distensibility and LVFP was logarithmical. Compared with E/e', LA distensibility and LAEF were superior for identifying high LVFP. CONCLUSIONS: E/e' is not completely satisfactory for assessing LVFP in patients with stable angina, especially those with single-vessel disease, preserved systolic function or high MPI variation. For identifying high LVFP, LA distensibility and LAEF are better than E/e'.

Right ventricular infarction and tissue Doppler imaging ­ insights from acute inferior myocardial infarction after primary coronary intervention ­.

BACKGROUND: Tissue Doppler imaging (TDI) data for acute inferior myocardial infarction (MI) patients who have received primary percutaneous coronary intervention (PCI) are sparse. METHODS AND RESULTS: One hundred and sixty-five patients received primary PCI for acute inferior MI were enrolled. Right ventricular infarction (RVI) was defined as a culprit lesion proximal to the right ventricular branch of right coronary artery (RCA). Echocardiograms and TDI were obtained within 6 h after primary PCI. The prevalence of multi-vessel disease in the RCA-P culprit group (50%) was higher than that in other groups (39% of RCA-D culprit, 43% of left circumflex artery (LCX) culprit). The myocardial performance index (MPI) of the lateral tricuspid annulus provides discriminatory power for identifying RVI, whereas systolic velocity (Sm) of the lateral tricuspid annulus does not. Lateral mitral annular MPI divided by the lateral tricuspid annular MPI is a reliable index for identifying a culprit lesion (>1.06 predicts culprit over LCX; <0.96 predicts culprit over RCA-P and RVI). Kaplan-Meier survival curves revealed that late cardiovascular events were more likely in RVI patients. However, multivariate Cox proportional hazards analysis revealed that the most important factor in hard events and all cardiovascular events was multivessel disease. CONCLUSIONS: TDI is useful for identifying RVI and culprit lesions in inferior MI patients received primary PCI. RVI itself isn't associated with 1-year hard events and all cardiovascular events.

Meridian study on the response current affected by electrical pulse and acupuncture.

Acupuncture and its meridians are important components of traditional Chinese medicine, and numerous opinions have been previously expressed regarding these meridians. This study aims to explore the phenomenon of meridians from the perspective of electronic physics by studying these meridians for the response current affected by electrical pulse and acupuncture. In this study, acupuncture which applies an electrical pulse was used to research the physical properties of the meridians. Different kinds of pulses were applied to the human body to realize abnormal electrical signals. Comparing these electrical measurement results with the isothermal transient ionic current (ITIC) theory, we found that the transmission of meridian messages may be related to ion conduction. The movement of ions induced by acupuncture and electrical stimulation can lead to drift and diffusion currents through the meridians. The ionic conduction of meridian hypothesis is proved in that the substances delivered by meridians are in fact ions.

Stabilizing resistive random access memory by constructing an oxygen reservoir with analyzed state distribution.

In this paper, the instability mechanism of resistive random access memory (RRAM) was investigated, and a technique was developed to stabilize the distribution of high resistance states (HRS) and better concentrate the set voltage. Due to the accumulation of oxygen, an interface-type switching characteristic was observed on the I-V curves beneath the filament-type switching behavior. In this work, the interface-type switching characteristic is used to fit the natural distribution of HRS as an analysis of the instability mechanism. According to the results, the HRS distribution is attributed to the accumulation of excess oxygen ions left from the lower oxygen content and oxygen vacancy recombination during the reset process. The proposed solution with simple plasma treatment, can create an excess oxygen reservoir by changing the surface topography of the electrode to store the surplus oxygen ions from the reset process, eliminating the oxygen accumulation effect and further improving the device stability.

Myocardial tissue Doppler-based indexes to distinguish right ventricular volume overload from right ventricular pressure overload.

