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1.
J Korean Med Sci ; 39(23): e179, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38887200

RESUMO

BACKGROUND: This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss. METHODS: Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires. RESULTS: Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire. CONCLUSION: While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.


Assuntos
Estudos Cross-Over , Auxiliares de Audição , Perda Auditiva Unilateral , Percepção da Fala , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Perda Auditiva Unilateral/reabilitação , Idoso , Adulto , Satisfação do Paciente , Ruído , Razão Sinal-Ruído
2.
Sensors (Basel) ; 24(2)2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38257660

RESUMO

This paper presents the design of a low-noise amplifier (LNA) with a bypass mode for the n77/79 bands in 5G New Radio (NR). The proposed LNA integrates internal matching networks for both input and output, combining two LNAs for the n77 and n79 bands into a single chip. Additionally, a bypass mode is integrated to accommodate the flexible operation of the receiving system in response to varying input signal levels. For each frequency band, we designed a low-noise amplifier for the n77 band to expand the bandwidth to 900 MHz (3.3 GHz to 4.2 GHz) using resistive-capacitance (RC) feedback and series inductive-peaking techniques. For the n79 band, only the RC feedback technique was employed to optimize the performance of the LNA for its 600 MHz bandwidth (4.4 GHz to 5.0 GHz). Because wideband techniques can lead to a trade-off between gain and noise, causing potential degradation in noise performance, appropriate bandwidth design becomes crucial. The designed n77 band low-noise amplifier achieved a simulated gain of 22.6 dB and a noise figure of 1.7 dB. Similarly, the n79 band exhibited a gain of 21.1 dB and a noise figure of 1.5 dB with a current consumption of 10 mA at a 1.2 supply voltage. The bypass mode was designed with S21 of -3.7 dB and -5.0 dB for n77 and n79, respectively.

3.
Nano Lett ; 23(10): 4557-4563, 2023 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-37154863

RESUMO

Topological textures of ferroelectric polarizations have promise as alternative devices for future information technology. A polarization rotation inevitably deviates from the stable orientation in axial ferroelectrics, but local energy losses compromise the global symmetry, resulting in a distorted shape of the topological vortex or inhibiting the vortex. Easy planar isotropy helps to promote rotating structures and, accordingly, to facilitate access to nontrivial textures. Here, we investigate the domain structure of an epitaxial thin film of bismuth tungsten oxide (Bi2WO6) grown on a (001) SrTiO3 substrate. By using angle-resolved piezoresponse force microscopy and scanning transmission electron microscopy, we find the existence of a hidden phase with ⟨100⟩-oriented ferroelectric polarizations in the middle of the four variant ⟨110⟩-oriented polarization domains, which assists in the formation of flux closure domains. The results suggest that this material is one step closer to becoming an isotropic two-dimensional polar material.

4.
Medicina (Kaunas) ; 60(6)2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38929619

RESUMO

Background and Objectives: Cervical radiculopathy (CR) manifests as pain and sensorimotor disturbances in the upper extremities, often resulting from nerve root compression due to intervertebral disc herniation, degenerative changes, or trauma. While conservative treatments are initially preferred, persistent or severe cases may require surgical intervention. Ultrasound-guided selective nerve root block (SNRB) has emerged as a promising intervention for alleviating symptoms and potentially obviating the need for surgery. This study evaluates the therapeutic efficacy of ultrasound-guided SNRB in managing chronic CR, aiming to determine its potential in symptom relief and delaying or avoiding surgical procedures. Materials and Methods: A retrospective analysis was conducted on 720 outpatients treated for CR between October 2019 and March 2022. After excluding patients with traumatic CR, previous surgeries, malignancies, progressive neurological symptoms requiring immediate surgery, or inadequate conservative treatment, 92 patients who had experienced cervical radicular pain for more than three months and had failed to improve after more than six weeks of conservative treatment with VAS scores ≥ 5 were included. The patients underwent single or multiple ultrasound-guided SNRB procedures, involving the injection of dexamethasone and lidocaine under real-time ultrasound guidance. Symptom severity was assessed at the baseline, and at 4, 8, and 12 weeks post-procedure using the Visual Analog Scale (VAS). The data collected included age, sex, presence of neck and/or radicular pain, physical examination findings, recurrence of symptoms, improvement in symptoms, and whether surgical intervention was ultimately required. Statistical analyses were performed to identify the factors associated with symptom improvement or recurrence. Results: Significant symptom improvement was observed in 69 (75.0%) participants post-SNRB, with 55 (79.7%) showing improvement at 4 weeks, 11 (15.9%) at 8 weeks, and 3 (4.4%) at 12 weeks. Symptom recurrence, defined by an increase in VAS score accompanied by a pain flare lasting at least 24 h after a pain-free interval of at least one month, was noted in 48 (52.2%) patients. The presence of combined neck and radicular pain was a significant predictor of recurrence (p = 0.008). No significant associations were found between symptom relief and factors such as age, gender, initial pain severity, or MRI findings. Conclusions: Ultrasound-guided SNRB effectively manages chronic CR, providing substantial symptom relief and potentially reducing the need for surgical intervention. This technique offers a promising conservative treatment option, especially given its real-time visualization advantages and minimal radiation exposure.


