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1.
Rev. colomb. cir ; 37(1): 90-95, 20211217. fig, tab
Article in Spanish | LILACS | ID: biblio-1355314

ABSTRACT

Introducción. La fístula enteroatmosférica es una patología compleja que puede ser el resultado de múltiples intervenciones quirúrgicas de la cavidad abdominal. Describimos una nueva técnica para el control de la contaminación en pacientes con fístulas enteroatmosféricas en abdomen abierto Björck 4.Métodos. Se realizó un análisis retrospectivo de cuatro pacientes con fístulas enteroatmosféricas desarrolladas como complicación de procedimientos quirúrgicos abdominales. Se trataron integralmente por un grupo multidisciplinario de Cuidados Intensivos, Cirugía general, Soporte nutricional y Cuidado de heridas y ostomías. Se utilizó una novedosa técnica quirúrgica basada en el principio de capilaridad para mantener limpios los tejidos periostomales. Resultados. Con esta técnica se logró el control de la contaminación abdominal en todos los pacientes y una evo-lución clínica satisfactoria. Posteriormente se programaron para cierre quirúrgico definitivo con éxito. Conclusiones. El manejo de la fístula enteroatmosférica representa un reto para el cirujano y el grupo multidisciplinario que trata al paciente. Esta nueva técnica utilizada en pacientes con fístula enteroatmosférica con abdomen abierto Björck 4 se basa en el principio de capilaridad, y es eficaz en el control de la contaminación, infección y de la sepsis asociada.


Introduction. Enterocutaneous fistula is a complex pathology that can be the result of multiple surgical interventions of the abdominal cavity. We describe a new technique for the control of contamination in patients with enterocutaneous fistulas in the open abdomen Björck 4. Methods. A retrospective analysis of four patients with enterocutaneous fistulas developed as a complication of abdominal surgical procedures was performed. They were treated by a multidisciplinary team of Intensive Care, General Surgery, Nutritional support and Wound and ostomy care. A novel surgical technique based on the capillarity principle was used to keep the periostomies tissues clean. Results. With this technique, control of abdominal contamination was achieved in all patients and a satisfactory clinical evolution. Later they were scheduled for definitive surgical closure with total success. Conclusions. The management of an enterocutaneous fistula represents a challenge for the surgeon and the multidisciplinary group that treats these patients. This new technique used in patients with an enterocutaneous fistula with open abdomen Björck 4 is based on the principle of capillarity action, and is effective in controlling contamination, infection, and associated sepsis.


Subject(s)
Humans , Intestinal Fistula , Sepsis , Peritonitis , General Surgery , Capillaries
2.
Rev. ecuat. pediatr ; 22(3): 1-9, 30 de diciembre del 2021.
Article in Spanish | LILACS | ID: biblio-1352440

ABSTRACT

Introducción: no existe un criterio único para evaluar el estado hemodinámico de los recién nacidos y prematuros y las diferentes variables en el grupo de recién nacidos, como la edad gestacional, el peso al nacer y los períodos de nacimiento. Métodos: Se trata de un estudio observacional descriptivo, transversal, epidemiológico con dos cohortes de pacientes. Los recién nacidos a término y Pretérmino, atendidos en la Unidad de Neonatal del Hospital Pablo Arturo Suárez, participan durante los meses comprendidos entre Noviembre de 2019 a enero de 2020. Resultados: la medición ecográfica del flujo de la vena cava inferior (FVCI) es útil para el tratamiento de manejo del paciente neonatal hemodinámicamente inestable. La muestra estuvo conformada por 110 recién nacidos atendidos en el servicio de neonatología del Hospital Pablo Arturo Suárez desde noviembre de 2019 a enero de 2020. Quito, Pichincha, Ecuador. Las variables bajo peso al nacer y prematuridad moderada tienen un valor estadística-mente significativo para el uso de inotrópicos. Las demás variables no presentan valor esta-dísticamente significativo. La frecuencia cardíaca, el gasto urinario, la presión arterial media, el ácido láctico, el llenado capilar, el flujo de la vena cava superior y el flujo de la vena cava inferior tienen valores estadísticamente significativos. Las comparaciones de FVCI y superior (FVCS) con frecuencia cardíaca, gasto urinario, presión arterial media, ácido láctico, llenado capilar tienen un valor estadísticamente significativo, excepto para el llenado capilar >3 segundos en FCVI. Se utilizó el análisis multivariado de Componentes Principales Categóricos (CATPCA) para caracterizar el estado hemodinámico e inotrópico, que resultaron significativos en el análisis bivariado. Dimensión, uno de los gráficos bidimensionales, discrimina el uso o no de inotrópicos y las categorías de parámetros hemodinámicos TAM <35 mmHg, ácido láctico, llenado capilar, FVCI y FVCS. La dimensión dos discrimina entre las categorías de gasto urinario y FC. Conclusión: En recién nacidos a término y prematuros con bajo peso y adecuado peso al nacer con inestabilidad hemodinámica en general, que fueron evaluados con ecografía para medir el flujo de la vena cava, la concordancia entre los criterios clínicos y la valoración ecográfica del flujo fue de 0.4 cm / seg en ambos métodos. Esta situación significa que la medición de los flujos cava venosos por ecografía es útil para evaluar el estado hemodinámico de los pacientes neonatales.


Introduction: There is no single criterion available to assess the hemodynamic state of new-born in-fants and preterm infants and the different variables in the group of newborns, such as gestational age, birth weight, and periods of birth. Methods: This is an epidemiological, cross-sectional, descriptive observational study with two patient cohorts. Newborn-to-term and preterm neonates assisted at the Neonatal Unit of the Pablo Arturo Suarez Hospital participated during the months between November 2019 to January 2020. Results: Ultrasound measurement of the vena cava (FVC) flow is useful for the management treatment of hemodynamically unstable neonatal patients. The sample was made up of 110 newborns treated in the Pablo Arturo Suarez Hospital's neonatology service from November 2019 to January 2020. Quito, Pichincha, Ecuador. The variables low birth weight and moder-ate prematurity have a statistically sig-nificant value for inotropic use.The other variables do not present statistically significant values. Heart rate, urinary output, mean blood pressure, lactic acid, capillary filling, upper vena cava flow, and lower vena cava flow had statistically significant values. FVCI and FVCS comparisons with heart rate, urinary output, mean blood pressure, lactic acid, and capillary filling had statistically significant values, except for capil-lary filling >3 sec in FCVI. Multivariate analysis of categorical main components (CATPCA) was used to characterize the hemodynamic state and inotropic state, which were significant in the bivariate analysis. Dimension, one of the two-dimensional graphs, discriminates the use or not of inotropics and the categories of hemodynamic parameters TAM <35 mmHg, lactic acid, capillary filling, FVCI, and FVCS. Dimension IIdiscriminates between the categories of urinary expenditure and HR. Conclusion: In term and preterm infants with low weight and adequate birth weight with hemody-namic instability in general, who were evaluated with ultrasonography to measure the flow of the vena cava, the agreement between the clinical criteria and the ultrasound assessment of the flow was 0.4 cm/sec in both methods. This situation means that the measurement of venous cava flows by echo sonography is useful for assessing neonatal patients' hemodynamic status.


Subject(s)
Humans , Infant, Newborn , Shock , Venae Cavae , Infant, Newborn , Arterial Pressure , Capillaries , Lactic Acid , Diuresis , Heart Rate
3.
Article in English | LILACS | ID: biblio-1353129

ABSTRACT

The restriction of sodium intake, one of the pillars of antihypertensive treatment, has been associated with the increase in cholesterol levels. Given this, we hypothesize that a sodium intake restriction may increase cholesterol levels in hypertensive women. The present study aimed to evaluate the influence of sodium intake, sociodemo-graphic, lifestyle and anthropometric variables on the blood cholesterol levels of hypertensive women. This was a cross-sectional study with hypertensive and nondiabetic women aged 20 to 59 years, recruited from the primary healthcare units of Maceio, Alagoas, in the Brazilian Northeast. Sodium intake was estimated by the 24-hour urinary excretion of sodium; and blood cholesterol was estimated by capillary blood. Age (years), education level (<4 or ≥4 years), race (white or nonwhite), smoking and alcohol consumption were evaluated. The weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio were quantified. The percentage of body fat was measured using a tetrapolar bioelectrical impedance device. The relationship between blood cholesterol and other variables was assessed by multiple regression analysis. A significance level of 5% was used in the final model. This study included 165 hypertensive women. In linear regression, blood cholesterol was directly proportional to age (p<0.001), education level (p=0.01) and race (p=0.04). These variables, as well as sodium intake (p = 0.07) and conicity index (p = 0.12), were included in the multiple regression analysis. Sodium intake (p=0.03) and age (p=0.001) were related, in an inverse and a direct way, respectively, to the blood choles-terol in the hypertensive women studied. (AU)


ção da ingestão de sódio, um dos pilares do tratamento anti-hipertensivo, tem sido associada ao aumen-to dos níveis de colesterol. Diante disso, levantou-se a hipótese de que a ingestão de sódio influencia os níveis de colesterol de mulheres hipertensas, independentemente de outros fatores associados. Trata-se de um estudo transversal realizado com mulheres hipertensas e não diabéticas, na faixa etária entre 20 e 59 anos, recrutadas em unidades básicas de saúde de Maceió, Alagoas, situada no Nordeste do Brasil. A ingestão de sódio foi estimada pela excreção urinária de sódio de 24 horas; e o colesterol sérico foi mensurado por coleta de sangue capilar. Foram ava-liados idade (anos), escolaridade (<4 ou ≥4 anos), raça (branca ou não branca), tabagismo e consumo de álcool. O peso, a estatura e a circunferência da cintura foram aferidos e o índice de massa corporal, índice de conicidade e razão cintura/estatura foram calculados. A porcentagem de gordura corporal foi medida usando um dispositivo de impedância bioelétrica tetrapolar. A relação entre o colesterol sérico e as outras variáveis em estudo foi avalia-da por meio de análise de regressão múltipla, adotando-se um nível de significância de 5% no modelo final. Este estudo incluiu 165 mulheres hipertensas. Na análise de regressão linear, o colesterol sérico foi relacionado à idade (p<0,001), escolaridade (p=0,01) e raça (p=0,04). Essas variáveis, assim como o consumo de sódio (p=0,07) e o índice de conicidade (p=0,12), foram incluídas na análise de regressão múltipla. As variáveis que permaneceram no modelo final foram ingestão de sódio (p=0,03) e idade (p=0,001). A ingestão de sódio e a idade foram as variáveis que influenciaram o colesterol sérico de mulheres hipertensas. (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Tobacco Use Disorder , Body Height , Alcohol Drinking , Capillaries , Anthropometry , Cholesterol , Hypertension , Life Style , Antihypertensive Agents , Obesity
4.
Arq. bras. oftalmol ; 83(6): 517-525, Nov.-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1153088

ABSTRACT

ABSTRACT Purpose: To evaluate vascular density in super­ficial and deep capillary plexuses of the retina, measured using optical coherence tomography angiography in patients with branch retinal vein occlusion. Affected eyes were compared with the contralateral eye of the same patient and both were compared with normal eyes. Methods: A cross-sectional study including 16 previously untreated patients with branch retinal vein occlusion. Patients with poor quality examinations, bilateral disease, high refractive error, or any other retinal or choroidal disease were excluded. A total of 31 patients without eye disease were also selected as a comparison group. All participants underwent five optical coherence tomography angiographies, and only those with at least two good quality examinations were selected. The Kruskal-Wallis, Wilcoxon signed-rank, and Mann-Whitney U tests were used for the statistical analysis. Results: Vascular density was lower in affected eyes compared with contralateral eyes: whole density (p=0.020 for capillary plexuses superficial; p=0.049 for deep capillary plexuses) and parafoveal density (p=0.020 for capillary plexuses superficial; p=0.011 for deep capillary plexuses). Vascular density was also lower in affected eyes compared with normal eyes: whole density (p<0.001 for capillary plexuses superficial and deep) and parafoveal density (p<0.001 for capillary plexuses superficial and deep). Whole density (p=0.001 for capillary plexuses superficial and deep) and parafoveal density (p=0.001 for capillary plexuses superficial; p<0.001 for deep capillary plexuses) were both lower in the contralateral eyes compared with normal eyes. Following adjustment for arterial hypertension, this difference was no longer observed. Conclusions: Vascular density in capillary plexuses and deep capillary plexuses was lower in the eyes affected by branch retinal vein occlusion. Furthermore, the lower vascular density noted in the contralateral eyes indicates that changes most likely occurred in these eyes prior to the appearance of any clinically detectable alterations, reflecting the early signs of hypertensive retinopathy.