The objective of this study was to develop tissue Doppler parameters that could be used to differentiate right ventricular (RV) volume overload from RV pressure overload. The RV-pressure-overload group consisted of 40 patients with severe pulmonary hypertension, and the RV-volume-overload group consisted of 40 patients who had an atrial septal defect without evidence of right-to-left shunt, significant pulmonary hypertension, or Eisenmenger's complex. Another 40 healthy subjects were enrolled and served as a control group. Routine echocardiography and tissue Doppler imaging were performed. RV myocardial performance index was determined based on data collected during tissue Doppler imaging over the lateral tricuspid annulus. In patients with RV pressure overload, tissue Doppler parameters showed characteristically lower systolic velocity over the tricuspid annulus (RV myocardial systolic wave [Sm]) and longer isovolumic relaxation time (RV-IVRT). Nevertheless, in patients with RV volume overload, RV-Sm increased significantly, but early-diastolic velocity over tricuspid annulus was relatively low. In conclusion, RV-MPI, RV-Sm/early-diastolic velocity over tricuspid annulus, and RV-IVRT/RV-Sm were all useful to differentiate RV pressure overload from volume overload, although RV-IVRT/RV-Sm was the best parameter, with excellent sensitivity and specificity.

An Ultra-Low Power Smart Headband for Real-Time Epileptic Seizure Detection.

In this paper, the design of a smart headband for epileptic seizure detection is presented. The proposed headband consists of four key components: 1) an analog front-end circuitry; 2) an epileptic seizure detection tag (ESDT); 3) a Bluetooth low-power chip; and 4) customized electrodes. All the above components are integrated into a fabric headband with only 50.3 g. The smart headband system dissipates 55.89 mW. The epileptic seizure detection algorithm inside ESDT is validated by using Boston Children's Hospital's CHB-MIT scalp EEG clinical database with the detection rate of 92.68% and the false alarm of 0.527/h. We develop a service APP connected to the cloud so that the patients' health condition can be recorded and then referenced by doctors for further diagnosis or research.

Utility of Left Atrial Expansion Index and Stroke Volume in Management of Chronic Systolic Heart Failure.

BACKGROUND: Titration of evidence-based medications, important for treating heart failure (HF), is often underdosed by symptom-guided treatment. The aim of this study was to investigate, using echocardiographic parameters, stroke volume and left ventricular (LV) filling pressure to guide up-titration of medications, increasing prognostic benefits. METHODS: A total of 765 patients with chronic HF and severely reduced LV ejection fractions (<35%), referred from 2008 to 2016, were prospectively studied. Echocardiographic guidance was performed in 149 patients. LV filling pressure was assessed by left atrial expansion index, and stroke volume was estimated from diameter and time-velocity integral in the LV outflow tract. Up-titration of evidence-based medications and adjustment for side effects or worsening clinical conditions according to those parameters were performed. Propensity score matching was used to match pairs of patients with (n = 110) or without (n = 110) echocardiographic guidance. End points were 4-year frequencies of HF hospitalization and all-cause mortality. RESULTS: During a mean follow-up time of 4.1 years, rates of adverse events were 58 (52.7%) with no echocardiographic guidance and 36 (32.7%) with echocardiographic guidance (P < .0001). Echocardiography provided effective guidance to reduce prescribing frequency and dose of diuretics and to promote evidence-based medication prescription. It reduced HF rehospitalization and all-cause mortality. By multivariate analysis, prognostic improvement was associated with up-titration of medications with echocardiographic guidance. CONCLUSIONS: There was a statistically significant difference in long-term prognosis between propensity score-matched pairs of patients with chronic severe HF with and without echocardiographic guidance. These findings need further validation in large prospective clinical trials.

Multidetector row computed tomography can identify and characterize the occlusive culprit lesions in patients early (within 24 hours) after acute myocardial infarction.

BACKGROUND: The reliable noninvasive assessment of occluded disrupted plaques and thromboses in culprit vessels could constitute an important step forward in risk stratification of patients early after acute myocardial infarction (AMI). However, noninvasive identification of patency of culprit vessels remains a challenging issue. This prospective study was designed to identify the occluded culprit vessels by multidetector row computed tomography (MDCT) and to compare the stenotic and occlusive culprit lesions by MDCT in patients early (within 24 hours) after AMI. METHODS: We enrolled 62 patients with first Q-wave AMI (54 males). Multidetector row computed tomography was performed 16.5 +/- 7.1 hours after the onset of chest pain without any complication. Coronary angiography was done within 6 hours after MDCT. Patients were divided into 2 groups according to angiographic findings: stenotic group (35 patients) and occluded group (27 patients). The following MDCT data were collected: luminal artery stenosis, remodeling index, plaque burden, and lesion attenuation. RESULTS: Compared to coronary angiography, MDCT detected occluded culprit vessels with sensitivity, specificity, negative predict value, and positive predict value of 92.6%, 88.6%, 93.9%, and 86.2%, respectively. Compared with the stenotic group, culprit lesions in the occlusive group had significantly longer length (18.9 +/- 9.7 vs 11.9 +/- 6.2 mm; P = .024) and higher MDCT lesion attenuation (38.8 +/- 15.6 vs 29.2 +/- 12.9 Hounsfield unit; P = .008). Multidetector row computed tomography attenuation was negatively correlated with thrombolysis in myocardial infarction flow (Spearman rho = -0.46; P < .001). CONCLUSIONS: Multidetector row computed tomography could accurately and safely identify occluded culprit lesions in patients early after AMI, providing important information to aid in risk stratification.

