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1.
Eur J Neurosci ; 60(9): 6279-6290, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39358869

RESUMO

Freezing of gait (FOG) is a disabling motor symptom prevalent in patients with Parkinson's disease (PD); however, its pathophysiological mechanisms are poorly understood. This study aimed to investigate whole-brain functional connectivity (FC) pattern alterations in PD patients with FOG. A total of 18 PD patients, 10 with FOG (PD-FOG) and 8 without FOG (PD-nFOG), and 10 healthy controls were enrolled. High-resolution 3D T1-weighted and resting-state functional MRI (rs-fMRI) data were obtained from all participants. The groups' internetwork connectivity differences were explored with rs-fMRI FC using seed-based analysis and graph theory. Multiple linear regression analysis estimated the relationship between FC changes and clinical measurements. Rs-fMRI analysis demonstrated alterations in FC in various brain regions between the three groups. Freezing of Gait Questionnaire severity was correlated with decreased brain functional connection between Vermis12 and the left temporal occipital fusiform cortex (r = -0.82, P < .001). Graph theory topological metrics indicated a decreased clustering coefficient in the right superior temporal gyrus in the PD-nFOG group. PD-FOG patients exhibited a compensatory increase in connectivity between the left inferior frontal gyrus language network and the postcentral gyrus compared to PD-nFOG patients. Further, the decreased connection between Vermis 12 and the left temporal occipital fusiform cortex may serve as a potential neuroimaging biomarker for tracking PD-FOG and distinguishing between PD subtypes.


Assuntos
Transtornos Neurológicos da Marcha , Imageamento por Ressonância Magnética , Doença de Parkinson , Humanos , Doença de Parkinson/fisiopatologia , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/complicações , Masculino , Feminino , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/diagnóstico por imagem , Transtornos Neurológicos da Marcha/etiologia , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Idoso , Conectoma/métodos , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Rede Nervosa/diagnóstico por imagem
2.
Cell Commun Signal ; 22(1): 413, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39192276

RESUMO

Nasopharyngeal carcinoma (NPC) is a malignant tumor of epithelial origin in head and neck with high incidence rate in South China, Southeast Asia and North Africa. The intervention of tumor-associated macrophages (Mφs) (TAMs)-mediated immunosuppression is a potential therapeutic strategy against tumor metastasis, but the exact mechanisms of TAM-mediated immunosuppression in nasopharyngeal carcinoma are unclear. Furthermore, how TAM affects the occurrence and development of nasopharyngeal carcinoma through metabolism is rarely involved. In this work, we revealed that NPC cells promoted M2-type Mφ polarization and elevated itaconic acid (ITA) release. Also, TAMs facilitated NPC cell proliferation, migration, and invasion through immune response gene 1 (IRG1)-catalyzed ITA production. Then, IRG1-mediated ITA production in TAMs repressed the killing of CD8+ T cells, induced M2-type polarization of TAMs, and reduced the phagocytosis of TAMs. Moreover, we demonstrated ITA played a tumor immunosuppressive role by binding and dampening ten-eleven translocation-2 (TET2) expression. Finally, we proved that ITA promotes NPC growth by facilitating immune escape in CD34+ hematopoietic stem cell humanized mice. In Conclusion, TAM-derived ITA facilitated NPC progression by enhancing immune escape through targeting TET2, highlighting that interfering with the metabolic pathway of ITA may be a potential strategy for NPC treatment.


Assuntos
Proteínas de Ligação a DNA , Dioxigenases , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Proteínas Proto-Oncogênicas , Succinatos , Evasão Tumoral , Macrófagos Associados a Tumor , Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/imunologia , Macrófagos Associados a Tumor/imunologia , Macrófagos Associados a Tumor/metabolismo , Humanos , Proteínas de Ligação a DNA/metabolismo , Proteínas de Ligação a DNA/genética , Animais , Camundongos , Succinatos/farmacologia , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/imunologia , Neoplasias Nasofaríngeas/metabolismo , Linhagem Celular Tumoral , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas/genética , Progressão da Doença , Proliferação de Células , Movimento Celular/efeitos dos fármacos , Linfócitos T CD8-Positivos/imunologia , Carboxiliases
3.
Hu Li Za Zhi ; 65(4): 24-29, 2018 Aug.
Artigo em Zh | MEDLINE | ID: mdl-30066320