Assuntos
Bloqueio Nervoso , Radiculopatia , Ultrassonografia de Intervenção , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Radiculopatia/tratamento farmacológico , Estudos Retrospectivos , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Adulto , Resultado do Tratamento , Medição da Dor/métodos , Idoso , Lidocaína/administração & dosagem , Lidocaína/uso terapêutico , Doença Crônica , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico
5.
Angew Chem Int Ed Engl ; 63(12): e202319707, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38294268

RESUMO

Fast charging technology for electric vehicles (EVs), offering rapid charging times similar to conventional vehicle refueling, holds promise but faces obstacles owing to kinetic issues within lithium-ion batteries (LIBs). Specifically, the significance of cathode materials in fast charging has grown because Ni-rich cathodes are employed to enhance the energy density of LIBs. Herein, the mechanism behind the loss of fast charging capability of Ni-rich cathodes during extended cycling is investigated through a comparative analysis of Ni-rich cathodes with different microstructures. The results revealed that microcracks and the resultant cathode deterioration significantly compromised the fast charging capability over extended cycling. When thick rocksalt impurity phases form throughout the particles owing to electrolyte infiltration via microcracks, the limited kinetics of Li+ ions create electrochemically unreactive areas under high-current conditions, resulting in the loss of fast charging capability. Hence, preventing microcrack formation by tailoring microstructures is essential to ensure stability in fast charging capability. Understanding the relationship between microcracks and the loss of fast charging capability is essential for developing Ni-rich cathodes that facilitate stable fast charging upon extended cycling, thereby promoting widespread EV adoption.

6.
Am J Physiol Heart Circ Physiol ; 325(1): H149-H162, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37204873

RESUMO

Patients with two congenital heart diseases (CHDs), Ebstein's anomaly (EA) and left ventricular noncompaction (LVNC), suffer higher morbidity than either CHD alone. The genetic etiology and pathogenesis of combined EA/LVNC remain largely unknown. We investigated a familial EA/LVNC case associated with a variant (p.R237C) in the gene encoding Kelch-like protein 26 (KLHL26) by differentiating induced pluripotent stem cells (iPSCs) generated from affected and unaffected family members into cardiomyocytes (iPSC-CMs) and assessing iPSC-CM morphology, function, gene expression, and protein abundance. Compared with unaffected iPSC-CMs, CMs containing the KLHL26 (p.R237C) variant exhibited aberrant morphology including distended endo(sarco)plasmic reticulum (ER/SR) and dysmorphic mitochondria and aberrant function that included decreased contractions per minute, altered calcium transients, and increased proliferation. Pathway enrichment analyses based on RNASeq data indicated that the "structural constituent of muscle" pathway was suppressed, whereas the "ER lumen" pathway was activated. Taken together, these findings suggest that iPSC-CMs containing this KLHL26 (p.R237C) variant develop dysregulated ER/SR, calcium signaling, contractility, and proliferation.NEW & NOTEWORTHY We demonstrate here that iPSCs derived from patients with Ebstein's anomaly and left ventricular noncompaction, when differentiated into cardiomyocytes, display significant structural and functional changes that offer insight into disease pathogenesis, including altered ER/SR and mitochondrial morphology, contractility, and calcium signaling.


Assuntos
Anomalia de Ebstein , Células-Tronco Pluripotentes Induzidas , Humanos , Anomalia de Ebstein/genética , Anomalia de Ebstein/metabolismo , Anomalia de Ebstein/patologia , Células-Tronco Pluripotentes Induzidas/metabolismo , Miócitos Cardíacos/metabolismo , Diferenciação Celular , Sinalização do Cálcio
7.
J Clin Periodontol ; 50(4): 440-451, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36415182

RESUMO

AIM: The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. We investigate the effect of periodontitis on the incidence of fungal sinusitis over a 12-year follow-up period using nationwide population-based data. MATERIALS AND METHODS: The periodontitis group was randomly selected from the National Health Insurance Service database. The non-periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls (SFBs) and invasive fungal sinusitis (IFS). RESULTS: The periodontitis and non-periodontitis groups included 12,442 and 12,442 individuals, respectively. The overall adjusted hazard ratio (aHR) for SFBs in the periodontitis group was 1.46 (p = .002). In subgroup analysis, the aHR for SFBs was 1.59 (p = 0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p = .022) for those with underlying atopic dermatitis, 1.48 (p = .019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p = .030) for those with diabetes mellitus (DM), but these values are applicable only when considering the relationship between periodontitis and SFB. The aHR for IFS in the periodontitis group was higher than in the non-periodontitis group (2.80; p = .004). CONCLUSIONS: The risk of SFBs and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is applicable only when considering the association between periodontitis and fungal sinusitis.


Assuntos
Diabetes Mellitus , Micoses , Periodontite , Insuficiência Renal Crônica , Sinusite , Humanos , Seguimentos , Sinusite/complicações , Sinusite/microbiologia , Micoses/complicações , Micoses/epidemiologia , Diabetes Mellitus/epidemiologia , Periodontite/complicações , Insuficiência Renal Crônica/complicações , Estudos Retrospectivos , Fatores de Risco
8.
Perfusion ; 38(5): 1037-1044, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35678471

RESUMO

BACKGROUND: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) remains controversial in trauma patients with acute respiratory distress syndrome (ARDS). Here, we aimed to investigate the therapeutic benefits of VV ECMO and the factors affecting patient outcomes. METHODS: From 2017 to 2019, 21/1938 trauma patients (median age: 47 years; 18 men) at a level I trauma center received VV ECMO for post-traumatic ARDS. Demographic, injury-specific, ECMO, and outcome data were prospectively collected and retrospectively reviewed to analyze the factors affecting hospital mortality and ECMO results. RESULTS: 19 patients (90.5%) were successfully weaned off ECMO; 16 patients (76.2%) survived to discharge. In univariate analysis, there was a significant difference in survival between the groups with a Trauma and Injury Severity Score (TRISS) ⩾0.5 and TRISS <0.5 (p = 0.05). The area under the receiver operating characteristic curve (AUC) for both TRISS and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) scores for death was 0.78. In those who failed ECMO weaning, the AUCs of the TRISS and RESP scores were 0.90 and 0.80, respectively. CONCLUSIONS: In patients with ARDS caused by severe trauma and supported by VV ECMO, survival is associated with TRISS; TRISS and RESP scores may be predictive of mortality and failure in ECMO weaning.


