Left atrial appendage (LAA) flow profile of its different waves and its correlation with direct left atrial pressure measurement: Can LAA flow profile be a surrogate to estimate left atrial pressure

Background:Left Atril Appendage(LAA) is one of the most contractile structure of the heart. Elevated Left atrial pressure (LAP) can change the flow profile in and out of LAA. There is little data on the effect of LAP on LAA flow velocities for patients in sinus rhythm, and it’s not properly known that by evaluation of LAA flow spectra and its velocities, the LAP can be predicted. We tried to find the relationship between LAA flow velocities and LAP, with the premise that LAA flow velocities can be used as a surrogate for measuring LAP, by obtaining a regression equation in this prospective observational study. Methods: In forty patients with normal systolic and diastolic heart function undergoing elective off pump coronary artery bypass (OPCAB) under general anaesthesia, TEE based LAA flow velocities were measured and simultaneous direct measurements of LAP was done by the surgeon. We also studied the relation between the ratio of early mitral inflow velocity (E) and mitral lateral annular early diastolic velocity (E’), that is, (E/E’) in all patients. Results: We found significant correlation between E/E’ and LAP (r = 0.424, p = 0.024) however there was no significant correlation between LAA flow velocities and LAP. Conclusion: LAA flow profile can not be used under anaesthesia to evaluate LAP however E/E’ shows a strong correlation with directly measured LAP.

Wandering gallbladder

Cholecystectomy preferably laparoscopy is gold standard treatment for symptomatic cholelithiasis. However for some anatomical and/or pathological reasons the procedure is converted to open. Conversion rates at high volume centres is <5%. We present a case report of 48 aged lady, previously operated multiple times for hydatid liver and lung with symptomatic cholelithiasis. She was planned for laparoscopic cholecystectomy. During the procedure, inadvertent anatomy of “the wandering gallbladder” was noted. Here we describe the management approach selected for this type of unusual presentation. We recommend noting down detailed past history (preferably surgical) and preoperative consideration of deviant anatomical location and findings of gallbladder. We should maintain a low threshold for conversion to open.

Health Status of Leprosy Affected People in Rehabilitation Colonies of Uttarakhand

In the post elimination era for leprosy in India, with changing disease epidemiology and controlled incidence rates, now the focus must shift to rehabilitative strategies for leprosy affected persons (LAP) residing in leprosy rehabilitation colonies. For this, firstly it is important to reassess their socioeconomic and health status before making any recommendations. This study has been conducted among 137 LAP residing in 7 such colonies in Uttarakhand, who were interviewed on a predesigned, pretested questionnaire with aims to study the overall health status of LAPs, to assess their awareness about the disease and to assess their access to various health facilities and make recommendation for their rehabilitation. Out of 137 participants, 72% belonged to 41-80 years' age group. 85% of study participants were either illiterate or had less than or equal to primary education. More than half of the participants were engaged in begging. 87% LAPs had disabilities in hands and feet, 28.3% had disability in eyes. 24% participants had BMI <18.5. 13.9% participants had diabetes, 28.5% - Hypertension, and 13.1% had history of Tuberculosis. NGO's hospital/ private clinic is the nearest health facility for 62.8% of LAPs. Although all inhabitants (100%) are getting support from the government in form of land for rehabilitation colonies, disability cards etc., however, 44.53% had not been visited by any government functionary in the last month indicating need for proper supervision. Socioeconomic and health status of LAPs was found to be poor with most being illiterate, disabled, having comorbidities like diabetes mellitus. Strategies should be considered to improve the access to government services and developing collaboration with certain NGO's for strengthening of health infrastructure and administration, disability care and rehabilitation.

