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1.
Zhonghua Yi Xue Za Zhi ; 101(17): 1246-1249, 2021 May 11.
Artículo en Chino | MEDLINE | ID: mdl-34865393

RESUMEN

Objective: To investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and its underlying mechanism through a prospective cohort study. Methods: From July 2018 to July 2019, 80 patients who underwent day surgery in Taizhou Central Hospital (including patients with laparoscopic cholecystectomy and oophorocystectomy) were selected, there were 46 males and 34 females with a mean age of (28.8±4.3) years. The patients were divided into dexmedetomidine group and control group with random number table, 40 cases in each group. After anesthesia induction, the dexmedetomidine group was managed with intravenous infusion of dexmedetomidine (1 µg/kg) within 10 minutes, while the control group was treated with an equal volume of normal saline. The patient's general information and the intraoperative data were recorded. The visual analogue scale (VAS) was evaluated before the operation and 1, 6 and 12 h after the surgery. The Von Frey cilia method was conducted to determine the mechanical pain threshold of the patient's non-surgical body parts. The vein blood was extracted at the corresponding time point to evaluate the expression level of miR-183 via the RT-PCR method. The demographic and preoperative parameters were comparable between the two groups. Results: Compared with the control group, the mechanical pain threshold in the dexmedetomidine group increased significantly at 1, 6, and 12 h after surgery (all P<0.05), and the VAS score at the corresponding time point declined significantly (all P<0.05). At the same time points, the serum miR-183 levels in the dexmedetomidine group were all significantly higher than those in the control group after surgery (2.07±0.41 vs 1.68±0.60, 1.99±0.33 vs 1.74±0.54, 1.88±0.36 vs 1.67±0.54, respectively, all P<0.05). Conclusion: A perioperative dose of dexmedetomidine in day surgery can significantly improve the remifentanil-related hyperalgesia, and it may be related to up-regulation of the expression of miR-183 in the blood.


Asunto(s)
Dexmedetomidina , MicroARNs , Adulto , Femenino , Humanos , Hiperalgesia/inducido químicamente , Masculino , Estudios Prospectivos , Remifentanilo , Adulto Joven
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(9): 628-631, 2019 Sep 09.
Artículo en Chino | MEDLINE | ID: mdl-31550787

RESUMEN

Objective: To explore the feasibility of using da Vinci Surgical System to perform supraomohyoid neck dissection (SOND) to avoid visible scar and reduce trauma. Methods: Between September 2017 and December 2018, twenty patients (two females and 18 males, mean age, 54.8 years) with oral cancer treated in the Department of Stomatology, Hainan Hospital of General Hospital of Chinese PLA were enrolled in this study. Eight patients were assigned into robotic surgery group, and received robot-assisted SOND with retroauricular hairline incision. After the da Vinci Surgical System robotic platform was positioned, the neck dissection was performed in level Ⅱb, Ⅱa, Ⅲ, Ⅰb and Ⅰa orderly from the near region to far region. The other 12 patients were assigned into traditional surgery group, and received SOND with a traditional incision. The operation time, bleeding and amount of lymph node dissected were compared between two groups. Results: All the 8 cases of robot-assisted SOND were completed smoothly. Operation time [(4.5±1.0) h] was significantly longer in robotic surgery group than that [(2.5±1.0) h] in traditional surgery group (P<0.05). The amount of bleeding in robotic surgery group [30.0 (27.5) ml] was significantly lower than that in traditional surgery group [(100.0 (87.5) ml, P<0.05]. There's no difference in the number of lymph nodes dissected between robotic surgery group (23.6±5.2) and traditional surgery group (22.8±6.0)(P>0.05). No postoperative hemorrhage, symptoms of nerve injury, flap necrosis and secondary healing were observed in robotic surgery group. Conclusions: SOND through retroauricular hairline incision is feasible with the assistance of da Vinci Surgical System. The main advantage of this method is superior esthetic effects due to a hidden incision with minimal bleeding. There was no obvious differences in the amount of lymph nodes dissected and postoperative complications between two methods. However, robotic surgery costs a significantly longer operation time than traditional neck dissection.