Assuntos
Oxigenação por Membrana Extracorpórea , Síndrome do Desconforto Respiratório , Masculino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Oxigenação por Membrana Extracorpórea/métodos , Síndrome do Desconforto Respiratório/terapia , Mortalidade Hospitalar , Curva ROC
9.
Sensors (Basel) ; 23(13)2023 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-37447658

RESUMO

This paper presents a low-noise amplifier (LNA) with an integrated input and output matching network designed using RF-SOI technology. This LNA was designed with a resistive feedback topology and an inductive peaking technology to provide 600 MHz of bandwidth in the N79 band (4.4 GHz to 5.0 GHz). Generally, the resistive feedback structure used in broadband applications allows the input and output impedance to be made to satisfy the broadband conditions through low-impedance feedback. However, feedback impedance for excessive broadband characteristics can degrade the noise performance as a consequence. To achieve a better noise performance for a bandwidth of 600 MHz, the paper provided an optimized noise performance by selecting the feedback resistor value optimized for the N79 band. Additionally, an inductive peaking technique was applied to the designed low-noise amplifier to achieve a better optimized output matching network. The designed low-noise amplifier simulated a gain of 20.68 dB and 19.94 dB from 4.4 to 5.0 GHz, with noise figures of 1.57 dB and 1.73 dB, respectively. The input and output matching networks were also integrated, and the power consumption was designed to be 9.95 mA at a supply voltage of 1.2 V.


Assuntos
Amplificadores Eletrônicos , Tecnologia , Retroalimentação , Ruído , Impedância Elétrica
10.
J Vasc Surg ; 76(1): 122-131, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34954270

RESUMO

OBJECTIVE: Open or endovascular repair of abdominal aortic aneurysms (AAAs) can involve sacrifice of the internal iliac artery (IIA). In the present study, we investigated the effect of IIA exclusion on ischemic complications and overall mortality. METHODS: The data from 326 patients who had undergone elective open surgical or endovascular treatment of a nonruptured AAA from January 2010 to December 2019 in a tertiary hospital were retrospectively reviewed. Ischemic complications included buttock claudication, spinal ischemia (including paraparesis), ischemic colitis, lower limb paresthesia, and skin necrosis. Their duration and mortality during the study period were investigated. RESULTS: Nearly 50% of patients (148; 45.4%) had undergone endovascular aortic aneurysm repair and 178 (54.6%) had undergone open surgery. The median patient age was 78 years (range, 31-94 years). The median follow-up period was 1140 days (range, 0-4757 days). Of the 326 patients, 50 (15.3%) had died during follow-up. The bilateral IIAs were preserved in 187 patients (57.4%), a single IIA in 86 patients (26.4%), and no IIA in 53 patients (16.3%). Ischemic complications occurred in 57 patients (17.5%). Multivariable analysis revealed failure to preserve the bilateral IIAs (hazard ratio [HR], 8.65; 95% confidence interval [CI], 4.31-17.36; P < .01), management of the IIA (HR, 3.05, 95% CI, 2.17-4.28; P < .01), and hyperlipidemia (HR, 2.09; 95% CI, 1.04-4.17; P = .04) affected the occurrence of ischemic complications. Furthermore, univariable analysis revealed that patients had experienced more ischemic complications when a single IIA (HR, 6.97; 95% CI, 3.74-13.02; P < .01) or none of the IIAs had been preserved (HR, 8.88; 95% CI, 4.12-19.16; P < .01) than when both IIAs were preserved. Moreover, multivariable analysis revealed that stage 5 chronic kidney disease (HR, 2.7; 95% CI, 1.09-6.14; P = .03), age >75 years (HR, 2.48; 95% CI, 1.12-5.49; P = .03), cerebrovascular accident (HR, 1.95; 95% CI, 1.00-3.78; P = .05), and failure to preserve the bilateral IIAs (HR, 1.91; 95% CI, 1.02-3.46; P = .04) were associated with higher mortality after AAA repair. CONCLUSIONS: IIA exclusion is a risk factor for ischemic complications and overall mortality. Thus, preservation of the IIA as much as possible during AAA repair is recommended.