RESUMO

The best first-aid treatment for cardiac arrest patients is advanced cardiac life support (ACLS) in terms both of saving lives and of reducing the incidence of sequelae. The American Heart Association (AHA) published updated ACLS guidelines for care in 2015. These updated guidelines emphasized the importance of teamwork in resuscitation, noting that, in addition to standard procedures, team members should be familiar with their distinct roles and should cooperate together during emergent situations. Implementing ACLS is not easy due to stress and unfamiliarity with the process and thus often achieves less-than-optimal results in practice. However, ACLS is a standard approach that uses the same procedures to address different cardiac arrest situations. Therefore, we wanted to use an information system to assist the medical team to fully implement the ACLS process. The information system helps the medical team perform resuscitation actions more intensively and precisely while avoiding problems and mistakes due to forgetfulness / unfamiliarity, facilitating an optimal resuscitation effort. Concurrently, electronic medical and nursing records are completed automatically, avoiding the need for medical staff to compile these records afterwards. This information system helps save time and effort and improves precision. Furthermore, data analysis is more convenient, which facilitates the effective management and supervision of resuscitation quality. The information system performs timing, prompting, and guidance in accordance with the ACLS process and records the procedures that will used in emergency treatment (i.e., chest compression frequency, establishment of intravenous route, placement of endotracheal tubes, electric shock, drug type, dose) with a simple click of a mouse. Finally, the associated medical record is completed and logged as soon as the automatically generated file is uploaded. All hospital staffs may use this information system to assist in the implementation of advanced CPR. The system improves the quality of the first aid measures applied in life support, reduces the burden on clinics and medical staff, and streamlines the preparation and submission of medical records.


Assuntos
Suporte Vital Cardíaco Avançado , Serviço Hospitalar de Emergência/organização & administração , Parada Cardíaca/terapia , Sistemas de Informação , Reanimação Cardiopulmonar , Humanos
5.
PLoS One ; 19(7): e0306857, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39037987

RESUMO

OBJECTIVE: Using pediatric anthropomorphic phantoms (APs), we aimed to determine the scanning tube voltage/current combinations that could achieve optimal image quality and avoid excessive radiation exposure in pediatric patients. MATERIALS AND METHODS: A 64-slice scanner was used to scan a standard test phantom to determine the volume CT dose indices (CTDIvol), and three pediatric anthropomorphic phantoms (APs) with highly accurate anatomy and tissue-equivalent materials were studied. These specialized APs represented the average 1-year-old, 5-year-old, and 10-year-old children, respectively. The physical phantoms were constructed with brain tissue-equivalent materials having a density of ρ = 1.07 g/cm3, comprising 22 numbered 2.54-cm-thick sections for the 1-year-old, 26 sections for the 5-year-old, and 32 sections for the 10-year-old. They were scanned to acquire brain CT images and determine the standard deviations (SDs), effective doses (EDs), and contrast-to noise ratios (CNRs). The APs were scanned by 21 combinations of tube voltages/currents (80, 100, or 120 kVp/10, 40, 80, 120, 150, 200, or 250 mA) and rotation time/pitch settings of 1 s/0.984:1. RESULTS: The optimal tube voltage/current combinations yielding optimal image quality were 80 kVp/80 mA for the 1-year-old AP; 80 kVp/120 mA for the 5-year-old AP; and 80 kVp/150 mA for the 10-year-old AP. Because these scanning tube voltages/currents yielded SDs, respectively, of 12.81, 13.09, and 12.26 HU, along with small EDs of 0.31, 0.34, and 0.31 mSv, these parameters and the induced values were expediently defined as optimal. CONCLUSIONS: The optimal tube voltages/currents that yielded optimal brain image quality, SDs, CNRs, and EDs herein are novel and essentially important. Clinical translation of these optimal values may allow CT diagnosis with low radiation doses to children's heads.


