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1.
Neuroepidemiology ; : 1-14, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38705143

RESUMO

INTRODUCTION: Preclinical evidence demonstrated the therapeutic potential of thiazolidinediones (TZDs) for the treatment of intracerebral hemorrhage (ICH). The present study conducted an investigation of cerebrovascular and cardiovascular outcomes following ICH in patients with type 2 diabetes mellitus (T2DM) treated with or without TZDs. METHODS: This retrospective nested case-control study used data from the Taiwan National Health Insurance Research Database. A total of 62,515 T2DM patients who were hospitalized with a diagnosis of ICH were enrolled, including 7,603 TZD users. Data for TZD non-users were extracted using propensity score matching. Primary outcomes included death and major adverse cardiovascular events (MACEs), which were defined as a composite of ischemic stroke, hemorrhagic stroke (HS), acute myocardial infarction, and congestive heart failure. Patients aged <20 years with a history of traumatic brain injury or any prior history of MACEs were excluded. RESULTS: TZD users had significantly lower MACE risks compared with TZD non-users following ICH (adjusted hazard ratio [aHR]: 0.90, 95% confidence interval [CI]: 0.85-0.94, p < 0.001). The most significant MACE difference reported for TZD users was HS, which possessed lower incidence than in TZD non-users, especially for the events that happened within 3 months following ICH (aHR: 0.74, 95% CI: 0.62-0.89 within 1 month, p < 0.01; aHR: 0.68, 95% CI: 0.54-0.85 between 1 and 3 month). CONCLUSION: The use of TZD in patients with T2DM was associated with a lower risk of subsequent HS and mortality following ICH.

2.
Int J Med Sci ; 21(4): 656-663, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38464824

RESUMO

Purpose: With advances in medical technology, the average lifespan has increased, leading to a growing significance of idiopathic normal pressure hydrocephalus (iNPH), particularly in the elderly population. Most patients with iNPH have been treated either with ventriculo-peritoneal shunts (VPS) or conservative measures. However, lumbo-peritoneal shunts (LPS) have emerged as an alternative treatment option for iNPH in recent decades, extensive research still lacks comparing outcomes with LPS to those with VPS or non-surgical treatment. The aim of the resent study is to disclose the long-term therapeutic outcomes of LPS, VPS, and non-shunting in patients with iNPH. Methods: We used the National Health Insurance Research Database in Taiwan to assess the long-term outcomes of these treatment options. We enrolled 5,537 iNPH patients who received shunting surgery, of which 5,254 were VPS and 283 were LPS. To compare the difference between each group, matching was conducted by propensity score matching using a 1:1 ratio based on LPS patients. Primary outcomes included death and major adverse cardiovascular events (MACEs) Results: Our findings show that VPS resulted in significantly more MACEs than non-surgical treatment (Odds ratio: 1.83, 95% confidence interval: 1.16-2.90). In addition, both VPS and LPS groups had significantly lower overall mortality rates than non-shunting group. Moreover, LPS had lower overall mortality but similar MACEs rates to VPS. Conclusions: Based on these findings, we propose that the LPS is preferable to the VPS, and surgical treatment should be considered the primary choice over conservative treatment unless contraindications are present.


Assuntos
Hidrocefalia de Pressão Normal , Humanos , Idoso , Hidrocefalia de Pressão Normal/epidemiologia , Hidrocefalia de Pressão Normal/cirurgia , Estudos Retrospectivos , Lipopolissacarídeos , Derivação Ventriculoperitoneal/efeitos adversos , Derivação Ventriculoperitoneal/métodos , Procedimentos Cirúrgicos Vasculares , Resultado do Tratamento
3.
Sensors (Basel) ; 23(4)2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36850785

