Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 571
Filtrar
Mais filtros

Tipo de documento
Intervalo de ano de publicação
1.
J Dairy Sci ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38908688

RESUMO

The aim of this study was to evaluate the effect of hoof trimming on overall limb movements by comparing the changes in 8 limb joint angles before and after one week of hoof trimming. Seventeen Holstein-Friesian dairy cows that were able to move freely and had no history of hoof diseases were included in the study. The cows were walked on a rubber mat with a high friction coefficient (HFM) and a low friction coefficient by the spraying of sodium polyacrylate (LFM). A high-speed camera was set to 200 fps on the image analysis software, and the images of the cows that were given 15 reflective markers on their right side were captured while walking on the test mat. The tests were conducted before and after one week of hoof trimming, and the cows were trimmed by the functional hoof trimming method. With image analysis software, video clips of walking cows were confirmed visually and tracked during one gait cycle by each reflective marker attached to the hoof of the forelimb and hindlimb, after which the stance phase and swing phase were identified. The durations of the stance phase and swing phase of the forelimb and hindlimb, respectively, and the maximum, minimum, and range of motion (ROM) values of the 8 joint angles, shoulder joint, elbow joint, carpus joint, forelimb fetlock joint, hip joint, stifle joint, hock joint and hindlimb fetlock joint during one gait cycle were included in the analysis. The maximum and minimum angles of the hip and stifle joints were narrower after hoof trimming than before, although the ROM did not change and was clearer for HFM than for LFM. It was thought that the flexion of the proximal hindlimb would progress smoothly during walking after trimming.

2.
Br J Surg ; 106(12): 1649-1656, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31626342

RESUMO

BACKGROUND: The length of tumour-vein contact between the portal-superior mesenteric vein (PV/SMV) and pancreatic head cancer, and its relationship to prognosis in patients undergoing pancreatic surgery, remains controversial. METHODS: Patients diagnosed with pancreatic head cancer who were eligible for pancreatoduodenectomy between October 2002 and December 2016 were analysed. The PV/SMV contact was assessed retrospectively on CT. Using the minimum P value approach based on overall survival after surgery, the optimal cut-off value for tumour-vein contact length was identified. RESULTS: Among 491 patients included, 462 underwent pancreatoduodenectomy for pancreatic head cancer. PV/SMV contact with the tumour was detected on preoperative CT in 248 patients (53·7 per cent). Overall survival of patients with PV/SMV contact exceeding 20 mm was significantly worse than that of patients with a contact length of 20 mm or less (median survival time (MST) 23·3 versus 39·3 months; P = 0·012). Multivariable analysis identified PV/SMV contact longer than 20 mm as an independent predictor of poor survival, whereas PV/SMV contact greater than 180° was not a predictive factor. Among patients with a PV/SMV contact length exceeding 20 mm on pretreatment CT, those receiving neoadjuvant therapy had significantly better overall survival than patients who had upfront surgery (MST not reached versus 21·6 months; P = 0·002). CONCLUSION: The length of PV/SMV contact predicts survival, and may be used to suggest a role for neoadjuvant therapy to improve prognosis.


ANTECEDENTES: El valor pronóstico de la longitud del contacto del tumor de la cabeza pancreática con las venas porta y mesentérica superior (portal-superior mesenteric vein, PV/SMV) en los pacientes sometidos a cirugía pancreática sigue siendo un tema controvertido. MÉTODOS: Se analizaron los pacientes diagnosticados de un cáncer de la cabeza pancreática a los que se realizó una duodenopancreatectomía cefálica entre octubre de 2002 y diciembre de 2016. El contacto tumoral con la PV/SMV se evaluó de forma retrospectiva mediante tomografía computarizada (TC). Se identificó el valor de corte óptimo para la longitud del contacto tumoral con la PV/SMV, utilizando el valor mínimo de la P basado en la supervivencia global (overall survival, OS) después de la cirugía. RESULTADOS: De 491 pacientes incluidos, en 462 pacientes se realizó una duodenopancreatectomía cefálica por cáncer de la cabeza de páncreas. En la TC preoperatoria, se detectó contacto tumoral con la PV/SMV en 248 (53,7%) pacientes. La OS de los pacientes en los que el contacto del tumor con la PV/SMV fue > 20 mm fue significativamente peor que en aquellos cuyo contacto fue ≤ 20 mm (mediana de supervivencia (median survival time, MST) 23,3 versus 39,3 meses; P = 0,012). En un análisis multivariado se identificó el contacto tumoral-PV/SMV > 20 mm como un factor independiente predictor de mala supervivencia, pero el contacto tumor-PV/SMV > 180° no fue un factor pronóstico. En los pacientes en los que el contacto tumor-PV/SMV fue > 20 mm en el TC preoperatorio, la OS en aquellos que recibieron tratamiento neoadyuvante fue significativamente mejor en comparación con los pacientes tratados directamente con cirugía (MST, no alcanzada versus 21,6 meses, P = 0,002). Conclusión La longitud del contacto tumoral con la PV/SMV predice la supervivencia, por lo cual dicha longitud podría jugar un papel en la indicación de tratamiento neoadyuvante para mejorar el pronóstico.


