419 research outputs found

    Sindrom Lutembacher Sebuah Penilaian ekhokardiografi

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    Lutembacher’s syndrome (LS), consisted of Atrial Septal Defect(ASD) and Mitral Stenosis (MS), is a very rare form of cardiac anomaly. Rene Lutembacher’s first described this syndrome in 1916. Currently, any combination of ASD, congenital or iatrogenic and MS, acquired or congenital is referred as LS.By using echocardiography, the hemodynamic of LS could be assesed. Pathophysiologically, the hemodynamic of ASD is related to the magnitude and direction of shunting across the interatrial communication. The determinants of the amount of shunting are the defect size and theventricles relative resistance to inflow. In MS, the restricted in?low leads to increased diastolic pressures in the left ventricle. This resulted in marked accentuation of the left-to-right shunt.We reported a case of a 34 years old female, first came to Harapan Kita National Cardiac Center, in 2010. She was diagnosed with LS, and was planned to have ASD closure and mitral valve repair by surgery. However, she refused to undertake the procedure. In summary, to illustrate the interactions between ASD and MS, the presence of ASD underestimated the severi?y of MS; meanwhile the existence of MS magnified the left to right shunt in patients with ASD.Sindrom Lutembacher (SL), terdiri dari Atrial Septal Defek (ASD) dan Mitral Stenosis (MS), adalah suatu bentuk kelainan jantung yang langka. Rene Lutembacher pertama kali menjabarkan sindrom ini pada tahun 1916. Saat ini, semua kombinasi dari ASD ataupun MS, baik kongenital maupun didapat, diartikan sebagai SL. Dengan menggunakan ekhokardiografi, hemodinamik sindrom ini dapat dinilai. Secara patofisiologis, hemodinamik dari ASD tergantung dari besarnya defek dan aliran darah yang melalui komunikasi interatrial tersebut. Penentu dari jumlah aliran yang melewati defek adalah ukuran dari defek dan resistensi relatif dari aliran yang masuk ke ventrikel kiri. Pada MS, aliran masuk ke ventrikel kiri yang terestriksi menyebabkan peningkatan tekanan diastolik di ventrikel kiri. Hal ini menyebabkan peningkatan aliran dari kiri ke kanan yang berrmakna (left to right shunt). Kami melaporkan sebuah kasus, seorang wanita berusia 34 tahun yang berobat ke Pusat Jantung Nasional Harapan Kita pada 2010. Pasien didiagnosis dengan SL dan ditawarkan untuk dilakukan penutupan defek ASD dan perbaikan katup mitral secara operasi. Namun, pasien menolak prosedur tersebut. Sebagai ringkasan, untuk menggambarkan interaksi antara ASD dan MS, kehadiran dari ASD meringankan gejala yang dit-imbulkan oleh MS; sementara keberadaan MS akan semakin meningkatkan aliran left to right shunt

    Pengembangan virtual laboratory pada materi metabolisme sebagai alternatif kegiatan praktikum siswa kelas XII SMA/MA

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    Media pembelajaran berperan penting dalam membantu pencapaian kompetensi pembelajaran, salah satunya adalah keterampilan. Pelaksanaan kegiatan praktikum penting dilaksanakan untuk mencapai kompetensi keterampilan siswa, namun kenyataanya sering terkendala sarana dan waktu. Guna menjawab permasalahan tersebut peneliti mengembangkan Virtual Laboratory bernama META Labs. Penelitian ini bertujuan untuk mendeskripskan hasil pengembangan dan menyajikan tingkat kelayakan Virtual laboratry pada materi metabolisme. Produk ini dapat digunakan sebagai alternatif pengganti kegiatan praktikum metabolisme jika mengalami kendala waktu dan sarana serta sebagai bahan belajar mandiri siswa. Jenis penelitian pengembangan ini menggunakan model ADDIE yang terdiri dari tahap analisis, desain, pengembangan, implementasi dan evaluasi. Data diperoleh melalui wawancara dan angket. Subjek penelitian ini terdiri dari Guru biologi dan 30 siswa kelas XII MAN Kendal. META Labs merupakan media alternatif pengganti praktikum yang dapat diinstal pada perangkat android dan windows. Hasil validasi META Labs yang dikembangkan oleh ahli media mendapatkan hasil sebesar 84% dengan kategori sangat layak, sedangkan ahli materi sebesar 84% dengan kategori sangat layak. Berdasarkan penilaian guru terhadap META Labs memperoleh hasil sebesar 89% dengan kategori sangat layak, sedangkan tanggapan siswa memperoleh hasil sebesar 86% dengan kategori sangat layak. Jika keseluruhan hasil di rata-rata maka diperoleh hasil sebesar 85,75%. Sehingga dapat diambil kesimpulan bahwa META Labs tergolong sangat layak untuk digunakan sebagai alternatif kegiatan praktikum dalam pembelajaran

