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1.
Sci Rep ; 14(1): 23640, 2024 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-39384854

RESUMO

This study aimed to explore the clinical applicability of the shade-matching function in intraoral scanners. This study measured the tooth colors of maxillary anterior dentitions of 83 adults using visual matching, a spectrophotometer, and a scanner according to two color systems: VITA Classical (VC) and VITA 3D-Master (V3D). Agreement between each method was assessed by weighted Cohen's kappa coefficient (KW, α = 0.05). For V3D, the overall agreement between the scanner and spectrophotometer (KW = 0.498) was higher than that between the scanner and visual matching (KW = 0.473). Similarly, the agreement between the scanner and spectrophotometer (KW = 0.283) was higher than that between a scanner and visual matching (KW = 0.140) for VC. Regarding tooth position, the highest agreement between the scanner and spectrophotometer was observed on the right central incisor (KW = 0.542) for V3D. Tooth color measurement with a scanner was comparable to that with a spectrophotometer, especially on the central incisors when using the VITA 3D-Master system. A scanner could serve as an alternative to a spectrophotometer for shade selection. However, color matching should still be visually verified.


Assuntos
Cor , Espectrofotometria , Humanos , Espectrofotometria/métodos , Espectrofotometria/instrumentação , Masculino , Feminino , Adulto , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Adulto Jovem , Incisivo/anatomia & histologia , Pessoa de Meia-Idade , Pigmentação em Prótese/métodos , Pigmentação em Prótese/instrumentação
2.
J Gastrointest Surg ; 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39419276

RESUMO

BACKGROUND: Per-oral pyloromyotomy (POP), also known as gastric per-oral pyloromyotomy (G-POEM), is the first-line endoscopic intervention for medically refractory gastroparesis. We sought to assess the value of pyloric impedance planimetry using functional luminal imaging probe (FLIP) during POP. METHODS: Patients undergoing POP were retrospectively reviewed from October 2019-February 2024. FLIP measurements, symptoms measured by the gastroparesis cardinal symptom index (GCSI), and gastric emptying scintigraphy (GES) were evaluated before and after POP. RESULTS: Thirty-five patients (29 (82.9%) female, 51.3 (38.4, 60.9) years old, BMI 29.26 (25.46, 32.56kg/m2) underwent POP. Twenty-three patients had pre- and post-POP FLIP measurements. Median pyloric diameter increased from 14.4 (12, 16) to 16 (14.8, 18) mm (S=116.5, p<0.0001). Median distensibility index (DI) increased from 4.85 (3.38, 6) to 8.45 (5.25, 11) mm2/mmHg (S=112, p<0.0001). Management changed based on FLIP values for 5 patients (21.7%) prompting additional myotomy. At 18 (12.8, 47.8) days post-procedure, median GCSI score decreased from 3.33/5 (2.56, 4.12) preoperatively to 2/5 (1, 2.89) postoperatively (S=-193, p<0.001). At 136 (114, 277) day follow-, improvement in GCSI score persisted with a median score of 2.44/5 (1.44, 3.67) (S=-61, p=0.021). Median retention at 4hours on GES decreased from 29% (16.5, 52) to 19.5% (5.75, 35.3) at 97 (88, 130) days post-procedure (S=-108, p=0.0038). There was 75% improvement and 40% normalization of objective gastric emptying (n=26). Greater increase in diameter after pyloromyotomy correlated to a greater decrease in four-hour gastric retention (r=-0.4886, p=0.021). CONCLUSION: POP with FLIP resulted in clinical and radiographic improvement in patients with gastroparesis. FLIP measurements guided myotomy extent, changing management in 21.7% of patients and were correlated with gastric emptying, demonstrating its distinct utility in treatment of gastroparesis.