Assuntos
Veias Mesentéricas/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Veia Porta/patologia , Idoso , Feminino , Humanos , Masculino , Veias Mesentéricas/diagnóstico por imagem , Pessoa de Meia-Idade , Terapia Neoadjuvante , Invasividade Neoplásica , Neoplasias Pancreáticas/diagnóstico por imagem , Pancreaticoduodenectomia , Veia Porta/diagnóstico por imagem , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Tomografia Computadorizada por Raios X
3.
Br J Surg ; 104(3): 257-266, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27864927

RESUMO

BACKGROUND: The clinical impact of major hepatectomy for advanced gallbladder cancer is currently unclear. METHODS: Patients who underwent resection for stage II, III or IV gallbladder cancer were enrolled. The surgical outcomes of patients who underwent major hepatectomy were compared with those of patients treated with minor hepatectomy and those with unresectable gallbladder cancer. The clinical impact of major hepatectomy and combined advanced procedures such as portal vein resection or pancreatoduodenectomy for advanced gallbladder cancer were evaluated. RESULTS: A total of 96 patients were enrolled; 29 patients underwent major and 67 had minor hepatectomy. The overall morbidity rate was higher in the major hepatectomy group (55 versus 27 per cent; P = 0·022). There were no deaths after major hepatectomy. Overall survival was better in the major hepatectomy group than in the group of 15 patients with unresectable disease (median survival 17·7 versus 11·4 months; P = 0·003). In a subgroup analysis of the major hepatectomy group, liver metastasis (P = 0·038) and hepatic arterial invasion (P = 0·017) were independently associated with overall survival. Overall survival in patients with liver metastasis (P = 0·572) or hepatic arterial invasion (P = 0·776) was comparable with that in the unresectable group. However, overall survival among patients with lymph node metastasis (P = 0·062) or following portal vein resection (P = 0·054) or pancreatoduodenectomy (P = 0·011) was better than in the unresectable group. CONCLUSION: Major hepatectomy combined with portal vein resection or pancreatoduodenectomy, if necessary, may be considered in the treatment of advanced gallbladder cancer, especially in selected patients without liver metastasis or hepatic arterial invasion.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias da Vesícula Biliar/cirurgia , Hepatectomia/métodos , Pancreaticoduodenectomia , Veia Porta/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Neoplasias da Vesícula Biliar/mortalidade , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
4.
Br J Surg ; 103(7): 891-8, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27005995

RESUMO

BACKGROUND: The preoperative serum neutrophil to lymphocyte ratio (NLR) has been associated with survival in patients with hepatocellular carcinoma (HCC). However, it is still unclear what the NLR reflects precisely. This study aimed to elucidate the relationship between the NLR and TNM stage, and the role of NLR as a prognostic factor after liver resection for HCC. METHODS: This retrospective study enrolled patients who underwent liver resection as initial treatment for HCC. The best cut-off value of serum NLR was determined, and overall survival was compared among patients grouped according to TNM stage (I, II and III). RESULTS: The best cut-off value for NLR was 2·8. A high preoperative NLR was more frequently associated with poor overall survival than a low preoperative NLR after resection for TNM stage I tumours (5-year survival 45·0 versus 76·4 per cent, P < 0·001), but not stage II (P = 0·283) or stage III (P = 0·155) tumours. Among patients with TNM stage I disease, the proportion of patients with extrahepatic recurrence was greater in the group with a high preoperative NLR than in the low-NLR group (P = 0·006). In multivariable analysis, preoperative NLR was the strongest independent prognostic risk factor for overall survival in TNM stage I (hazard ratio 2·69, 95 per cent c.i. 1·57 to 4·59; P < 0·001). CONCLUSION: Preoperative NLR was an important prognostic factor for TNM stage I HCC after liver resection with curative intent. These results suggest that the NLR may reflect the malignant potential of HCC.


