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1.
Diabet Med ; 37(1): 105-113, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31621107

RESUMO

AIM: To evaluate the association between sarcopenic obesity and the decline in estimated GFR in people with type 2 diabetes. METHODS: We enrolled 745 people with type 2 diabetes (mean age 64.6 years, 53.6% men). Body composition was evaluated using dual-energy X-ray absorptiometry. Skeletal muscle index, calculated as appendicular non-fat mass (kg) divided by height squared (m2 ), was used to determine sarcopenia. Sarcopenic obesity was defined as the coexistence of sarcopenia and a ratio of android to gynoid fat mass greater than the median values in each gender. The association of sarcopenic obesity both with the annual rate of decline in estimated GFR and a >30% decline in estimated GFR was evaluated using multivariate linear regression models and Cox proportional hazard models, respectively. RESULTS: Participants with sarcopenic obesity were at an increased risk of a high annual rate of decline in estimated GFR, even after adjustment for the confounding variables (standardized ß = -0.228, P <0.001). Sarcopenic obesity was also significantly associated with risk of a >30% decline in estimated GFR (hazard ratio 4.52, 95% CI 2.16-9.47; P < 0.01) in multivariate model. CONCLUSIONS: Sarcopenic obesity evaluated by dual energy X-ray absorptiometry is associated with a faster decline in renal function in people with type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Rim/fisiopatologia , Obesidade/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Sarcopenia/epidemiologia , Idoso , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Reino Unido
2.
Spinal Cord ; 55(10): 940-943, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28555661

RESUMO

STUDY DESIGN: A retrospective, consecutive case series. OBJECTIVES: The relationship between dysphagia and acute cervical spinal cord injury (CSCI) has been recently reported; however, the cause and mechanism of dysphagia are still not well understood. No definitive factors have yet been established according to multivariate analysis. The objective is to elucidate the incidence and risk factors of dysphagia in patients with acute CSCI. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: A total of 298 patients with acute CSCI, who were evaluated for neurological impairment within 3 days after injury, were reviewed. CSCI patients with tube dependence due to obvious aspiration after injury were defined as having dysphagia. The factors postulated to increase the risk for dysphagia, including the patient's age, sex, American Spinal Injury Association (ASIA) impairment scale at 3 days after injury, level of injury, tracheostomy and operative treatment, were analyzed using a multiple logistic regression model. RESULTS: Of 298 patients, 21 were suffering from severe dysphagia after acute CSCI (7.0%). Of these 21 patients, 12 (57%) had CSCI at the C3-C4 level. Multivariable logistic regression analysis revealed that old age (>72 years), severe ASIA impairment scale (A or B) and presence of tracheostomy were significant risk factors of dysphagia. Level of injury ⩾C3-C4 was not a significant risk factor after adjustment for several potential confounders. CONCLUSION: The incidence of severe dysphagia associated with aspiration was 7%. Old age, severe paralysis and presence of tracheostomy may be the risk factors for dysphagia. The risk for dysphagia should be evaluated to prevent aspiration pneumonia.


Assuntos
Medula Cervical/lesões , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/epidemiologia , Doença Aguda , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Traqueostomia , Adulto Jovem
3.
Spinal Cord ; 55(12): 1066-1070, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28653674

RESUMO

STUDY DESIGN: A randomized controlled trial. OBJECTIVES: To determine the effects of orthotic therapeutic electrical stimulation (TES) on the hand in patients with paresis associated with acute cervical spinal cord injury. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: The study included patients treated for spinal cord injuries (Frankel classification, grades B and C) at our institution within 1 week post injury between May 2011 and December 2014. The patients were allocated randomly to TES and control groups at the time of admission and underwent TES+conventional training or conventional training alone, respectively. Both hands of each patient were treated in the same way. The primary outcome was total passive motion (TPM) of the fingers (degrees). The secondary outcomes were edema (cm) and the upper-extremity motor scores of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI). After randomization, outcomes were assessed at 1 week, 1 month and 3 months post injury in both groups. RESULTS: Twenty-nine individuals were assessed at 3 months (15, TES; 14, control). There were no significant between-group differences for TPM of the fingers, edema and upper-extremity motor scores at 1 week, 1 month and 3 months after injury, although TPM of the fingers tended to be lower in the control group. CONCLUSIONS: It is unclear from the results of this study whether TES has a therapeutic effect on TPM, edema or the upper-extremity motor score of the ISNCSCI. The results of this study provide useful data for future meta-analyses.