RESUMO Objetivo: Avaliar a densidade vascular do plexo capilar superficial e profundo da retina, usando angiografia por tomografia de coerência óptica em pacientes com oclusão de ramo da veia central da retina, comparando o olho afetado com o contralateral do mesmo paciente e ambos com olhos normais. Métodos: Estudo transversal. Incluídos dezesseis pacientes com oclusão de ramo da veia central da retina sem tratamento prévio. Pacientes com exames de baixa qualidade, altas ametropias, outras patologias de retina ou coróide foram excluídos. Para comparação, trinta e um pacientes sem doença ocular foram selecionados. Todos foram submetidos a cinco exames angiografia por tomografia de coerência óptica, apenas aqueles com pelo menos dois exames de boa qualidade permaneceram no estudo. Os testes Kruskal-Wallis, Wilcoxon, e Mann-Whitney foram utilizados. Resultados: Densidades vasculares mais baixas do plexo capilar superficial e plexo capilar profundo foram observadas quando olhos com oclusão de ramo da veia central da retina foram comparados com os contralaterais: densidade total (p=0,02 para plexo capilar superficial, p=0,049 para plexo capilar profundo), densidade parafoveal (p=0,02 para plexo capilar superficial, p=0,011 para plexo capilar profundo). Comparando olhos acometidos com olhos normais, também foram observadas densidades vasculares mais baixas de plexo capilar superficial e plexo capilar profundo: densidade total (ambos com p<0,001) e densidade parafoveal (ambos com p<0,001). Quando os olhos contralaterais foram comparados aos normais, tanto a densidade total do plexo capilar superficial e plexo capilar profundo (ambos com p=0,001) quanto a densidade parafoveal (plexo capilar superficial com p=0,001, plexo capilar profundo com p<0,001) foram menores. Ao se realizar uma subanálise, minimizando o fator hipertensão arterial, esta diferença não se manteve. Conclusões: Densidades vasculares mais baixas do plexo capilar superficial e do plexo capilar profundo foram observadas em olhos com oclusão de ramo da veia central da retina. Além disso, a presença de densidades vasculares mais baixas nos olhos contralaterais mostra que já existem altera­ções nesses olhos antes das alterações clínicas, devido a al­terações inicias da retinopatia hipertensiva.


Subject(s)
Humans , Male , Female , Middle Aged , Retinal Vessels/diagnostic imaging , Recombinant Fusion Proteins/administration & dosage , Retinal Vein Occlusion/diagnosis , Capillaries/diagnostic imaging , Fluorescein Angiography/methods , Visual Acuity , Choroid/diagnostic imaging , Tomography, Optical Coherence/methods , Retinal Vein Occlusion/physiopathology , Retinal Vein Occlusion/drug therapy , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Fundus Oculi , Microcirculation/drug effects
5.
Rev. colomb. reumatol ; 27(supl.1): 10-25, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1341320

ABSTRACT

ABSTRACT Background: Capillaroscopy is an essential tool for the diagnosis of systemic sclerosis. Using this exam as a prognostic factor will allow earlier intervention and probably, delay on disease progression. We aimed to evaluate the prognostic value of capillaroscopy for the prediction of systemic compromise and subtype differentiation in systemic sclerosis. Methods: A systematic literature search was applied in the following electronic databases: Medline, PubMed, Embase, Cochrane, and Lilacs. The research question was designed based on the PICOT model, and the search strategy was built using the MeSH terms "Microscopic Angioscopy," "Scleroderma systemic," "Scleroderma diffuse," Scleroderma Limited," "Early Diagnosis" and Boolean operators. The language was restricted to papers published in Spanish or English, from 1990 to 2019. The search terms were explored for each database, and new terms were added, as appropriate. The searches were made again before the final analyses and further studies were retrieved for inclusion at that time. Reference lists of included studies and recent aligned systematic reviews were also screened. Gray literature was not considered in this review. Results: A total of 183 articles were found in the selected databases: Medline (n: 115), Embase (n: 66), Cochrane (n: 2), Lilacs (n: 0). After excluding articles due to duplication, a total of 66 studies were selected. Within these articles, a screening process was applied based on the title and abstract, taking into account the eligibility criteria, finally obtaining 21 references. Two researchers assessed the selected articles, and all disagreements were solved by consensus. Finally, a total of 14 articles were included. Conclusions: The different abnormalities found in capillaroscopy, especially loss of capillaries, have been consistently associated not only with organ involvement but also with severity of the disease, especially with vascular manifestations (digital ulcers and pulmonary hypertension). The importance of capillaroscopy is not only its diagnostic value but also its predictive value with its consequent implications in the follow-up and management of systemic sclerosis.