Assuntos
Aneurisma da Aorta Abdominal , Implante de Prótese Vascular , Procedimentos Endovasculares , Aneurisma Ilíaco , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Humanos , Aneurisma Ilíaco/cirurgia , Artéria Ilíaca/cirurgia , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
11.
Sensors (Basel) ; 22(22)2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36433461

RESUMO

Broadband wavelength-swept lasers (WSLs) are widely used as light sources in biophotonics and optical fiber sensors. Herein, we present a polygonal mirror scanning wavelength filter (PMSWF)-based broadband WSL using two semiconductor optical amplifiers (SOAs) with different center wavelengths as the gain medium. The 10-dB bandwidth of the wavelength scanning range with 3.6 kHz scanning frequency was approximately 223 nm, from 1129 nm to 1352 nm. When the scanning frequency of the WSL was increased, the intensity and bandwidth decreased. The main reason for this is that the laser oscillation time becomes insufficient as the scanning frequency increases. We analyzed the intensity and bandwidth decrease according to the increase in the scanning frequency in the WSL through the concept of saturation limit frequency. In addition, optical alignment is important for realizing broadband WSLs. The optimal condition can be determined by analyzing the beam alignment according to the position of the diffraction grating and the lenses in the PMSWF. This broadband WSL is specially expected to be used as a light source in broadband distributed dynamic FBG fiber-optic sensors.

12.
Sensors (Basel) ; 22(15)2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35957311

RESUMO

Cholesteric liquid crystals (CLCs) can be applied to various physical and chemical sensors because their alignment structures are changed by external stimuli. Here, we propose a CLC device fabricated by vertically forming the helical axis of the CLC between the cross-sections of two optical fiber ferrules. An optical fiber temperature sensor was successfully implemented using the proposed optical fiber ferrule-based CLC device. A wideband wavelength-swept laser with a center wavelength of 1073 nm and scanning range of 220 nm was used as a light source to measure the variations in the reflection spectrum band according to the temperature change in the CLC cell. The wavelength variation of the reflection spectrum band according to the temperature applied to the CLC cell was reversible and changed linearly with a change in the temperature, and the long-wavelength edge variation rate according to the temperature change was -5.0 nm/°C. Additionally, as the temperature applied to the CLC cell increased, the reflection spectrum bandwidth gradually decreased; the reflection spectrum bandwidth varied at a rate of -1.89 nm/°C. The variations in the refractive indices with temperature were calculated from the band wavelengths of the reflection spectrum. The pitch at each temperature was calculated based on the refractive indices and it gradually decreased as the temperature increased.

13.
Ann Vasc Surg ; 71: 257-263, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32659416

RESUMO

BACKGROUND: Compared with conventional bilateral femoral (BF) approach, radial plus ipsilateral femoral (RF) approach may be feasible in the percutaneous intervention for iliac artery chronic total occlusion (CTO). METHODS: We included patients who underwent iliac CTO intervention between August 2009 and July 2018 in a tertiary referral center in Korea. RESULTS: A total of 83 patients were enrolled in this study. Of them, 51 and 32 patients were categorized into RF and BF initial access groups, respectively. The overall success rates were 98.0% and 96.7% in RF and BF group, respectively, and the techniques were also similar including use of bilateral wiring, stent type and profile, and post balloon but longer procedure time in the BF group. Additional contralateral femoral access was needed in 6 patients for the treatment of contralateral lesions, distal embolization, and due to tortuous right subclavian artery. Periprocedural complications including vascular injury, iliac perforation, and distal embolization occurred similarly in both groups with numerically lower rate of periprocedural bleeding in the RF group (9.8%) than in the BF group (21.9%). Clinical follow-up at 6 months showed there were no difference in the rates of death, cardiovascular death, target-limb reintervention, and unplanned target limb amputation in both groups. CONCLUSIONS: RF approach for iliac CTO intervention was related to similar technical success rate with acceptable periprocedural safety outcomes compared with conventional BF approach.


Assuntos
Cateterismo Periférico , Procedimentos Endovasculares , Artéria Femoral , Artéria Ilíaca , Doença Arterial Periférica/terapia , Artéria Radial , Idoso , Idoso de 80 Anos ou mais , Cateterismo Periférico/efeitos adversos , Doença Crônica , Constrição Patológica , Procedimentos Endovasculares/efeitos adversos , Estudos de Viabilidade , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Punções , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular
14.
Knee Surg Sports Traumatol Arthrosc ; 29(12): 3921-3928, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33095333

