Pre- and postoperative left ventricular (LV) function was assessed by Doppler echocardiography in 95 infants who underwent open heart surgery during the past two and half years. The patients were divided into three groups: 43 patients with ventricular septal defect (VSD group), 37 with atrial septal defect (ASD group) and 15 with the tetralogy of Fallot (TOF group). Echocardiography was performed before and at an early stage after surgery (average: 11.6 days) in all cases. The forward flow velocity pattern was evaluated by Doppler echocardiography, placing the sample volume at the pulmonary vein (PV) and the LV inflow portion. At the PV, the peak velocity of the S wave during systole (p-PV_S) and the D wave during diastole (p-PV_D) in patients with ASD were significantly lower (p<0.01) postoperatively. In patients with VSD, only p-PV_D was significantly lower (p<0.05) postoperatively, showing a decrease of pulmonary blood flow. These results are thought to reflect a difference in the compliance of the left atrium between the two groups. At the LV inflow portion, the ratio of peak velocity of the wave during atrial systole to R wave on rapid inflow during diastole (A/R) was significantly lower in patients with VSD (p <0.01) postoperatively. At the same time, LV ejection fraction and fractional shortening were significantly lower (p<0.01), but these values remained within the normal range. These results suggest that LV can maintain a sufficient systolic performance against the decrease in preload and the increase in afterload as well as the improvement of diastolic function during the early period after surgery in the VSD group. In patients with ASD or TOF, there were no significant differences in parameters of LV function between preoperative and postoperative periods.

A study was conducted to clarify the effect of hyperoxia (HO) on exercise tolerance andhemodynamics in patients with ischemic heart disease (IHD) . The subjects were 10 patients with serious IHD who showed ischemic ST depression during low-intensity exercise testing. In all subjects, cardiopulmonary exercise testing (CPX) was performed using two types of inhalation : normoxia (NO) and HO (O₂: 60%, N₂: 40%) . Heart rate (HR), blood pressure (BP), rating of perceived exertion (RPE), elapsed exercise duration and pressure rate product (PRP) were measured, and ECG was recorded during CPX according to the Bruce protocol. The peak oxygen uptake (VO₂peak) was calculated using the appropriate formula. These data were compared between the NO and HO groups, and the following results were obtained.
ST depressions on ECG, BP, HR and PRP after 20 min of rest showed no changes under NO. The other hand, only ST depression was improved after 20 min of rest under HO. The exercise duration in HO group was longer than in the NO group, and the VO₂peak in the HO group was higher than in the NO group. However, peak RPE showed no significant difference between the HO and NO groups. The incidence of ST depression as an endpoint of CPX showed no significant difference between the two groups. BP, HR and PRP at the CPX endpoint showed no significant differences between the HO and NO groups. In patients whose exercise duration was prolonged beyond the mean value by HO, peak HR and PRP were increased significantly. However, this tendency was not seen in patients whose exercise was prolonged for less than the mean value.
In conclusion, these results suggest that an increase in the oxygen supply to peripheral working muscles may play an important role in increasing exercise tolerance under HO in IHD patients.

Purpose: Consensus is lacking regarding the optimal antibiotic treatment for pediatric complicated appendicitis. This study determined the optimal first-line antibiotic treatment for pediatric patients with complicated appendicitis based on peritoneal fluid cultures. Methods: This retrospective study examined the cases of pediatric patients who underwent appendectomy for complicated appendicitis at our institution between 2013 and 2019. Peritoneal fluid specimens obtained during appendectomy were cultured for the presence of bacteria. Results: Eighty-six pediatric patients were diagnosed with complicated appendicitis.Of them, bacteria were identified in 54 peritoneal fluid samples. The major identified bacteria were Escherichia coli (n=36 [66.7%]), Bacteroides fragilis (n=28 [51.9%]), α-Streptococcus (n=25 [46.3%]), Pseudomonas aeruginosa (n=10 [18.5%]), Enterococcus avium (n=9 [16.7%]), γ-Streptococcus (n=9 [16.7%]), and Klebsiella oxytoca (n=6 [11.1%]). An antibiotic susceptibility analysis showed E. coli was inhibited by sulbactam/ampicillin in 43.8% of cases versus cefmetazole in 100% of cases. Tazobactam/piperacillin and meropenem inhibited the growth of 96.9-100% of the major identified bacteria. E. coli (100% vs. 84.6%) and P. aeruginosa (100% vs. 80.0%) were more susceptible to amikacin than gentamicin. Conclusion Tazobactam/piperacillin or meropenem is a reasonable first-line antibiotic treatment for pediatric complicated appendicitis. In the case of aminoglycoside use, amikacin is recommended.

OBJECTIVETo evaluate the effects of the application of tongue pressure sensor sheet on the signal waveform of laryngeal movement produced by the bend sensor during deglutition.

METHODSTwelve adult male subjects were recruited to perform a single swallow of 5 ml water when sitting on the dental chair with upright position. The data recorded by bend sensor was obtained with attaching tongue pressure sensor sheet simultaneously or not. Then the measured parameters by bend sensor with or without concurrent application of tongue pressure sensor sheet were compared.

