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1.
Eur J Pharm Sci ; 198: 106784, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38705422

RESUMO

To investigate the effect of retinoids, such as retinol (ROL), retinal (RAL), and retinyl palmitate (RP), on epidermal integrity, skin deposition, and bioconversion to retinoic acid (RA). 3-D human skin equivalent model (EpiDermFT™) was used. Epidermal cellular integrity measured by TEER values was significantly higher for a topical treatment of ROL and RAL than RP (p < 0.05). The skin deposition (µM) of ROL and RAL was approximately 269.54 ± 73.94 and 211.35 ± 20.96, respectively, greater than that of RP (63.70 ± 37.97) over 2 h incubation. Spectral changes were revealed that the CO maximum absorbance occurred between 1600∼1800 cm-1 and was greater from ROL than that from RAL and RP, indicating conjugation of R-OH to R-CHO or R-COOH could strongly occur after ROL treatment. Subsequently, a metabolite from the bioconversion of ROL and RAL was identified as RA, which has a product ion of m/z 283.06, by using liquid a chromatography-mass spectrometry (LC-MS) - total ion chromatogram (TIC). The amount of bioconversion from ROL and RAL to RA in artificial skin was 0.68 ± 0.13 and 0.70 ± 0.10 µM at 2 h and 0.60 ± 0.04 and 0.57 ± 0.06 µM at 24 h, respectively. RA was not detected in the skin and the receiver compartment after RP treatment. ROL could be a useful dermatological ingredient to maintain epidermal integrity more effectively, more stably deposit on the skin, and more steadily metabolize to RA than other retinoids such as RAL and RP.

2.
Neurosurgery ; 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38690884

RESUMO

BACKGROUND AND OBJECTIVES: The role of bypass surgery in intracranial atherosclerotic steno-occlusive diseases (ICADs) remains controversial. We aimed to analyze the surgical outcomes of bypass surgery in patients with the ICADs in a single tertiary institution. METHODS: Among 1018 cases of low-flow bypass surgery between 2003 and 2022, 215 patients with the ICAD refractory to medical treatment were finally enrolled in this study. Clinical and radiological outcomes were retrospectively evaluated, with survival analyses. RESULTS: All strokes, cerebral infarctions, and intracranial hemorrhages occurred in 12.1% (n = 26), 9.8% (n = 21), and 2.3% (n = 5), respectively, during the clinical follow-up of 54.6 ± 47.6 months (range, 0.6-237.8 months). Among all stroke events, 84.6% (n = 22) occurred within 30 postoperative days. The 2-year and 5-year cumulative risks of all strokes were 12.1% each. The mean modified Rankin Scale scores were 1.6 ± 1.1 (range, 0-5) preoperatively and 0.8 ± 1.2 (range, 0-6) at last (P < .01). The patency of direct bypass was 99.1% (n = 213) just before discharge and 96.3% (n = 184 of 191 patients with available tests) at the last angiographic follow-up of 27.0 ± 27.3 months (range, 2.3-97.3 months). All the patients with available data (n = 190) showed hemodynamic improvement on acetazolamide-challenged single-photon emission computed tomography with 99mTc-hexamethylpropyleneamine oxime during the follow-up of 38.6 ± 36.7 months (range, 2.3-158.6 months). CONCLUSION: Low-flow bypass surgery showed acceptable treatment outcomes in the prevention of recurrent stroke.