RESUMO

PURPOSE: Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who required revision surgeries at early and late periods after failed arthroscopic rotator cuff repair, and to identify clinical and radiological differences related to the timing of revision surgery. METHODS: Sixty patients who underwent revision surgery due to symptomatic failed rotator cuff repair after arthroscopic repair were included. Patients were divided into two groups: patients who underwent revision surgeries within 1 year postoperatively (21 patients, group I) and patients who underwent revision surgeries more than 1 year postoperatively (39 patients, group II). Clinical and radiological characteristics were compared between the two groups before primary and revision surgery. RESULTS: VAS for pain (5.9 ± 1.9 in group I, 3.9 ± 1.4 in group II, P < 0.001) and Constant score (50.7 ± 9.9 in group I, 60.4 ± 8.9 in group II, P < 0.001) at the time of revision surgery were significantly different between the two groups. In group II, isometric muscle strength of forward flexion (74.1 ± 21.1 to 63.9 ± 15.1, P = 0.020) and external rotation (73.0 ± 23.5 to 61.2 ± 15.0, P = 0.032) were significantly deteriorated after primary surgery, even with significant improvement of pain and shoulder function (VAS: 5.7 ± 1.9 to 3.9 ± 1.4, P < 0.001; Constant score: 50.3 ± 11.0 to 60.4 ± 8.9, P < 0.001). On postoperative MRI, re-tear at the tendon-bone interface on the greater tuberosity occurred significantly more in group I (81.0%) than group II (51.3%, P = 0.024). Incidence of full-thickness tear of the subscapularis tendon was significantly different between the two groups (42.9% in group I, 12.8% in group II, P = 0.012). CONCLUSION: Patients who had early revision surgeries had significantly worse clinical outcomes after primary surgery than patients who had late revision surgeries. Healing failure at the tendon-bone interface on the greater tuberosity and re-tear combined with full-thickness tear of subscapularis tendon were related to early revision. Conversely, patients of the late revision group had muscle weakness that considerably impacted daily activities, even with improved pain and shoulder function. LEVEL OF EVIDENCE: III.


Assuntos
Lesões do Manguito Rotador , Articulação do Ombro , Artroscopia , Humanos , Amplitude de Movimento Articular , Reoperação , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia , Resultado do Tratamento
15.
J Cell Mol Med ; 24(4): 2688-2700, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31958895

RESUMO

In this study, we investigated the effects and molecular mechanisms of 2-phenylbenzimidazole-5-sulphonic acid (PBSA), an ultraviolet B protecting agent used in sunscreen lotions and moisturizers, on ovarian cancer cell responses and tumour angiogenesis. PBSA treatment markedly blocked mitogen-induced invasion through down-regulation of matrix metalloproteinase (MMP) expression and activity in ovarian cancer SKOV-3 cells. In addition, PBSA inhibited mitogen-induced cell proliferation by suppression of cyclin-dependent kinases (Cdks), but not cyclins, leading to pRb hypophosphorylation and G1 phase cell cycle arrest. These anti-cancer activities of PBSA in ovarian cancer cell invasion and proliferation were mediated by the inhibition of mitogen-activated protein kinase kinase 3/6-p38 mitogen-activated protein kinase (MKK3/6-p38MAPK ) activity and subsequent down-regulation of MMP-2, MMP-9, Cdk4, Cdk2 and integrin ß1, as evidenced by treatment with p38MAPK inhibitor SB203580. Furthermore, PBSA suppressed the expression and secretion of vascular endothelial growth factor in SKOV-3 cells, leading to inhibition of capillary-like tubular structures in vitro and angiogenic sprouting ex vivo. Taken together, our results demonstrate the pharmacological effects and molecular targets of PBSA on modulating ovarian cancer cell responses and tumour angiogenesis, and suggest further evaluation and development of PBSA as a promising chemotherapeutic agent for the treatment of ovarian cancer.