Efficacy of conventional pharmacotherapy of syndromic management of STIs: a two year cross-sectional prospective study

Background: Syndromic management has been the centre for treating STIs in a resource constraint facility since its introduction by WHO and CDC more than a decade back. Recently there has been lots of debate on its empirical use in an era of antibiotics resistance and ever-changing varieties of microorganisms causing these infections. Present study evaluated the efficacy of pharmacotherapy of syndromic management measured by symptomatic improvement in females presenting with STIs.Methods: It was a two year cross-sectional prospective study including all the females of STI syndromes, attending Gynecology OPD of Sanjay Gandhi Memorial Hospital and results were assessed in pharmacology department, Gajra Raja medical college Gwalior from Jan 2015 to December 2016.Results: During the study period total of 24,556 patients attended the Gynecology OPD out of which 8562 patients presented with different STI syndromes. Lower abdomen pain with vaginal discharge was the most common symptom while Ulcerative lesions were the least common complaint. Maximum recurrence was seen in patients of vaginal discharge and itching followed by PID syndrome which responded to second line of drugs.Conclusions: Syndromic Management of STIs is an old approach to deal with a very common gynecological problem and needs to be reviewed in an era of wide spread antibiotics resistance.

Predictive Factors In Successful Completion Of Laparoscopic Cholecystectomy In Acute Cholecystitis.

Background: Laparoscopic Cholecystectomy in acute Cholecystitis is the established treatment of choice for the management of acute Cholecystitis. The conversion rate and morbidity is higher in Laparoscopic Cholecystectomy done in acute Cholecystitis. Aims and Objectives: To identify certain preoperative criteria for the selection of patients in acute Cholecystitis that can undergo laparoscopic Cholecystectomy, so that there is decrease in the conversion rate to open procedure and decrease in the complications. Methods: A Prospective interventional study was conducted in the Department of General Surgery, Moolchand Medcity, New Delhi, on 50 patients with acute Cholecystitis from September 2009 to September 2010. Data was analyzed using standard statistical software SPSS. Chi-square test was used for statistical analysis of qualitative data. Results: There were 4 males and 46 female patients with a mean age of 37. 74 years (range 18 to 65 years). There was no significant variation in intraoperative severity (IOS) pattern of acute Cholecystitis across the various age groups (p=0. 532). Males had significantly higher IOS grades of acute Cholecystitis as (p=0. 000). Among patients with varying IOS of acute Cholecystitis, there was significant difference in mean values of duration of symptoms before surgery (p=0.006), TLC at admission (adm.) (p=0.037) and at 24 hours of adm. (p=0.016) and serum AMS at adm. (p=0.005). The difference in mean serum ALP at adm. (p=0. 0171), at 24 hours of adm. (p=0. 137) and at 48 hours of adm. (p=0. 151), and mean values of TLC (p=0. 052) at 48 hours of adm. were insignificant across the various IOS grades of acute cholecystitis. There was no significant variation in histopathological severity (HPS) pattern of acute cholecystitis across the various age groups (p=0.826). Males had significantly higher HPS grades of acute Cholecystitis compared to females (p=0.042). Among patients with varying HPS of acute cholecystitis, there was no significant difference in mean duration of symptoms before surgery (p=0. 065). The difference in mean values of TLC at adm. (p=0.001), at 24 hours of adm. (p=0.001) and 48 hours of adm. (p=0.003); serum ALP at adm. (p=0.001), at 24 hours of adm.(p=0.001) and at 48 hours of adm.(p=0.022) was very significant across the various HPS grades of acute cholecystitis. The IOS (p=0.035) and HPS (p=0.032) of acute cholecystitis was significantly less with successful early lap Chole than with failed procedure. There was no significant difference in success versus failure rates of early Lap Chole across the age distribution of the patients (p=0. 153); mean values of duration of symptoms before surgery (p=0.971); TLC at adm. (p=0.422), at 24 hours of adm. (p=0.990) and at 48 hours of adm. (p=0. 478); serum ALP at adm. (p=0.113), at 24 hours of adm. (p=0.135) and at 48 hours of adm.(p= 0. 238). Male patients had significantly higher failure rate of early Lap Chole (p=0.022). Patients with failed early Lap Chole had a significantly longer mean duration of surgery (p=0. 032) and postoperative hospital stay (p=0.028) than those undergoing a successful procedure. Conclusion: Acute Cholecystitis is much more common in females. Severity of inflammation (intraoperative/ histopathological) in acute Cholecystitis is associated with higher failure/conversion rate of early laparoscopic Cholecystectomy because of dense pericholecystic adhesions, and has longer duration of surgery and postoperative hospital stay. This has a positive relation with male sex and TLC(IOS and TLC at 48 hrs of adm. , however had insignificant relation in our study ), while as no relation with age (at least up to 65 years) and mean duration of symptoms before surgery (if surgery is done within 1.5-4 days of onset of symptoms).

