• Title/Summary/Keyword: non-vascular

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Effects of folic acid supplementation on serum homocysteine levels, lipid profiles, and vascular parameters in post-menopausal Korean women with type 2 diabetes mellitus

  • Vijayakumar, Aswathy;Kim, Eun-kyung;Kim, Hyesook;Choi, Young Ju;Huh, Kap Bum;Chang, Namsoo
    • Nutrition Research and Practice
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    • v.11 no.4
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    • pp.327-333
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    • 2017
  • BACKGROUND/OBJECTIVES: Complications of diabetes, such as cardiovascular disease, are associated with increased mortality among type 2 diabetes mellitus patients. Homocysteine has been recently identified as a predictor of cardiovascular disease-related complications in diabetes. We investigated whether or not supplementation with folic acid tablets can lower homocysteine levels and improve parameters related with vascular complications. SUBJECTS/METHODS: We conducted a non-randomized 8-week trial involving postmenopausal diabetic women (n = 25) supplemented with $800{\mu}g$ of folic acid ($400{\mu}g$ twice a day) daily. Subjects' serum levels of folate, homocysteine, and vitamin $B_{12}$ were measured, along with vascular function and brachial-ankle pulse wave velocity. RESULTS: Folic acid supplementation significantly increased serum folate levels (P < 0.0001), reduced homocysteine levels (P < 0.0001), and increased vitamin $B_{12}$ levels (P = 0.0063). There were significant decreases in low-density lipoprotein cholesterol levels as well as the ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol. Brachial-ankle pulse wave velocities were not altered by supplementation. Changes in serum vitamin $B_{12}$ after folic acid supplementation were negatively correlated with changes in brachial-ankle pulse wave velocity. CONCLUSIONS: In this study on postmenopausal Korean women with type 2 diabetes mellitus, folic acid supplementation reduced serum homocysteine levels, increased serum folate and vitamin $B_{12}$ levels, and lowered lipid parameters.

Prognostic Impact of Elevation of Vascular Endothelial Growth Factor Family Expression in Patients with Non-small Cell lung Cancer: an Updated Meta-analysis

  • Zheng, Chun-Long;Qiu, Chen;Shen, Mei-Xiao;Qu, Xiao;Zhang, Tie-Hong;Zhang, Ji-Hong;Du, Jia-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1881-1895
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    • 2015
  • Background: The vascular endothelial growth factor family has been implicated in tumorigenesis and metastasis. The prognostic value of each vascular endothelial growth factor family member, particular VEGF/VEGFR co-expression, in patients with non-small lung cancer remains controversial. Materials and Methods: Relevant literature was identified by searching PubMed, EMBASE and Web of Science. Studies evaluating expression of VEGFs and/or VEGFRs by immunohistochemistry or ELISA in lung cancer tissue were eligible for inclusion. Hazard ratios (HRs) and 95% confidence intervals (CIs) from individual study were pooled by using a fixed- or random-effect model, heterogeneity and publication bias analyses were also performed. Results: 74 studies covering 7,631 patients were included in the meta-analysis. Regarding pro-angiogenesis factors, the expression of VEGFA (HR=1.633, 95%CI: 1.490-1.791) and VEGFR1 (HR=1.924, 95%CI: 1.220-3.034) was associated separately with poor survival. Especially, VEGFA over-expression was an independent prognostic factor in adenocarcinoma (ADC) (HR=1.775, 95%CI: 1.384-2.275) and SCC (HR=2.919, 95%CI: 2.060-4.137). Co-expression of VEGFA/VEGFR2 (HR=2.011, 95%CI: 1.405-2.876) was also significantly associated with worse survival. For lymphangiogenesis factors, the expression of VEGFC (HR=1.611, 95%CI: 1.407-1.844) predicted a poor prognosis. Co-expression of VEGFC/VEGFR3 (HR=2.436, 95%CI: 1.468-4.043) emerged as a preferable prognostic marker. Conclusions: The expression of VEGFA (particularly in SCC and early stage NSCLC), VEGFC, VEGFR1 indicates separately an unfavorable prognosis in patients with NSCLC. Co-expression VEGFA/VEGFR2 is comparable with VEGFC/VEGFR3, both featuring sufficient discrimination value as preferable as prognostic biologic markers.

Comparison of Early Complications of Oral Anticoagulants after Totally Thoracoscopic Ablation: Warfarin versus Non-vitamin K Antagonist Oral Anticoagulants

  • MuHyung Heo;Dong Seop Jeong;Suryeun Chung;Kyoung Min Park;Seung Jung Park;Young Keun On
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.90-98
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    • 2023
  • Background: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. Totally thoracoscopic ablation (TTA) is a surgical treatment showing a high success rate as a hybrid procedure with radiofrequency catheter ablation to control AF. This study compared the early complications of warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) in patients who underwent TTA. Methods: This single-center retrospective cohort study enrolled patients who underwent planned TTA for AF from February 2012 to October 2020. All patients received postoperative anticoagulation, either with warfarin or a NOAC (apixaban, rivaroxaban, dabigatran, or edoxaban). Propensity score matching was performed for both groups. Early complications were assessed at 12 weeks after TTA and were divided into efficacy and safety outcomes. Both efficacy and safety outcomes were compared in the propensity score-matched groups. Results: Early complications involving efficacy outcomes, such as stroke and transient ischemic attack, were seen in 5 patients in the warfarin group and none in the NOAC group. Although the 2 groups differed in the incidence of efficacy outcomes, it was not statistically significant. In safety outcomes, 11 patients in the warfarin group and 24 patients in the NOAC group had complications, but likewise, the between-group difference was not statistically significant. Conclusion: Among patients who underwent TTA, those who received NOACs had a lower incidence of thromboembolic complications than those who received warfarin; however, both groups showed a similar bleeding complication rate. Using a NOAC after TTA does not reduce efficacy and safety when compared to warfarin.

