Interventional Medicine and Applied Science最新文献

ST-elevation myocardial infarction (STEMI) due to septic coronary embolism is a rare complication of infective endocarditis (IE) and is associated with high mortality rates. When common signs of IE are often overlooked on admission, the diagnosis may be established through complications, which may cause prominent symptoms. Here, we report a case of native mitral valve endocarditis with an unusual presentation with STEMI and concomitant ischemic stroke, which was due to multiple coronary and cerebral septic embolisms.

Background: Chronic alcohol ingestion-induced kidney structure and function alterations are very well known, but the precise underlying molecular mediators involved in ethanol-induced kidney abnormalities remain elusive. The aim of this study was to investigate the effect of chronic ethanol exposure on matrix metalloproteinase 2, 9 (MMP), glomerular filtration barrier proteins (nephrin and podocin), as well as vascular endothelial growth factor receptor 1, 2 (VEGFRs) isoforms gene expression in the kidney of rats.

Methods: Sixteen male Wistar rats with an initial body weight of 220 ± 10 g were divided into the following two groups: (1) control and (2) ethanol (4.5 g/kg BW).

Results: After 6 weeks of treatment, the results revealed a significant increase in isoforms VEGFR1 and VEGFR2 of VEGFR gene expression, significant increases of MMP2 and MMP9 activities, as well as significant decrease of nephrin and podocin gene expressions in the ethanol group, compared with that in the control group.

Conclusion: These findings indicate that ethanol-induced kidney abnormalities may be in part associated with alteration in expressions of VEGFRs, nephrin, and podocin and in increasing activities of MMP2 and MMP9 as key molecular mediators in the kidney function.

Thermal behavior of biological apatite is the object of several studies. Crystal size, carbonate content, phase composition, and other parameters change during annealing up to 900 °C in biological minerals with apatite structure. The way these parameters change reflects the specific properties of the initial bioapatite. This work presents data on thermal transformations of pathological bioapatite from the human cardiovascular system, namely aortic wall deposits. Some minor elements, foreign to calcium hydroxyapatite (e.g., Na and Mg), can be both incorporated in the apatite structure and localized in the surface layers of crystals, modifying functions of the mineral. A new approach was proposed to determine the predominant location of minor elements, such as Mg, Na, and K, in the mineral of pathological deposits. Mg and Na in pathological apatite can be in both structurally bound (substituting calcium in lattice) and labile (localized on the crystal surface) states, while K is not able to join the apatite structure in significant amount or be chemically bound to it. This approach, based on atomic spectrometry, can be used effectively in combination with a set of traditional techniques, such as like EDS, IRS, and XRD.

Aim: The objective was to compare the marginal leakage (silver nitrate uptake) of nanohybrid resin-based composite (RBC) and two bulk-fill flowable RBCs with specific clinical protocols.

Methods: Four experimental groups of RBC were investigated including conventional composite Filtek™ Supreme in 2 mm increment (FS2), Filtek™ Supreme in 4 mm increment (FS4), Filtek™ Supreme Flowable (BFF), and SureFil^® SDR^® flow (SDR). Class II box preparation (4 × 4 × 3 mm) in extracted intact human molars was carried out and restored using the experimental groups, all according to the manufacturers' recommendations except FS4. Samples were aged by thermocycling (2,000 cycles). Microleakage was calculated by measuring dye penetration in sectioned teeth using a stereomicroscope. Level of significance was set at P < 0.05.

Results: BFF and FS2 exhibited the least dye penetration and microleakage measurement with no significant difference between the two groups, followed by SDR. FS4 showed the highest microleakage with significant difference in comparison with BFF and FS2. Gingival microleakage was found to be significantly higher than occlusal microleakage.

Conclusion: The microleakage of the bulk-fill composites BFF and SDR are comparable with conventional composite FS2; however, it is more predictable to use FS2.

Objectives: The objective of this study is to investigate the effect of comorbid conditions [Charlson comorbidity index (CCI)] on stent restenosis who underwent coronary angioplasty earlier.

Methods: Patients were divided into two groups; patients with critical restenosis [recurrent diameter stenosis >50% at the stent segment or its edges (5-mm segments adjacent to the stent) (Group 1; n = 53, mean age: 63.8 ± 9.9 years)] and patients with no critical restenosis [<50% obstruction (Group 2; n = 94, mean age: 62.1 ± 9.1 years)]. The CCI and modified CCI were used for the presence of comorbid conditions. The Gensini scoring system was used to assess the extent of coronary artery disease (CAD).

Results: Group 1 had a significantly greater CCI and modified CCI score compared to Group 2 (7.1 ± 3.7 vs. 5.6 ± 1.6, p = 0.006; 6.9 ± 3.6 vs. 4.5 ± 1.5, p = 0.008, respectively). There was a weak correlation, albeit significant, between the modified CCI score and restenosis percentage (r = 0.29, p < 0.001; r = 0.25, p = 0.003, respectively).

Conclusions: In conclusion, the CCI score is greater among patients with stent restenosis than those without. CCI score is higher among patients with a more diffuse CAD than with a milder disease extent.

