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The inability to pass stool for a prolonged period can lead to the formation of fecaliths, which occurs most often in the colon or rectum. Although large fecaliths can lead to serious or life-threatening complications, the detailed process of their formation is unknown. This report describes a 65-year-old woman who presented with melena due to ischemic proctitis caused by a large fecalith. On computed tomography, the fecalith showed a unique multilayered calcification sign. We successfully dismantled and removed the fecalith transanally, assisted by a traction method using a balloon catheter. A review of imaging studies from 6 years ago revealed the growth of the fecalith over the previous year and provided an insight into the mechanism underlying the development of large fecaliths.
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A diverticulum is a relatively common finding that is generally discovered incidentally; it is most commonly observed in the colon, followed by the duodenum. However, duodenal diverticulum perforation (DDP) is a rare complication. Due to its rarity, its diagnosis is often challenging and the appropriate treatment remains unclear, possibly contributing to its high mortality rate. Traditionally, surgical repair is the primary mode of treatment. However, with the recent advancements in medical technology, conservative management such as bowel rest and endoscopic drainage help successfully manage DDP. Duodenal diverticulum bleeding (DDB) is a rare cause of upper gastrointestinal bleeding. While endoscopic, angiographical, and surgical treatments have been performed to achieve hemostasis, there is no consensus regarding the optimal treatment for DDB. We describe a case of a perforated duodenal diverticulum (DD) with postoperative diverticulum bleeding. Our patient, an elderly female, complained of abdominal pain. Computed tomography images revealed free air in the retroperitoneum, and gastrointestinal perforation was suspected. During the emergency surgery, a perforated DD was detected in the third portion of the duodenum. Due to severe inflammation, diverticulectomy was not performed as it was deemed risky. Instead, we directly sutured the orifice using an omental patch. Duodenal leakage was observed from postoperative day (POD) 3 with bleeding from the remnant DD occurred on PODs 6 and 13. An attempt at endoscopic hemostasis failed, but transcatheter arterial embolization (TAE) was successfully performed. The postoperative course was complicated, and the patient died on POD 54. To the best of our knowledge, this is the first report on DD perforation with postoperative DDB. The remnant DD may be damaged by the digestive juices and result in bleeding. Precautionary measures for duodenal leakage should be undertaken when the DD is unresectable. Additionally, TAE is effective for postoperative DDB.
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The purpose of this study was to clarify the viability of a novel method for removing debris from broken instruments from root canals using a laser apparatus. Laser welding was performed on stainless steel or nickel titanium files using an Nd:YAG laser. Retention force between the files and extractors was measured. Increase in temperature on the root surface during laser irradiation was recorded and the irradiated areas evaluated with a scanning electron microscope. Retention force on stainless steel was significantly greater than that on nickel titanium. The maximum temperature increase was 4.1°C. The temperature increase on the root surface was greater in the vicinity of the welded area than that at the apical area. Scanning electron microscopy revealed that the files and extractors were welded together. These results indicate that the laser welding method is effective in removing debris from broken instruments from root canals.
Assuntos
Cavidade Pulpar/patologia , Lasers de Estado Sólido , Preparo de Canal Radicular/instrumentação , Soldagem/métodos , Temperatura Corporal , Ligas Dentárias/química , Falha de Equipamento , Corpos Estranhos/terapia , Temperatura Alta , Humanos , Microscopia Eletrônica de Varredura , Níquel/química , Fibras Ópticas , Transição de Fase , Aço Inoxidável/química , Estresse Mecânico , Propriedades de Superfície , Titânio/química , Ápice Dentário/fisiologia , Raiz Dentária/fisiologia , Soldagem/instrumentaçãoRESUMO
OBJECTIVE: To assess the effect of chemotherapy plus bevacizumab on tumor vessels, as well as the reversibility of this effect, using contrast-enhanced ultrasonography (CEUS) and histology in patients with metastatic liver tumors derived from colorectal cancer. METHODS: The study included 12 patients who received chemotherapy plus bevacizumab, experienced a reduction in tumor vascularity as demonstrated by CEUS and consequently underwent liver resection. CEUS was performed before and after four courses of chemotherapy and before surgery. The numbers of microvessels highlighted by anti-CD34 antibodies in the viable tumor tissue were counted to quantify the microvessel density (MVD). As a control, 12 surgical specimens from 12 patients who had not received chemotherapy were examined. RESULTS: A reversal of tumor vascularity was observed in 10 of 12 patients. In two patients, the vascularity remained reduced. The MVD in the treatment group was significantly lower than that observed in the group without treatment. CONCLUSION: The data suggest that the tumor vessels regenerated substantially, although the effect of chemotherapy plus bevacizumab remained weak for approximately 6 weeks after the cessation of treatment. Therefore, future research must determine whether bevacizumab should be used prior to surgery.
