RESUMO
Hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract obstruction that doesn't improve with pharmacological management often requires septal myectomy. However, there are few centers with experience in the practice of this procedure in our country. We describe the clinical and echocardiographic characteristics and postoperative outcomes of patients with HCM indicated for septal myectomy at a reference center in Colombia. MATERIALS AND METHODS: Retrospective cohort study. Patients undergoing septal myectomy between 2010 and 2023 were included. Data were collected before and two years after surgery. RESULTS: 18 patients were included. The mean age was 50 years. The predominant functional class was NYHA II/III (94 %). Asymmetric septal variant (83.3 %) was the most frequent as well as obstructive phenotype (88.8 %). After myectomy, 70.5 % improved to NYHA I and 62.4 % had no significant gradient (<30 mmHg), and the most of patient improved SAM. One patient died post-procedure, anymore complications were presented. DISCUSSION/CONCLUSIONS: Septal myectomy is a safe procedure, with clinical and echocardiographic improvement, with low complication rates.
RESUMO
Background: In patients with colorectal carcinoma, insertions or deletions of short sequences of DNA, a phenomenon called microsatellite instability, are observed. Aim: To look for microsatellite instability and mutations of MLH1 and MSH2 gene mutations in patients with colorectal carcinoma. Material and Methods: Ten patients with sporadic colorectal carcinoma and 31 patients fulfilling criteria for hereditary nonpolyposis colon cancer (HNPCC), aged 9 to 70 years, were studied. Microsatellite instability was studied in samples of tumor and peripheral blood mononuclear cell DNA. Six markers were amplified by polymerase chain reaction and capillary electrophoresis. In samples with microsatellite instability, mutations of MLH1 and MSH2 genes were studied by direct sequencing. Results: Thirty four percent of patients had microsatellite instability and among these, 76 percent had a high degree of instability. BAT40 marker had the higher frequency of instability. No mutations for MLH1 and MSH2 genes were observed. However a new polymorphism, C399T, was identified in exon 3 of MSH2 gene. This polymorphism was observed both in patients with sporadic colorectal carcinoma and patients with HNPCC. Conclusions: There is a high frequency of microsatellite instability among patients with colorectal cancer. A new polymorphism, not previously reported, was identified in MSH2 gene.
Assuntos
Adolescente , Adulto , Idoso , Criança , Humanos , Pessoa de Meia-Idade , Proteínas Adaptadoras de Transdução de Sinal/genética , Carcinoma/genética , Neoplasias Colorretais/genética , Instabilidade de Microssatélites , /genética , Proteínas Nucleares/genética , Polimorfismo Genético/genética , Testes Genéticos , Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias Colorretais Hereditárias sem Polipose/genética , Análise Mutacional de DNA , Reação em Cadeia da PolimeraseRESUMO
Four acylated glycosides along with six known glycosides were isolated from the leaves of Monochaetum multiflorum. The new compounds were characterized as 4-O-(6'-O-galloyl-beta-glucopyranosyl)-cis-p-coumaric acid, 6'-O-galloylprunasin, benzyl 6'-O-galloyl-beta-glucopyranoside, and a novel diester of tetrahydroxy-mu-truxinic acid with 2 mol of hyperin (monochaetin), based on NMR and MS spectral data and chemical evidence.
Assuntos
Glicosídeos/isolamento & purificação , Magnoliopsida/química , Acilação , Ésteres , Flavonoides/química , Flavonóis , Glicosídeos/química , Lignanas/química , Estrutura Molecular , Folhas de Planta/química , Análise EspectralRESUMO
Two hydrolysable tannins, nobotanin O and nobotanin P, were isolated from the leaf extract of Tibouchina multiflora (Melastomataceae) and their dimeric and tetrameric structures elucidated on the basis of spectral data and chemical correlations with nobotanin B and K, respectively. Thirteen known hydrolysable tannins including nobotanins A, B, C and J, which are oligomers characteristic of the Melastomataceae, were also isolated.
Assuntos
Extratos Vegetais/análise , Folhas de Planta/química , Taninos/química , Sequência de Carboidratos , Dimerização , Modelos Moleculares , Dados de Sequência Molecular , Estrutura Molecular , Oligossacarídeos/química , Taninos/isolamento & purificaçãoRESUMO
STUDY DESIGN: This study analyzed the fusion rate and clinical success rate in adult patients undergoing surgical treatment for symptomatic, low grade, isthmic spondylolisthesis. A postoperative questionnaire and grading scale were used to judge clinical success. Successful fusion was judged using radiographic criteria. OBJECTIVE: To evaluate the clinical success and fusion success in a group of adult patients undergoing instrumented posterolateral arthrodesis for symptomatic isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Seventeen consecutive adult patients with symptomatic low grade isthmic spondylolisthesis underwent the identical surgical procedure consisting of Gill laminectomy, L5 nerve root decompression, Luque pedicle-screw plate instrumentation, and posterolateral arthrodesis at L5-S1 using autogenous iliac crest bone graft. Results were analyzed at an average 30-month follow-up. METHODS: An independent observer reviewed the results using a postoperative questionnaire to determine rates of return to work, symptom relief, and analgesic medication usage. Radiographs were evaluated to determine the fusion status. RESULTS: Seventeen patients were evaluated at an average of 30 months after the index procedure. Sixteen of 17 had solid fusions using radiographic criteria. Sixteen of 17 had satisfactory clinical results. Eight of 13 (62%) employed patients, including three of six patients with worker's compensation, returned to their usual jobs. CONCLUSIONS: An instrumented posterolateral arthrodesis in combination with a Gill procedure and L5 nerve root decompression results in a high rate of fusion, satisfactory clinical success, and a high rate of return to work.
Assuntos
Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Adolescente , Adulto , Transplante Ósseo , Feminino , Seguimentos , Humanos , Fixadores Internos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Radiografia , Estudos Retrospectivos , Espondilolistese/diagnóstico por imagem , Inquéritos e Questionários , Resultado do TratamentoRESUMO
The inhibitory effect of fat in the upper small intestine was studied in dogs prepared with a Heidenhain pouch, gastric fistula, and jejunal fistula. Gastric secretion was stimulated by a constant intravenous infusion of pentagastrin, and emulsified olive oil was introduced into the jejunum. The small intestine of the dog was denervated by complete transection of the mesentery except for the superior mesenteric vessels. After intestinal denervation inhibition of the vagally innervated stomach was almost abolished while that in the Heidenhain pouch was unchanged. It is concluded that either autonomic innervation is important in the formation of enterogastrone or, more likely, that efferent inhibitory fibres in the vagus to the stomach act synergistically with enterogastrone.
