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Feasibility of self-measurement telemonitoring using a handheld heart sound recorder in patients with heart failure - SELPH multicenter pilot study. J Cardiol 2024:S0914-5087(24)00082-0. [PMID: 38701945 DOI: 10.1016/j.jjcc.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Multi-parametric assessment, including heart sounds in addition to conventional parameters, may enhance the efficacy of noninvasive telemonitoring for heart failure (HF). We sought to assess the feasibility of self-telemonitoring with multiple devices including a handheld heart sound recorder and its association with clinical events in patients with HF. METHODS Ambulatory HF patients recorded their own heart sounds, mono‑lead electrocardiograms, oxygen saturation, body weight, and vital signs using multiple devices every morning for six months. RESULTS In the 77 patients enrolled (63 ± 13 years old, 84 % male), daily measurements were feasible with a self-measurement rate of >70 % of days in 75 % of patients. Younger age and higher Minnesota Living with Heart Failure Questionnaire scores were independently associated with lower adherence (p = 0.002 and 0.027, respectively). A usability questionnaire showed that 87 % of patients felt self-telemonitoring was helpful, and 96 % could use the devices without routine cohabitant support. Six patients experienced ten HF events of re-hospitalization and/or unplanned hospital visits due to HF. In patients who experienced HF events, a significant increase in heart rate and diastolic blood pressure and a decrease in the time interval from Q wave onset to the second heart sound were observed 7 days before the events compared with those without HF events. CONCLUSIONS Self-telemonitoring with multiple devices including a handheld heart sound recorder was feasible even in elderly patients with HF. This intervention may confer a sense of relief to patients and enable monitoring of physiological parameters that could be valuable in detecting the deterioration of HF.
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Impact of control measures including decolonization and hand hygiene for orthopaedic surgical site infection caused by MRSA at a Japanese tertiary-care hospital. J Hosp Infect 2024; 146:151-159. [PMID: 37516280 DOI: 10.1016/j.jhin.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/16/2023] [Accepted: 07/01/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Meticillin-resistant Staphylococcus aureus (MRSA) is the most common pathogen in orthopaedic surgical site infections (SSIs). However, few studies have investigated the transmission process of orthopaedic MRSA SSI. AIM To investigate the transmission process of orthopaedic MRSA SSI using epidemiological and molecular analyses and to determine a method to prevent MRSA SSI in nosocomial orthopaedic surgery. METHODS Active MRSA surveillance, preoperative decolonization and contact precautions for MRSA-positive cases was performed at our institution. Changes in epidemic strains were evaluated and the possibility of transmission from patients in an orthopaedic ward of a Japanese tertiary-care hospital was assessed by genotyping stored MRSA strains. In addition, data on the prevalence of MRSA SSI, MRSA colonization, and use of an alcohol antiseptic agent (mL/patient-days) during 2005-2022 were retrospectively assessed. FINDINGS SCCmec type II strain in the SSI group decreased over time, associated with fewer outbreaks. Even during a period of high infection rates, no cases of transmission-induced SSI from nasal MRSA carriers were identified. The infection rate correlated negatively with the use of an alcohol antiseptic agent (r = -0.82; P < 0.0001). Two cases among five nasal carriers developed MRSA SSI caused by strains different from those related to nasal colonization. CONCLUSION The infection control measures for transmission from the hospital reservoirs including strict adherence to hand hygiene and decolonization of carriers is likely to be important for the prevention of orthopaedic MRSA SSI. However, the need for contact precautions for decolonized nasal carriers might be low.
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Changes in cardiac acoustic biomarkers before and after cardiac events in a patient with right-sided heart failure due to cor pulmonale. J Cardiol Cases 2023; 27:108-112. [PMID: 36910036 PMCID: PMC9995676 DOI: 10.1016/j.jccase.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/02/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
Chronic heart failure (HF) has various phenotypes. It is accompanied by repeated hospitalizations over a long period. Therefore, accumulating long-term observational data of patients with various backgrounds is important to establish a prediction technology for the exacerbation of HF. In a patient with chronic right-sided HF caused by cor pulmonale, heart sounds and electrocardiograms were recorded at home or our hospital twice a week for 7 months including the stable (31 days), pre-exacerbation (2 weeks just before the onset of exacerbation), and hospitalization periods and quantified as cardiac acoustic biomarkers (CABs) using AUDICOR technology (Inovise Medical, Inc., Portland, OR, USA). The relationship between the change in CABs and hospitalization events due to HF were investigated. During the pre-exacerbation period just before the onset of exacerbation of HF leading to hospitalization, inaudible changes in the third heart sound (S3) strength that were probably derived from the right heart were observed. Although the values of the fourth heart sound (S4) strength were high during the stable and pre-exacerbation period, values decreased markedly during hospitalization. These findings suggest that CABs including S3 and S4 are useful for the early detection of signs of HF exacerbation. Learning Objective In a case of chronic right-sided heart failure, the change in the third heart sound (S3) caused by the right ventricle could be detected using cardiac acoustic biomarkers in exacerbations of heart failure. Even if S3 is inaudible by auscultation, it is possible to observe its changes using quantification technology.
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Diagnostic value of simultaneous 99mTc-sestamibi/123I-BMIPP imaging parameters for predicting the improvement of left ventricular wall motion after acute myocardial infarction using CZT SPECT system. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although the presence of 99mTc-sestamibi/123I-BMIPP-mismatch, the reverse redistribution (RR) of 99mTc-sestamibi and RR of 123I-BMIPP in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of LV wall motion in the infarcted territory in chronic phase, few studies were performed to analyze them by simultaneous dual-isotope imaging using cadmium-zinc-telluride (CZT) SPECT system.
Purpose
The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP-mismatch or RR of 99mTc-sestamibi, RR of 123I-BMIPP make better prediction of the improvement of LV wall motion in the infarcted territory.
Methods
We evaluated 42 consecutive patients with AMI who had undergone both dual-isotope SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS.