RESULTSThere were no significant differences between the same time point on the signal waveform produced by bend sensor whether concurrently attaching tongue pressure sensor sheet or not (P > 0.05). Additionally, we found no statistical significances between matched phases on the signal waveform recorded by bend sensor with or without application of tongue pressure sensor sheet (P > 0.05).

CONCLUSIONThe findings in this study suggest us that the usage of tongue pressure sensor sheet exerted no influences on the waveform of the laryngeal movement produced by bend sensor during deglutition, facilitating us to further apply tongue pressure sensor sheet and bend sensor simultaneously to record tongue pressure production and hyoid activity during deglutition.

Adult ; Biosensing Techniques ; instrumentation ; Deglutition ; physiology ; Humans ; Hyoid Bone ; physiology ; Larynx ; physiology ; Male ; Middle Aged ; Pressure ; Tongue ; physiology

OBJECTIVETo investigate the tongue pressure (TP) produced by tongue-hard palate contact in the process of normally swallowing liquid in healthy adults.

METHODSThirteen adult male subjects were recruited to perform a single swallow of 5 ml water when sitting with upright position. The tongue pressure sensor sheet was used to monitor TP as a result of tongue-hard palate approximatation in the anteriomedian, midmedian, posteriomedian and circumferential parts, and the swallowing sound was recorded by microphone. The temporal sequence of TP at each measured part was obtained after setting the swallowing sound as the reference time. Also, the total duration, pre-peak duration, post-peak duration, maximum magnitude and integrated value of TP were recorded and compared among the measured parts.

RESULTSTP was produced from anterior to posterior along the midline of hard palate during normal swallowing of water [Ch1: (-0.40 ± 0.22) s, Ch2: (-0.36 ± 0.21) s, Ch3: (-0.24 ± 0.18) s], with the circumferential TP [Ch4: (-0.38 ± 0.23) s, Ch5: (-0.40 ± 0.23) s] occurring nearly to the anteriomedian one (P > 0.05). Before the swallowing sound (P < 0.05), TP at each part reached a peak synchronously [Ch1: (-0.12 ± 0.24) s, Ch2: (-0.16 ± 0.22) s, Ch3: (-0.13 ± 0.21) s, Ch4: (-0.16 ± 0.23) s, Ch5: (-0.17 ± 0.23) s] in a rapid manner (P > 0.05), then decreased gradually until disappeared simultaneously [Ch1: (0.32 ± 0.23) s, Ch2: (0.27 ± 0.21) s, Ch3: (0.23 ± 0.16) s, Ch4: (0.33 ± 0.31) s, Ch5: (0.33 ± 0.29) s] (P > 0.05) after the swallowing sound (P < 0.05). The TP related parameters (the total duration of TP:Ch1: (0.72 ± 0.20) s, Ch2: (0.63 ± 0.16) s, Ch3: (0.47 ± 0.17) s, Ch4: (0.70 ± 0.35) s, Ch5: (0.73 ± 0.29) s; the pre-peak duration of TP: Ch1: (0.28 ± 0.21) s, Ch2: (0.20 ± 0.16) s, Ch3: (0.12 ± 0.10) s, Ch4: (0.21 ± 0.22) s, Ch5: (0.23 ± 0.21) s; the post-peak duration of TP: Ch1: (0.44 ± 0.23) s, Ch2: (0.43 ± 0.18) s, Ch3: (0.36 ± 0.18) s, Ch4: (0.49 ± 0.25) s, Ch5: (0.50 ± 0.23) s; the maximum magnitude of TP: Ch1: (13.80 ± 7.73) kPa, Ch2: (12.40 ± 6.51) kPa, Ch3: (10.26 ± 7.15) kPa, Ch4: (12.16 ± 5.38) kPa, Ch5: (13.08 ± 5.05) kPa; the integrated value of TP: Ch1: (4.99 ± 3.69) kPa×s, Ch2: (4.25 ± 2.13) kPa×s, Ch3: (2.88 ± 1.87) kPa×s, Ch4: (4.32 ± 3.47) kPa×s, Ch5: (4.63 ± 2.49) kPa×s were significantly smaller in the posteriomedian part among all the five parts measured. No laterality was found in TP produced at the circumferential parts of the hard palate (P > 0.05).

CONCLUSIONSThe TP at each part coordinates precisely during swallowing. The effective measurement of TP by tongue pressure sensor sheet will facilitate the evaluation of oral swallowing and the diagnosis of dysphagia simply and non-invasively.

Adult ; Deglutition ; physiology ; Deglutition Disorders ; diagnosis ; Drinking ; physiology ; Drinking Water ; Humans ; Male ; Palate, Hard ; Pressure ; Time Factors ; Tongue ; physiology

BACKGROUND/AIMS: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2). METHODS: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically. RESULTS: In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032). CONCLUSIONS: TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.
Antibodies ; Cohort Studies* ; Colon ; Crohn Disease* ; Humans ; Infliximab* ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity