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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgical therapy for reflux esophagitis remains controversial. Sixty-five patients who underwent posterior gastropexy between November, 1970 and February, 1976 are presented. Indications for surgery were: esophagitis, 43 patients; esophagitis with stricture, 12 patients; paraesophageal hernia seven patients; incapacitating postfundoplication syndrome, three patients. The average follow-up was 15.6 months. Eighty-two per cent of the patients had a good to excellent result. Twenty-three per cent of the patients developed radiographically recurrent hiatus hernia; however, the incidence of recurrent esophagitis was only nine per cent. Two patients developed postoperative strictures (one de novo, one recurrent). Two patients ultimately required a fundoplication for control of their esophagitis; one patient required a Thal-Nissen procedure. Lower esophageal sphincter pressure on patients with satisfactory results increased from 6.3 +/- 1.3 cm H2O SEM preoperatively, to 17.4 +/- 3.0 cm H2O SEM postoperatively. This increase achieved a statistical significance of p less than 0.001. In patients who had an unsatisfactory result, postoperative sphincter pressures were unchanged from preoperative values. All unsatisfactory results were obtained in patients with complicated esophagitis, i.e., Barrett's ulcer or stricture, alkaline esophagitis, or previous hiatal surgery. Posterior gastropexy appears to constitute effective therapy in the treatment of uncomplicated reflux esophagitis and paraesophageal hiatus hernia without the distressing morbidity associated with the postfundoplication syndrome.
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PMID:An analysis of recurrent esophagitis following posterior gastropexy. 63 76

Treatment of severe hypertension is beneficial, but reversibility of target-organ damage has not been characterized. Serial studies were performed in 15 patients with severe essential hypertension (age of 56 +/- 3 years, mean +/- SEM) treated for 1 year with 60 to 150 mg/day of continuous-release nifedipine; 3 patients required 50 mg of chlorthalidone/day to lower diastolic blood pressure (BP) to less than 95 mm Hg. Left ventricular (LV) structure and function was evaluated with two-dimensional-directed M-mode echocardiography, digitized from videotape and analyzed blindly. BP was markedly reduced from 194 +/- 8/115 +/- 4 to 146 +/- 4/88 +/- 14 mm Hg (p less than 0.0001) and maintained at this level for 1 year. Posterior wall and septal LV thickness, elevated at entry (12.9 +/- 0.1 and 13.4 +/- 0.1 mm), dropped steadily over 1 year into the normal range (10.0 +/- 0.03 and 11.2 +/- 0.1 mm, p less than 0.001). LV mass index, above 95% for normals at entry, decreased by 19% at 6 months (129 +/- 10 to 104 +/- 7 g/m2, p less than 0.01), and remained at this level at 1 year. LV fractional shortening rose steadily over 1 year from 34 to 42% (p less than 0.02). Atrial natriuretic peptide, which reflects LV filling pressures, was markedly elevated at entry, but was significantly reduced by 6 months (76 +/- 22 vs. 45 +/- 14 pg/ml, p less than 0.05). Sustained reduction of arterial BP with continuous-release nifedipine for 1 year normalizes LV mass, improves LV systolic function, and reduces circulating levels of atrial natriuretic peptide.
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PMID:Effect of nifedipine GITS on left ventricular mass and diastolic function in severe hypertension. 171 75

The mechanism of reperfusion induced injury in acutely ischaemic myocardium is controversial but may be connected with oxygen free radical generation. However, chronic allopurinol treatment has beneficial effects in ischaemic myocardium which are not due to its inhibition of xanthine oxidase induced oxygen free radical production. Allopurinol is rapidly metabolised to oxypurinol, so we have examined the effects of this compound on nutrient blood flow and contractility in a canine model of stunned, reperfused myocardium. Twenty anaesthetised dogs underwent 15 min of total circumflex artery occlusion followed by 15 min restricted reflow and 2 h full reflow. Posterior wall thickening was determined by sonomicrometry and expressed as % control function. Regional myocardial blood flow was measured by microsphere technique and expressed in ml.min-1.g-1. Dogs in the treatment group (n = 10) received 25 mg.kg-1 oxypurinol as a 5 min left atrial infusion, 15 min prior to circumflex occlusion. Controls (n = 10) received a saline infusion. During occlusion mean circumflex pressure (17.6 v 18.2 mm Hg), endocardial flow [0.02(SEM 0.01) v 0.03(0.01) ml.min-1g-1], and area at risk [31.4(1.2%) v 34.6(2.4%)] were similar for both groups (control v treated respectively). Endocardial blood flow increased following acute administration of oxypurinol: 1.57(0.15) v 0.92(0.15) ml.min-1g-1 in control (vehicle) group, p less than 0.05. This effect persisted for the duration of the experiment, with a significant increase during early reflow: 1.83(0.32) v 0.74(.21), p = 0.03. There was also a marked increase in posterior wall function in the treated group, at 54.6(5.5)% v 5.1(8.4)% in the control group (p = 0.0003). These results show that pretreatment with oxypurinol protects acutely ischaemic myocardium, producing enhanced myocardial blood flow, diminished systolic bulge during occlusion, and markedly enhanced function recovery following reperfusion.
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PMID:Beneficial effects of oxypurinol pretreatment in stunned, reperfused canine myocardium. 259 Sep 15

