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1.
BJU Int ; 134(2): 276-282, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38797721

RESUMEN

OBJECTIVES: To address the paucity of literature comparing outcomes achieved with utilisation of the high-power holmium:yttrium-aluminium-garnet (Ho:YAG) laser with MOSES technology vs those achieved with the thulium fibre laser (TFL) in mini-percutaneous nephrolithotomy (PCNL). METHODS: A retrospective review was performed of patients undergoing supine mini-PCNL between August 2021 and May 2023. Exclusion criteria were urinary diversion, simultaneous utilisation of >1 laser platform, use of any other form of fragmentation, and ureteric stones. The Ho:YAG platform (Lumenis Pulse P120H™ with MOSES technology, 120W; Boston Scientific®) and the TFL (Soltive SuperPulsed Thulium Fibre [SPTF], 60W; Olympus®) were compared. Data on stone-free rate (SFR) were determined by computed tomography performed on the first postoperative day and presented as absence of stone fragments, no fragments larger than 2 mm, or no fragments larger than 4 mm. RESULTS: A total of 100 patients met the inclusion criteria, 51 mini-PCNLs with the Ho:YAG laser and 49 with the SPTF laser. No significant differences in demographics or stone characteristics were detected between the two groups. The Ho:YAG laser utilised less energy and time, resulting in higher ablation efficiency (P < 0.05) and less total operating time (P < 0.05). Overall, there was no difference in SFR in any category between the Ho:YAG group and the SPTF group (no fragments: relative risk [RR] 0.81, 95% confidence interval [CI] 0.59-1.12, P = 0.21; fragments <2 mm: RR 0.86, 95% CI 0.67-1.10, P = 0.23; fragments <4 mm: RR 0.96, 95% CI 0.80-1.15, P = 0.67). CONCLUSIONS: Although we observed an equivalent postoperative SFR, this study supports a shorter operating time and greater intra-operative laser efficiency with the Ho:YAG laser over the SPTF laser in mini-PCNL.


Asunto(s)
Cálculos Renales , Láseres de Estado Sólido , Nefrolitotomía Percutánea , Tulio , Humanos , Femenino , Láseres de Estado Sólido/uso terapéutico , Masculino , Nefrolitotomía Percutánea/métodos , Nefrolitotomía Percutánea/instrumentación , Tulio/uso terapéutico , Estudios Retrospectivos , Persona de Mediana Edad , Cálculos Renales/cirugía , Adulto , Resultado del Tratamiento , Posición Supina , Anciano , Litotripsia por Láser/métodos , Litotripsia por Láser/instrumentación
2.
Occup Med (Lond) ; 74(5): 370-377, 2024 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-38876984

RESUMEN

BACKGROUND: Previous studies have suggested that firefighters, police officers and civil servants in the education sector, particularly in Western countries, are vulnerable to mental stress and disorders; however, evidence for this association in South Korea is lacking. AIMS: This study aimed to identify whether firefighters, police officers and teachers are at a higher risk for occupational mental health disorders. METHODS: We used workers' compensation claims from civil servants (2009-18). Our target population comprised 46 209 civil servants (9009 civil servants in administrative and technical positions, 23 107 police officers, 4417 firefighters and 8676 civil servants in the educational sector). Occupational and environmental medicine physicians and medical doctors defined and confirmed mental disorders. We conducted Cox proportional hazards regression analyses to evaluate civil servants' risk of occupational mental health disorders. RESULTS: Compared with the civil servants in administrative and technical positions, civil servants in the education sector (hazard ratio [HR] = 2.16; 95% confidence interval [CI]:1.65-2.84) showed a statistically significant increased risk of mental disorders; conversely, firefighters did not (HR = 0.80; 95% CI 0.51-1.27). Police officers had a significantly decreased mental disorder risk compared with civil servants in administrative and technical positions (HR = 0.17; 95% CI 0.11-0.25). CONCLUSIONS: The risk of occupational mental health disorders was higher in civil servants in the education sector but lower in police officers and firefighters than civil servants in administrative and technical positions. Further studies on civil servants' mental health awareness are required to confirm our results.