Oxidative stress is a major contributor in the pathogenesis of insulin resistance (IR) and DNA damage in HIV/AIDS patients. Bilirubin has been shown to have antioxidant effects. In this case-control study, 600 subjects were included. We determined serum total bilirubin and IR in all subjects. We measured 8-hydroxy-2-deoxyguanosine with 8-hydroxy-2-deoxyguanosine enzyme-linked immunosorbent assay kit. IR and oxidative DNA damage were significantly higher in HIV-positive patients with second-line antiretroviral therapy (ART) and first-line ART than ART-naive patients. However, average serum total bilirubin was higher in ART-naive patients than the HIV-positive patients with second-line ART and first-line ART. In a logistic regression analysis, serum total bilirubin was negatively associated with the IR [odds ratio (OR): 0.0127, 95% confidence interval (CI): 0.023-0.070, p = 0.0000] and DNA damage (OR: 0.525, 95% CI: 0.351-0.783, p = 0.0016). We found that prevalence of IR and DNA damage was less in ART-naive patients compared with ART first-line and ART second-line HIV-positive patients. Larger studies are warranted to determine the molecular mechanisms involved in the negative association of serum bilirubin and DNA damage in ART naive patients.

Introduction: Renal leiomyosarcoma is a rare entity in the world and its understanding is based on reports and various cases; however, the prognosis is bleak for its malignant potential and an average survival of 18 months.

Clinical case: A 54-year-old woman with a clinical picture of 6 months of pain in the right flank and a tomographic image of a bilateral renal lesion underwent right radical nephrectomy and left conservative surgery. The definitive histopathological study reported right primary renal leiomyosarcoma with left metastasis.

Conclusion: Renal leiomyosarcoma is an entity of low incidence and high mortality; however, our case represents the minority of patients with contralateral kidney metastasis reported in the literature.

Aims: This study was aimed to determine the levels of hs-CRP, serum ferritin, and Lp(a) and to study the prevalence of metabolic syndrome (MetS) in young patients (≤45 years) with and without acute myocardial infarction (AMI).

Methods: This was a cross-sectional, case-control study conducted at a tertiary care center in India. Equal number of patients with matched age and sex (n = 51) were included in case group (with AMI) and in control group (without AMI). Subjects were assessed for the presence of MetS as per modified ATP III criteria. The hs-CRP, Lp(a), and serum ferritin were also measured.

Results: The prevalence of MetS was found to be 62.74% in case group, whereas 33.33% in control group with decreased HDL level as the most prevalent parameter. The hs-CRP level was found to be 15.35 ± 8.27 mg/dl in case group and 1.85 ± 1.05 mg/dl in control group and Lp(a) was 33.84 ± 23.69 mg/dl in case group and 19.68 ± 10.39 mg/dl in control group. No significant difference was observed in the serum ferritin level in case (264.2 ± 40.6 ng/dl) and control (225.51 ± 45.35 ng/dl) groups.

Conclusion: From this study, we can conclude that the assessment of these novel risk factors [hs-CRP, Lp(a), and MetS] may be used for the risk estimation and can help to prevent future mortality and morbidity due to CVD.

A 46-year-old man underwent angioplasty of a restenotic bifurcation lesion of the circumflex artery. The procedure required repeated balloon exchanges and during the last balloon inflation, no balloon was visualized. A test injection revealed a massive coronary air embolism due to expulsion of air that had accumulated in the guiding catheter shaft. The patient was rapidly resuscitated from electromechanical dissociation with intracoronary injection of adrenaline and atropine and forceful intracoronary saline injections. Inspection of the balloon revealed a defect and scratch marks at the junction of the wire part and shaft of the monorail balloon, a location that places the air leakage inside the guiding catheter. This is the first report of massive intracoronary air embolism due to an undetectable damage to the shaft of a balloon angioplasty catheter. Recognition of the problem and immediate intervention is vital in limiting the duration of cardiac dysfunction.

Introduction: This study was designed to determine self-efficacy and its related factors in patients with hypertension.

Materials and methods: This study is descriptive-sectional from the correlation. A total of 250 patients from a blood pressure clinic of Semnan city (in Iran) completed Medication Understanding and Use Self-Efficacy Scale were randomly selected in 2017. Data were analyzed using variance, Pearson's Correlation, and χ² using the LISREL 8.8 software.

Results: The items 1, 6, 7, and 8 have high correlation (at least higher than 0.60), indicating the possibility of aggregation of these four variables in the first factor (taking medication), and the four items 2, 3, 4, and 5 are highly correlated with each other, which are the second factor (learning about medication). In addition, Cronbach's α of reliability (taking medication) for the first factor was 0.67 and 0.63 for the second factor (learning about medication) and 0.69 for the whole scale.

Conclusion: The effectiveness of blood pressure self-efficacy is an appropriate tool for measure-taking responsibility for the time and taking medications by patients, and researchers can use it as a valid tool in therapeutic, psychological, and health research.