In this research we have valued at SEM the smoothness degree of the surface obtained in vitro on three kinds of composite resins for posterior restoration (P-30, P-50, Clearfil Photo Posterior); then we have compared it with the result obtained in vitro with an alloy not gamma-2 (Dispersalloy). The surfaces of the composite restorations show at SEM irregularities more or less accentuated for the presence of particles of filling got in comparison with the matrix. The surface of alloy restorations results on the contrary perfectly polished and completely comparable with the enamel surface.
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PMID:[Surface polishing of posterior composites]. 263 77

The effect of a moderate increase in heart rate on regional blood flow (8-10 mu radiolabeled microspheres) to myocardium supplied by a stenosed left circumflex coronary artery with (n = 11) or without (n = 7) concomitant left anterior descending coronary artery occlusion was investigated in anesthetized mongrel dogs. In the presence of a left circumflex coronary artery stenosis (gradient 32 +/- 5 mmHg [x +/- SEM]) and an unstenosed left anterior descending coronary artery a pacing-induced rise in heart rate (22 +/- 1 beats/min) increased epicardial flow to the posterior wall supplied by the left circumflex coronary artery (+0.21 +/- 0.08 mL/min/g, p = 0.03). Posterior bed endocardial flow was unchanged (-0.03 +/- 0.08 mL/min/g, p = 0.76). In dogs with a left circumflex coronary artery stenosis of similar severity (gradient 34 +/- 4 mmHg), left anterior descending coronary occlusion did not significantly alter posterior bed endocardial or epicardial flow. Atrial pacing increased heart rate by 22 +/- 1 beats per minute and caused remote posterior bed endocardial flow to fall (-0.08 +/- 0.03 mL/min/g, p = 0.03). Epicardial flow to that region rose (+0.09 +/- 0.02 mL/min/g, p less than 0.0002). Thus, a moderately severe coronary stenosis prevents the expected increase in endocardial flow normally seen after an increase in heart rate. Remote bed endocardial flow actually falls when heart rate is increased in the presence of an occlusion in a second major coronary artery.
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PMID:The effect of an increase in heart rate on remote myocardial blood flow in a two vessel coronary stenosis-occlusion model. 359 95

Thinning of the posterior sclera may imply that stretching and/or weakening of the sclera plays a role in axial elongation of myopic eyes. We investigated the elastic stress-strain properties of sclera from developing tree shrew eyes made myopic by monocular deprivation (MD) of form vision. Five days of MD induced a relative myopia (mean +/- SEM) of -5.6 D +/- 0.6 D (retinoscopy) and a vitreous chamber elongation (deprived minus control) of 106 +/- 14 microns, n = 10 (ultrasonography). Posterior scleral test samples (2 mm wide) cut from myopic eyes were significantly thinner than their contralateral eye controls (149 +/- 4 microns versus 164 +/- 4 microns, n = 10, P < 0.01) when measured with a force-controlled micrometer. However, posterior sclera from control eyes was significantly thicker than that from age-matched normal eyes (164 +/- 4 microns versus 149 +/- 3 microns, n = 10, P < 0.01). Under uniaxial tension, posterior scleral samples from myopic eyes failed at 18% lower load (162 g versus 198 g) and extended approximately 25% more than controls at a load corresponding to 20 mm Hg intraocular pressure. These differences were largely accounted for by the differences in scleral thickness. Finite element modelling of tree shrew eyes using the material properties summarised above, implies that simple elastic stretching of the sclera accounts for less than 20% of the observed difference in axial length between myopic and contralateral control eyes.
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PMID:Form deprivation myopia: elastic properties of sclera. 852 54

The purpose of this study was to determine whether there are changes in anterior and posterior glenohumeral translation after arthroscopic, nonablative, thermal capsuloplasty with a laser. Two anteriorly and two posteriorly directed loads were sequentially applied to the humerus of nine cadaveric glenohumeral joints, and anterior and posterior translation of the humerus on the glenoid was measured. The glenoid was rigidly fixed, and the glenohumeral joint was positioned simulating 90 degrees of shoulder abduction and 90 degrees of external rotation. Using the holmium:yttrium-aluminum-garnet laser, thermal energy was then applied to the anterior capsuloligamentous structures and anterior and posterior translation measurements were then repeated. The results showed a significant reduction in anterior and posterior translation after laser anterior capsuloplasty. Anterior translation decreased from 10.9 +/- 2.0 mm (mean +/- SEM) to 6.4 +/- 1.5 mm with the 15-N load; and from 13.4 +/- 2.1 mm to 8.9 +/- 1.8 mm with the 20-N load. Posterior translation decreased from 7.2 +/- 1.2 mm to 4.4 +/- 0.6 mm with the 15-N load and from 10.4 +/- 1.4 mm to 6.5 +/- 0.9 mm with the 20-N load. These results indicate that the holmium:yttrium-aluminum-garnet laser can be used to decrease glenohumeral joint translation and may be an effective treatment for glenohumeral joint instability.
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PMID:Glenohumeral joint translation after arthroscopic, nonablative, thermal capsuloplasty with a laser. 968 66