Results
Of 42 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 29 patients. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch and RR of 99mTc-sestamibi and RR of 123I-BMIPP were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.0001 and p=0.002, respectively). To predict the improvement of LV wall motion in the infarcted territory in chronic phase, the presence of 99mTc-sestamibi/123I-BMIPP-mismatch showed sensitivity of 93%, specificity of 85% and accuracy of 91%, while RR of 99mTc-sestamibi and RR of 123I-BMIPP had sensitivities of 72%, 48%, specificities of 85%, 100% and accuracies of 76%, 64%, respectively. The multivariate discriminant analysis revealed that the combination of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP best predicted the improvement of LV wall motion in the infarcted territory in chronic phase with sensitivity of 93%, specificity of 85% and accuracy of 91% (chi-square=40.6), compared with RR of 99mTc-sestamibi and RR of 123I-BMIPP only (sensitivity 79%, specificity 85% and accuracy of 81%, chi-square=16.9).
Conclusions
The addition of 99mTc-sestamibi/123I-BMIPP-mismatch on RR of 99mTc-sestamibi and RR of 123I-BMIPP in patients with AMI, help better predict the improvement of LV wall motion in the infarcted territory in chronic phase.
Funding Acknowledgement
Type of funding sources: None.
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Temporal changes of cardiac acoustic biomarkers and cardiac function in acute decompensated heart failure. ESC Heart Fail 2021; 8:4037-4047. [PMID: 34184415 PMCID: PMC8497215 DOI: 10.1002/ehf2.13492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 11/11/2022] Open
Abstract
AIMS Relationships between cardiac acoustic biomarkers (CABs) measured by acoustic cardiography and clinical outcomes have been reported in heart failure (HF) patients. However, no studies have investigated the temporal change of CABs and the corresponding changes in HF status. The purpose of this study was to assess whether the temporal changes of CABs in patients with acute decompensated heart failure (ADHF) reflect changes in cardiac function and status. METHODS AND RESULTS Sixty ADHF patients were enrolled prospectively. CABs and echocardiography data were collected at admission, before discharge, and at the first clinic visit. CABs included electromechanical activation time (EMAT); the time interval from Q wave onset on electrocardiography to the first heart sound (S1), QoS2; the time interval from Q wave onset on electrocardiography to the second heart sound (S2); and third heart sound (S3) and fourth heart sound (S4) intensities, defined as the peak-to-peak amplitudes of S3 and S4. EMATc (EMAT/RR) (P = 0.001), S3 intensity (P < 0.001), and S4 intensity (P < 0.001) were significantly decreased, and QoS2 (P = 0.005) was significantly increased from admission to discharge. The change in S3 intensity was significantly correlated with that of E/A (ρ = 0.571, P < 0.001), and the extended QoS2 was also significantly correlated with the increase in the stroke volume index (ρ = 0.383, P = 0.004). CONCLUSIONS Some CABs in ADHF patients changed significantly in the normal direction throughout the treatment course and could be useful biomarkers in ADHF management.
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Honedra® (CLBS12) autologous CD34+ cells improve outcomes in patients with Buerger’s disease. Cytotherapy 2021. [DOI: 10.1016/s146532492100390x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prediction of the improvement of left ventricular wall motion after acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP using cadmium-zinc-telluride SPECT. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Although both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of left ventricular (LV) wall motion in the infarcted territory in chronic phase, few studies evaluated them by simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) imaging using cadmium-zinc-telluride (CZT) SPECT system.
Purpose
The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP mismatch or the reverse redistribution of 99mTc-sestamibi make better prediction of the improvement of LV wall motion in the infarcted territory.
Methods
We evaluated 30 consecutive patients with AMI who had undergone both dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Both 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS.
Results
Of 30 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 20 patients. Both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.011, respectively). The respective sensitivities, specificities and accuracies in the prediction of the improvement of LV wall motion in the infarcted territory were 90%, 90% and 90% with 99mTc-sestamibi/123I-BMIPP mismatch, and 60%, 90%, 70% with reverse redistribution of 99mTc-sestamibi.
Conclusions
In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging using CZT SPECT system, both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in acute phase are useful for predicting the improvement of LV wall motion in chronic phase, but the presence of 99mTc-sestamibi/123I-BMIPP mismatch is superior to the reverse redistribution of 99mTc-sestamibi for it.
Funding Acknowledgement
Type of funding source: None
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Prediction of myocardial viability in chronic phase in patients with acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP SPECT using CZT camera system. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The objective of this study was to determine the optimal cut-off value of % uptake of simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in patients with acute myocardial infarction (AMI) for prediction of myocardial viability in chronic phase.
Methods
We evaluated 30 consecutive patients with AMI who had undergone both dual-SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Regional % uptake with a 17-segment model was obtained using QPS software. The presence of myocardial viability was defined when regional % uptake ≥50% in 99mTc SPECT at rest in chronic phase was observed. Receiver operating characteristic (ROC) curves were analyzed to determine the optimal cutoff values of regional % uptake in both left anterior descending artery (LAD) territory and non-LAD coronary territory in acute phase to predict the myocardial viability in chronic phase.
Results
The cutoff values for prediction of viable myocardium were %uptake ≥47% for 99mTc-sestamibi, %uptake ≥31% for 123I-BMIPP in acute phase in LAD territory and %uptake ≥52% for 99mTc-sestamibi, %uptake ≥48% for 123I-BMIPP in non-LAD territory. The respective sensitivities, specificities and the area under the ROC curve (AUC) values in the prediction of myocardial viability were 92%, 92% and 0.94 with 99mTc-sestamibi, 90%, 85%, 0.92 with 123I-BMIPP in LAD territory, and 81%, 93% and 0.92 with 99mTc-sestamibi, 81%, 90%, 0.92 with 123I-BMIPP in non-LAD territory. There were no significant differences in AUC values between 99mTc-sestamibi and 123I-BMIPP in both LAD territory and non-LAD coronary territory.