Asunto(s)
Bomberos , Trastornos Mentales , Enfermedades Profesionales , Policia , Indemnización para Trabajadores , Humanos , República de Corea/epidemiología , Trastornos Mentales/epidemiología , Masculino , Adulto , Femenino , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/psicología , Bomberos/estadística & datos numéricos , Bomberos/psicología , Persona de Mediana Edad , Policia/estadística & datos numéricos , Indemnización para Trabajadores/estadística & datos numéricos , Factores de Riesgo , Modelos de Riesgos Proporcionales
3.
Tech Coloproctol ; 28(1): 116, 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39198315

RESUMEN

BACKGROUND: Surgery for Crohn's disease (CD) is considered to have more complications due to the underlying inflammation, immunosuppression, and malnutrition. We sought to study the outcomes of right-sided colonic resection in patients with CD and patients with cancer at a high-volume tertiary center utilizing a standardized perioperative protocol. METHODS: This is a retrospective study of outcomes for all patients with CD or patients undergoing ileocolic resection or right hemicolectomy with ileocolic anastomosis at a single institution from 2013 to 2022. Patients were excluded if they simultaneously underwent another procedure or ostomy creation. Data were analyzed using Wilcoxon rank-sum and chi-squared tests for univariate analyses, and logistic and linear regressions for multivariate analyses. RESULTS: In total 141 patients with CD and 589 patients with cancer were included. Patients with CD were significantly younger with lower body mass index and less likely to have comorbidities, including diabetes and hypertension. Patients with CD were less likely to have a smoking history or prior abdominal surgery, but more likely to be on steroids. Both groups had similar rates of laparoscopy, intraoperative complications, and blood loss. Despite the preoperative and intraoperative differences, both patients with CD and patients with cancer had similar lengths of stay (LOS), readmission, reoperation, and mortality rates. None of the surgical outcomes differed significantly between the two groups. On multivariate analysis, CD diagnosis was not associated with reoperation, readmission, mortality, or LOS while controlling for other characteristics. CONCLUSIONS: With the use of standardized perioperative protocols, surgery for CD at a high-volume center with expertise in CD can be performed with comparable results to other indications like cancer.


Asunto(s)
Colectomía , Enfermedad de Crohn , Humanos , Enfermedad de Crohn/cirugía , Enfermedad de Crohn/complicaciones , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Colectomía/efectos adversos , Colectomía/métodos , Adulto , Resultado del Tratamiento , Tiempo de Internación/estadística & datos numéricos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Anciano , Colon/cirugía , Neoplasias del Colon/cirugía , Neoplasias del Colon/mortalidad , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Readmisión del Paciente/estadística & datos numéricos , Reoperación/estadística & datos numéricos , Íleon/cirugía , Laparoscopía/métodos , Laparoscopía/estadística & datos numéricos , Laparoscopía/efectos adversos , Complicaciones Intraoperatorias/etiología
4.
Occup Med (Lond) ; 73(1): 49-52, 2023 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-36282619

RESUMEN

We describe the case of a 52-year-old male who presented with two episodes of acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) during work, while suspending live chickens for slaughter. The patient was exposed to high levels of bioaerosols, including endotoxins and microorganisms. Endotoxins can induce bronchoconstriction and airway inflammation, and COPD patients are more vulnerable to airway infections caused by microorganisms inhaled with bioaerosols. This study suggests that a high level of bioaerosols may induce airway infections, resulting in acute exacerbations of COPD.


Asunto(s)
Mataderos , Enfermedad Pulmonar Obstructiva Crónica , Masculino , Humanos , Animales , Pollos , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Progresión de la Enfermedad
7.
Eur J Neurol ; 27(10): 2079-2088, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32478888

RESUMEN

BACKGROUND AND PURPOSE: Hidden hearing loss has been reported in patients with Charcot-Marie-Tooth (CMT) disease; however, the auditory-processing deficits have not been widely explored. We investigated the psychoacoustic and neurophysiological aspects of auditory processing in patients with CMT disease type 1A (CMT1A) and type 2A (CMT2A). METHODS: A total of 43 patients with CMT1A and 15 patients with CMT2A were prospectively enrolled. All patients with CMT disease had normal sound-detection ability by using pure-tone audiometry. Spectral-ripple discrimination, temporal modulation detection and auditory frequency-following response were compared between CMT1A, CMT2A and control groups. RESULTS: Although all participants had normal audiograms, patients with CMT disease had difficulty understanding speech in noise. The psychoacoustic auditory processing was somewhat different depending on the underlying pathophysiology of CMT disease. Patients with CMT1A had degraded auditory temporal and spectral processing. Patients with CMT2A had no reduced spectral resolution, but they showed further reduced temporal resolution than the patients with CMT1A. The amplitudes of the frequency-following response were reduced in patients with CMT1A and CMT2A, but the neural timing remained relatively intact. CONCLUSIONS: When we first assessed the neural representation to speech at the brainstem level, the grand average brainstem responses were reduced in both patients with CMT1A and CMT2A compared with healthy controls. As the psychoacoustic aspects of auditory dysfunctions in CMT1A and CMT2A were somewhat different, it is necessary to consider future auditory rehabilitation methods based on their pathophysiology.