RESUMEN Introducción: La capilaroscopia es una herramienta esencial para el diagnóstico de la esclerosis sistémica. Usar este examen como factor pronóstico permitirá realizar una intervención temprana y probablemente retardará la progresión de la enfermedad. Se realizó una revisión de la literatura evaluando el valor pronóstico de la capilaroscopia para predecir el compromiso sistémico de la esclerosis sistémica y su diferenciación por subtipos. Métodos: Se realizó una revisión sistemática de la literatura en las siguientes bases de datos: Medline, PubMed, Embase, Cochrane y Lilacs. La búsqueda se hizo basada en el modelo PICOT y la estrategia de búsqueda fue construida mediante los términos MeSH «Microscopic angioscopy¼, «Scleroderma systemic¼, «Scleroderma diffuse¼, «Scleroderma limited¼, «Early diagnosis¼ y operadores booleanos. El lenguaje fue restringido a artículos publicados en español e inglés desde 1990 hasta 2019. Se realizó la búsqueda en cada base de datos y se adicionaron nuevos términos según fuera apropiado. La búsqueda se realizó de nuevo al final del análisis y se incluyeron los estudios más recientes. La lista de referencias de los estudios incluidos y las revisiones sistemáticas recientemente adicionadas también fueron registradas. No se consideró literatura gris en esta revisión. Resultados: Un total de 183 artículos fueron encontrados en las siguientes bases de datos: Medline (n = 115), Embase (n = 66), Cochrane (n = 2), Lilacs (n = 0). Después de excluir los que estaban duplicados, un total de 66 estudios fueron seleccionados. Dentro de estos artículos, se realizó un proceso de selección basado en título y resumen tomando en cuenta los criterios de elegibilidad, obteniendo finalmente 21 referencias. Dos investigadores revisaron los artículos seleccionados y todas las discrepancias fueron resueltas en consenso. Finalmente, un total de 14 artículos fueron incluidos. Conclusiones: Las diferentes anormalidades encontradas en la capilaroscopia, especialmente la pérdida de capilares, han sido constantemente asociadas no solo con compromiso de órganos sino también a la severidad de la enfermedad, especialmente con manifestaciones vasculares (úlceras digitales e hipertensión pulmonar). La importancia de la capilaroscopia no solo es por su valor diagnóstico sino también por su valor predictivo en relación al seguimiento y manejo de la esclerosis sistémica.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Prognosis , Scleroderma, Systemic , Microscopic Angioscopy , Capillaries , Early Diagnosis , Early Medical Intervention
6.
Int. j. morphol ; 38(6): 1779-1785, Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134511

ABSTRACT

SUMMARY: The Bactrian camel, which is native to China and Mongolia, is large in size and is an even-toed ungulate species. The double humps on the Bactrian camel back differentiate it from the dromedary camel, which has a single hump. This species has adapted to unsuitable conditions (lack of food and water) in the Gobi Desert and is advanced in unique anatomical and physiological characteristics during a prolonged evolution period. Several studies have been conducted on the anatomical features of the Bactrian camel, but none have given attention to the alveolar capillaries of the Bactrian camel lung. Therefore, the current study aims to explore the architecture of the alveolar capillary in the Bactrian camel lung and further explain the mechanism of blood flow in its lung. The current study extracted and examined the architecture of the alveolar capillary in the lung of the Bactrian camel (Camelus bactrianus) and further explained the mechanism of blood flow by performing lung casting and replica scanning electron microscopy methods. The reports showed that the resources of the alveolar-capillary originated from the capillaries of the subpleural space or interlobular septulum, sometimes originating from the precapillary arterioles or directly from the terminal arterioles. The alveolar capillaries anastomosed and formed a single layer of dense, basket-like network surrounding the alveolus. The mash diameter of the alveolar-capillary network was larger than that of the capillary, and the appearance of the mash was oval and elliptical. Many of the collapsed alveolar-capillary networks were found in the alveolar microvascular architecture in the lung of the Bactrian camel. The study found that, due to many collapsed alveoli in the Bactrian camel lung, the disproportional pressure between the pulmonary alveoli induced less imbalance of blood flow in the alveolar capillary, which affected the gas exchange efficiency. Therefore, the function of the anastomosing capillary branch was likely to regulate the blood flow between the alveolar-capillary network.


RESUMEN: El camello bactriano, es originario de China y Mongolia, es de gran tamaño y es una especie de ungulado de dedos pares. Las dobles jorobas del lomo del camello bactriano lo diferencian del dromedario, que tiene una sola joroba. Esta especie se ha adaptado a condiciones inadecuadas (falta de alimento y agua) en el desierto de Gobi y ha avanzado en características anatómicas y fisiológicas únicas durante un período de evolución prolongado. Se han realizado varios estudios sobre las características anatómicas del camello bactriano, pero ninguno ha prestado atención a los capilares alveolares del pulmón de este animal. Por lo tanto, el presente estudio tuvo como objetivo principal explorar la arquitectura del capilar alveolar en el pulmón del camello bactriano y explicar el mecanismo del flujo sanguíneo. A partir de nuestro trabajo se examinó la arquitectura del capilar alveolar en el pulmón del camello bactriano (Camelus bactrianus) mediante la realización de métodos de microscopía electrónica de barrido y escaneo pulmonar. Los informes mostraron que los recursos del alvéolo-capilar se originaban en los capilares del espacio subpleural o del tabique interlobulillar y a veces se originaban en las arteriolas precapilares o directamente en las arteriolas terminales. Los capilares alveolares se anastomosaban y formaban una densa red de capa única en forma de cesta que rodeaba el alvéolo. El diámetro del macerado de la red alveolar-capilar era mayor que el del capilar y el aspecto del macerado era ovalado y elíptico. Muchas de las redes alvéolo-capilares colapsadas se encontraron en la arquitectura microvascular alveolar en el pulmón del camello bactriano. El estudio encontró que, muchos alvéolos colapsados en el pulmón del camello bactriano, la presión desproporcionada entre los alvéolos pulmonares inducía un menor desequilibrio del flujo sanguíneo en el capilar alveolar, lo que afectaba la eficiencia del intercambio de gases. Por lo tanto, la función de la rama capilar anastomosante probablemente regularía el flujo sanguíneo entre la red alveolar-capilar.