Asunto(s)
Neoplasias de la Boca , Disección del Cuello , Procedimientos Quirúrgicos Robotizados , Robótica , Estética Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/cirugía , Disección del Cuello/métodos
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(8): 537-539, 2019 Aug 09.
Artículo en Chino | MEDLINE | ID: mdl-31378032

RESUMEN

This pilot study aimed to investigate the feasibility of trans-oral ultrasonography of the temporomandibular joint (TMJ) in oblique sagittal plane. Six volunteers who were receiving residency training at Hainan Hospital of General Hospital of Chinese PLA were recruited into this study, five of them had normal TMJ and one had anterior displaced disc all of which had been confirmed by MRI. A hockey-stick-shaped ultrasound probe was placed between the cheek and maxilla to push against the mucosa lateral to posterior maxillary tuberosity, and every volunteer underwent bilateral scans. The sonographic imaging were completed successfully on the six volunteers; the condyle, the superior and the inferior head of the lateral pterygoid muscle, the disc and the maxillary vein were clearly identified in all the twelve ultrasonographic scans. The feasibility of trans-oral ultrasonography of TMJ in oblique sagittal plane was confirmed.


Asunto(s)
Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Humanos , Luxaciones Articulares/diagnóstico por imagen , Imagen por Resonancia Magnética , Cóndilo Mandibular , Proyectos Piloto , Articulación Temporomandibular , Disco de la Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Ultrasonografía
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(4): 263-265, 2019 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-30955299

RESUMEN

Submandibular gland excision was performed on two patients using trans-oral robotic surgery (TORS). Complications such as the injury of marginal mandibular branch of facial nerve, ranula in the floor of the mouth, and postoperative hemorrhage were not observed. Visible cervical scar can be avoided and esthetic outcome can be expected by using this surgical modality.


Asunto(s)
Ránula , Procedimientos Quirúrgicos Robotizados , Glándula Submandibular , Estética Dental , Humanos , Glándula Submandibular/cirugía
6.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(3): 209-214, 2019 Mar 24.
Artículo en Chino | MEDLINE | ID: mdl-30897880

RESUMEN

Objective: To analyze the trends on constituent ratio of non-ST-segment-elevation (NSTEMI) and ST-segment-elevation myocardial infarction (STEMI) and related in-hospital mortality in acute myocardial infarction (AMI) patients hospitalized in Beijing Anzhen Hospital from 2004 to 2014. Methods: This is a single-center, retrospective study. We reviewed all patients hospitalized for AMI in Beijing Anzhen Hospital from January 1 2004 to December 31 2014, and collected all related information including hospitalization stay, the type of AMI, revascularization and in-hospital mortality. We analyzed the trends of constituent ratio of NSTEMI and STEMI, and their in-hospital mortalities during the 11 years. Results: Data from a total of 23 864 patients with AMI, including 5 539 STEMI and 18 325 NSTEMI, were analyzed. Compared with STEMI patients, NSTEMI patients were older, less likely to be male (P<0.001), had higher prevalence of hypertension, hyperlipidemia, diabetes (P<0.001), and lower prevalence of smoking (P<0.001). Additionally, patients with NSTEMI were more likely to have prior history of MI (12.6% (695/5 539) vs. 7.4% (1 354/18 325), P<0.001) and coronary artery bypass graft surgery (2.7% (152/5 539) vs. 0.7% (124/18 325), P<0.001). The constituent ratio of NSTEMI was significantly increased during the observation period, rising from 15.8% (107/802) in 2004 to 35.7% (1 273/3 583) in 2014 (P value for trend <0.001). The in-hospital mortality of NSTEMI patients was significantly lower compared with those with STEMI (1.84% (102 cases) vs. 2.74% (502 cases), P<0.001). The mortality of both STEMI and NSTEMI were significantly decreased during the 11 years (both P value for χ(2) trend test <0.001). After adjusting for other risk factors, NSTEMI was independently associated with lower in-hospital mortality (OR=0.50, 95%CI 0.40-0.63, P<0.001). Conclusions: In patients with AMI, the constituent ratio of NSTEMI versus STEMI is increased during the 11 years. The in-hospital mortality is decreased for both STEMI and NSTEMI patients in the past 11 years, and the in-hospital mortality rate of NSTEMI patients is lower than STEMI patients in this patient cohort during the observation period.