Assuntos
Encéfalo , Imagens de Fantasmas , Doses de Radiação , Tomografia Computadorizada por Raios X , Humanos , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Tomografia Computadorizada por Raios X/métodos , Lactente , Masculino
6.
Radiother Oncol ; 200: 110502, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39197500

RESUMO

BACKGROUND AND PURPOSE: Carotid blowout syndrome (CBS) is a rare but potentially life-threatening complication that can occur in patients with head and neck cancer (HNC), especially with a history of radiotherapy. This study aimed to review and initially compare managements for post-radiation CBS in patients with HNC. MATERIALS AND METHODS: A systematic review of published studies was performed. Information including management, survival, and complication were collected. RESULTS: A total of 39 articles and 917 cases were included in the systematic review. The interval between radiation therapy and CBS ranged from 1.2 years to 17.8 years. The managements of CBS included embolization, stent, bypass surgery, surgical ligation, electrocoagulation, flap coverage, arterial repair, and nasopharyngeal packing. The cumulative 30-day, 1-year, and 2-year overall survival rates were 85.2 %, 48.9 %, and 37.0 %, respectively, with a median survival time of 11.3 months. Disease progression and rebleeding were the most common death causes. The lowest rebleeding rate and neurologic complications rate were presented in cases receiving bypass surgery at 1.4 % and 10.8 %, respectively. The highest rebleeding rate of 35.6 % was showed in cases underwent stent, and the highest neurologic complications rate of 32.0 % was showed in cases underwent ligation. CONCLUSION: Post-radiation CBS in patients with HNC had a low survival rate and high complication rate. Rebleeding and neurologic complication were common complications. Endovascular embolization and stent were the mainstream management, and bypass surgery presented a promising outcome in survival and complication for selected patients.


Assuntos
Doenças das Artérias Carótidas , Neoplasias de Cabeça e Pescoço , Humanos , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/terapia , Embolização Terapêutica/métodos , Embolização Terapêutica/efeitos adversos , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Lesões por Radiação/etiologia , Lesões por Radiação/terapia
7.
Artigo em Inglês | MEDLINE | ID: mdl-39009321

RESUMO

Locally recurrent nasopharyngeal carcinoma (NPC) presents substantial challenges in clinical management. Although postoperative re-irradiation (re-RT) has been acknowledged as a potential treatment option, standardized guidelines and consensus regarding the use of re-RT in this context are lacking. This article provides a comprehensive review and summary of international recommendations on postoperative management for potentially resectable locally recurrent NPC, with a special focus on postoperative re-RT. A thorough search was conducted to identify relevant studies on postoperative re-RT for locally recurrent NPC. Controversial issues, including resectability criteria, margin assessment, indications for postoperative re-RT, and the optimal dose and method of re-RT, were addressed through a Delphi consensus process. The consensus recommendations emphasize the need for a clearer and broader definition of resectability, highlighting the importance of achieving clear surgical margins, preferably through an en bloc approach with frozen section margin assessment. Furthermore, these guidelines suggest considering re-RT for patients with positive or close margins. Optimal postoperative re-RT doses typically range around 60 Gy, and hyperfractionation has shown promise in reducing toxicity. These guidelines aim to assist clinicians in making evidence-based decisions and improving patient outcomes in the management of potentially resectable locally recurrent NPC. By addressing key areas of controversy and providing recommendations on resectability, margin assessment, and re-RT parameters, these guidelines serve as a valuable resource for clinical experts involved in the treatment of locally recurrent NPC.

