Background: Functional tricuspid regurgitation (TR) greater than or equal to a mild grade requires tricuspid valvuloplasty, and tricuspid valvuloplasty with ring annuloplasty has shown good outcomes. We report here on our early experience with the Edwards $MC^3$ annuloplasty system (Edwards LifeSciences, Irvine, CA). Material and Method: From November 2004 to July 2006, 72 patients with tricuspid annular dilatation and TR underwent tricuspid valvuloplasty with using the Edwards $MC^3$ annuloplasty ring. Sixty-eight patients were operated on via median sternotomy and four patients were operated on using robotic assisted minimal invasive thoracotomy. The patient population included 21 males and 51 females and their mean age was $53.9{\pm}12.3$. The mean grade of TR, as assessed by the preoperative echocardiography, was $2.2{\pm}1.0$. The mean NYHA functional class was $3.1{\pm}0.8$. The mean left ventricular ejection fraction was $57.0{\pm}9.9$%. Result: The TR and NYHA functional class, as assessed by postoperative echocardiography, was significantly reduced (mean=$0.4{\pm}0.6$ and $2.0{\pm}0.7$, respectively p<0.001). There was one case of hospital mortality. One patient required permanent pacemaker insertion for third degree atrioventricular block. Conclusion: Our study shows that the Edwards $MC^3$ remodeling ring is easy to implant and it effectively corrects functional TR with excellent clinical and echocardiographic outcomes. Further follow-up and a larger clinical series are required to establish the long-term stability of this repair technique.
Cai, Elijah Zhengyang;Teo, Erin Yiling;Jing, Lim;Koh, Yun Pei;Qian, Tan Si;Wen, Feng;Lee, James Wai Kit;Hing, Eileen Chor Hoong;Yap, Yan Lin;Lee, Hanjing;Lee, Chuen Neng;Teoh, Swee-Hin;Lim, Jane;Lim, Thiam Chye
Archives of Plastic Surgery
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v.41
no.6
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pp.638-646
/
2014
Background The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. Methods 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two $3.0{\times}3.0cm$ full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. Results Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): $8.33cm^2$, $4.90cm^2$, $3.12cm^2$, $1.84cm^2$; Mepitel (n=6): $10.29cm^2$, $5.53cm^2$, $3.63cm^2$, $2.02cm^2$; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. Conclusions BPM is comparable to Mepitel as a safe and efficacious wound dressing.
We investigated the effects of yohimbine and atipamezole in dogs anesthetized with xylazine-ketamine combination on electroencephalography (EEG) . Experiment groups were divided into three according to antagonists . Saline (1 ml) was used as an antagonist in group C, yohimbine (0.1 mg/kg) in group Y and atipamezole (50 ug/kg) in group A. Each group consisted of 5 dogs. Glycopyrrolate was injected 15 minutes prior to xylazine injection. Xylazine (1.1 mg/kg, IM) and ketamime (10 mg/kg, IV) were injected with the interval of 10 minutes. After 15 minutes, antagonists were administered intravenously. For EEG measurements, a recording electrode was positioned at Cz, which was applied to International 10-20 system. Heart rates, body temperature, respiratory rates, arterial blood pressure, $PaO_2$$PaCO_2$$PaCO_2$ at S4 in group Y was significantly decreased(p<0.05). Changes of electrolytes were not significant, except value of $Cl^-$ at S3 in group A. Mean head-up time (the time dogs showing head-up movement after antagonist injection, minutes) was $38.23^{\circ}$ae6.46 in group C, 2.54 $\pm$ 0.93 in group Y and 2.12$\pm$ 1.32 in group A. Mean sternal recumbent time (the time dogs showing sternal recumbency after antagonist injection, minutes) was 45.93$\pm$ 10.27 in group C, 11.91 $\pm$ 7.19 in group Y and 9.88$\pm$ 3.38 in group A. Mean walking time (minutes) was 53.49$\pm$ 9.21 in group C, 22.10$\pm$ 11.10 in group Y and 18.48$\pm$ 4.39 in group A. In group Y all dogs showed excitation and muscle rigidity in emergence. In group A, two dogs were also showed excitation and muscle rigidity, but were weaker than those of group Y.