Asunto(s)
Enfermedad de Charcot-Marie-Tooth , Percepción Auditiva , Enfermedad de Charcot-Marie-Tooth/complicaciones , Humanos , Neurofisiología , Psicoacústica
8.
Nutr Metab Cardiovasc Dis ; 29(4): 409-420, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30799179

RESUMEN

BACKGROUND AND AIM: Metabolic syndromes are prevalent worldwide and result in various complications including obesity, cardiovascular disease and type II diabetes. Betulinic acid (BA) is a naturally occurring triterpenoid that has anti-inflammatory properties. We hypothesized that treatment with BA may result in decreased body weight gain, adiposity and hepatic steatosis in a diet-induced mouse model of obesity. METHODS AND RESULTS: Mice fed a high-fat diet and treated with BA showed less weight gain and tissue adiposity without any change in calorie intake. Gene expression profiling of mouse tissues and cell lines revealed that BA treatment increased expression of lipid oxidative genes and decreased that of lipogenesis-related genes. This modulation was mediated by increased AMP-activated protein kinase (AMPK) phosphorylation, which facilitates energy expenditure, lipid oxidation and thermogenic capacity and exerts protective effects against obesity and nonalcoholic fatty liver disease. Overall, BA markedly inhibited the development of obesity and nonalcoholic fatty liver disease in mice fed a high-fat diet, and AMPK activation in various tissues and enhanced thermogenesis are two possible mechanisms underlying the antiobesity and antisteatogenic effects of BA. CONCLUSIONS: The current findings suggest that treatment with BA is a potential dietary strategy for preventing obesity and nonalcoholic fatty liver disease.


Asunto(s)
Proteínas Quinasas Activadas por AMP/metabolismo , Adipocitos/efectos de los fármacos , Fármacos Antiobesidad/farmacología , Metabolismo Energético/efectos de los fármacos , Hígado/efectos de los fármacos , Enfermedad del Hígado Graso no Alcohólico/prevención & control , Obesidad/prevención & control , Triterpenos/farmacología , Células 3T3-L1 , Adipocitos/enzimología , Adipocitos/patología , Adiposidad/efectos de los fármacos , Animales , Dieta Alta en Grasa , Modelos Animales de Enfermedad , Activación Enzimática , Hígado/enzimología , Hígado/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Enfermedad del Hígado Graso no Alcohólico/enzimología , Enfermedad del Hígado Graso no Alcohólico/patología , Enfermedad del Hígado Graso no Alcohólico/fisiopatología , Obesidad/enzimología , Obesidad/patología , Obesidad/fisiopatología , Triterpenos Pentacíclicos , Fosforilación , Transducción de Señal , Aumento de Peso/efectos de los fármacos , Ácido Betulínico
9.
Anaesthesia ; 74(8): 1033-1040, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31106853

RESUMEN

Phase lag entropy, an electro-encephalography-based hypnotic depth indicator, calculates diversity in temporal patterns of phase relationship. We compared the performance of phase lag entropy with the bispectral index™ in 30 patients scheduled for elective surgery. We initiated a target-controlled infusion of propofol using the Schnider model, and assessed sedation levels using the Modified Observer's Assessment of Alertness/Sedation scale every 30 s with each stepwise increase in the effect-site propofol concentration. Phase lag entropy and bispectral index values were recorded. The correlation coefficient and prediction probability between phase lag entropy or bispectral index and the sedation level or effect-site propofol concentration were analysed. We calculated baseline variabilities of phase lag entropy and bispectral index. In addition, we applied a non-linear mixed-effects model to obtain the pharmacodynamic relationships among the effect-site propofol concentration, phase lag entropy or bispectral index and sedation level. As sedation increased, phase lag entropy and bispectral index both decreased. The prediction probability values of phase lag entropy and bispectral index for sedation levels were 0.697 and 0.700 (p = 0.261) and for the effect-site concentration of propofol were 0.646 and 0.630 (p = 0.091), respectively. Baseline variability in phase lag entropy and bispectral index was 3.3 and 5.7, respectively. The predicted propofol concentrations, using the Schnider pharmacokinetic model, producing a 50% probability of moderate and deep sedation were 1.96 and 3.01 µg.ml-1 , respectively. Phase lag entropy was found to be useful as a hypnotic depth indicator in patients receiving propofol sedation.