8.
Neurogastroenterol Motil ; 35(3): e14506, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36458529

RESUMO

BACKGROUND/AIM: Reflux episodes and postreflux swallow-induced peristaltic wave (PSPW) index are useful impedance parameters that can augment the diagnosis of gastroesophageal reflux disease (GERD). However, manual analysis of pH-impedance tracings is time consuming, resulting in limited use of these novel impedance metrics. This study aims to evaluate whether a supervised learning artificial intelligence (AI) model is useful to identify reflux episodes and PSPW index. METHODS: Consecutive patients underwent 24-h impedance-pH monitoring were enrolled for analysis. Multiple AI and machine learning with a deep residual net model for image recognition were explored based on manual interpretation of reflux episodes and PSPW according to criteria from the Wingate Consensus. Intraclass correlation coefficients (ICCs) were used to measure the strength of inter-rater agreement of data between manual and AI interpretations. RESULTS: We analyzed 106 eligible patients with 7939 impedance events, of whom 38 patients with pathological acid exposure time (AET) and 68 patients with physiological AET. On the manual interpretation, patients with pathological AET had more reflux episodes and lower PSPW index than those with physiological AET. Overall accuracy of AI identification for reflux episodes and PSPW achieved 87% and 82%, respectively. Inter-rater agreements between AI and manual interpretations achieved excellent for individual numbers of reflux episodes and PSPW index (ICC = 0.965 and ICC = 0.921). CONCLUSIONS: AI has the potential to accurately and efficiently measure impedance metrics including reflux episodes and PSPW index. AI can be a reliable adjunct for measuring novel impedance metrics for GERD in the near future.


Assuntos
Monitoramento do pH Esofágico , Refluxo Gastroesofágico , Humanos , Monitoramento do pH Esofágico/métodos , Impedância Elétrica , Inteligência Artificial , Refluxo Gastroesofágico/diagnóstico , Concentração de Íons de Hidrogênio
9.
Diagnostics (Basel) ; 13(5)2023 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-36900104

RESUMO

Novel metrics extracted from pH-impedance monitoring can augment the diagnosis of gastroesophageal reflux disease (GERD). Artificial intelligence (AI) is being widely used to improve the diagnostic capabilities of various diseases. In this review, we update the current literature regarding applications of artificial intelligence in measuring novel pH-impedance metrics. AI demonstrates high performance in the measurement of impedance metrics, including numbers of reflux episodes and post-reflux swallow-induced peristaltic wave index and, furthermore, extracts baseline impedance from the entire pH-impedance study. AI is expected to play a reliable role in facilitating measuring novel impedance metrics in patients with GERD in the near future.

10.
CNS Neurosci Ther ; 28(1): 92-104, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34643338

RESUMO

AIMS: The effects of subthalamic nucleus (STN)-deep brain stimulation (DBS) on brain topological metrics, functional connectivity (FC), and white matter integrity were studied in levodopa-treated Parkinson's disease (PD) patients before and after DBS. METHODS: Clinical assessment, resting-state functional MRI (rs-fMRI), and diffusion tensor imaging (DTI) were performed pre- and post-DBS in 15 PD patients, using a within-subject design. The rs-fMRI identified brain network topological metric and FC changes using graph-theory- and seed-based methods. White matter integrity was determined by DTI and tract-based spatial statistics. RESULTS: Unified Parkinson's Disease Rating Scale III (UPDRS- III) scores were significantly improved by 35.3% (p < 0.01) after DBS in PD patients, compared with pre-DBS patients without medication. Post-DBS PD patients showed a significant decrease in the graph-theory-based degree and cost in the middle temporal gyrus and temporo-occipital part-Right. Changes in FC were seen in four brain regions, and a decrease in white matter integrity was seen in the left anterior corona radiata. The topological metrics changes were correlated with Beck Depression Inventory II (BDI-II) and the FC changes with UPDRS-III scores. CONCLUSION: STN-DBS modulated graph-theoretical metrics, FC, and white matter integrity. Brain connectivity changes observed with multi-modal imaging were also associated with postoperative clinical improvement. These findings suggest that the effects of STN-DBS are caused by brain network alterations.


Assuntos
Estimulação Encefálica Profunda , Doença de Parkinson/terapia , Substância Branca/patologia , Idoso , Encéfalo/patologia , Imagem de Tensor de Difusão , Feminino , Humanos , Levodopa/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/patologia
11.
Zhong Yao Cai ; 34(8): 1196-9, 2011 Aug.
Artigo em Zh | MEDLINE | ID: mdl-22233032

RESUMO

OBJECTIVE: To choose the optimum initial processing methods of Rheum palmatum. METHODS: Fresh crude Rheum palmatum was sliced and dealt with the different drying methods such as sun drying, shady drying, microwave heating and various temperatures drying. The content of the Anthraquinones derivatives, slicing colors and dried rates were used as evaluation indexes. The sliced Rheum palmatum was compared with the traditional processing. RESULTS: Sliced fresh crude Rheum palmatum had the low content of the Anthraquinones derivatives and dry rates, slicing colours had obviously changes. For various drying methods, smoking drying was superior to sun drying, shady drying, microwave heating and various temperatures drying methods. CONCLUSION: Fresh crude Rheum palmatum is not suitable for slicing processing. The best drying method is smoking drying.


