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The cardiovascular, respiratory and metabolic effects of pressure-supported ventilation with 7, 14 and 21 cm H2O were studied in 16 spontaneously breathing patients convalescing from severe illness. No statistically significant changes occurred in the hemodynamic variables, although CVP and urine output were increased at the higher levels of pressure support. Minute volume and blood gases did not change. Pressure-supported ventilation was associated with a statistically significant decrease in respiratory rate (p less than .002), a significant increase in tidal volume (p less than .01) and in mean airway pressure (p less than .001). Oxygen consumption, CO2 production, and resting energy expenditure were reduced by 14% to 20%, 17% to 25% and 10% to 18%, respectively, the decrease being proportional to the level of pressure support. These changes of the metabolic variables were not found to be statistically significant. 相似文献
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C. Staikou A. Tsaroucha A. Mani A. Fassoulaki 《Journal of clinical monitoring and computing》2012,26(6):487-489
Laparoscopic surgery is possibly associated with a risk of intracranial pressure (ICP) increase due to pneumoperitoneum in patients with ventriculoperitoneal shunts (VPS). Invasive techniques for shunt pressure monitoring are not routinely used because of the possible complications. Transcranial Doppler (TCD) is a non-invasive, safe method which gives accurate information about blood-flow velocities in basal cerebral arteries and indirectly about the ICP. Moreover it is inexpensive and simple in use. We report the use of TCD for middle cerebral flow velocity monitoring in a patient with a VPS who underwent laparoscopic surgery. In the case we present, during 60?min of pneumoperitoneum, TCD showed a sustained, but not clinically significant increase of the Pulsatility Index, with a recorded maximum change of 31?%. We consider that the use of TCD may increase the safety of laparoscopic procedures in patients with preexisting VPS. 相似文献
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Maria Kostaki Argyro D. Manona Irene Stavraka Penelope Korkolopoulou Georgia Levidou Eleni‐Andriana Trigka Eleftheria Christofidou Grigorios Champsas Alexandros J. Stratigos Andreas Katsambas Othon Papadopoulos Christina Piperi Athanasios G. Papavassiliou 《Experimental dermatology》2014,23(5):332-338
Epigenetic mechanisms participate in melanoma development and progression. The effect of histone modifications and their catalysing enzymes over euchromatic promoter DNA methylation in melanoma remains unclear. This study investigated the potential association of p16INK4A promoter methylation with histone methyltransferase SETDB1 expression in Greek patients with sporadic melanoma and their correlation with clinicopathological characteristics. Promoter methylation was detected by methylation‐specific PCR in 100 peripheral blood samples and 58 melanoma tissues from the same patients. Cell proliferation (Ki‐67 index), p16INK4A and SETDB1 expression were evaluated by immunohistochemistry. High‐frequency promoter methylation (25.86%) was observed in tissue samples and correlated with increased cell proliferation (P = 0.0514). p16INK4A promoter methylation was higher in vertical growth‐phase (60%) melanomas than in radial (40%, P = 0.063) and those displaying epidermal involvement (P = 0.046). Importantly, p16INK4A methylation correlated with increased melanoma thickness according to Breslow index (P = 0.0495) and marginally with increased Clark level (I/II vs III/IV/V, P = 0.070). Low (1–30%) p16INK4A expression was detected at the majority (19 of 54) of melanoma cases (35.19%), being marginally correlated with tumor lymphocytic infiltration (P = 0.078). SETDB1 nuclear immunoreactivity was observed in 47 of 57 (82.46%) cases, whereas 27 of 57 (47.37%) showed cytoplasmic immunoexpression. Cytoplasmic SETDB1 expression correlated with higher frequency of p16INK4A methylation and p16INK4A expression (P = 0.033, P = 0.011, respectively). Increased nuclear SETDB1 levels were associated with higher mitotic count (0–5/mm2 vs >5/mm2, P = 0.0869), advanced Clark level (III‐V, P = 0.0380), epidermal involvement (P = 0.0331) and the non‐chronic sun exposure‐associated melanoma type (P = 0.0664). Our data demonstrate for the first time the association of histone methyltransferase SETDB1 with frequent methylation of the euchromatic p16INK4A promoter and several prognostic parameters in melanomas. 相似文献
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Athanassios Kyrgidis Georgios Koloutsos Argyro Kommata Nikolaos Lazarides Konstantinos Antoniades 《Journal of cranio-maxillo-facial surgery》2013,41(7):637-643