Asunto(s)
Sedación Consciente , Entropía , Hipnóticos y Sedantes/farmacología , Propofol/farmacología , Adulto , Anciano , Electroencefalografía , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad
10.
Br J Anaesth ; 121(3): 559-566, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30115253

RESUMEN

BACKGROUND: The modified Marsh and Schnider pharmacokinetic models for propofol consistently produce negatively and positively biased predictions in underweight patients, respectively. We aimed to develop a new pharmacokinetic model of propofol in underweight patients. METHODS: Twenty underweight (BMI<18.5 kg m-2) patients aged 20-68 yr were given an i.v. bolus of propofol (2 mg kg-1) for induction of anaesthesia. Anaesthesia was maintained with a zero-order infusion (8 mg kg-1 h-1) of propofol and target-controlled infusion of remifentanil. Arterial blood was sampled at preset intervals. A population pharmacokinetic analysis was performed using non-linear mixed effects modelling. The time to peak effect (tpeak, maximally reduced bispectral index) was measured in 28 additional underweight patients receiving propofol 2 mg kg-1. RESULTS: In total, 455 plasma concentration measurements from the 20 patients were used to characterise the pharmacokinetics of propofol. A three-compartment mammillary model well described the propofol concentration time course. BMI and lean body mass (LBM) calculated using the Janmahasatian formula were significant covariates for the rapid peripheral volume of distribution and for the clearance of the final pharmacokinetic model of propofol, respectively. The parameter estimates were as follows: V1(L)=2.02, V2(L)=12.9(BMI/18.5), V3(L)=139, Cl (L⋅min-1)=1.66(LBM/40), Q1 (L⋅min-1)=1.44, Q2 (L⋅min-1)=0.87+0.0189×(LBM-40). The median tpeak of propofol was 1.32 min (n=48). CONCLUSIONS: A three-compartment mammillary model can be used to administer propofol via target effect-site concentration-controlled infusion of propofol in underweight patients. CLINICAL TRIAL REGISTRATION: KCT0001760.


Asunto(s)
Anestesia General/métodos , Anestésicos Intravenosos/sangre , Propofol/sangre , Delgadez/sangre , Adulto , Anciano , Anestésicos Intravenosos/administración & dosificación , Índice de Masa Corporal , Peso Corporal/fisiología , Esquema de Medicación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Propofol/administración & dosificación , Estudios Prospectivos , Delgadez/fisiopatología , Adulto Joven
11.
Anaesthesia ; 73(9): 1123-1130, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29790159

RESUMEN

Although surrogate measures to quantify pain intensity have been commercialised, there is a need to develop a new index with improved accuracy. The aim of this study was to develop a new analgesic index using nasal photoplethysmography data. The specially designed sensor was placed between the columella and the nasal septum to acquire nasal photoplethysmography in surgical patients. Nasal photoplethysmography and Surgical Pleth Index® (GE Healthcare) data were obtained for 14 min both in the absence (pre-operatively) or presence (postoperatively) of pain in a group of surgical patients, each patient acting as their own control. Various dynamic photoplethysmography variables were extracted to quantify pain intensity; the most accurate index was selected using logistic regression as a classifier. The area under the curve of the receiver-operating characteristic curve was measured to evaluate the accuracy of final model predictions. In total, 12,012 heart beats from 89 patients were used to develop a new Nasal Photoplethysmography Index for analgesic depth quantification. The two-variable model (a combination of diastolic peak point variation and heart beat interval variation) was most accurate in discriminating between the presence and absence of pain (numerical rating scale (NRS) ≥ 3). The accuracy and area under the curve of the receiver-operating characteristic curve for the Nasal Photoplethysmography Index were 75.3% and 0.8018, respectively, and 64.8% and 0.7034, respectively, for the Surgical Pleth Index. The Nasal Photoplethysmography Index clearly distinguished pain (NRS ≥ 3) in awake surgical patients with postoperative pain. The Nasal Photoplethysmography Index performed better than the Surgical Pleth Index. Further validation studies are needed to evaluate its feasibility to quantify pain intensity during general anaesthesia.


Asunto(s)
Dimensión del Dolor/métodos , Dolor Postoperatorio/diagnóstico , Fotopletismografía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Analgesia Controlada por el Paciente/métodos , Analgésicos Opioides/administración & dosificación , Anestesia General/métodos , Humanos , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Cavidad Nasal , Oxicodona/administración & dosificación , Dolor Postoperatorio/prevención & control , Cuidados Posoperatorios/métodos , Curva ROC , Adulto Joven
12.
Am J Physiol Heart Circ Physiol ; 313(4): H810-H827, 2017 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-28710068