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Inibidores da Angiogênese/farmacologia , Anticorpos Monoclonais Humanizados/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias Colorretais/patologia , Hepatectomia , Neoplasias Hepáticas/secundário , Microvasos/efeitos dos fármacos , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab , Quimioterapia Adjuvante , Meios de Contraste , Esquema de Medicação , Compostos Férricos , Fluoruracila/farmacologia , Fluoruracila/uso terapêutico , Humanos , Ferro , Leucovorina/farmacologia , Leucovorina/uso terapêutico , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Microvasos/patologia , Terapia Neoadjuvante , Compostos Organoplatínicos/farmacologia , Compostos Organoplatínicos/uso terapêutico , Óxidos , Estudos Retrospectivos , Resultado do Tratamento , UltrassonografiaRESUMO
A 73-year-old man with a diagnosis of rectal cancer concomitant with multiple liver metastases underwent resection of the primary lesion. The postoperative immunohistochemical study revealed AFP production in the cancer tissue. The initial serum level of AFP after operation was 721 ng/mL. Although the mFOLFOX6 regimen had been started as the first postoperative chemotherapy, the AFP is serum level aggressively elevated to 9, 521 ng/mL and the size of the liver metastases markedly increased. As a second choice of treatment, transarterial chemo-embolization(TACE)using epirubicin hydrochloride and Lipiodol was performed because it was reported to have a high efficacy. After two sessions of the TACE, the serum level of the AFP decreased to 130 ng/mL and the size of the liver metastases reduced by approximately 30%in diameter. The third session of TACE, however, was unable to prevent re-progression of the liver lesion and the development of lung metastases. The patient died of hepatic failure 9 months after operation. It is known that AFP-producing colorectal cancers frequently develop life-limiting liver metastases. As shown in the present case, transcatheter drug delivery exclusively to the lesion in the liver might be the first choice for improving patient survival.
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Neoplasias Retais/metabolismo , alfa-Fetoproteínas/biossíntese , Idoso , Evolução Fatal , Humanos , Masculino , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Recently, optical microscopes have been used in endodontic treatment, as they offer advantages in terms of magnification, illumination, and documentation. Documentation is particularly important in presenting images to patients, and can take the form of both still images and motion video. Although high-quality still images can be obtained using a 35-mm film or CCD camera, the quality of still images produced by a video camera is significantly lower. The purpose of this study was to determine the potential of RegiStax in obtaining high-quality still images from a continuous video stream from an optical microscope. Video was captured continuously and sections with the highest luminosity chosen for frame alignment and stacking using the RegiStax program. The resulting stacked images were subjected to wavelet transformation. The results indicate that high-quality images with a large depth of field could be obtained using this method.