Asunto(s)
Mortalidad Hospitalaria , Infarto del Miocardio con Elevación del ST , Beijing/epidemiología , Puente de Arteria Coronaria , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/mortalidad
7.
Zhonghua Wai Ke Za Zhi ; 55(3): 172-178, 2017 Mar 01.
Artículo en Chino | MEDLINE | ID: mdl-28241717

RESUMEN

Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all patients had achieved bone union. According to the modified Merle D'Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions: Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.


Asunto(s)
Placas Óseas , Fijación Interna de Fracturas , Impresión Tridimensional , Fracturas de la Columna Vertebral/cirugía , Acetábulo , Adulto , Anciano , Anestesia General , Tornillos Óseos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis , Huesos Pélvicos , Periodo Posoperatorio
8.
Eur Rev Med Pharmacol Sci ; 20(20): 4343-4347, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27831637

RESUMEN

OBJECTIVE: To investigate the significance of the combined treatment with ganciclovir and interferon for patients with hepatitis C (HCV) liver fibrosis. PATIENTS AND METHODS: We retrospectively summarize 86 patients with hepatitis C treated in our hospital from October 2013 to October 2015. 49 cases, considered as control group, received combined treatment with α-interferon and ribavirin; 37 cases, considered as observation group, received combined treatment with ganciclovir and interferon. The changes of liver fibrosis, viral replication and liver function of both groups were compared for two weeks and six months. RESULTS: The levels of sera hyaluronic acid (HA), laminin (LN), type IV collagen (IVC) and type III procollagen (PIII NP) of both groups were reduced after treatment, and the observation group improved more significantly (p <0.05). Compared to the rate of antigen-positive after treatment and HCV copy number before and after treatment, the differences were not statistically significant (p > 0.05). The level of alanine aminotransferase (ALT) of the control group increased after treatment, compared with that before. This was done along with the decrease of the level of albumin. By contrast, the level of ALT in the observation group was reduced and the level of albumin was increased compared with that before (p < 0.05). CONCLUSIONS: Ganciclovir combined with interferon may further reduce the fibrosis process of patients with hepatitis C, and may improve liver function. The effect of antiviral was similar as ganciclovir combined with Interferon was comparatively good applied, safety and effectiveness.


Asunto(s)
Antivirales/uso terapéutico , Ganciclovir/uso terapéutico , Cirrosis Hepática/tratamiento farmacológico , Hepacivirus , Hepatitis C/tratamiento farmacológico , Humanos , Interferón-alfa/uso terapéutico , Estudios Retrospectivos
9.
Genet Mol Res ; 15(4)2016 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-27819738

RESUMEN

The relationship between the Pro12Ala polymorphism of PPARγ and the risk of gestational diabetes mellitus remains unresolved. Here, we attempted to resolve this inconsistency. Case-control studies pertaining to the effect of the Pro12Ala polymorphism in the PPARγ protein and risk of gestational diabetes mellitus were extracted from the HuGE, PubMed, Web of Science, CNKI, and SinoMed databases after an extensive literature search. The studies were statistically analyzed using STATA (v.12.0) software. Twelve case-control studies composed of 2968 GDM cases and 5576 controls that fulfilled the inclusion criteria were included in this meta-analysis. We identified no significant relation between the Pro12Ala polymorphism of PPAR-γ and risk of GDM, when analyzed by the allele [G vs C: odds ratio (OR) = 0.85; 95% confidence interval (CI): 0.71-1.01] and dominant (CG+GG vs CC: OR = 0.86; 95% CI: 0.72-1.03) models. Subgroup analysis by ethnicity revealed that East Asian and Middle Eastern females expressing the A allele showed reduced susceptibility to GDM. Additionally, we observed significant differences between the East Asian, Middle Eastern, and Caucasian females (P = 0.008) with respect to GDM susceptibility. The results of this meta-analysis indicated the influence of ethnicity in determining GDM susceptibility, in the presence of a Pro12Ala polymorphism in PPARγ.