Regulation of mesenchymal stem cells on CD4+LAP+Freg cells in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the immune regulatory effects of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation on CD4+LAP+Treg cells in the peripheral blood of patients with systemic lupus erythematosus (SLE).Methods CD4+LAP+ Treg cells were detected in the peripheral blood from 30 SLE patients and 30 normal controls by flow cytometry.Five SLE patients received UC-MSCs transplantation,and their peripheral blood was collected before and after 24 hours of cell infusion.The percentages of CD4+ LAP+ T cells were detected by flow cytometry.Data were analyzed with t test and Spearman correlation test.Results The percentage of CD4+LAP+ Treg cells in the peripheral blood of SLE patients [(2.49 ±0.23)％]decreased remarkably compared with healthy controls [(3.35±0.19)％] (r=3.079,P＜0.01),and it was negatively correlated with serum alanine aminotransferase (ALT) [(40±44) U/L,r=-0.51,P＜0.05],AST [(35±53) U/L,r=-0.52,P＜0.05) and ALP [(64±25) U/L,r=-0.53,P＜0.01) level res-pectively.24 hours after UC-MSCs transplantation,the percentages of CD4+LAP+ Treg cells increased signif-icantly in SLE patients[(3.6±0.9)％ vs (2.1±0.6)％,r=3.508,P＜0.05].Conclusion The significantly decreased percentage of CD4+LAP+ Treg cells in patients with SLE suggests thatthey may participate in the pathogenesis of SLE.UC-MSCs transplantation can upregulate the expression of CD4+LAP+Treg cells in SLE patients,and the modulatory effects of UC-MSCs on CD4+LAP+ Treg cells may be one of the mechanisms of UC-MSCs therapy in ameliorating the disease.

Analysis of computed tomographic findings according to gastroesophageal flap valve grade

BACKGROUND/AIMS: The gastroesophageal junction is an important barrier against gastroesophageal ref lux. Endoscopic grading of gastroesophageal f lap valve is simple, reproducible, and may predict reflux activity. We investigated the correlation between gastroesophageal flap valve grade and the gastroesophageal junction’s structural properties using abdominal computed tomography. METHODS: A total of 138 patients with early gastric cancer who underwent both pre-treatment esophagogastroduodenoscopy and water-distended stomach two-phase computed tomography were enrolled. Endoscopic gastroesophageal f lap valve grade and abdominal computed tomography findings were analyzed to assess anatomical factors including the gastroesophageal junction and related organs. RESULTS: The angle of His increased significantly with gastroesophageal flap valve grade (grade I, 65.2˚± 19.6˚; grade II, 66.6˚± 19.8˚; grade III, 76.7˚± 11.9˚; grade IV, 120.0˚± 30.3˚; p < 0.001), as did the size of the diaphragmatic hiatus (grade I, 213.0 ± 53.8 mm2 ; grade II, 232.6 ± 71.0 mm2 ; grade III, 292.3 ± 99.2 mm2 ; grade IV, 584.4 ± 268.3; p < 0.001). The length of the abdominal esophagus decreased as gastroesophageal flap valve grade increased (grade I, 34.6 ± 5.8 mm; grade II, 32.0 ± 6.5 mm; grade III, 24.6 ± 7.8 mm; grade IV, –22.6 ± 38.2 mm; p < 0.001). There was no significant relationship between gastroesophageal flap valve grade and visceral and subcutaneous fat areas (p = 0.877 and p = 0.508, respectively). CONCLUSIONS: Endoscopic grading of the gastroesophageal flap valve is well correlated with anatomical changes around the gastroesophageal junction on abdominal computed tomography, and it can provide useful information about the anti-reflux barrier.