Assuntos
Antraquinonas/análise , Dessecação/métodos , Plantas Medicinais/química , Rheum/química , Cromatografia Líquida de Alta Pressão , Micro-Ondas , Raízes de Plantas/química , Plantas Medicinais/crescimento & desenvolvimento , Controle de Qualidade , Reprodutibilidade dos Testes , Rheum/crescimento & desenvolvimento , Rizoma/química , Tecnologia Farmacêutica/métodos
12.
Radiat Prot Dosimetry ; 194(1): 36-41, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-33969422

RESUMO

This study aimed to establish the diagnostic reference levels (DRLs) for coronary computed tomography angiography (CCTA) and coronary arterial calcium score (CACS) owing to a large variability in patient radiation dose and the lack of dose recommendations in Taiwan. Volume computed tomography dose index (CTDIvol) and dose-length product (DLP) were obtained using CCTAs and the CACS of 445 patients over a 3-y period in a single medical center in Taiwan. CCTAs were performed using routine protocols and 256-detector CT scanners. Electrocardiogram gating was retrospective. The obtained data were analyzed using Prism 6 to determine the 25th, 50th (median) and 75th DRL percentiles for CTDIvol and DLP. These DRL results were compared with existing DRLs from seven countries. The DRLs for CCTA determined from this survey were similar to the existing data from other countries. Such DRLs could provide a useful tool for the optimization of radiation dose for CCTA in Taiwan.


Assuntos
Angiografia por Tomografia Computadorizada , Níveis de Referência de Diagnóstico , Humanos , Doses de Radiação , Valores de Referência , Estudos Retrospectivos , Taiwan , Tomografia Computadorizada por Raios X
13.
PLoS One ; 16(11): e0259772, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34767600

RESUMO

Exposure to ionizing radiation can cause cancer, especially in children. In computed tomography (CT), a trade-off exists between the radiation dose and image quality. Few studies have investigated the effect of dose reduction on image quality in pediatric neck CT. We aimed to assess the effect of peak kilovoltage on the radiation dose and image quality in pediatric neck multidetector-row CT. Measurements were made using three phantoms representative of children aged 1, 5, and 10 years, with tube voltages of 80, 100, and 120 kilovoltage peak (kVp); tube current of 10, 40, 80, 120, 150, 200, and 250 mA; and exposure time = 0.5 s (pitch, 0.984:1). Radiation dose estimates were derived from the dose-length product with a 64-multidetector-row CT scanner. Images obtained from the control protocol (120 kVp) were compared with the 80- and 100-kVp protocols. The effective dose (ED) was determined for each protocol and compared with the 120-kVp protocol. Quantitative analysis entailed noise measurements by recording the standard deviation of attenuation for a circular 1-cm2 region of interest placed on homogeneous soft tissue structures in the phantom. The mean noise of the various kVp protocols was compared using the unpaired Student t-test. Reduction of ED was 37.58% and 68.58% for neck CT with 100 kVp and 80 kVp, respectively. The image noise level increased with the decrease in peak kilovoltage. Noise values were higher at 80 kVp at all neck levels, but did not increase at 100 kVp, compared to 120 kVp in the three phantoms. The measured noise difference was the greatest at 80 kVp (absolute increases<2.5 HU). The subjective image quality did not differ among the protocols. Thus, reducing voltage from 120 to 80 kVp for neck CT may achieve ED reduction of 68.58%, without compromising image quality.