3.
Surg Endosc ; 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39327296

RESUMO

OBJECTIVE: During the advent of laparoscopy, surgeons directly explored the abdominal cavity with a telescope-like device through a small incision. Since then, numerous technological advances have transformed minimally invasive surgery (MIS). Yet, in our wireless world, various devices crowd the surgical field, with long wires and light sources posing fall and fire risks. The primary objective of this study was to analyze the first reported human use of a novel wireless laparoscopy system or WLS (ArthroFree™, Lazurite®, Cleveland, Ohio). METHODS: The utility and convenience of the WLS was assessed via two avenues: (1) by analyzing surgical outcomes from first human use and (2) by surveying healthcare professionals regarding its quality and utility. RESULTS: Eighteen patients (mean age 44.2, 83.3% female, mean BMI 33.4) underwent operations with the WLS. Operations included gynecologic and general surgical procedures. There were no intraoperative or postoperative complications, and no conversions to traditional laparoscopy or laparotomy. Mean operating time was 71.94 ± 20.41 min, and estimated blood loss was minimal. Survey results revealed varied individual experiences. Strengths included adequate illumination, improved ergonomics, and simplicity of setup and ease of operation. One respondent criticized the image resolution. Feedback indicated an overall positive impact, and 67% of respondents supported inclusion of the device at their facility. Moreover, its deployment in resource-limited settings abroad has demonstrated its efficacy in global surgery, indicating its potential in various healthcare environments. CONCLUSIONS: This is the first reported human use of a novel WLS. Clinical results supported efficiency and safety of the technology. The successful deployment of the WLS in diverse surgical environments, including resource-limited settings, highlights its potential as a universally adaptable tool in global surgery. This report represents a strong first step toward a wireless operating room with the promise of redefining surgical standards as well as bridging gaps in surgical care worldwide.

4.
5.
Ther Adv Med Oncol ; 16: 17588359241265209, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39091605

RESUMO

Background: Esophagogastric and pancreaticobiliary cancers are associated with chronic blood loss, poor nutrition, and surgical interventions that interfere with iron absorption. Patients with these cancers often have a higher incidence of chemotherapy-induced anemia (CIA) than patients with other malignancies. Objectives: To investigate the efficacy of intravenous iron or erythropoietin-stimulating agents (ESA) for CIA treatment in patients with esophagogastric or pancreaticobiliary cancer. Design: Retrospective, comparative chart review of patients with esophagogastric or pancreaticobiliary cancer who received ferric carboxymaltose (FCM), or darbepoetin alfa (DA), and myelosuppressive chemotherapy at Chungbuk National University Hospital between June 2018 and December 2022. Methods: To assess the efficacy of FCM or DA over time, data on hemoglobin (Hb) levels were collected from the time of administration of FCM or DA (baseline) until 6 months post-baseline, when available. Results: In total, 214 patients (124 in the FCM and 90 in the DA group) were included in the analysis. The FCM group had a higher maximum Hb level and Hb changes for 3 months (mean ± standard deviation) following FCM or DA administration from baseline than the DA group (11.3 ± 1.5 versus 10.9 ± 1.2 g/dL, p = 0.02 and 2.0 ± 1.4 versus 1.5 ± 1.1 g/dL, p = 0.004, respectively). The FCM group had a higher proportion of Hb responders than the DA group (83.9% versus 68.9%, p = 0.013). Based on multivariable analysis, only the CIA treatment group was a significant factor for Hb response (odds ratio = 2.06, 95% confidence interval = 1.05-4.06, p = 0.036). Conclusion: Both FCM and DA are effective, and FCM showed a higher Hb response than DA for CIA treatment in patients with esophagogastric or pancreaticobiliary cancer. Therefore, further randomized controlled trials should determine the optimal treatment for CIA in patients with these cancers undergoing myelosuppressive chemotherapy.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39174014

RESUMO

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion: This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

7.
Front Endocrinol (Lausanne) ; 15: 1392247, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39015180

RESUMO

Background: Papillary thyroid microcarcinoma (PTMC) is characterized by its favorable prognosis and potential for active surveillance (AS) as a management option. However, the presence of cervical lymph node (LN) metastasis, especially lateral LN metastasis, significantly impacts management and prognosis. Previous studies have focused on post-surgery risk factors for cervical LN metastasis. This study aims to identify predictors of lateral LN metastasis by analyzing pre-operative ultrasonographic findings alongside clinicopathological factors. Methods: A retrospective review of medical records was conducted for patients with PTMC who underwent surgery at Chonnam National University Hwasun Hospital between 2004 and 2013. This is a case-control study that compares patients with lateral LN metastasis (N1b) to age- and sex-matched patients without LN metastasis (N0). Subgroup analysis was performed to evaluate risk factors of skip metastasis. Results: The study included 90 patients with PTMC with lateral LN metastasis (N1b) and 268 age- and sex-matched patients without LN metastasis (N0). The mean age was 49.3 years, and female patients were dominant in both groups. Structural recurrences of 4.4% (4/90) were observed only in the N1b group. The N1b group exhibited a higher frequency of upper lobe tumor location compared to the N0 group (38.9% vs. 16.0%, p < 0.001). There was no significant difference in the locations with the presence of invasion to adjacent organs. A higher proportion of non-parallel shape was observed in the N1b group than the N0 group (80.0% vs. 66.0%, p = 0.013). There were no differences in echogenicity, sonographic feature, margin, and AP diameter of the thyroid gland between the two groups. In multivariate analysis, independent risk factors for lateral LN metastasis included extrathyroidal extension, multiplicity, upper lobe tumor location, and non-parallel shape. Skip metastasis in patients with PTMC was associated with upper lobe tumor location. Conclusion: Detailed ultrasound examinations, evaluating tumor location, number, orientation, and the presence of ETE, are crucial in accurately predicting lateral LN metastasis especially when primary tumor was in the upper lobe to avoid missing skip metastasis. These evaluations can help guide the decision between AS and immediate surgery in patients with PTMC.


Assuntos
Carcinoma Papilar , Metástase Linfática , Neoplasias da Glândula Tireoide , Humanos , Feminino , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Masculino , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Carcinoma Papilar/diagnóstico por imagem , Adulto , Estudos de Casos e Controles , Prognóstico , Fatores de Risco , Linfonodos/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/cirurgia , Tireoidectomia , Ultrassonografia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem
8.
Appl Nurs Res ; 78: 151819, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-39053992

RESUMO

AIMS: This study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses. METHODS: Structured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs. RESULTS: The total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health. CONCLUSION: The study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health. IMPLEMENTATION: Our research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.


Assuntos
Esgotamento Profissional , Enfermagem Psiquiátrica , Apoio Social , Humanos , Esgotamento Profissional/psicologia , República da Coreia , Adulto , Feminino , Masculino , Inquéritos e Questionários , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Saúde Mental/estatística & dados numéricos , Análise de Classes Latentes , Violência/psicologia , Violência/estatística & dados numéricos
9.
Surg Endosc ; 38(9): 5377-5384, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39043885

RESUMO

INTRODUCTION: Peroral endoscopic myotomy (POEM) is the standard treatment for achalasia. Functional luminal imaging probe (FLIP) technology enables objective measurement of lower esophageal sphincter (LES) geometry, with literature linking specific values to improved post-POEM outcomes. Our study assesses FLIP's intraoperative use in evaluating myotomy extent in real-time. METHODS: Retrospective data from all patients undergoing POEM with intraoperative FLIP measurements were extracted from June 2020 to January 2023. The primary endpoint was intraoperative FLIP measurements, management changes, and symptom improvement (Eckardt score). RESULTS: Fourteen patients (age 56 ± 14 years, BMI 28 ± 7 kg/m2) were identified. Most patients were female (64%). Predominantly, patients presented with type II achalasia (50%). FLIP measurements were taken before and after myotomy, demonstrating increases in mean distensibility index (DI) 1.6 ± 1. 4 to 5.4 ± 2.1 mm2/mmHg (p < 0.05) and mean diameter (Dmin) 6 ± 1.8 to 10.9 ± 2.3 mm (p < 0.05) at 50 ml balloon fill. Additional myotomy was performed in one patient when an inadequate increase in FLIP values were noted. Mean operative time was 98 ± 28 min, and there were no intraoperative complications. At the 30-day follow-up, median Eckardt score decreased from mean a preoperative score of 7 ± 2 to a post-operative mean of 2 ± 3, with 10 patients (78%) having a score ≤ 2. In total, four patients experienced symptom recurrence, with repeat FLIP values revealing a significant decrease in DI from 7 ± 2.2 post-POEM to 2.5 ± 1.5 at recurrence. FLIP technology identified LES pathology in 3 out of 4 (75%) patients, facilitating referral to LES-directed therapy. CONCLUSION: Our study adds to the literature supporting the use of FLIP technology during the POEM procedure, with most patients achieving ideal values after a standard-length myotomy. This suggests the potential benefits of shorter myotomies guided by FLIP to achieve comparable outcomes and reduce postoperative GERD risk. Collaborative standardization of study designs and outcome measures is crucial for facilitating prospective trials and cross-setting outcome comparisons.


