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1.
Inflamm Res ; 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39164592

RESUMO

OBJECTIVE: Porphyromonas gingivalis (P. gingivalis), one of the major periodontopathogens, is associated with the progression and exacerbation of atherosclerosis. In this study, we aimed to investigate whether the gastrin-releasing peptide receptor antagonist, RC-3095, could attenuate P. gingivalis LPS-induced inflammatory responses in endothelial cells and macrophages, as well as atherosclerosis in an ApoE-/- mouse model treated with P. gingivalis LPS. METHODS: The effect of RC-3095 on P. gingivalis LPS-induced endothelial inflammation was examined using HUVECs and rat aortic endothelium. THP-1 cells were polarized into M1 macrophages by exposure to P. gingivalis LPS, with or without RC-3095. The effect of RC-3095 on atherosclerosis progression was assessed in high-fat-fed male ApoE-/- mice through injections of P. gingivalis LPS, RC-3095, or a combination of both. RESULTS: RC-3095 significantly reduced P. gingivalis LPS-induced leukocyte adhesion to endothelial cells and aortic endothelium by suppressing NF-κB-dependent expressions of ICAM-1 and VCAM-1. In addition, RC-3095 inhibited the P. gingivalis LPS-induced polarization of M1 macrophages by blocking the MAPK and NF-κB signaling pathways. Moreover, RC-3095 decreased the area of atherosclerotic lesions in ApoE-/- mice, which was accelerated by P. gingivalis LPS injection, and lowered the expressions of ICAM-1 and VCAM-1 in the aortic tissue of mice with atherosclerosis. CONCLUSIONS: RC-3095 can alleviate P. gingivalis LPS-induced endothelial inflammation, macrophage polarization, and atherosclerosis progression, suggesting its potential as a therapeutic approach for periodontal pathogen-associated atherosclerosis.

2.
J Pers Med ; 14(8)2024 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-39202018

RESUMO

In this study, we aimed to demonstrate the feasibility and safety of navigating the ureters, middle sacral artery (MSA), and superior hypogastric nerve (SHN) using indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging during robot-assisted sacrocolpopexy (RSCP). Overall, 15 patients who underwent RSCP for apical vaginal prolapse were retrospectively enrolled. All patients underwent cystoscopic intraureteric instillation of 5 cc ICG (2.5 mg/mL) before RSCP and intravenous injection of 3 cc ICG during presacral dissection and mesh fixation. In all patients, the fluorescent right ureter was clearly identified in real time. The MSA was visualized on ICG-NIRF images in 80% (13/15) of patients. The mean time from ICG injection to MSA visualization was 43.7 s; the mean duration of the arterial phase was 104.3 s. Fluorescent SHN was detected in 73.3% (11/15) of patients. The time from ICG injection to SHN fluorescence was 48.4 s; the duration of fluorescence was 177.2 s. There was no transfusion, iatrogenic ureteral injury, or bowel or urinary dysfunction. Our results indicated that intraoperative ureter, MSA, and SHN mapping using ICG-NIRF images during RSCP is a valuable and safe technique to avoid iatrogenic ureteral, vascular, and neural injuries and to simplify surgical procedures. Nonetheless, further studies are required.

3.
Yonsei Med J ; 65(7): 406-412, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38910303

RESUMO

PURPOSE: Robotic single-site plus one-port myomectomy (RSOM) was designed to reduce the number of incision sites for greater cosmetic satisfaction of patients while retaining the benefits of conventional robotic multi-site myomectomy (CRM). Robotic single-site plus two-port myomectomy (RSTM) eliminated one port relative to conventional CRM, and RSOM achieved the same advantage with respect to RSTM. This study aimed to compare RSOM with RSTM in terms of their respective methodologies and surgical outcomes. MATERIALS AND METHODS: The medical records of 230 patients who had undergone RSOM and 146 patients who had undergone RSTM were reviewed. The groups' surgical outcomes were compared using propensity score matching (PSM) analysis. RESULTS: In the total data, RSOM had a shorter operative time (135.1±57.4 min vs. 149.9±46.2 min, p=0.009) and a shorter hospital stay (5.2±0.5 days vs. 5.4±0.7 days, p=0.033) relative to RSTM. The PSM analysis showed that there were no statistically significant intergroup differences in the patients' baseline characteristics. Regarding the surgical outcomes, the RSOM group showed shorter operative time (129.2±49.3 min vs. 148.7±46.3 min, p=0.001) compared to the RSTM group. CONCLUSION: Compared with RSTM, RSOM was associated with shorter operative time. Additionally, more detailed comparative and prospective studies are needed to evaluate RSOM relative to RSTM.