Asunto(s)
Diabetes Gestacional/genética , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , PPAR gamma/genética , Polimorfismo de Nucleótido Simple/genética , Femenino , Humanos , Embarazo , Sesgo de Publicación , Factores de Riesgo
10.
Animal ; 8(9): 1469-78, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24909980

RESUMEN

Fatty acid synthase (FASN) is known as a crucial enzyme of cellular de novo fatty acid synthesis in mammary gland which has been proved as the main source of short and medium-chain fatty acids of milk. However, the regulatory role of FASN in goat-specific milk fatty acids composition remains unclear. We cloned and analyzed the full-length of FASN gene from the mammary gland of Capra hircus (Xinong Saanen dairy goat) (DQ 915966). Comparative gene expression analysis suggested that FASN is predominantly expressed in fat, small intestine and mammary gland tissues, and expresses higher level at lactation period. Inhibition of FASN activity by different concentrations (0, 5, 15, 25 and 35 µM) of orlistat, a natural inhibitor of FASN, resulted in decreased expression of acetyl-CoA carboxylase α (ACCα), lipoprotein lipase and heart-type fatty acid binding protein (H-FABP) in a concentration-dependent manner in goat mammary gland epithelial cells (GMEC). Similar results were also obtained by silencing of FASN. Additionally, reduction of FASN expression also led to apparent decline of the relative content of decanoic acid (C10:0) and lauric acid (C12:0) in GMEC. Our study provides a direct evidence for inhibition of FASN reduces cellular medium-chain fatty acids synthesis in GMEC.


Asunto(s)
Ácido Graso Sintasas/antagonistas & inhibidores , Ácidos Grasos/metabolismo , Cabras/metabolismo , Glándulas Mamarias Animales/metabolismo , Leche/química , Acetil-CoA Carboxilasa/antagonistas & inhibidores , Animales , Secuencia de Bases , ADN Complementario/química , ADN Complementario/genética , Inhibidores Enzimáticos/farmacología , Células Epiteliales/metabolismo , Ácido Graso Sintasas/genética , Femenino , Regulación de la Expresión Génica , Lactancia , Lactonas/farmacología , Datos de Secuencia Molecular , Orlistat , ARN/genética , ARN/aislamiento & purificación , Análisis de Secuencia de ADN , Especificidad de la Especie
11.
Clin Radiol ; 69(10): 1004-10, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24919983

RESUMEN

AIM: To investigate the imaging characteristics of pancreatic serous oligocystic adenoma (SOA) and mucinous cystic neoplasms (MCNs) using spectral computed tomography (CT) and to evaluate whether quantitative information derived from spectral imaging can improve the differential diagnosis of these diseases. MATERIALS AND METHODS: From February 2010 to June 2013, 44 patients (24 SOAs and 20 MCNs) who underwent spectral CT imaging were included in the study. Conventional characteristics and quantitative parameters were compared between the two disease groups. Logistic regression was used for multiparametric analysis. The receiver-operating characteristic curve was used to evaluate the diagnostic performance of single parameter and multiparametric analysis. Two radiologists diagnosed the diseases blinded and independently, without and with the information of the statistical analysis. RESULTS: Tumour location, contour, size, and monochromatic CT values at 40 keV to 70 keV, iodine concentration, and effective atomic number (effective-Z) in the late arterial phase were the independent factors correlated with category. Multiparametric analysis with logistic regression showed that tumour size, location, and contour were the most effective variations, and obtained an area under the ROC curve (AUC) of 0.934. With the knowledge of statistical analysis, the accuracy of the first reader increased from 70.5% to 86.4%, and the accuracy of the second reader increased from 81.8% to 90.9%. CONCLUSIONS: Although CT spectral imaging provided additional information and multiparametric analysis obtained better performance than single-parameter analysis in differentiating MCNs from SOAs, multiparametric analysis with the combination of quantitative parameters derived from CT spectral imaging did not improve the diagnostic performance. Tumour size, location, and contour played an important role in differentiating MCNs from SOAs.