Kim, Eu-Gene;Shin, Hun-Kyu;Jeong, Haw-Jae;Choi, Jae-Yeol;Park, Se-Jin;Choi, Kyu-Bo;Lim, Jong-Jun
Clinics in Shoulder and Elbow
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v.13
no.2
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pp.194-201
/
2010
Purpose: We evaluated clinical and radiological results for open reduction and internal fixation of acromioclavicular dislocation without coracoclavicular ligament repair after removal of implants. Materials and methods: Clinical and radiological results were obtained for 53 patients who underwent open reduction and internal fixation of an acromioclavicular joint dislocation between 1998 and 2007. A total of 21 patients were treated with a modified-Phemister method and 32 patients were treated with a Hook plate method. All subjects were surveyed after removal of their implants. The Constant scoring system was administered postoperatively to evaluate clinical results. Radiologic outcomes were evaluated by both coracoclavicular intervals on plain films. Results: Constant scores were $87.59{\pm}7.8$ in the Phemister group and $89.35{\pm}5.3$ in the Hook plate group. For both groups, the mean coracoclavicular interval at preoperative radiography was 15.9 mm at the injured site and 8.0 mm at the opposite site. After metal removal, the mean difference between coracoclavicular distances between normal and injured sites were 1.0 mm for the Hook plate group and 1.2 mm for the modified Phemister method group (p>0.05). Conclusion: Open reduction and internal fixation of an acromioclavicular joint without coracoclavicular ligament repair shows good long-term clinical and radiological results.
Mammalian oviductal epithelial cells have been known to improve in vitro fertilization and embryonic development. Recently, co-cultured human embryos with the epithelial cells in human genital tract has been reported to improve the pregnancy rate. The purpose of the study was to investigate the effects of the epithelial cells of human genital tract on the development of mouse early embryos and human fertilized oocytes. The epithelial cells of human genital tract were collected from the fallopian tubes which were obtained during hysterectomy in fertile women and from the endometrium during endometrium biopsy. Collected human ampullary cells(HACs) and endometrial cells(HECs) were cultured for 10 days to establish primary monolayer. Second passaged HACs and HECs were obtained by trypsinization were cryopreserved in PBS with 1.5 M DMSO for later use. To investigate the effect when co-cultured with HACs and HECs, we tried to apply strict quality control on mouse embryo, from two cell to blastocyst prior to human trial. The results of quality control were as follows; In Group I (Ham's F10 with 10% FCS), Group IT (co-cultured with HACs) and Group ill (co-cultured with HECs), developmental rates to blastocyst were 63.3%(253/400), 76.0%(304/ 400),74.0%(296/400), respectively. Hatching rates were 36.8%(147/400), 41.80/0(167/400), 38.0%(152/400), respectively(p<0.05). To perform the human IVF, cryopreserved HACs were thawed at 37$^{\circ}C$ waterbath, seeded on the well dish and cultured for 48 hI'S. The pronuclear stage embryos were transferred to the seeded well dish. After 24 hRS, co-cultured embryos were examined and transferred to patient's uterus. The results of human IVF when co-cultured with HACs were that fertilization and developmental rates were 61.8% (256/414), 95.3% (244/256) as compared with 57.2% (279/488) and 94.6%(264/279) in Ham's F10 supplemented with 10% FCS(control). However, 62.9% (161/256) of co-cultured human embryos showed good embryos(no or slight fragmentation) as compared with 53.8 % (150/279) in control(p < 0.05). Pregnancy rate was 40.0% (12/30) when co-cultured with HACs whereas 30.6%(11/36) in control. In conclusions, co-culture system using HACs and HECs improved the developmental and hatching rates of mouse embryo. Also, in human IVF system when co-cultured with HACs, it improved both the quality of human embryos and the pregnancy rate.
This study was carried to investigate the physicochemical and microbiological characteristics of seasonal salted-Kimchi cabbage order to provide basic data for optimal salting and storage condition of seasonal Kimchi cabbage. Generally, fall season samples had slightly higher pH and acidity value than the other seasonal salted Kimchi cabbage. The soluble solids content of spring, summer, fall and winter samples were 5.95%, 6.18%, 6.29% and 7.76%, respectively. The salt content of all the seasonal salted Kimchi cabbage samples were insignificant. The number of microbial bacteria in the summer samples were generally much more significant than spring and winter samples. There was no significant difference in the color of seasonal salted Kimchi cabbage. As for the texture properties, the firmest samples in the surface rupture test were the spring samples (force: 4.92 kg), and the hardest samples in the puncture test were the summer samples (force: 11.71 kg). In the correlation analysis of the quality characteristics of seasonal samples, the soluble solids content and hardness of the seasonal salted Kimchi cabbage was significantly correlated at 1% significance level. Also, in the principal component analysis, F1 and F2 were shown to explain 27.28% and 35.59% of the total variance (62.87%), respectively. The hierarchical cluster analysis of the quality characteristics of seasonal samples, the samples were divided into three groups: spring cabbage group, summer cabbage group and fall and winter cabbage group.