RESUMO

In the biometric field, vein identification is a vital process that is constrained by the invisibility of veins as well as other unique features. Moreover, users generally do not wish to have their personal information uploaded to the cloud, so edge computing has become popular for the sake of protecting user privacy. In this paper, we propose a low-complexity and lightweight convolutional neural network (CNN) and we design intellectual property (IP) for shortening the inference time in finger vein recognition. This neural network system can operate independently in client mode. After fetching the user's finger vein image via a near-infrared (NIR) camera mounted on an embedded system, vein features can be efficiently extracted by vein curving algorithms and user identification can be completed quickly. Better image quality and higher recognition accuracy can be obtained by combining several preprocessing techniques and the modified CNN. Experimental data were collected by the finger vein image capture equipment developed in our laboratory based on the specifications of similar products currently on the market. Extensive experiments demonstrated the practicality and robustness of the proposed finger vein identification system.


Assuntos
Algoritmos , Redes Neurais de Computação , Humanos , Biometria , Extremidades , Laboratórios
4.
BMC Surg ; 22(1): 36, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35109844

RESUMO

BACKGROUND: Bertolotti's syndrome (BS) is characterized by the enlargement of transverse processes in caudal lumbar segments, causing chronic and persistent low back pain or sciatica. The present study aimed to describe our surgical technique for BS treatment and to review existing literature describing unsatisfactory outcomes. CASE PRESENTATION: We report a patient who complained of lower back pain and soreness that intermittently radiated to his left leg for longer than 10 years. Based on an examination of his symptoms and signs, including imaging and electrical physiology assessments, in addition to the report of temporary pain relief after a local steroid injection to a diagnostic trigger site (articulation between the transverse process and the sacral ala or iliac crest), the patient was diagnosed with BS. The applied surgical techniques included minimally invasive, three-dimensional C-arm guidance, a tubing approach, and microscopic and bone cavitron ultrasonic surgical aspirator-assisted operations. After surgery, improvements were reported on the visual analog scale (from 8 to 2 points on a 10-point scale) and the straight leg raising test for the left leg (20° to 90°) within 3 days. The patient gained an ordinary life and returned to work within one week of surgery, with no observed postoperative complications. CONCLUSIONS: Minimally invasive tubular microscopic decompression and disarticulation is an effective method for treating BS. However, to achieve a successful outcome, it is recommended to use physician-proficient techniques that are in line with the patient's diagnosis.


Assuntos
Dor Lombar , Humanos , Perna (Membro) , Dor Lombar/etiologia , Dor Lombar/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Região Lombossacral , Resultado do Tratamento
5.
Sensors (Basel) ; 22(14)2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35891065

RESUMO

Accidents caused by fatigue occur frequently, and numerous scholars have devoted tremendous efforts to investigate methods to reduce accidents caused by fatigued driving. Accordingly, the assessment of the spirit status of the driver through the eyes blinking frequency and the measurement of physiological signals have emerged as effective methods. In this study, a drowsiness detection system is proposed to combine the detection of LF/HF ratio from heart rate variability (HRV) of photoplethysmographic imaging (PPGI) and percentage of eyelid closure over the pupil over time (PERCLOS), and to utilize the advantages of both methods to improve the accuracy and robustness of drowsiness detection. The proposed algorithm performs three functions, including LF/HF ratio from HRV status judgment, eye state detection, and drowsiness judgment. In addition, this study utilized a near-infrared webcam to obtain a facial image to achieve non-contact measurement, alleviate the inconvenience of using a contact wearable device, and for use in a dark environment. Furthermore, we selected the appropriate RGB channel under different light sources to obtain LF/HF ratio from HRV of PPGI. The main drowsiness judgment basis of the proposed drowsiness detection system is the use of algorithm to obtain sympathetic/parasympathetic nervous balance index and percentage of eyelid closure. In the experiment, there are 10 awake samples and 30 sleepy samples. The sensitivity is 88.9%, the specificity is 93.5%, the positive predictive value is 80%, and the system accuracy is 92.5%. In addition, an electroencephalography signal was used as a contrast to validate the reliability of the proposed method.


Assuntos
Condução de Veículo , Vigília , Eletroencefalografia/métodos , Fadiga , Humanos , Reprodutibilidade dos Testes , Fases do Sono/fisiologia , Vigília/fisiologia
6.
World Neurosurg ; 183: e658-e667, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38181875

RESUMO

OBJECTIVE: Biportal endoscopic spinal surgery (BESS) is recommended as a safer and less destructive option for lumbar disc herniations. However, limited data exist on clinical outcomes for extraforaminal lumbar disc herniation (ELDH) surgery. This retrospective study presents our preliminary experience with transforaminal unilateral BESS for ELDH. METHODS: Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with ELDH by magnetic resonance imaging, and treated with transforaminal unilateral BESS in 2021-2023 in 2 institutions in Taiwan were eligible for inclusion. Those with lumbar spondylolisthesis grade 2 or more with segmental instability, history of drug abuse or psychiatric diseases, or with a follow-up duration <1 year were excluded. Primary outcomes included visual analog scale for pain, assessed at 1 week, 1 month, 6 months, and 1 year using generalized estimating equations analysis; success and satisfaction of BESS graded by the Macnab criteria; and perioperative complications. Secondary outcomes were operative time and hospital length of stay. RESULTS: Seventeen patients were included in the analysis, with a mean age of 65.8 years; 11 (64.7%) were males and 15 (88.2%) had no prior lumbar spine surgery. mean operative time was 107.9 minutes, and length of stay was 3.5 days. Graded by Macnab criteria, 16 (94.1%) of patients had good to excellent outcomes. Only 1 patient experienced complications. No recurrence/reoperation was observed. Generalized estimating equations analysis showed that postoperative visual analog scale scores decreased significantly at 1 week (adjusted Beta [aBeta] = -5.47, standard error: 0.29, P < 0.001), 1 month (aBeta = -5.82), 6 months (aBeta = -5.88), and 1 year (aBeta = -6.29). CONCLUSIONS: Transforaminal unilateral BESS is an alternative and feasible method for treating ELDH, producing good surgical outcomes with few complications and sustaining pain improvement. Future studies with larger patient numbers and comparisons between BESS and other minimally invasive techniques for ELDH are warranted.


Assuntos
Discotomia Percutânea , Deslocamento do Disco Intervertebral , Masculino , Humanos , Idoso , Feminino , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Estudos Retrospectivos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Discotomia Percutânea/métodos , Endoscopia/métodos , Dor/cirurgia , Resultado do Tratamento
7.
J Neurosci ; 32(1): 62-7, 2012 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-22219270

RESUMO

GABAergic signaling in hippocampal pyramidal neurons undergoes a switch from depolarizing to hyperpolarizing during early neuronal development. Whether such a transformation of GABAergic action occurs in dentate granule cells (DGCs), located at the first stage of the hippocampal trisynaptic circuit, is unclear. Here, we use noninvasive extracellular recording to monitor the effect of synaptically released GABA on the DGC population. We find that GABAergic responses in adolescent and adult rat DGCs are still depolarizing from rest. Using a morphologically realistic DGC model, we show that GABAergic action, depending on its precise timing and location, can have either an excitatory or inhibitory role in signal processing in the dentate gyrus.


Assuntos
Potenciais de Ação/fisiologia , Giro Denteado/crescimento & desenvolvimento , Potenciais Pós-Sinápticos Excitadores/fisiologia , Neurônios/fisiologia , Transmissão Sináptica/fisiologia , Ácido gama-Aminobutírico/fisiologia , Envelhecimento/fisiologia , Animais , Giro Denteado/citologia , Masculino , Modelos Neurológicos , Neurônios/citologia , Técnicas de Cultura de Órgãos , Ratos , Ratos Sprague-Dawley
8.
Stroke ; 44(6): 1682-9, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23592763