Assuntos
Acalasia Esofágica , Miotomia , Cirurgia Endoscópica por Orifício Natural , Humanos , Pessoa de Meia-Idade , Feminino , Acalasia Esofágica/cirurgia , Acalasia Esofágica/diagnóstico por imagem , Masculino , Estudos Retrospectivos , Miotomia/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Impedância Elétrica , Adulto , Idoso , Esfíncter Esofágico Inferior/cirurgia , Esfíncter Esofágico Inferior/fisiopatologia , Resultado do Tratamento
10.
Front Oncol ; 14: 1395473, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39035743

RESUMO

Purpose: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive tumor with a poor prognosis that poses challenges for diagnosis using traditional tissue-based techniques. DNA methylation alterations have emerged as potential and promising biomarkers for PDAC. In this study, we aimed to assess the diagnostic potential of a novel DNA methylation assay based on epigenetic-specific peptide nucleic acid (Epi-sPNA) in both tissue and plasma samples for detecting PDAC. Materials and methods: The study involved 46 patients with PDAC who underwent surgical resection. Epi-TOP pancreatic assay was used to detect PDAC-specific epigenetic biomarkers. The Epi-sPNA allowed accurate and rapid methylation analysis without bisulfite sample processing. Genomic DNA extracted from paired normal pancreatic and PDAC tissues was used to assess the diagnostic efficacy of epigenetic biomarkers for PDAC. Subsequent validation was conducted on cell-free DNA (cfDNA) extracted from plasma samples, with 10 individuals represented in each group: PDAC, benign pancreatic cystic neoplasm, and healthy control. Results: The combination of seven epigenetic biomarkers (HOXA9, TWIST, WT1, RPRM, BMP3, NPTX2, and BNC1) achieved 93.5% sensitivity and 96.7% specificity in discerning normal pancreatic from PDAC tissues. Plasma cfDNA, analyzed using these markers and KRAS mutations, exhibited a substantial 90.0% sensitivity, 95.0% specificity, and an overall 93.3% accuracy for discriminating PDAC. Notably, cancer antigen 19-9 and carcinoembryonic antigen both had an accuracy of 90.0%. Conclusion: Our study suggests that analyzing seven differentially methylated genes with KRAS mutations in cfDNA using the novel Epi-TOP pancreatic assay is a potential blood-based biomarker for the diagnosis of PDAC.