Assuntos
Duração da Cirurgia , Pontuação de Propensão , Procedimentos Cirúrgicos Robóticos , Miomectomia Uterina , Humanos , Feminino , Miomectomia Uterina/métodos , Adulto , Procedimentos Cirúrgicos Robóticos/métodos , Tempo de Internação , Resultado do Tratamento , Pessoa de Meia-Idade , Estudos Retrospectivos , Leiomioma/cirurgia , Neoplasias Uterinas/cirurgia
4.
ACS Infect Dis ; 10(5): 1624-1643, 2024 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-38652574

RESUMO

The discovery of safe and efficient inhibitors against efflux pumps as well as metallo-ß-lactamases (MBL) is one of the main challenges in the development of multidrug-resistant (MDR) reversal agents which can be utilized in the treatment of carbapenem-resistant Gram-negative bacteria. In this study, we have identified that introduction of an ethylene-linked sterically demanding group at the 3-OH position of the previously reported MDR reversal agent di-F-Q endows the resulting compounds with hereto unknown multitarget inhibitory activity against both efflux pumps and broad-spectrum ß-lactamases including difficult-to-inhibit MBLs. A molecular docking study of the multitarget inhibitors against efflux pump, as well as various classes of ß-lactamases, revealed that the 3-O-alkyl substituents occupy the novel binding sites in efflux pumps as well as carbapenemases. Not surprisingly, the multitarget inhibitors rescued the antibiotic activity of a carbapenem antibiotic, meropenem (MEM), in NDM-1 (New Delhi Metallo-ß-lactamase-1)-producing carbapenem-resistant Enterobacteriaceae (CRE), and they reduced MICs of MEM more than four-fold (synergistic effect) in 8-9 out of 14 clinical strains. The antibiotic-potentiating activity of the multitarget inhibitors was also demonstrated in CRE-infected mouse model. Taken together, these results suggest that combining inhibitory activity against two critical targets in MDR Gram-negative bacteria, efflux pumps, and ß-lactamases, in one molecule is possible, and the multitarget inhibitors may provide new avenues for the discovery of safe and efficient MDR reversal agents.


Assuntos
Antibacterianos , Proteínas de Bactérias , Farmacorresistência Bacteriana Múltipla , Testes de Sensibilidade Microbiana , Simulação de Acoplamento Molecular , Quercetina , beta-Lactamases , beta-Lactamases/metabolismo , Animais , Antibacterianos/farmacologia , Antibacterianos/química , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Camundongos , Proteínas de Bactérias/antagonistas & inibidores , Proteínas de Bactérias/metabolismo , Quercetina/farmacologia , Quercetina/química , Inibidores de beta-Lactamases/farmacologia , Inibidores de beta-Lactamases/química , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/enzimologia , Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos , Sinergismo Farmacológico , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/microbiologia , Feminino
5.
Stem Cell Res ; 76: 103361, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38437769

RESUMO

We generated a human induced pluripotent stem cell (iPSC) line from the peripheral blood mononuclear cells isolated from a 59-year-old male patient with Alzheimer's disease (AD). The iPSC line was meticulously characterized to confirm its pluripotency, absence of transgenes, and normal karyotype. The unexpected discovery of the M232R variant in PRNP makes this cell line a valuable resource for investigating AD pathogenesis.