The distribution of LAP+CD4+ T cells in gastric carcinoma microenvironment and its clinical significance / 中国医师进修杂志

Objective To investigate the distribution of LAP+CD4+T cells in gastric carcinoma microenvironment and the correlation of LAP + CD4 + T cells with the progression of gastric tumor. Methods Forty gastric tumor patients and 20 healthy donors were enrolled in this study. The percentage of LAP+CD4+T cells in the peripheral blood and tumor tissue was detected by flow cytometry. The correlation of LAP+CD4+T cells with the progression of gastric tumor was analyzed. Results The percentage of LAP+CD4+T cells in the peripheral blood of gastric tumor patients was higher than that of health donors:(10.9±3.3)%vs. (4.3 ± 1.2)%;the percentage of LAP+CD4+T cells from tumor tissue was higher than that from non-tumor tissue:(13.5 ± 5.3)%vs. (4.7 ± 1.4)%. The percentage of LAP+CD4+T cells in peripheral blood from metastasis patients was higher than that from non-metastasis patients and health donors: (10.1 ± 6.4)% vs. (4.5 ± 1.3)% and (4.3 ± 1.2)%. Conclusions LAP+ CD4+ T cells accumulates in gastric carcinoma microenvironment and the percentage of LAP+CD4+T cells increases along with the progression of gastric tumor.

The distribution of LAP+CD4+ T cells in gastric carcinoma microenvironment and its clinical significance / 中国医师进修杂志

Objective To investigate the distribution of LAP+CD4+T cells in gastric carcinoma microenvironment and the correlation of LAP + CD4 + T cells with the progression of gastric tumor. Methods Forty gastric tumor patients and 20 healthy donors were enrolled in this study. The percentage of LAP+CD4+T cells in the peripheral blood and tumor tissue was detected by flow cytometry. The correlation of LAP+CD4+T cells with the progression of gastric tumor was analyzed. Results The percentage of LAP+CD4+T cells in the peripheral blood of gastric tumor patients was higher than that of health donors:(10.9±3.3)%vs. (4.3 ± 1.2)%;the percentage of LAP+CD4+T cells from tumor tissue was higher than that from non-tumor tissue:(13.5 ± 5.3)%vs. (4.7 ± 1.4)%. The percentage of LAP+CD4+T cells in peripheral blood from metastasis patients was higher than that from non-metastasis patients and health donors: (10.1 ± 6.4)% vs. (4.5 ± 1.3)% and (4.3 ± 1.2)%. Conclusions LAP+ CD4+ T cells accumulates in gastric carcinoma microenvironment and the percentage of LAP+CD4+T cells increases along with the progression of gastric tumor.

Clinical features and identification of LEMD3 gene mutation in 4 osteopoikilosis patients / 中华内分泌代谢杂志

Objective To analyze the clinical features and the mutation of LEMD3 gene in four osteopoikilosis patients.Methods Clinical data of 4 patients were collected, peripheral blood samples were obtained for DNA extract, and LEMD3 gene mutation was analyzed by direct DNA sequencing.Results 4 patients with osteopoikilosis included a male aged 44, a female aged 42, a 26-year-old male, a 21-year-old female.All these patients were from families of non-consanguineous marriage.The main complaint of these patients was pain on arthrosis.Abnormal X-ray radiography was found in medical examination, while markers of bone metabolism were normal.The results of X-ray examination showed that numerous, discrete round or ovoid calcification were scattered throughout the wrist, pelvis and scapula.A de novo mutation c.595delG(NM_014319.4) localized in exon1 of the LEMD3 gene resulting in p.Ala199ProfsX46 of Case 3, while the mutation is not found in his parents and the remaining 3 patients.Conclusions A de novol LEMD3 mutation led to osteopoikilosis was found, and the pathogenesis of molecular mechanism in Chinese remained further exploration.