Assuntos
Medula Cervical/lesões , Terapia por Estimulação Elétrica , Paresia/terapia , Traumatismos da Medula Espinal/terapia , Edema/etiologia , Edema/fisiopatologia , Edema/terapia , Feminino , Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Paresia/etiologia , Paresia/fisiopatologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
4.
Spinal Cord ; 55(5): 515-517, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27995938

RESUMO

STUDY DESIGN: A retrospective radiographic study with a minimum 2-year follow-up. OBJECTIVE: To evaluate the relationships between the cervical articular facets' morphology and the incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation. SETTING: Spinal Injuries Center, Japan. METHODS: This study included 113 patients with traumatic CSCI without major fracture or dislocation. Eighty-four healthy volunteers without neurological deficits or cervical cord pathology on magnetic resonance imaging (MRI) were defined as control subjects. We used a plain sagittal radiograph to measure the facet sagittal angles (FSA) at four cervical segments in all the CSCI patients and controls. We defined the FSA as the angle between the inferior margin of the superior cervical spinal body and the inferior articular process of the superior vertebra. RESULTS: Most frequent incidence of CSCI was seen at C3-4 segment (54%). With respect to CSCI at C3-4 segment, 55.7% of the subjects showed smallest FSA at C3-4 segment. CONCLUSION: Most of the traumatic CSCI at C3-4 segment showed raised cervical articular facets at C3-4 segment. On the basis of our results, we hypothesized that the raised cervical articular facets might have an important role in the etiology of traumatic CSCI. The cervical spinal cord at the C3-4 segment might receive the highest load during acute hyperextension of the cervical spine because of the C3-4 articular facets' morphology.


Assuntos
Vértebras Cervicais/fisiopatologia , Traumatismos da Medula Espinal/etiologia , Adulto , Medula Cervical/lesões , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/lesões , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/epidemiologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos da Medula Espinal/diagnóstico por imagem , Adulto Jovem
5.
Spinal Cord ; 54(1): 24-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26078230

RESUMO

STUDY DESIGN: A retrospective imaging and clinical study. OBJECTIVES: To evaluate the relationship between magnetic resonance imaging (MRI) features and neurological prognosis in patients with traumatic cervical spinal cord injury (CSCI) without major bone injury. METHODS: A total of 72 patients with CSCI without major bone injury were treated conservatively in our hospital. MRI was performed for all patients at admission and 1 month following injury. We measured the antero-posterior and cranio-caudal diameter of intramedullary intensity changed area with T1-weighted images at the injured segment. Neurological evaluations were performed using the American Spinal Injury Association (ASIA) motor score and the modified Frankel grade at the time of admission and discharge. RESULTS: There was a significant relationship between the antero-posterior diameter ratio of the T1-weighted low-intensity area on MRI at the subacute stage and the ASIA motor score. The optimal threshold of the T1-weighted low-intensity diameter ratio for predicting the patient's ability to walk with or without assistance at discharge was determined to be 46%. Moreover, 96.8% of the patients with <50% T1-weighted low-intensity area recovered to walk with or without a cane at discharge. CONCLUSION: The T1-low intensity area may be an important predictive factor for the neurological recovery of CSCI without major bone injury.


Assuntos
Vértebras Cervicais/patologia , Transtornos Neurológicos da Marcha/etiologia , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Cervical , Feminino , Transtornos Neurológicos da Marcha/diagnóstico , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença
6.
Spinal Cord ; 53(5): 408-12, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25179656

RESUMO

STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To elucidate the pathophysiology of rapid progressive clinical deterioration following the onset of cervical myelopathy. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: A total of 43 cervical spondylotic myelopathy (CSM) patients were treated surgically by a senior surgeon. All patients showed intramedullary intensity changes on magnetic resonance (MR) imaging. Overall, eight patients suffered rapid progressive clinical deterioration; four of them had obvious anamnesis of minor trauma. We assessed the responsible injured segment by MR T2-weighted images. Clinical instabilities at the focal segment were evaluated using functional sagittal plain radiographs. Neurological evaluations were performed preoperatively and at 12 months postoperatively using American Spinal Injury Association (ASIA) motor scores and Japanese Orthopaedic Association (JOA) scores for cervical myelopathy. Intraoperatively, we evaluated the presence of adhesive scar tissue on the dura mater at the focal segment. RESULTS: The responsible injured segment was C3-4 in 75% of the rapid progressive (rp)-CSM and in 28.57% of the conventional CSM subjects. One with rp-CSM showed sagittal translational segmental instability. Preoperative ASIA motor scores and JOA scores in the rp-CSM were significantly lower than those in the conventional CSM subjects. Postoperative ASIA motor scores between the subjects showed no significant differences; however, postoperative JOA scores in the rp-CSM subjects were significantly lower. Moreover, an epidural membrane was observed in 62.5% of rp-CSM and 11.4% of conventional CSM subjects. CONCLUSIONS: We hypothesized that the pathophysiology of rp-CSM might be additional cervical cord disorder following the onset of cervical myelopathy. Early decompression surgery is recommended in such patients.