Posterior cingulate cortex is the site of earliest reductions in glucose metabolism and qualitatively different laminar patterns of neurodegeneration in Alzheimer's disease (AD). This study used multivariate analyses of area 23 in 72 cases of definite AD to assess relationships between laminar patterns of neurodegeneration, neurofibrillary tangle (NFT) and senile plaque (SP) densities, age of disease onset and duration, and apolipoprotein E (ApoE) genotype. No age-related changes in neurons occurred over four decades in 17 controls and regression analysis of all AD cases showed no relationships between neuron, SP, and tau-immunoreactive NFT densities. Principal components analysis of neurons in layers III-Va and eigenvector projections showed five subgroups. The subgroups were independent because each had a full range of disease durations and qualitatively different laminar patterns in degeneration suggested disease subtypes (ST). Cases with most severe neuron losses (STSevere) had an early onset, most SP, and highest proportion of ApoE epsilon4 homozygotes. Changes in the distribution of NFT were similar over disease course in two subtypes and NFT did not account for most neurodegeneration. In STII-V with moderate neuron loss in most layers, cases with no NFT had a disease duration of 3.5 +/- 0.9 years (mean +/- SEM), those with most in layers IIIc or Va had a duration of 7.3 +/- 1 years, and those with most in layers II-IIIab had a duration of 12.1 +/- 1 years. In STSevere, cases with highest NFT densities in layers II-IIIab also were late stage. Finally, epsilon4 homozygotes were most frequent in STSevere, but four statistical tests showed that this risk is not directly involved in neurodegeneration. In conclusion, multivariate pattern recognition shows that AD is composed of independent neuropathological subtypes and NFT in area 23 do not account for most neuron losses.
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PMID:Multivariate analysis of laminar patterns of neurodegeneration in posterior cingulate cortex in Alzheimer's disease. 974 63

In a two-month in vitro experiment cervical marginal adaptation was examined in relation to the preparation, filling method and restorative material. Fifty Class II cavities were prepared in fifty extracted sound human premolar and molar teeth extending to the approximal cement-enamel junction. The cavities to receive composite restorations were bevelled at the vestibulo-occlusal and -approximal enamel margins, the other aspects of the cavity enamel and gingival margins at the cement-enamel junction being prepared conventionally. The cavities for amalgam were prepared and filled conventionally. The specimens were cycled in different buffer solutions and temperature, modelling possible variations in the oral environment and examined with SEM. The results were analysed using ANOVA. The best marginal adaptation among the composites was achieved with Charisma, Estilux Posterior, Durafil and Prisma AP. H at the bevelled enamel margins, the worst marginal fit was with Heliomolar and Polofil. It was concluded, that adhesive technique reduces, but does not eliminate marginal leakage.
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PMID:[In vitro comparison of marginal adaptation of various filling materials. I. Effect of the filling material on marginal adaptation]. 1020 85

During polymerization of resin composites, shrinkage stresses compete with resin-dentin bonds in a manner that can cause failure of the bond, depending upon the configuration of the cavity, its depth, and the restorative technique. The hypothesis tested in this study was that the effect of cavity configuration (C) and remaining dentin thickness (RDT) influence resin bond strength to the dentin of Class I cavity floors. The occlusal enamel was ground to expose a flat superficial dentin surface as a control (superficial dentin, C-factor = 1) in human extracted third molars. Cavities 3 mm long x 4 mm wide were prepared to a depth 2 mm below the ground dentin surfaces (deep dentin within cavity floor, C-factor = 3). To assess the relationship between C-factor and RDT, we removed the walls of cavities, making a deep flat surface for bonding (deep dentin, C-factor = 1). The teeth were restored with either Clearfil Liner Bond II (LB II), One-Step (OS), or Super-Bond D Liner (DL), followed by Clearfil Photo Posterior resin composite. After 24 hrs' storage in water, the teeth were sectioned vertically into 3 or 4 slabs (0.7 mm thick) and trimmed for the micro-tensile bond test so that we could determine the strength of the resin bonds to the pulpal floor. All groups gave high bond strengths to superficial dentin, but OS and DL gave significantly lower bond strengths to flat deep dentin when the C-factor was 1. When the C-factor was increased to 3 by the creation of a three-dimensional cavity preparation, the bond strengths of all materials fell (range, 21 to 35%), but the difference was significant (p < 0.05) only with DL. SEM observations of failure patterns showed that specimens with high bond strengths tended to exhibit cohesive failures within the hybrid layer, while specimens exhibiting low bond strengths showed failures at the top of the hybrid layer. Some adhesives do not bond well to deep dentin, making them more susceptible to polymerization shrinkage stress that develops in cavities with high C-factors.
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PMID:Effects of dentin depth and cavity configuration on bond strength. 1032 34


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