scholarly journals Patterns of core and penumbra in acute MI occlusion and their clinical correlates

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 348-348
Author(s):  
Tudor G Jovin ◽  
Steven Goldstein ◽  
Gebel M James ◽  
Wechsler R Lawrence ◽  
Margareth-Beth Ott ◽  
...  
Keyword(s):  
Ischemic Penumbra ◽  
The Core ◽  
Functionally Impaired ◽  
Acute Mi ◽  
Group 3 ◽  
Group 2 ◽  
Core Volume ◽  
Selection Of Patients ◽  
Selection Of ◽  
Group 1

P51 Background and Purpose: The ischemic penumbra is composed of neurons that are functionally impaired but structurally intact, and thus potentially salvageable. Identifying the penumbra and its relationship with the ischemic core may lead to a more physiologic selection of patients who might benefit from recanalization therapy. We sought to explore the core/penumbra relationship by quantitatively measuring cerebral blood flow (CBF) in patients with acute M1 occlusion. Methods: 19 patients with M1 occlusion proven by CT angiography or conventional cerebral angiography underwent a Xe-CT/CBF study within 6 hours of symptoms onset. Mean CBF values were measured in the ipsilateral cortical MCA territory. The core was defined as areas with CBF< 8 ml/100g/min and the penumbra was defined as areas with CBF 9–20 ml/100g/min. Findings were correlated with the admission NIH stroke scale (NIHSS). Results: In 6/19 patients (31.5%)(group 1), the size of the penumbra was greater than twice the size of the core. In 8/19 patients (42.1%) (group 2), the size of the penumbra was approximately equal the size of the core. In 5/19 patients (26.8%)(group 3) the size of the penumbra was less than half the size of the core. The median core volumes for each of the three groups, expressed as percentage of core relative to ipsilateral cortical MCA territory, increased from group 1 to group 3. While there was a trend towards a correlation between the admission NIHSS and the combined core and penumbral volumes, no such correlation could be established between admission NIHSS and core or penumbral volumes alone. Conclusions: In the first 6 hours after M1 occlusion, penumbral volumes that are larger than or equal to core volumes are present in 14 out of 19 patients. A smaller core volume is associated with an increased penumbra to core ratio. The admission NIHSS in patients with M1 occlusion correlates with the combined volumes of core and penumbra.

Evaluation of the preventive care effectiveness in the adults with odontogenic infection given social and hygienic risk factors

2021 ◽  
Vol 21 (3) ◽  
pp. 175-181
Author(s):  
S. B. Ulitovskiy ◽  
O. V. Kalinina ◽  
A. V. Shevcov ◽  
E. S. Soloveva ◽  
N. K. Fok
Keyword(s):  
Preventive Care ◽  
Oral Hygiene ◽  
Adult Population ◽  
Oral Care ◽  
Odontogenic Infection ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Selection Of ◽  
Group 1

Relevance. Odontogenic infection is one of the most important problems of dental science. The variety of anti-inflammatory oral hygiene products determines the need for targeted selection of preventive toothpastes and rinses, balms, foams, elixirs, as well as monitoring and training the algorithm of hygienic measures for a patient with an odontogenic infection. The aim of the study was to study the hygienic status of the adult population for the selection of individual oral hygiene products for odontogenic infection, taking into account social and hygienic factors.Materials and methods. The study examined the prevalence of odontogenic infection in the adult population to determine the need for professional care and dental education. The study involved 198 people without somatic pathology, who were allocated into four groups according to the performed oral care and taking into account the dental status and the intensity of oral microbiota formation in the adult population. The patients were followed-up every week for one month. The study examined the simplified oral hygiene index by GreenVermillion (OHI-S), PMA index and Mühlemann and Son sulcus bleeding index, which allowed calculating the effectiveness of oral care products.Results. The preventive care effectiveness evaluation showed an increase in the cleansing effect in the adult population over the entire study period. The anti-inflammatory effectiveness analysis demonstrated positive changes: by the end of the study, the PMA index was 51.52 ± 3.40% in group 1; it increased by a factor of 3 and amounted to 44.17 ± 2.77% in group 2; 56.51 ± 4.61% – in group 3, 48.95 ± 3.60% – in group 4. The Mühlemann and Son sulcus bleeding index demonstrated the changes in the periodontal tissue condition and amounted to 52.78 ± 3.62% in group 1, 44.11 ± 3.54% in group 2, 54.97 ± 3.98% in group 3, 47.78 ± 2.73% in group 4.Conclusions. The development of oral health promotion measures determines the significance of oral care products for the prevention of odontogenic infection in the adult population, which plays a crucial role in the individual program planning for the main dental disease prevention.

Evaluation of the New Classification and Surgical Strategy for Myasthenia Gravis

2012 ◽  
Vol 78 (12) ◽  
pp. 1329-1335 ◽  
Author(s):  
Xin-Zheng Cui ◽  
Xin-Ying Ji ◽  
Feng Gao ◽  
Kun-Peng Yang ◽  
Hui-Ling Bai ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
New Classification ◽  
New Methods ◽  
Group 3 ◽  
Group 2 ◽  
Level Group ◽  
Median Incision ◽  
Selection Of ◽  
Made In ◽  
Group 1

The aim of this study was to discuss the new methods of clinical classification and staging of patients with myasthenia gravis (MG) proposed by our group and to summarize the experiences of surgical treatment of MG with a novel incision by cutting the sternum cross-sectionally at the second intercostal level. A retrospective analysis was made for the clinical data from the patients with MG who underwent thymectomy from July 1988 to May 2009. The surgical procedures were designed into three groups, a group with Osserman classification and median incision of the sternum (Group 1), a group with MGFA typing (Myasthenia Gravis Foundation of America) and a small transverse sternal incision at the second intercostal level (Group 2), and a group with new typing and a smaller transverse sternal incision at the second intercostal level (Group 3). Observation of the clinical typing and staging was made in the patients with myasthenia crisis. The parameters such as procedure duration in Group 2 and 3 was significantly lower than those in Group 1 ( P < 0.05). The incidence of myasthenia crisis in Group 3 was significantly lower than that in Groups 2 and 3 ( P < 0.05). The procedure with a smaller transverse sternal incision at the second intercostal level (Group 3) is a safer method for patients with MG. The combination of this procedure with the new typing and staging methods proposed by our group could facilitate the selection of operation indications and opportunity, resulting in the lower incidence of myasthenia crisis and mortality. Our new procedure is well deserved to be a preferential selection by other hospitals.

scholarly journals Induction of Spreading Depression in the Ischemic Hemisphere following Experimental Middle Cerebral Artery Occlusion: Effect on Infarct Morphology

1996 ◽  
Vol 16 (2) ◽  
pp. 202-213 ◽  
Author(s):  
Tobias Back ◽  
Myron D. Ginsberg ◽  
W. Dalton Dietrich ◽  
Brant D. Watson
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Spreading Depression ◽  
Ischemic Injury ◽  
Artery Occlusion ◽  
Ischemic Penumbra ◽  
Mca Occlusion ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

This study was undertaken to test whether transient depolarizations occurring in periinfarct regions are important in contributing to infarct spread and maturation. Following middle cerebral artery (MCA) occlusion we stimulated the ischemic penumbra with recurrent waves of spreading depression (SD) and correlated the histopathological changes with the electrophysiological recordings. Halothane-anesthetized, artificially ventilated Sprague–Dawley rats underwent repetitive stimulation of SD in intact brain (Group 1; n = 8) or photothrombotic MCA occlusion coupled with ipsilateral common carotid artery occlusion (Groups 2 and 3, n = 9 each). The electroencephalogram and direct current (DC) potential were recorded for 3 h in the parietal cortex, which represented the periinfarct border zone in ischemic rats. In Group 2, only spontaneously occurring negative DC shifts occurred; in Group 3, the (nonischemic) frontal pole of the ischemic hemisphere was electrically stimulated to increase the frequency of periinfarct DC shifts. Animals underwent perfusion-fixation 24 h later, and volumes of complete infarction and scattered neuronal injury (“incomplete infarction”) were assessed on stained coronal sections by quantitative planimetry. Electrical induction of SD in Group 1 did not cause morphological injury. During the initial 3 h following MCA occlusion, the number of spontaneous periinfarct depolarizations in Group 2 (7.0 ±1.5 DC shifts) was doubled in Group 3 by frontal current application (13.4 ± 2.7 DC shifts; p < 0.001). The duration as well as the integrated negative amplitude of DC shifts over time were significantly greater in Group 3 than in Group 2 rats (duration, 5.7 ± 3.8 vs. 4.1 ± 2.5 min; p < 0.05). Histopathological examination disclosed well-defined areas of pannecrosis surrounded by a cortical rim exhibiting selectively damaged acidophilic neurons and astrocytic swelling in otherwise normal-appearing brain. Induction of SD in the ischemic hemisphere led to a significant increase in the volume of incomplete infarction (19.0 ± 6.1 mm3 in Group 3 vs. 10.3 ± 5.1 mm3 in Group 2; p < 0.01) and of total ischemic injury (100.7 ± 41.0 mm3 in Group 3 vs. 66.5 ± 24.7 mm3 in Group 2; p < 0.05). The integrated magnitude of DC negativity per experiment correlated significantly with the volume of total ischemic injury ( r = 0.780, p < 0.0001). Thus, induction of SD in the ischemic hemisphere accentuated the development of scattered neuronal injury and increased the volume of total ischemic injury. This observation may be explained by the fact that, with limited perfusion reserve, periinfarct depolarizations are associated with episodic energy failure in the acute ischemic penumbra.

Cutting or Round-Bodied Needles for Tendon Repair

2003 ◽  
Vol 28 (5) ◽  
pp. 475-477 ◽  
Author(s):  
W. L. LAM ◽  
A. GARRIDO ◽  
J. VANDERMEULEN ◽  
M. J. FAGAN ◽  
P. R. W. STANLEY
Keyword(s):  
Tensile Strength ◽  
Tendon Repair ◽  
Biomechanical Study ◽  
Suture Repair ◽  
Longitudinal Stress ◽  
The Core ◽  
Group 3 ◽  
Group 2 ◽  
Repair Group ◽  
Group 1

We carried out a biomechanical study comparing tensile strength after using round-bodied or cutting needles for tendon repair. Swine tendons were repaired in three groups: Group 1 core suture repair only; group 2 core and circumferential suture repair; and group 3 isolated circumferential suture repair. The tendons were tested at longitudinal stress to failure at 5 mm/minute. No significant differences were found between the round-bodied and cutting needles in any group. Equal numbers in the core suture repair group failed by suture pullout when comparing cutting and round-bodied needles. We conclude that the choice of needle has no effect on the outcome of tendon repair if there is consistency of surgeon’s skill and experience.

scholarly journals Treatment of Adults with Anterior Mandibular Teeth Crowding: Reliability of Little’s Irregularity Index

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
J. Antoszewska-Smith ◽  
M. Bohater ◽  
M. Kawala ◽  
M. Sarul ◽  
M. Rzepecka-Skupień
Keyword(s):  
Treatment Plan ◽  
Irregularity Index ◽  
Reliable Parameter ◽  
Group 3 ◽  
Group 2 ◽  
Mandibular Teeth ◽  
Enamel Reduction ◽  
Selection Of ◽  
Group 1 ◽  
Mandibular Incisors