3.
Sci Rep ; 14(1): 8358, 2024 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-38600292

RESUMO

The necessity of bilateral bypass in adult moyamoya disease (MMD) remains unclear despite its recommendation for pediatric and hemorrhagic cases. We aimed to investigate the natural course of hemodynamically stable unoperated hemispheres after bypass surgery for symptomatic and hemodynamically unstable hemispheres in adult patients with ischemic MMD. Among 288 patients, the mean age at the first operation of the unstable hemispheres was 40.8 ± 12.2 years. The mean follow-up period was 62.9 ± 46.5 months. 45 patients (15.6%) experienced stroke events in the unoperated hemisphere, consisting of hemorrhagic stroke in 8 (2.8%) and ischemic stroke in 37 (12.8%), including progressive transient ischemic attack in 25 (8.7%) and infarction in 12 (4.2%). Among them, 39 patients (13.5%) underwent bypass surgery. The annual risk of total stroke is 3.0%/patient-year, with 2.5% for ischemic stroke and 0.5% for hemorrhagic stroke. The 5- and 10-year cumulative risks of ischemic stroke were 13.4% and 18.3%, respectively, and those of hemorrhagic stroke were each 3.2%. The natural course of hemodynamically stable hemispheres contralateral to the operated ones appeared fairly good. Additional bypass surgery on the unoperated hemispheres should be considered for symptomatic and hemodynamically unstable hemispheres in adult patients with ischemic MMD during the follow-up.


Assuntos
Revascularização Cerebral , Acidente Vascular Cerebral Hemorrágico , AVC Isquêmico , Doença de Moyamoya , Acidente Vascular Cerebral , Adulto , Humanos , Criança , Pessoa de Meia-Idade , Doença de Moyamoya/cirurgia , Resultado do Tratamento , Estudos Retrospectivos
4.
Inorg Chem ; 63(17): 7992-8000, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38627375

RESUMO

The electrochemical reduction of carbon dioxide (CO2) to produce fuels and chemicals has garnered significant attention. However, achieving control over the selectivity of the resulting products remains a challenging task, particularly within molecular systems. In this study, we employed a molecular silver complex immobilized on graphitized mesoporous carbon (GMC) as a catalyst for converting CO2 into CO, achieving an impressive selectivity of over 90% at -1.05 V vs RHE. Notably, the newly formed silver nanoparticles emerged as the active sites responsible for this high CO selectivity rather than the molecular system. Intriguingly, the introduction of copper ions into the restructured Ag-nanoparticle-decorated carbon altered the product selectivity. At -1.1 V vs RHE in 0.1 M KCl, we achieved a high C2 selectivity of 75%. Furthermore, not only the Ag-Cu bimetallic nanoparticle but also the small-sized Ag-Cu nanocluster decorated over GMC was proposed as active sites during catalytic reactions. Our straightforward approach offers valuable insights for fine-tuning the product selectivity of immobilized molecular systems, extending beyond C1 products.

5.
Int J Dent Hyg ; 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38659166

RESUMO

OBJECTIVES: This study aimed to determine the overall oral health statuses of patients with fixed orthodontic appliance and clear aligner, as well as their oral hygiene management behaviours and satisfaction. METHODS: We selected 40 participants (20 each with fixed orthodontic devices and clear aligners) who visited a dental clinic. We conducted a survey to determine the oral hygiene management behaviours of the subjects and their satisfaction with their orthodontic treatment. Three measurements were also conducted at 4-week intervals to determine the oral health statuses of the subjects. RESULTS: The Löe and Silness gingival index of patients with fixed orthodontic appliances indicated moderate gingivitis (1.1 ± 0.3), and those with clear aligners had mild gingivitis (0.6 ± 0.4) (p < 0.001). The modified O'Leary index also indicated that the degree of dental plaque deposition in the oral cavity was lower in patients treated with a clear aligner (43.0 ± 18.2 points) than in those treated with a fixed orthodontic (28.1 ± 10.9 points) (p = 0.004). Regarding oral hygiene management, the fixed orthodontic group received scaling more frequently (p = 0.006), received more oral health education (p < 0.001) and had a longer brushing time (p = 0.008) than the clear aligner group. No significant difference was observed in satisfaction between the fixed orthodontic appliance and the clear aligner. CONCLUSIONS: Regarding the oral health status by orthodontic appliance type, the clear aligner group had the advantages of reduction in dental plaque attachment and gingival health. The fixed orthodontic group exhibited better oral hygiene management behaviours. Satisfaction with orthodontic treatment was found to be similar for the two device types.