    Follicular and endocrine dose responses according to anti-Müllerian hormone levels in IVF patients treated with a novel human recombinant FSH (FE 999049)

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    Objective: To study the association between serum anti-Mullerian hormone (AMH) levels and follicular development and endocrine responses induced by increasing doses (5.2-12.1 mu g/day) of a novel recombinant human FSH (rhFSH, FE 999049) in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a GnRH antagonist protocol. Design: Secondary analysis of a randomized controlled trial with stratified randomization according to AMH (lower stratum: 5.0-14.9 pmol/l; higher stratum: 15.0-44.9 pmol/l). Patients: Infertile women of good prognosis (n = 265). Measurements: Follicular development and endocrine parameters during controlled ovarian stimulation (COS) with rhFSH. Results: Serum FSH levels increased with increasing rhFSH doses and steady-state levels for each dose were similar in both AMH strata. In the whole study population, significant (P = 12 mm, and serum levels of oestradiol, inhibin B, inhibin A and progesterone at end of stimulation. In comparison with the higher AMH stratum, patients in the lower AMH stratum had significantly different slopes of the dose-response curves for these hormones, and no clear dose-related increase was observed for the number of follicles in these patients. Conclusions: Dose-response relationships between rhFSH and follicular development and endocrine parameters are significantly different for IVF/ICSI patients with lower and higher serum AMH levels at start of COS

    A European multicentre prospective randomized study to assess the use of assisted hatching with a diode laser and the benefit of an immunosuppressive/antibiotic treatment in different patient populations

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    BACKGROUND: Assisted hatching (AH) techniques, designed for facilitating the embryo escape out of the zona pellucida (ZP) have been used in IVF centres since 1992. The initial indications for AH were patient's age, ZP thickness, high basal FSH and repeated IVF failures. Several retrospective and prospective studies assessing AH in these indications have given disparate results. Our aims were to evaluate the benefits of AH and immunosuppressive/antibiotic treatment (IA) in patients with either a poor prognosis of success, previous implantation failures or transfers of cryopreserved embryos. METHODS: Four IVF centres allocated 426 patients, randomized for AH and IA, into four groups of AH indications between 1997 and 1999. AH was performed with a diode laser. ZP thickness, opening size and embryo score were recorded. Outcome measures were implantation and delivery rates. RESULTS: Patients coming for a first or third transfer of cryopreserved embryos and poor prognosis patients admitted for a first trial did not benefit from AH. Even patients with repeated implantation failures of fresh embryos did not gain significantly from AH. CONCLUSIONS: Among AH indications, absence of implantation after several transfers of good quality embryos remains the strongest patient selection criterion. Prescription of an immunosuppressive/antibiotic treatment is essentia

    The Effectiveness of Dramatic Role-Playing on the Linguistic Achievement and the Development of Verbal Expressive Performance among the Basic 4th Grade Students in Jordan

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    This study aimed at examining the effectiveness of the dramatic role- playing upon the linguistic achievement and the development of verbal expressive performance among the basic 4th grade students in Jordan. To achieve the aims of the study, a linguistic patterns achievement test and the verbal expressive performance checklist were used. The sample of the study consisted of (52) 4th grade students from a school that was purposefully selected from public school of Al- Zarqa educational district. The sample was randomly distributed into two groups. The experimental group consisted of (25) students who were taught by             ) dramatic role- playing methods, and the control group consisted of 27( students who were taught by the conventional methods. The results indicated that there were statistically significant differences between the two groups in the linguistic pattern achievement test and the verbal expressive performance checklist in the favor of the experimental group. Key words: Dramatic, Role-playing, Linguistic Achievement, Verbal Expressive Performance