Assuntos
Vértebras Cervicais/patologia , Doenças da Medula Espinal/etiologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/cirurgia , Espondilose/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Estudos Retrospectivos , Estatísticas não Paramétricas
7.
J Dent Res ; 103(4): 369-377, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38533640

RESUMO

Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.


Assuntos
Atividades Cotidianas , Perda de Dente , Idoso , Humanos , Masculino , Estudos Prospectivos , Avaliação Geriátrica , Japão
8.
Spinal Cord ; 51(4): 331-3, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23208542

RESUMO

STUDY DESIGN: Retrospective radiographic study. OBJECTIVE: To investigate the pincers effect on cervical spinal cord in the development of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation. SETTING: The Japan LHWO Spinal Injuries Center. METHODS: Two hundred and twenty cases of traumatic CSCI without major fracture or dislocation were examined. The pinched diameters of the cervical spinal cord for 70 patients who complained of neck pain without neurological deficits were measured using sagittal-plane neutral and extension radiographs at 5 segments. These 70 patients were divided into 2 groups: group A patients were less than 40 years old and group B patients were 41 or more. We defined the pinched ratio of the cervical spinal cord during extension as ((sagittal diameter in the neutral image)-(sagittal diameter in the extension image))/(sagittal diameter in the neutral image)*100. RESULTS: The incidence of traumatic CSCI without major fracture or dislocation at the C3-4, C4-5, C5-6 and C6-7 was 59.5, 25, 11.4 and 4.1%, respectively. Further, the pinched ratio of the cervical spinal cord at the C3-4 segment was significantly higher than that at the other segments. CONCLUSION: We concluded that the cervical spinal cord at the C3-4 segment might receive the highest bony impingement load during acute hyperextension of the cervical spine. The extreme pincers load on the cervical spinal cord at the C3-4 segment may have one of the important roles in the development of traumatic CSCI at the C3-4 segment.


Assuntos
Vértebras Cervicais/lesões , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Japão , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Estudos Retrospectivos , Traumatismos da Medula Espinal/diagnóstico por imagem , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Spinal Cord ; 51(11): 819-22, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24042986

RESUMO

STUDY DESIGN: This was a retrospective observational study. OBJECTIVES: The objectives were to describe the prognosis of upper extremity function following cervical spinal cord injury (CSCI), and to identify prognostic factors for functional recovery. SETTING: Spinal Injuries Center, Japan. METHODS: Sixty patients with C3-4 CSCI without major bone injury participated in the study. Patients were treated nonsurgically and evaluated using the American Spinal Injury Association (ASIA) scales for the upper and lower extremities, their residual cervical motor functions, the modified Frankel grade and an upper extremity function scale. We compared the findings for the upper extremity function scale at 6 months with those for the residual cervical motor functions and modified Frankel grade obtained 3 days after injury. RESULTS: Most patients with CSCI who could flex their hip and knee from a supine position (95%) or who showed some active elbow extension (86%) 3 days after their injury could use a spoon at 6 months. We compared patients who used their fingers at 6 months to those who could not, and observed significant differences in age and ASIA scores for the upper and lower extremities obtained 3 days after injury. A strong correlation was observed between the initial motor scores and the extent of functional recovery at 6 months. CONCLUSION: Hip and knee flexion from the supine position and elbow extension 3 days after injury significantly predicted a positive prognosis for upper extremity function. Younger age and higher ASIA motor scores obtained 3 days after injury were factors associated with neurological recovery.