Assuntos
Tomografia Computadorizada Multidetectores/métodos , Pescoço/diagnóstico por imagem , Doses de Radiação , Radiação Ionizante , Criança , Pré-Escolar , Humanos , Lactente
14.
Laryngoscope ; 131(7): 1548-1556, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33571390

RESUMO

OBJECTIVE/HYPOTHESIS: To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer-related carotid blowout syndrome (CBS). STUDY DESIGN: Retrospective case series. METHODS: Retrospective analysis of clinical data of patients with head and neck cancer-related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. RESULTS: Thrity-seven patients were included. Twenty-five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA-related CBS, the median survival was 6 months, and the 90-day, 1-year, and 2-year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1-month, 6-month, and 2-year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA-related CBS, the median survival was 22.5 months, and the 90-day, 1-year, and 2-year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA-related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. CONCLUSIONS: For patients with ICA/CCA-related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1548-1556, 2021.


Assuntos
Doenças das Artérias Carótidas/cirurgia , Revascularização Cerebral/métodos , Procedimentos Endovasculares/métodos , Neoplasias de Cabeça e Pescoço/complicações , Hemorragia/cirurgia , Adulto , Idoso , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/mortalidade , Artéria Carótida Externa/cirurgia , Artéria Carótida Interna/cirurgia , Revascularização Cerebral/instrumentação , Revascularização Cerebral/estatística & dados numéricos , Embolização Terapêutica/estatística & dados numéricos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/estatística & dados numéricos , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/mortalidade , Hemorragia/etiologia , Hemorragia/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Medição de Risco/estatística & dados numéricos , Ruptura Espontânea/etiologia , Ruptura Espontânea/mortalidade , Ruptura Espontânea/cirurgia , Prevenção Secundária/instrumentação , Prevenção Secundária/métodos , Prevenção Secundária/estatística & dados numéricos , Stents , Taxa de Sobrevida , Resultado do Tratamento
15.
Sci Rep ; 10(1): 12501, 2020 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-32719414

RESUMO

Cephalic arch stenosis (CAS) is a common cause of AV dialysis access failure and is notoriously difficult to treat with conventional venoplasty. Although stent graft (SG) placement has improved patency rate, they are prone to stent failure caused by edge stenosis. We investigate the effect of SG diameter relative to cephalic vein on patency rate among hemodialysis patients with dysfunctional arteriovenous access caused by CAS. We identified 22 patients with recalcitrant cephalic arch stenosis or post-venoplasty vessel rupture and received SG placement. Patients were divided into two groups based on the stent-to-vessel diameter (S/V) ratio: undersized group, < 1; and apposed group, 1-1.2. Outcomes were assessed through follow-up angiography. S/V ratio was significant smaller in the undersized patient group (p < 0.001). Placement of undersized SG demonstrated higher primary stent (p = 0.001) and access patency rates (p = 0.021) and a reduced number of post-treatment reinterventions per access year (p = 0.021). A decreased number of lateral edge stenosis was noted in undersized SG (p = 0.005). Increased S/V ratio was significantly associated with lateral edge stenosis (OR = 5.19; p = 0.027). Undersized SG is associated with higher primary stent and access patency rate, and decreased number of post-SG interventions, and are suggested in the treatment of cephalic arch stenosis.


Assuntos
Derivação Arteriovenosa Cirúrgica , Diálise Renal , Stents , Veias/patologia , Adulto , Idoso , Constrição Patológica , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Flebografia , Fatores de Risco , Resultado do Tratamento , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem , Veias/fisiopatologia
16.
J Clin Neurosci ; 68: 235-242, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31420273

RESUMO

This study used Voxel-based morphometry (VBM) and resting-state functional magnetic resonance imaging (rs-fMRI) to investigate changes in brain structure and networks functional connectivity, respectively. We tried to identify the potential biomarkers in Parkinson's disease (PD) progression. We recruited nine idiopathic PD patients and seven healthy control participants (HC group) who were age-matched to undergo T1-weighted images and rs-fMRI on 1.5 T. Brain structure differences were analyzed by VBM. Topological properties of networks functional connectivity were analyzed by graph theory. Thirty-two nodes of 8 networks and 133 nodes of interest then were identified with graph theory approaches. VBM examinations showed significant decreases of brain gray matter regions including the left temporal lobe, left middle temporal, middle temporal gyrus, parietal lobe, postcentral gyrus, left inferior parietal gyrus, medial frontal gyrus and supplement motor area in PD patients compared to the HC group. The 32 ROI of networks topological metrics measurement in PD demonstrated increases of global efficiency, cost, and degree in frontoparietal PPC (R) network, but decreases of local efficiency, clustering coefficient, and average path length in salience ACC, dorsal attention FEF (L), and salience aInsula (R) networks, respectively. All 165 ROI connectomes showed eight connections intensity changes, that decrease in OP r to frontoparietal PPC, putamen r to cereb11, and SFG l to Ver8 in PD. These results suggest that the graph theory and the network topological metrics measurement may be the potential biomarkers in PD to evaluate the disease progress and to monitor the therapeutic results.