Assuntos
Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/cirurgia , Contagem de Linfócitos , Neutrófilos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Carcinoma Hepatocelular/patologia , Feminino , Hepatectomia , Humanos , Japão/epidemiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
5.
Clin Exp Obstet Gynecol ; 43(3): 341-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27328487

RESUMO

OBJECTIVE: The aim of the present study was to identify predictive data on the short-term outcomes of fetuses with oligohydramnios. MATERIALS AND METHODS: A retrospective study of all pregnancies diagnosed with oligohydramnios was performed. RESULTS: A total of 17 fetuses (seven males, seven females, and three unknown) with oligohydramnios were treated from 2004 to 2011. Oligohydramnios was first diagnosed at a 21.6 ± 4.2 weeks gestation. Terminations of pregnancy before 22 weeks were identified in five cases, and intrauterine fetal deaths occurred in two cases. Ten neonates were born alive, five cases survived over 28 days, and five cases died within 48 hours. Prognostic factors for survival included birth weight (2,457 ± 480 grams in survivors vs. 1973 ± 124 grams in non-survivors; p < 0.05) and the mean amniotic fluid index (AFI) (2.32 ± 1.19 cm in survivors vs. 0.46 ± 0.68 cm in non-survivors;p < 0.05). CONCLUSION: All patients who survived had a mean AFI > 1.0 cm.


Assuntos
Peso ao Nascer , Morte Fetal , Oligo-Hidrâmnio/mortalidade , Morte Perinatal , Aborto Induzido/estatística & dados numéricos , Adulto , Líquido Amniótico , Anormalidades Congênitas , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Rim/anormalidades , Nefropatias/complicações , Nefropatias/congênito , Masculino , Oligo-Hidrâmnio/etiologia , Parto , Rim Policístico Autossômico Recessivo/complicações , Gravidez , Resultado da Gravidez , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Natimorto , Anormalidades Urogenitais/complicações , Adulto Jovem
6.
Br J Surg ; 102(12): 1561-6, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26206386

RESUMO

BACKGROUND: Several risk factors for complications after pancreaticoduodenectomy have been reported. However, the impact of intraoperative bacterial contamination on surgical outcome after pancreaticoduodenectomy has not been examined in depth. METHODS: This retrospective study included patients who underwent pancreaticoduodenectomy and peritoneal lavage using 7000 ml saline between July 2012 and May 2014. The lavage fluid was subjected to bacterial culture examination. The influence of a positive bacterial culture on surgical-site infection (SSI) and postoperative course was evaluated. Risk factors for positive bacterial cultures were also evaluated. RESULTS: Forty-six (21.1 per cent) of 218 enrolled patients had a positive bacterial culture of the lavage fluid. Incisional SSI developed in 26 (57 per cent) of these 46 patients and in 13 (7.6 per cent) of 172 patients with a negative lavage culture (P < 0.001). Organ/space SSI developed in 32 patients with a positive lavage culture (70 per cent) and in 43 of those with a negative culture (25.0 per cent) (P < 0.001). Grade B/C pancreatic fistula was observed in 22 (48 per cent) and 48 (27.9 per cent) respectively of patients with positive and negative lavage cultures (P = 0.010). Postoperative hospital stay was longer in patients with a positive lavage culture (28 days versus 21 days in patients with a negative culture; P = 0.028). Multivariable analysis revealed that internal biliary drainage, combined colectomy and a longer duration of surgery were significant risk factors for positive bacterial culture of the lavage fluid. CONCLUSION: Intraoperative bacterial contamination has an adverse impact on the development of SSI and grade B/C pancreatic fistula following pancreaticoduodenectomy.


Assuntos
Cavidade Abdominal/microbiologia , Bactérias/isolamento & purificação , Pancreatopatias/cirurgia , Pancreaticoduodenectomia/efeitos adversos , Lavagem Peritoneal/métodos , Infecção da Ferida Cirúrgica/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/terapia , Taxa de Sobrevida/tendências
7.
Biomacromolecules ; 16(2): 437-46, 2015 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-25545620

RESUMO

Surface modification of biodegradable vascular grafts is an important strategy to improve the in situ endothelialization of tissue engineered vascular grafts (TEVGs) and prevent major complications associated with current synthetic grafts. Important strategies for improving endothelialization include increasing endothelial cell mobilization and increased endothelial cell capture through biofunctionalization of TEVGs. The objective of this study was to assess two biofunctionalization strategies for improving endothelialization of biodegradable polyester vascular grafts. These techniques consisted of cross-linking heparin to graft surfaces to immobilize vascular endothelial growth factor (VEGF) or antibodies against CD34 (anti-CD34Ab). To this end, heparin, VEGF, and anti-CD34Ab attachment and quantification assays confirmed the efficacy of the modification strategy. Cell attachment and proliferation on these groups were compared to unmodified grafts in vitro and in vivo. To assess in vivo graft functionality, the grafts were implanted as inferior vena cava interpositional conduits in mice. Modified vascular grafts displayed increased endothelial cell attachment and activity in vivo, according to microscopy techniques, histological results, and eNOS expression. Inner lumen diameter of the modified grafts was also better maintained than controls. Overall, while both functionalized grafts outperformed the unmodified control, grafts modified with anti-CD34Ab appeared to yield the most improved results compared to VEGF-loaded grafts.