Assuntos
Recuperação de Função Fisiológica/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Extremidade Superior/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Osso e Ossos/fisiologia , Feminino , Quadril/fisiopatologia , Humanos , Japão , Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Traumatismos da Medula Espinal/complicações
10.
J Nutr Health Aging ; 27(2): 124-133, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36806867

RESUMO

OBJECTIVES: Research suggests that cardiometabolic disease risks are elevated among survivors of natural disasters, possibly mediated by changes in diet. Using the Brief Dietary History Questionnaire, we examined (1) dietary patterns among older survivors of the 2011 Great East Japan Earthquake and Tsunami, and (2) the contribution of posttraumatic stress symptoms (PTSS)/depressive symptoms, as well as relocation to temporary housing on dietary patterns and (3) gender differences in the associations. DESIGN, SETTING AND PARTICIPANTS: Data came from a prospective cohort study of 1,375 survivors aged 65-89 years (44.6% male). MEASUREMENTS: PTSS/depression onset was evaluated in 2013, 2.5 years after the disaster. Dietary data was collected with a self-administered brief-type diet history questionnaire in 2020. A principal component analysis identified three posterior dietary patterns. RESULTS: Diet 1 consisted of high intake of vegetables, soy products, and fruits; Diet 2 consisted of carbohydrate-rich foods and snacks/sweets; Diet 3 consisted of high intake of alcoholic beverages, meat, and seafood. Least-squares linear regression revealed that individuals with PTSS/depression were less likely to exhibit Diet 1, while individuals with PTSS were more likely to exhibit Diet 2 and 3. Especially, males who had depression showed an unhealthy dietary pattern. Those who have lived in a trailer-style temporary housing reported less consumption of Diet 3. CONCLUSION: Survivors of disaster with symptoms of mental illness tended to exhibit less healthy dietary patterns after 9 years. Diet varied by type of post-disaster mental illness, gender, and current social circumstances. We lacked pre-disaster BDHQ data, which is a limitation.


Assuntos
Desastres , Terremotos , Masculino , Humanos , Feminino , Tsunamis , Saúde Mental , Estudos Prospectivos , Sobreviventes/psicologia , Japão
12.
Int J Obes (Lond) ; 35(5): 619-28, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-20938442

RESUMO

The hypothalamus has a critical role in the regulation of feeding behavior, energy metabolism and reproduction. Galanin-like peptide (GALP), a novel 60 amino-acid peptide with a nonamidated C-terminus, was first discovered in porcine hypothalamus. GALP is mainly produced in the hypothalamic arcuate nucleus and is involved in the regulation of feeding behavior and energy metabolism, with GALP-containing neurons forming networks with several feeding-regulating peptide-containing neurons. The effects of GALP on food intake and body weight are complex. In rats, the central effect of GALP is to first stimulate and then reduce food intake, whereas in mice, GALP has an anorectic function. Furthermore, GALP regulates plasma luteinizing hormone levels through activation of gonadotropin-releasing hormone-producing neurons, suggesting that it is also involved in the reproductive system. This review summarizes the research on these topics and discusses current evidence regarding the function of GALP, particularly in relation to feeding and energy metabolism. We also discuss the effects of GALP activity on food intake, body weight and locomotor activity after intranasal infusion, a clinically viable mode of delivery.


Assuntos
Ingestão de Alimentos/fisiologia , Metabolismo Energético/fisiologia , Peptídeo Semelhante a Galanina/fisiologia , Hormônio Liberador de Gonadotropina/metabolismo , Homeostase/fisiologia , Hipotálamo/metabolismo , Animais , Peso Corporal/fisiologia , Comportamento Alimentar , Humanos , Hormônio Luteinizante/metabolismo , Camundongos , Atividade Motora , Ratos
13.
Spinal Cord ; 48(7): 548-53, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20065985

RESUMO

STUDY DESIGN: A multicenter prospective study comparing the neurological outcome of patients treated by surgical intervention versus conservative treatment for cervical spinal cord injury (CSCI) without bone and disc injury. OBJECTIVE: To evaluate the neurological outcome of decompression surgery for CSCI without bone and disc injury in patients with spinal cord compression with incomplete paralysis (AIS B, C). SETTING: The Japan LHWO Spinal Injuries Center and the other 10 labor accident hospitals in Japan. METHODS: Thirty-four patients with AIS B, C and cervical spinal cord compression were classified into either a surgical treatment group or a conservative treatment group. The 34 patients enrolled were equally divided between the groups. Patients with AIS B, C and mild spinal compression were enrolled into another group. RESULTS: The neurological outcome of surgical treatment and conservative treatment for AIS B, C with spinal cord compression was found to be closely similar. In addition, the neurological outcome was also similar to that observed after conservative treatment for AIS B, C in patients presenting with mild spinal cord compression. CONCLUSIONS: Surgical treatment was not found to be superior to conservative treatment for CSCI patients without bone and disc injury suffering from spinal cord compression in the acute phase.