Studies on the concentrations of hormones and the structure of uterine endometrium during the implantation period in rats (흰쥐 수정란 착상시기에 있어서의 호르몬 농도의 변화와 자궁내막의 구조에 관한 연구)

  • Yoon, Mi-Chung;Sohn, Seong-Hyang;Kim, Chang-Mee;Choe, Rim-Soon
    • Applied Microscopy
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    • v.23 no.1
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    • pp.77-90
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    • 1993
  • The mechanism by which blastocysts implant to uterine endometrium has not been clearly understood. In the present study, the following question was investigated: how are hormonal levels changed and how is uterine endometrium morphologically changed? Results obtained are as follows: Concentrations of serum estradiol and progesterone were significantly increased on day 4 and 5 of pregnancy. Uterine concentrations of PGE and $PGE_{2a}$ were sharply increased on day 1 and maintained similar concentrations thereafter, reaching the maximum on day 5. Both prostaglandins (PGs) concentrations were gradually decreased thereafter. Furthermore, concentrations of PGs in implant sites were greater than those in non-implant sites. PBR (pontamine blue reaction) in uterine endometrium was positive on day 6 of pregnancy, indicating that vascular permeability was increased. Edema and changes in structure of cell components were pronounced in stroma where PBR was developed. Moreover, these were more prominent in implant sites than non-implant sites. These results suggest that uterine PGs as well as steroid hormones increase during implantation in rats and these hormones might be involved in the process of implantation by modulating vascular permeability and the fine structures of uterine endometrial cells.

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Motor and Somato Sensory Evoked Potentials During Intraoperative Surveillance Testing in Patients with Diabetes

  • Lee, Kyuhyun;Kim, Jaekyung
    • International journal of advanced smart convergence
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    • v.9 no.1
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    • pp.37-46
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    • 2020
  • Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.

Soft Tissue Sarcomas Originating from Retroperitoneal Cavity in a Maltese Dog (후복강에서 기원한 비혈관성 연부조직 육종 증례)

  • Shin, Jung-Min;Park, Seuingjo;Lee, Sang-Kwon;Choi, Jihye
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.115-119
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    • 2015
  • An 11-year-old spayed female maltese was presented for abdominal distention, dysuria and dyschezia. Panting and heart murmur was found and abdominal palpation was difficult due to increased abdominal pressure. A soft tissue mass, $6{\times}3cm$ in size, was identified radiographically in pelvic canal, displacing the descending colon to the medioventral direction and the urinary bladder cranially. On ultrasonography, the mass consisted of homogeneous hypoechoic parenchyma containing the focal hyperechoic region ($1.6{\times}1.5cm$). The mass had distinct margin and no connection with adjacent organs. It was considered as a mass originating from the retroperitoneal cavity. Additional diagnostic procedures were not advanced because of the owner's request, and only a surgical excision of the mass was performed to alleviate the dysuria and dyschezia. Histopathologic examination and immunohistochemistry determined the mass as a soft tissue sarcoma and excluded hemangiosarcoma and osteosarcoma, both are the most common types of the retroperitoneal tumors. This report described non-vascular soft tissue sarcoma originating from the retroperitoneal cavity in a maltese dog.

Late reconstruction of oncological maxillary defect with microvascular free flap (상악결손부의 2차적 재건에 있어 유리 혈관화 피판의 적용)

  • Kwon, Tae-Geon;Kim, Chin-Soo
    • The Journal of the Korean dental association
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    • v.49 no.9
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    • pp.527-534
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    • 2011
  • Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy.

Massive Hemorrhage Caused by a Non-Displaced Pubic Ramus Fracture from Low-Energy Trauma (저에너지 외상에 의한 비전위 치골지 골절에서 발생한 대량출혈)

  • Na, Hwa-Yeop;Shin, Keun-Young;Choe, Saehun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.557-561
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    • 2019
  • Most low-energy pelvic ring fractures in elderly patients are treated conservatively so that an initial evaluation for complications such as vascular injury is usually overlooked. An 81-year-old female, who was taking regular aspirin, visited the emergency room and was diagnosed with a simple non-displaced pubic ramus fracture from a low-energy fall from standing, which was complicated by massive hemorrhage from the overlooked injury of the corona mortis. Elderly patients with pelvic ring fractures can have a delayed presentation of vascular injuries, regardless of the degree of displacement of the fractures, which highlights the need for a careful physical examination and close monitoring.

Non-Intrusive Healthcare System for Estimation of Vascular Condition in IP-Enabled Wireless Network (IP 기반 무선네트워크에서의 혈관상태 평가를 위한 무구속 헬스케어 시스템)

  • Jung, Sang-Joong;Kwon, Tae-Ha;Chung, Wan-Young
    • Journal of Sensor Science and Technology
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    • v.22 no.1
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    • pp.76-83
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    • 2013
  • A real-time wireless monitoring and analysis methods using the wearable PPG sensor to estimate cardiovascular condition is studied for ubiquitous healthcare service. A small size and low-power consuming wearable photoplethysmogram (PPG) sensor is designed as a wrist type device and connected with the IP node assigned its own IPv6 address. The measured PPG waveform in the IP node is collected and transferred to a central server PC through the IP-enabled wireless network for storage and analysis purposes. A monitoring and analysis program is designed to process the accelerated plethysmogram (APG) waveform by applying the second order derivatives to analyze systolic waves as well as heart rate variability analysis from the measured PPG waveform. From our results, the features of cardiovascular condition from individual's PPG waveform and estimation of vascular compliance by the comparison of APG-aging index (AI) and ratio of LF/HF are demonstrated.