12.
Cancer Res Treat ; 56(4): 1050-1057, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38853540

RESUMO

PURPOSE: Hand-foot syndrome (HFS) and hand-foot skin reaction (HFSR) are relatively common toxicities that interfere with the quality of life (QoL) of patients with cancer. Anti-inflammatory tripeptide cream (ATPC) is a complex formulation of anti-inflammatory tripeptides, the CD99-agonist Binterin and the Wnt-antagonist Winhibin. The present study aimed to assess the therapeutic effects of ATPC in HFS/HFSR associated with anticancer drugs. MATERIALS AND METHODS: This was a single-center, randomized, double-blind, placebo-controlled trial. Patients who developed grade 1 HFS/HFSR after systemic anticancer treatments were enrolled, and randomly assigned to receive either ATPC or placebo cream (PC) and followed up at 3-week intervals for up to 9 weeks. Primary endpoint was the development of grade ≥ 2 HFS/HFSR. RESULTS: Between April 2019 and July 2022, 60 patients (31 in the ATPC and 29 in the PC group) completed the study. The incidence of grade ≥ 2 HFS/HFSR was significantly lower in the ATPC than in the PC group (25.8% vs. 51.7%, p=0.039). The ATPC showed trends towards a better QoL score, assessed by a HFSR and QoL questionnaire at 9 weeks (26.0 vs. 29.9, p=0.574), and a lower frequency of discontinuation, interruption, or dose reduction of anticancer drugs (51.6% vs. 58.6%, p=0.586) than the PC group over 9 weeks, though without statistical significance. CONCLUSION: Our results showed that ATPC significantly decreased the development of grade ≥ 2 HFS/HFSR in patients already with HFS/HFSR. Therefore, ATPC may be an effective treatment for HFS/HFSR associated with anticancer drugs.


Assuntos
Antineoplásicos , Síndrome Mão-Pé , Humanos , Feminino , Masculino , Síndrome Mão-Pé/etiologia , Síndrome Mão-Pé/tratamento farmacológico , Método Duplo-Cego , Pessoa de Meia-Idade , Projetos Piloto , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Idoso , Creme para a Pele/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Anti-Inflamatórios/farmacologia , Qualidade de Vida , Resultado do Tratamento , Adulto , Oligopeptídeos/uso terapêutico , Oligopeptídeos/administração & dosagem , Oligopeptídeos/farmacologia , Oligopeptídeos/efeitos adversos , Neoplasias/tratamento farmacológico
13.
Endoscopy ; 56(10): 749-758, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38718833

RESUMO

BACKGROUND: Disposable digital single-operator cholangioscopy (D-SOC) and direct peroral cholangioscopy (D-POC) using an ultraslim endoscope are established POC modalities for the diagnosis and treatment of various biliary diseases. We compared the usefulness of D-SOC and D-POC for the diagnosis of intraductal superficial lesions of the bile duct (ISL-Bs). METHODS: 38 consecutive patients with suspected biliary diseases who underwent both D-SOC and D-POC were enrolled. The primary outcome was ISL-B detection rate, and the secondary outcomes were technical success of POC and POC-guided forceps biopsy sampling (POC-FB), procedure time, visualization quality, and tissue adequacy. RESULTS: D-SOC had a higher technical success rate than D-POC but the difference was not statistically significant (100% vs. 92.1%, P = 0.25). D-POC had a marginally higher ISL-B detection rate (34.2% vs. 28.9%, P = 0.68) and significantly higher visualization quality (P = 0.03). The mean (SD) procedure time was significantly shorter with D-SOC (11.00 [1.33] vs. 19.03 [2.95] minutes, P<0.001). The technical success rate of POC-FB and tissue adequacy did not differ between the two techniques (D-SOC vs. D-POC: 81.8% vs. 84.6%, P = 0.69 and 77.8% vs. 90.9%, P = 0.57, respectively). CONCLUSIONS: Both POC systems were safe and useful for the detection, characterization, and diagnosis of minute ISL-Bs. While D-SOC displayed a shorter procedure time and a tendency for higher technical success rate, D-POC provided superior visualization quality, allowing detailed observation of the surface structure and microvascular patterns.