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Endodontia/instrumentação , Processamento de Imagem Assistida por Computador/instrumentação , Microscopia/instrumentação , Gravação em Vídeo/métodos , HumanosRESUMO
BACKGROUND & AIMS: Graft dysfunction is one of the major complications after liver transplantation, but its precise mechanism remains unclear. Since steatotic liver grafts are susceptible to post-transplant dysfunction, and peroxisome proliferator-activated receptor (PPAR) α plays an important role in the maintenance of hepatic lipid homeostasis, we examined the role of PPARα in liver transplantation. METHODS: Livers were harvested from Sv/129 wild-type (Ppara(+/+)) mice and PPARα-null (Ppara(-/-)) mice and transplanted orthotopically into syngeneic Ppara(+/+) mice. RESULTS: Hepatocellular damage was unexpectedly milder in transplanted Ppara(-/-) livers compared with Ppara(+/+) ones. This was likely due to decreased lipid peroxides in the Ppara(-/-) livers, as revealed by the lower levels of fatty acid oxidation (FAO) enzymes, which are major sources of reactive oxygen species. Hepatic PPARα and its target genes, such as FAO enzymes and pyruvate dehydrogenase kinase 4, were strongly down-regulated after transplantation, which was associated with increases in hepatic tumor necrosis factor-α expression and nuclear factor-κB activity. Inhibiting post-transplant PPARα down-regulation by clofibrate treatment markedly augmented oxidative stress and hepatocellular injury. CONCLUSIONS: Down-regulation of PPARα seemed to be an adaptive response to metabolic alterations following liver transplantation. These results provide novel information to the understanding of the pathogenesis of early post-transplant events.
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Transplante de Fígado/fisiologia , PPAR alfa/genética , PPAR alfa/metabolismo , Disfunção Primária do Enxerto/metabolismo , Disfunção Primária do Enxerto/fisiopatologia , Acetilcoenzima A/metabolismo , Adaptação Fisiológica/fisiologia , Animais , Ciclo do Ácido Cítrico/fisiologia , Regulação para Baixo/fisiologia , Masculino , Camundongos , Camundongos da Linhagem 129 , Camundongos Mutantes , Mitocôndrias/metabolismo , Estresse Oxidativo/fisiologia , FenótipoRESUMO
The objective of this study was to three-dimensionally observe the morphological characteristics of mesiobuccal root canals of Japanese maxillary first molars using microcomputed tomography (Micro-CT) and classify root canal variations. This study used 90 maxillary first molars. Three-dimensional reconstruction was performed using data obtained by Micro-CT, and cross-sections of the root canals were observed. Moreover, the root canal morphology was classified by the configuration and root canal diameter, and was evaluated for occurrence using the classification by Weine et al. (1969) as a reference. Overall, single root canals were observed in 44.4%, incomplete separation root canals in 22.3%, and completely separate root canals (upper and lower separation root canals) in 33.3%. Mesiobuccal root canals often had intricate configurations, and accessory root canals (lateral canals and apical ramifications) were observed in most of the mesiobuccal root canals (76.7%), irrespective of whether there were ramifications of the main root canals. While there were no marked differences in the incidence of root canal ramifications between this study and earlier reports, the incidence of accessory root canals was higher in this study. This result may be explained by the far more superior visualization ability of Micro-CT than conventional methods, which allowed the detection of microscopic apical ramifications previously difficult to observe.
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Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Imageamento Tridimensional/métodos , Dente Molar/diagnóstico por imagem , Microtomografia por Raio-X , Povo Asiático , Classificação , Humanos , Japão , Maxila , Dente Molar/anatomia & histologia , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagemRESUMO
This study investigated the effects of diode (GaAlAs) laser irradiation at an effective energy density of 5 or 20 J/cm(2) on cell growth factor-induced differentiation and proliferation in pheochromocytoma cells (PC12 cells), and whether those effects were related to activation of the p38 pathway. Laser irradiation at 20 J/cm(2) significantly decreased the number of PC12 cells, while no difference was seen between the 5 J/cm(2) group and the control group (p<0.05). Western blotting revealed marked expression of neurofilament and ß-tubulin, indicating greater neurite differentiation in the irradiation groups than in the control group at 48 hr. Irradiation also enhanced expression of phospho-p38. The decrease in number of cells after laser irradiation was accelerated by p38 inhibitor, while neurite differentiation was up-regulated by laser irradiation, even when the p38 pathway was blocked. This suggests that laser irradiation up-regulated neurite differentiation in PC12 cells involving p38 and another pathway.