The application of a new type of laparoscopic training method in the standardized training for res-idents / 中华医学教育探索杂志

For a long time, limited by the factors such as laparoscopic technology, and limited medical resources , the residents accepting standardized training are lack of mastery of the technology . Meanwhile, it is the key to the training of personnel training and reserve in the field for residents to contact the laparoscope as soon as possible and carry out scientific and effective training. Therefore, based on the traditional method, we have developed a new type of laparoscopic teaching system for the standardized training residents and increased and integrated the LAP GAME R operations training system and the real-time multimedia teaching platform. The preliminary practice effect is good.

Progress in the treatment of the overlap syndrome / 天津医药

The key treatment for overlap syndrome should focus on maximizing the therapeutic effect of each condition and concentrate of interventions that have showed benefit in both diseases. The goal of therapy includes the improvement in objective data including the reduction in sleep fragmentation, exacerbation rate, hospitalization frequency and mortality, and subjective data such as daytime functioning, quality of life and sleep quality. At present, the treatment of overlap syndrome is mainly rely on the positive airway pressure to improve ventilatory capacity and gas exchange function. Oxygen therapy as auxiliary treatment can alleviate hypoxemia. The key of drug therapy is to dilate the bronchus, clear secretions, reduce in?flammatory response to improve the ventilation function. Meanwhile, daily exercise and dietary habits of life activity are indis?pensable in the treatment of the disease as important supporting role to improve the motor function and the quality of life in patients.

Placental Leucine Aminopeptidase/Oxytocinase Expression in Miscarriage.

Objectives: To evaluate the role of placental leucine aminopeptidase (P-LAP) in miscarriage and searching to select the gene of this enzyme in miscarriage to exclude direct or indirect effects of abortion. Methods: Total RNA is purified from the fresh placental tissue sample according to the protocol of the QIAamp®RNA Tissues Mini Kit (Qiagen). The sample is visualized by 0.7% agrose gel containing. Total RNA is reverse-transcribed RT-PCR carried out on the previously extracted RNA samples using (QIAGEN One Step RT –PCR Kit). Aliquots (1ml) of RT reaction samples are amplified by PCR, the PCR products (10μl) per lane are resolved by using electrophoresis on 2.0% agrose gel .Later the product is detected and examined under UV transiluminator. Results: The obtained results indicate that there is an expression of P-LAP mRNAs in placentas of normal pregnancy women (28±SE0.45) and there is a decrease in miscarriage. Furthermore, there is a difference between single miscarriage and those with recurrent miscarriage, the mean values in single miscarriage (1st and 2nd) are (16.1%±SE0.84) and (13%±SE0.24) respectively while the mean values in recurrent miscarriage (1st and 2nd) are (12%±SE0.19) and (9%±SE0.52) respectively. The expression of P-LAP is significantly lower (p=0.05) in miscarriage and highly significant decrease in recurrent than in single miscarriage women. Conclusion: The decrease of P-LAP mRNA levels in miscarriage placentas could be a sign that p-LAP function is an important step in pregnancy regulation.