6.
Toxicol In Vitro ; 97: 105813, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38522493

RESUMO

The aims of the current study included characterizing the intestinal transport mechanism of polystyrene microplastics (MPs) with different charges and sizes in the intestinal epithelial cell model and determining the inhibitory effect of green tea extracts (GTEs) on the intestinal absorption of MPs in Caco-2 cells. The smaller sizes, which included diameters of 0.2 µm, of amine-modified MPs compared to either larger size (1 µm diameter, or carboxylate-MPs (0.2 and 1 µm diameter) significantly lowered the cell viability of caco-2 cells that were measured by MTT assay (p < 0.05). The transported amount (particles/mL of the cell media) of amine-modified MPs by the Caco-2 cell, was not dependent according to the concentrations, energy, or temperature, but it was higher than the carboxylate-modified MPs. The co-treatment of GTEs with the amine-modified MPs inhibited Caco-2 cell cytotoxicity as well as reduced the production of intracellular reactive oxygen species (ROS) in HepG2 generated by the exposure of amine-modified MPs. The GTEs co-treatment also increased trans-epithelial electrical resistances (TEER) and reduced the transportation of Lucifer Yellow via the Caco-2 monolayer compared to only the amine-modified MPs exposure. The GTEs treatment led to a decrease in the number of amine-modified MPs transported to the basal side of the Caco-2 monolayer. The results from our study suggest that the consumption of GTEs could enhance the intestinal barrier function by recovering intestinal epithelial cell damage induced by MPs, which resulted in a decrease of the intestinal absorption of MPs.


Assuntos
Microplásticos , Poliestirenos , Humanos , Poliestirenos/toxicidade , Microplásticos/toxicidade , Plásticos , Células CACO-2 , Antioxidantes , Absorção Intestinal , Chá , Aminas
7.
Int J Clin Oncol ; 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38526622

RESUMO

BACKGROUND: The real-world evidence about the efficacy of cytotoxic chemotherapy in desmoid tumors is still limited. We investigated the efficacy of chemotherapy in the treatment of recurrent or progressive desmoid tumors. METHODS: The patients with desmoid tumors who had received cytotoxic chemotherapy between November 2007 and June 2020 in two tertiary hospitals in Korea were reviewed. RESULTS: A total of 25 patients were included in the analysis. The most common primary tumor site was the intra-abdominal or pelvic cavity (56%), followed by the trunk and abdominal wall (24%), extremities (16%), and head and neck (4%). Sixty percent of the patients had familial adenomatous polyposis and 76% received doxorubicin plus dacarbazine. The objective response rate and disease control rate was 64% (95% confidence interval [CI]: 40.7-82.8) and 96% (95% CI: 77.2-99.9), respectively. With the median follow-up time of 55 months (95% CI: 41.0-68.2), the 3-year PFS rate was 65% (95% CI: 41.1-80.5), and the 3-year OS rate was 89% (95% CI: 63.8-97.3). Grade 3 or 4 hematologic adverse events were reported in 14 patients, all of which were manageable. CONCLUSION: Our real-world evidence suggests that doxorubicin-based cytotoxic chemotherapy can be an effective treatment option for recurrent and progressive desmoid tumors with respect to favorable clinical outcomes.

8.
Environ Sci Pollut Res Int ; 31(19): 28306-28320, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38536572

RESUMO

Evaluation of the ecological health of rivers requires a focused examination of how biological indicators respond to chemical stressors to offer key insights for effective conservation strategies. We examined the influence of stressors on aquatic ecosystems by analyzing various ecological entities and biotic integrity metrics of fish communities. A nonmetric multidimensional scaling (NMDS) approach was applied to determine scores based on 19 fish ecological entities (FEs) and a fish-based multi-metric index of biotic integrity (mIBI-F). The composition of fish communities in reference clusters differed from the disturbed clusters due to instream chemical stressors. These chemical stressors, including high levels of nutrients, organic matter, and ionic/suspended solids, were linked to variation in the key indicator FEs, whose guild identities were closely associated with instream chemical degradation. The scores of FEs (abundance weighted) and mIBI-F metrics in the first NMDS axis (NMDS1) were significantly linked with chemical health indicators (p < 0.001), such as total phosphorus (R2 = 0.67 and 0.47), electrical conductivity (R2 = 0.59 and 0.49), and chlorophyll-a (R2 = 0.48 and 0.25). These NMDS1 scores showed better accuracy than the conventional mIBI-F score in capturing river ecological health linked with chemical health status as determined by a multi-metric index of water pollution. Our study suggests that based on the ordination approach, the biological integrity of these systems reflected the chemical health.