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Terapia com Luz de Baixa Intensidade , Regeneração Nervosa/efeitos da radiação , Neuritos/efeitos da radiação , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Animais , Diferenciação Celular/efeitos da radiação , Proliferação de Células/efeitos da radiação , Lasers Semicondutores , Sistema de Sinalização das MAP Quinases/fisiologia , Fator de Crescimento Neural/farmacologia , Neuritos/efeitos dos fármacos , Neuritos/metabolismo , Proteínas de Neurofilamentos/biossíntese , Células PC12/efeitos da radiação , Ratos , Tubulina (Proteína)/biossíntese , Regulação para CimaRESUMO
Pregnenolone (PRG), a major neurosteroid, suppressed carbachol-induced salivary secretion in perfused submandibular gland in rats. These effects were enhanced and depressed by agonistic muscimol (MUS) and antagonistic bicuculline to the γ-aminobutyric acid A receptor (GABA(A)-R), respectively. In contrast, PRG-sulfate, a sulfate-conjugated PRG metabolite, antagonized the suppressive effects of MUS, resulting in upregulation of salivary secretion. Quantitative RT-PCR and Western blotting revealed lesser expression of the PRG synthetase CYP11A1 protein and mRNA in the parotid, submandibular, and sublingual gland than in the cerebral cortex or adrenal gland as positive control organs. However, in response to methamphetamine withdrawal-induced stress, CYP11A1 production in each type of the salivary gland was highly upregulated to levels similar to those seen in the cerebral cortex. These results indicate that the salivary gland is capable of producing neurosteroids, as well as the brain. This suggests that steroid biosynthesis occurs in the salivary gland and is involved in the inhibitory regulation of salivary secretion in cooperation with GABA(A)-R. Further studies are needed to determine the pathophysiological significance of the biosynthesis of neurosteroids and their mechanisms of action via nuclear and membrane receptors.
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Pregnenolona/biossíntese , Pregnenolona/fisiologia , Receptores de GABA-A/fisiologia , Saliva/metabolismo , Glândulas Salivares/metabolismo , Glândula Submandibular/metabolismo , Animais , Enzima de Clivagem da Cadeia Lateral do Colesterol/metabolismo , Enzima de Clivagem da Cadeia Lateral do Colesterol/fisiologia , Masculino , Pregnenolona/farmacologia , Ratos , Ratos Wistar , Receptores de GABA-A/metabolismo , Glândulas Salivares/enzimologia , Glândula Submandibular/enzimologiaRESUMO
Core carrier techniques are unique among the various root canal filling techniques for delivering and compacting gutta-percha in the prepared root canal system. Thermafil (TF), considered the major core carrier device, is provided as an obturator consisting of a master core coated with thermoplasticized gutta-percha. We have devised a thermoplasticized gutta-percha filling technique using a polypropylene core, FlexPoint® NEO (FP), which was developed as a canal filling material that can be sterilized in an autoclave. Therefore, FP can be coated onto thermoplasticized gutta-percha and inserted into the prepared canal as a core carrier. The FP core carrier technique offers many advantages over the TF system: the core can be tested in the root canal and verified radiographically; the core can be adjusted to fit and surplus material easily removed; furthermore the core can be easily removed for retreatment. The clinical procedure of the FP core carrier technique is simple, and similar that with the TF system. Thermoplasticized gutta-percha in a syringe is heated in an oven and extruded onto the FP core carrier after a trial insertion. The FP core carrier is inserted into the root canal to the working length. Excess FP is then removed with a red-hot plastic instrument at the orifice of the root canal. The FP core carrier technique incorporates the clinical advantages of the existing TF system while minimizing the disadvantages. Hence the FP core carrier technique is very useful in clinical practice. This paper describes the FP core carrier technique as a new core based method.