Conclusions
In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging in patients with AMI, these results suggest that not only 99mTc-sestamibi SPECT, but also 123I-BMIPP SPECT may be possible to predict the presence of myocardial viability in chronic phase. But it should be noted that the optimal cutoff values of regional % uptake in acute phase to predict the myocardial viability may differ for LAD territory and non-LAD coronary territory.
Funding Acknowledgement
Type of funding source: None
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P1828Aortic calcification detected by computed tomography and aortic vulnerable plaques: aortic angioscopy study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Aortic calcification is associated with atherosclerotic risk factors and an increased risk of death and cardiovascular disease. However, the relationships aortic calcification and aortic plaque instability are not yet elucidated. Recently, some reports showed non-obstructive aortic angioscopy seemed to visualize atherosclerotic changes of aortic wall more clearly compared with computed tomography (CT). The purpose of this study was to evaluate whether aortic calcification is associated with aortic vulnerable plaques in patients with cardiovascular disease.
Methods
We investigated 60 consecutive patients with confirmed or suspected coronary artery disease who underwent both aortic angioscopy and CT. The AC volume (ACV) was measured using the volume-rendering method by extracting the area >130 HU within the whole aorta. ACV index (ACVI) was defined as ACV divided by the body surface area. We evaluated the number of ruptured plaque (RP), ulceration and fissure by aortic angioscopy in the whole aorta. We excluded 4 hemodialysis patients. All patients were divided into the median value of ACVI.
Results
The mean age of patients was 68±10. The median of ACVI was 10.7 ml/m2 [3.9–22.7]. High ACVI patients had significantly greater number of RP, ulceration and atheromatous plaques detected by aortic angioscopy compared with those of low ACVI (2.2±2.7 vs 0.8±1.1, p=0.033, 1.6±1.2 vs 0.9±1.0, p=0.041, 4.0±3.1 vs 1.9±1.8, p=0.009, respectively). Furthermore, the patients without aortic calcification did not have RP at all. In a multivariate model, the number of the atheromatous plaques was independently associated with high ACVI (odds ratio 1.57, 95% confidence interval 1.07–2.69, p=0.018)
Conclusions
Aortic calcification detected by CT was related to aortic vulnerable plaques in patients with cardiovascular disease.
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6125High wall shear stress predicts plaque rupture of the aortic arch: computational fluid dynamics model and non-obstructive general angioscopy study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Wall shear stress (WSS) has been considered as a major determinant of aortic atherosclerosis. Recently, non-obstructive general angioscopy (NOGA) was developed to be able to visualize a variety of its atherosclerotic pathology, including in vivo ruptured plaque (RP) in the aorta. We, therefore, investigated the relationship between NOGA derived RP in the aortic arch and the stereographic distribution of WSS by using computational fluid dynamics modeling (CFD) on three-dimensional CT angiography (3D-CT).
Methods
We investigated 30 consecutive patients who underwent 3D-CT before and NOGA during coronary angiography. WSS in the aortic arch was measured with an application of CFD based on finite element method by using uniform inlet and outlet flow conditions. Aortic RP was detected by NOGA.
Results
The maximum and mean values of WSS were 67.2±29.2 Pa and 2.4±0.6 Pa. A total of 18 RPs was detected by NOGA. The patients with a distinct RP showed a significantly higher maximum WSS in the whole aortic arch, and the greater and lesser curvature of the aortic arch than those without it (73.3±29.0 Pa vs 50.4±15.2 Pa, p=0.035, 95.0±27.5 Pa vs 42.8±25.2 Pa, p=0.003, 70.8±29.3 Pa vs 46.1±11.9 Pa, p=0.013, respectively), whereas there was no significant difference in the mean WSS between those with and without it. In a multivariate analysis, the maximum value of WSS was an independent predictor of RP in the aortic arch (odds ratio 1.05, 95% confidence interval 1.01–1.13, p=0.019).
Representative picture of WSS and NOGA
Conclusions
Aortic RP detected by NOGA was strongly associated with the higher maximum WSS in the aortic arch derived by CFD using 3D-CT. Maximum WSS may explain the underlying mechanism of not only aortic atherosclerosis, but also aortic RP.
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P2638Comparison of in-stent responses in 8 month between durable polymer and bioabsorbable polymer everolimus-eluting stent: serial observation with angioscopy and optical coherence tomography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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2459Diagnostic value of simultaneous dual-isotope imaging with 99mTc-sestamibi and 123I-BMIPP using cadmium-zinc-telluride SPECT system in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P2969Comparison of diagnostic performance of cadmium-zinc-telluride camera system between 201Tl and 99mTc-radiotracers as assessed by fractional flow reserve. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P2351Spatial distribution of macrophage accumulation within coronary arterial wall in diabetic versus non-diabetic patients with acute coronary syndrome: a study with multi-intravascular imaging modalities. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Characteristics of meso-particles formed in coagulation process causing irreversible membrane fouling in the coagulation-microfiltration water treatment. WATER RESEARCH 2016; 101:127-136. [PMID: 27262117 DOI: 10.1016/j.watres.2016.05.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/19/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023]
Abstract
In coagulation-membrane filtration water treatment processes, it is still difficult to determine the optimal coagulation condition to minimize irreversible membrane fouling. In microfiltration (MF), meso-particles (i.e., 20 nm-0.5 μm) are thought to play an important role in irreversible membrane fouling, especially their characteristics of particle number (PN) and zeta potential (ZP). In this study, a new nanoparticle tracker combined a high-output violet laser with a microscope was developed to identify the physicochemical characteristics of these microscopic and widely dispersed meso-particles. The effects of pH and coagulant dose on ZP and PN of micro-particles (i.e., >0.5 μm) and meso-particles were investigated, and then coagulation-MF tests were conducted. As the result, irreversible membrane fouling was best controlled for both types of membranes, while meso-particle ZP approached zero at around pH 5.5 for both types of natural water. Since PN was greatest under these conditions, ZP is more important in determining the extent of irreversible membrane fouling than PN. However, the acidic condition to neutralize meso-particles is not suitable for actual operation, as considering residual aluminum concentration, pipe corrosion, and chlorination efficiency. It is therefore necessary to investigate coagulants or other methods for the appropriate modification of meso-particle characteristics.
