Interventional Medicine and Applied Science最新文献

Objectives: Although rare, incidents of broken/dislodged fragment of various angioplasty hardwares, including catheters, guidewires, angioplasty balloons, and stents, are being increasingly reported in recent years. Since these broken fragments may cause life-threatening consequences for a patient, it is vital for an interventional cardiologist to be acquainted with different retrieval techniques. Here, we are reporting our observations of several incidents of device dislodgement/fracture during cardiac interventions and their retrieval using simple balloon method.

Methods: We present a study of eight patients in whom we attempted to retrieve dislodged/fractured cath-lab hardwares during cardiac interventions, using simple balloon method. These cases include two cases of balloon, three cases of stent, and three cases of guidewire dislodgement/fracture.

Results: Fractured/dislodged cath-lab hardwares were successfully retrieved using a simple balloon method in six out of eight cases (75%), without any need of other retrieval hardwares. We observed no major complications in any patient.

Conclusions: The balloon-assisted retrieval method is a simple, safe, and cost-effective way to avoid complications of endothelial injury, myocardial infarction, emergency coronary artery bypass graft, and sudden cardiac death. This study, particularly the context of retrieval technique used in each case, will offer valuable information to fellow interventional cardiologists.

Fulminant hepatitis in pregnant women is one of the major public health issues and remains a challenging clinical problem with extremely high maternal and fetal morbidity and mortality, which, in parallel, viral factors are the most common cause of hepatic disorders and dysfunction during pregnancy that may lead to fulminant hepatic with a fast progression. Therefore, this review helps to inform clinicians about the current status of the incidence of fulminant hepatitis due to viral agents during pregnancy.

Acute lymphoblastic leukemia (ALL) in pregnant women is rare experience, but it can complicate the gestation by increasing the risk of miscarriage and premature birth. However, the adequate carrying of the pregnancy is possible for women who suffered from leukemia in childhood and achieved the remission during the treatment. Furthermore, there are some facts about the possibility of immunosuppression in children whose parents suffer from various immunodeficiency disorders, including ALL. This clinical case demonstrates the importance of correct diagnostics in order to reveal the congenital pathologies of the immune system in children, whose parents suffered from lymphocytic leukemia, even in case of full clinical and laboratory remission for a significant period of time. In the hospital, the thread metric approach was used for sepsis diagnostics. Conducted treatment was ineffective due to the inadequate immune response in the child and lack of the targeted adjusted measures to immunodeficiency disorder. The present case demonstrates the congenital T-cells immunodeficiency in a child who was complicated by the development of acute ulceronecrotic enterocolitis after vaccination. The treatment that was targeted mainly at the agent eradication did not give the desired results due to non-responsiveness of the immune system of the child.

Introduction: Operating rooms in hospitals are facilitated with different types of electronic systems, which produce electromagnetic waves. High intensities of magnetic waves may have harmful effects on biological environments. This study aims to evaluate the electromagnetic field intensity at different parts of operating rooms at the first stage and estimate the occupational exposure to operating room personnel at the next phase.

Materials and methods: At this cross-sectional study, the magnetic field intensity was evaluated using teslameter at several parts of operating rooms, during operating procedures, while electrical instruments were working. Background electromagnetic field intensity was measured when all the electrical systems were idle. Statistical analysis was performed using SPSS software. The results were compared with ICNIRP standards.

Results: The maximum intensity of magnetic field was measured around high-voltage systems at the distance of 50 cm in the personnel's standing area at DCR and PCNL operating procedures were 5.9 and 5.6, respectively. The number of on-mode electrical systems was inconsistent with the intensity of electromagnetic fields at the standing area of operating room personnel's. The intensity of magnetic fields around high-voltage systems, which was about 46.75 mG at the distance of 10 cm, was the highest among measured electromagnetic fields.

Conclusions: The highest magnetic field intensity measured in this study was related to high-voltage systems and is lower than advised intensity by ICNIRP for occupational exposure. Based on this study, it can be concluded that there are no considerable risks of electromagnetic exposure for operating room personnels.

Background: Lichen planus (LP) carries the increased risk of cardiovascular events as it is a chronic inflammatory disease. This study aimed at determining the relationship between total atrial conduction time (TACT), P-wave dispersion, and the left atrium (LA) global strain in the patients with LP.

Methods: Forty people as a control group and 40 patients with LP were included in this study. Patient assessed global longitudinal LA strain by two-dimensional speckle-tracking strain echocardiography.

Results: The global peak systolic LA myocardium strain during the left ventricular systole (LAGLSRs) and the global peak negative LA myocardial strain rate during the early ventricular diastole (LAGLSRe) values were significantly lower in the patients with LP in proportion to the control group according to the strain measurements (1.7 ± 0.07 vs. 1.9 ± 0.1%, p = 0.001; 1.23 ± 0.04 vs. 1.2 ± 0.08 s^-1, p = 0.001), respectively. TACT value was found to be significantly longer (102.6 ± 6.3 ms) in the patients with LP than the control group (96.3 ± 5.3 ms, p = 0.001), considering the terms of the artial conduction features.

Conclusion: This study demonstrated that the subclinical cardiac involvement in LP can determine the prolonged TACT and the impaired left atrial myocardial deformation values.