Assuntos
Prótese Vascular , Materiais Revestidos Biocompatíveis/metabolismo , Heparina/metabolismo , Células Endoteliais da Veia Umbilical Humana/metabolismo , Enxerto Vascular/métodos , Animais , Antígenos CD34/metabolismo , Prótese Vascular/tendências , Materiais Revestidos Biocompatíveis/administração & dosagem , Materiais Revestidos Biocompatíveis/química , Feminino , Heparina/administração & dosagem , Heparina/química , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Camundongos , Fator A de Crescimento do Endotélio Vascular/metabolismo , Enxerto Vascular/tendências
8.
Transfus Med ; 25(1): 42-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25752582

RESUMO

OBJECTIVE: To prevent neonatal alloimmune thrombocytopenia due to anti-group A antibody perinatal management was performed. BACKGROUND: We previously reported a case of severe intracranial haemorrhage associated with neonatal alloimmune thrombocytopenia due to anti-group A isoantibody. MATERIAL/METHODS: A 40-year-old Japanese woman, gravida 4 para 1, was pregnant with her second baby. The previous sibling developed severe thrombocytopenia and died 10 days after birth due to intracranial haemorrhage. He was diagnosed with neonatal alloimmune thrombocytopenia; the causative antibody was found to be the anti-group A antibody. Prednisone was started at 7 weeks' gestational age. Intravenous immunoglobulin 1 g kg(-1) week(-1) was started at 29 weeks' gestational age and continued to delivery. Serological studies and genotyping were performed. RESULTS: The second boy was delivered at 33 weeks' gestational age by caesarean section. He was discharged without intracranial haemorrhage or thrombocytopenia. The anti-group A antibody titre in the maternal serum was 2048-4096 (normal range: 4-64). The anti-group A antibody titre in the newborn's serum was 4. Cross-matching between the maternal serum and the paternal platelets was positive. CONCLUSION: Owing to the history of neonatal alloimmune thrombocytopenia causing intracranial haemorrhage and death of the previous sibling, strict follow-up of the subsequent pregnancy was conducted.


Assuntos
Sistema ABO de Grupos Sanguíneos/sangue , Transfusão Feto-Materna/terapia , Isoanticorpos/sangue , Assistência Perinatal/métodos , Trombocitopenia Neonatal Aloimune/terapia , Feminino , Transfusão Feto-Materna/sangue , Humanos , Recém-Nascido , Masculino , Gravidez , Trombocitopenia Neonatal Aloimune/sangue
9.
Eur Surg Res ; 51(3-4): 118-28, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24247292

RESUMO

BACKGROUND: Preoperative portal vein embolization (PVE) is performed to enhance the future remnant liver function (FRLF) and volume (FRLV). However, the volume of the nonembolized liver does not increase enough in some patients, which results in an insufficient FRLF. The aim of this study was to evaluate the predictors of insufficient FRLF after PVE for extended hepatectomy. METHODS: This retrospective study included 172 patients (107 patients with cholangiocarcinoma, 40 patients with metastatic liver cancer and 25 patients with hepatocellular carcinoma) who underwent PVE before extended hepatectomy. The total liver function was evaluated by measuring the indocyanine green plasma clearance rate (KICG). Computed tomography volumetry was conducted to evaluate the total liver volume and FRLV. The KICG of the future remnant liver (remK) was calculated using the following formula: KICG × FRLV/total liver volume. The safety margin for hepatectomy was set at remK after PVE (post-PVE remK) ≥ 0.05. RESULTS: One hundred and twenty-three patients with a post-PVE remK level of >0.05 underwent hepatectomy without postoperative liver failure [sufficient liver regeneration (SLR) group], and 9 patients with a post-PVE remK level of <0.05 did not due to insufficient FRLF [insufficient liver regeneration (ILR) group]. In the SLR group, the KICG values did not change after PVE (median, 0.144-0.146, p = 0.523); however, the %FRLV and remK increased significantly (35.0-44.3%, p < 0.001 and 0.0488-0.0610, p < 0001, respectively). In contrast, in the ILR group, the KICG values decreased significantly (0.128-0.108, p = 0.021) and the %FRLV increased marginally (27.4-32.6%, p = 0.051). As a result, the remK did not increase significantly (0.0351-0.0365, p = 0.213). A receiver operating characteristic curve demonstrated an remK value of 0.04 obtained before PVE (pre-PVE remK) to be the optimal cutoff point for defective liver regeneration. The univariate and multivariate analyses revealed that a pre-PVE remK value of <0.04 was a factor for ILR. It was also correlated with postoperative liver failure in the analysis of the patients who underwent hepatectomy. CONCLUSIONS: The patients in the ILR group did not achieve SLR after PVE due to a significant decrease in the KICG and an insufficient increase in %FRLV. A pre-PVE remK value of <0.04 is a useful predictor of insufficient regeneration of the nonembolized liver, even after PVE.