Assuntos
Doença de Alzheimer , Células-Tronco Pluripotentes Induzidas , Masculino , Humanos , Pessoa de Meia-Idade , Células-Tronco Pluripotentes Induzidas/metabolismo , Doença de Alzheimer/patologia , Leucócitos Mononucleares/metabolismo , Linhagem Celular , Diferenciação Celular , Proteínas Priônicas/metabolismo
6.
Pharmaceutics ; 16(2)2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38399246

RESUMO

The combination of aztreonam (ATM) and ceftazidime-avibactam (CAZ-AVI; CZA) has shown therapeutic potential against serine-ß-lactamase (SBL)- and metallo-ß-lactamase (MBL)-producing Enterobacterales. However, the ability of CZA to restore the antibiotic activity of ATM is severely limited in MBL-producing multidrug-resistant (MDR) Pseudomonas aeruginosa strains because of the myriad of intrinsic and acquired resistance mechanisms associated with this pathogen. We reasoned that the simultaneous inhibition of multiple targets associated with multidrug resistance mechanisms may potentiate the antibiotic activity of ATM against MBL-producing P. aeruginosa. During a search for the multitarget inhibitors through a molecular docking study, we discovered that di-F-Q, the previously reported efflux pump inhibitor of MDR P. aeruginosa, binds to the active sites of the efflux pump (MexB), as well as various ß-lactamases, and these sites are open to the 3-O-position of di-F-Q. The 3-O-substituted di-F-Q derivatives were thus synthesized and showed hereto unknown multitarget MDR inhibitory activity against various ATM-hydrolyzing ß-lactamases (AmpC, KPC, and New Delhi metallo-ß-lactamase (NDM)) and the efflux pump of P. aeruginosa, presumably by forming additional hydrophobic contacts with the targets. The multitarget MDR inhibitor 27 effectively potentiated the antimicrobial activity of ATM and reduced the MIC of ATM more than four-fold in 19 out of 21 MBL-producing P. aeruginosa clinical strains, including the NDM-producing strains which were highly resistant to various combinations of ATM with ß-lactamase inhibitors and/or efflux pump inhibitors. Our findings suggest that the simultaneous inhibition of multiple MDR targets might provide new avenues for the discovery of safe and efficient MDR reversal agents which can be used in combination with ATM against MBL-producing MDR P. aeruginosa.

7.
Molecules ; 28(18)2023 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-37764491

RESUMO

Hispidulin is a natural bioactive flavonoid that has been studied for its potential therapeutic properties, including its anti-inflammatory, antioxidant, and neuroprotective effects. The aim of this study was to explore whether hispidulin could inhibit the endothelial inflammation triggered by Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS). The adhesion of monocytes to the vascular endothelium was evaluated through in vitro and ex vivo monocyte adhesion assays. We analyzed the migration of monocytes across the endothelial layer using a transmigration assay. The results showed that treatment with hispidulin decreased the P. gingivalis LPS-induced adhesion of monocytes to endothelial cells and their migration by suppressing the P. gingivalis LPS-triggered expression of intercellular adhesion molecule-1 (ICAM-1) through downregulating nuclear factor-қB (NF-қB). In addition, hispidulin inhibited P. gingivalis LPS-induced mitogen-activated protein kinases (MAPKs) and AKT in endothelial cells. Altogether, the results indicate that hispidulin suppresses the vascular inflammation induced by P. gingivalis LPS. Mechanistically, it prevents the adhesion of monocytes to the vascular endothelium and migration and inhibits NF-қB, MAPKs, and AKT signaling in endothelial cells.