Usefulness of pulmonary arterial flow discordance to identify pulmonary embolism.

The present study was undertaken to determine the sensitivity and specificity of echocardiography in the diagnosis of pulmonary embolism (PE). The study consisted of 2 stages. First, 600 patients were enrolled to measure bilateral pulmonary blood flow by echocardiography. Using multidetector row computed tomography, 200 subjects were diagnosed with pulmonary hypertension and 100 with defined PE. Another 300 subjects without cardiopulmonary distress served as controls. The time-velocity integral (TVI) and flow volume of both pulmonary arteries were obtained. The percentage differences in bilateral pulmonary arterial TVI (DeltaTVI/mean) were 12.0 +/- 9.3%, 13.8 +/- 12.1%, and 38.6 +/- 14.9% for controls, subjects with pulmonary hypertension, and subjects with PE, respectively. The percentage differences in bilateral pulmonary flow (Deltaflow/mean) were 15.1 +/- 11.7%, 17.6 +/- 14.9%, and 36.8 +/- 17.5% for controls, subjects with pulmonary hypertension, and subjects with PE, respectively. By receiver-operating characteristic curve analysis, the cut-off points for DeltaTVI/mean and Deltaflow/mean to identify PE were 25% and 26.5%, respectively. In the second part of study, the accuracy of DeltaTVI/mean and Deltaflow/mean to screen 300 patients with suspected PE was tested. Echocardiography provided high degrees of sensitivity and specificity for the diagnosis of PE. In conclusion, bilateral pulmonary arterial flow measurement is a simple and useful test to assess the possibility of PE.

Tissue Doppler velocity is not totally preload-independent: a study in a uremic population after hemodialysis.

OBJECTIVES: The aim of this study was to investigate the changes of regional tissue Doppler velocity after volume removal following regular hemodialysis (HD) in uremic patients. Is tissue Doppler velocity really preload-independent? BACKGROUND: Diastolic dysfunction was divided into four stages: normal pattern, abnormal relaxation pattern, pseudonormalization pattern, and restrictive pattern. Pulse wave Doppler and color Doppler echocardiography were important diagnostic tools for these forms of diastolic dysfunction. However, they were preload-dependent and sometimes there was confusion between the normal pattern and the pseudonormalization pattern. Tissue Doppler echocardiography was promising for problems in diastolic dysfunction and appeared to be preload-independent. However, there are still some disputes over this point. METHODS: Ninety-three uremic patients receiving regular HD were included in the study. There were 45 males and 48 females aged 59 +/- 14 years. The mean volume removed after HD was 2.3 +/- 0.9 kg. The mean heart rates before and after HD were 77 +/- 11 and 76 +/- 12 beats per minute, respectively (p = 0.73). All patients received complete transthoracic echocardiography examinations before and after HD. The studies included cardiac chamber size, left ventricular systolic performance, pulse wave Doppler echocardiographic data of mitral inflow and the right upper pulmonary vein including peak velocity of early diastolic E wave, E wave time velocity integral (TVI-E), peak velocity of late diastolic A wave, A wave TVI, systolic phase of pulmonary vein (S wave TVI), early diastolic phase of pulmonary vein (D wave TVI) and atrial contraction phase of pulmonary vein (Ar wave TVI). Pulsed tissue Doppler echocardiography (TDE) was performed and a 4-mm sample volume was placed at the 6 corners of the mitral annulus including septal, lateral, anterior, inferior, anteroseptal and posterior corners. Five to ten cardiac cycles were recorded and the data were averaged. Measurements performed included peak velocity of systolic phase (Sa), early diastolic phase (Ea), late diastolic phase (Aa), Ea/Aa ratio and time from the beginning of electrocardiogram Q wave to the beginning of Sa (Q-Sa time). The same measurements were repeated after HD. RESULTS: After HD, left atrium diameter and left ventricular internal dimensions at end diastole became smaller. There were significant reductions for mitral peak E wave velocity, TVI-E, peak A wave velocity and E/A ratio. As for the pulmonary vein, systolic phase of pulmonary vein and early diastolic phase of pulmonary vein decreased significantly. Peak Ar wave did not change significantly. For TDE, Sa and Aa did not change but Ea did decrease. CONCLUSION: After HD, there is a significant reduction of intravascular effective volume. No significant change is found for myocardial peak systolic velocity and peak late diastolic velocity. However, there is a significant reduction of myocardial early diastolic phase peak velocity. This suggests that TDE is not completely preload-independent; at least, it is phase-dependent within each cardiac cycle.