Assuntos
Embolização Terapêutica , Hepatectomia/métodos , Regeneração Hepática , Cuidados Pré-Operatórios , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veia Porta
10.
Scand J Immunol ; 75(6): 633-40, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22340436

RESUMO

Neuro-Behçet's disease (NBD) is a serious complication of Behçet's disease. Generally, NBD patients with a chronic course are refractory to immunosuppressive treatment, resulting in the deterioration of personality. In this study, levels of B cell-activating factor belonging to the TNF family (BAFF) were measured in the cerebrospinal fluid (CSF) from 18 patients with NBD, 27 patients with epidemic aseptic meningitis (AM), 24 patients with multiple sclerosis (MS) and 34 healthy controls. BAFF levels in patients with NBD were significantly elevated compared with healthy controls, but showed no statistically significant elevation compared with either of the disease controls. In contrast, CSF IL-6 levels were slightly elevated in patients with NBD and significantly elevated in patients with AM and MS compared with healthy controls. Patients with NBD were subdivided into two groups according to their clinical course (eight patients with a slowly progressive course presenting with psychosis and dementia and 10 patients with an acute course including aseptic meningitis, brainstem involvement and myelopathy). BAFF levels were significantly increased in those with a slowly progressive course compared with those with an acute course. CSF BAFF levels did not correlate with serum BAFF levels, CSF cell counts or CSF IL-6 levels in patients with NBD. These data suggested that BAFF was produced within the central nervous system and may be associated with the development of NBD, particularly with a progressive course.


Assuntos
Fator Ativador de Células B/líquido cefalorraquidiano , Síndrome de Behçet/líquido cefalorraquidiano , Demência/líquido cefalorraquidiano , Transtornos Psicóticos/líquido cefalorraquidiano , Fator Ativador de Células B/imunologia , Síndrome de Behçet/complicações , Síndrome de Behçet/imunologia , Demência/etiologia , Demência/imunologia , Progressão da Doença , Humanos , Transtornos Psicóticos/etiologia , Transtornos Psicóticos/imunologia
11.
BJS Open ; 5(4)2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34355240

RESUMO

BACKGROUND: Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated. METHODS: Patients undergoing surgical resection for PHCC from 2002-2017 were studied. The surgical outcomes of VR and non-VR groups were compared. RESULTS: Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520). CONCLUSION: Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Tumor de Klatskin , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/cirurgia , Hepatectomia , Humanos , Tumor de Klatskin/cirurgia
12.
BJS Open ; 5(1)2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33609394

RESUMO

BACKGROUND: Hepatectomy with extrahepatic bile duct resection is associated with a high risk of posthepatectomy liver failure (PHLF). However, the utility of the remnant liver volume (RLV) in cholangiocarcinoma has not been studied intensively. METHODS: Patients who underwent major hepatectomy with extrahepatic bile duct resection between 2002 and 2018 were reviewed. The RLV was divided by body surface area (BSA) to normalize individual physical differences. Risk factors for clinically relevant PHLF were evaluated with special reference to the RLV/BSA. RESULTS: A total of 289 patients were included. The optimal cut-off value for RLV/BSA was determined to be 300 ml/m2. Thirty-two patients (11.1 per cent) developed PHLF. PHLF was more frequent in patients with an RLV/BSA below 300 ml/m2 than in those with a value of 300 ml/m2 or greater: 19 of 87 (22 per cent) versus 13 of 202 (6.4 per cent) (P < 0.001). In multivariable analysis, RLV/BSA below 300 ml/m2 (P = 0.013), future liver remnant plasma clearance rate of indocyanine green less than 0.075 (P = 0.031), and serum albumin level below 3.5 g/dl (P = 0.015) were identified as independent risk factors for PHLF. Based on these risk factors, patients were classified into three subgroups with low (no factors), moderate (1-2 factors), and high (3 factors) risk of PHLF, with PHLF rates of 1.8, 14.8 and 63 per cent respectively (P < 0.001). CONCLUSION: An RLV/BSA of 300 ml/m2 is a simple predictor of PHLF in patients undergoing hepatectomy with extrahepatic bile duct resection.


