RESUMEN
The ECG stress test allows to determine possible presence of obstructive coronary atherosclerosis. The more severe the atherosclerotic lesion of coronary arteries the more likely a ST segment depression during the stress test. The article provides a description of a negative result of a stress test in a patient with multivessel coronary disease.
Asunto(s)
Aterosclerosis , Enfermedad de la Arteria Coronaria , Angiografía Coronaria , Electrocardiografía , Prueba de Esfuerzo , Humanos , Resultados NegativosRESUMEN
Characterization of the pluripotent cell populations within the porcine embryo is essential for understanding pluripotency and self-renewal regulation in the inner cell mass (ICM) and epiblast. In this study, we perform detailed ultrastructural and molecular characterization of the developing pluripotent cell population as it develops from the ICM to the late epiblast. The ultrastructural observations revealed that the outer cells of the ICM have a high nuclear:cytoplasmic ratio but are transcriptionally inactive and contain mitochondria with few cristae. In contrast, the epiblast cells have a reduced nuclear:cytoplasmic ratio, are more transcriptionally active, and contain abundant cellular organelles. This study also revealed cavitation and potential unfolding of the epiblast. As the ICM forms the epiblast, SSEA1 is lost and VIMENTIN is lost and re-expressed. The D6 blastocyst expressed high levels of STELLA, TERF1, and GDF3, and the epiblast expressed epithelial markers, MUC1 and E-CADHERIN, and the pluripotency markers, DNMT3B and CRIPTO.
Asunto(s)
Masa Celular Interna del Blastocisto/metabolismo , Masa Celular Interna del Blastocisto/ultraestructura , Embrión de Mamíferos/metabolismo , Estratos Germinativos/metabolismo , Estratos Germinativos/ultraestructura , Células Madre Pluripotentes/metabolismo , Células Madre Pluripotentes/ultraestructura , Animales , Masa Celular Interna del Blastocisto/citología , Cadherinas/metabolismo , ADN (Citosina-5-)-Metiltransferasas/metabolismo , Embrión de Mamíferos/citología , Estratos Germinativos/citología , Factor 3 de Diferenciación de Crecimiento/metabolismo , Humanos , Inmunohistoquímica , Antígeno Lewis X/metabolismo , Ratones , Microscopía Electrónica de Transmisión , Mucina-1/metabolismo , Células Madre Pluripotentes/citología , Reacción en Cadena de la Polimerasa , Porcinos , Proteína 1 de Unión a Repeticiones Teloméricas/metabolismo , Uniones Estrechas/metabolismo , Vimentina/metabolismoRESUMEN
Following recent advances in arthroscopy of the hip, interest has increased in injuries to the ligamentum teres and treatment strategies for them. Following a traumatic dislocation of the hip joint it is thought that the ligamentum teres is likely to be ruptured and it is thought that healing cannot occur because of the continued movement of the joint. We report on two patients with a past history of an established traumatic dislocation of the hip joint who were seen at subsequent hip arthroscopy to have a soft-tissue connection between the femoral head and the cotyloid fossa of the acetabulum. This suggests that the ligamentum teres has the potential to heal.
Asunto(s)
Luxación de la Cadera/complicaciones , Articulación de la Cadera , Ligamentos Articulares/lesiones , Ligamentos Articulares/fisiología , Cicatrización de Heridas , Adulto , Artroscopía , Estudios de Seguimiento , Humanos , MasculinoRESUMEN
OBJECTIVE: To compare the effectiveness and safety of very early high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV) in treatment of the respiratory distress syndrome (RDS) and to evaluate their impact on the incidence of chronic pulmonary disease and early and late morbidity of very low-birthweight neonates. DESIGN: A prospective randomized clinical trial. SETTING: Tertiary neonatal intensive care unit in the Perinatology Center in Prague. PATIENTS: 43 premature newborns, delivered in the Department of Obstetrics in the Perinatology Center, were randomly divided into two groups (HFOV and CMV) immediately after delivery; 2 patients in each group died, 2 fulfilled crossover criteria from CMV to HFOV, and 2 were excluded because of congenital malformations. Nineteen patients treated with HFOV were therefore compared with 18 infants in the CMV group. METHODS: The two contrasting modes of ventilation were introduced immediately after intubation. Maintenance of optimal lung volume in HFOV to optimize oxygenation and the therapeutic administration of surfactant after fulfilling defined criteria are important points of the strategy and design of the study. MEASUREMENTS AND MAIN RESULTS: Except for a higher proportion of males in the HFOV group (p<0.02), the basic clinical characteristics (gestational age, birthweight, Apgar score at 5 min, umbilical arterial pH), the two groups were similar. In the acute stage of RDS, infants treated with HFOV had higher proximal airway distending pressure with HFOV for 6 h after delivery (p<0.05). For a period of 12 h after delivery lower values for the alveolar-arterial oxygen difference (p<0.03) were noted. The number of patients who did not require surfactant treatment was higher in the HFOV group (11 vs. 1, p<0.001). In the HFOV group the authors found a lower roentgenographic score at 30 days of age (p<0.03) and a lower clinical score in the 36th postconceptional week (p<0.05), using these two scoring systems for assessing chronic lung disease according to Toce scale. The incidence of pneumothorax, pulmonary interstitial emphysema, intraventricular hemorrhage and retinopathy of prematurity in both groups was the same. CONCLUSIONS: HFOV, when applied early and when the clinical strategy of maintenance of optimal lung volume is used, improves oxygenation in the acute stage of RDS, reduces the need of surfactant administration, and can decrease the injury to lung tissue even in extremely immature newborns to whom surfactant is administered therapeutically.