Ergospirometry and Echocardiography in Early Stage of Heart Failure with Preserved Ejection Fraction and in Healthy Individuals

Background

Heart failure with preserved ejection fraction is a syndrome characterized by changes in diastolic function; it is more prevalent among the elderly, women, and individuals with systemic hypertension (SH) and diabetes mellitus. However, in its early stages, there are no signs of congestion and it is identified in tests by adverse remodeling, decreased exercise capacity and diastolic dysfunction.

Objective

To compare doppler, echocardiographic (Echo), and cardiopulmonary exercise test (CPET) variables - ergospirometry variables - between two population samples: one of individuals in the early stage of this syndrome, and the other of healthy individuals.

Methods

Twenty eight outpatients diagnosed with heart failure according to Framingham’s criteria, ejection fraction > 50% and diastolic dysfunction according to the european society of cardiology (ESC), and 24 healthy individuals underwent Echo and CPET.

Results

The group of patients showed indexed atrial volume and left ventricular mass as well as E/E’ and ILAV/A´ ratios significantly higher, in addition to a significant reduction in peak oxygen consumption and increased VE/VCO₂ slope, even having similar left ventricular sizes in comparison to those of the sample of healthy individuals.

Conclusion

There are significant differences between the structural and functional variables analyzed by Echo and CPET when comparing two population samples: one of patients in the early stage of heart failure with ejection fraction greater than or equal to 50% and another of healthy individuals.     

SULF2 overexpression positively regulates tumorigenicity of human prostate cancer cells

Background

SULF2 is a 6-O-endosulfatase which removes 6-O sulfate residues from N-glucosamine present on heparan sulfate (HS). The sulfation pattern of HS influences signaling events mediated by heparan sulfate proteoglycans (HSPGs) located on cell surface, which are critical for the interactions with growth factors and their receptors. Alterations in SULF2 expression have been identified in the context of several cancer types but its function in cancer is still unclear where the precise molecular mechanism involved has not been fully deciphered. To further investigate SULF2 role in tumorigenesis, we overexpressed such gene in prostate cancer cell lines.

Methods

The normal prostate epithelial cell line RWPE-1 and the prostate cancer cells DU-145, and PC3 were transfected with SULF2-expressing plasmid pcDNA3.1/Myc-His(−)-Hsulf-2. Transfected cells were then submitted to viability, migration and colony formation assays.

Results

Transfection of DU-145 and PC3 prostate cancer cells with SULF2 resulted in increased viability, which did not occur with normal prostate cells. The effect was reverted by the knockdown of SULF2 using specific siRNAs. Furthermore, forced expression of SULF2 augmented cell migration and colony formation in both prostate cell lines. Detailed structural analysis of HS from cells overexpressing SULF2 showed a reduction of the trisulfated disaccharide UA(2S)-GlcNS(6S). There was an increase in epithelial-mesenchymal transition markers and an increase in WNT signaling pathway.

Conclusions

These results indicate that SULF2 have a pro-tumorigenic effect in DU-145 and PC3 cancer cells, suggesting an important role of this enzyme in prostatic cancer metastasis.     

Influence of Tooth Orientation on the Detection of Vertical Root Fracture in Cone-beam Computed Tomography

Introduction

The purpose of this study was to assess the influence of tooth orientation in relation to the projection plane of the x-rays on the detection of vertical root fracture (VRF) with different filling materials using cone-beam computed tomographic (CBCT) imaging.

Evaluation of the load system produced by a single intrusion bend in a maxillary lateral incisor bracket with different alloys

Objectives:To evaluate if a 0.5-mm vertical bend applied on an incisor bracket produces movements in other planes and if different wires influence these effects.Materials and Methods:An acrylic model of a treated patient with brackets passively bonded was attached to an Orthodontic Force Tester, and a load cell was attached to the left lateral incisor. Thirty 0.019 × 0.025-inch archwires were divided into three groups according to their alloy: SS (stainless steel), B-Ti (beta-titanium), and MF (beta-titanium wire coated with nickel-titanium). Step-bends of 0.5 mm high were placed on the lateral incisor bracket using a universal plier, and the forces and moments in three dimensions were statistically analyzed by analysis of variance and Tukey post hoc test.Results:SS produced a larger force (3.4 N) than the B-Ti (1.41 N) and the MF (0.53 N; P < .001). Lingual forces were produced by the SS (0.82 N) and B-Ti (0.31 N) groups, while in the MF group, the force was insignificant. SS produced a mesial force of 0.24 N, while the B-Ti force was insignificant and MF produced 0.09 N. Groups produced different crown-distal tipping moments (SS = 31.48 N-mm, B-Ti = 11.7 N-mm, and MF = 4.55 N-mm) and different crown-buccal tipping moments. SS produced larger moments (3.63 N-mm) than B-Ti (1.02 N-mm) and MF (0.36 N-mm) wires. A mesial-out rotational moment was observed in all groups (SS = 7.17 N-mm, B-Ti = 3.46 N-mm, and MF = 0.86 N-mm).Conclusions:A 0.5-mm intrusion bend produced lingual and mesial side effects. In addition to the distal and buccal crown-tipping moments, there was a mesial-out moment. Compared with SS, B-Ti and MF wires produced lower forces. These more flexible wires showed side effects with lesser intensity.     

The final stage of the laparoscopic procedure: exploring final steps

Despite significant advances in laparoscopic technique and technologies, laparoscopic Urologic surgery remains technically demanding regarding various surgical steps including the challenge of specimen retrieval and extraction, whether to install a drainage system and the best option for wound closure. Laparoscopic specimen entrapment and extraction occurs at what is falsely considered the ″end of the procedure″. During open surgery, after the specimen has been mobilized, the specimen is simply lifted out of the larger incision which has been made to achieve the surgical objectives. In contrast, significant laparoscopic skill is required to entrapand safely extract laparoscopic specimens. Indeed, the Urologist and surgical team which are transitioning from open surgery may disregard this important part of the procedure which may lead to significant morbidity. As such, it is imperative that during laparoscopic procedures, the ″end of the procedure″ be strictly defined as the termination of skin closure and dressing placement. Taking a few minutes to focus on safe specimen entrapment and extraction will substantially reduce major morbidity. The following review focus on the technology and technique of specimen entrapment and extraction, on the matter of whether to install a drainage system of the abdominal cavity and the options for adequate closure of trocar site wounds. This article 's primary objectives are to focus on how to minimize morbidity while maintain the advantages of a minimally invasive surgical approach.