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SAT0633-HPR Social Support May Be Important for Improving Patient Satisfaction and Health Status in Patients with Rheumatoid Arthritis Treated with Biologics. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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SAT0632-HPR The Efficacy of Biologics on Health Status Including Psychological Status, Self-Efficacy and Patient Satisfaction in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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FRI0631-HPR Patient Satisfaction is Correlated with Role, Psychological State and Patient Global Assessment in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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AB1216-HPR A Study of Possible Correlations of Sleep Disturbance with Disease Activity, Psychological State and Health Status in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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THU0580-HPR Psychological Remission May BE Effective to Attain Remission of Boolean-Based Definition of Patient Global Assessment in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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THU0579-HPR Psychological State and Health Status Account for the Discrepancy between Patient Global Assessment and Evaluator Global Assessment in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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SAT0126 Correlation of Sleep Disturbance with Disease Activity, Psychological State, Self-Efficacy and Quality of Life in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Improved Abiotic Stress Tolerance in Plants by Accumulation of Osmoprotectants—Gene Transfer Approach. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.1080/13102818.2005.10817287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Follow-Up of Reactivation of HB Virus in HBV Antibody Positive Lymphoma After Chemotherapy in a Single Institution. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Long-term follow-up after endovascular treatment in patients with femoropopliteal TASC II class A and B lesion. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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THU0589 Correlation of Depression with Patient Global Assessment, Sleep Disturbance and Health Status in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0822-HPR Correlation of psychological state with patient global assessment in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
In orthodontic tooth movement (OTM), we should be concerned about external root resorption (ERR) as an undesirable iatrogenic problem, but its mechanisms are not fully understood. Since our previous epidemiologic studies found that patients with allergic diseases showed higher rates of ERR during orthodontic treatment, we explored the possible effect of allergic sensitization on ERR. In ovalbumin (OVA)-sensitized Brown–Norway rats, the amounts of ERR and OTM were greater than those in animals subjected to orthodontic force alone. The expression levels of RANKL and pro-inflammatory cytokines were increased in the periodontal tissues of sensitized rats with OTM, compared with control rats. Furthermore, leukotriene B4 (LTB4), a potent lipid mediator of allergic inflammation, and enzymes of the 5-lipoxygenase pathway, the biosynthetic pathway of leukotrienes, were also up-regulated. We found that low doses of aspirin suppressed ERR in allergen-sensitized rats, as well as the expressions of RANKL, pro-inflammatory cytokines, and LTB4. The present findings indicate that allergen sensitization has adverse effects on ERR under OTM, and that aspirin is a potential therapeutic agent for combating ERR.
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A robust approach to independent component analysis of signals with high-level noise measurements. ACTA ACUST UNITED AC 2012; 14:631-45. [PMID: 18238044 DOI: 10.1109/tnn.2002.806648] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We propose a robust approach for independent component analysis (ICA) of signals where observations are contaminated with high-level additive noise and/or outliers. The source signals may contain mixtures of both sub-Gaussian and super-Gaussian components, and the number of sources is unknown. Our robust approach includes two procedures. In the first procedure, a robust prewhitening technique is used to reduce the power of additive noise, the dimensionality and the correlation among sources. A cross-validation technique is introduced to estimate the number of sources in this first procedure. In the second procedure, a nonlinear function is derived using the parameterized t-distribution density model. This nonlinear function is robust against the undue influence of outliers fundamentally. Moreover, the stability of the proposed algorithm and the robust property of misestimating the parameters (kurtosis) have been studied. By combining the t-distribution model with a family of light-tailed distributions (sub-Gaussian) model, we can separate the mixture of sub-Gaussian and super-Gaussian source components. Through the analysis of artificially synthesized data and real-world magnetoencephalographic (MEG) data, we illustrate the efficacy of this robust approach.
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Genetic decrease in fatty acid unsaturation of phosphatidylglycerol increased photoinhibition of photosystem I at low temperature in tobacco leaves. BIOCHIMICA ET BIOPHYSICA ACTA 2012; 1817:1374-9. [PMID: 22445720 DOI: 10.1016/j.bbabio.2012.03.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/02/2012] [Accepted: 03/07/2012] [Indexed: 11/28/2022]
Abstract
Leaves of transgenic tobacco plants with decreased levels of fatty acid unsaturation in phosphatidylglycerol (PG) exhibited a slightly lower level of the steady state oxidation of the photosystem I (PSI) reaction center P700 (P700(+)) than wild-type plants. The PSI photochemistry of wild-type plants was only marginally affected by high light treatments. Surprisingly, all plants of transgenic lines exhibited much higher susceptibility to photoinhibition of PSI than wild-type plants. This was accompanied by a 2.5-fold faster re-reduction rate of P700(+) in the dark, indicating a higher capacity for cyclic electron flow around PSI in high light treated transgenic leaves. This was associated with a much higher intersystem electron pool size suggesting over-reduction of the PQ pool in tobacco transgenic lines with altered PG unsaturation compared to wild-type plants. The physiological role of PG unsaturation in PSI down-regulation and modulation of the capacity of PSI-dependent cyclic electron flows and distribution of excitation light energy in tobacco plants under photoinhibitory conditions at low temperatures is discussed. This article is part of a Special Issue entitled: Photosynthesis Research for Sustainability: from Natural to Artificial.
