Comparación de cambios clínicos y hemodinámicos en pacientes con insuficiencia venosa mixta según tipo de manejo.

Existen varias causas de la insuficiencia venosa profunda, la insuficiencia venosa superficial es una de ellas; por tal motivo, una intervención activa de la insuficiencia superficial ya sea cirugía convencional, esclerosis o radiofrecuencia mejora el reflujo del sistema venoso profundo. En nuestro medio no se acostumbra a intervenir los pacientes con insuficiencia venosa mixta bajo la creencia de exacerbar la enfermedad o generar complicaciones. Se pretende documentar los cambios clínicos y hemodinámicos en pacientes con insuficiencia venosa mixta según tipo de manejo, médico vs quirúrgico

X-ray crystallographic study of DNA duplex cross-linking: simultaneous binding to two d(CGTACG)(2) molecules by a bis(9-aminoacridine-4-carboxamide) derivative

Acridine-4-carboxamides form a class of known DNA mono-intercalating agents that exhibit cytotoxic activity against tumour cell lines due to their ability to inhibit topoisomerases. Previous studies of bis-acridine derivatives have yielded equivocal results regarding the minimum length of linker necessary between the two acridine chromophores to allow bis-intercalation of duplex DNA. We report here the 1.7 angstrom resolution X-ray crystal structure of a six-carbon-linked bis(acridine-4-carboxamide) ligand bound to d(CGTACG)(2) molecules by non-covalent duplex cross-linking. The asymmetric unit consists of one DNA duplex containing an intercalated acridine-4-carboxamide chromophore at each of the two CG steps. The other half of each ligand is bound to another DNA molecule in a symmetry-related manner, with the alkyl linker threading through the minor grooves. The two crystallographically independent ligand molecules adopt distinct side chain interactions, forming hydrogen bonds to either O6 or N7 on the major groove face of guanine, in contrast to the semi-disordered state of mono-intercalators bound to the same DNA molecule. The complex described here provides the first structural evidence for the non-covalent cross-linking of DNA by a small molecule ligand and suggests a possible explanation for the inconsistent behaviour of six-carbon linked bis-acridines in previous assays of DNA bis-intercalation.

Extrinsic compression of popliteal artery in asymptomatic athlete and non-athlete individuals - A comparative study using duplex scan (color duplex sonography)

Aim. Extrinsic compression of the popliteal artery and absence of surrounding anatomical abnormalities characterize the functional popliteal artery entrapment syndrome (PAES). The diagnosis is confirmed to individuals who have typical symptoms of popliteal entrapment and occlusion or important stenosis of the popliteal artery with color duplex sonography (CDS), magnetic resonance imaging (MRI) or arteriography during active plantar flexion-extension maneuvers. However, variable result findings in normal asymptomatic subjects have raised doubts as to the validity of these tests. The purpose of this study was to compare the frequency of popliteal artery compression in 2 groups of asymptomatic subjects, athletes and non-athletes.Methods. Forty-two individuals were studied. Twenty-one subjects were indoor soccer players, and 21 were sedentary individuals. Physical activity was evaluated through questionnaires, anthropometric measurements, and cardiopulmonary exercise test. Evaluation of popliteal artery compression was performed in lower limbs with CDS, ankle-brachial index (ABI) measurements and continuous wave Doppler of the posterior tibial artery.Results. The athletes studied fulfilled the criteria of high level of physical activity whereas sedentary subjects met the criteria of low level of activity. Popliteal artery compression was observed with CDS in 6 (14.2%) studied subjects; 2 of whom (4.7%) were athletes and 4 (9.5%) were non-athletes. This difference was not statistically significant (p=0.21). Doppler of the tibial arteries and ABI measurements gave good specificity and sensibility in the identification of popliteal artery compression.Conclusion. The frequency of popliteal artery compression during maneuvers in normal subjects was 14.2% irrespective of whether or not they performed regular physical activities. Both Doppler and ABI showed good agreement with CDS and should be considered in screening popliteal arteries in individuals suspected of PAES.