    Sinking seaweed in the deep ocean for carbon neutrality is ahead of science and beyond the ethics

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    Unidad de excelencia María de Maeztu CEX2019-000940-MSinking vast amounts of seaweed in the deep ocean is currently being proposed as a promising ocean carbon dioxide removal strategy as well as a natural-based solution to mitigate climate change. Still, marketable carbon offsets through large-scale seaweed sinking in the deep ocean lack documentation and could involve unintended environmental and social consequences. Managing the risks requires a number of urgent actions

    From component reduced models to reduced modelling of multi-component systems

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    The present work focuses on the reduced modelling of multi-component systems, in particular on a two stages stamping chain process. Starting from snapshots collected by using the commercial software PAM-STAMP, the non-intrusive sparse-PGD constructor is used in order to build a parametric transfer function of each operation in a separated representation, circumventing the problem of the curse of dimensionality. Moreover, in order to fill the gap between this deterministic solution and the measured fields and safely applied control strategies, data driven-modeling can be employed according to the new “hybrid twin” methodology

    Groundwater and nutrient discharge through karstic coastal springs (Castelló, Spain)

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    Altres ajuts: Support from the Fulbright Commission for a post-doctoral fellowship to J.G-O. (ref 2007-0516) is gratefully acknowledged. Support for the research of PM was received through the prize ICREA Academia, funded by the Generalitat de Catalunya.Discharge of groundwater and associated chemical compounds into coastal karstic regions, which are abundant in the Mediterranean basin, is envisaged to be significant. In this study, we evaluate the groundwater discharge and its nutrient load to the open karstic site of Badum (Castelló, East Spain). Salinity profiles evidenced that groundwater discharge from coastal brackish springs causes a buoyant fresher layer, as identified with thermal infrared images. Chemical tracers (radium isotopes, dissolved inorganic silicate and seawater major elements) have been used to determine a brackish groundwater proportion in coastal waters of 36% in October 2006 and 44% in June 2007. Based on a radium-derived residence time of 2.7 days in October 2006 and 2.0 days in June 2007, total SGD fluxes have been estimated in 71 500 and 187 000m³ d⁻¹, respectively, with fresh-SGD contributions representing 71% and 85%. The calculated SGD-associated nutrient fluxes, most likely of natural origin, were 1500 and 8300 μmolm⁻² d⁻¹ of DIN and 19 and 40 μmolm⁻² d⁻¹ of DIP in October 2006 and June 2007, respectively. These inputs may actually lead to or enhance P limitation, thereby altering the structure of biological communities in the area

    Fragments of the nonlytic proline-rich antimicrobial peptide Bac5 kill Escherichia coli cells by inhibiting protein synthesis

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    Unlike most antimicrobial peptides (AMPs), the main mode of action of the subclass of proline-rich antimicrobial peptides (PrAMPs) is not based on disruption of the bacterial membrane. Instead, PrAMPs exploit the inner membrane transporters SbmA and YjiL/MdtM to pass through the bacterial membrane and enter the cytosol of specific Gram-negative bacteria, where they exert an inhibitory effect on protein synthesis. Despite sharing a high proline and arginine content with other characterized PrAMPs, the PrAMP Bac5 has a low sequence identity with them. Here we investigated the mode of action of three N-terminal Bac5 fragments, Bac5(1-15), Bac5(1-25), and Bac5(1-31). We show that Bac5(1-25) and Bac5(1-31) retained excellent antimicrobial activity toward Escherichia coli and low toxicity toward eukaryotic cells, whereas Bac5(1-15) was inactive. Bac5(1-25) and Bac5(1-31) inhibited bacterial protein synthesis in vitro and in vivo. Competition assays suggested that the binding site of Bac5 is within the ribosomal tunnel, where it prevents the transition from the initiation to the elongation phase of translation, as reported for other PrAMPs, such as the bovine PrAMP Bac7. Surprisingly, unlike Bac7, Bac5(1-25) exhibited speciesspecific inhibition, being an excellent inhibitor of protein synthesis on E. coli ribosomes but a poor inhibitor on Thermus thermophilus ribosomes. This indicates that while Bac5 most likely has an overlapping binding site with Bac7, the mode of interaction is distinct, suggesting that Bac5 fragments may be interesting alternative lead compounds for the development of new antimicrobial agents
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