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Retrospective analysis of an efficient peripheral blood stem cell collection and the relation between infused cell dose and clinical outcome in patients with malignant lymphoma and multiple myeloma. Int J Lab Hematol 2012; 34:403-9. [PMID: 22376221 DOI: 10.1111/j.1751-553x.2012.01410.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Etoposide (VP16) is a drug used not only for the treatment of lymphoma but also for the collection of peripheral blood stem cells (PBSCs). We analysed the efficacy and adverse effects of collecting PBSCs and the relation between the infused cell dose and the clinical outcome in lymphoid malignancies. METHOD Investigating 30 patients with non-Hodgkin's lymphoma, one patient with Hodgkin's lymphoma, and five patients with multiple myeloma, we compared the effects of several doses of etoposide with those of CHOP or CHOP-like treatments or salvage treatments. We also analysed the relation between the amount of CD34(+) cells collected (above or below 5.0 × 10(6) /kg/day) and prognosis of these patients. RESULTS We found the collected cell count to be highest in patients treated with 500 mg/m(2) of VP16 and lowest in those not treated with VP16 (P = 0.0073). A CD34(+) cell count above 100/μL on the collection day indicates that the target amount of CD34(+) cells (4.0 × 10(6) /kg) can be readily obtained and was reached most rapidly by the patients who had received 500 mg/m(2) of VP16 (P = 0.01). The longer duration of neutropenia in those patients (P = 0.000006) resulted in longer antibiotic treatment (P = 0.0052). Both progression-free survival (PFS) and overall survival (OS) were better for the patients who yielded more than 5.0 × 10(6) CD34(+) cells/kg/day (P = 0.087 for PFS and P < 0.033 for OS). CONCLUSION We show here that 3 days of VP16 at 500 mg/m(2) was useful for the collection of PBSCs and that patients who yielded more than 5.0 × 10(6) CD34(+) cells/kg/day survived longer than those who yielded less.
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1.065 PREVALENCE AND CLINICAL CORRELATES OF ANXIETY IN PARKINSON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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High-flow Neonatal Macrocerebral Arteriovenous Fistulas in Hereditary Hemorrhagic Telangiectasia. Neuroradiol J 2011; 24:772-8. [PMID: 24059775 DOI: 10.1177/197140091102400517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 05/15/2011] [Indexed: 11/16/2022] Open
Abstract
Although some cases of vein of Galen aneurysmal malformation (VGAM) present initial clinical symptoms such as cardiopulmonary disturbance in the neonatal period, pial arteriovenous fistula is very seldom present as a clinical symptom immediately after birth. A neonatal patient, the first-born to his family, presented with tachypnea postpartum. This baby had a family history of hereditary hemorrhagic telangiectasia. A cerebral MR image revealed multiple macrocerebral arteriovenous fistulas (MCAVFs), resulting in a large partially thrombosed venous pouch within the cerebral cortex. Trans-arterial embolizations of the main two fistulas were performed using N-butyl cyanoacrylate (NBCA) with tantalum powder six months after birth. Post-embolization angiography confirmed the obliteration of the fistulas and magnetic resonance imaging (MRI) revealed thrombosis and reduction in size of the venous component. His tachypnea disappeared completely. There were no neurological complications due to the treatment. The prognosis of multiple MCAVFs mainly depends on the presence of medullar signs and symptoms and a delay before treatment. Pure glue endovascular intervention, as used in our case, is considered to be the first therapeutic choice to decrease the risk of neurological consequences.
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Isolation and characterization of an ether-type polyurethane-degrading micro-organism and analysis of degradation mechanism by Alternaria sp. J Appl Microbiol 2009; 108:1946-53. [PMID: 19912428 DOI: 10.1111/j.1365-2672.2009.04600.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To degrade ether-type polyurethane (ether-PUR), ether-PUR-degrading micro-organism was isolated. Moreover, ether-PUR-degrading mechanisms were analysed using model compounds of ether-PUR. METHODS AND RESULTS A fungus designated as strain PURDK2, capable of changing the configuration of ether-PUR, has been isolated. This isolated fungus was identified as Alternaria sp. Using a scanning electron microscope, the grid structure of ether-PUR was shown to be melted and disrupted by the fungus. The degradation of ether-PUR by the fungus was analysed, and the ether-PUR was degraded by the fungus by about 27.5%. To analyse the urethane-bond degradation by the fungus, a degraded product of ethylphenylcarbamate was analysed using GC/MS. Aniline and ethanol were detected by degradation with the supernatant, indicating that the fungus secreted urethane-bond-degrading enzyme(s). PURDK2 also degraded urea bonds when diphenylmethane-4,4'-dibutylurea was used as a substrate. CONCLUSIONS The enzyme(s) from PURDK2 degraded urethane and urea bonds to convert the high molecular weight structure of ether-PUR to small molecules; and then the fungus seems to use the small molecules as an energy source. SIGNIFICANCE AND IMPACT OF THE STUDY Ether-PUR-degrading fungus, strain PURDK2, was isolated, and the urethane- and urea-bonds-degrading enzymes from strain PURDK2 could contribute to the material recycling of ether-PUR.
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La radiochirurgie dans le traitement de la névralgie trigéminale : résultats à long terme et influence des nuances techniques. Neurochirurgie 2009; 55:213-22. [DOI: 10.1016/j.neuchi.2009.01.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 01/27/2009] [Indexed: 11/29/2022]
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Superconductivity in thin films of boron-doped carbon nanotubes. PHYSICAL REVIEW LETTERS 2008; 101:027002. [PMID: 18764216 DOI: 10.1103/physrevlett.101.027002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Indexed: 05/26/2023]
Abstract
Superconductivity in carbon nanotubes (CNTs) is attracting considerable attention. However, its correlation with carrier doping has not been reported. We report on the Meissner effect found in thin films consisting of assembled boron (B)-doped single-walled CNTs (B-SWNTs). We find that only B-SWNT films consisting of low boron concentration leads to evident Meissner effect with Tc=12 K and also that a highly homogeneous ensemble of the B-SWNTs is crucial. The first-principles electronic-structure study of the B-SWNTs strongly supports these results.