Double-lumen endobronchial tube intubation in patients with difficult airways using Trachlight and a modified technique.

We present a modified method for the insertion of double-lumen endobronchial tubes with Trachlight in patients with difficult airways. We also discuss whether our method is applicable to smaller double-lumen endobronchial tubes.

Evaluation of changes in cardiac output from the electrical impedance waveform in the forearm.

We tested the validity of regional impedance cardiography (RIC) for measuring changes in both cardiac output and stroke volume by comparing the values with a 2D ultrasound technique in response to the breath-hold manipulation. Among 13 subjects, changes in the maximum amplitude of the regional impedance waveform from the forearm conformed to those in stroke volume (r = 0.86, p < 0.001) and cardiac output (r = 0.76, p < 0.003) measured with the ultrasound technique in baseline and immediately after a 30 s breath-hold maneuver. We also found that the per cent change in cardiac output (r = 0.73, p < 0.005) and the per cent change in stroke volume (r = 0.84, p < 0.0003) by the echocardiography were both positively correlated with the per cent change in the peak impedance amplitude. In addition, both the change and the per cent change in the mean area under the impedance curve were consistent with those in the stroke volume, respectively. Accordingly, the regional electrical impedance waveform from lower limbs may be helpful in providing a non-invasive and continuous assessment of left ventricular output, especially during cardiac procedures.

Usefulness of regional myocardial performance index to diagnose pulmonary embolism in patients with echocardiographic signs of pulmonary hypertension.

In this study, myocardial performance index (MPI) was used to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred patients with echocardiographic signs of pulmonary hypertension were enrolled in this study after informed consent was obtained. All patients underwent multidetector-row computed tomography of the chest, and PE was found in 50 patients. Another 100 patients without any cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as the control group. All cohorts were enrolled after the exclusion of (1) any rhythm other than sinus rhythm; (2) complete bundle branch block; (3) ischemic heart disease proved by stress test, perfusion scan, or coronary angiography; (4) a left ventricular (LV) ejection fraction <50%; and (5) inadequate echocardiograms. Routine echocardiography and tissue Doppler imaging were performed, including the MPIs of the right and left ventricles. The right ventricular (RV) MPI was significantly higher in patients with PE than in others (p <0.0001). Patients without PE had concordant changes in the RV and LV MPIs. In patients with acute PE, the RV MPI became higher, but the LV MPI was relatively constant. Using the RV MPI divided by the LV MPI (the V index), PE could be distinguished in patients with echocardiographic signs of pulmonary hypertension. By receiver-operating characteristic curve analysis, the V index >1.2 identified PE with sensitivity of 82% and specificity of 83%. In conclusion, the V index is a useful parameter to assess the possibility of PE in patients with echocardiographic signs of pulmonary hypertension.

Usefulness of tissue Doppler parameters for identifying pulmonary embolism in patients with signs of pulmonary hypertension.