The effect of patient-control transcutaneous electroacupoint stimulation on PONV of gynecological laparoscopy patients / 临床麻醉学杂志

Objective To evaluate the effect of the electronic anti-nausea instrument on the postoperative nausea and vomiting of patients with gynecological laparoscopic surgery.Methods One hundred and eighty patients for gynecological laparoscopic surgery were enrolled and randomized into 2 groups with 90 patients in each.Patients in group T accepted patient-control transcutaneous elec-troacupoint stimulation at P6 (Neiguan)point from the time before the induction of anesthesia to 24 h after surgery.Patients in group C accepted the same device of electronic anti-nausea instrument with-out transcutaneous acupoint stimulation.Data were recorded of the nausea and vomiting in postopera-tive 2,6,12 and 24 h respectively.Results The incidence and severity of nausea at 6,12 and 24 h and vomiting at 6,24 h after operation in group T were both lower than those in group C(P < 0.05 ). Conclusion With patient-control transcutaneous acupoint stimulation at P6 point,the incidence of both early PONV and late PONV are reduced in patients with gynecological laparoscopic surgery.

Comparison of ramosetron and ondansetron for control of post-operative nausea and vomiting following laparoscopic cholecystectomy.

Background: Post-operative nausea and vomiting (PONV) is common. 5HT 3 receptor antagonists are commonly used drugs for its prevention. A study was designed to compare the efficacy and safety of ramosetron and ondansetron in patients undergoing laparoscopic cholecystectomy (lap chole). Materials and Methods: A prospective randomized case controlled study was conducted at J. N. Medical College Hospital, Aligarh Muslim University, Aligarh, India, in patients who underwent lap chole following intravenous administration of ondansetron (4mg) or ramosetron (0.3mg) at the end of surgery, and efficacy as well as side effects of ondansetron and ramosetron was documented and compared. Results: One hundred and thirty adult females undergoing lap chole were studied - 65 patients in each of the two groups. In first 24 h after surgery, complete response (No PONV) was observed in 28 patients of the ondansetron group and in 32 patients of the ramosetron group (P>0.05). Complete response in the second 24 h after surgery was observed in 30 patients of the ondansetron group and in 45 patients of the ramosetron group (P<0.05). During the first and second 24 h, PONV requiring rescue antiemetic was significantly higher (P<0.05) in the ondansetron group as compared to the ramosetron group. Adverse drug effects in the post-operative period were observed in 11 and 8 patients in ondansetron and ramosetron groups respectively (P>0.05). Conclusion: Ramosetron was found safe and more effective antiemetic than ondansetron in patients undergoing lap chole.

The role of surface treatments on the bond between acrylic denture base and teeth

The aim of this study was to compare the bond strength between acrylic denture base and teeth subjected to 6 surface treatments. Ninety-six specimens were made with poly(methylmethacrylate) teeth bonded to a microwave-polymerized acrylic denture base material. The specimens were distributed into 6 groups (n=16) according to surface treatments: CT - no treatment (control); MN - methylmethacrylate monomer etching; AO - 50-µm-particle aluminum oxide air abrasion; BR - glaze removal with a round bur; ST - surface grinding with an aluminum oxide abrasive stone; group CV - cavity preparation (diatorics). The control and surface-treated groups were subjected to a compressive load at 45º angle to the long axis of the teeth. Data were analyzed by one-way ANOVA, followed by Scheffé's test (p<0.05). Bond strength means and (SD) in kgf for groups were: CT: 18.19 (7.14), MN: 18.34 (5.28), AO: 23.82 (5.40), BR: 23.30 (4.79), ST: 25.39 (7.80) and CV: 17.48 (7.17). There was statistically significant difference (p=0.037997) only between ST and CV. In conclusion, ridge lap surface grinding with an aluminum oxide abrasive stone provided the highest bond strength, though it differed significantly only when compared to diatorics. The other surface treatments provided similar bond between the acrylic denture base and teeth.