Assuntos
Lipopolissacarídeos , Porphyromonas gingivalis , Humanos , Porphyromonas gingivalis/metabolismo , Lipopolissacarídeos/farmacologia , Células Endoteliais , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Monócitos , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Molécula 1 de Adesão Intercelular/metabolismo , NF-kappa B/metabolismo
8.
J Dent Sci ; 18(3): 1062-1072, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37404644

RESUMO

Background/purpose: Human dental pulp stem cells (hDPSCs) are an emerging source of mesenchymal stem cells (MSCs) for bone tissue regeneration and engineering. In bone regeneration using transplanted MSCs, the extracellular environment or co-injected drugs can affect their success or failure. In this study, we investigated the effects and signaling mechanisms of lidocaine on osteogenic differentiation of hDPSCs after inducing inflammatory conditions with lipopolysaccharide (LPS) and tumor necrosis factor-alpha (TNF-α). Materials and methods: To investigate the effect of lidocaine on the osteogenic differentiation of LPS/TNF-α-treated hDPSCs, alkaline phosphatase (ALP) and Alizarin red S (ARS) staining were conducted. The expression of osteogenesis-related genes was assessed using quantitative real-time polymerase chain reaction and western blotting. The expression of mitogen-activated protein kinases was analyzed to evaluate the effect of lidocaine on osteogenic differentiation of LPS/TNF-α-treated hDPSCs. Results: Various concentrations of lidocaine (0.05, 0.2, and 1 mM) further decreased ALP and ARS staining of LPS/TNF-α-treated hDPSCs. Similarly, the mRNA and protein expression of osteogenesis-related genes was suppressed via lidocaine treatment in LPS/TNF-α-treated hDPSCs. Lidocaine treatment downregulated the protein expression of p-ERK and p-JNK in LPS/TNF-α-treated hDPSCs. Conclusion: Lidocaine intensified the inhibition of osteogenic differentiation on inflammation-induced hDPSCs by inhibiting the ERK and JNK signaling pathways. This in vitro study suggested that lidocaine may have an inhibitory effect on bone regeneration.

9.
J Dent Sci ; 18(2): 577-585, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37021242

RESUMO

Background/purpose: Naringenin, a naturally occurring flavanone in citrus fruits, regulates bone formation by bone marrow-derived mesenchymal stem cells. The purpose of this study was to characterize the effects of naringenin on some biological behaviors of human dental pulp stem cells (HDPSCs). Materials and methods: HDPSCs were cultured in osteogenic differentiation medium and osteo/odontogenic differentiation and mineralization were analyzed by alkaline phosphatase (ALP) staining and Alizarin Red S (ARS) staining. The migration of HDPSCs was evaluated by transwell chemotactic migration assays and scratch wound healing migration assay. Using tooth slice/scaffold model, we assessed the in vivo odontogenic differentiation potential of HDPSCs. Results: We have demonstrated that naringenin increases the osteogenic/odontogenic differentiation of HDPSCs through regulation of osteogenic-related proteins and the migratory ability of HDPSCs through stromal cell derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4) axis. Moreover, naringenin promotes the expression of dentin matrix acidic phosphoprotein-1 (DMP-1) and dentin sialophosphoprotein (DSPP) in HDPSCs seeded on tooth slice/scaffolds that are subcutaneously implanted into immunodeficient mice. Conclusion: Our present study suggests that naringenin promotes migration and osteogenic/odontogenic differentiation of HDPSCs and may serve as a promising candidate in dental tissue engineering and bone regeneration.