Assuntos
Encéfalo/fisiopatologia , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Modelos Teóricos , Doença de Parkinson/fisiopatologia , Idoso , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Conectoma/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Modelos Neurológicos , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/patologia
17.
Medicine (Baltimore) ; 98(28): e16350, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305425

RESUMO

Most of the recent studies have used fixed tube current while few investigators use automatic current selection (ACS) with iterative reconstruction (IR) techniques to reduce effective dose (ED) to < 1 mSv in low-dose chest computed tomography (LDCCT). We investigated whether image quality of lungs as produced by a fixed tube current (FTC) of 35 mAs can be maintained with ED < 1 mSv produced by ACS with IR techniques in LDCCT. A total of 32 participants were included. The LDCCT was performed by a FTC 35 mAs (with a kilovoltage peak of 120 kVp) in 16 participants (Group A), and by a DoseRight ACS in 16 participants (Group B). Their images were improved by IR technique. The ED was estimated by multiplying the individual dose length product (DLP) by the dose conversion factor. The image quality was assessed by the CT number, noise levels, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the regions of interest in the apex, upper lobe, and lower lobe of lung regions in the CT images. A t-test was used to evaluate the LDCCT image quality between the groups. The ED was significantly 49.2% lower in Group B than in Group A (0.71 ±â€Š0.05 mSv vs 1.40 ±â€Š0.02 mSv, P < .001). However, noise level, SNR, and CNR were not significantly different between Groups A and B, indicating the image quality was similar between two groups, or our setting parameters for DoseRight ACS with IR technique can achieve the image quality as good as obtained on the FTC 35 mAs with IR techniques. Our results suggest that the DoseRight ACS with IR technique reduces ED to lower than 1 mSv (averagely 0.71 mSv) yet maintains an image quality as good as produced by FTC 35 mAs with IR technique in normal BMI persons. The ACS setup thus is more preferable than the FTC to achieve the ALARA (as low as reasonably achievable) principle.


Assuntos
Pulmão/diagnóstico por imagem , Doses de Radiação , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Automação/métodos , Índice de Massa Corporal , Eletricidade , Feminino , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Cell Transplant ; 27(3): 456-470, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29756519

RESUMO

Parkinson's disease (PD) causes motor dysfunction and dopaminergic cell death. Drug treatments can effectively reduce symptoms but often cause unwanted side effects. Stem cell therapies using cell replacement or indirect beneficial secretomes have recently emerged as potential therapeutic strategies. Although various types of stem cells have been proposed as possible candidates, adipose-derived stem cells (ADSCs) are easily obtainable, more abundant, less ethically disputed, and able to differentiate into multiple cell lineages. However, treatment of PD using adult stem cells is known to be less efficacious than neuron or embryonic stem cell transplantation. Therefore, improved therapies are urgently needed. n-Butylidenephthalide (BP), which is extracted from Angelica sinensis, has been shown to have anti-inflammatory and neuroprotective effects. Indeed, we previously demonstrated that BP treatment of ADSCs enhances the expression of neurogenesis and homing factors such as nuclear receptor related 1 protein, stromal-derived factor 1, and brain-derived neurotrophic factor. In the present study, we examined the ability of BP-pretreated ADSC transplantation to improve PD motor symptoms and protect dopamine neurons in a mouse model of PD. We evaluated the results using neuronal behavior tests such as beam walking, rotarod, and locomotor activity tests. ADSCs with or without BP pretreatment were transplanted into the striatum. Our findings demonstrated that ADSC transplantation improved motor abilities with varied efficacies and that BP stimulation improved the therapeutic effects of transplantation. Dopaminergic cell numbers returned to normal in ADSC-transplanted mice after 22 d. In summary, stimulating ADSCs with BP improved PD recovery efficiency. Thus, our results provide important new strategies to improve stem cell therapies for neurodegenerative diseases in future studies.