Assuntos
Imidazóis/farmacologia , Neovascularização Patológica/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Piridinas/farmacologia , Adipatos/farmacologia , Animais , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Quinases Ciclina-Dependentes/metabolismo , Regulação para Baixo/efeitos dos fármacos , Feminino , Fase G1/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Neovascularização Patológica/metabolismo , Neoplasias Ovarianas/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Ratos , Ratos Sprague-Dawley , Succinatos/farmacologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
16.
Arch Phys Med Rehabil ; 101(2): 187-195, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31562872

RESUMO

OBJECTIVE: To examine the therapeutic effects of the lateral push-off skater exercise vs conventional treadmill training on health-related quality of life, cardiorespiratory fitness (CRF), and balance. DESIGN: Single-blinded, randomized controlled trial. SETTING: Outpatient clinic at a tertiary hospital. PARTICIPANTS: Patients after minor stroke (N=36) with National Institutes of Health Stroke Scale scores≤3 between 20 and 65 years of age were randomly assigned to the intervention group (n=18) or the control group (n=18). INTERVENTIONS: Thirty-minute sessions of the skater exercise were performed 3 times weekly for 12 weeks in the intervention group. Conventional treadmill aerobic exercise was conducted in the control group at the same frequency and duration as the experimental group exercise. MAIN OUTCOME MEASURES: The primary outcome was measured using the European Quality of Life-5 Dimension (EQ-5D). Secondary outcomes included CRF and balance indicators. Assessments were performed at baseline (T0), 12 weeks from T0 (T1), and 16 weeks from T0 (T2). RESULTS: Significant improvements in EQ-5D, peak oxygen uptake (VO2peak), peak oxygen pulse, peak minute ventilation (VE), Dynamic Gait Index (DGI), and Berg Balance Scale (BBS) were found in the intervention group after performing the skater exercise (P<.05, all), and these improvements were sustained at T2 (P<.05, all). Between-group comparisons demonstrated greater improvements in EQ-5D, VO2peak, peak oxygen pulse, peak VE, DGI, and BBS in the intervention group than those in the control group at both T1 (P<.05, all) and T2 (P<0.05, all). Correlation analysis showed significant relationships between EQ-5D and VO2peak, peak VE, DGI, and BBS (P<.05, all). CONCLUSIONS: The skater exercise improved health-related quality of life, CRF, and balance in patients after minor stroke more effectively than conventional treadmill-based aerobic exercise. We recommend the skater exercise as a high-intensity interval training program for patients after minor stroke.


Assuntos
Terapia por Exercício/métodos , Treinamento Intervalado de Alta Intensidade/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Adulto , Idoso , Aptidão Cardiorrespiratória , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Equilíbrio Postural , Qualidade de Vida , Método Simples-Cego , Patinação/fisiologia , Caminhada , Adulto Jovem
17.
Ann Vasc Surg ; 69: 246-253, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32512111

RESUMO

BACKGROUND: Behcet's disease with arterial involvement shows rapid poor progression compared with Behcet's disease without arterial involvement, such that it may be thought of as a different disease. With arterial involvement, high rates of postoperative recurrence and anastomotic complications are observed. METHODS: The medical records of 1,361 patients diagnosed with Behcet's disease who visited our hospital from January 2007 to December 2019 were reviewed. Overall, 118 patients with blood vessel involvement were considered. Those with only vein involvement, intracerebral arterial involvement, and coronary arterial involvement were excluded. The 8 patients who underwent surgical treatments and the 9 patients who underwent conservative treatments were included and reported in this study. RESULTS: The mean age and mean follow-up duration of the 17 patients with peripheral arterial involvement were 49.82 ± 13.24 years and 89.85 ± 52.70 months, respectively. In all cases where the operations were performed, the first operation was an emergency operation for rupture of the aneurysm, impending sign of rupturing, or acute ischemia. Eight patients received a total of 18 operations. The average number of operations per patient and the reoperation rate were 2.25 ± 0.89 times and 75%, respectively. The 5-year and 10-year survival rates of the patients who underwent surgery were 75.0% and 30.0%, respectively. When arterial involvement occurs in the form of an aneurysm, the hazard ratio for death is 9.644 (P = 0.040, confidence interval 1.11-83.74). CONCLUSIONS: When the artery invades in the form of an aneurysm, the mortality rate is higher regardless of surgery. The main cause of mortality is complications that occur in the anastomosis sites after the operation. Postoperative short-term and regular imaging of the anastomosis area can be beneficial to detect such complications early to decrease the frequency of emergency surgeries, which will help reduce mortality.