Subject(s)
Animals , Pulmonary Alveoli/blood supply , Pulmonary Alveoli/ultrastructure , Capillaries/anatomy & histology , Capillaries/ultrastructure , Camelus/anatomy & histology , Lung/blood supply , Lung/ultrastructure , Microscopy, Electron, Scanning
7.
Arq. bras. oftalmol ; 83(2): 120-126, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088977

ABSTRACT

ABSTRACT Purpose: To investigate retinal microvasculature changes in patients treated with anti-VEGF for macular edema secondary to branch retinal vein occlusion. Methods: We examined 38 eyes of 19 patients for the study. We measured superficial and deep capillary plexus vessel densities (%), foveal avascular zone areas (mm2), and central macular thicknesses. Results: Parafoveal superficial and deep capillary plexus values were significantly lower in eyes with branch retinal vein occlusion than in fellow eyes (p<0.001). We found a significant increase in parafoveal deep capillary plexus values after the anti-VEGF treatment (p=0.032). The mean foveal avascular zone was larger in eyes with branch retinal vein occlusion than in control eyes (p<0.001). The mean central macular thickness was significantly higher in eyes with branch retinal vein occlusion than in controls, and we observed a significant decrease in central macular thickness after anti-VEGF treatment (<0.001). In addition, the cystic structures in the deep capillary plexus regressed. Conclusion: Optical coherence tomography angiography enables qualitative and quantitative evaluations during follow-up of patients treated for branch retinal vein occlusion.


RESUMO Objetivo: Investigar as alterações na microvascu latura da retina em pacientes tratados com anti-VEGF para ede ma macular secundário à oclusão de ramo da veia retiniana. Métodos: Foram examinados 38 olhos de 19 pacientes para o estudo. Medimos as densidades dos vasos do plexo capilar superficial e profunda (%), áreas da zona avascular foveal (mm2) e espessura macular central. Resultados: Os valores do plexo capilar superficial e profundo parafoveal foram significativamente menores nos olhos com oclusão de ramo da veia retiniana do que nos outros olhos (p<0,001). Encontramos um aumento significativo nos valores de plexo capilar profundo parafoveal após o tratamento com anti-VEGF (p=0,032). A zona avascular foveal média foi maior nos olhos com oclusão de ramo da veia retiniana do que nos olhos controle (p<0,001). A espessura macular central média foi significativamente maior nos olhos com oclusão de ramo da veia retiniana do que nos controles, e observamos uma diminuição significativa na espessura macular central após o tratamento com anti-VEGF (< 0,001). Além disso, as estruturas císticas no plexo capilar profundo regrediram. Conclusão: A angiotomografia de coerência óptica permite avaliações qualitativas e quantitativas durante o acompanhamento de pacientes tratados por oclusão de ramo da veia retiniana.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Retinal Vein Occlusion/drug therapy , Fluorescein Angiography/methods , Macular Edema/drug therapy , Angiogenesis Inhibitors/therapeutic use , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Tomography, Optical Coherence/methods , Reference Values , Time Factors , Retinal Vein Occlusion/complications , Capillaries/drug effects , Capillaries/pathology , Capillaries/diagnostic imaging , Macular Edema/etiology , Macular Edema/pathology , Macular Edema/diagnostic imaging , Retrospective Studies , Statistics, Nonparametric , Macula Lutea/drug effects , Macula Lutea/pathology , Macula Lutea/diagnostic imaging
8.
J. bras. nefrol ; 41(4): 580-584, Out.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1056602

ABSTRACT

Abstract In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA. On fundus examination, a severe acute hypertensive retinopathy was found. The kidney biopsy showed severe endothelial damage with widening of mucoid cells at the level of the intima, focal concentric proliferation on most small arterioles, and C3, C4d, and IgM deposits along the capillary walls. The genetic study of complement only showed the presence of membrane cofactor protein (MCP) risk haplotypes, without other genetic complement disorders. We understand that in a patient with TMA and SSc, the kidney damage would be fundamentally endothelial and of an acute type; moreover, we would observe clear evidence of complement activation. Once further studies correlate clinical-analytical data with anatomopathological studies, it is likely that we will be forced to redefine the SRC concept, focusing on the relationship between acute endothelial damage and complement activation.


Resumo Nas revisões de biópsias renais, a crise renal esclerodérmica (CRE) é caracterizada por lesões endoteliais vasculares, depósitos de C4d em vasos peritubulares e lesões agudas e crônicas que coexistem na mesma biópsia. Os sinais clínicos de microangiopatia trombótica (MAT) são descritos na esclerose sistêmica (ES); no entanto, não foram relacionados às lesões agudas descritas nas biópsias renais. Relatamos um caso de CRE em um paciente com síndrome de superposição de esclerodermia-dermatomiosite, que também apresentou dados clínicos e histopatológicos de MAT. No exame de fundo do olho, foi encontrada uma retinopatia hipertensiva aguda grave. A biópsia renal mostrou lesão endotelial grave com alargamento das células mucoides ao nível da íntima, proliferação concêntrica focal na maioria das pequenas arteríolas e depósitos de C3, C4d e IgM ao longo das paredes dos capilares. O estudo genético do complemento mostrou apenas a presença de haplótipos de risco da proteína cofator de membrana (PCM), sem outros distúrbios genéticos do complemento. Entendemos que em um paciente com MAT e ES, o dano renal seria fundamentalmente endotelial e do tipo agudo; além disso, observaríamos evidências claras de ativação do complemento. Uma vez que novos estudos correlacionam dados clínico-analíticos com estudos anatomopatológicos, é provável que sejamos forçados a redefinir o conceito de CRE, enfocando a relação entre dano endotelial agudo e ativação do complemento.