Assuntos
Adipócitos/efeitos dos fármacos , Adipócitos/fisiologia , Doença de Parkinson/terapia , Anidridos Ftálicos/farmacologia , Adipócitos/metabolismo , Animais , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Citometria de Fluxo , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Endogâmicos C57BL
19.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 24(3): 325-7, 2007 Jun.
Artigo em Zh | MEDLINE | ID: mdl-17557248

RESUMO

OBJECTIVE: To investigate muscle segment homeobox 1 (MSX1) microsatellite marker distribution and the relationship between MSX1 gene and the genetic susceptibility of nonsyndromic cleft lip and palate (NSCLP) in Hunan Hans. METHODS: One microsatellite DNA marker CA repeat in MSX1 intron region was used as genetic markers. The genotypes of 129 patients with NSCLP and 108 controls were analyzed by the techniques of polymerase chain reaction (PCR) and denaturing polyacrylamide gel electrophoresis (PAGE). Then case-control study was used to conduct association analysis. RESULTS: The allele frequencies of the CA repeat microsatellite DNA in Hunan Han normal population were in good agreement with Hardy-Weinberg equilibrium. The polymorphism information content and heterozygosity of CA repeat microsatellite DNA were 0.50 and 0.50 respectively. The allele CA4 frequency in CL/P and CPO group was significantly higher than that of normal controls (P<0.05). The genotype CA4,4 frequency was significantly higher in CL/P and CPO group than that in normal controls (P<0.05). CONCLUSION: The microsatellite DNA marker CA repeat in MSX1 is a good genetic marker. MSX1 gene is significantly associated with NSCLP in Hunan Hans.


Assuntos
Fenda Labial/genética , Fissura Palatina/genética , Fator de Transcrição MSX1/genética , Repetições de Microssatélites/genética , Polimorfismo Genético , Sequência de Bases , China/etnologia , Etnicidade/genética , Frequência do Gene , Marcadores Genéticos/genética , Predisposição Genética para Doença , Genótipo , Humanos
20.
Zhonghua Yi Xue Za Zhi ; 87(6): 396-8, 2007 Feb 06.
Artigo em Zh | MEDLINE | ID: mdl-17456381

RESUMO

OBJECTIVE: To investigate the relationship between D17S579 microsatellite marker allelic polymorphisms in retinoic acid receptor-alpha (RARA) gene and the genetic susceptibility to nonsyndromic cleft lip with or without cleft palate (NSCL/P) in Hunan Hans. METHODS: PCR and denaturing polyacrylamide gel electrophoresis (PAGE) were used to detect the polymorphism of RARA gene marked by D17S579 among 140 patients with NSCL/P, 82 males and 58 females, aged 3 months-14 years, and 132 healthy persons, 68 males and 64 females, aged 6 months-14 years, who underwent physical examination. RESULTS: The A6 allele frequency of the NSCL/P patients was 8.93%, significantly higher than that of the healthy persons (4.17%, P = 0.026). The A9 allele frequency the NSCL/P patients was 13.21%, significantly higher than that of the healthy persons (5.68%, P = 0.003). There were not significant differences in the frequencies of different alleles between the patients with family history and the patients without family history (chi2 = 2.710, P = 0.978). CONCLUSION: The A6 and A9 alleles in D17S579 microsatellite marker of RARA gene may be correlated with the development of NSCL/P in Hunan Hans. There is no association between the family history and RARA polymorphism in the NSCL/P patients.


Assuntos
Fenda Labial/genética , Fissura Palatina/complicações , Polimorfismo de Nucleotídeo Único , Receptores do Ácido Retinoico/genética , Alelos , Criança , Pré-Escolar , Fenda Labial/complicações , Fenda Labial/patologia , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Repetições de Microssatélites/genética
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