Este estudo comparou a resistência de união entre base de prótese e dentes de resina acrílica submetidos a 6 tratamentos de superfície. Noventa e seis espécimes foram feitos com dentes de poli(metilmetacrilato) unidos a uma resina para base de prótese polimerizada por energia de microondas. Os espécimes foram distribuídos em seis grupos (n=16) de acordo com o tratamento de superfície: CT - controle, superfície não alterada; MN - aplicação de monômero de metilmetacrilato; OA - jateamento com partículas de óxido de alumínio de 50 µm; BR - remoção do brilho superficial com broca esférica; PE - asperização com pedra abrasiva de óxido de alumínio e; CV - confecção de cavidade. Os grupos foram submetidos a uma carga compressiva em ângulo de 45 graus com o longo eixo dos dentes. Os resultados foram analisados por meio da ANOVA de um fator, seguido do teste de Scheffé (p<0,05). As médias de resistência (kgf) dos grupos foram: CT: 18,19 (7,14), MN: 18,34 (5,28), OA: 23,82 (5,40), BR: 23,30 (4,79), PE: 25,39 (7,80) e CV: 17,48 (7,17). Houve diferença estatisticamente significante apenas entre os grupos PE e CV (p=0,037997). Pode-se concluir que a asperização da base do dente com pedra abrasiva proporcionou a maior resistência de união, embora com diferença estatisticamente significante apenas em relação à confecção de uma cavidade na base do dente. Os demais tratamentos de superfície proporcionaram valores sem diferenças estatisticamente significativas.

PML-RARalpha gene detection method optimization for quantitative PCR

Hybrid gene PML-RARα is the molecular target found in most cases of acute promyelocytic leukemia (APL) and has been used for diagnosis and minimal residual disease studies. The standard molecular technique employed is qualitative reverse transcriptase-polymerase chain reaction (RT-PCR), but with the emergence of real time PCR (Q-PCR), PML-RARα gene detection approaches have been described allowing transcript detection, with the methodological advantage of eliminating post-PCR processing. However, current protocols report the use of expensive fluorescent labeled probes, limiting its routine application in the laboratory. The objective of this study was to optimize PML-RARalpha gene detection method for Q-PCR, using SYBR® Green fluorescent dye. The analysis was performed with NB4 cellular lineage cDNA. Thermal cycling protocols, cDNA synthesis with random or specific primer and different MgCl2 and amplification primers concentrations were tested. Results show that amplification improved in the following conditions: 2 mM MgCl2, 10 pmol primers and cDNA synthesized with specific primer. There were no significant differences using annealing temperature (58ºC/30 s) followed by extension (72ºC/30 s) or annealing associated with extension as a single step (60ºC/45 s). This paper demonstrates the optimization of PML-RARα gene detection for Q-PCR studies using a technique considered sensitive and less expensive for routine use in the laboratory.

O gene híbrido PML-RARα é o marcador molecular presente na maioria dos casos de leucemia aguda promielocítica (LAP), sendo útil ao diagnóstico e ao estudo da doença residual mínima. A técnica molecular empregada como rotina laboratorial é a reação em cadeia da polimerase com transcrição reversa (RT-PCR) qualitativa, porém com o surgimento da PCR em tempo real (Q-PCR), foram descritas abordagens de detecção do gene PML-RARalfa possibilitando a quantificação de transcritos, com a vantagem metodológica da eliminação do processamento pós-PCR. No entanto, os protocolos relatam o uso de sondas fluorescentes de custo elevado para a rotina clínica, limitando sua aplicação. Este estudo teve como objetivo otimizar o método de detecção do gene PML-RARα para Q-PCR, utilizando como sistema de marcação fluorescente o intercalante SYBR® Green. A análise foi realizada com cDNA da linhagem celular NB4, tendo sido testados protocolos de termociclagem, síntese de cDNA com primer randômico ou específico e diferentes concentrações de MgCl2 e primers para amplificação. Os resultados mostraram amplificação mais eficiente nas seguintes condições: 2 mM MgCl2, 10 pmol de primers e cDNA sintetizado com primer específico. Não houve diferença na utilização de etapas para anelamento (58ºC/30 s) seguido de extensão (72ºC/30 s) ou etapa única de anelamento associado à extensão (60ºC/45 s). Esses resultados demonstram a otimização da detecção do gene PML-RARα para Q-PCR através de um método considerado sensível e de baixo custo para a rotina laboratorial.