Assuntos
Descompressão Cirúrgica/métodos , Avaliação de Resultados em Cuidados de Saúde/métodos , Compressão da Medula Espinal/cirurgia , Adulto , Idoso , Vértebras Cervicais/cirurgia , Feminino , Humanos , Japão , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Estudos Prospectivos , Estudos Retrospectivos , Compressão da Medula Espinal/fisiopatologia
14.
Science ; 278(5335): 120-3, 1997 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-9311916

RESUMO

Familial adenomatous polyposis coli (FAP) is a disease characterized by the development of multiple colorectal adenomas, and affected individuals carry germline mutations in the APC gene. With the use of a conditional gene targeting system, a mouse model of FAP was created that circumvents the embryonic lethality of Apc deficiency and directs Apc inactivation specifically to the colorectal epithelium. loxP sites were inserted into the introns around Apc exon 14, and the resultant mutant allele (Apc580S) was introduced into the mouse germline. Mice homozygous for Apc580S were normal; however, upon infection of the colorectal region with an adenovirus encoding the Cre recombinase, the mice developed adenomas within 4 weeks. The adenomas showed deletion of Apc exon 14, indicating that the loss of Apc function was caused by Cre-loxP-mediated recombination.


Assuntos
Polipose Adenomatosa do Colo/genética , Marcação de Genes , Genes APC , Proteínas Virais , Proteína da Polipose Adenomatosa do Colo , Adenoviridae/genética , Animais , Colo/metabolismo , Proteínas do Citoesqueleto/biossíntese , Modelos Animais de Doenças , Éxons , Feminino , Mutação da Fase de Leitura , Deleção de Genes , Vetores Genéticos , Mutação em Linhagem Germinativa , Homozigoto , Integrases/genética , Integrases/metabolismo , Íntrons , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Recombinação Genética
15.
Spinal Cord ; 47(8): 640-2, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19223860

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: We have encountered several cases of complete sensorimotor paralysis in which patellar tendon reflex (PTR) was demonstrated approximately 3 days after injury and improvement of motor paralysis was subsequently achieved. We considered that PTR apparent in the early stage after injury may offer an index to predict improvements in motor paralysis. MATERIALS AND METHODS: A total of 142 patients assessed as ASIA Impairment Scale A on admission from 1979 to 1998 were included in the study. The patients who demonstrated PTR within 72 h after injury were classified as the PTR(+) group and those who did not constituted the PTR(-) group. With regard to the method of motor paralysis assessment at about 6 months after injury, patients assessed as ASIA Impairment Scale A or B (that is, complete motor paralysis) were classified as 'Non-recovered', whereas those assessed as ASIA Impairment Scale C, D or E (that is, showing obvious improvement of motor paralysis) were considered as 'Recovered'. RESULTS: A significant difference was noted between groups, with the Recovered group including 16 of the 17 PTR(+) patients (94.1%) and 11 of the 115 PTR(-) patients (9.6%) (P<0.0001). CONCLUSION: The results obtained indicate that motor paralysis recovery could be expected at a very high rate among patients demonstrating PTR within 72 h of injury. As all physicians should be familiar with the PTR, this seems to represent a simple and highly useful sign to predict improvements in motor paralysis during the acute stage of cervical cord injury.


Assuntos
Paralisia/fisiopatologia , Paralisia/reabilitação , Ligamento Patelar/fisiopatologia , Reflexo/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Vértebras Cervicais , Humanos , Paralisia/etiologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Traumatismos da Medula Espinal/complicações
16.
Trends Biochem Sci ; 22(12): 453-7, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9433122

RESUMO

The universal genetic code is determined by the aminoacylation of tRNAs. In spite of the universality of the code, there are barriers to aminoacylation across taxonomic domains. These barriers are thought to correlate with the co-segregation of sequences of synthetases and tRNAs into distinct taxonomic domains. By contrast, we show here examples of eukaryote-like synthetases that are found in certain prokaryotes. The associated tRNAs have retained their prokaryote-like character in each instance. Thus, co-segregation of domain-specific synthetases and tRNAs does not always occur. Instead, synthetases make adaptations of tRNA-protein contacts to cross taxonomic domains.