10.
Yonsei Med J ; 64(3): 204-212, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36825347

RESUMO

PURPOSE: The aims of this study were to evaluate the cumulative recurrence, reoperation, and pregnancy rates after ovarian endometrioma surgery at a single institution for more than a 5-year follow-up period. MATERIALS AND METHODS: This study was conducted as a retrospective chart review of patients with ovarian endometrioma who underwent surgery between January 2008 and March 2016. Study subjects included premenopausal women with at least 5 years of follow-up. Exclusion criteria were patients with stage I or II ovarian endometrioma, those who underwent hysterectomy or bilateral oophorectomy, and presence of residual ovarian lesions on the first postoperative ultrasonography at 3-6 months. Recurrence was defined as a cystic mass by ultrasonography. RESULTS: A total of 756 patients were recruited. The median follow-up duration was 85.5 months (interquartile range, 71-107 months). Recurrent endometrioma was detected in 27.9% patients, and reoperation was performed in 8.3% patients. Cumulative rates at 24, 36, 60, and 120 months were 5.8%, 8.7%, 15.5% and 37.6%, respectively, for recurrence and 0.1%, 0.5%, 2.9%, and 15.1%, respectively, for reoperation. After multivariable analysis, age ≤31 years [hazard ratio (HR)=2.108; 95% confidence interval (CI)=1.522-2.921; p<0.001], no subsequent pregnancy (HR=1.851; 95% CI=1.309-2.617; p<0.001), and postoperative hormonal treatment ≤15 months (HR=2.869; 95% CI=2.088-3.941; p<0.001) were significant risk factors for recurrent endometrioma. Among 315 patients who desired pregnancy, 54.0% were able to have a successful pregnancy and delivery. CONCLUSION: Considering that longer postoperative hormonal treatment is the sole modifiable factor for recurrent endometrioma, we recommend long-term hormonal treatment until subsequent pregnancy, especially in younger women.


Assuntos
Endometriose , Laparoscopia , Cistos Ovarianos , Neoplasias Ovarianas , Gravidez , Humanos , Feminino , Adulto , Endometriose/cirurgia , Endometriose/patologia , Taxa de Gravidez , Seguimentos , Estudos Retrospectivos , Cistos Ovarianos/cirurgia , Reoperação , Neoplasias Ovarianas/cirurgia , Fatores de Risco , Recidiva
11.
Taiwan J Obstet Gynecol ; 62(1): 12-15, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36720523

RESUMO

OBJECTIVE: The aim of this study was to determine whether robotic myomectomy (RM) resulted in any measurable clinical improvement over laparoscopic myomectomy (LM) in subsequent cesarean delivery. MATERIALS AND METHODS: The medical records of 273 patients who had undergone LM or RM followed by subsequent cesarean delivery for the period of September 2015 to December 2020 were retrospectively reviewed. The patients were divided into LM (n = 222) and RM (n = 51) groups. The cesarean delivery outcomes between the two groups were compared. RESULTS: RM had significantly more myomas removed (6.0 ± 4.8 vs. 3.6 ± 3.5, p < 0.001) and a larger size of largest myoma (7.7 ± 2.4 vs. 6.1 ± 2.4, p = 0.002) at myomectomy compared with LM. However, there were no significant differences in the groups' surgical characteristics at cesarean section, in their pregnancy complications, or in adhesion formation. CONCLUSIONS: Although more and larger myomas were removed in the RM group, RM showed similar cesarean delivery outcomes and adhesion formation to LM.


Assuntos
Laparoscopia , Leiomioma , Mioma , Procedimentos Cirúrgicos Robóticos , Miomectomia Uterina , Neoplasias Uterinas , Humanos , Gravidez , Feminino , Miomectomia Uterina/métodos , Leiomioma/cirurgia , Leiomioma/complicações , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/complicações , Cesárea , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Laparoscopia/métodos , Mioma/complicações , Mioma/cirurgia
12.
BMB Rep ; 56(2): 160-165, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36443004

RESUMO

Vascular calcification is common in cardiovascular diseases including atherosclerosis, and is associated with an increased risk of pathological events and mortality. Some semaphorin family members play an important role in atherosclerosis. In the present study, we show that Semaphorin 4D/Sema4D and its Plexin-B1 receptor were significantly upregulated in calcified aorta of a rat chronic kidney disease model. Significantly higher Sema4D and Plexin-B1 expression was also observed during inorganic phosphate-induced calcification of vascular smooth muscle cells. Knockdown of Sema4D or Plexin-B1 genes attenuated both the phosphate-induced osteogenic phenotype of vascular smooth muscle cells, through regulation of SMAD1/5 signaling, as well as apoptosis of vascular smooth muscle cells, through modulation of the Gas6/Axl/Akt survival pathway. Taken together, our results offer new insights on the role of Sema4D and Plexin-B1 as potential therapeutic targets against vascular calcification. [BMB Reports 2023; 56(3): 160-165].