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Polipropilenos , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular/métodos , Guta-Percha , Humanos , Obturação do Canal Radicular/instrumentaçãoRESUMO
Dens evaginatus is a rare dental anomaly characterized by the development of a tubercle on the occlusal surface of the tooth and can cause pulpitis, pulp necrosis, and periapical periodontitis due to tubercular fracture or attrition. Unlike with caries, pain caused by dens evaginatus may manifest itself in a distant location. Therefore, diagnosing the cause of that pain may prove problematic. Dens evaginatus usually occurs in the mandibular premolars. We report a successfully treated case in which dens evaginatus was difficult to diagnose due to distant radiation of pulpitis-induced pain. This pain occurred as a result of fracture of a tubercle located on the occlusal surface of the maxillary second molar, which is very rare.
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Dente Molar/anormalidades , Anormalidades Dentárias/complicações , Coroa do Dente/anormalidades , Necrose da Polpa Dentária/etiologia , Necrose da Polpa Dentária/terapia , Humanos , Masculino , Maxila , Dor Referida/etiologia , Dor Referida/terapia , Pulpite/complicações , Pulpite/etiologia , Pulpite/terapia , Tratamento do Canal Radicular , Anormalidades Dentárias/terapia , Coroa do Dente/lesões , Fraturas dos Dentes/complicações , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapia , Odontalgia/etiologia , Odontalgia/terapia , Adulto JovemRESUMO
Although the central role of ameloblasts in synthesis and resorption of enamel matrix proteins during amelogenesis is well documented, the Ca(2+)-transport/extrusion mechanism remains to be fully elucidated. To clarify Ca(2+)-transport in rat ameloblasts, we investigated expression and localization of Na(+)-Ca(2+) exchanger (NCX) isoforms and the functional characteristics of their ion transporting/pharmacological properties. RT-PCR and immunohistochemical analyses revealed expression of NCX1 and NCX3 in ameloblasts, localized in the apical membrane. In patch-clamp recordings, Ca(2+) efflux by Na(+)-Ca(2+) exchange showed dependence on external Na(+). Ca(2+) influx by Na(+)-Ca(2+) exchange, measured by fura-2 fluorescence, showed dependence on extracellular Ca(2+) concentration, and it was blocked by NCX inhibitors KB-R7943, SEA0400, and SN-6. These results showed significant expression of NCX1 and NCX3 in ameloblasts, indicating their involvement in the directional Ca(2+) extrusion pathway from cells to the enamel mineralizing front.
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Ameloblastos/metabolismo , Cálcio/metabolismo , Trocador de Sódio e Cálcio/metabolismo , Animais , Corantes Fluorescentes/química , Fura-2/química , Expressão Gênica , Técnicas de Patch-Clamp , Isoformas de Proteínas , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sódio/metabolismo , Trocador de Sódio e Cálcio/genéticaRESUMO
OBJECTIVE: A new ultrasonographic technique for detecting parenchymal stiffness of the pancreas is proposed. This technique measures changes in the diameter of the origin of the superior mesenteric vein (SMV) induced by deep inspiration. The origin of the SMV has extensive attachments to the pancreatic parenchyma; therefore, both physiologic enlargement and shrinkage of the venous lumen cannot occur without changes in the shape of the surrounding parenchyma. Therefore, increased parenchymal stiffness due to chronic pancreatitis (CP) may result in impaired changes in the venous diameter. To confirm this hypothesis, patients with CP and those with a normal pancreas were examined in this study. METHODS: Twelve patients in each group were examined. Images of the origin of the SMV were obtained with a commercial ultrasound system. The smallest diameter of the SMV was measured during normal breathing. The patients were then asked to take a deep breath to increase the portal blood pressure followed immediately by the same measurements as performed during normal breathing, and the ratio of the change was calculated. RESULTS: In the normal group, the diameter of the SMV changed by 79.5% +/- 43.8% (mean +/- SD), whereas a change of 1.4% +/- 7.3% was observed in the CP group. The difference between the two groups was statistically significant (P < .0001). CONCLUSIONS: The physiologic change in the diameter of the origin of the SMV enhanced by deep inspiration may reflect the stiffness of the pancreatic parenchyma. Therefore, detection of an impaired diameter change may be useful for screening of CP.