AimTo analyse the pattern of maxillofacial injuries and treatment outcomes in Northern Greece.MethodsA tertiary referral single centre hospital; retrospective chart review. Demographics, aetiology, fixation technique (Rigid Internal Fixation: RIF; Maxillomandibular Fixation: MMF) post-surgical infections, aesthetics and occlusion were recorded.ResultsOne thousand and ten males and 229 females were operated between 1998 and 2008. Mean age was 29.6 ± 13. Mean number of plates per patient was 3.96 ± 2.28. For those with midfacial fractures (n = 379) mean was 4.02 ± 2.05. For those with mandibular fractures (n = 333), mean was 2.74 ± 0.94 while those with combined mandible and midface fractures (n = 216) were treated using 5.74 ± 2.87 plates per patient. Among those treated with plates, an unadjusted 22% increased risk for post-surgical infection per plate used (OR = 1.22, 95%CI: 1.13–1.32) was found. Patients with mandibular fractures were more satisfied with their post-surgical facial appearance in contrast to those with midfacial or combined midfacial and mandibular fractures. Female patients were less satisfied with their post-surgical facial appearance than males.DiscussionThis study verified a young males predominance, a shift towards more assault related fractures –especially in females– and similar post-surgical results for MMF and RIF modalities in mandibular fractures. In those patients treated with RIF, placement of fewest plates possible to obtain stability better serves aesthetics at the same time reducing risk for post-surgical infections and malocclusion. 相似文献
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Despo Soteriou Argyro Ntasi Lisa Papagiannoulis Theodore Eliades 《Acta odontologica Scandinavica》2014,72(2):130-138
Objective. The aim of this study was to evaluate the elemental alterations of Ag soldering alloys used in space maintainers after intra-oral exposure. Materials and methods. Twenty devices were fabricated by using two different soldering alloys; US (Dentaurum Universal Silver Solder, n = 10) and OS (Leone Orthodontic Solder, n = 10). All devices were manufactured by the same technician. Surface morphology and elemental quantitative analysis of the soldering alloys before and after intra-oral placement in patients was determined by scanning electron microscopy and energy-dispersive X-ray microanalysis (SEM/EDX). Statistical analysis was performed by t-test, Mann Whitney tests and Pearson's correlation. For all tests a 95% confidence level was used (α = 0.05). Results. Both soldering alloys demonstrated substantially increase in surface roughness after intra-oral aging. Statistical analysis illustrated a significant decrease in the Cu and Zn content after treatment. OS demonstrated higher Cu release than US (p < 0.05). The remaining relative concentrations of Cu and Zn after the treatment did not show any correlation (p > 0.05) with intra-oral exposure time, apart from Zn in OS (r = 0.840, p = 0.04). Conclusions. Both soldering alloys demonstrated a significant Cu and Zn reduction after intra-oral exposure that may raise biocompatibility concerns. 相似文献
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Hei Man Fan Alice L. Mitchell Elena Bellafante Saraid McIlvride Laura I. Primicheru Mirko Giorgi Ivano Eberini Argyro Syngelaki Anita Lvgren-Sandblom Peter Jones David McCance Nithya Sukumar Nishanthi Periyathambi Yonas Weldeselassie Katharine F. Hunt Kypros H. Nicolaides David Andersson Stuart Bevan Paul T. Seed Gavin A. Bewick James E. Bowe Franca Fraternali Ponnusamy Saravanan Hanns-Ulrich Marschall Catherine Williamson 《Diabetes》2022,71(4):837
Serum progesterone sulfates were evaluated in the etiology of gestational diabetes mellitus (GDM). Serum progesterone sulfates were measured using ultra-performance liquid chromatography–tandem mass spectrometry in four patient cohorts: 1) the Hyperglycemia and Adverse Pregnancy Outcomes study; 2) London-based women of mixed ancestry and 3) U.K.-based women of European ancestry with or without GDM; and 4) 11–13 weeks pregnant women with BMI ≤25 or BMI ≥35 kg/m2 with subsequent uncomplicated pregnancies or GDM. Glucose-stimulated insulin secretion (GSIS) was evaluated in response to progesterone sulfates in mouse islets and human islets. Calcium fluorescence was measured in HEK293 cells expressing transient receptor potential cation channel subfamily M member 3 (TRPM3). Computer modeling using Molecular Operating Environment generated three-dimensional structures of TRPM3. Epiallopregnanolone sulfate (PM5S) concentrations were reduced in GDM (P < 0.05), in women with higher fasting plasma glucose (P < 0.010), and in early pregnancy samples from women who subsequently developed GDM with BMI ≥35 kg/m2 (P < 0.05). In islets, 50 µmol/L PM5S increased GSIS by at least twofold (P < 0.001); isosakuranetin (TRPM3 inhibitor) abolished this effect. PM5S increased calcium influx in TRPM3-expressing HEK293 cells. Computer modeling and docking showed identical positioning of PM5S to the natural ligand in TRPM3. PM5S increases GSIS and is reduced in GDM serum. The activation of GSIS by PM5S is mediated by TRPM3 in both mouse and human islets. 相似文献