Subject(s)
Humans , Male , Middle Aged , Raynaud Disease/complications , Vision Disorders/etiology , Acute Kidney Injury/etiology , Kidney/blood supply , Capillaries/metabolism , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Immunohistochemistry , Papilledema/pathology , Dermatomyositis/complications , Dermatomyositis/immunology , Hypertensive Retinopathy/diagnosis , Hypertensive Retinopathy/pathology , Hypertensive Retinopathy/drug therapy , Acute Kidney Injury/diagnosis , Anemia, Hemolytic/diagnosis , Anemia, Hemolytic/etiology , Kidney/pathology , Kidney/diagnostic imaging
9.
Rev. méd. Chile ; 147(10): 1273-1282, oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058594

ABSTRACT

Background: INR is used to monitor the treatment with vitamin K antagonists. A strategy to reduce waiting times for sampling is to measure INR in a capillary sample using a portable point of care (POC) type coagulometer. Aim: To evaluate the correlation of CoaguChek Pro II™, Xprecia™ and microINR™ with venous INR measured at the clinical laboratory and their ease of use. Materials and Methods: Patients provided capillary and venous blood samples for parallel tests comparing Xprecia™ Stride with CoaguChek Pro II™ and with venous INR, microINR™ with CoaguChek Pro IITM and with venous INR. The devices' ease of use was assessed surveying the sampling staff. Results: The three tested devices had good correlation coefficients with venous INR: CoaguChek Pro IITM 0.953 and 0.962; Xprecia™ of 0.912 and microINR™ of 0.932. The correlation coefficient of Xprecia™ with CoaguChek Pro IITM was 0.937 and microINR™ with CoaguChek Pro IITM was 0.976. Conclusions: CoaguChek Pro IITM, Xprecia™ and microINR™ results had a good correlation coefficient with INR measured at the laboratory. Our results indicate that, in the hands of trained users, POC-type coagulometers are reliable and acceptable for routine use in anticoagulant treatment control.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Point-of-Care Systems/standards , International Normalized Ratio/instrumentation , Reference Standards , Capillaries , Thromboplastin/therapeutic use , Chile , Reproducibility of Results , Drug Monitoring/instrumentation , Drug Monitoring/standards , International Normalized Ratio/standards , Anticoagulants/therapeutic use
10.
Arq. ciências saúde UNIPAR ; 23(2): 97-105, maio-ago. 2019.
Article in Portuguese | LILACS | ID: biblio-996705

ABSTRACT

Os mastócitos são células distribuídas pela maior parte do corpo e são reguladores importantes da resposta inflamatória. Nesse estudo o objetivo foi quantificar os mastócitos presentes em fígado humano normal, com esteatose e com cirrose. Foram utilizadas peças de fígado humano do Laboratório de Patologia Geral da Universidade Federal do Triângulo Mineiro, onde selecionaram 16 peças anatômicas, dividindo-se em três grupos: fígado normal (controle), com esteatose e com cirrose. Realizou-se a confecção de 32 lâminas, as quais foram submetidas à duas colorações, sendo HE para análise histopatológica, e Azul de Toluidina para quantificação de mastócitos. Realizou-se análise estatística e a confecção de gráfico, composto pelo número de mastócitos por campo em cada grupo. Observou-se que o aumento da quantidade de mastócitos presentes é diretamente proporcional ao agravo da doença, sendo que a maior população foi encontrada no processo crônico de cirrose hepática. Portanto, subentende-se que exista uma relação intrínseca entre a presença dos mastócitos e, consequente, agravo do processo fibrótico em humanos, de tal modo que uma célula influencie no funcionamento da outra. Torna-se necessário a realização de mais estudos para esclarecerem de forma detalhada tal interação.


Mast cells are distributed in most tissues of the human body and are key regulators of the inflammatory response. The aim of the study was to quantify the presence of mast cells in healthy human livers and diseased human livers presenting steatosis and cirrhosis. Human liver samples were obtained from the General Pathology Laboratory at the Federal University of Triângulo Mineiro. Sixteen samples were divided into three groups: normal liver (control), steatosis, and cirrhosis. A total of 32 slides were prepared, which were submitted to two stainings, the hematoxylin and eosin (HE) for histopathological analysis, and Toluidine Blue (TB) for mast cell quantification. Statistical analysis and a graph composition were performed, presenting the number of mast cells per field in each group. It was observed that the increase of mast cells is directly proportional to the disease burden, and the greatest increase was found in the population with chronic liver cirrhosis. Therefore, it is understood that there is an intrinsic relationship between the presence of mast cells and the consequent aggravation of the fibrotic process in humans, in such way that one cell influences the functioning of the other. Further studies area necessary in order to clarify such interaction.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Wounds and Injuries , Liver , Liver Cirrhosis , Mast Cells , Staining and Labeling , Capillaries , Cytokines , Hepatocytes
11.
Arq. bras. oftalmol ; 82(1): 72-77, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-973866

ABSTRACT

ABSTRACT A 33-year-old male presented to our clinic with low vision in both eyes that started during the previous week. Visual acuity was 20/63 in the right eye and 20/50 in the left eye. Fundus examination revealed signs of hypertensive retinopathy; thus, a multidisciplinary approach was adopted for the diagnosis and treatment of this patient. We consulted the nephrology and cardiology departments on this case. Upon diagnosing malignant hypertension and renal failure, the patient was put on hemodialysis. His visual acuity was 20/20 at 6 months, whereas foveal assessment on optical coherence tomography angiography revealed neither marked superficial and deep capillary density loss and foveal avascular zone enlargement nor a decrease in disc flow and radial peripapillary capillary density. Early diagnosis and treatment of malignant hypertension are critical in preventing progression of end-organ damage including the eyes. Optical coherence tomography angiography may be useful in cases when fundus fluorescein angiography is relatively contraindicated (e.g., renal failure).


RESUMO Um homem de 33 anos apresentou-se à nossa clínica com baixa visão em ambos os olhos que começou uma semana antes. A acuidade visual foi de 20/63 no olho direito e 20/50 no olho esquerdo. O exame de fundo de olho revelou sinais de retinopatia hipertensiva; então, adotou-se uma abordagem multidisciplinar para o diagnóstico e tratamento desse paciente. Consultamos os departamentos de nefrologia e cardiologia neste caso. Ao diagnosticar hipertensão maligna e insuficiência renal, o paciente foi colocado em hemodiálise. Sua acuidade visual era 20/20 aos 6 meses, enquanto a avaliação foveal com angiotomografia de coerência óptica não revelou perda de densidade capilar superficial e profunda acentuada e aumento da zona avascular foveal nem uma diminuição no fluxo de disco e na densidade capilar peripapilar radial. O diagnóstico precoce e o tratamento da hipertensão maligna são fundamentais na preveção da progressão de danos nos órgãos-alvo, incluindo os olhos. A Angiografia por tomografia de coerência óptica pode ser útil nos casos em que a angiografia com fluoresceína do fundo de olho é relativamente contraindicada (por exemplo, insuficiência renal).