In-vivo phase contrast magnetic resonance angiography of the cerebrovascular system: a comparative study with duplex sonography.

PURPOSE Assessment of the cerebral blood flow (CBF) is crucial in the evaluation of patients with steno-occlusive diseases of the arteries supplying the brain for prediction of stroke risk. Quantitative phase contrast magnetic resonance angiography (PC-MRA) can be utilised for noninvasive quantification of CBF. The aim of this study was to validate in-vivo PC-MRA data by comparing them with colour-coded duplex (CCD) sonography in patients with cerebrovascular disease. METHODS AND MATERIALS We examined 24 consecutive patients (mean age 63 years) with stenosis of arteries supplying the brain using PC-MRA and CCD. Velocities were measured in a total of 209 stenotic and healthy arterial segments (110 extra- and 99 intracranial). RESULTS Moderate to good correlation of velocity measurements between both techniques was observed in all six extracranial and five out of seven intracranial segments (p <0.05). Velocities measured with CCD sonography were generally higher than those obtained by PC-MRA. Reversal of flow direction was detected consistently with both methods. CONCLUSION PC-MRA represents a robust, standardised magnetic resonance imaging technique for blood flow measurements within a reasonable acquisition time, potentially evolving as valuable work-up tool for more precise patient stratification for revascularisation therapy. PC-MRA overcomes relevant weaknesses of CCD in being not operator-dependent and not relying on a bone window to assess the intracranial arteries.

Electrochemical study of UNS S32550 super duplex stainless steel corrosion in turbulent seawater using the rotating cylinder electrode

The cathodic and anodic characteristics of freshly polished and pre-reduced UNS S32550 (ASTM A479) super duplex stainless steel in a filtered and conductivity-adjusted seawater have been investigated under controlled flow conditions. A rotating cylinder electrode was used together with both steady and non-steady-state voltammetry and a potential step current transient technique to investigate the electrode reactions in the fully characterized electrolyte. Both oxygen reduction and hydrogen evolution were highly irreversible and the material exhibited excellent passivation and repassivation kinetics. Relative corrosion rates were derived and the corrosion mechanism of the alloy was found to be completely independent of the mass-transfer effects, which can contribute to flow-induced corrosion.

Surface integrity analysis in the super duplex stainless steel ASTM-A890 after machining

The purpose of this paper was to study the main effects of the turning in the superficial integrity of the duplex stainless steel ASTM A890-6A. The tests were conducted on a turning centre with carbide tools and the main entrances variables were: tool material class, feed rate, cutting depth, cutting speed and cutting fluid utilisation. The answers were analysed: microstructural analysis by optical microscopy and x-ray diffraction, cutting forces measurements by a piezoelectric dynamometer, surface roughness, residual stress by x-ray diffraction technique and the microhardness measurements. The results do not show any changes in the microstructural of the material, even when the greater cutting parameters were used. The smaller feed rate (0.1 mm/v), smaller cutting speed (110 m/min) and the greater cutting depth (0.5 mm) provided the smaller values for the tensile residual stress, the smaller surface roughness and the greater microhardness.

Corrosion Versus Mechanical Tests for Indirect Detection of Alpha Prime Phase in UNS S32520 Super Duplex Stainless Steel

Alpha prime formation leads to material embrittlement and deterioration of corrosion resistance. In the present study, the mechanical and corrosion behavior of super duplex stainless steel UNS S32520 aged at 475 degrees C from 0.5 h to 1,032 h was evaluated using microhardness measurements, Charpy impact tests, electrochemical impedance spectroscopy, and cyclic polarization curves. The sensibility of these tests to the effects of alpha prime phase was investigated. The microhardness test showed a gradual increase in hardness with aging time, whereas the impact tests revealed losses of about 80% in the energy absorption capacity for the material aged for 12 h in comparison with the solution-annealed samples. The most responsive analysis was the impact test, which indirectly revealed the presence of this deleterious phase in samples aged for 0.5 h. The electrochemical impedance spectroscopy and polarization tests were not highly sensitive to the alpha prime phase unless these are present in large amounts in the stainless steel.