Assuntos
Aneurisma/terapia , Síndrome de Behçet/terapia , Tratamento Conservador , Doença Arterial Periférica/terapia , Procedimentos Cirúrgicos Vasculares , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/mortalidade , Síndrome de Behçet/diagnóstico por imagem , Síndrome de Behçet/mortalidade , Tratamento Conservador/efeitos adversos , Tratamento Conservador/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/mortalidade , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/cirurgia , Recidiva , Reoperação , República da Coreia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/mortalidade
18.
Artigo em Inglês | MEDLINE | ID: mdl-31905363

RESUMO

OBJECTIVE: The radial forearm free flap (RFFF) is a commonly used free flap for tongue cancer. Postoperative changes in the volume of free flap are known to influence the functional restoration of the resected tongue. This study aimed to estimate chronological volume changes in RFFFs for tongue cancer and to determine the clinical factors affecting these changes. METHODS: Clinical data for 19 patients who underwent RFFF reconstruction for tongue cancer between May 2004 and September 2013 were retrospectively reviewed. The flap volume was measured 3, 6, 12, 24, and 36 months after surgery using CT and the Picture Archiving and Communication System software. RESULTS: Relative to volumes at 3 months, median flap volumes decreased to 98.55, 70.16, 62.86, and 58.84% at 6, 12, 24, and 36 months, respectively. None of the evaluated parameters were correlated with volume changes. CONCLUSIONS: Over time, the volume of RFFF in the tongue decreased. Considering this, free flap reconstruction should be carried out in tongue cancer surgery.

19.
J Craniofac Surg ; 31(3): e236-e239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977681

RESUMO

Odontogenic myxoma is a benign tumor, mostly located in the mandible. It shows locally aggressive behavior and requires surgical removal. Common treatment options for reconstructing the bone defects are immediate or delayed autologous bone graft or free flap. In this article, the authors present the successful reconstruction with autogenous bone graft and autologous human bone marrow mesenchymal stem, followed by distraction osteogenesis, dental implant placement and prosthodontic restoration in the mandibular defect.


Assuntos
Células da Medula Óssea , Neoplasias Mandibulares/terapia , Reconstrução Mandibular , Mixoma/terapia , Tumores Odontogênicos/terapia , Transplante de Células-Tronco , Implantes Dentários , Humanos , Masculino , Neoplasias Mandibulares/patologia , Pessoa de Meia-Idade , Tumores Odontogênicos/patologia , Osteogênese por Distração , Células-Tronco
20.
Am J Orthod Dentofacial Orthop ; 157(6): 818-831, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487312

RESUMO

When performing single-jaw surgery for mandibular setback, the distal segment of the mandible is brought distally along the occlusal plane, leaving the relationship of the B-point and pogonion unchanged. Double-jaw surgery for rotation of the maxillomandibular complex can be considered for solving this problem. However, maxillary surgery for rotational setback of the mandible can be replaced with orthodontic intrusion of the maxillary molars. Correcting the mandibular asymmetry that frequently accompanies mandibular prognathism often requires corrections of roll, yaw, and transverse shift of the mandible. Performing these corrections in mandibular single-jaw setback surgery requires transverse decompensation and orthodontic correction of maxillary occlusal-plane canting. This case report describes the simultaneous achievement of maxillary molar intrusion, transverse decompensation, and canting correction using a palatal lever supported by 2 midpalatal mini-implants. After creating a lateral open bite, mandibular setback surgery was performed with a 13.5° clockwise rotation, 2.9° roll correction, 3.5° yaw correction, and 3.5-mm transverse shift. The application of rotational setback significantly improved the facial esthetics. This case report demonstrates that orthodontic intrusion of the maxillary molars and transverse decompensation can replace maxillary surgery in the treatment of mandibular prognathism with asymmetry.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Prognatismo , Cefalometria , Estética Dentária , Humanos , Mandíbula , Maxila , Dente Molar
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