Assuntos
Endoscopia do Sistema Digestório , Humanos , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Endoscopia do Sistema Digestório/métodos , Endoscopia do Sistema Digestório/instrumentação , Equipamentos Descartáveis , Duração da Cirurgia , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Doenças dos Ductos Biliares/diagnóstico
14.
Endocrinol Metab (Seoul) ; 39(2): 334-343, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38572536

RESUMO

BACKGRUOUND: Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), serve as valuable prognostic indicators in various cancers. This multicenter, retrospective cohort study assessed the treatment outcomes of lenvatinib in 71 patients with radioactive iodine (RAI)-refractory thyroid cancer, considering the baseline inflammatory biomarkers. METHODS: This study retrospectively included patients from five tertiary hospitals in Korea whose complete blood counts were available before lenvatinib treatment. Progression-free survival (PFS) and overall survival (OS) were evaluated based on the median value of inflammatory biomarkers. RESULTS: No significant differences in baseline characteristics were observed among patients grouped according to the inflammatory biomarkers, except for older patients with a higher-than-median NLR (≥2) compared to their counterparts with a lower NLR (P= 0.01). Patients with a higher-than-median NLR had significantly shorter PFS (P=0.02) and OS (P=0.017) than those with a lower NLR. In multivariate analysis, a higher-than-median NLR was significantly associated with poor OS (hazard ratio, 3.0; 95% confidence interval, 1.24 to 7.29; P=0.015). However, neither the LMR nor the PLR was associated with PFS. A higher-than-median LMR (≥3.9) was significantly associated with prolonged OS compared to a lower LMR (P=0.036). In contrast, a higher-than-median PLR (≥142.1) was associated with shorter OS compared to a lower PLR (P=0.039). CONCLUSION: Baseline inflammatory biomarkers can serve as predictive indicators of PFS and OS in patients with RAI-refractory thyroid cancer treated with lenvatinib.


Assuntos
Radioisótopos do Iodo , Neutrófilos , Compostos de Fenilureia , Quinolinas , Neoplasias da Glândula Tireoide , Humanos , Compostos de Fenilureia/uso terapêutico , Feminino , Masculino , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/mortalidade , Pessoa de Meia-Idade , Estudos Retrospectivos , Prognóstico , Idoso , Quinolinas/uso terapêutico , Radioisótopos do Iodo/uso terapêutico , Adulto , Inflamação , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/sangue , Linfócitos , Idoso de 80 Anos ou mais , República da Coreia , Biomarcadores/sangue
15.
Gastric Cancer ; 27(4): 858-868, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38647977

RESUMO

BACKGROUND: During sentinel node navigation surgery in patients with gastric cancer, intraoperative pathologic examination of sentinel nodes is crucial in determining the extent of surgery. In this study, we evaluated the feasibility and accuracy of intraoperative pathologic protocols using data from a prospective, multicenter, randomized trial. METHODS: A retrospective analysis was conducted using data from the SEntinel Node ORIented Tailored Approach trials from 2013 to 2016. All sentinel lymph nodes were evaluated during surgery with hematoxylin-eosin (HE) staining using a representative section at the largest plane for lymph nodes. For permanent histologic evaluation, sentinel basin nodes were stained with HE and cytokeratin immunohistochemistry in formalin-fixed, paraffin-embedded (FFPE) sections and examined with HE for three deeper-step sections at 200-µm intervals. The failure rate of identification by frozen section and the metastasis rate in non-sentinel basins were investigated. RESULTS: Of the 237 patients who underwent sentinel node basin dissection, 30 had lymph node metastases on permanent pathology. Thirteen patients had macrometastasis confirmed in frozen sections as well as FFPE sections (failure rate: 0%). Patients with negative sentinel nodes in frozen sections but micrometastasis in FFPE sections had no lymph node recurrence during the follow-up period (0%, 0/6). However, in cases with tumor-positive nodes in frozen sections, metastases in non-sentinel basins were detected in the paraffin blocks (8.3%, 2/24). CONCLUSIONS: The single-section HE staining method is sufficient for detecting macrometastasis via intraoperative pathological examination. If a negative frozen-section result is confirmed, sentinel basin dissection can be performed safely. Otherwise, standard surgery is required.