The objective of this study was to use tissue Doppler parameters to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred fifty patients with echocardiographic signs of pulmonary hypertension were enrolled, 50 of whom had PE on multidetector row computed tomography of the chest. Another 150 patients without cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as a control group. All patients were in sinus rhythm. Routine echocardiography and tissue Doppler imaging were performed. The right ventricular (RV) myocardial performance index (MPI) was obtained during tissue Doppler imaging over the lateral tricuspid annulus. The M index was measured and defined as the peak early diastolic mitral inflow velocity divided by the RV MPI. Statistical analysis was preformed using receiver-operating characteristic curves. Peak early diastolic mitral inflow velocity was significantly less and the RV MPI was significantly greater in patients with PE than in patients without PE (both p values < 0.0001). The RV MPI and the M index were useful in identifying PE in patients with echocardiographic signs of pulmonary hypertension. On statistical analysis, a RV MPI > 0.55 identified PE with a sensitivity of 85% and a specificity of 78%. A M index < 112 had a sensitivity of 92% and a specificity of 92%. In conclusion, the sensitivity and specificity of the RV MPI and the M index to identify PE were excellent. Echocardiography is a useful method to screen for PE.

Characterization of nano recorded marks at different writing strategies on phase-change recording layer of optical disks.

Conductive-atomic force microscopy has been successfully used for characterizing recorded marks on commercial digital versatile disk and Blu-ray disk. Nano recorded marks beyond diffraction limit are imaged with high spatial resolution and excellent contrast of conductivity. The smallest mark size resolved is around 23.5 nm which is limited by background spots around 18.5 nm. The results of different optical power and writing strategy on the size, shape, and close packed writing process of recorded marks clearly show the opto-thermal response of phase-change recording layer.

Role of shortened QTc dispersion in in-hospital cardiac events in patients undergoing percutaneous coronary intervention for acute coronary syndrome.

BACKGROUND: QT dispersion (QTD) refers to the difference between maximal and minimal QT values on the electrocardiogram (ECG). QTD values are calculated and corrected with Bazett's formula (corrected QTD = QTcD = QTD/square root of RR). QTcD increases in patients with acute coronary syndrome (ACS). Recovery of increased QTcD (shortened QTcD) develops after successful revascularization, but prolonged QTcD occurs in certain patients. The aim of this study is to ascertain the clinical significance between shortened and prolonged QTcD groups after percutaneous coronary intervention (PCI). METHODS: We retrospectively enrolled 128 patients with ACS who had received PCI. The values of QTcD were measured manually on 12-lead standard ECGs obtained within 3 days before and after PCI (pre-PCI QTcD and post-PCI QTcD). All the patients were divided into 2 groups. The shortened QTcD group was defined as those patients with a decrease in QTcD after PCI and the prolonged QTcD group as those with an increase in QTcD after PCI. The underlying diseases, various clinical classifications and some prognostic factors were taken into comparison and statistical analysis between these 2 groups. RESULTS: The shortened QTcD group showed a significantly higher rate of in-hospital cardiac death (13% vs. 0%, p = 0.006) and a greater pre-PCI QTcD (100.8 +/- 39.5 vs. 61.3 +/- 24.1 ms, p < 0.001) than the prolonged QTcD group. There was a significantly greater pre-PCI QTcD in patients with cardiac death than those without cardiac death (111.6 +/- 38.3 vs. 83.3 +/- 38.3ms, p = 0.027). Furthermore, the patients with in-hospital cardiac death presented with a significantly more frequent occurrence of in-hospital ventricular arrhythmia, compared with those without cardiac death (30.0% vs. 4.0%, p = 0.014). CONCLUSION: Among the patients with ACS undergoing PCI, directly divided into shortened and prolonged QTcD groups regardless of initial pre-PCI QTcD, the shortened QTcD group showed a higher occurrence of in-hospital cardiac death and a greater pre-PCI QTcD. Shortened QTcD might be 1 risk factor for in-hospital cardiac death.

Use of a video fiberoptic bronchoscope to assist double-lumen endobronchial tube intubation in a patient with a difficult airway.

In clinical scenarios, the insertion of double-lumen endobronchial tubes (DLTs) is usually employed as a technique of separation of lungs for treatment purposes inclusive of one-lung ventilation for the ease of thoracic surgery. However, in patients with difficult airways, the DLT intubation can be challenging, even with the aid of a fiberoptic bronchoscope (FOB). Insertion of the FOB itself into the trachea may be relatively simple, but the advancement of the DLT with the FOB enclosed in the lumen may be hindered by the abnormal or diseased laryngeal aperture. Herein, we present an alternative approach by using a 5.5-mm video FOB to monitor the DLT rather than using it to act as an introducer to overcome the difficulties often met in DLT intubation in oral cancer patients.