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Técnicas de Imagem por Elasticidade/métodos , Veias Mesentéricas/diagnóstico por imagem , Pâncreas/irrigação sanguínea , Pâncreas/diagnóstico por imagem , Pancreatite Crônica/diagnóstico por imagem , Adulto , Idoso , Feminino , Fibrose , Humanos , Masculino , Microscopia Acústica , Pessoa de Meia-Idade , Pancreatite Crônica/patologiaRESUMO
We used porous sapphire dental implants made of alumina clinically for 4 years 1 month, commencing September, 1984 until September, 1988. Subjects consisted of 18 men and 42 women 20-71 years old (mean age: 35 years). Sixty-five implants were inserted in 60 patients. Of these, 20 were clinical cases of an implant connected with natural teeth and 45 were free-standing cases. We conducted a follow-up study on these patients over a 23-year period. One implant in 1 patient had to be removed because of postoperative infection and 8 implants in 7 patients had to be removed because of fracturing or detachment of the porous-part. This paper reports 3 cases where implants remained in place for 21-23 years. These cases have all shown good long-term clinical progress.
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Óxido de Alumínio , Implantes Dentários , Porcelana Dentária , Planejamento de Prótese Dentária , Adulto , Idoso , Coroas , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Prótese Parcial Fixa , Feminino , Seguimentos , Humanos , Masculino , Ligas Metalo-Cerâmicas , Pessoa de Meia-Idade , Porosidade , PrognósticoRESUMO
BACKGROUND/AIMS: The independent risk factors contributing to long-term survival (> or = 10-year survival rate) and recurrence after curative hepatic resection for hepatocellular carcinoma (HCC) were evaluated. METHODOLOGY: The prognoses were retrospectively analyzed in 247 consecutive patients (187 men and 60 women) treated with curative hepatic resection for HCC and discharged from the hospital. Prognostic factors were evaluated by multivariate analysis using Cox's proportional hazards model. RESULTS: Multivariate analysis revealed that pTNM stage IV, indocyanine green retention rate at 15 minutes (ICGR15) of > or = 20%, tumor size of > or = 5 cm, and positive hepatitis B surface antigen were independent risk factors of overall survival. Stage IV and ICGR15 of > or = 20% were also independent risk factors of disease-free survival. CONCLUSIONS: pTNM stage and ICGR15 may be simple and useful predictors to improve long-term survival and recurrence after curative hepatic resection for HCC.
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Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/etiologia , Idoso , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/virologia , Corantes/farmacocinética , Feminino , Antígenos de Superfície da Hepatite B/sangue , Humanos , Verde de Indocianina/farmacocinética , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Fatores de TempoRESUMO
BACKGROUND/AIMS: Although the risk factors for the development of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC) have been widely studied, little attention has been given to the prognostic factors affecting such patients. METHODOLOGY: Intrahepatic recurrence occurred in 105 (56%) of 188 patients who underwent curative hepatic resection of HCC and were discharged from the hospital. Among them, 17 (16%) also had simultaneous extrahepatic recurrence. Independent prognostic factors were evaluated by multivariate analysis using Cox's proportional hazards model. RESULTS: Multivariate analysis revealed that presence of extrahepatic recurrence, hepatitis B, and non-surgical treatments for recurrence were independent predictors of poor overall survival after initial hepatic resection or after recurrence. Risk factors of extrahepatic recurrence were young age, solitary and large HCC, high hepatitis activity, and large amount of intraoperative blood loss and blood transfusion. CONCLUSIONS: Survival of patients with intrahepatic recurrent HCC after resection should be stratified by the type of recurrence, type of hepatitis, and type of treatment for recurrence.