The attempt of this article was to assess reliability of Little’s Irregularity Index (LII) as for stability of the treatment outcomes in adults with crowded mandibular incisors. LII was measured on a digital cast prior to an orthodontic treatment (T1) of the 302 patients thus allowing us to establish the treatment plan, which called for (a) expansion (group 1), interproximal stripping (group 2), or extraction of one of the mandibular incisors. LII was measured after debonding (T2) and a year after retention (T3). Treatment resulted in significant reduction of LII values after treatment, in T1-T2 period in all groups. As for T2-T3 period it brought significant but clinically irrelevant relapse that occurred in groups 1 and 2; group 3 presented with insignificant improvement of occlusion. Conclusively, 30 years after introducing LII it has been a reliable parameter that allows selection of optimal treatment methods, provided that the appropriate ranges of values displaying dentoalveolar discrepancy are obeyed, namely, (1) up to 3 mm: expansion, (2) from 3 to 5 mm: interproximal enamel reduction, and (3) above 5 mm: extraction.

scholarly journals Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Pouya Dehestani ◽  
Farzam Farahmand ◽  
Amirhossein Borjali ◽  
Kaveh Bashti ◽  
Mahmoud Chizari
Keyword(s):  
Bone Density ◽  
Acl Reconstruction ◽  
Interference Screw ◽  
Reconstruction Technique ◽  
Fixation Technique ◽  
The Core ◽  
Group 3 ◽  
Group 2 ◽  
Bone Plug ◽  
Group 1

Abstract Purpose Core Bone Plug Fixation (CBPF) technique is an implant-less methodology for ACL reconstruction. This study investigates the effect of bone density on CBPF stability to identify the bone quality that is likely to benefit from this technique. Methods Artificial blocks with 160 (Group 1), 240 (Group 2), and 320 (Group 3) kg/m3 densities were used to simulate human bone with diverse qualities. These groups are representative of the elderly, middle age and young people, respectively. A tunnel was made in each test sample using a cannulated drill bit which enabled harvesting the core bone plug intact. Fresh animal tendon grafts were prepared and passed through the tunnel, so the core bone was pushed in to secure the tendon. The fixation stability was tested by applying a cyclic load following by a pullout load until the failure occurred. The selected group was compared with interference screw fixation technique as a gold standard method in ACL reconstruction. Results The Group 2 stiffness and yield strength were significantly larger than Group 1. The graft slippage of Group 1 was significantly less than Group 3. The ultimate strengths were 310 N and 363 N, in Groups 2 and 3, significantly larger than that of Group 1. The ultimate strength in fixation by interference screw was 693.18 N, significantly larger than the bone plug method. Conclusions The stability of CBPF was greatly affected by bone density. This technique is more suitable for young and middle-aged people. With further improvements, the CBPF might be an alternative ACL reconstruction technique for patients with good bone quality. Clinical relevance The CBPF technique offers an implant-less organic ACL reconstruction technique with numerous advantages and likely would speed up the healing process by using the patient’s own bones and tissues rather than any non-biologic fixations.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Analysis of the quality of early diagnostics of cardiovascular diseases in students of educational institutions of Khabarovsk (according to the data of preventive examinations)

2020 ◽  
pp. 13-16
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Sinus Tachycardia ◽  
Blood Pressure Level ◽  
Educational Institutions ◽  
Conduction Disturbances ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

To identify the prevalence of early pathology of cardiovascular diseases, a survey of 400 200 girls) in the age group 15 and 17 years old was conducted as a part of routine medical of the level of blood pressure (BP) was carried out, with the calculation of the average level pressure on the basis of three separate measurements estimated by percentile tables for a registration of a standard resting ECG in 12 leads. According to the results of the survey, into 3 groups: with an increase in blood pressure above 95 ‰ (group 1 – 16 people), which recorded in males (p<0,05); Group 2 (67 people) – adolescents with a normal blood pressure level and group 3 of adolescents with a decrease in blood pressure below 5 ‰ changes in the form of rhythm and conduction disturbances were noted in almost every a predominance of sinus tachycardia in the first group. In the third group of adolescents, form of ectopic rhythm and pacemaker migration were significantly more frequently only 78 % of adolescents were referred for consultation and in-depth examination by a pediatric cardiologist.

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