Subject(s)
Humans , Male , Adult , Angiography/methods , Tomography, Optical Coherence/methods , Hypertensive Retinopathy/diagnostic imaging , Hypertension, Malignant/diagnostic imaging , Retinal Vessels/pathology , Retinal Vessels/diagnostic imaging , Time Factors , Capillaries/pathology , Capillaries/diagnostic imaging , Disease Progression , Renal Insufficiency, Chronic , Hypertensive Retinopathy/pathology , Hypertension, Malignant/pathology
12.
Article in English | WPRIM | ID: wpr-785603

ABSTRACT

OBJECTIVE: Assessing the severity of injury and predicting outcomes are essential in traumatic brain injury (TBI). However, the respiratory rate and Glasgow Coma Scale (GCS) of the Revised Trauma Score (RTS) are difficult to use in the prehospital setting. This investigation aimed to develop a new prehospital trauma score for TBI (NTS-TBI) to predict mortality and disability.METHODS: We used a nationwide trauma database on severe trauma cases transported by fire departments across Korea in 2013 and 2015. NTS-TBI model 1 used systolic blood pressure < 90 mmHg, peripheral capillary oxygen saturation < 90% measured via pulse oximeter, and motor component of GCS. Model 2 comprised variables of model 1 and age >65 years. We assessed discriminative power via area under the curve (AUC) value for in-hospital mortality and disability defined according to the Glasgow Outcome Scale with scores of 2 or 3. We then compared AUC values of NTS-TBI with those of RTS.RESULTS: In total, 3,642 patients were enrolled. AUC values of NTS-TBI models 1 and 2 for mortality were 0.833 (95% confidence interval [CI], 0.815 to 0.852) and 0.852 (95% CI, 0.835 to 0.869), respectively, while AUC values for disability were 0.772 (95% CI, 0.749 to 0.796) and 0.784 (95% CI, 0.761 to 0.807), respectively. AUC values of NTS-TBI model 2 for mortality and disability were higher than those of RTS (0.819 and 0.761, respectively) (P < 0.01).CONCLUSION: Our NTS-TBI model using systolic blood pressure, motor component of GCS, oxygen saturation, and age was feasible for prehospital care and showed outstanding discriminative power for mortality.


Subject(s)
Hypoxia , Area Under Curve , Blood Pressure , Brain Injuries , Capillaries , Fires , Glasgow Coma Scale , Glasgow Outcome Scale , Hospital Mortality , Humans , Hypotension , Korea , Mortality , Observational Study , Oxygen , Quality Improvement , Respiratory Rate
13.
Article in Korean | WPRIM | ID: wpr-787532

ABSTRACT

Peripheral giant cell granuloma (PGCG) is an benign non-neoplastic lesion most commonly occurring in oral cavity but extraoral PGCG is extremely rare. Recently, we experienced a case of an isolated PGCG in the parotid gland in 59-year-old man. FNAB findings and radiologic findings including CT and US were suggestive of Warthin's tumor. Partial parotidectomy was performed. Pathologic findings showed fibrillar connective tissue stroma with spindled, ovoid, and round histiocytes-like cells mixed with uneven multinuclear giant cells, small capillaries, hemorrhage, hemosiderin-laden macrophages, and necrosis which were consistent with giant cell granuloma. We report a case of an PGCG in parotid with a review of literature.


Subject(s)
Capillaries , Connective Tissue , Giant Cells , Granuloma, Giant Cell , Hemorrhage , Humans , Macrophages , Middle Aged , Mouth , Necrosis , Parotid Gland
14.
Neuroscience Bulletin ; (6): 551-560, 2019.
Article in English | WPRIM | ID: wpr-775461

ABSTRACT

Cerebral pericytes are perivascular cells that stabilize blood vessels. Little is known about the plasticity of pericytes in the adult brain in vivo. Recently, using state-of-the-art technologies, including two-photon microscopy in combination with sophisticated Cre/loxP in vivo tracing techniques, a novel role of pericytes was revealed in vascular remodeling in the adult brain. Strikingly, after pericyte ablation, neighboring pericytes expand their processes and prevent vascular dilatation. This new knowledge provides insights into pericyte plasticity in the adult brain.


Subject(s)
Animals , Brain , Physiology , Brain Diseases , Capillaries , Physiology , Cellular Microenvironment , Diabetic Retinopathy , Endothelial Cells , Physiology , Humans , Pericytes , Physiology , Vascular Remodeling
15.
Article in English | WPRIM | ID: wpr-766186

ABSTRACT

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of systemic vasculitides, that are characterized by inflammation in the small vessels, ranging from capillaries to arterioles or venules. AAV is divided into three variants based on the clinical manifestations and histological findings such as microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA). MPA often induces rapid progressive necrotising glomerulonephritis, and occasionally induces diffuse alveolar hemorrhage. In contrast, GPA preferentially affects the respiratory tracts from the bronchus to the nasal cavity. GPA can also involve the kidneys, but the frequency of renal involvement is less than MPA. EGPA is based on allergic components such as asthma, peripheral eosinophilia, migratory eosinophilic pneumonia and eosinophil infiltration. Since 1982, when the association between ANCA and systemic vasculitis was first reported, several classification criteria for AAV have been proposed. This review describes the classification criteria for and nomenclature of AAV from the 1990 American College of Rheumatology (ACR) classification criteria to the 2012 revised Chapel Hill consensus conference (CHCC) nomenclature of Vasculitides. New classification trials for AAV such as AAV based on the ANCA-types (myeloperoxidase-ANCA vasculitis, proteinase 3-ANCA vasculitis and ANCA negative vasculitis) and the ACR/European League Against Rheumatism (EULAR) 2017 provisional classification criteria for GPA were also introduced. In addition, the histopathological classification of ANCA-associated glomerulonephritis and the revised 2017 international consensus on testing of ANCAs in GPA and MPA are also discussed.