Assuntos
Monitoramento Ambiental , Peixes , Rios , Poluentes Químicos da Água , Rios/química , Animais , Monitoramento Ambiental/métodos , Ecossistema , Poluição Química da Água
9.
Cancer Res Treat ; 56(2): 357-371, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38487832

RESUMO

PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2021. MATERIALS AND METHODS: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2021, with survival follow-up until December 31, 2022. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. RESULTS: The number of new cancer diagnoses in 2021 increased by 27,002 cases (10.8%) compared to 2020. In 2021, newly diagnosed cancer cases and deaths from cancer were reported as 277,523 (age-standardized rate [ASR], 289.3 per 100,000) and 82,688 (ASR, 67.6 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% from 2012 to 2015, thereafter, followed by non-significant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.8% from 2002 to 2013; 3.2% from 2013 to 2021). The 5-year relative survival between 2017 and 2021 was 72.1%, which contributed to prevalent cases reaching over 2.4 million in 2021. CONCLUSION: In 2021, the number of newly diagnosed cancer patients increased as healthcare utilization recovered from the coronavirus disease 2019-related declines of 2020. Revised cancer registration guidelines expanded the registration scope, particularly for stomach and colorectal cancer. Survival rates have improved over the years, leading to a growing population of cancer survivors, necessitating a comprehensive cancer control strategy. The long-term impact of the pandemic on cancer statistics requires future investigation.


Assuntos
Neoplasias , Humanos , Incidência , Prevalência , Taxa de Sobrevida , República da Coreia/epidemiologia
10.
Cancer Res Treat ; 56(2): 372-379, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38487833

RESUMO

PURPOSE: This study aimed to report the projected cancer incidence and mortality for the year 2024 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2021 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2022 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and multiplying the projected age-specific rates by the anticipated age-specific population for 2024. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend for prediction. RESULTS: In total, 292,221 new cancer cases and 83,770 cancer deaths are expected to occur in Korea in 2024. The most common cancer site is expected to be the thyroid, followed by the colon and rectum, lung, breast, and stomach. These five cancers are expected to represent 55.7% of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers. CONCLUSION: The age-standardized incidence rates for female breast and prostate cancers are estimated to continue to increase. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.


Assuntos
Neoplasias Pulmonares , Neoplasias , Neoplasias da Próstata , Masculino , Humanos , Incidência , Neoplasias/epidemiologia , Coreia (Geográfico)/epidemiologia , República da Coreia/epidemiologia
11.
BMC Public Health ; 24(1): 748, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38459451

RESUMO

BACKGROUND: Perceiving oneself as obese has been associated with weight loss attempts. However, such a perception may not sufficiently drive significant weight reduction in many individuals. Hence, relying solely on the traditionally emphasized perceived risk of behavioral changes in obesity is challenging. This study used an extended parallel process model and a risk perception attitude framework to explore the influence of perceived risk and perceived efficacy on individual obesity knowledge and obesity prevention behaviors. METHODS: Data were obtained from 1,100 Korean adults aged 40-69 years through an online survey conducted in October 2022. Multinomial logistic regression and analysis of variance were employed to assess the relationships among perceived risk, perceived efficacy, obesity knowledge, and obesity prevention behaviors. RESULTS: Sex was associated with being underweight, overweight, and obese. Moreover, perceived severity was associated with obesity, whereas perceived susceptibility was associated with overweight and obese. Response efficacy was related to being overweight alone, whereas self-efficacy was associated with being underweight, overweight, and obese. The main effects of sex and perceived risk, and their interaction effect were statistically significant for obesity knowledge. Additionally, the main effects of sex, perceived risk, and perceived efficacy on obesity prevention behaviors were statistically significant. CONCLUSIONS: The extended parallel process model and risk perception attitude framework proved effective in classifying obesity based on body mass index, obesity knowledge, and obesity prevention behaviors.