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Low-Dose Gamma Knife Radiosurgery for Cavernous Sinus Hemangioma: Report of 3 Cases and Literature Review. ACTA ACUST UNITED AC 2008; 51:140-6. [DOI: 10.1055/s-2008-1065346] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Concise Asymmetric Total Synthesis of Scyphostatin, a Potent Inhibitor of Neutral Sphingomyelinase. Chemistry 2007; 13:10225-38. [PMID: 17907134 DOI: 10.1002/chem.200700871] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The concise asymmetric total synthesis of scyphostatin has been achieved by condensation of the optically active cyclohexane unit, prepared from the commercially available 1,4-cyclohexadiene by our own method, and the side chain, prepared by the method developed by Hoye and Tennakoon (T. R. Hoye, M. A. Tennakoon, Org. Lett. 2000, 2, 1481-1483). The modification of the epoxy cyclohexenone unit was achieved in a late stage of the total synthesis, and deprotection of the primary alcohol was conducted in the final step. During the synthesis several key reactions were attained: 1) intramolecular bromoetherification of the cyclohexadiene acetal; 2) stereoselective introduction of the tertiary alcohol, 3) deprotection of the acetal function to the aldehyde by combination with silyl triflate/2,4,6-collidine and the one-pot synthesis of the disilyl aldehyde compounds, with different types of silyl groups, from the dihydroxy acetal compounds; and 4) facile deprotection of the 2,4-dimethoxyphenylmethyl ((2,4)DMPM) protecting group of the primary alcohol.
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Reaction of the acetals with TESOTf-base combination; speculation of the intermediates and efficient mixed acetal formation. J Am Chem Soc 2007; 128:5930-8. [PMID: 16637661 DOI: 10.1021/ja060328d] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report here unexpected highly chemoselective deprotection of the acetals from aldehydes. Treatment of acetal compounds from aldehydes with TESOTf-2,6-lutidine or TESOTf-2,4,6-collidine in CH2Cl2 at 0 degrees C followed by H2O workup at the same temperature caused the conversion of the acetal functions to aldehyde functions. The reaction had generality and was applied to many acetal compounds. Study using various bases revealed the reaction and reached the best combination of TESOTf-base. It was very mild and highly chemoselective and proceeded under weakly basic conditions. Then, many functional groups such as allyl alcohol, silyl ether, acetate, methyl ether, triphenylmethyl (Tr) ether, 1,3-dithiolane, methyl ester, and tert-butyl ester could survive under these conditions. Furthermore, this methodology could selectively deprotect the acetals in the presence of ketals as the most characteristic feature, although this chemoselectivity is difficult to achieve by other previously reported methods. A detailed study of the reaction including MS and NMR studies revealed the reaction mechanism for determining the structures of the intermediates, pyridinium-type salts. These intermediates had a weak electrophilicity and were successfully applied to the efficient formation of the mixed acetals in high yields.
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Molecular mechanisms of stress resistance of the photosynthetic apparatus. BIOCHEMISTRY MOSCOW SUPPLEMENT SERIES A-MEMBRANE AND CELL BIOLOGY 2007. [DOI: 10.1134/s1990747807030014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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A double three-step theory of brain metastasis in mice: the role of the pia mater and matrix metalloproteinases. Neuropathol Appl Neurobiol 2007; 33:288-98. [PMID: 17493010 DOI: 10.1111/j.1365-2990.2007.00799.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The brain is frequently affected by the spread of lung cancer, and haematogenous metastasis is a common route to brain metastasis. We therefore developed an isogenic brain metastasis model of lung cancer to use the Lewis lung carcinoma cell line and analysed dynamics of neoplastic cells after extravasation. Histological analysis revealed two characteristic patterns: metastatic foci exhibiting an angiocentric pattern were designated 'perivascular proliferations'; neoplastic cells infiltrating the brain parenchyma were designated 'invasive proliferations'. Electron microscopic observation of perivascular proliferations showed that neoplastic cells were confined to the perivascular space. In invasive proliferations, however, fragments of collagen fibre were observed in the gaps between neoplastic cells, indicating that the neoplastic cells had disintegrated the pia-glial membrane. We analysed the expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 by using both immunohistochemical analysis and real-time polymerase chain reaction analysis. MMP-2 expression was significantly higher in invasive proliferations. MMP-9 expression was significantly higher in day 7, but there was no significant difference in day 11. The pia-glial membrane and perivascular space are the barriers that neoplastic cells must overcome to infiltrate the brain. In conclusion, our findings suggest that brain metastasis requires two distinct processes.
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Follow up of a multicenter phase II study of sequential paclitaxel and S-1 (TXL/S1) as postoperative adjuvant chemotherapy for gastric cancer (GC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15084 Background: Of patients who undergo R0 resection for GC with serosal invasion (T3–4), more than half recur mainly in the peritoneum, while TXL and S1 exhibited efficacy for diffuse type and peritoneal metastases in the phase II studies. Primary analysis of the sequential chemotherapy with TXL/S1 had shown its safety and tolerability, its survival benefit is being tested in a large phase III study (the SAMIT trial) with oral fluoropyrimidines as controls. The analysis for survival of this preceding phase II study is performed. Methods: Eligibility criteria included histologically proven GC; sT3–4; sN0–2; M0 (except peritoneal cytology: CY); post D2–3 gastrectomy and R0–1; ECOG PS 0–1; and 20–80 years old. On postoperative day 14 to 56, patients received 3 courses of weekly TXL (80mg/m2 on day 1, 8 for the 1st course and on day 1, 8, 15 for the 2nd and 3rd courses, repeated every 3 or 4 weeks) followed by 4 courses of S1 (80mg/m2 daily for 2 weeks, repeated every 3 weeks). The primary endpoints were % of patients who completed all 7 courses (compliance) to see whether the lower 95% confidence limit of compliance was greater than 69% and incidence of severe toxicities and the secondary endpoints were 3-year survival and toxicities. Results: 50 patients were accrued from May 2003 to March 2004. The median age was 63 (range 34–74); male/female: 34/16; pT2/T3/T4: 1/44/5; CY0/CY1: 4/46; f-stage2/3a/3b/4: 12/15/16/7. The overall compliance was 84%. Median follow up time was 1063 days for survivors (694–1332) and 1030 days for all. Three-year DFS were 64.6% for all, 66.1% for CY0 and 50.0% for CY1. Conclusions: Sequential TXL/S1 may serve as an active adjuvant for gastric cancer patients especially who are at high risk for peritoneal spread. No significant financial relationships to disclose.