The cyclohexanol dehydrogenase (ChnA), produced by Rhodococcus sp. TK6, which is capable of growth on cyclohexanol as the sole carbon source, has been previously purified and characterized. However, the current study cloned the complete gene (chnA) for ChnA and its flanking regions using a combination of a polymerase chain reaction (PCR) based on the N-terminal amino acid sequence of the purified ChnA and plaque hybridization from a phage library of Rhodococcus sp. TK6. A sequence analysis of the 5,965-bp DNA fragment revealed five potential open reading frames (ORFs) designated as partial pte (phosphotriesterase), acs (acyl-CoA synthetase), scd (short chain dehydrogenase), stp (sugar transporter), and chnA (cyclohexanol dehydrogenase), respectively. The deduced amino acid sequence of the chnA gene exhibited a similarity of up to $53\%$ with members of the short-chain dehydrogenase/reductase (SDR) family. The chnA gene was expressed using the pET21 a(+) system in Escherichia coli. The activity of the expressed ChnA was then confirmed (13.6 U/mg of protein) and its properties investigated.
In-Ceram system is one of contemporary esthetic all ceramic restorations and has relatively high flexural strength. The purpose of this study was to evaluate the marginal fidelity according to type of resin cement and measuring position, and to evaluate fracture strength according to type of resin cement. In this study, twenty seven In-Ceram crowns were fabricated on the metal master die of prepared maxillary right central incisor and devided into three groups. All specimens were cemented with Panavia 21 (group PV), Super-bond (group SB) and Lute-it (group LI) on the metal master die. After cementation, specimens were measured marginal gap between the margin of the In-Ceram crown and the finishing line of metal master die by using a stereomicroscope (SZ-ST, Olympus, Japan). Marginal gaps were recorded at the labial, lingual, mesial and distal measuring points on the metal master die. For the mesurement of fracture strength, lingual surfaces of cemented specimens were loaded at a distance of 1mm from incisal edge by using the Autograph S-2000 (Shimadzu, Japan). The results of marginal fidelity and fracture strength were statistically analyzed with the SPSS version 8.0 programs. The results of this study were as follows: 1. In comparison of marginal fidelity according to the measuring points, there was no significant difference. 2. The marginal fidelity according to the type of resin cement was decreased in order of group $LI\;(63.75{\mu}m),\;SB\;(77.78{\mu}m),\;PV\;(86.53{\mu}m)$, and there was significant difference between group LI and PV (p<0.05). 3. The fracture strength according to the type of resin cement was showed descending order of group $LI\;(60.00kg/cm^2),\;SB\;(56.80kg/cm^2),\;PV\;(56.11kg/m^2)$, but there was no significant difference.
The purpose of this study was to evaluate effect of head posture change on initial occlusal contacts through measuring the distances between initial occlusal contacts and maximum intercuspal position at different head posture. Two special devices were designed and constructed. Mandibular movement replicator was used to assess reliability of the K6 diagnostic system(MKG; Myo-tronic Inc, Seatle, USA) and head posture calibrator was used to maintain the constant head posture during experiment. We measured difference of distance between initial occlusal contact and maximum intercuspal position with MKG in upright, supine, 45 degrees extension, 30 degrees flexion, 30 degrees right and left bending postion of the head. The Frankfurt horizontal plane was used as a reference plane. 21 adults aged from 23 to 25 were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. The obtained results were as follows : The mean absolute distances between initial occlusal contact and maximum intercuspal postion were 0.39(0.18mm in the upright position, 0.65(0.37mm in the supine position, 0.59(0.33mm in the 45 degree extension, 0.70(0.53mm in the 30 degrees flexion, 1.12(1.10mm in the 30 degrees right bending and 1.94(0.67mm in the 30 degrees left bending of the head. The positions of the initial occlusal contacts have a tendency to locate anterior, left and inferior to maximal intercuspal position in upright position, posterior and inferior in supine position and 45 degrees extension, anterior and inferior in 30 degrees flexion, right and inferior in 30 degrees right bending, and left and inferior in 30 degrees left bending of the head. There were significant differences among the initial occlusal contacts in each head postures(P<0.0001). Therefore, we need to check initial occlusal contacts in the altered head posture during occlusal analysis and adjustment of occlusal appliance and dental occlusion for diagnosis and treatment of temporomandibular disorder.
Abdul Rashid, Rima Marhayu;Ramli, Sophia;John, Jennifer;Dahlui, Maznah
Asian Pacific Journal of Cancer Prevention
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v.15
no.13
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pp.5143-5147
/
2014
Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.
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