Asunto(s)
Cistadenocarcinoma Mucinoso/diagnóstico por imagen , Cistadenocarcinoma Seroso/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Área Bajo la Curva , Medios de Contraste , Diagnóstico Diferencial , Femenino , Humanos , Yopamidol , Masculino , Persona de Mediana Edad , Páncreas/diagnóstico por imagen , Curva ROC , Intensificación de Imagen Radiográfica/métodos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto Joven
12.
AJNR Am J Neuroradiol ; 34(5): 971-5, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23292530

RESUMEN

BACKGROUND AND PURPOSE: Improved CTA delineation of arteries and unruptured aneurysms is clinically desired in the posterior fossa. We present a novel model-based iterative reconstruction that models system statistics and optics to improve CT image quality. We investigated the utility of MBIR for improving delineation of arteries in the posterior fossa on 3D brain CTA. MATERIALS AND METHODS: Using filtered back-projection with a standard kernel and MBIR, we reconstructed axial images of 0.625-mm thickness of 28 consecutive patients (14 men; mean age, 58.6 ± 14.6 years) who underwent 64-detector brain CTA. We placed regions of interest on the axial images, measured the mean CT value in the basilar artery and the value and SD in the pons and bilateral cerebellar hemispheres, and calculated the contrast-to-noise ratio of the brain arteries in the posterior fossa. Using volume-rendered CTA and a 4-point scale, 2 radiologists independently graded delineation of the BA, bilateral vertebral artery, superior cerebellar artery, and anterior and posterior inferior cerebellar arteries. We compared the results between FBP and MBIR by using paired t and Wilcoxon signed-rank tests. RESULTS: Compared with FBP, MBIR significantly improved the contrast-to-noise ratio (P < .0001) and subjective delineation of all arteries in the posterior fossa except the BA (VA, SCA, AICA, and PICA; P < .05 for all). The mean visual score by MBIR was 3.0 or higher for all those arteries except the AICA assessed by reader 1 (2.6 ± 0.7). CONCLUSIONS: With 3D brain CTA, contrast-to-noise ratio and arterial delineation of the VA, SCA, AICA, and PICA in the posterior fossa are better with MBIR than FBP.


Asunto(s)
Angiografía Cerebral/métodos , Arterias Cerebrales/diagnóstico por imagen , Trastornos Cerebrovasculares/diagnóstico por imagen , Imagenología Tridimensional/métodos , Reconocimiento de Normas Patrones Automatizadas/métodos , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Simulación por Computador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Neurológicos , Modelos Estadísticos , Intensificación de Imagen Radiográfica/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
13.
J Int Med Res ; 40(4): 1390-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22971490

RESUMEN

OBJECTIVE: To compare the incidence of postoperative nausea and vomiting (PONV) and postoperative pain in thyroidectomy patients undergoing general anaesthesia, with or without bilateral superficial cervical plexus block (BSCPB). METHODS: In this prospective, randomized, double-blind study, adult patients scheduled for thyroid surgery under general anaesthesia were randomized to receive BSCPB with 20 ml 0.5% ropivacaine (ropivacaine group) or placebo (20 ml saline; saline group) before surgery. The incidence of PONV and postoperative pain, and the need for rescue antiemetics were assessed at 0-24 h postoperatively. RESULTS: Data from 135 patients were evaluated and the incidence of PONV, the need for rescue antiemetics and the number of patients needing additional perioperative pain relief in the postanaesthetic care unit were significantly lower in the ropivacaine group compared with the saline group. Early postoperative (0-8 h) visual analogue scale pain scores were significantly lower in the ropivacaine group compared with the saline group. CONCLUSIONS: BSCPB with 0.5% ropivacaine administered before surgery can significantly reduce the incidence of PONV and early postoperative pain and also reduce perioperative opioid requirements in thyroidectomy patients undergoing general anaesthesia.


