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1.
RNA ; 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918043

RESUMO

Telomere replication is essential for continued proliferation of human cells, such as stem cells and cancer cells. Telomerase lengthens the telomeric G-strand, while C-strand replication is accomplished by CST-polymerase α -primase (CST-PP). Replication of both strands is inhibited by formation of G-quadruplex (GQ) structures in the G-rich single-stranded DNA. TMPyP4 and pyridostatin (PDS), which stabilize GQ structures in both DNA and RNA, inhibit telomerase in vitro, and they cause telomere shortening in human cells that has been attributed to telomerase inhibition. Here, we show that TMPyP4 and PDS also inhibit C-strand synthesis by stabilizing DNA secondary structures and thereby preventing CST-PP from binding to telomeric DNA. We also show that these small molecules inhibit CST-PP binding to a DNA sequence containing no consecutive guanine residues, which is unlikely to form GQs. Thus, while these "telomerase inhibitors" indeed inhibit telomerase, they are also robust inhibitors of telomeric C-strand synthesis. Furthermore, given their limited specificity for GQ structures, they may disrupt many other protein-nucleic acid interactions in human cells.

2.
Nature ; 614(7949): 632-633, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36792896
3.
J Dtsch Dermatol Ges ; 21(12): 1500-1510, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37814388

RESUMO

BACKGROUND: Visible blue light (wavelength 400-495 nm) is a promising new treatment option for both psoriasis and atopic dermatitis (AD). Whilst previous clinical trials featured various devices and blue light at a variety of wavelengths, none of these interventions were challenged in objective clinical criteria. PATIENTS AND METHODS: Eighty-seven patients diagnosed with AD were enrolled in AD-Blue, an international, prospective, double-blinded, three-armed (415 nm vs. 450 nm vs. sham control), randomized trial designed to investigate the safety and efficacy of prototype full-body blue light devices. RESULTS: Full-body irradiation with 450 nm blue light but not 415 nm had a significant impact on itch (Itch-VAS, -1.6 ± 2.3; p  =  0.023 vs. sham irradiation). PO-SCORAD values also decreased significantly in response to irradiation at 415 nm (-11.5 ± 18.4; p = 0.028 vs. sham irradiation). None of the other outcome measures (EASI, SCORAD, IGA, DLQI) changed significantly. No safety signals were observed. Evaluation of skin transcriptomes, cytokine levels in serum, and ELISpots from peripheral blood mononuclear cells isolated from a subset of patients revealed moderate decreases in IL-31 in response to irradiation with blue light. CONCLUSIONS: Despite its favorable safety profile and moderate reductions in itch and IL-31 levels, full-body blue light irradiation did not lead to an amelioration of any of the objective measures of AD.


Assuntos
Dermatite Atópica , Humanos , Dermatite Atópica/diagnóstico , Estudos Prospectivos , Leucócitos Mononucleares , Índice de Gravidade de Doença , Prurido/etiologia , Prurido/radioterapia , Resultado do Tratamento
4.
J Mater Sci Mater Med ; 30(1): 10, 2019 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-30610462

RESUMO

For both the incorporation of cells and future therapeutic applications the sterility of a biomaterial must be ensured. However, common sterilisation techniques are intense and often negatively impact on material physicochemical attributes, which can affect its suitability for tissue engineering and 3D printing. In the present study four sterilisation methods, autoclave, supercritical CO2 (scCO2) treatment, UV- and gamma (γ) irradiation were evaluated regarding their impact on material properties and cellular responses. The investigations were performed on methyl cellulose (MC) as a component of an alginate/methyl cellulose (alg/MC) bioink, used for bioprinting embedded bovine primary chondrocytes (BPCs). In contrast to the autoclave, scCO2 and UV-treatments, the γ-irradiated MC resulted in a strong reduction in alg/MC viscosity and stability after extrusion which made this method unsuitable for precise bioprinting. Gel permeation chromatography analysis revealed a significant reduction in MC molecular mass only after γ-irradiation, which influenced MC chain mobility in the Ca2+-crosslinked alginate network as well as gel composition and microstructure. With regard to cell survival and proteoglycan matrix production, the results determined UV-irradiation and autoclaving as the best candidates for sterilisation. The scCO2-treatment of MC resulted in an unfavourable cell response indicating that this method needs careful optimisation prior to application for cell encapsulation. As proven by consistent FT-IR spectra, chemical alterations could be excluded as a cause for the differences seen between MC treatments on alg/MC behaviour. This investigation provides knowledge for the development of a clinically appropriate 3D-printing-based fabrication process to produce bioengineered tissue for cartilage regeneration.