Assuntos
Estudos de Viabilidade , Metástase Linfática , Biópsia de Linfonodo Sentinela , Linfonodo Sentinela , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Masculino , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Feminino , Biópsia de Linfonodo Sentinela/métodos , Idoso , Pessoa de Meia-Idade , Estudos Retrospectivos , Metástase Linfática/patologia , Estudos Prospectivos , Gastrectomia/métodos , Idoso de 80 Anos ou mais , Adulto , Secções Congeladas/métodos , Excisão de Linfonodo/métodos
16.
J Nat Prod ; 87(3): 591-599, 2024 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-38442389

RESUMO

A new polyol polyketide, named retinestatin (1), was obtained and characterized from the culture of a Streptomyces strain, which was isolated from a subterranean nest of the termite Reticulitermes speratus kyushuensis Morimoto. The planar structure of 1 was elucidated on the basis of the cumulative analysis of ultraviolet, infrared, mass spectrometry, and nuclear magnetic resonance spectroscopic data. The absolute configuration of 1 at 12 chiral centers was successfully assigned by employing a J-based configuration analysis in combination with ROESY correlations, a quantum mechanics-based computational approach to calculate NMR chemical shifts, and a 3 min flash esterification by Mosher's reagents followed by NMR analysis. Biological evaluation of retinestatin (1) using an in vitro model of Parkinson's disease revealed that 1 protected SH-SY5Y dopaminergic cells from MPP+-induced cytotoxicity, indicating its neuroprotective effects.


Assuntos
Isópteros , Neuroblastoma , Policetídeos , Polímeros , Streptomyces , Animais , Humanos , Policetídeos/química , Estrutura Molecular , Streptomyces/química
17.
Int J Mol Sci ; 25(5)2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38473814

RESUMO

Alzheimer's disease (AD) stands as the most prevalent neurodegenerative disorder, characterized by a multitude of pathological manifestations, prominently marked by the aggregation of amyloid beta. Recent investigations have revealed a compelling association between excessive adiposity and glial activation, further correlating with cognitive impairments. Additionally, alterations in levels of insulin-like growth factor 1 (IGF-1) have been reported in individuals with metabolic conditions accompanied by memory dysfunction. Hence, our research endeavors to comprehensively explore the impact of IGF-1 on the hippocampus and adipose tissue in the context of Alzheimer's disease. To address this, we have conducted an in-depth analysis utilizing APP/PS2 transgenic mice, recognized as a well-established mouse model for Alzheimer's disease. Upon administering IGF-1 injections to the APP/PS2 mice, we observed notable alterations in their behavioral patterns, prompting us to undertake a comprehensive transcriptomic analysis of both the hippocampal and adipose tissues. Our data unveiled significant modifications in the functional profiles of these tissues. Specifically, in the hippocampus, we identified changes associated with synaptic activity and neuroinflammation. Concurrently, the adipose tissue displayed shifts in processes related to fat browning and cell death signaling. In addition to these findings, our analysis enabled the identification of a collection of long non-coding RNAs and circular RNAs that exhibited significant changes in expression subsequent to the administration of IGF-1 injections. Furthermore, we endeavored to predict the potential roles of these identified RNA molecules within the context of our study. In summary, our study offers valuable transcriptome data for hippocampal and adipose tissues within an Alzheimer's disease model and posits a significant role for IGF-1 within both the hippocampus and adipose tissue.


Assuntos
Doença de Alzheimer , Camundongos , Animais , Doença de Alzheimer/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Peptídeos beta-Amiloides/metabolismo , Transcriptoma , Hipocampo/metabolismo , Camundongos Transgênicos , Perfilação da Expressão Gênica , Tecido Adiposo Branco/metabolismo
18.
Endocrinol Metab (Seoul) ; 39(1): 152-163, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38417830