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[Preoperative morphological assessments of congenital heart disease by multidetector computed tomography]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2007; 60:475-8. [PMID: 17564064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Preoperative morphological assessments and anatomical delineation are keys to treatment of adult patients with congenital heart disease. We report on 2 cases where morphological assessments by multidetector-row computed tomography (MDCT) were useful. Case 1. A 33-year-old male was diagnosed with atrial septal defect (ASD) complicated by mitral regurgitation (MR), tricuspid regurgitation (TR), and severe pulmonary hypertension. In establishing the diagnosis, we carefully examined and confirmed that there was no possibility of ostium primum defect or other complicating malformations. MDCT was useful for demonstrating the location and morphology of the defect, anatomical relation to the tricuspid ring and the presence or absence of complicating malformations. Case 2. A 61-year-old female was diagnosed with double-chambered right ventricle with an intraventricular pressure gradient of 80 mmHg. MDCT extensively and clearly delineated the position and shape of abnormal muscle bundles and the morphology of complicating ventricular septal defect (VSD). MDCT was also useful in the determination of specific surgical procedures and the quick understanding of the anatomy during surgery, and even in postoperative assessments of therapeutic effects.
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Radiochirurgie gamma-knife des névralgies faciales. Résultats à moyen et long terme. Neurochirurgie 2006. [DOI: 10.1016/s0028-3770(06)71270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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[Chondrosarcoma of rib origin; report of a case]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2006; 59:501-4. [PMID: 16780073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Chondrosarcoma of rib origin is rare. A 50-year-old man without symptom was pointed out an abnormal shadow on chest X-ray. Computed tomography (CT) showed a low density mass arising from the right chest wall, and a CT-guided needle aspiration biopsy disclosed the tumor consisted of cartilage matrix with a partial necrosis. We suspected the tumor to be a chondrosarcoma of rib origin and performed a wide resection with the right 3rd and 4th ribs. The defect of the chest wall was repaired with double prolene mesh. Histological examination revealed grade 2 chondrosarcoma. Postoperative course has been uneventful for 25 months.
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Unexpected highly chemoselective deprotection of the acetals from aldehydes and not ketones: TESOTf-2,6-lutidine combination. J Am Chem Soc 2005; 126:11800-1. [PMID: 15382908 DOI: 10.1021/ja046103p] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Acetal functions are recognized as good protecting groups of carbonyl groups. Although many deprotecting methods of acetals to carbonyl functions have already been developed, there is no methodology which can deprotect acetals in the presence of ketals because the usual acidic or radical reactions occur more easily via the more stable cationic or radical intermediates from the ketals. On the other hand, this new method can proceed in a reverse manner to that described in previous reports. That is, the method can deprotect aliphatic acetals in the presence of ketals. The reaction condition is common for silylation, i.e., the TESOTf-2,6-lutidine combinations. Although the TMSOTf-2,6-lutidine combination can also deprotect acetals, it lacks chemoselectivity in deprotection of the acetals from aldehydes and ketones. The treatment of acetals with TESOTf and 2,6-lutidine in CH2Cl2 followed by a H2O workup gave the corresponding aldehydes. Of course, the compounds, which have both acetal and hydroxyl functions afforded the compounds obtained by the usual silylation of an alcohol and deprotection of an acetal without any problem. However, deprotection of the ketals from ketones was not observed during the conversion reaction of acetals from aldehydes. This chemoselectivity was confirmed in the reactions of the compounds that have the acetal and ketal in the same molecule. In both cases, the acetal functions were deprotected to give aldehydes with intact ketals. Furthermore, under the conditions described here, many functional groups such as methoxy, acetoxy, allyl alcohol, and silyloxy ether are intact. This method is very mild and available for many compounds.
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Psychrophilic Pseudomonas syringae requires trans-monounsaturated fatty acid for growth at higher temperature. Extremophiles 2004; 8:401-10. [PMID: 15241658 DOI: 10.1007/s00792-004-0401-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2004] [Accepted: 05/18/2004] [Indexed: 10/26/2022]
Abstract
A psychrophilic bacterium, Pseudomonas syringae (Lz4W) from Antarctica, was used as a model system to establish a correlation, if any, between thermal adaptation, trans-fatty acid content and membrane fluidity. In addition, attempts were made to clone and sequence the cti gene of P. syringae (Lz4W) so as to establish its characteristics with respect to the cti of other Pseudomonas spp. and also to in vitro mutagenize the cti gene so as to generate a cti null mutant. The bacterium showed increased proportion of saturated and trans-monounsaturated fatty acids when grown at 28 degrees C compared to cells grown at 5 degrees C, and the membrane fluidity decreased with growth temperature. In the mutant, the trans-fatty acid was not synthesized, and the membrane fluidity also decreased with growth temperature, but the decrease was not to the extent that was observed in the wild-type cells. Thus, it would appear that synthesis of trans-fatty acid and modulation of membrane fluidity to levels comparable to the wild-type cells is essential for growth at higher temperatures since the mutant exhibits growth arrest at 28 degrees C. In fact, the cti null mutant-complemented strain of P. syringae (Lz4W-C30b) that was capable of synthesizing the trans-fatty acid was indeed capable of growth at 28 degrees C, thus confirming the above contention. The cti gene of P. syringae (Lz4W) that was cloned and sequenced exhibited high sequence identity with the cti of other Pseudomonas spp. and exhibited all the conserved features.