Asunto(s)
Amidas , Anestésicos Locales , Bloqueo Nervioso Autónomo , Dolor Postoperatorio/prevención & control , Náusea y Vómito Posoperatorios/prevención & control , Tiroidectomía/efectos adversos , Adulto , Analgésicos/administración & dosificación , Análisis de Varianza , Antieméticos/administración & dosificación , Plexo Cervical , Método Doble Ciego , Femenino , Flurbiprofeno/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Ondansetrón/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Cuidados Posoperatorios , Náusea y Vómito Posoperatorios/tratamiento farmacológico , Estudios Prospectivos , Ropivacaína , Estadísticas no Paramétricas
14.
J Neuroradiol ; 39(5): 295-300, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22172647

RESUMEN

OBJECTIVES: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterized by severe attacks of optic neuritis and myelitis. Brain was classically, unlike in multiple sclerosis (MS), spared. Nevertheless recent studies showed that brain lesions can be seen with MRI. We studied the diffusion characteristics of normal-appearing white matter (NAWM) and abnormal white matter in NMO patients compared with NAWM in healthy subjects. PATIENTS AND METHODS: Diffusion tensor imaging (DTI) scans of the brain and spinal cord were obtained from 25 patients with NMO and 20 age- and gender-matched healthy subjects. Region of interest (ROI) analysis of the apparent diffusivity coefficient (ADC) and fractional anisotropy (FA) was performed in brain NAWM (optic radiations, corpus callosum [CC] and anterior and posterior limbs of the internal capsule [IC]) and in spinal cord NAWM and in lesions. RESULTS: ADC was increased and FA decreased in NMO patients in the posterior limb of the IC in the optic radiations and in spinal cord NAWM. FA was lower in spinal cord lesions. In contrast, there was no difference between the two groups in the anterior limb of the IC nor in the CC. CONCLUSION: These results suggest that DTI abnormalities are very severe in NMO spinal cord lesions. In our study, DTI abnormalities in NAWM were restricted to optic radiations and cortico-spinal tracts, suggesting secondary Wallerian degeneration. In contrast, NAWM outside these tracts (CC and anterior IC) remained normal suggesting that, unlike what is observed in MS, there is no infra-lesional abnormality in NMO.


Asunto(s)
Encéfalo/patología , Imagen de Difusión Tensora/métodos , Fibras Nerviosas Mielínicas/patología , Neuromielitis Óptica/patología , Médula Espinal/patología , Adulto , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
15.
Eur J Surg Oncol ; 37(7): 604-10, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21602012

RESUMEN

BACKGROUND AND AIMS: Hepatocellular carcinoma can be treated with heat-based therapies, especially radiofrequency ablation (RFA). However, RFA has limited efficacy and is quite expensive. We designed a new system using fine needles combined with an alternating magnetic field to generate hyperthermia for the treatment of hepatocellular carcinoma in a rat hepatoma model. Our aims are to assess the efficacy of our method and determine survival up to 30 days. METHODS: An N1-S1 cell line was inoculated into the livers of Sprague-Dawley rats, generating tumors after 14 days. The animals were randomized into 5 groups and treated after laparotomy either with normal saline (group I), iron oxide nanoparticles (group II), fine needles (group III), fine needles and iron oxide nanoparticles combined (group IV) or self-designed two-part needles placed under ultrasonographic guidance percutaneously (group V). Every rat was placed in an alternating magnetic field. The temperature in the treatment area was maintained between 55 and 60 °C. At day 30 after treatment, tumor volumes and mortality were assessed and histology samples were studied. RESULTS: Tumor volumes were significantly reduced and survival rate was prolonged in groups III, IV and V versus groups I and II (P < 0.05). On pathological examination, groups III, IV and V presented obvious necrosis, apoptosis, calcifications and inflammatory changes in the treatment area. CONCLUSION: Our study demonstrates that hyperthermia generated by fine stainless-steel needles combined with an alternating magnetic field effectively inhibits hepatoma growth in rats and prolongs their survival. Further, this method can be applied percutaneously under ultrasonographic guidance.