Assuntos
Alginatos/química , Bioimpressão , Metilcelulose/química , Esterilização , Engenharia Tecidual , Alicerces Teciduais , Animais , Condrócitos/fisiologia
6.
Clin Chem Lab Med ; 53(3): 499-506, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25389993

RESUMO

BACKGROUND: Intra-tumoral macrophages have been involved as important players in the pathogenesis and progression of cancer. Recently, inflammatory parameters of the systemic inflammatory response have also been proposed as usefully prognostic biomarkers. One of these, the lymphocyte to monocyte ratio (LMR) in peripheral blood has been shown as a prognostic factor in hematologic and some solid tumors. In this study we analyzed for the first time the prognostic value of LMR in a large middle European cohort of pancreatic cancer (PC) patients. METHODS: Data from 474 consecutive patients with ductal adenocarcinoma of the pancreas were evaluated retrospectively. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method. To further evaluate the prognostic significance of the LMR, univariate and multivariate Cox regression models were calculated. RESULTS: Increased LMR at diagnosis was significantly associated with well-established prognostic factors, including high tumor stage and tumor grade (p<0.05). In univariate analysis, we observed that an increased LMR was a significant factor for better CSS in PC patients (HR 0.70; 95% CI 0.57-0.85; p<0.001). In multivariate analysis including age, Karnofsky Index, tumor grade, tumor stage, administration of chemotherapy, LMR and surgical resection, we confirmed increased LMR as an independent prognostic factor for CSS (HR 0.81; 95% CI 0.66-0.99; p=0.04). CONCLUSIONS: In conclusion, we identified LMR as an independent prognostic factor in PC patients. Our results indicate that the LMR might represent a novel and useful marker for patient stratification in PC management.


Assuntos
Biomarcadores Tumorais/sangue , Linfócitos , Monócitos , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico , Idoso , Feminino , Humanos , Estimativa de Kaplan-Meier , Contagem de Leucócitos , Masculino , Análise Multivariada , Neoplasias Pancreáticas/tratamento farmacológico , Prognóstico , Estudos Retrospectivos
7.
Animals (Basel) ; 11(12)2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34944180

RESUMO

The objectives of this paper were (i) to perform a systematic review of the literature over the last 21 yr and (ii) to evaluate the efficacy of selective dry cow treatment (SDCT) vs. blanket dry cow treatment (BDCT) in dairy cows regarding the risk of intramammary infection (IMI) after calving, new IMI risk after calving, cure risk during the dry period, and a reduction in antibiotic use at drying-off by meta-analysis. The systematic search was carried out using the databases PubMed, CAB Direct, and ScienceDirect. A meta-analytical assessment was performed for each outcome of interest using random-effects models, and the relative risk (RR) for IMI and cure or the pooled proportion for antibiotic use was calculated. The final number of included studies was n = 3 for IMI risk after calving and n = 5 for new IMI risk after calving, cure risk during the dry period, and antibiotic use. The RR levels for IMI (RR, 95% confidence interval [CI]: 1.02, 0.94-1.11; p = 0.592), new IMI (RR, 95% CI: 1.06, 0.94-1.20; p = 0.994), and cure (RR, 95% CI: 1.00, 0.97-1.02; p = 0.661) did not differ significantly between SDCT and BDCT. Substantial heterogeneity was observed between the trials regarding the pooled proportion of antibiotic use within the SDCT groups (I2 = 97.7%; p < 0.001). This meta-analysis provides evidence that SDCT seems to be an adequate alternative to BDCT regarding udder health with a simultaneous reduction in antibiotic use. Limitations might arise because of the small number of studies included.