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Injury of the lacrimal component of the nervus intermedius function after radiosurgery versus microsurgery. Neurochirurgie 2004; 50:338-44. [PMID: 15179287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
RATIONALE Due to the synergetic role of the facial nerve and the nervus intermedius in the mechanical protection of the eye, vestibular schwannomas (VS) and/or their treatment are dangerous for the visual function. Our goal was to evaluate and compare the impact of the tumor itself, and the microsurgery (MS) or radiosurgery (RS). MATERIAL AND METHOD A functional questionnaire evaluating among other items the patient's complaints related to the eye was addressed to a series of 100 patients, 3 years after GKS of a previously unresected unilateral VS. Answers were compared with those of a group of 100 patients operated microsurgically. A Shirmer test was additionally performed before radiosurgery, and more than 2 years after radiosurgery in 46 patients. RESULTS The risk of dry eye and burning eye was much higher in patients operated by MS compared to patients operated by GKS due to the high incidence of facial palsy in the former (57/99) and the its absence in the later (0/80). In the population operated microsurgically, the presence of a permanent facial palsy (57 patients among 99 responding to the questionnaire) was, of course, associated with a high rate of complaints about burning eye (n=18) and crying eye (n=23). Among patients from the two arms with no facial palsy, a dry eye was reported by 8/64 after GKS and 7/42 after MS (NS) and a burning eye by 9/64 after GKS and 9/42 after MS (NS). Thus patients with no clinical signs of impairement of the VII motor nerve accounted for 14% of the cases signs indicating injury of the intermedius nerve with the same probability whatever the kind of surgery. When no permanent facial palsy was observed a crocodile tear syndrome was more frequently observed after MS (4/42 versus 1/64, p=0.07). This suggests an early lesion of the VII motor and intermedius, and a subsequent abnormal regrowth. The only patient reporting a crocodile tear syndrome after GKS turned out to have presented transiently a discret deficit of orbicular muscle signaling transient partial facial nerve injury. In absence of facial palsy, a "crying eye" was reported more frequently after MS (16/42 versus 9/64, p=0.01), leading us to suspect frequent infraclinical VII nerve injury in patients with no obvious facial palsy operated by MS. Patients tested with Shirmer test, before and more than 2 Years after, were improved in 28.3%, stable in 56.5%, and worse in 15.2%. CONCLUSIONS This study is the first demonstrating that radiosurgery can induce nervus intermedius injury in a small percentage of cases (14%). These patients had been treated 11 years ago with what we can consider as "archeoGKS technology" compared to today's refinements. The impact of modern GKS on the nervus intermedius is currently under evaluation in our group. However, symptoms related to the eye either due to the injury of the nervus intermedius or of the VII motor or both are much more frequent after MS than after RS.
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Oncological effects of insufflation with different gases and a gasless procedure in rats. Surg Endosc 2003; 17:1151-5. [PMID: 12712382 DOI: 10.1007/s00464-002-8913-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2002] [Accepted: 12/17/2002] [Indexed: 11/24/2022]
Abstract
BACKGROUND The validity of using carbon dioxide (CO2) pneumoperitoneum in laparoscopic tumor surgery has not been investigated thoroughly. The oncologic effects of a gasless procedure and insufflation with different gases were compared in rats. METHODS In all the experiments, Donryu rats were randomized to receive a gasless procedure; to receive insufflation with CO2, helium, or air at 10 mmHg for 30 min, or to serve as control subjects without insufflation. In experiment 1, involving 60 rats, ascites hepatoma AH130 cells were inoculated intraperitoneally just before the procedures. The S-phase fraction of the intraperitoneal tumor cells was determined using a flow cytometry on day 7. In experiment 2, 60 rats injected intraperitoneally with latex particles received one of the procedures. At the end of the procedure, peritoneal macrophages were harvested to determine the number of phagocytosed particles. In experiment 3, 75 rats inoculated intraperitoneally with AH130 cells received one of the procedures for 5 consecutive days and were followed for survival analysis. RESULTS EXPERIMENT 1: The S-phase fraction was lower after insufflation with air or helium (p < 0.01) than with the anesthesia control condition. Insufflation with CO2 showed a higher S-phase fraction than the gasless procedure or insufflation with air or helium (p < 0.01). EXPERIMENT 2: The phagocytotic activity of peritoneal macrophages was increased by insufflation with helium and air, as compared with the control condition (p < 0.01). Insufflation with CO2 deteriorated the phagocytotic activity more than the gasless procedure (p < 0.05) or insufflation with air or helium (p < 0.001). EXPERIMENT 3: Insufflation with gases demonstrated shorter survival than the anesthesia control condition or the gasless procedure regardless of the gases used (p < 0.01). CONCLUSIONS These results suggest that the choice of gases may affect the proliferation of tumor cells and the phagocytotic activity of peritoneal macrophages, insufflation itself may promote tumor spread regardless of the gases used, and the gasless procedure may be oncologically advantageous in this animal model.
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Transgenics of an elite indica rice variety Pusa Basmati 1 harbouring the codA gene are highly tolerant to salt stress. TAG. THEORETICAL AND APPLIED GENETICS. THEORETISCHE UND ANGEWANDTE GENETIK 2002; 106:51-7. [PMID: 12582870 DOI: 10.1007/s00122-002-1063-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2002] [Accepted: 03/28/2002] [Indexed: 05/23/2023]
Abstract
Transgenic lines of indica rice were generated by Agrobacterium-mediated transformation with the choline oxidase ( codA) gene from Arthrobacter globiformis. Choline oxidase catalyses conversion of choline to glycine betaine. Glycine betaine is known to provide tolerance against a variety of stresses. Molecular analyses of seven independent transgenic lines as performed by Southern, Northern and Western hybridization revealed integration and expression of the transgene as well as inheritance in the progeny plants. A good correlation was observed between levels of mRNA and protein accumulation, and a significant amount of choline oxidase product, i.e. glycine betaine, accumulated in R0 as well as R1 plants. Mendelian as well as non-Mendelian segregation patterns were obtained in the progeny plants. Challenge studies performed with R1 plants by exposure to salt stress (0.15 M NaCl) for 1 week, followed by a recovery period, revealed that in some cases more than 50% of the transgenic plants could survive salt stress and set seed whereas wild-type plants failed to recover.
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