Assuntos
Semaforinas , Calcificação Vascular , Ratos , Animais , Receptores de Superfície Celular/metabolismo , Músculo Liso Vascular/metabolismo , Semaforinas/genética , Semaforinas/metabolismo , Semaforinas/farmacologia
13.
Planta Med ; 89(4): 423-432, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36130708

RESUMO

(-)-Epigallocatechin gallate (EGCG) is one of the autophagy stimulators that have been reported to protect vascular endothelial cells from oxidative stress-induced damage. In this study, we attempted potentiation of the autophagy-stimulating activity of EGCG in human aortic epithelial cells (HAECs) by using the EGCG-phenylalanine conjugate, E10. Autophagy-stimulating activity of E10 was evaluated by LC3-II measurement in the absence and presence of the lysosomal blocker chloroquine, CTYO-ID staining, and reporter assay using tandem fluorescence-tagged LC3. These experiments revealed significantly enhanced autophagic flux stimulation in HAECs by E10 compared with EGCG. Further elaboration of E10 showed that activation of AMPK through phosphorylation as the major mechanism of its autophagy stimulation. Like other autophagy stimulators, E10 protected HAECs from lipotoxicity as well as accompanying endothelial senescence. Finally, stimulation of autophagy by E10 was shown to protect HAECs from oxidative stress-induced apoptosis. These findings collectively suggest potential clinical implications of E10 for various cardiovascular complications through stimulation of autophagy.


Assuntos
Catequina , Células Endoteliais , Humanos , Fenilalanina/farmacologia , Chá , Catequina/farmacologia , Catecóis , Autofagia
14.
Surgery ; 172(4): 1270-1277, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35934550

RESUMO

BACKGROUND: This study aimed to compare postoperative and clinical outcomes according to age and analyze the effect of age on mortality in patients admitted to the intensive care unit immediately after gastrointestinal cancer surgery. METHODS: A total of 477 patients admitted to the intensive care unit after gastrointestinal cancer surgery between March 2018, and February 2020, were classified into 3 groups according to age: young (<65 years), older (65-79 years), and oldest (≥80 years) groups. We compared their disease severity scores as well as postoperative and clinical outcomes including mortality. RESULTS: The young group comprised 167 (35.0%) patients, the older group 222 (46.5%) patients, and the oldest group 88 (18.4%) patients. There was a significant difference in the American Society of Anesthesiologists score, but not in the Acute Physiology and Chronic Health Evaluation II score, among the groups. The younger the age, the higher was the rate of vasopressor use; however, there were no significant differences in other postoperative and clinical outcomes, such as mechanical ventilation, length of hospital stay, length of intensive care unit stay, form of discharge, intensive care unit re-admission rate, in-hospital mortality, and in-30 days mortality. No significant differences in in-hospital survival, in-30 days survival, and overall survival were observed among the 3 groups. CONCLUSION: The comorbidities of patients increase with age; however, there was no significant difference in postoperative and clinical outcomes related to age. Thereby, the older population can successfully undergo major operations if adequate perioperative management is provided.


Assuntos
Neoplasias Gastrointestinais , Unidades de Terapia Intensiva , Idoso , Neoplasias Gastrointestinais/cirurgia , Mortalidade Hospitalar , Humanos , Tempo de Internação , Respiração Artificial , Estudos Retrospectivos
15.
J Pers Med ; 12(6)2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35743713

RESUMO

Background: Robotic single-site plus two port myomectomy (RSTM) was designed to reduce the number of incision sites while retaining the advantage of conventional robotic multi-port myomectomy (CRM). This study aimed to explicate RSTM and compare surgical outcomes between it and CRM. Methods: The medical records of 146 patients who had undergone RSTM and 173 who had undergone CRM were reviewed. The surgical outcomes between them were compared by propensity score matching (PSM) analysis. Results: The PSM analysis showed no statistically significant inter-group differences in patient characteristics. With regard to surgical outcomes, the RSTM group enjoyed shorter operative time (148.30 ± 44.8 vs. 162.3 ± 47.4 min, p = 0.011), less hemoglobin decrement (1.8 ± 0.9 vs. 2.3 ± 1.0 g/dL, p < 0.001), and shorter duration of hospital stay (5.4 ± 0.7 vs. 5.8 ± 0.7 days, p < 0.001). Conclusions: RSTM was associated with shorter operative time relative to CRM. Further prospective studies are needed in order to more fully investigate the advantages of RSTM.