8.
N Biotechnol ; 39(Pt B): 222-231, 2017 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-28890405

RESUMO

The diversity and complexity of biotechnological applications are constantly increasing, with ever expanding ranges of production hosts, cultivation conditions and measurement tasks. Consequently, many analytical and cultivation systems for biotechnology and bioprocess engineering, such as microfluidic devices or bioreactors, are tailor-made to precisely satisfy the requirements of specific measurements or cultivation tasks. Additive manufacturing (AM) technologies offer the possibility of fabricating tailor-made 3D laboratory equipment directly from CAD designs with previously inaccessible levels of freedom in terms of structural complexity. This review discusses the historical background of these technologies, their most promising current implementations and the associated workflows, fabrication processes and material specifications, together with some of the major challenges associated with using AM in biotechnology/bioprocess engineering. To illustrate the great potential of AM, selected examples in microfluidic devices, 3D-bioprinting/biofabrication and bioprocess engineering are highlighted.


Assuntos
Biotecnologia/métodos , Indústria Manufatureira , Imageamento Tridimensional , Microfluídica
9.
Biofabrication ; 9(4): 045011, 2017 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-28837040

RESUMO

Plant cell cultures produce active agents for pharmaceuticals, food and cosmetics. However, up to now process control for plant cell suspension cultures is challenging. A positive impact of cell immobilization, such as encapsulation in hydrogel beads, on secondary metabolites production has been reported for several plant species. The aim of this work was to develop a method for bioprinting of plant cells in order to allow fabrication of free-formed three-dimensional matrices with defined internal pore architecture for in depth characterization of immobilization conditions, cell agglomeration and interactions. By using extrusion-based 3D plotting of a basil cell-laden hydrogel blend consisting of alginate, agarose and methylcellulose (alg/aga/mc), we could demonstrate that bioprinting is applicable to plant cells. The majority of the cells survived plotting and crosslinking and the embedded cells showed high viability and metabolic activity during the investigated cultivation period of 20 d. Beside its compatibility with the plant cells, the novel alg/aga/mc blend allowed fabrication of defined 3D constructs with open macropores both in vertical and horizontal direction which were stable under culture conditions for several weeks. Thus, Green Bioprinting, an additive manufacturing technology processing live cells from the plant kingdom, is a promising new immobilization tool for plant cells that enables the development of new bioprocesses for secondary metabolites production as well as monitoring methods.


Assuntos
Biopolímeros/química , Bioimpressão/métodos , Hidrogéis/química , Células Vegetais/química , Alicerces Teciduais/química , Alginatos/química , Técnicas de Cultura de Células , Sobrevivência Celular , Força Compressiva , Desenho Assistido por Computador , Ácido Glucurônico/química , Química Verde , Ácidos Hexurônicos/química , Metilcelulose/química , Microscopia Eletrônica de Varredura , Ocimum basilicum/citologia , Ocimum basilicum/metabolismo , Reologia , Sefarose/química , Viscosidade
10.
J Clin Pathol ; 68(6): 427-33, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25759406