Assuntos
Aminoacil-tRNA Sintetases/genética , Filogenia , RNA de Transferência/metabolismo , Aminoacil-tRNA Sintetases/classificação , Aminoacil-tRNA Sintetases/metabolismo , Archaea/enzimologia , Archaea/genética , Bactérias/enzimologia , Bactérias/genética , Sítios de Ligação , Classificação , Alinhamento de Sequência
17.
J Bronchology Interv Pulmonol ; 25(2): 103-110, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29346249

RESUMO

BACKGROUND: The ideal concentration of lignocaine for topical anesthesia in bronchoscopy remains investigational. In this randomized, double blind study, we compared 1% versus 2% lignocaine for topical anesthesia. METHODS: Consecutive patients undergoing bronchoscopy were randomized to receive either 1% or 2% lignocaine solution by spray-as-you-go technique. All received 10% lignocaine spray to the oropharynx along with nasal 2% lignocaine gel. Nebulized lignocaine was not administered. Primary outcomes were operator-rated overall procedural satisfaction, visual analogue scale (VAS)-rated and operator-rated cough, VAS. Secondary objectives were total lignocaine dose administered, patient-rated pain on faces pain scale, cumulative dose of lignocaine and procedural complications. RESULTS: A total of 500 patients (250 in each group) were randomized. Baseline characteristics were comparable. Operator-rated overall procedural satisfaction, VAS (72.05±20.16 and 72.20±21.96 in 1% and 2% group respectively; P=0.93) and operator-rated cough, VAS [1% group: 19.1 (12.6-34.6) and 2% group: 20.6 (12.5-36.9); P>0.05] were similar between the 2 groups. Cumulative dose of lignocaine used in 2% lignocaine group was greater (220.89±12.96 mg in 1% and 319.55±19.32 mg in 2% group; P<0.001). Patients receiving sedation were comparable between the 2 groups. (10% in 1% lignocaine group and 6% in 2% lignocaine group; P=0.13). Minor complications occurred in 2 patients in each group. CONCLUSION: One percent lignocaine in flexible bronchoscopy is as efficacious as 2% lignocaine when administered using the spray as you go technique without concurrent lignocaine nebulization, at a significantly lower total dose of lignocaine administered.


Assuntos
Anestésicos Locais/administração & dosagem , Broncoscopia/métodos , Lidocaína/administração & dosagem , Administração por Inalação , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do Tratamento
18.
J Neuroendocrinol ; 19(11): 870-81, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17927665

RESUMO

We recently reported that rodent anterior pituitary (AP) cells (with the exception of corticotrophs and melanotrophs) express neuronal markers, including 68-kDa neurofilaments (NF68) in an oestrogen-dependent manner. The functional significance of neurofilament (NF) expression in the AP is unknown, but recent data in myelinated nerve fibres from NF-null mice suggest that NFs can regulate ion channel function. Because Ca(2+) influx through voltage-gated Ca(2+) channels is required for hormone secretion in AP cells, and oestrogen regulates the expression of Ca(2+) channels in AP cells, the present study examined the expression of alpha1 subunits of voltage gated Ca(2+) channels in relation to that of NF68. Using quantitative immunofluorescence, we demonstrate that alpha 1C and alpha 1D subunits are abundantly expressed in female AP cells, alpha 1A subunits are moderately expressed, and alpha 1G and alpha 1B subunits are expressed at the lowest levels. Double-immunostaining showed that NF68 expression is not correlated with that of alpha 1C, alpha 1D or alpha 1B. Expression of alpha 1G and NF68 appear to be mutually exclusive from each other. Moreover, alpha 1A subunit and NF68 expression are significantly correlated and alpha 1A immunoreactivity is sexually dimorphic (i.e. low in males and high in females) and its levels of expression vary during the oestrous cycle, similar to NF68. Finally, omega-agatoxin IVA, a specific blocker of P/Q type Ca(2+) currents that are a result of the activity of alpha 1A subunits, inhibited to a greater extent spontaneous [Ca(2+)](i) fluctuations in AP cells from females in oestrous and dioestrous, whereas cells from females in pro-oestrous and males were less affected by this toxin. These results suggest a preferential participation of P/Q-type Ca(2+) channels and hence alpha 1A subunits, in regulating spontaneous Ca(2+) transients in AP cells under conditions where the proportion of NF68-expressing cells is high. It remains to be determined whether the expression of NF68 affects that of alpha 1A Ca(2+) channel subunits or vice versa.