16.
Yonsei Med J ; 63(5): 446-451, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35512747

RESUMO

PURPOSE: This study aimed to evaluate the cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis (AWE) after surgical treatment. MATERIALS AND METHODS: A retrospective cohort study was conducted at a single gynecological surgery center between January 2004 and December 2020. Patients who were surgically treated and followed up for at least 6 months after surgery were selected. RESULTS: Eighteen patients with pathologically diagnosed AWE were included in this study. The median follow-up duration was 22.5 months (range, 6-106). The median age was 37 years (range, 22-48), and 33.3% of the patients were nulliparous. Among the patients included in our study, 55.6% complained of a mass with cyclic pain, and 27.8% had a palpable mass. In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence. The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively. There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment. CONCLUSION: The recurrence rate of AWE appears to be correlated with the follow-up duration. There was no statistically significant risk factor for the recurrence of AWE. Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE. The findings of the current study may help healthcare providers in counselling and managing patients with AWE.


Assuntos
Parede Abdominal , Endometriose , Parede Abdominal/cirurgia , Adulto , Endometriose/cirurgia , Feminino , Humanos , Dor , Recidiva , Estudos Retrospectivos , Fatores de Risco
17.
J Ovarian Res ; 15(1): 41, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35387670

RESUMO

BACKGROUND: Ovarian "seromucinous carcinoma" has been recently removed in 2020 5th Edition of WHO classification of Female Genital Tumors and is considered as a subtype of endometrioid carcinoma with mucinous differentiation, while "seromucinous borderline tumor" remains and exists as a distinct entity. Both diseases may be considered as no more same lineage. However, ovarian seromucinous borderline tumor (SMBT) is also one of the endometriosis-related neoplasm of ovary similar to endometrioid tumor, featuring that about 50% of ovarian SMBTs combine endometriosis. The present study was aimed to investigate whether the ovarian SMBTs are different in clinical features and molecular patterns, according to the presence of combined endometriosis. RESULTS: There were no statistical differences in clinical findings between two groups. There was also no significant difference in pregnancy outcomes and recurrence between two groups. In immunohistochemical patterns, there was a statistically significant difference in PAX2 and PAX8 expression between in ovarian SMBT with or without endometriosis (P = 0.016, P < 0.001). Only a few cases of ovarian SMBT with endometriosis showed expression of PAX2 and conversely, most of the cases showed expression of PAX8. PR positivity was more prominent in ovarian SMBT with endometriosis than without endometriosis (P = 0.018), although there was no difference in positive ER expression. There were no statistical differences in WT1, CK20 and CDX2 expressions between two groups. CONCLUSIONS: Ovarian SMBT with endometriosis did not clinically differ from that without endometriosis. However, the molecular patterns were different between two groups and ovarian SMBT with endometriosis is close to endometrioid tumor types unlike SMBT without endometriosis. Further, a direct comparison study between seromucinous borderline tumor and endometrioid borderline tumor is needed with a gene profiling study to prove their relationship.