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Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/cirurgia , Idoso , Envelhecimento , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Perda Sanguínea Cirúrgica , Carcinoma Hepatocelular/enzimologia , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Fígado/patologia , Fígado/fisiopatologia , Neoplasias Hepáticas/enzimologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Prognóstico , Fatores de Risco , Análise de Sobrevida , Reação TransfusionalRESUMO
Previous reports have shown the expression of several mechanosensitive ionic channels on the plasma membrane in odontoblasts, which are the cells responsible for dentin formation. The membrane characteristics of odontoblasts imply that they could play critical roles in the mechano-transduction of fluid displacement within dentinal tubules into the electrical cell signals, to carry dentin sensation to the central nervous system. However, the direct ionic mechanism underlying such a dentin nociceptive function remains unclear. In the present study, we investigated the expression of the transient receptor potential vanilloid subfamily member 1 (TRPV1) channel--which essentially contributes to the detection of pain sensation--in rat odontoblasts by immunohistochemical and nystatin perforated patch-clamp techniques. Immunohistochemical observation showed the localization of TRPV1-immunoreactions on the distal regions of odontoblast membranes. In the patch-clamp experiments, we observed capsaicin-induced inward currents that were inhibited by capsazepine, a TRPV1 channel antagonist. Our results indicate a significant expression of TRPV1 channels in odontoblasts, suggesting that odontoblasts may directly respond to noxious stimuli such as a thermal-heat stimulus, and point to the necessity for a reconsideration of the cellular mechanisms of dentin sensation based on the transmembrane ionic signals in odontoblasts.
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Odontoblastos/metabolismo , Células Receptoras Sensoriais/citologia , Células Receptoras Sensoriais/metabolismo , Canais de Cátion TRPV/biossíntese , Canais de Cátion TRPV/genética , Animais , Animais Recém-Nascidos , Dentina/fisiologia , Regulação da Expressão Gênica/fisiologia , Imuno-Histoquímica , Potenciais da Membrana/fisiologia , Nociceptores/química , Nociceptores/metabolismo , Nociceptores/fisiologia , Odontoblastos/química , Odontoblastos/fisiologia , Técnicas de Patch-Clamp , Ratos , Ratos Wistar , Células Receptoras Sensoriais/fisiologia , Canais de Cátion TRPV/fisiologiaRESUMO
UFT is an anti-cancer drug which combines uracil with tegafur at a mole rate of 1:4, and shows a high anti-tumor effect by raising the 5-FU level in a tumor. A 55-year-old man with hypochondriac pain was admitted to Shinshu University Hospital. The preoperative diagnosis was giant hepatocellular carcinoma (HCC) of the right hepatic anterior region, and extended anterior segmentectomy of the liver was performed. Three months later, serum alpha-fetoprotein (AFP) and PIVKA-II were elevated markedly, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed a recurrence in the remnant liver and multiple lung metastasis. Chemotherapy with oral UFT (300 mg/day) administration alone was started for the unresectable HCC. Three months later, CT and MRI showed complete disappearance of the recurrent HCC and multiple lung metastasis. Also, the titers of AFP and PIVKA-II were reduced to normal levels. This case suggests that oral UFT administration is a safe and effective therapy for postoperative HCC, even with lung metastasis.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Administração Oral , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/secundário , Carcinoma Hepatocelular/cirurgia , Esquema de Medicação , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Precursores de Proteínas/sangue , Protrombina , Tegafur/administração & dosagem , Uracila/administração & dosagem , alfa-Fetoproteínas/análiseRESUMO
Bone tissue reactions to EBA, IRM, and cyanoacrylate cement (Base Liner) were studied in the rat mandible using an intraosseous implant method. Osseous cavities (1.4 mm in diameter) were surgically created in the mandibles, and materials were implanted in 60 male Wistar rats. Each specimen was evaluated histologically after 4 and 8 weeks. The development of fibrous connective tissue in direct apposition to the material was observed in the EBA and IRM groups at 4 weeks. A slight degree of macrophage infiltration was seen in the EBA group. After the 8-week observation period, IRM and EBA were frequently separated from the bone cavity by a fibrous connective tissue layer (p < 0.01). The Base Liner appeared to be in direct apposition to the osseous tissue in several areas (p < 0.01). These findings indicate that Base Liner reacts favorably with osseous tissue, compared with the EBA and IRM materials tested and seems to be a biocompatible material.