A Study on the Implementation of Medical Telemetry Systems Using Wireless Public Data Network Medical Telemetry System / 대한의료정보학회지

As information communication technology developed we could check our blood pressure, pulsation, electrocardiogram, saturation of arterial oxygen (Sa02) and serologic chemical tests easily at home. It is possible though interlocking the house medical instrument with the wireless public data network. Data from patients can be transmitted to the distant hospital and will be essentially applied through wireless public data network. In this study we measured electrocardiogram (ECG) for the telemetry. We put the EGG function into the movable device and add 900MHz band wireless public data interface, through which patients could record EGG and keep the data at home. We used wireless network modem and NCL (Native Gontrol Language) protocol to contact through wireless network, and 8CR (Standard Context Routing) protocol in the networkto connect to the wired host computer. The host computer checks the recorded individual EGG data and then sends the correspondant reply to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network. The suggestion in the study of telemetry system provides movement and preservation. And it will exam the health condition in distance or at home.

P100 Latency in Normal Persons by Pattern Reversal VEP and Flash VEP

The Flash Light Emitted Diode Flash Visual Evoked Potential(Flash VEP) is useful when patients are unable to cooperate sufficiently for a Pattern Reversal Visual Evoked Potential(RP-VEP). In order to evaluate the clinical utility of Flash VEP, we performed the PR-VEP and Flash VEP in 208 eyes of 104 normal persons. The average P100 latency(LaP100) was analyzed according to check size, age, sex, and the laterality of the eye. The LaP100 of PR-VEP stimulated with 8 X 8(120' X 96'), 16 X 16(60' X 48'), 32 X 32 (30' X 24') and 64 X 64(15' X 12') check size were 98.88 +/- 7.57msec(mean S.D msec) , 97.68 +/- 7.44msec, 96.31 +/- 7.21msec, 101.20 +/- 7.81msec, respectively. The LaP100 of PR-VEP stimulated with 32 X 32 check size at 3rd, 4th, 5th, 6th and 7th decades were 93.95 +/- 5.61msec, 94.70 +/- 7.71msec, 92.92 +/- 6.28msec, 97.78 +/- 6.24 msec, 102.79 +/- 5.27msec, respectively. The LaP100 of PR-VEP remained relatively stable until over 6th decade when it increased significantly (p0.05), and between male and female(p>0.05) in the LaP100 of both VEP. These results showed that LaP100 of PR-VEP changes according to the check size and patient's age. We should interprete the LaP100 of PR-VEP or Flash VEP after the processing of averaging its P100 according to the patient's.

The Discrepancy between Pulmonary Capillary Wedge and Left Atrial Pressures during the Continuous Administration of Lidocaine with Verapamil / 대한마취과학회지

Simultaneous measurements of pulmonary capillary wedge and left atrial pressures as well as other hemodynamic effects of lidocaine with verapamil infusion were investigated in six dogs given fentanyl-nitrous oxide anesthesia. They were an initial bolus of lidocaine 3 mcg/kg/min. After 30 minutes of lidocaine infusion, Verapamil 0.2 mg/kg was given initially, followed by infusions of 3, 6, 9 and 12 mcg/kg/min respectively. Each infusion of verapamil lasted 30 minutes. Hemodynamic measurements were taken every 30 minutes following each infusion. We found that the pulmonary capillary wedge pressures were significantly higher than the left atrial pressures in each of the cases in which verapamil 6.9 and 12 mcg/kg/min(p<0.05) were respectively injected. The discrepancy between pulmonary capillary wedge and left atrial pressures may be due to an increase in pulmonary vascular resistance index. This may be related to an increase in mean pulmonary arterial pressures and a decrease in left ventricular stroke work index. We concluded from this data that the left atrial pressure reflects more accurately left ventricular filling. Therefore, The left atrial pressure should be used instead of pulmonary capillary wedge pressure to monitor the hemodynamics of depressed ventricular performance.