A cost study of common surface finish systems for steel structures

This paper presents part of a study aimed at finding a suitable, yet cost-effective, surface finish for a steel structure subject to the car washing environment and corrosive chemicals. The initial, life cycle and average equivalent annual (AEAC) costs for surface finishing methods were calculated for a steel structure using the LCCC algorithm developed by American Galvanizers Association (AGA). The cost study consisted of 45 common surface finish systems including: hot-dip galvanization (HDG), metallization, acrylic, alkyd and epoxy as well as duplex coatings such as epoxy zinc and inorganic zinc (IOZ). The results show that initial, life cycle and AEAC costs for hot dip galvanization are the lowest among all the other methods, followed by coal tar epoxy painting. The annual average cost of HDG for this structure was estimated about €0.22/m2, while the other cost-effective alternatives were: IOZ, polyurea, epoxy waterborne and IOZ/epoxy duplex coating.

Duplex Hemodinamic evaluation of hepatosplenic mansoni schistosomiasis

Conventional ultrasonography highly contributes to a non invasive diagnosis of HS schistosomiasis (Cerri et al., 1984). The introduction of Dopple allowed new advances in the knowledge of the portal dinamics of this disease (Taylor et al., 1985; Moriyasu et al., 1986). The aim of this paper was to analize the hemodinamic behavior of the portal vessels, considering caliper, maximum flow speed, direction of flow and preferential disposition of the collateral vessels. Thirty two patients with schistosomiasis mansoni with confirmed hepatosplenic form (HSSM), were analyzed. Fourteen patients with the intestinal form, have been analyzed as a control group. The results demonstrated that the maximum speed of the portal vein in the two groups has not been significantly diferent. Nevertheless, the diameter of the PV in the hepatosplenic group has been larger. The splenic vein presented speed and caliper larger than the superior mesenteric vein. The hepatic artery has been detectly in only 40% of the cases. The hepatic veins presented normal caliper and spectral pattern. The duplex proved to be an useful technich complementar and non-invasive, in the study of the HSSM.

Tailed Duplex DNA is the preferred substrate for Rad51 protein-mediated homologous pairing.

Purpose of the Study: To elucidate the mechanism of homologous recombination and double-strand break repair mediated by the eukaryotic recombination pin, Rad51.

Duplex-PCR assay for the detection of adenovirus and respiratory syncytial virus in nasopharyngeal samples

Human adenovirus (HAdV) and human respiratory syncytial virus (HRSV) are important etiologic agents of acute respiratory infections. In this study, a duplex polymerase chain reaction (PCR) assay was developed for the simultaneous detection of HAdV and HRSV in clinical samples. Sixty previously screened nasopharyngeal aspirates were used: 20 HAdV-positive, 20 HRSV-positive and 20 double-negative controls. Eight samples were positive for both viruses. The duplex PCR assay proved to be as sensitive and specific as single-target assays and also detected the mixed infections with certainty. The identification of both viruses in a single reaction offers a reduction in both cost and laboratory diagnostic time.

Viability study of a multiplex diagnostic platform for Chagas disease

A new multiplex assay platform was evaluated to detect Trypanosoma cruzi infection using the recombinant antigens CRA, FRA, CRAFRA fusion and parasite lysate. The antigens presented different sensitivity and specificity in a singleplex test when compared to a serial dilution of two pools comprising 10 positive serum samples and one pool of 10 negative samples. The recombinant protein CRA presented lower sensitivity (55%) in contrast to the 100% specificity and sensitivity of FRA, CRAFRA and T. cruzi lysate. These antigens also showed good results in a duplex test and the duplex test with CRAFRA/T. cruzi lysate showed better performance with 100% specificity and sensitivity, as well as a lower cut-off value in comparison to the other duplex test, FRA/T. cruzi lysate. Hence, when the antigens were used in duplex format, both tests showed decreased cut-off values and no interference between different bead sets, resulting in increasing sensitivity and specificity. The results of these multiplex tests show that they could be an alternative to singleplex detection for Chagas disease, and also indicate the necessity of using multiplex diagnostic tools to increase the sensitivity and specificity for diagnostic tests. Emerging data from the T. cruzi genome and from its ORFeome project will also allow the identification of new antigens for this disease detection application.

Role of intra-operative duplex ultrasound in living renal donor transplantation

Objective: The treatment of choice in end-stage renal disease is¦transplantation.¦Hemodynamic disturbances can evoke graft loss, while early ultrasound¦identification of vascular problems improves outcome. The primary endpoint¦of this study was to identify differences in post-op complications with and¦without systematic, intraoperative Doppler ultrasound use. A secondary aim¦was to find a predictive resistance index limit which would show where surgical¦reintervention was necessary.¦Methods: Between Jan 2000 and Dec 2010, 108 renal transplants were¦performed from living donors at our institution. In group 1 (n = 67),¦intra-operative duplex ultrasound and intra-parenchymatous resistance index¦measurements assessed patients, while in group 2 (n = 41), no ultrasound was¦performed.¦Results. There were no inter-group differences in the overall post-op¦complication rate or in benefit to graft or patient survival with Doppler use,¦however, significantly more vascular complications (10% vs. 0%, p = 0·02) and¦more acute rejections (37% vs. 10%) occurred in group 2 than in group 1,¦respectively. When the resistance index was <0·5 intra-operatively, immediate¦surgical revision was undertaken to raise the index >0·6.¦Results: There were no inter-group differences in the overall post-op¦complication rate or in benefit to graft or patient survival with Doppler use,¦however, significantly more vascular complications (10% vs. 0%, p = 0·02) and¦more acute rejections (37% vs. 10%) occurred in group 2 than in group 1,¦respectively. When the resistance index was <0·5 intra-operatively, immediate¦surgical revision was undertaken to raise the index >0·6.¦Conclusion: This is the first report demonstrating benefits of systematic¦intraoperative Doppler ultrasound on post-operative complications in renal¦transplantation from living donors. Our results support surgical revision with a¦resistance index <0·5.

Mangaaniseosteisen duplex-teräksen hitsattavuus

Diplomityön tavoitteena oli selvittää mangaaniseosteisen LDX2101 duplex-teräksen ja LDX2101 hitsauslisäaineiden hitsausparametrit puikkohitsaus-, MAG-täytelankahitsaus- ja plasmahitsausprosessilla. Toisena tavoitteena oli selvittää lämmöntuonnin vaikutuksia hit-sausliitosten mekaanisiin ominaisuuksiin, iskusitkeyteen (-40 °C) ja ferriitti- / austeniittipitoi-suuksien jakaantumiseen. Tutkittavat hitsit olivat päittäishitsejä ja koelevyjen aineenpaksuus oli 6 mm. Koetulosten perusteella tehtiin hitsausohjeet kyseisille hitsausprosesseille. Työn kirjallisessa osassa on selvitetty yleisesti duplex-terästen käyttökohteita, mekaanisia ja kemiallisia ominaisuuksia sekä duplex-terästen korroosio-ominaisuuksia. Lisäksi on käsitelty eri hitsausprosesseja ja duplex-terästen hitsattavuutta, jossa selvitetään mm. terästen jähmet-tymistä, erkaumia ja faaseja, lämmöntuonnin vaikutuksia ja hitsausliitosten korroosionkestä-vyyttä. Teoriaosassa on kerrottu myös hitsausliitosten tarkastuksesta ja hitsiluokista. Työn kokeellisessa osassa esitellään kokeiden suoritus sekä ainetta rikkova ja ainetta rikko-maton tarkastus. Liitoksille suoritettava koestusohjelma noudatti pääosin menetelmäkoestan-dardin SFS-EN 15614-1 ohjetta. Hitseille tehtiin ainetta rikkomaton tarkastus, joka käsittää silmämääräisen tarkastuksen, pintatarkastuksen ja röntgentarkastuksen. Rikkovaa aineen-koetusta tehtiin sisältäen kovuusmittaukset, vetokokeet, taivutuskokeet jaiskusitkeyskokeet. Lisäksi valmistettiin metallografiset hieet, joita tutkimalla selvitettiin hitsausliitoksen metal-lurgiaa ja määriteltiin ferriitti- ja austeniittipitoisuudet. Kokeiden perusteella on laadittu hit-sausohjeet kullekin hitsausprosessille. Lisäksi kokeellisessa osassa on esitelty tulokset syö-pymäkokeesta, jossa selvitettiin eri materiaalien syöpymiskestävyyttä valkolipeäliuoksessa. Tutkimustuloksien perusteella LDX2102 duplex-materiaali onhyvin hitsattavaa laajalla hit-sausparametrialueella. Mekaaniset ominaisuudet, kuten lujuus- ja iskusitkeysarvot täyttävät materiaalistandardin SFS-EN10028-7 niille asettamat vaatimukset. Taivutussitkeys ja murto-venymät jäivät kuitenkin osalla koekappaleista vaatimustasoa alhaisemmiksi. Austeniitti- ja ferriittipitoisuudet vastaavat materiaalistandardin vaatimuksia.

The laser weldability of lean duplex stainless steels

Ruostumattomien terästen hinta on kasvanut maailman laajuisen kysynnän kasvun seurauksena. Samoin on käynyt myös ruostumattomien terästen valmistukseen käytettävien seosaineiden hinnalle. Terästen valmistajat ovatkin kehittäneet lean duplex teräksiä vastatakseen hintatietoisten markkinoiden kysyntään. Näissä lean duplex teräksissä kalliita seosaineita kuten nikkeliä ja molybdeenia on korvattu typellä ja mangaanilla. Houkutteleviksi vaihtoehdoiksi perinteisille ruostumattomille teräksille lean duplex laadut tekee myös niiden hyvät lujuus- ja korroosio-ominaisuudet. Kirjallisuus osio esittelee lasereiden toimintaperiaatteen. Myös avaimenreikähitsauksen periaate on esitetty. Ruostumattomien terästen yleisimmät seosaineet ovat esitelty, kuten myös syy niiden seostamiseen. Ruostumattomat duplex-teräkset on esitelty samoin kuin lean duplex teräkset. Kokeellisen osion koehitsit hitsattiin osin samalla tuotantolinjalla lopputuotteen kanssa ja osin laboratoriossa. Koemateriaaleina olivat lean duplex teräkset 1.4162 ja 1.4362 joiden materiaalipaksuudet olivat 1.2 mm ja 1.5 mm. Hitsatuille lamelleille tehtiin painetestaus. Makroskopiaa ja valomikroskopiaa käytettiin koehitsien arvioinnissa kuten myös ristivetokoetta. Kiinnostavimmista hitseistä määritettiin myös faasisuhde. Lean duplex teräs 1.4362 havaittiin sopivammaksi laaduksi tämän kaltaisessa sovelluksessa, mutta myös laatu 1.4162 täyttää sovelluksen hitsille asetetut vaatimukset, tosin huomattavasti pienemmässä parametri ikkunassa. Valittu menetelmä faasisuhteen määrittämiseen osoittautui epätarkaksi, joten faasisuhteen osalta tämän tutkimuksen tulokset ovat vain suuntaa-antavia.