Assuntos
Sobrepeso , Magreza , Adulto , Humanos , Obesidade/prevenção & controle , Índice de Massa Corporal , Redução de Peso , Percepção , República da Coreia/epidemiologia , Peso Corporal
13.
Korean J Fam Med ; 45(3): 157-163, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38282438

RESUMO

BACKGROUND: Evidence on the association between obesity parameters, including body mass index (BMI) and waist circumference (WC), and osteoarthritis is limited. This study aimed to investigate these associations in Korean adults. METHODS: This nationwide cross-sectional study used data from 24,101 adults aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2016-2020. Odds ratios (ORs) and 95% confidence intervals (CIs) for osteoarthritis according to BMI and WC were analyzed using multivariable logistic regression analyses. RESULTS: The prevalence of osteoarthritis was higher in individuals with general (10.0%) and abdominal obesity (12.8%) compared with those without. Greater BMI and WC were associated with a higher prevalence (P<0.001) and risk of osteoarthritis (Model 3, P for trend <0.001). Individuals with general and abdominal obesity were associated with a 1.50-fold (OR, 1.50; 95% CI, 1.35-1.67) and 1.64-fold (OR, 1.64; 95% CI, 1.47-1.84) increased risk of osteoarthritis, compared with those without. Similar associations were observed in subgroups according to age, sex, smoking status, and presence of diabetes mellitus. The odds of osteoarthritis 1.73-fold increased (OR, 1.73; 95% CI, 1.53-1.95) in individuals with both general and abdominal obesity compared with those without any of them. CONCLUSION: Greater BMI, WC, and general and abdominal obesity were associated with an increased risk of osteoarthritis in Korean adults. Appropriate management of abdominal and general obesity may be important to reduce the risk of osteoarthritis.

14.
Cancer Res Treat ; 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38271925

RESUMO

Purpose: To report the results from an early-phase study of rivoceranib, an oral tyrosine kinase inhibitor highly selective for vascular endothelial growth factor receptor 2, in patients with advanced solid tumors. Materials and Methods: In this open-label, single-arm, dose-escalating, multicenter three-part phase 1/2a trial, patients had advanced solid tumors refractory to conventional therapy. Part 1 evaluated the safety and pharmacokinetics of five ascending once-daily doses of rivoceranib from 81 mg to 685 mg. Part 2 evaluated the safety and antitumor activity of once-daily rivoceranib 685 mg. Part 3 was conducted later, due to lack of MTD determination in part 1, to evaluate the safety and preliminary efficacy of once-daily rivoceranib 805 mg in patients with unresectable or advanced gastric cancer. Results: A total of 61 patients were enrolled in parts 1 (n=25), 2 (n=30), and 3 (n=6). In parts 1 and 2, patients were white (45.5%) or Asian (54.5%), and 65.6% were male. The most common grade ≥3 adverse events (AEs) were hypertension (32.7%), hyponatremia (10.9%), and hypophosphatemia (10.9%). The overall response rate (ORR) was 15.2%. In part 3, dose-limiting toxicities occurred in 2 out of 6 patients: grade 3 febrile neutropenia decreased appetite, and fatigue. The ORR was 33%. Conclusion: The recommended phase 2 dose of rivoceranib was determined to be 685 mg once daily, which showed adequate efficacy with a manageable safety profile. (NCT01497704 and NCT02711969).