RESUMO

BACKGRUOUND: Active surveillance (AS) has been introduced as a management strategy for low-risk papillary thyroid carcinoma (PTC) due to its typically indolent nature. Despite this, the widespread adoption of AS has encountered several challenges. The aim of this systematic review was to evaluate the safety of AS related to disease progression and its benefits compared with immediate surgery (IS). METHODS: Studies related to AS in patients with low-risk PTC were searched through the Ovid MEDLINE, Embase, Cochrane Library, and KoreaMed databases. Studies on disease progression, surgical complication, quality of life (QoL), and cost-effectiveness were separately analyzed and narratively synthesized. RESULTS: In the evaluation of disease progression, the proportions of cases with tumor growth ≥3 mm and a volume increase >50% were 2.2%-10.8% and 16.0%-25.5%, respectively. Newly detected lymph node metastasis was identified in 0.0%-1.4% of patients. No significant difference was found between IS and delayed surgery in surgical complications, including vocal cord paralysis and postoperative hypoparathyroidism. AS was associated with better QoL than IS. Studies on the cost-effectiveness of AS reported inconsistent data, but AS was more cost-effective when quality-adjusted life years were considered. CONCLUSION: AS is an acceptable management option for patients with low-risk PTC based on the low rate of disease progression and the absence of an increased mortality risk. AS has additional benefits, including improved QoL and greater QoL-based cost-effectiveness.


Assuntos
Progressão da Doença , Qualidade de Vida , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Conduta Expectante , Humanos , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Câncer Papilífero da Tireoide/patologia , Conduta Expectante/métodos , Análise Custo-Benefício , Tireoidectomia/métodos
19.
Gut Liver ; 18(2): 358-364, 2024 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-38409663

RESUMO

Background/Aims: : Peroral cholangioscopy (POC) has been used to assess intrahepatic duct (IHD) lesions but with a limited role. A new multibending (MB) ultraslim endoscope has been designed to improve POC performance. We evaluated the usefulness of POC using the MB ultraslim endoscope for the management of IHD lesions. Methods: : Between March 2017 and March 2020, 22 patients underwent direct POC using the MB ultraslim endoscope for IHD lesions documented by previous imaging or cholangiopancreatography. The primary outcome was technical success of POC, and secondary outcomes were technical success of POC-guided interventions, median procedure time, and POC-related adverse events. Results: : The technical success rate for POC using the MB ultraslim endoscope for IHD lesions was 95.5% (21/22). Free-hand insertion was successful in 95.2% (20/21). The overall technical success rate for POC-guided intervention was 100% (21/21), including nine diagnostic and 12 therapeutic procedures (eight direct stone removal and four intraductal lithotripsies). The median procedure time was 29 minutes (range, 9 to 79 minutes). There were no procedure-related adverse events. Conclusions: : Direct POC using the MB ultraslim endoscope allows direct visualization of IHD lesions and may be useful for diagnosis and therapeutic management in selected patients.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar , Endoscopia do Sistema Digestório , Humanos , Endoscopia do Sistema Digestório/métodos , Endoscópios , Cateterismo , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/cirurgia
20.
Respirology ; 29(5): 413-420, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38185765

RESUMO

BACKGROUND AND OBJECTIVE: To investigate the difference in lung function according to diabetes status in a community-based prospective study. METHODS: Individuals aged 40-69 years from two community-based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross-sectional and longitudinal analyses based on diabetes status. RESULTS: Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, -1.853; 95% confidence interval [CI] -2.715 to -0.990 for prediabetes and mean, -4.088; 95% CI -5.424 to -2.752 for diabetes) and forced vital capacity (FVC) (mean, -2.087; 95% CI -2.837 to -1.337 for prediabetes and mean, -4.622; 95% CI -5.784 to -3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, -0.227; 95% CI -0.366 to -0.089) and FVC % predicted (mean, -0.232; 95% CI -0.347 to -0.117) during follow-up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow-up. CONCLUSION: Diabetes is associated with a lower baseline lung function and a faster rate of deterioration.


Assuntos
Diabetes Mellitus , Estado Pré-Diabético , Adulto , Humanos , Seguimentos , Estudos Prospectivos , Estado Pré-Diabético/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Volume Expiratório Forçado , Capacidade Vital , Pulmão
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