Asunto(s)
Carcinoma Hepatocelular/cirugía , Ablación por Catéter/instrumentación , Campos Electromagnéticos , Neoplasias Hepáticas/cirugía , Agujas , Animales , Carcinoma Hepatocelular/patología , Ablación por Catéter/métodos , Compuestos Férricos , Neoplasias Hepáticas/patología , Masculino , Modelos Animales , Nanopartículas , Trasplante de Neoplasias , Ratas , Ratas Sprague-Dawley , Resultado del Tratamiento , Ultrasonografía Intervencional
16.
Radiol Med ; 115(6): 898-905, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20221707

RESUMEN

PURPOSE: The authors sought to determine the influence of two different iodine concentrations of nonionic contrast media (cm) on contrast enhancement in pancreatic computed tomography angiography (CTA). MATERIALS AND METHODS: Sixty patients with clinically suspected or known pancreatic disease underwent pancreatic CTA. The patients were randomly assigned to group A (n = 30) and group B (n = 30). The contrast agent was injected with iodine concentrations of 400 mg I/ml (Iomeron 400) in group A and 300 mg I/ml (Iopamidol 300) in group B with the same total iodine dose (36 g). Arterial and portal venous phase contrast enhancement of the vessels, organs and pancreatic masses was measured, and blinded qualitative image assessment was performed by two expert radiologists. RESULTS: In the arterial and portal venous phase, the highly concentrated cm led to significantly greater enhancement in the abdominal main vessels, pancreas and pancreatic carcinoma than did the low concentrated cm. No statistically significant attenuation differences were measured between pancreatic carcinomas and the pancreatic parenchyma in the arterial and portal venous phase between group A and B. The overall trend for both readers was to assign higher scores to group A than group B. CONCLUSIONS: The higher iodine concentration leads to greater contrast enhancement of abdominal vessels and organs in pancreatic CTA. Detection and demarcation of hypovascular pancreatic carcinoma was not found to be improved by the higher iodine concentration.


Asunto(s)
Carcinoma/diagnóstico por imagen , Medios de Contraste/administración & dosificación , Yopamidol/análogos & derivados , Yopamidol/administración & dosificación , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Medios de Contraste/química , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Reproducibilidad de los Resultados
17.
Radiol Med ; 114(8): 1232-8, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19789954

RESUMEN

PURPOSE: The authors sought to quantitatively analyse enhancement characteristics of pancreatic insulinomas in different phases and determine the value of multidetector-row computed tomography (CT) for detecting insulinomas. MATERIALS AND METHODS: Forty-six patients with surgically proven insulinomas diagnosed between 2002 and 2007 were retrospectively reviewed. These patients underwent single-phase (group 1) or dual-phase (group 2) helical CT scanning. RESULTS: Sensitivity for detecting insulinomas in group 2 was superior to that in group 1 (p<0.05).The sensitivity for insulinoma detection in the arterial phase was superior to that in the portal-venous phase (p<0.05). The mean attenuation values of the insulinomas and normal pancreas during the unenhanced arterial and portal-venous phases were, respectively, 40.5+/-8.75 HU (Hounsfield units), 114.48+/-27.30 HU, 112.19+/-19.52 HU and 44.56+/-6.48 HU, 81.16+/-15.22 HU, 90.54+/-13.80 HU, and there was statistical difference between them (p=0.000). The contrast enhancement of insulinomas in the arterial and portal-venous phases was 74.03+/-29.51 HU and 70.90+/-21.93 HU, respectively, and there was no statistical difference between them (p=0.499). The tumour to normal-pancreas attenuation differences in the arterial and portal-venous phases were respectively 33.32+/-20.96 HU and 20.58+/-16.32 HU, respectively, and there was statistical difference between them (p=0.011). CONCLUSIONS: Dual-phase CT has a promising sensitivity in detecting pancreatic insulinomas. The acquisition of images in the arterial phase is more helpful for detecting insulinomas.