15.
Int J Cancer ; 154(4): 748-756, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-37718333

RESUMO

The prognostic role of the recurrence score (RS) based on the 21-gene expression assay in premenopausal women is not well delineated, and we investigated the association of outcomes and the RS in premenopausal patients who had 21-gene expression assay at Asan Medical Center, Seoul, Korea, between June 2005 and July 2018. Invasive breast cancer-free survival (IBCFS) by STEEP version 2.0 was compared according to the RS and clinical risk factors. A total of 554 patients were included in our study and 116 patients (20.9%) had age <40 years, 238 patients (43.0%) had luminal B subtype (Ki67 ≥ 20%), and 83 patients (15.0%) had RS >25. All patients received adjuvant tamoxifen ± chemotherapy. Overall, patients with RS >25 showed trend toward worse IBCFS from multivariable analysis (adjusted HR 1.89 [95% CI: 0.95-3.73], P = .069). When comparing outcomes according to age and luminal subtypes, patients with luminal B subtype and age <40 years (n = 60) showed significantly worse outcomes compared to the others (luminal A or luminal B + age ≥40 years, n = 494; adjusted HR 2.95 [95% CI: 1.49-5.82], log-rank P < .001). Among patients with luminal B subtype and age <40 years, there was no significant association observed between IBCFS and the RS (log-rank P = .51). In conclusion, while RS >25 showed association with poor outcomes in premenopausal women, it may have less prognostic significance among those with luminal B subtype and age <40 years.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Adulto , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , Neoplasias da Mama/complicações , Prognóstico , Tamoxifeno , Fatores de Risco , Perfilação da Expressão Gênica , Receptor ErbB-2/genética , Receptor ErbB-2/metabolismo , Receptores de Progesterona/genética , Receptores de Progesterona/metabolismo , Recidiva Local de Neoplasia/genética
16.
J Invest Dermatol ; 144(1): 43-52.e6, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37419444

RESUMO

Clinical overlaps between psoriasis and atopic dermatitis (AD) are sometimes undiscernible, and there is no consensus on whether to treat the overlap phenotype as psoriasis or AD. We enrolled 41 patients diagnosed with either psoriasis or AD and clinically re-stratified them into classic psoriasis (n = 11), classic AD (n = 13), and the overlap phenotype between psoriasis and AD (n = 17). We compared the gene expression profiles of lesional and nonlesional skin biopsy tissues and the proteomic profiles of blood samples among the three comparison groups. Global mRNA expression and T-cell subset cytokine expression in the skin and protein biomarker elevation in the blood of the overlap phenotype were consistent with the profiles of psoriasis and different from the profiles of AD. Unsupervised k-means clustering indicated that the best number of distinct clusters for the total population of the three comparison groups was two, and the two clusters of psoriasis and AD were differentiated by gene expression. Our study suggests that the clinical overlap phenotype between psoriasis and AD has dominant molecular features of psoriasis, and genomic biomarkers can differentiate psoriasis and AD at molecular levels in patients with a spectrum of psoriasis and AD.


Assuntos
Dermatite Atópica , Psoríase , Humanos , Dermatite Atópica/diagnóstico , Dermatite Atópica/genética , Dermatite Atópica/metabolismo , Proteômica , Psoríase/diagnóstico , Psoríase/genética , Psoríase/metabolismo , Pele/patologia , Citocinas/genética , Citocinas/metabolismo , Fenótipo
17.
J Cereb Blood Flow Metab ; 44(3): 345-354, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37910856

RESUMO

Little has been reported about the association between cerebral hyperperfusion syndrome (CHS) and blood-brain barrier (BBB) disruption in human. We aimed to investigate the changes in permeability after bypass surgery in cerebrovascular steno-occlusive diseases using dynamic contrast-enhanced MRI (DCE-MRI) and to demonstrate the association between CHS and BBB disruption. This retrospective study included 36 patients (21 hemispheres in 18 CHS patients and 20 hemispheres in 18 controls) who underwent combined bypass surgery for moyamoya and atherosclerotic steno-occlusive diseases. DCE-MRI and arterial spin labeling perfusion-weighted imaging (ASL-PWI) were obtained at the baseline, postoperative state, and discharge. Perfusion and permeability parameters were calculated at the MCA territory (CBF(territorial), Ktrans(territorial), Vp(territorial)) and focal perianastomotic area (CBF(focal), Ktrans(focal), Vp(focal)) of operated hemispheres. As compared with the baseline, both CBF(territorial) and CBF(focal) increased in the postoperative period and decreased at discharge, corresponding well to symptoms in the CHS group. Vp(focal) was lower in the postoperative period and at discharge, as compared with the baseline. In the control group, no parameters significantly differed among the three points. In conclusion, Vp at the focal perianastomotic area significantly decreased in patients with CHS during the postoperative period. BBB disruption may be implicated in the development of CHS after bypass surgery.