RESUMO

AIMS: Tumour markers including carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9) are frequently determined at the time of diagnosis in patients with pancreatic cancer. Several studies indicate a prognostic relevance of these markers in pancreatic cancer, but space for improvement with regard to the predictive accuracy and ability is given. In this work, the main focus is on mathematical combinations of these two tumour markers in order to validate an improvement of prognostic test results in terms of sensitivity and specificity. METHODS: This retrospective study includes 393 patients with pancreatic cancer, who were treated between the years 2005 and 2012 at the Division of Oncology, Medical University of Graz, Austria. The goal of this study was to explore whether an appropriate combination of two tumour markers leads to a statistically significant improvement of the prognostic prediction. RESULTS: Receiver operating characteristic curves comparison analyses with the classification variable cancer-specific survival showed that the mathematical product of two tumour markers (TM(product)= (CEA×CA19-9); area under the curve (AUC)=0.727; 95% CI 0.680 to 0.770) is significantly better than CEA alone (AUC=0.644; 95% CI 0.594 to 0.691; p=0.003) but not significant compared with CA19-9 (AUC=0.710; 95% CI 0.662 to 0.754; p=0.1215). A linear combination of CEA and CA19-9 (TM(linear)=(85×CEA+CA19-9); AUC=0.748; 95% CI 0.702 to 0.790) is significantly better than CEA (p<0.0001) as well as CA19-9 alone (p=0.0304). CONCLUSIONS: Mathematical combinations of pretherapeutic tumour markers CEA and CA19-9 are feasible and can significantly improve the prognostic prediction in patients with pancreatic cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Antígeno CA-19-9/metabolismo , Antígeno Carcinoembrionário/metabolismo , Neoplasias Pancreáticas/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Neoplasias Pancreáticas/diagnóstico , Prognóstico , Curva ROC , Estudos Retrospectivos
11.
PLoS One ; 9(8): e104730, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25133546

RESUMO

BACKGROUND: Recently, chemical blood parameters gain more attraction as potential prognostic parameters in pancreatic cancer (PC). In the present study we investigated the prognostic relevance of the uric acid (UA) level in blood plasma at the time of diagnosis for overall survival (OS) in a large cohort of patients with PC. PATIENTS AND METHODS: Data from 466 consecutive patients with ductal adenocarcinoma of the pancreas were evaluated retrospectively. Overall survival (OS) was analysed using the Kaplan-Meier method. To further evaluate the prognostic significance of the UA level, univariate and multivariate Cox regression models were calculated. RESULTS: None of the clinicopathological parameters (tumour grade, clinical stage, age, CA19-9 level, Karnofski Index (KI) or surgical resection) except gender was associated with UA level. In univariate analysis we observed the elevated UA level (<5.1 versus ≥5.1 mg/dl, p = 0.017) as poor prognostic factor for OS. In the multivariate analysis that included age, gender, tumour grade, tumour stage, surgical resection, CA19-9 level, the KI and UA level we confirmed the UA level as independent prognostic factor for OS (HR = 1.373%; CI = 1.077-1.751; p = 0.011). CONCLUSION: In conclusion, we identified the UA level at time of diagnosis as an independent prognostic factor in PC patients. Our results indicate that the UA level might represent a novel and useful marker for patient stratification in PC management.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Ductal Pancreático/sangue , Neoplasias Pancreáticas/sangue , Ácido Úrico/sangue , Idoso , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/mortalidade , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/mortalidade , Prognóstico , Modelos de Riscos Proporcionais
12.
Free Radic Biol Med ; 51(3): 626-40, 2011 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-21651978

RESUMO

Peroxiredoxin 6 (Prx 6) is a bifunctional enzyme with both glutathione peroxidase and acidic Ca(2+)-independent phospholipase A(2) activities. We have recently shown that exposure of murine bone marrow-derived macrophages to LPS and IFN-γ leads to induction of COX-2 expression and secretion of PGE(2), up-regulating Prx 6 mRNA levels. This study was designed to investigate various prostaglandins (PGs) for their ability to induce gene expression of Prxs, in particular Prx 6, and to determine the underlying regulatory mechanisms. We provide evidence that both conventional and cyclopentenone PGs enhance Prx 6 mRNA expression. Treatment with either activators or inhibitors of adenylate cyclase as well as cAMP analogs indicated that Prx 6 gene expression is regulated by adenylate cyclase in response to PGD(2) or PGE(2). Furthermore, our study revealed that JAK2, PI3K, PKC, and p38 MAPK contribute to the PGD(2)- or PGE(2)-dependent Prx 6 induction. Using stimulated macrophages from Nrf2-deficient mice or activators of Nrf2 and PPARγ, we found that Nrf2, but not PPARγ, is involved in the PG-dependent increase in Prx 6 mRNA expression. In summary, our data suggest multiple signaling pathways of Prx 6 regulation by PGs and identified Nrf2 as a critical player mediating transcriptional induction.


Assuntos
Dinoprostona/metabolismo , Macrófagos/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Peroxirredoxina VI/metabolismo , Prostaglandina D2/metabolismo , Adenilil Ciclases/metabolismo , Animais , Células Cultivadas , AMP Cíclico/análogos & derivados , AMP Cíclico/farmacologia , Dinoprostona/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Janus Quinase 2/metabolismo , Sistema de Sinalização das MAP Quinases , Macrófagos/efeitos dos fármacos , Macrófagos/patologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fator 2 Relacionado a NF-E2/genética , Peroxirredoxina VI/genética , Fosfatidilinositol 3-Quinases/metabolismo , Prostaglandina D2/genética , Proteína Quinase C/metabolismo , Ativação Transcricional/genética
13.
Eur J Obstet Gynecol Reprod Biol ; 156(1): 50-5, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21292384

RESUMO

OBJECTIVES: Fetal glucocorticoid excess is thought to play an important role in early-life programming, promoting growth restriction and contributing to adult metabolic, cardiovascular and neuroendocrine disease. We hypothesized that dexamethasone incubation of primary trophoblastic cells from human healthy placentas at term might induce altered gene and protein expression of several endocrine placental regulators. STUDY DESIGN: Primary villous trophoblastic cells were incubated with 10 µM dexamethasone for 6, 12, 24, 48 and 72 h. Non-incubated trophoblastic cells served as vehicle control. Gene expression of leptin, 11ß-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) and insulin-like growth factor-binding protein-1 (IGFBP-1) was measured. Moreover, leptin, ß-human chorionic gonadotropine (ß-hCG) and lactate dehydrogenase (LDH) release into the culture medium was determined. RESULTS: Leptin gene expression was significantly increased in dexamethasone-incubated trophoblastic cells after 24, 48 and 72 h. There was a significant increase in leptin concentration in the medium of the cell culture after 48 h. Gene expression of 11ß-HSD2 was significantly higher in dexamethasone-stimulated trophoblastic cells compared to vehicle controls after 72 h. The expression rate of IGFBP-1 mRNA was basal throughout the incubation period. The concentration of ß-HCG in the supernatant increased significantly after 72 h of dexamethasone incubation, while LDH concentrations remained stable. CONCLUSION: Our findings suggest that dexamethasone incubation stimulates leptin and 11ß-HSD2 gene expression in primary villous trophoblastic cells of healthy human placentas, while enhancing cytotrophoblast differentiation.


Assuntos
11-beta-Hidroxiesteroide Desidrogenase Tipo 2/metabolismo , Dexametasona/farmacologia , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Glucocorticoides/farmacologia , Leptina/metabolismo , Placenta/efeitos dos fármacos , Trofoblastos/efeitos dos fármacos , 11-beta-Hidroxiesteroide Desidrogenase Tipo 2/genética , Animais , Células Cultivadas , Gonadotropina Coriônica Humana Subunidade beta/metabolismo , Feminino , Humanos , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/genética , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/metabolismo , Leptina/genética , Placenta/citologia , Placenta/metabolismo , Gravidez , Proteínas da Gravidez/genética , Proteínas da Gravidez/metabolismo , RNA Mensageiro/metabolismo , Reprodutibilidade dos Testes , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , Trofoblastos/citologia , Trofoblastos/metabolismo
14.
Neurosurgery ; 65(4 Suppl): A189-96, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19927067

RESUMO

OBJECTIVE: Little is known about patient satisfaction and disability after brachial plexus surgery. Would patients undergo the procedure again, if they knew the current result beforehand? How do they rate their result and their disability? METHODS: Of 319 plexus patients who had undergone surgery between 1995 and 2005, 199 received a 65-item questionnaire. Measurement instruments included a new plexus-specific outcome questionnaire (Ulm Questionnaire) with categories of satisfaction, functionality, pain, comorbidities, and work; and the disability of the arm, shoulder, and hand questionnaire (DASH; scale, 0-100). RESULTS: Of 99 returned questionnaires, 70 were returned in a useful form for evaluation. The results of patients with C5-C6 lesions (21 of 70) are as follows: 90% (19 of 21) would undergo surgery again, 95% (20 of 21) were satisfied with the result, and 86% (18 of 21) subjectively improved. The mean DASH score was 41 (standard deviation [SD], 24). The results of patients with C5-C7 lesions (6 of 70) are as follows: 50% (3 of 6) were satisfied and would undergo surgery again, and 67% (4 of 6) improved. The mean DASH score was 46 (SD, 13). The results of patients with C5-T1 lesions (43 of 70) are as follows: 67% (29 of 43) would undergo surgery again, 81% (35 of 42) were satisfied, and 74% (32 of 43) reported improvement. The mean DASH score was 58 (SD, 26). The overall mean DASH score was 52 (SD, 26). Pain since the injury was prevalent in 86% of patients (60 of 70), back pain in 53%, and depression/anxiety in 21%. Fifty-two percent of those who worked before their injury (27 of 53 patients) remained unemployed or incapacitated for work. Forty-five percent of previous workers (24 of 53) returned to their former occupation. Occupational retraining was successful for 70% of patients (16 of 23). The mean duration until return to work was 9 months overall and 5 months for those who returned to their previous occupation. CONCLUSION: Eighty-seven percent of patients were satisfied with the results and 83% would undergo the procedure again. Despite a high satisfaction rate, patients remained considerably disabled, and half of the previous workers did not return to work. Occupational retraining is effective.


Assuntos
Neuropatias do Plexo Braquial/reabilitação , Neuropatias do Plexo Braquial/cirurgia , Plexo Braquial/lesões , Plexo Braquial/cirurgia , Procedimentos Neurocirúrgicos/psicologia , Avaliação de Resultados em Cuidados de Saúde/métodos , Atividades Cotidianas/psicologia , Adulto , Plexo Braquial/fisiopatologia , Neuropatias do Plexo Braquial/epidemiologia , Comorbidade , Depressão/epidemiologia , Avaliação da Deficiência , Emprego , Feminino , Humanos , Masculino , Terapia Ocupacional/estatística & dados numéricos , Dor Pós-Operatória/epidemiologia , Satisfação do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Recuperação de Função Fisiológica/fisiologia , Licença Médica , Inquéritos e Questionários
15.
Neurosurgery ; 62(3): 664-73; discussion 664-73, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18425013

RESUMO

OBJECTIVE: In this study, we compare different surgical procedures regarding the functional outcome of traumatic peroneal nerve lesions. METHODS: In a retrospective study, 48 patients with traumatic lesions (17 iatrogenic) of the peroneal nerve were evaluated. Twenty-two patients presented with lesions in continuity displaying regenerative potential by nerve action potential recording. In these cases, surgery was restricted to either external (12/) or interfascicular neurolysis (10/). Twenty-two cases had no regenerative potential (10/) or showed discontinuity (12/) and thus were reconstructed with autologous sural nerve grafts. In four cases, a reconstructive procedure was intraoperatively abandoned as a result of the large extent of the lesion. RESULTS: Thirty-six patients with an adequate follow-up period of at least 18 months were included in this study. Among those with external neurolysis, 73% (eight out of 11) showed a good functional outcome, obviating the need for a kick-up foot brace (M >or= 4). In the interfascicular neurolysis group, 71% (five out of seven) exhibited a similar outcome. In the grafted group, however, only 28% (five out of 18) obtained a functionally useful result dependent on graft length. A graft length under 6 cm led to a functionally useful outcome in 44% of patients (four out of nine) compared with 11% (one out of nine) when the graft length was greater than or equal to 6 cm. In six patients, muscle-tendon transfers were performed, resulting in strong, useful foot lift. CONCLUSION: Peroneal nerve lesions lacking regenerative signs should be explored. A functionally useful result (M >or=4) was achieved in 72% of the patients with either external or internal neurolysis and in 28% of the patients after a nerve graft procedure. Patients in whom nerve surgery failed to reconstitute useful foot lift need to be evaluated for their suitability to undergo a tendon transfer procedure.


Assuntos
Procedimentos Neurocirúrgicos/métodos , Nervo Fibular/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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