Mcdaniel English (sortcirrus55)

BACKGROUND This study investigated the value of layer-specific strain analysis by two-dimensional speckle tracking echocardiography (2D-STE) for evaluating left ventricular (LV) systolic function and synchrony in maintenance hemodialysis (MHD) patients. METHODS A total of 34 MHD patients and 35 healthy controls were enrolled in this study. Dynamic images were collected at the LV apical long-axis, the four- and two- chamber, and the LV short-axis views at the basal, middle, and apical segments. The layer-specific speckle tracking (LST) technique was used to analyze the longitudinal strain (LS) and circumferential strain (CS) of LV sub-endocardium, mid-myocardium, sub-epicardium, global longitudinal strain (GLS), global circumferential strain (GCS), the LV 17 segment time to peak LS (TTP), and the peak strain dispersion (PSD). The differences in these parameters were compared between control and MHD groups, and the correlation between PSD and each LS parameter was examined. The receiver operator characteristic ) of sub-endocardial, mid-myocardial, and sub-epicardial LS in MHD patients were 0.894, 0.852, and 0.870, respectively; the AUCs of sub-epicardial, mid-myocardial, and sub-endocardial CS were 0.852, 0.837, and 0.669, respectively. ABT-199 inhibitor CONCLUSIONS LST may detect early changes of all three-layer LS and CS and PSD in MHD patients, and is therefore a valuable tool to diagnose LV systolic dysfunction in MHD patients.BACKGROUND Acute pyelonephritis (APN) with obstructive uropathy often causes sepsis. Recently, sepsis was redefined using the sequential organ failure assessment (SOFA) score, based on the new Sepsis-3 criteria. We investigated predictors for sepsis using this new definition in patients with obstructive APN associated with upper urinary tract calculi. METHODS We retrospectively evaluated patients who were admitted to our hospital for treatment of obstructive APN associated with upper urinary tract calculi. Blood and urine samples were collected before treatment of obstructive APN. Treatment included adequate antimicrobial therapy and emergency drainage to decompress the renal collecting system. We diagnosed sepsis using the new Sepsis-3 definition. We assessed predictors for sepsis by multivariate logistic regression analysis. RESULTS Sixty-one patients were included in this study. Overall, all patients underwent emergency drainage, and 11 (18.0%) patients showed sepsis. There were no significant differences in performance status or comorbidities between sepsis and non-sepsis groups. Platelet count and serum albumin level were significantly lower in the sepsis group than in the non-sepsis group (p = 0.001 and p = 0.016, respectively). Procalcitonin (PCT) and presepsin (PSEP) levels were significantly higher in the sepsis group than in the non-sepsis group (p less then 0.001 and p  less then 0.001, respectively). Multivariate analysis showed that PCT elevation (OR = 13.12, p = 0.024) and PSEP elevation (OR = 13.13, p = 0.044) were independent predictors for sepsis. CONCLUSIONS Elevation of PCT and PSEP levels before treatment might predict the development of sepsis in patients with obstructive APN.BACKGROUND Glycomer 631 and lactomer 9-1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research; however, reports of tissue reactions to both suture materials in pigs are limited. The aim of this study was to assess clinical and histologic responses of skin incisions closed with a subcuticular technique using glycomer 631 and lactomer 9-1 in pigs. RESULTS Skin incisions on 17 pigs were closed with glycomer 631 and lactomer 9-1, and a clinical reactive score (CRS) including erythema, swelling, discharge and dehiscence was calculated on postoperative days 7 and 14. Subcuticular tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macropha