Periodontal ligament stem cells (PDLSCs) possess extensive regeneration potential. However, their therapeutic application demands a scaffold with appropriate properties. HydroMatrix (HydM) is a novel injectable peptide nanofiber hydrogel developed recently for cell culture. Our aim was to test whether HydM would be a suitable scaffold for proliferation and osteogenic differentiation of PDLSCs. PDLSCs were seeded on non-coated or HydM-coated surfaces. Both real-time impedance analysis and cell viability assay documented cell growth on HydM. PDLSCs showed healthy, fibroblast-like morphology on the hydrogel. After a 3-week-long culture in osteogenic medium, mineralization was much more intense in HydM cultures compared to control. Alkaline phosphatase activity of the cells grown on the gels reached the non-coated control levels. Our data provided evidence that PDLSCs can adhere, survive, migrate, and proliferate on HydM and this gel also supports their osteogenic differentiation. We first applied impedimetry for dental stem cells cultured on a scaffold. HydM is ideal for in vitro studies of PDLSCs. It may also serve not only as a reference material but also in the future as a promising biocompatible scaffold for preclinical studies.

Aims: The aim of this study is to compare tricuspid annular plane systolic excursion (TAPSE) in pre- and postoperative valvular heart surgery patients using M-mode imaging, to determine changes in tissue Doppler parameters among patients undergoing valvular heart surgery, and to analyze tissue deformation parameters of right ventricle (RV) and RV strain in pre- and postoperative patients.

Materials and methods: This was an observational, cross-sectional, single-center study that included 24 patients who underwent echocardiographic assessment prior to surgery, after surgery, and at 1-month follow-up. Assessment of left and right ventricles by M-mode echocardiography, evaluation of RV by 2D Doppler echocardiography, tissue Doppler imaging, and strain imaging were performed.

Results: The TAPSE was significantly reduced immediately after surgery (14.8 ± 0.37 vs. 10.9 ± 0.26 mm), which was then improved on follow-up assessment (17.8 ± 34 mm) (p = 0.001). Tricuspid valve diastolic velocity was increased after surgery and then gradually declined at 1-month follow-up (p = 0.003). Presurgery RV free wall strain was found to be reduced, which was then improved during post-procedure analysis as well as on follow-up (p = 0.001).

Conclusions: After cardiac valvular surgery, RV myocardial deformation showed a gradual improvement after 1 month, although there was an immediate decline in RV function postsurgery. The pattern of RV contraction, as showed by RV strain, varied postsurgery, which was remarkably increased in postoperative patients at the time of follow-up. Tissue deformation imaging being an emerging technique helps in the assessment of minute, subtle changes that occur in the RV myocardial function in cardiac patients undergoing valve surgery.

Background: Otomycosis is a common ear problem in countries with hot and humid climate. Emergence of new fungal species is a possibility particularly in patients with chronic illness or who receives antibiotics either systemically or topically.

Aim: To identify the otomycotic species, which are responsible for developing the otomycosis.

Methods: A descriptive study was carried out in 63 patients who were clinically diagnosed with otomycosis. Swabs were taken from the fungal debris to identify the causative agent and to determine the effective antifungals against it.

Results: Aspergillus species were the most common agents and were found in 47 patients (74.6%), represented by A. fumigatus (36.5%), A. niger (27%), A. flavus (6.5%), and A. terreus (4.8%). Ketoconazole (90%) and miconazole (76%) were the most effective antifungals against the species obtained from cultures, whereas fluconazole was the least effective.

Conclusions: Although there is no change in the mycology of otomycosis, there is still a significant variability in the isolated species and in their sensitivity to antifungal drugs. Ketoconazole exhibited broad spectrum effect against fungal isolates in this study, whereas fluconazole was the least efficacious.

Background: This study was aimed to evaluate the association of serum vitamins D and E level with age-related macular degeneration (AMD).

Methods: This pilot study was performed in two groups of 15 patients in treatment group and 15 patients in control group. Measurements of blood factors [such as C-reactive protein (CRP) and high-density lipoprotein (HDL)] were performed after 12 h of fasting. To measure vitamins D and E, the serum was isolated from 5 cc blood samples.

Results: HDL was higher in the control group as compared with the AMD group. However, no significant difference was found between the two groups (p = 0.08). On the other hand, serum vitamin E in the AMD group was remarkably higher as compared to the control group (p < 0.002). However, no significant difference was found in serum vitamin D levels between the two groups (p = 0.662). Our findings also revealed that there was no statistically significant relationship between BMI and AMD. Moreover, no significant correlation was determined between serum CRP and AMD (p = 0.96).

Conclusions: Our data indicated that none provides evidence for associations between AMD and serum vitamin D levels. The association between vitamin D and AMD requires further investigations in a large population studies, to elucidate whether vitamin D deficiency can be an important risk factor for AMD.

Objectives: During mid-trimester, it is necessary to terminate pregnancy due to some fetal anomalies and intrauterine death. Therefore, in this study, we aimed to compare abortion induction methods and combined use retrospectively.

Methods: About 112 out of 223 pregnant patients were included in the study. The groups were determined as follows: Group 1 including pregnant patients who were administered misoprostol only (50 patients), Group 2 including pregnant patients who were administered single dose misoprostol (according to FIGO) and subsequently received cervical Foley catheter (30 patients), and Group 3 including pregnant patients who received Foley catheter only (32 patients). These three groups were compared in terms of effectiveness of the method, side effects, and complications as well as their characteristics.

Results: In terms of characteristic of the groups, the average age of the women in the Group 1 was significantly higher than other two groups (p < 0.001). In terms of effectiveness of the method, the termination period in Groups 1 and 2 was significantly lower than Group 3 (p < 0.001). However, in terms of complications, it was observed that uterine rupture was developed in Group 1.

Conclusions: Although medical methods may seem to be more effective in the process of termination, mechanical methods seem more reliable in terms of reliability. Especially combined methods can be used to increase effectiveness and also to reduce complications.