Assuntos
Carcinoma Endometrioide , Endometriose , Neoplasias dos Genitais Femininos , Neoplasias Ovarianas , Carcinoma Epitelial do Ovário , Feminino , Humanos , Neoplasias Ovarianas/patologia , Fator de Transcrição PAX2 , Fator de Transcrição PAX8
18.
J Pers Med ; 13(1)2022 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-36675678

RESUMO

BACKGROUND: The aim of this study was to introduce a coaxial-robotic single-site myomectomy (C-RSSM) technique to compensate for the shortcomings of robotic single-site myomectomy (RSSM) using semi-rigid instruments and to compare the surgical outcomes of C-RSSM and RSSM. METHODS: The medical records of 13 consecutive women who had undergone C-RSSM and 131 consecutive women who had undergone RSSM were retrospectively reviewed. Patient characteristics and surgical outcomes after propensity score matching were evaluated and compared between the two groups. RESULTS: According to the propensity score matching results, the C-RSSM group had a lower estimated blood loss (75.0 vs. 210.5 mL, p = 0.001) and a shorter operating time (101.0 vs. 146.1 min, p = 0.008) relative to the RSSM group. In RSSM, there was one case of conversion to conventional laparoscopy and four cases of conversion to the multi-site robotic approach. There was no case of conversion from C-RSSM to conventional laparoscopy or the multi-site robotic approach. CONCLUSIONS: C-RSSM was found to be associated with shorter operative time and lower estimated blood loss. However, further prospective studies are needed to confirm these advantages.

19.
J Pers Med ; 13(1)2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36675753

RESUMO

Background: There is still concern regarding postoperative adhesion formation and adverse effects on pregnancy outcomes caused by barbed suture (BS) after myomectomy. The aim of this study was to compare the postoperative adhesion and pregnancy outcomes between conventional suture (CS) and BS after minimally invasive myomectomy (MIM) by robotic myomectomy (RM) or laparoscopic myomectomy (LM). Methods: The medical records of 94 women who had undergone MIM with CS and 97 who had undergone MIM with BS and achieved pregnancy were reviewed. Postoperative adhesion was evaluated following cesarean section. Results: The number of removed myomas was greater (5.3 ± 4.6 vs. 3.5 ± 3.1, p = 0.001) and the size of the largest myoma was larger (7.0 ± 2.2 vs. 5.8 ± 2.7 cm, p = 0.001) in the BS group relative to the CS group. A total of 98.9% of patients in the CS group and 45.4% in the BS group had undergone LM (p < 0.001), while the others underwent RM. There was no significant difference in the presence of postoperative adhesion at cesarean section between the BS and CS groups (45.5 vs. 43.7%, p = 0.095). Additionally, there were no intergroup differences in pregnancy complications such as preterm labor, placenta previa, accrete or abruption. Note also that in our logistic regression analysis, the suture type (BS or CS) was excluded from the independent risk factors regarding postoperative adhesion formation. Conclusions: Our data indicated that the incidence of postoperative adhesion after MIM with BS was similar when compared with CS. Also it seems that the suture type does not have a significant effect on pregnancy outcomes.

20.
Medicine (Baltimore) ; 100(39): e27327, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34596135

RESUMO

ABSTRACT: During the COVID-19 pandemic, there are concerns about medical delay, including confirmatory tests after screening for various cancers. We evaluated the lead time to a confirmatory test after an abnormal screening Papanicolaou (Pap) test in women before the COVID-19 period and during the COVID-19 period.The medical records of 1144 women who underwent colposcopy at a single institution located in Seoul after abnormal Pap results from January 2019 to December 2020 were reviewed. The lead time to colposcopy from the Pap test between 2019 and 2020 was compared; the adverse factors for a long lead time to colposcopy were also evaluated.Age, residence, institution, and the Pap results did not differ between women who underwent colposcopy in 2019 (n = 621) and 2020 (n = 523). The time to colposcopy from the Pap test was also not different. A higher number of women were diagnosed with high-grade dysplasia in 2020 and underwent excision procedures; however, the difference was not statistically significant. Instead, patients' residence, institution of the Pap test, and results of the Pap test were associated with a long lead time to colposcopy of >6 weeks.The lead time to colposcopy from the abnormal Pap test was not delayed in the COVID-19 era compared to before. However, regional factors could affect a long lead time.


Assuntos
COVID-19/epidemiologia , Teste de Papanicolaou/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pandemias , República da Coreia/epidemiologia , Características de Residência , SARS-CoV-2 , Fatores de Tempo , Tempo para o Tratamento
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