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Biomedical subjects

P Fan

Publications and source records attributed to P Fan.

130 records · Page 8Linked to original sources

Influence of longer term left ventricular assist device support on valvular regurgitation.

The authors previously published data that describe acute alterations in ventricular dimensions and in the severity of mitral and tricuspid regurgitation (MR/TR) after initiation of left ventricular assist device (LVAD) pumping. In the current study, measurements of ventricular size and regurgitant jet area acquired after LVAD implantation are presented. Eight patients had LVAD implanted pending cardiac transplantation (duration of assist 70-279 days; mean, 162 +/- 29 days). Echocardiograms were obtained at the time of LVAD implant and later during LVAD support (mean time for late echo, 95 +/- 32 days post-implant). Comparisons of pre-implant with late post-implant data showed: increased TR jet area (4.8 +/- 1.0 cm2 vs. 8.0 +/- 1.7 cm2 P < 0.05); increased right ventricular (RV) end-systolic dimension (31 +/- 4 vs 40 +/- 5 mm, P < 0.05); and increased RV end-diastolic dimension (35 +/- 4 vs. 45 +/- 5 mm, P < 0.065). Decreased MR jet area and decreased LV dimensions (P < 0.05) also were noted on comparison of pre-implant and late post-implant data. There were no significant differences between any immediate post-implant and late post-implant echocardiographic measurements. No patient had clinical evidence of RV failure. LV mechanical assist causes an acute increase in TR, presumably by volume loading the RV. TR and RV enlargement persisted but did not discernibly worsen on subsequent post-implant echocardiograms. LV dimensions and MR remained less than the pre-implant values on later post-implant determinations.

Alkaline Phosphatase↗

Popliteal cyst involvement with gonococcal arthritis-dermatitis syndrome.

The gonococcal arthritis-dermatitis syndrome includes tenosynovitis, arthralgias, arthritis, skin lesions, and constitutional symptoms. A patient with popliteal cyst involvement and gonococcal arthritis-dermatitis syndrome is the subject of this report. The detection of areas of involvement by the use of gallium-67 citrate, 99m-technetium phosphate, and indium-111-labeled granulocytes is also detailed.

Arthritis, Infectious↗

Load fatigue of five restoration modalities in structurally compromised premolars.

Twenty-five freshly extracted maxillary first premolars were divided equally among five modalities for rebuilding structurally compromised premolars. These modalities were: (A) buccal stainless steel Parapost/amalgam core, (B) palatal stainless steel parapost/amalgam core, (C) two stainless steel Paraposts/amalgam core, (D) two regular Link Plus TMS single-shear Minim pins/amalgam core, and (E) palatal cast gold post and core. Load fatigue was used as the testing protocol, using a 5.2-kg load applied at 72 cycles per minute. Each tooth was prepared with a 1.0-mm ferrule, and an upper limit of 250,000 load cycles was set for the testing. Two failures were exhibited, (1) preliminary failure which involved a crack in the luting cement layer, and (2) catastrophic failure wherein the core and crown separated from the root section. Statistical analysis using Kruskal-Wallis test showed three subsets (P < or = .05). The subset with the highest number of load cycles to failure contained the palatal stainless steel post/amalgam core, two stainless steel Paraposts/amalgam core, and palatal cast gold post and core.

Bicuspid↗

Effect of stent on radiation dosimetry in an in-stent restenosis model.

PURPOSE: Intravascular brachytherapy is the leading modality being evaluated for treatment of in-stent restenosis. Stent struts may have an effect on the dose distributions of various radiation sources. We evaluated dosimetry in a stented coronary artery model using a variety of beta and gamma sources and stent materials. METHODS: We determined the dose distributions with and without stent in the in-stent restenosis model. Three beta-particle emitting radionuclides, 90Y (2.3 MeV), 144Pr (3.0 MeV), and 106Rh (3.5 MeV), and two gamma-ray emitters, 192Ir (380 keV) and 125I (30 keV), were studied. Stent materials included stainless steel, nitinol, and tantalum. Monte Carlo dose calculations were performed in a stent model of multiple stent struts placed at 1.5 mm from the source. Isodose curves were generated and the ratios of dose rates with and without stent, the stent factors, were evaluated. A stent factor of greater or less than unity represents dose enhancement or reduction in the presence of a stent. RESULTS: For the three beta radionuclides, dose reduction was found on the adventitial side of the stent strut and dose enhancement was noted on the luminal side. On the luminal side, the maximum dose enhancement ranges from 7% to 29%, and the dose reduction on the adventitial side ranges from 13% to 43%. Both the reduction and enhancement effects were most pronounced for the high atomic number material, tantalum. For a given stent material, the dose reduction and enhancement are similar for the three beta radionuclides. For the gamma sources, the stent had no effect for the high-energy 192Ir, but for the low-energy 125I, drastic dose reduction on the adventitial side was observed (up to 86% for tantalum stent), and about 10% dose enhancement on the luminal side was also noted. The dose reduction with 125I was more pronounced than that seen with the beta sources. CONCLUSIONS: The presence of stent struts significantly affects dose distributions of 90Y, 106Rh, 144Pr, and 125I. The maximum dose reduction can be as much as 86%. 192Ir was unaffected. These factors need to be considered in choosing radionuclides and dose prescriptions in treating in-stent restenosis.

Brachytherapy↗