RESUMEN

Cardiac fibroblasts (CFs) are known to regulate cardiomyocyte (CM) function in vivo and in two-dimensional in vitro cultures. This study examined the effect of CF activation on the regulation of CM electrical activity in a three-dimensional (3-D) microtissue environment. Using a scaffold-free 3-D platform with interspersed neonatal rat ventricular CMs and CFs, Gq-mediated signaling was selectively enhanced in CFs by Gαq adenoviral infection before coseeding with CMs in nonadhesive hydrogels. After 3 days, the microtissues were analyzed by signaling assay, histological staining, quantitative PCR, Western blots, optical mapping with voltage- or Ca2+-sensitive dyes, and microelectrode recordings of CF resting membrane potential (RMPCF). Enhanced Gq signaling in CFs increased microtissue size and profibrotic and prohypertrophic markers. Expression of constitutively active Gαq in CFs prolonged CM action potential duration (by 33%) and rise time (by 31%), prolonged Ca2+ transient duration (by 98%) and rise time (by 65%), and caused abnormal electrical activity based on depolarization-induced automaticity. Constitutive Gq activation in CFs also depolarized RMPCF from -33 to -20 mV and increased connexin 43 and connexin 45 expression. Computational modeling confers that elevated RMPCF and increased cell-cell coupling between CMs and CFs in a 3-D environment could lead to automaticity. In conclusion, our data demonstrate that CF activation alone is capable of altering action potential and Ca2+ transient characteristics of CMs, leading to proarrhythmic electrical activity. Our results also emphasize the importance of a 3-D environment where cell-cell interactions are prevalent, underscoring that CF activation in 3-D tissue plays a significant role in modulating CM electrophysiology and arrhythmias.NEW & NOTEWORTHY In a three-dimensional microtissue model, which lowers baseline activation of cardiac fibroblasts but enables cell-cell, paracrine, and cell-extracellular matrix interactions, we demonstrate that selective cardiac fibroblast activation by enhanced Gq signaling, a pathophysiological trigger in the diseased heart, modulates cardiomyocyte electrical activity, leading to proarrhythmogenic automaticity.


Asunto(s)
Potenciales de Acción/fisiología , Fibroblastos/fisiología , Subunidades alfa de la Proteína de Unión al GTP Gq-G11/fisiología , Miocitos Cardíacos/fisiología , Animales , Animales Recién Nacidos , Conexina 43/biosíntesis , Conexinas/biosíntesis , Uniones Comunicantes/fisiología , Potenciales de la Membrana/fisiología , Miocitos Cardíacos/ultraestructura , Técnicas de Placa-Clamp , Ratas , Ratas Sprague-Dawley
13.
Clin Exp Immunol ; 187(2): 251-258, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27774581

RESUMEN

Psoriasis is a polygenic and multi-factorial disease showing ethnic differences in terms of its severity and frequency. Therapies targeting interleukin (IL)-17A, IL-17 receptor (IL-17R) and Janus kinases (JAKs) are in clinical development for the treatment of psoriasis, and their success suggests the essential role of these molecules in psoriasis. To investigate the genetic susceptibility in T helper type 17 (Th17) cell signal transduction pathways for promoting psoriasis, we performed candidate gene and linkage disequilibrium analysis. In 208 patients and 266 normal controls, we analysed 31 single nucleotide polymorphisms in 12 genes (CAMP, IL17A, IL17F, IL17RA, IL22, JAK1, JAK2, JAK3, STAT3, TLR7, TLR9 and TYK2; abbreviations: CAMP, human cathelicidin antimicrobial peptide; STAT-3, signal transducer and activator of transcription 3; TLR, Toll-like receptor; TYK2, tyrosine kinase 2). Patients with psoriasis showed a strong association for IL17F rs763780 [odds ratio (OR) = 3·27, P = 0·04], which results in a histidine-to-arginine substitution, and JAK2 rs2274471 (OR = 2·66, P = 0·02). In addition, JAK2 rs7849191 showed a protective pattern, met the significance threshold (OR = 0·77, P = 0·05) and showed a tendency for an inverse association with the frequency of early-onset psoriasis under age 40 years (P = 0·07). In haplotype analysis, JAK1 rs310241A/rs2780889T showed a protective effect (OR = 0·73, P = 0·03) in psoriasis. In conclusion, we report two new psoriasis-susceptibility loci, in IL17F and JAK2, as well as a newly identified late-onset associated protective JAK2 locus and a protective JAK1 haplotype in the Korean population.


Asunto(s)
Interleucina-17/genética , Janus Quinasa 1/genética , Janus Quinasa 2/genética , Psoriasis/genética , Células Th17/fisiología , Adulto , Alelos , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Desequilibrio de Ligamiento , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , República de Corea
14.
Osteoarthritis Cartilage ; 25(8): 1345-1352, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28284999