RESUMO

BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is associated with high mortality and neurological deficits, and concurrent hyperglycemia usually worsens clinical outcomes. Aquaporin-4 (AQP-4) is important in cerebral water movement. Our aim was to investigate the role of AQP-4 in hyperglycemic ICH. METHODS: Hyperglycemia was induced by intraperitoneal injection of streptozotocin (STZ; 60 mg/kg) in adult Sprague-Dawley male rats. ICH was induced by stereotaxic infusion of collagenase/heparin into the right striatum. One set of rats was repeatedly monitored by MRI at 1, 4, and 7 days after ICH induction so as to acquire information on the formation of hematoma and edema. Another set of rats was killed and brains were examined for differences in the degree of hemorrhage and edema, water content, blood-brain barrier destruction, and AQP-4 expression. RESULTS: Hyperglycemia ICH rats exhibited increased brain water content, more severe blood-brain barrier destruction, and greater vasogenic edema as seen on diffusion-weighted MRI. Significant downregulation of AQP-4 was observed in STZ-treated rats after ICH as compared with non-STZ-treated rats. Apoptosis was greater on day 1 after ICH in STZ-treated rats. CONCLUSIONS: The expression of AQP-4 in the brain is downregulated in hyperglycemic rats as compared with normoglycemic rats after ICH. This change is accompanied by increased vasogenic brain edema and more severe blood-brain barrier destruction.


Assuntos
Aquaporina 4/fisiologia , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/fisiopatologia , Imagem de Difusão por Ressonância Magnética , Regulação para Baixo/fisiologia , Hiperglicemia/epidemiologia , Hiperglicemia/fisiopatologia , Animais , Aquaporina 4/genética , Edema Encefálico/epidemiologia , Edema Encefálico/patologia , Hemorragia Cerebral/induzido quimicamente , Colagenases/administração & dosagem , Colagenases/efeitos adversos , Comorbidade , Modelos Animais de Doenças , Hematoma/epidemiologia , Hematoma/patologia , Heparina/administração & dosagem , Heparina/efeitos adversos , Hiperglicemia/induzido quimicamente , Incidência , Infusões Intraventriculares , Injeções Intraperitoneais , Masculino , Ratos , Ratos Sprague-Dawley , Estreptozocina/administração & dosagem , Estreptozocina/efeitos adversos
9.
Cells ; 12(14)2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37508556

RESUMO

Au decorated with type I collagen (Col) was used as a core material to cross-link with stromal cell-derived factor 1α (SDF1α) in order to investigate biological performance. The Au-based nanoparticles were subjected to physicochemical determination using scanning electron microscopy (SEM), dynamic light scattering (DLS) and ultraviolet-visible (UV-Vis) and Fourier-transform infrared spectroscopy (FTIR). Mesenchymal stem cells (MSCs) were used to evaluate the biocompatibility of this nanoparticle using the MTT assay and measuring reactive oxygen species (ROS) production. Also, the biological effects of the SDF-1α-conjugated nanoparticles (Au-Col-SDF1α) were assessed and the mechanisms were explored. Furthermore, we investigated the cell differentiation-inducing potential of these conjugated nanoparticles on MSCs toward endothelial cells, neurons, osteoblasts and adipocytes. We then ultimately explored the process of cell entry and transportation of the nanoparticles. Using a mouse animal model and retro-orbital sinus injection, we traced in vivo biodistribution to determine the biosafety of the Au-Col-SDF1α nanoparticles. In summary, our results indicate that Au-Col is a promising drug delivery system; it can be used to carry SDF1α to improve MSC therapeutic efficiency.