Assuntos
Canais de Cálcio Tipo P/metabolismo , Canais de Cálcio Tipo Q/metabolismo , Imuno-Histoquímica , Proteínas do Tecido Nervoso/metabolismo , Proteínas de Neurofilamentos/metabolismo , Subunidades Proteicas/metabolismo , Animais , Cálcio/metabolismo , Canais de Cálcio Tipo N , Canais de Cálcio Tipo P/genética , Canais de Cálcio Tipo Q/genética , Ciclo Estral/fisiologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Subunidades Proteicas/genética
19.
Nanoscale ; 9(43): 16791-16799, 2017 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-29072757

RESUMO

A titania-stearic acid hybrid layer was deposited onto well-defined silica-hexadecyltrimethylammonium hybrid spherical particles with 854 nm size to obtain nanoporous particles with a useful hierarchical core-shell structure. The deposition of a 35 nm-thick titania layer was confirmed by transmission electron microscopy. The core-shell particles were washed with acidic ethanol (solvent extraction) and calcined at 550 °C for 5 h to remove the template, resulting in the formation of nanoporous titania coated nanoporous silica spherical particles, which have a bimodal pore size distribution attributed to the hierarchical porous core and porous shell structure. The nanoporous titania coated particles exhibited an unusual crystal phase transition; only anatase was present even after the calcination at 1000 °C for 1 h. This would be due to the interfacial bonding between the core silica and the shell titania, preventing the crystal phase transition from anatase to rutile. On the other hand, the direct calcination of the titania-stearic acid coated particles without solvent extraction led to a shell composed of both anatase and rutile. The transformation to rutile could be caused by the strong exothermic reaction during the oxidative decomposition of the occluded stearic acid. Furthermore, the intense exothermic reaction induced the formation of a yolk-shell structure, which played a role in the sensitive/selective sensing properties for acetic acid when the yolk-shell particles were coated onto a nanomechanical Membrane-type Surface stress Sensor (MSS).

20.
Neuroscience ; 140(3): 1079-88, 2006 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-16650611

RESUMO

To determine the synaptic source of the respiratory-related activity of laryngeal motoneurons, spike-triggered averaging of the membrane potentials of laryngeal motoneurons was conducted using spikes of respiratory neurons located between the Bötzinger complex and the rostral ventral respiratory group as triggers in decerebrate, paralyzed cats. We identified one excitatory and two inhibitory sources for inspiratory laryngeal motoneurons, and two inhibitory sources for expiratory laryngeal motoneurons. In inspiratory laryngeal motoneurons, monosynaptic excitatory postsynaptic potentials were evoked by spikes of inspiratory neurons with augmenting firing patterns, and monosynaptic inhibitory postsynaptic potentials (IPSPs) were evoked by spikes of expiratory neurons with decrementing firing patterns and by spikes of inspiratory neurons with decrementing firing patterns. In expiratory laryngeal motoneurons, monosynaptic IPSPs were evoked by spikes of inspiratory neurons with decrementing firing patterns and by spikes of expiratory neurons with augmenting firing patterns. We conclude that various synaptic inputs from respiratory neurons contribute to shaping the respiratory-related trajectory of membrane potential of laryngeal motoneurons.


Assuntos
Vias Eferentes/fisiologia , Músculos Laríngeos/inervação , Bulbo/fisiologia , Neurônios Motores/fisiologia , Centro Respiratório/fisiologia , Transmissão Sináptica/fisiologia , Potenciais de Ação/fisiologia , Animais , Gatos , Membrana Celular/fisiologia , Vias Eferentes/anatomia & histologia , Estimulação Elétrica , Potenciais Pós-Sinápticos Excitadores/fisiologia , Feminino , Músculos Laríngeos/fisiologia , Nervos Laríngeos/anatomia & histologia , Nervos Laríngeos/fisiologia , Masculino , Bulbo/anatomia & histologia , Rede Nervosa/anatomia & histologia , Rede Nervosa/fisiologia , Inibição Neural/fisiologia , Terminações Pré-Sinápticas/fisiologia , Centro Respiratório/anatomia & histologia , Fenômenos Fisiológicos Respiratórios
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