Assuntos
Revascularização Cerebral , Transtornos Cerebrovasculares , Doença de Moyamoya , Humanos , Barreira Hematoencefálica/diagnóstico por imagem , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Doença de Moyamoya/diagnóstico por imagem , Doença de Moyamoya/cirurgia , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/etiologia , Período Pós-Operatório , Circulação Cerebrovascular/fisiologia , Revascularização Cerebral/efeitos adversos , Revascularização Cerebral/métodos
18.
Cancer Res Treat ; 56(2): 404-413, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37933112

RESUMO

PURPOSE: The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade ≥ 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex. MATERIALS AND METHODS: This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea. RESULTS: A total of 1,170 patients with colorectal, gastric, or non-small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade ≥ 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits. CONCLUSION: Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Neutropenia , Humanos , Masculino , Feminino , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/etiologia , Estudos Retrospectivos , Neoplasias Pulmonares/tratamento farmacológico , Náusea/tratamento farmacológico , Vômito/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Quimioterapia Adjuvante/efeitos adversos
19.
Am J Geriatr Psychiatry ; 32(1): 45-54, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37634955

RESUMO

INTRODUCTION: Amyloid PET scans provide individuals with mild cognitive impairment (MCI) information about their risk of progressing to Alzheimer's dementia (AD). Given the wide-ranging implications of this information, best practice guidelines are needed to support researchers and clinicians disclosing these high-stakes test results. To inform the development of such guidelines, this analysis aims to describe questions and concerns raised during the disclosure of amyloid PET results in the context of MCI. METHODS: Qualitative description was performed to analyze (n = 34) transcripts of audio-recorded amyloid PET results disclosure sessions involving MCI care dyads. The analysis focused on characterizing the frequency and nature of questions raised during an open question-and-answer (Q&A) period following the return of scan results using a standardized protocol. RESULTS: Nearly all (n = 32/34) dyads posed questions during Q&A. Questions fell within six main categories with the most common being requests for clarification regarding AD/MCI, and next steps given the result. Questions were interspersed with comments reflecting the need for emotional support. Independently administered assessments of comprehension of results showed that, following the disclosure and Q&A, 31/32 participants with MCI and 31/31 care partners scored ≥4 on a 5-point scale. The number of questions asked by care partners during Q&A positively correlated with their level of comprehension (n = 31, Spearman's r = 0.370, p = 0.040). DISCUSSION: This analysis highlights the value of providing opportunities for patients and their family members to ask questions upon learning patients' brain amyloid status. Disclosing clinicians should be prepared to provide clarification, resources, and support to patients and families during the return of amyloid PET results.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Humanos , Doença de Alzheimer/diagnóstico por imagem , Revelação , Amiloide/metabolismo , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/psicologia , Encéfalo/metabolismo , Tomografia por Emissão de Pósitrons/métodos
20.
Ann Dermatol ; 35(Suppl 2): S239-S242, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38061712

RESUMO

Pilomatricoma is a benign skin tumor that arises from hair follicle stem cells. It typically presents in the facial region and rarely involves the palms and soles. A 15-year-old boy presented with a solitary tender nodule on the left sole. He had a history of plantar warts on the same site and had received multiple treatments including cryotherapy and intralesional bleomycin injection for nine months. Excisional biopsy was performed, and the specimen showed a well-demarcated mass in the deep dermis with basaloid cells undergoing abrupt keratinization. Ghost cells were seen with calcification. Based on these findings, he was diagnosed with pilomatricoma on the sole. We report a case of pilomatricoma, which developed on a site without hair follicles.

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