Assuntos
Neoplasias dos Ductos Biliares/cirurgia , Colangiocarcinoma/cirurgia , Hepatectomia/efeitos adversos , Falência Hepática/etiologia , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ductos Biliares Extra-Hepáticos/cirurgia , Corantes/farmacocinética , Feminino , Hepatectomia/métodos , Hepatectomia/mortalidade , Humanos , Verde de Indocianina/farmacocinética , Falência Hepática/sangue , Falência Hepática/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Período Pós-Operatório , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Albumina Sérica/análise
13.
Clin Transl Oncol ; 22(3): 319-329, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31041718

RESUMO

BACKGROUND AND AIM: Intrahepatic metastasis (IM) of hepatocellular carcinoma (HCC) occurs via vascular invasion; the tumor diameter that affects the risk of micro intra-hepatic metastasis (MIM) should be larger than that which affects the risk of micro vessel invasion (MVI). The aim of the present study was to determine the optimum tumor diameter cut-off value for predicting the presence of MIM in HCC patients without treatment history and HCC patients with a treatment history and to compare these diameters between cases of MVI and MIM. METHODS: This retrospective study included 621 patients without macroscopic vessel invasion or intrahepatic metastasis on preoperative imaging who underwent hepatectomy. The cut-off tumor diameter for predicting the presence of MIM was determined by a receiver operating characteristic curves analysis. RESULTS: The optimum cut-off value for predicting the presence of MIM in HCC patients without treatment history was 43 mm. In contrast, the optimum cut-off value for predicting the presence of MIM in HCC patients with a treatment history was 20 mm. Among 46 HCC patients with MIM without treatment history, there were 20 patients with MIM without MVI who were considered to have potential multi-centric (MC) tumors rather than IM. The cumulative overall survival rates in patients with MIM without MVI (potential MC) was significantly better than that in patients with both MIM and MVI (P = 0.022). CONCLUSIONS: The tumor diameter cut-off value for predicting MIM differed between HCC patients without treatment history and with a treatment history and slightly smaller than those for predicting MVI beyond our expectation.


Assuntos
Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/irrigação sanguínea , Carcinoma Hepatocelular/mortalidade , Intervalo Livre de Doença , Feminino , Hepatectomia , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Micrometástase de Neoplasia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Carga Tumoral
14.
Ann Rheum Dis ; 68(12): 1921-4, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19054818

RESUMO

OBJECTIVES: To validate the association of a single nucleotide polymorphism (SNP) of the connective tissue growth factor gene (CTGF) with susceptibility to systemic sclerosis (SSc) in the Japanese population. METHODS: 395 Japanese patients with SSc, 115 patients with rheumatoid arthritis and 269 healthy Japanese volunteers were enrolled in the study. An SNP (rs6918698) at -945 bp from the start codon in the promoter region of the CTGF gene was determined by allelic discrimination with the use of a specific TaqMan probe. RESULTS: The G allele showed a significantly higher frequency in patients with SSc than in controls (p<0.001; odds ratio 1.5; 95% confidence interval 1.2 to 1.9). In particular, the clinical subsets of SSc showed a more significant association between the G allele and diffuse cutaneous SSc (p<0.001) and the presence of interstitial lung disease (p<0.001), the presence of anti-topoisomerase I antibody (p<0.001) and anti-U1RNP antibody (p = 0.010). Association analyses using the genotype of the SNP yielded results similar to those of analyses using the allele. CONCLUSIONS: This study confirms the association between an SNP in the CTGF gene and susceptibility to SSc, especially in the presence of diffuse cutaneous SSc, interstitial lung disease and anti-topoisomerase I antibody. The results strongly suggest that this SNP may be a powerful indicator of severe skin and lung involvement in patients with SSc.


Assuntos
Fator de Crescimento do Tecido Conjuntivo/genética , Polimorfismo de Nucleotídeo Único , Escleroderma Sistêmico/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático/genética , Autoanticorpos/análise , Criança , Feminino , Fibrose/etiologia , Fibrose/genética , Frequência do Gene , Predisposição Genética para Doença , Humanos , Japão , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/genética , Masculino , Pessoa de Meia-Idade , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/imunologia , Pele/patologia , Adulto Jovem
15.
J Cell Biol ; 146(6): 1375-89, 1999 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-10491398

RESUMO

Tumor cell migration through the three- dimensional extracellular matrix (ECM) environment is an important part of the metastatic process. We have analyzed a role played by the integrin-tetraspanin protein complexes in invasive migration by culturing MDA-MB-231 cells within Matrigel. Using time-lapse video recording, we demonstrated that the Matrigel-embedded cells remain round and exhibit only limited ability for migration by extending short, highly dynamic pseudopodia. The alpha3beta1-tetraspanin protein complexes were clustered on the thin microvilli-like protrusions extending from both the main cell body and pseudopodia. Ligation of the alpha3beta1-tetraspanin protein complexes with monoclonal antibodies specifically stimulates production of matrix metalloproteinase 2 (MMP-2) and induces formation of long invasive protrusions within Matrigel. Accordingly, treatment with the monoclonal antibodies to various tetraspanin proteins and to the alpha3 integrin subunit increases invasive potential of the MDA-MB-231 cells in the Matrigel-penetration assay. A specific inhibitor of phosphoinositide 3-kinase (PI3K), LY294002, negated the effect of the monoclonal antibodies on the morphology of the Matrigel-embedded cells and on production of MMP-2. Interestingly, broad-spectrum inhibitors of protein tyrosine kinases (genistein) and protein tyrosine phosphatases (orthovanadate), and actin filament stabilizing compound (jasplakinolide), also block protrusive activity of the Matrigel-embedded cells but have no effect on the production of MMP-2. These results indicate that alpha3beta1-tetraspanin protein complexes may control invasive migration of tumor cells by using at least two PI3K-dependent signaling mechanisms: through rearrangement of the actin cytoskeleton and by modulating the MMP-2 production.