RESUMEN

OBJECTIVE: To investigate whether granulocyte macrophage-colony stimulating factor (GM-CSF) can be used to increase the number of mesenchymal stem cells (MSCs) in blood clots formed by microfracture arthroplasty (MFX) and whether it can improve the therapeutic outcome for cartilage repair. METHODS: Thirty-six New Zealand white rabbits were divided into four groups: (1) control, (2) GM-CSF, (3) MFX, and (4) GM-CSF + MFX. GM-CSF was administrated intravenously (IV) at 10 µg/kg body weight 20 min before the MFX surgery. The repaired tissues were retrieved and examined by histological observation, quantitative assessment, and biochemical assays at 4, 8, and 12 weeks after treatment. The number of MSCs was measured in the blood clots by the colony forming unit-fibroblast (CFU-F) assay. The kinetic profile and distribution of GM-CSF in vivo was also evaluated by near-Infrared (NIR) fluorescence imaging and enzyme-linked immune sorbent assay. RESULTS: In the histological observations and chemical assays examined at 4, 8, and 12 weeks, the MFX after GM-CSF administration showed better cartilage repair than the one without GM-CSF. The CFU-F assay showed a significantly larger amount of MSCs present in the blood clots of the GM-CSF + MFX group than in the blood clots of the other groups. The blood concentration of GM-CSF peaked at 10 min and decreased back to almost the initial level after a couple of hours. GM-CSF was distributed in many organs including the bone marrow but was not observed clearly in the joint cavity. CONCLUSION: Intravenous administration of GM-CSF together with MFX could be a promising therapeutic protocol to enhance the repair of cartilage defects.


Asunto(s)
Cartílago Articular/efectos de los fármacos , Fracturas del Cartílago/fisiopatología , Factor Estimulante de Colonias de Granulocitos y Macrófagos/farmacología , Cicatrización de Heridas/efectos de los fármacos , Animales , Artroplastia de Reemplazo de Rodilla/métodos , Médula Ósea/química , Cartílago Articular/cirugía , Células Cultivadas , Condrocitos/fisiología , Células Madre Mesenquimatosas/efectos de los fármacos , Microcirugia/métodos , Conejos , Líquido Sinovial/química
15.
J Periodontal Res ; 52(1): 135-146, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27021598

RESUMEN

BACKGROUND AND OBJECTIVE: Periodontal ligament stem cells (PDLSCs) from the periodontal ligament tissue were recently identified as mesenchymal stem cells (MSCs). The capabilities of PDLSCs in periodontal tissue or bone regeneration have been reported, but their immunomodulatory role in T-cell immune responses via dendritic cells (DCs), known as the most potent antigen-presenting cell, has not been studied. The aim of this study is to understand the immunological function of homogeneous human STRO-1+ CD146+ PDLSCs in DC-mediated T-cell immune responses to modulate the periodontal disease process. MATERIAL AND METHODS: We utilized highly purified (> 95%) human STRO-1+ CD146+ PDLSCs and human bone marrow mesenchymal stem cells (BMSCs). Each stem cell was co-cultured with human monocyte-derived DCs in the presence of lipopolysaccharide isolated from Porphyromonas gingivalis, a major pathogenic bacterium responsible for periodontal disease, in vitro to examine the immunological effect of each stem cell on DCs and DC-mediated T-cell proliferation. RESULTS: We discovered that STRO-1+ CD146+ PDLSCs, as well as BMSCs, significantly decreased the level of non-classical major histocompatibility complex glycoprotein CD1b on DCs, resulting in defective T-cell proliferation, whereas most human leukocyte antigens and the co-stimulatory molecules CD80 and CD86 in/on DCs were not significantly affected by the presence of BMSCs or STRO-1+ CD146+ PDLSCs. CONCLUSIONS: This study unveiled an immunomodulatory role of STRO-1+ CD146+ PDLSCs in negatively regulating DC-mediated T-cell immune responses, demonstrating their potential to be utilized in promising new stem cell therapies.


Asunto(s)
Antígenos CD1/metabolismo , Células Dendríticas/metabolismo , Células Madre Mesenquimatosas/metabolismo , Ligamento Periodontal/metabolismo , Linfocitos T/metabolismo , Técnicas de Cocultivo , Regulación hacia Abajo , Humanos , Activación de Linfocitos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
16.
Br J Anaesth ; 118(6): 883-891, 2017 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-28541533