Subject(s)
Antibodies, Antineutrophil Cytoplasmic , Arterioles , Asthma , Bronchi , Capillaries , Classification , Consensus , Cytoplasm , Eosinophilia , Eosinophils , Glomerulonephritis , Granulomatosis with Polyangiitis , Hemorrhage , Inflammation , Kidney , Microscopic Polyangiitis , Nasal Cavity , Pulmonary Eosinophilia , Respiratory System , Rheumatic Diseases , Rheumatology , Systemic Vasculitis , Vasculitis , Venules
16.
Article in English | WPRIM | ID: wpr-763150

ABSTRACT

PURPOSE: Control of metastatic spread of colorectal cancer (CRC) remains as a major therapeutic challenge. [V4 Q5 ]dDAVP is a vasopressin peptide analog with previously reported anticancer activity against carcinoma tumors. By acting as a selective agonist of arginine vasopressin type 2 membrane receptor (AVPR2) present in endothelial and tumor cells, [V⁴Q⁵]dDAVP is able to impair tumor aggressiveness and distant spread. Our aim was to evaluate the potential therapeutic benefits of [V⁴Q⁵]dDAVP on highly aggressive CRC disease using experimental models with translational relevance. MATERIALS AND METHODS: Murine CT-26 and human Colo-205 AVPR2-expressing CRC cell lines were used to test the preclinical efficacy of [V⁴Q⁵]dDAVP, both in vitro and in vivo. RESULTS: In syngeneic mice surgically implanted with CT-26 cells in the spleen, sustained intravenous treatment with [V⁴Q⁵]dDAVP (0.3 µg/kg) dramatically impaired metastatic progression to liver without overt signs of toxicity, and also reduced experimental lung colonization. The compound inhibited in vivo angiogenesis driven by Colo-205 cells in athymic mice, as well as in vitro endothelial cell migration and capillary tube formation. [V⁴Q⁵]dDAVP exerted AVPR2-dependent cytostatic activity in vitro (IC₅₀ 1.08 µM) and addition to 5-fluorouracil resulted in synergistic antiproliferative effects both in CT-26 and Colo-205 cells. CONCLUSION: The present preclinical study establishes for the first time the efficacy of [V⁴Q⁵]dDAVP on CRC. These encouraging results suggest that the novel second generation vasopressin analog could be used for the management of aggressive CRC as an adjuvant agent during surgery or to complement standard chemotherapy, limiting tumor angiogenesis and metastasis and thus protecting the patient from CRC recurrence.


Subject(s)
Animals , Arginine Vasopressin , Capillaries , Cell Line , Colon , Colorectal Neoplasms , Complement System Proteins , Drug Therapy , Endothelial Cells , Fluorouracil , Humans , In Vitro Techniques , Liver , Lung , Membranes , Mice , Mice, Nude , Models, Theoretical , Neoplasm Metastasis , Recurrence , Robenidine , Spleen , Vasopressins
17.
Article in English | WPRIM | ID: wpr-762782

ABSTRACT

BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.


Subject(s)
Animals , Capillaries , Carbon Dioxide , Carbon , Lasers, Gas , Lidocaine , Neutrophils , Rats , Skin , Survival Rate , Vascular Endothelial Growth Factor A
18.
Yonsei Medical Journal ; : 626-632, 2019.
Article in English | WPRIM | ID: wpr-762098

ABSTRACT

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.


Subject(s)
Adult , Arthroplasty, Replacement, Knee , Blood Platelets , Capillaries , Erythrocyte Aggregation , Fibrinogen , Heparin, Low-Molecular-Weight , Humans , Incidence , Plasma , Prothrombin Time , Research Subjects , Thromboplastin , Venous Thrombosis , Viscosity
19.
Article in Korean | WPRIM | ID: wpr-761588

ABSTRACT

Endoscopic ultrasonography (EUS) is commonly used to detect the depth of cancer invasion in the preoperative stage. Intrapapillary capillary loop (IPCL) patterns observed in magnification endoscopy with narrow band image are also known to well demonstrate cancer invasion depth. Here, we report a case of superficial esophageal cancer with massive submucosal invasion, which presented as a superficial esophageal cancer confined to the mucosal layer and with a coincidental hypoechoic submucosal tumor under EUS and IPCL evaluation.


Subject(s)
Capillaries , Carcinoma, Squamous Cell , Endoscopy , Endosonography , Esophageal Neoplasms
20.
Neonatal Medicine ; : 162-168, 2019.
Article in Korean | WPRIM | ID: wpr-760585

ABSTRACT

PURPOSE: Comparison between lung ultrasound (LUS) score and indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. METHODS: We retrospectively reviewed medical records of 32 very preterm infants born at 28 to 31 weeks' gestation at Keimyung University Dongsan Medical Center. Before surfactant administration, bedside LUS in the neonatal intensive care unit was recorded within the first hour of life. Partial pressure of capillary oxygen to fraction of inspired oxygen ratio (PcO2)/FiO2, alveolar-arterial gradient (A-aO2), modified oxygenation index (OI), and arterial to alveolar ratio were calculated. Correlation between LUS score and indices of respiratory severity were analyzed between the intubation and nasal continuous positive airway pressure (NCPAP) groups depending on the presence or absence of endotracheal intubation. RESULTS: Mean LUS scores, A-aO2, and modified OI in the intubation group were significantly higher than those in the NCPAP group. Conversely, PcO2/FiO2 and arterial to alveolar ratios in the intubation group were significantly lower than those in the NCPAP group. LUS score was found to be significantly correlated with A-aO2 (r=0.448, P>0.05) and modified OI (r=0.453, P>0.05), but not with PcO2/FiO2 ratio (r=−0.205, P0.05). CONCLUSION: The LUS score is well correlated with indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. Further investigation is needed to use LUS as an alternative tool in infants with respiratory distress.


Subject(s)
Capillaries , Continuous Positive Airway Pressure , Humans , Infant , Infant, Newborn , Infant, Premature , Intensive Care, Neonatal , Intubation , Intubation, Intratracheal , Lung , Medical Records , Oxygen , Partial Pressure , Pregnancy , Respiratory Distress Syndrome, Newborn , Retrospective Studies , Ultrasonography
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