Assuntos
Neoplasias da Mama/patologia , Movimento Celular , Gelatinases/biossíntese , Integrinas/metabolismo , Proteínas de Membrana/metabolismo , Metaloendopeptidases/biossíntese , Invasividade Neoplásica , Actinas/agonistas , Actinas/antagonistas & inibidores , Actinas/metabolismo , Anticorpos Monoclonais , Neoplasias da Mama/enzimologia , Neoplasias da Mama/metabolismo , Adesão Celular/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Tamanho Celular/efeitos dos fármacos , Colágeno , Combinação de Medicamentos , Ativação Enzimática/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Matriz Extracelular/metabolismo , Gelatinases/antagonistas & inibidores , Gelatinases/química , Gelatinases/metabolismo , Humanos , Integrina alfa3beta1 , Integrinas/antagonistas & inibidores , Laminina , Metaloproteinase 2 da Matriz , Proteínas de Membrana/antagonistas & inibidores , Metaloendopeptidases/antagonistas & inibidores , Metaloendopeptidases/química , Metaloendopeptidases/metabolismo , Peso Molecular , Fosfatidilinositol 3-Quinases/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase , Fosforilação , Proteoglicanas , Pseudópodes/efeitos dos fármacos , Pseudópodes/metabolismo , Transdução de Sinais/efeitos dos fármacos , Células Tumorais Cultivadas
16.
Science ; 229(4719): 1261-2, 1985 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-17770815

RESUMO

Conspicuous changes in gas composition were observed at a fumarole and a mineral spring just before the occurrence of an inland earthquake (magnitude, 6.8) in central Japan in September 1984; the fumarole and spring were 9 and 50 kilometers, respectively, from the earthquake's epicenter. Deep-seated fluids emitted as a result of the compressional stress of the earth tide had been observed previously at this mineral spring and at a lava lake in Hawaii. By analogy, the gas anomaly observed before the earthquake in Japan probably resulted from deepseated fluids being squeezed to the surface by the tectonic stress that caused the earthquake.

17.
J Oral Rehabil ; 36(3): 159-67, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18713307

RESUMO

A variety of chewing tests and test items have been utilized to evaluate masticatory function. The purpose of this study was to compare a mixing ability test with masticatory performance tests using peanuts or gummy jelly as test foods. Thirty-two completely dentate subjects (Dentate group, mean age: 25.1 years) and 40 removable partial denture wearers (RPD group, mean age: 65.5 years) participated in this study. The subjects were asked to chew a two-coloured paraffin wax cube as a test item for 10 strokes. Mixing Ability Index (MAI) was determined from the colour mixture and shape of the chewed cube. Subjects were asked to chew 3 g portions of peanuts and a piece of gummy jelly for 20 strokes, respectively. Median particle size of chewed peanuts was determined using a multiple-sieving method. Concentration of dissolved glucose from the surface of the chewed gummy jelly was measured using a blood glucose meter. Pearson's correlation coefficient was used to test the relationships between the MAI, median particle size and the concentration of dissolved glucose. Mixing Ability Index was significantly related to median particle size (Dentate group: r = -0.56, P < 0.001, RPD group: r = -0.70, P < 0.001), but not significantly related to glucose concentration (Dentate group: r = 0.12, RPD group: r = 0.21, P > 0.05). It seems that ability of mixing the bolus is more strongly related to the ability of comminuting brittle food than elastic food.