RESUMEN

BACKGROUND: : In our preliminary study, the modified Marsh (M-Marsh) model caused an inadvertent underdosing of propofol in underweight patients. However, the predictive performance of the M-Marsh and Schnider models incorporated in commercially available target-controlled infusion (TCI) pumps was not evaluated in underweight patients. METHODS: : Thirty underweight patients undergoing elective surgery were randomly allocated to receive propofol via TCI using the M-Marsh or Schnider models. The target effect-site concentrations (Ces) of propofol were, in order, 2.5, 3, 4, 5, 6 and 2 µg ml -1 . Arterial blood samples were obtained at least 7 min after achieving each pseudo-steady-state. RESULTS: A total of 172 plasma samples were used to determine the predictive performance of both models. The pooled median (95% confidence interval) biases and inaccuracies at a target Ce ≤ 3 µg ml -1 were -22.6 (-28.8 to -12.6) and 31.9 (24.8-36.8) for the M-Marsh model and 9.0 (1.7-16.4) and 28.5 (21.7-32.8) for the Schnider model, respectively. These values at Ce ≥ 4 µg ml -1 were -9.6 (-16.0 to -6.0) and 24.7 (21.1-27.9) for the M-Marsh model and 19.8 (12.9-25.7) and 36.2 (31.4-39.7) for the Schnider model, respectively. CONCLUSIONS: The pooled biases and inaccuracies of both models were clinically acceptable. However, the M-Marsh and Schnider models consistently produced negatively and positively biased predictions, respectively, in underweight patients. In particular, the M-Marsh model showed greater inaccuracy at target Ce ≤ 3 µg ml -1 and the Schnider model showed greater inaccuracy at target Ce ≥ 4 µg ml -1 . Therefore, it is necessary to develop a new pharmacokinetic model for propofol in underweight patients. CLINICAL TRIAL REGISTRATION: KCT0001502.


Asunto(s)
Anestesia General/métodos , Anestesia Intravenosa/métodos , Anestésicos Intravenosos/administración & dosificación , Propofol/administración & dosificación , Delgadez/complicaciones , Adulto , Anestésicos Intravenosos/sangre , Simulación por Computador , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Valor Predictivo de las Pruebas , Propofol/sangre , Estudios Prospectivos , Reproducibilidad de los Resultados , Delgadez/fisiopatología
17.
Nutr Metab Cardiovasc Dis ; 27(9): 806-816, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28739188

RESUMEN

BACKGROUND AND AIMS: Low-grade inflammation, represented by minor C-reactive protein (CRP) elevation, has a critical role in the early stages of atherosclerosis, and pantothenic acid (PA) may have an antioxidant effect in inflammatory process. However, the long-term relationship between PA intake and CRP has not yet been studied. The objective of the present study was to evaluate the long-term relationship of PA intake to CRP concentration in healthy adults aged 40 years or older living in a rural area of South Korea. METHODS AND RESULTS: A total of 908 subjects (349 men, 559 women) with repeated data on dietary PA intake and CRP concentration were included in the final analysis. To represent the long-term effect of PA intake, both PA intake at the baseline and average PA intake were used as the exposure, and CRP concentration at the third visit and its change from the baseline to the third visit were used as the outcome. After adjustment for potential confounders, a significant inverse relationship between PA intake and CRP concentration at the third visit was observed (P for trend = 0.001, ß = -0.07 (P-value = 0.001) for PA baseline; P for trend = <0.0001, ß = -0.11 (P-value = 0.0004) for PA average (baseline, 2nd, 3rd)). Higher PA intake was significantly related to lower or attenuated increase in CRP concentration (P for trend = 0.002, ß = -0.24 (P-value = 0.002) for PA baseline; P for trend = 0.001, ß = -0.35 (P-value = 0.001) for PA average (baseline, 2nd, 3rd)). CONCLUSIONS: In conclusion, dietary PA intake was inversely related to subsequent CRP concentration in both men and women aged 40 years or older in South Korea.


Asunto(s)
Antiinflamatorios/administración & dosificación , Proteína C-Reactiva/análisis , Dieta , Mediadores de Inflamación/sangre , Inflamación/prevención & control , Ácido Pantoténico/administración & dosificación , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Estudios Longitudinales , Masculino , Persona de Mediana Edad , República de Corea , Salud Rural , Factores de Tiempo
18.
Nutr Metab Cardiovasc Dis ; 27(12): 1152-1164, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29167059

RESUMEN

BACKGROUND AND AIMS: Although a possible mechanism for developing type 2 diabetes in relation to calcium intake has been suggested, there is currently little epidemiological evidence on the association between dietary calcium and type 2 diabetes (T2D). This study aimed to evaluate the prospective association between dietary calcium and T2D incidence among adults 40 years of age or over, from the Multi-rural Communities Cohort (MRCohort), South Korea. METHODS AND RESULTS: In total, 8313 participants (3033 men and 5280 women) who did not have diabetes at baseline were recruited between 2005 and 2013. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator. During follow-up (31,570 person-years), 322 T2D cases were newly diagnosed. Dietary calcium (total and vegetable calcium) were inversely associated with the risk of T2D incidence among women (IRR = 0.61, 95% CI = 0.43-0.86, P for trend = 0.007 in third tertile of baseline total calcium intake comparing to the first tertile; IRR = 0.57, 95% CI = 0.39-0.84, P for trend = 0.006 for baseline vegetable calcium intake), not for men. The tendency of those inverse associations remained in both the normal fasting blood glucose group and the impaired fasting blood glucose group and were independent of obesity, smoking, and magnesium intake. CONCLUSIONS: Total and vegetable calcium may be inversely associated with T2D incidence among women, regardless of impaired fasting blood glucose group or normal group. The associations may be potentially dose-responsive. Moderate dietary calcium may be related to lower risk of T2D incidence comparing to low intake group among women.


Asunto(s)
Calcio de la Dieta/administración & dosificación , Diabetes Mellitus Tipo 2/epidemiología , Conducta Alimentaria , Salud Rural , Verduras , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevención & control , Encuestas sobre Dietas , Ayuno/sangre , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores Protectores , República de Corea/epidemiología , Factores Sexuales , Factores de Tiempo
19.
Anim Genet ; 48(2): 166-174, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27928823

RESUMEN

Intramuscular fat (IMF) content in pork is an important element of consumer preference and is positively correlated with meat quality, including tenderness and juiciness. With advances in RNA sequencing technologies, transcriptome-related differences can be associated with specific traits in animals. The objective of this study was to investigate differentially expressed genes (DEGs) closely related to IMF content in porcine longissimus muscle using RNA sequencing. A total of 107 Berkshire pigs were used for IMF content measurements, and significant differences between extremely high (H, n = 3) and low (L, n = 3) IMF content groups were found (P < 0.0001). From multi-dimensional scaling analyses, it was observed that the relationships between H and L groups were similar to each other. Here, we identified a total of 134 genes that were differentially expressed between the groups (false discovery rate <0.05; fold change ≥2). Functional analyses with DEGs revealed that lipid metabolism (SCD and FASN) was one of the significant biological processes related to IMF content determination. In addition, we found that DEGs related to muscle regeneration (MYOG and VEGFA) and extracellular matrix (COL1A1, COL1A2, COL5A1, COL14A1 and COL15A1) were changed among individuals with extreme IMF contents. These results will aid in understanding the regulation of IMF content in pigs.


Asunto(s)
Grasas/análisis , Carne , Músculo Esquelético/química , Sus scrofa/genética , Animales , Secuenciación de Nucleótidos de Alto Rendimiento , Reacción en Cadena en Tiempo Real de la Polimerasa , Análisis de Secuencia de ARN , Sus scrofa/fisiología , Transcriptoma
20.
Clin Exp Allergy ; 46(3): 411-21, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26436720

RESUMEN

BACKGROUND: Asthma in the elderly (aged ≥ 65 years old) is a significant concern with high morbidity, but the pathophysiology remains unclear particularly in late-onset asthma. Recent studies suggest staphylococcal enterotoxin IgE (SE-IgE) sensitization to be a risk factor for asthma in general populations; however, the associations have not been examined in late-onset elderly asthma. OBJECTIVE: We aimed to examine the associations of SE-IgE sensitization with late-onset asthma in the elderly, using a database of elderly asthma cohort study. METHODS: A total of 249 elderly patients with asthma and 98 controls were analysed. At baseline, patients were assessed for demographics, atopy, induced sputum profiles and comorbidities including chronic rhinosinusitis (CRS). Serum total IgE and SE-IgE levels were measured. Asthma severity was assessed on the basis of asthma outcomes during a 12-month follow-up period. RESULTS: At baseline, serum SE-IgE concentrations were significantly higher in patients with asthma than in controls [median 0.16 (interquartile range 0.04-0.53) vs. 0.10 (0.01-0.19), P < 0.001]. Elderly asthma patients with high SE-IgE levels had specific characteristics of having more severe asthma, sputum eosinophilia and CRS, compared to those with lower SE-IgE levels. In multivariate logistic regression analyses, the associations between serum SE-IgE concentrations and severe asthma were significant, independently of covariables [SE-IgE-high (≥ 0.35 kU/L) vs. negative (< 0.10 kU/L) group: odds ratio 7.47, 95% confidence interval 1.86-30.03, P = 0.005]. Multiple correspondence analyses also showed that high serum SE-IgE level had close relationships with severe asthma, CRS and sputum eosinophilia together. CONCLUSIONS AND CLINICAL RELEVANCE: This is the first report on the significant associations of SE-IgE sensitization with late-onset asthma in the elderly, particularly severe eosinophilic asthma with CRS comorbidity. Our findings indicate a potential implication of SE in the high morbidity burden of elderly asthma and suggest clues to the pathogenesis of severe late-onset eosinophilic asthma in the elderly.


Asunto(s)
Asma/inmunología , Asma/patología , Enterotoxinas/inmunología , Eosinófilos/inmunología , Eosinófilos/patología , Inmunoglobulina E/inmunología , Staphylococcus aureus/inmunología , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Especificidad de Anticuerpos/inmunología , Asma/diagnóstico , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Humanos , Inmunoglobulina E/sangre , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria , Factores de Riesgo , Índice de Severidad de la Enfermedad
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