Asunto(s)
Insulinoma/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Periodo Preoperatorio , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Niño , Diagnóstico Diferencial , Femenino , Humanos , Insulinoma/diagnóstico , Insulinoma/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirugía , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y Especificidad
18.
IET Nanobiotechnol ; 3(2): 46-54, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19485552

RESUMEN

This study reports an investigation of hyperthermia cancer therapy utilising an alternating magnetic field to induce a localised temperature increase on tumours by using injectable magnetic nanoparticles. In-vitro and in-vivo experiments represent the feasibility of hyperthermia cancer therapy. A feedback temperature control system was first developed to keep the nanoparticles at a constant temperature to prevent overheating in the tumours such that a safer and more precise cancer therapy becomes feasible. By using the feedback temperature control system, magnetic nanoparticles can be heated up to the specific constant temperatures, 37, 40, 42, 45, 46 and 47 degrees C, respectively, with a variation less than 0.2 degrees C. With this approach, the in-vitro survival rate of tumour cells at different temperatures can be systematically explored. It was experimentally found that the survival rate of cancer cells can be greatly reduced while CT-26 cancer cells were heated above 45 degrees C. Besides, localised temperatures increase as high as 59.5 degrees C can be successfully generated in rat livers by using the proposed method. Finally, complete regression of tumour was achieved. The developed method used injectable magnetic nanoparticles and may provide a promising approach for hyperthermia cancer therapy.


Asunto(s)
Neoplasias del Colon/terapia , Hipertermia Inducida/instrumentación , Hierro/administración & dosificación , Magnetismo/instrumentación , Nanopartículas/uso terapéutico , Nanotecnología/instrumentación , Óxidos/administración & dosificación , Animales , Línea Celular Tumoral , Supervivencia Celular , Neoplasias del Colon/patología , Dextranos , Diseño de Equipo , Análisis de Falla de Equipo , Óxido Ferrosoférrico , Hipertermia Inducida/métodos , Inyecciones , Hígado/patología , Nanopartículas de Magnetita , Ratones , Ratones Endogámicos BALB C , Nanotecnología/métodos , Ratas
20.
Am J Surg ; 182(3): 260-4, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11587689

RESUMEN

BACKGROUND: A stainless-sheathed, straight needle with a hook near the top of the inner needle was designed to facilitate hepatic resections. METHODS: First, using this needle, two rows of interlocking mattress sutures were made along the division line; then, hepatic transection was performed between these rows by electrocautery or forceps. RESULTS: Since 1997, we have performed this kind of hepatic resections in 43 cases, including 9 right lobectomies, 5 bisegmentectomies, 7 segmentectomies, 4 subsegmentectomies, 2 partial hepatectomies, 15 left lateral segmentectomies, and 1 hepatorrhaphy. In most cases, intraoperative hemorrhage was minimal. Neither specified inflow nor backflow control procedures were needed. CONCLUSION: Use of this needle may reduce the difficulty of the technique and blood loss for right hepatic lobectomy, left lateral segmentectomy, and some segmental or partial hepatectomy procedures.


Asunto(s)
Hepatectomía/instrumentación , Agujas , Pérdida de Sangre Quirúrgica/prevención & control , Diseño de Equipo , Humanos , Suturas
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