Upsala journal of medical sciences
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PTEN seems to play an important role in cell cycle, growth, migration, and death. Integrins are cell surface receptors that play a role in the regulation of cell proliferation, differentiation, implantation, and embryogenesis. PTEN inhibits beta1 integrin signaling. The objective of this study is to investigate the expression of PTEN and beta1 integrin in placental tissues of early spontaneous abortion and first and third trimesters of normal pregnancy. ⋯ Our findings suggest that altered patterns of PTEN expression may be associated with abortion, but it seems that beta1 integrin does not contribute to this process as a signaling protein. Further evaluation is needed to highlight this subject.
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Different pharmacokinetic models for target controlled infusion (TCI) of propofol are available in the recently launched open TCI systems. There is also a compelling choice to work with either plasma- or effect-site targets. Knowledge about the clinical consequences of different alternatives is of importance. ⋯ We observed clinically significant different results between the models. The choice of model will make a difference for the patient. To eliminate confusion - not necessarily to improve precision - we call for an optimised population based pharmacokinetic model for propofol - a consensus model!
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Comparative Study
A comparison of auditory evoked potentials and spectral EEG in the ability to detect marked sevoflurane concentration alterations and clinical events.
Level of consciousness monitors can distinguish between consciousness and unconsciousness during anaesthesia induction and awakening. However, this distinction is rarely a clinical problem. What we do need is a peroperative indicator signalling when the anaesthetic depth comes close to awakening, or when it is too deep. We investigated the ability of the Alaris fast extracted AEP (AAI) and the GE Healthcare Spectral Entropy algorithms State- and Response Entropy (SE/RE) to respond to marked changes in sevoflurane concentration during stable surgery and to clinical incidents. ⋯ The Spectral EEG monitor performed significantly better, with a larger number of events detected, compared with the AAI-monitor. However, at the best half the number of events was detected. An anaesthetic ceiling effect might to some part explain this finding. Notwithstanding, continuous anaesthetic depth monitoring may add information to low sensitive semi-continuous standard autonomic monitoring.
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Primary ciliary dyskinesia (PCD) is an autosomal recessive disease with extensive genetic heterogeneity. Dyskinetic or completely absent motility of cilia predisposes to recurrent pulmonary and upper respiratory tract infections resulting in bronchiectasis. Also infections of the middle ear are common due to lack of ciliary movement in the Eustachian tube. ⋯ Transmission electron microscopy is the most commonly used method for diagnosis of PCD, even though alternative methods, such as determination of ciliary motility and measurement of exhaled nitric oxide (NO) may be considered. The best method to distinguish PCD from SCD is the determination of the number of inner and outer dynein arms, which can be carried out reliably on a limited number of ciliary cross-sections. There is also a significant difference in the ciliary orientation (determined by the direction of a line drawn through the central microtubule pair) between PCD and SCD, but there is some overlap in the values, making this parameter less suitable to distinguish PCD from SCD.
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Dislocation of the tibiotalar joint without associated fracture is rare. We present here a 21-year-old man who sustained open posteromedial dislocation of the left ankle without malleolar facture when he jumped and sprained his right ankle while playing basketball. The most likely mechanism is forced flexion applied to the ankle joint leading to a rupture of the anterior capsule and lateral structures of the ankle followed by an accelerating inversion stress leading to a posteromedial dislocation of the talus from the tibial condyle. ⋯ The treatment consisted of wound irrigation, debridement, reduction and capsular suture followed by immobilization with a short leg cast. About 10 degrees of loss in the range of dorsiflexion was observed. The patient achieved good long-term functional results.