Assuntos
Alimentos , Mastigação/fisiologia , Adulto , Idoso , Arachis , Doces , Prótese Parcial Removível , Elasticidade , Feminino , Glucose/análise , Dureza , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho da Partícula , Reprodutibilidade dos Testes , Ceras , Adulto Jovem
18.
Physiol Res ; 68(2): 265-273, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-30628834

RESUMO

Microcurrent electrical neuromuscular stimulation (MENS) is known as an extracellular stimulus for the regeneration of injured skeletal muscle in sports medicine. However, the effects of MENS-associated increase in muscle protein content are not fully clarified. The purpose of this study was to investigate the effects of MENS on the muscular protein content, intracellular signals, and the expression level of caveolin-3 (Cav-3), tripartite motif-containing 72 (TRIM72) and MM isoenzyme of creatine kinase (CK-MM) in skeletal muscle using cell culture system. C2C12 myotubes on the 7th day of differentiation phase were treated with MENS (intensity: 10-20 microA, frequency: 0.3 Hz, pulse width: 250 ms, stimulation time: 15-120 min). MENS-associated increase in the protein content of myotubes was observed, compared to the untreated control level. MENS upregulated the expression of Cav-3, TRIM72, and CK-MM in myotubes. A transient increase in phosphorylation level of Akt was also observed. However, MENS had no effect on the phosphorylation level of p42/44 extracellular signal-regulated kinase-1/2 and 5'AMP-activated protein kinase. MENS may increase muscle protein content accompanied with a transient activation of Akt and the upregulation of Cav-3 and TRIM72.


Assuntos
Proteínas de Transporte/biossíntese , Caveolina 3/biossíntese , Fibras Musculares Esqueléticas/metabolismo , Animais , Linhagem Celular , Estimulação Elétrica/métodos , Proteínas de Membrana , Camundongos , Proteínas Musculares/biossíntese , Mioblastos/metabolismo
19.
Rheumatology (Oxford) ; 47(3): 289-91, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18263595

RESUMO

OBJECTIVES: To investigate the association between single-nucleotide polymorphisms (SNPs) in the pulmonary surfactant protein (SP) genes and the presence or absence of interstitial lung disease (ILD) in SSc patients. METHODS: We studied 127 Japanese patients with SSc and 206 normal subjects. Investigated SNPs were C/T within amino acid (aa) 219, Arg219Trp in the SP-A1 gene (rs4253527), C/T within aa 131 (at nucleotide 1580) and Thr131Ile of the SP-B gene (rs1130866). Genotypes were determined by the TaqMan method. RESULTS: Genotype frequencies were not different between the SSc patients and normal controls for both loci. The patients were subsequently divided into two groups based on presence or absence of ILD. In the SNP in the SP-B gene, the frequency of the T/T genotype was significantly lower in the patients with ILD than in those without ILD. Limited in the patients who were positive for anti-Scl-70 antibody, the difference in the frequency of the T/T genotype between the ILD-positive and ILD-negative groups became more apparent. On the other hand, in the SNP in the SP-A1 gene, there was no significant skewing for a certain genotype. CONCLUSION: In SSc, where massive fibrosis occurs, possession of the T/T genotype in the SP-B gene would reduce the risk of ILD in Japanese.


Assuntos
Predisposição Genética para Doença , Doenças Pulmonares Intersticiais/genética , Polimorfismo Genético , Proteína B Associada a Surfactante Pulmonar/genética , Escleroderma Sistêmico/genética , Adulto , Estudos de Casos e Controles , Intervalos de Confiança , Feminino , Regulação da Expressão Gênica , Frequência do Gene , Genótipo , Humanos , Japão , Doenças Pulmonares Intersticiais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Probabilidade , Proteína B Associada a Surfactante Pulmonar/metabolismo , Valores de Referência , Medição de Risco , Escleroderma Sistêmico/fisiopatologia , Sensibilidade e Especificidade
20.
J Oral Rehabil ; 35(5): 345-52, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18405270

RESUMO

The purpose of this study was to clarify association between food mixing ability and activity of jaw-closing muscles during chewing of a wax cube. Twenty subjects with complete dentitions (mean age 24.1 years) were directed to chew a two-coloured paraffin wax cube for 10 strokes on preferred chewing side. Surface electromyograms (EMG) were recorded from the right and left masseter and anterior temporalis muscles during chewing of the wax cube. Maximum voltage, duration and muscle work for burst of each chewing cycle were measured on integrated EMG in each muscle. Food mixing ability was estimated as mixing ability index determined from the colour mixture and shape of the chewed wax cube. Some EMG parameters of all muscles except for masseter muscle on non-chewing side showed significant positive correlations with the mixing ability index (r = 0.45-0.56, P < 0.05). However, most of the EMG parameters correlated with one another. As a result, only muscle work of masseter muscle on the chewing side was identified as a significant predictor accounting for 28% interindividual variation in the mixing ability index (P < 0.01). These results suggest that activity of jaw-closing muscles during chewing the wax cube seems to be weakly related to food mixing ability.


Assuntos
Mastigação/fisiologia , Músculos da Mastigação/fisiologia , Adulto , Eletromiografia/métodos , Feminino , Alimentos , Humanos , Masculino , Músculo Masseter/fisiologia , Músculo Temporal/fisiologia , Ceras
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA