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Biomedical subjects

E Ching

Publications and source records attributed to E Ching.

18 recordsLinked to original sources
PubMed2000

The effect of early static loading on the in vitro shear/peel bond strength of a 'no-mix' orthodontic adhesive.

This study addressed the question of whether shear and tensile loads applied 15 minutes after bonding metal brackets to enamel affected the shear/peel bond strength of the adhesive. Ninety standard 0.022-inch stainless steel edgewise premolar mesh-backed brackets were bonded using a no-mix chemical-cured adhesive to 90 teeth, which had been prepared in a standardized manner. After 15 minutes three groups of 30 teeth were subjected to the following regimes: no applied load, tensile static load of 0.77 N (78 g), and shear static load of 0.77 N. After 14 days storage in 100 per cent relative humidity at 37 degrees C, the shear/peel strength of the adhesive bond was measured using a purpose built jig mounted on a universal testing machine. Shear/peel bond strengths were analysed using Weibull statistics. The Weibull moduli of the three groups indicated that the adhesive performed consistently despite early static loading. Characteristic strengths were 9.22, 9.27, and 9.05 MPa for the control, tensile, and shear groups, respectively. The findings indicate that static loads (such as tying in of archwires) can be placed on brackets 15 minutes after cementation, without a clinically significant reduction in bond strength of the tested adhesive.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1999

A comparison of 50-J versus 100-J shocks for direct-current cardioversion of atrial flutter.

BACKGROUND: Direct-current cardioversion remains the gold standard for restoration of sinus rhythm in patients with atrial flutter. Although an initial energy of 50 J is recommended, the optimal energy settings have not been evaluated in a large series of contemporary patients. METHODS: We compared the outcome of cardioversion with 50 J versus 100 J in 330 consecutive patients with atrial flutter. Initial energy was based on attending physician preference. One hundred sixty patients received 50 J and 170 patients received 100 J. RESULTS: Patients in both groups did not differ significantly in age, sex, weight, body mass index, duration of the arrhythmia, postoperative status, presence and type of structural heart disease, or use of antiarrhythmic drugs. Patients in the 100-J group had more first shock conversion (85% vs 70%; P =. 001), fewer total shocks (1.2 +/- 0.5 vs 1.4 +/- 0.7; P =.001), and less induction of atrial fibrillation (2% vs 11%; P =.002). There were no significant differences in overall restoration of sinus rhythm, cumulative energy delivered, anesthetic dose, and procedure room time. On multivariate analysis, delivery of 100 J was the strongest predictor of first shock success (odds ratio 2.6, 95% confidence interval 2.13 to 3.16; P <.001). CONCLUSION: An initial energy of 100 J is more efficient for restoration of sinus rhythm in patients with atrial flutter.

Aged↗
PubMed1999

Factors predicting engraftment of autologous blood stem cells: CD34+ subsets inferior to the total CD34+ cell dose.

Data were analyzed on 178 consecutive patients (median age 43 years) who underwent autologous blood stem cell transplantation (ABSCT) at a single institution to determine if CD34+ subsets (CD34+38-, CD34+33-, CD34+33+, CD34+41+) or various clinical factors affect hematopoietic engraftment independent of the total CD34+ cell dose/kg. Using Cox proportional hazards models, the factors independently associated with rapid neutrophil engraftment were higher CD34+ dose/kg, use of G-CSF post-ABSCT, and conditioning regimen (single-agent melphalan +/- TBI slower). Factors independently associated with rapid platelet engraftment were higher CD34+ cell dose/kg, higher ratio of CD34+33-/total CD34+ cells infused, conditioning regimen (mitoxantrone, vinblastine, cyclophosphamide faster), and no CD34+ cell selection of the autograft. The CD34+ cell selection process seemed to deplete CD34+41+ cells to a greater extent than total CD34+ cells which may explain our observation that it resulted in slower platelet engraftment. In conclusion, the total CD34+ dose/kg was a better predictor of hematopoietic engraftment following ABSCT than the dose of any CD34+ subset. Platelet engraftment, however, was also influenced by the ratio of CD34+33-/total CD34+ cells for unmanipulated autografts, and possibly by the CD34+41+ dose for autografts manipulated by CD34+ selection. The use of CD34+ subsets requires further investigation in predicting engraftment of autografts which undergo ex vivo manipulation.

Adult↗
PubMed1999

Effects of extracorporeal shock wave lithotripsy on tiered therapy implantable cardioverter defibrillators.

The effects of extracorporeal shock wave lithotripsy (ESWL) were tested on four advanced generation implantable cardioverter-defibrillators (ICDs) in vitro and in vivo in two patients. During in vitro testing, advancement of nonsustained episode counters occurred in one device, and a set screw and power source cell loosened in another, which was connected to an external power source. No arrhythmias occurred during in vivo procedures, but programmed parameters were reset and elective replacement indicated after one procedure. ESWL can be performed safely in selected patients with ICDs, but testing should be performed afterwards to confirm satisfactory function and component continuity.

Defibrillators, Implantable↗
PubMed1998

NASPE expert consensus document: use of i.v. (conscious) sedation/analgesia by nonanesthesia personnel in patients undergoing arrhythmia specific diagnostic, therapeutic, and surgical procedures.

Use of IV (Conscious) Sedation/Analgesia by Nonanesthesia Personnel in Patients Undergoing Arrhythmia Specific Diagnostic, Therapeutic, and Surgical Procedures. This article is intended to inform practitioners, payers, and other interested parties of the opinion of the North American Society of Pacing and Electrophysiology (NASPE) concerning evolving areas of clinical practice or technologies or both, that are widely available or are new to the practice community. Expert consensus documents are so designated because the evidence base and experience with the technology or clinical practice are not yet sufficiently well developed, or rigorously controlled trials are not yet available that would support a more definitive statement. This article has been endorsed by the American College of Cardiology, October 1997.

Anesthesiology↗
PubMed1994

The P1 blood group and the severity of diarrhea-associated hemolytic uremic syndrome.

Thirty-one children with diarrhea-associated hemolytic uremic syndrome were retrospectively studied to determine if expression of the P1 blood type was related to the severity of the acute illness or to the prognosis. No differences were found in the clinical variables studied in the patients who were P1 positive compared to the patients who were P1 negative. The clinical variables studied included the age, hemoglobin, white blood cell count (WBC), and presence of central nervous system involvement at presentation, the duration of elevated WBC, thrombocytopenia, hemorrhagic colitis, and anuria, and the follow-up incidence of proteinuria, hypertension and decreased GFR. Expression of the P1 phenotype does not appear to exert a protective influence in patients with D+ HUS.

Child, Preschool↗
PubMed1991

Early clinical experience with a minute ventilation sensor DDDR pacemaker.

UNLABELLED: The new DDDR pacemaker META DDDR utilizes a minute ventilation sensor based on transthoracic impedance measurements. The sensor determines the metabolic indicated interval, the atrioventricular (AV) delay and the postventricular atrial refractory period (PVARP). The baseline PVARP must be carefully selected to define nonphysiological tachycardias. If a P wave falls within the PVARP the pacemaker will automatically switch to the VVIR mode. This behavior prevents tracking of paroxysmal atrial tachyarrhythmias (PAT). Twenty-eight patients with sinus node dysfunction (n = 20), AV junction ablation (n = 5), complete or intermittent AV block (n = 3); who received a META DDDR pacemaker were studied. The mean age was 65 +/- 13 years. RESULTS: mode switching (reversion) to VVIR was observed in 57% of the patients. Forty-two percent had episodes of mode switching to VVIR during a stress test, four related to PAT, and seven to sinus tachycardia. Fifty percent had episodes of mode switching to VVIR during a 24-hour Holter, four related to PAT, three to retrograde P wave sensing, and two to sinus tachycardia. At the last follow-up, 20 of the 26 patients initially programmed to the DDDR mode remained in the DDDR mode, while five were reprogrammed to the DDD and one to the VVIR mode. Mode switching has a high sensitivity but a low specificity for PAT. It appears to be a useful approach to prevent rapid tracking of atrial tachyarrhythmias. Careful PVARP programming is critical to appropriate reversion behavior, but further modifications of the algorithm are needed to improve its performance.

Aged↗
PubMed1986

Design-dependent cross-talk in a second generation DDD pacemaker.

A unique mechanism of "cross-talk" has recently been described in the Gemini 415A DDD pacemaker in which cross-inhibition of the ventricular output stimulus may occur in the early Gemini 415A models which were manufactured with dual anodal rings interconnected by a wire. The Gemini 415A units with dual anodal rings were implanted under investigational protocol in 53 patients from September 1982 to August 1984. To date, cross-talk has been discovered in six patients during clinical follow-up, manifesting as inappropriate ventricular inhibition. Syncope was documented in one patient. Non-Cordis atrial and ventricular leads were present in all six patients and five patients had at least one chronic lead. Cross-talk was neither evident nor provokable in Gemini 415A units which had compatible Cordis lead systems. Reduction of the atrial output and/or the ventricular sensitivity prevented cross-inhibition in three patients. Cross-talk persisted in three patients despite programming to the lowest atrial output and/or ventricular sensitivity parameters. Cross-talk, spontaneous or provoked, has not occurred in 36 patients having currently designed 415A pulse generators manufactured with a single anodal ring in the ventricular connector channel. We conclude that: this unique form of cross-talk is "design-dependent" and occurs only in Gemini 415As with dual interconnected anodal rings and cannot occur in 415As manufactured with a single anodal ring; this form of cross-talk has occurred only in 415As with non-Cordis leads and appears to be a time-dependent development; reduction of the atrial output or use of pacing modes without atrial pacing or ventricular sensing can prevent cross-talk.(ABSTRACT TRUNCATED AT 250 WORDS)

Bradycardia↗
PubMed1980

Isolation, subunit composition, and site of synthesis of human cytochrome c oxidase.

Cytochrome c oxidase (ferrocytochrome c:oxygen oxidoreductase, EC 1.9.3.1), the terminal oxidase of the respiratory chain in eucaryotic cells, has been purified from human placenta mitochondria. Seven polypeptides have been identified reproducibly by high-resolution electrophoresis of the enzyme complex through sodium dodecyl sulfate (Na-DodSO4)--urea polyacrylamide gels; these correspond closely in size to the subunits of beef heart cytochrome c oxidase. When HeLa cells, grown in suspension culture, were pulse-labeled with [35S]methionine in the presence of cycloheximide to inhibit cytoplasmic protein synthesis and chased with an excess of unlabeled methionine in the absence of the drug, the mitochondrially synthesized polypeptides were resolved into at least 17 components by NaDodSO4--urea polyacrylamide gel electrophoresis. After labeled HeLa mitochondria were mixed with human placenta mitochondria and the cytochrome c oxidase was isolated, three of the labeled components were found to copurify with the three largest subunits of the complex. We conclude that human cytochrome c oxidase contains seven subunits, the three largest of which are synthesized on mitochondrial ribosomes, while the other four are synthesized in the cytoplasm.

Electron Transport Complex IV↗