Assuntos
Células-Tronco Mesenquimais , Nanopartículas , Animais , Células Endoteliais , Distribuição Tecidual , Nanopartículas/química , Diferenciação Celular
10.
Front Cell Neurosci ; 17: 1146278, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37545878

RESUMO

Inhibitory γ-aminobutyric acid (GABA)-ergic interneurons mediate inhibition in neuronal circuitry and support normal brain function. Consequently, dysregulation of inhibition is implicated in various brain disorders. Parvalbumin (PV) and somatostatin (SST) interneurons, the two major types of GABAergic inhibitory interneurons in the hippocampus, exhibit distinct morpho-physiological properties and coordinate information processing and memory formation. However, the molecular mechanisms underlying the specialized properties of PV and SST interneurons remain unclear. This study aimed to compare the transcriptomic differences between these two classes of interneurons in the hippocampus using the ribosome tagging approach. The results revealed distinct expressions of genes such as voltage-gated ion channels and GABAA receptor subunits between PV and SST interneurons. Gabrd and Gabra6 were identified as contributors to the contrasting tonic GABAergic inhibition observed in PV and SST interneurons. Moreover, some of the differentially expressed genes were associated with schizophrenia and epilepsy. In conclusion, our results provide molecular insights into the distinct roles of PV and SST interneurons in health and disease.

11.
Diagnostics (Basel) ; 13(11)2023 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-37296715

RESUMO

BACKGROUND: Lumbar degenerative disc disease (LDDD) is a leading cause of chronic lower back pain; however, a lack of clear diagnostic criteria and solid LDDD interventional therapies have made predicting the benefits of therapeutic strategies challenging. Our goal is to develop machine learning (ML)-based radiomic models based on pre-treatment imaging for predicting the outcomes of lumbar nucleoplasty (LNP), which is one of the interventional therapies for LDDD. METHODS: The input data included general patient characteristics, perioperative medical and surgical details, and pre-operative magnetic resonance imaging (MRI) results from 181 LDDD patients receiving lumbar nucleoplasty. Post-treatment pain improvements were categorized as clinically significant (defined as a ≥80% decrease in the visual analog scale) or non-significant. To develop the ML models, T2-weighted MRI images were subjected to radiomic feature extraction, which was combined with physiological clinical parameters. After data processing, we developed five ML models: support vector machine, light gradient boosting machine, extreme gradient boosting, extreme gradient boosting random forest, and improved random forest. Model performance was measured by evaluating indicators, such as the confusion matrix, accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC), which were acquired using an 8:2 allocation of training to testing sequences. RESULTS: Among the five ML models, the improved random forest algorithm had the best performance, with an accuracy of 0.76, a sensitivity of 0.69, a specificity of 0.83, an F1 score of 0.73, and an AUC of 0.77. The most influential clinical features included in the ML models were pre-operative VAS and age. In contrast, the most influential radiomic features had the correlation coefficient and gray-scale co-occurrence matrix. CONCLUSIONS: We developed an ML-based model for predicting pain improvement after LNP for patients with LDDD. We hope this tool will provide both doctors and patients with better information for therapeutic planning and decision-making.

12.
Proteomics ; 12(1): 113-23, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22065606

RESUMO

Intracerebral hemorrhage (ICH) is associated with high mortality and disability, and hyperglycemia worsens the clinical and neurological outcomes of patients with ICH. In this study, we utilized proteomic approaches to investigate the role of hyperglycemia in ICH. Hyperglycemia was induced by intraperitoneal injection of streptozotocin (STZ) in adult Sprague-Dawley male rats; ICH was induced by stereotaxic infusion of collagenase/heparin into the right striatum. It was observed that the size of induced hemorrhage was significantly larger in the hyperglycemic group (n=6 in each group). On the first day after ICH, an apparent decrease in the bilateral grasp was also observed for the lesioned hyperglycemic rats compared with normoglycemic ones. When employing 2-DE and MS to examine the proteomes of perihematomal and control regions in individual hyperglycemic and normoglycemic rats, eight differentially expressed protein targets were identified. Most noteworthy, in response to ICH significant increase of albumin was ubiquitously observed in the brains of normoglycemic rats but not in the brains of hyperglycemic rats. Coincidentally, more significant neuronal apoptosis were found in the perihematomal regions of hyperglycemic rats. These observations described suggest the protection role of albumin in acute stage of ICH, which may be dependent on different blood sugar levels.


Assuntos
Encéfalo/metabolismo , Hemorragia Cerebral/complicações , Hiperglicemia/complicações , Albuminas/genética , Albuminas/metabolismo , Animais , Apoptose , Glicemia , Encéfalo/enzimologia , Encéfalo/patologia , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/metabolismo , Colagenases , Expressão Gênica , Heparina , Hiperglicemia/induzido quimicamente , Hiperglicemia/metabolismo , Lactoilglutationa Liase/genética , Lactoilglutationa Liase/metabolismo , Masculino , ATPases Mitocondriais Próton-Translocadoras/genética , ATPases Mitocondriais Próton-Translocadoras/metabolismo , Proteína de Ligação a Fosfatidiletanolamina/genética , Proteína de Ligação a Fosfatidiletanolamina/metabolismo , Fosfopiruvato Hidratase/genética , Fosfopiruvato Hidratase/metabolismo , Proteômica , Ratos , Ratos Sprague-Dawley , Ubiquitina Tiolesterase/genética , Ubiquitina Tiolesterase/metabolismo
13.
J Neurosurg Case Lessons ; 3(26): CASE22168, 2022 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-35855204

RESUMO

BACKGROUND: Percutaneous endoscopic lumbar decompression is gaining attention as a minimally invasive surgery. Here, the authors report a rare complication of pneumocephalus caused by vacuum drain after biportal endoscopic spinal surgery (BESS) for lumbar stenosis. OBSERVATIONS: A 79-year-old woman with spinal stenosis over the L4-5 level received BESS. No visible dural tear was encountered during surgery, and a vacuum drain was placed after surgery. Approximately 150 mL of cerebrospinal fluid was drained on postoperative day 1. Simultaneously, symptoms of intracranial hypotension were noted. Brain computed tomography (CT) revealed pneumocephalus. The patient was advised to have bed rest and hydration, and her symptoms improved subsequently. Follow-up brain CT indicated the resolution of pneumocephalus. LESSONS: Pneumocephalus after endoscopic lumbar surgery is rare. Dural tear, high rate of normal saline irrigation, and vacuum drain placement are the associated risk factors.

14.
World J Clin Cases ; 10(2): 725-732, 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35097100

RESUMO

BACKGROUND: Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management. CASE SUMMARY: A 66-year-old man who received thoracoscopic resection to remove an intrathoracic, posterior mediastinal, dumbbell-shaped, pathology-proven neurogenic tumor. The patient then reported experiencing progressively severe headaches, especially when in an upright position. A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus. Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient. During the operation, we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level. After that, we wrapped and sealed all the possible origins of the leakage with autologous fat, tissue glue, gelfoam, and duraseal layer by layer. The patient recovered well, and the computed tomography images showed resolution of the pneumocephalus. CONCLUSION: This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.

15.
PLoS One ; 17(12): e0278883, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36508407

RESUMO

BACKGROUND: Percutaneous cervical nucleoplasty (PCN) is a simple, safe, and effective treatment for contained cervical herniated intervertebral disc (CHIVD). However, few studies have compared the actual benefits of PCN against conservative treatment (CT), either clinically or radiographically. PURPOSE: The present study sought to analyze and to compare the outcomes of symptomatic contained CHIVD treated with PCN or CT. METHODS: The present study was designed as a case-control comparative study. Patients who indicated for PCN after a failed CT for more than 6 months were recruited. After the exclusion of some patients who did not meet the selection criteria of the study, we finally enrolled 71 patients treated with PCN. In addition, another 21 patients who indicated for PCN but finally chose to receive CT continuously were also enrolled and categorized as the control group. All patients completed the 6-month follow-up. Pain levels and functional outcomes were evaluated pre- and post-operatively by assessing the visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI). Radiographic images of 72 of 104 intervened segments were collected to measure disc height and other cervical spinal alignments, such as range of motion, C2-7 Cobb's angle, and C2-7 sagittal vertical axis. RESULTS: Compared with the CT group, the PCN group showed significantly better outcomes on VAS, ODI, and NDI at the 1-month post-operative follow-up, which continued through at least the 6-month follow-up (P < 0.01 for VAS and P < 0.05 for ODI and NDI). The mean disc height significantly decreased, from 6.04 ± 0.85 mm to 5.76 ± 1.02 mm, 3 months after PCN treatment (P = 0.003). However, the degree of disc height decrease did not correlate with the changes of the substantial VAS improvement. CONCLUSIONS: To provide therapeutic benefits for symptomatic contained CHIVD patients after an invalid CT for 6 months, PCN seems to be a better option than CT. The reduced disc heights did not alter the clinical outcomes of PCN.


Assuntos
Vértebras Cervicais , Deslocamento do Disco Intervertebral , Humanos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Estudos de Casos e Controles , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Radiografia , Pescoço , Resultado do Tratamento
16.
J Int Med Res ; 49(11): 3000605211058890, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34842480

RESUMO

Primary spinal chondrosarcoma (CS) is rare. Only a few previous case reports have included a detailed description of the surgical process used to treat the CS. In addition, a paucity of documentation exists comparing differences in the outcomes between the approaches in en bloc resection. Here, we present a case of CS in the lumbar (L) spine treated with two-stage (anterior and posterior approach) en bloc surgery and analyze the differences between one-stage and two-stage approaches in the treatment of primary lumbar CS. A 30-year-old male patient with an L3 vertebral body CS presented with back pain and lower limb weakness. Lumbar spine magnetic resonance imaging (MRI) showed an L3 vertebral body tumor with cord and root compression. Two-stage surgery comprising posterior total laminectomy and transpedicular screw fixation over L2-L4 in the first stage, with subsequent anterior corpectomy, cage implantation, and anterior lumbar interbody fusion was performed to achieve total tumor removal and stabilization. The patient's symptoms improved postoperatively, with no recurrence as of the 2-year follow-up. The analysis of previous similar cases showed that two-stage surgery, compared with one-stage surgery, appears to be beneficial in lumbar spine multisegment disease, providing a lower recurrence rate.


Assuntos
Condrossarcoma , Neoplasias da Coluna Vertebral , Adulto , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Humanos , Laminectomia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Região Lombossacral , Masculino , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Resultado do Tratamento
17.
J Proteome Res ; 9(6): 3091-102, 2010 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-20707402

RESUMO

The inhibition of dihydrofolate reductase (DHFR) by antifolates is a common practice both in cell culture and in chemotherapy. Surprisingly, antifolate resistance was also observed in cultured murine myeloma cells (SP2/0) in the presence of human plasma (HP); thus, we used a proteomic approach to identify novel plasma biomarker(s) for this condition. In contrast to the in vitro antifolate response, metabolic enzymes and translation machinery proteins were found to be up-regulated in the presence of HP. The antifolate resistance inherent in HP may be explained by a simultaneous promotion of cell proliferation and the maintenance of DNA integrity. Furthermore, the factor(s) was found to be extrinsic, heat stable and very small in size. Adenine, a supplemented additive in erythrocyte preservation, was subsequently identified as the contributing factor and exogenous addition in cultures reversed the cytotoxicity induced by antifolates. Importantly, adenine-containing blood components, which may provide enhanced survival to otherwise sensitive antifolate-targeted cells, showed a dose-dependent adverse effect in transfusion recipients receiving antifolate (methotrexate) medications. These findings not only highlight a previously unnoticed role of adenine, but also emphasize a novel mechanistic link between transfusion and subsequently reduced survival in patients taking methotrexate.


Assuntos
Proteínas Sanguíneas/farmacologia , Resistência a Medicamentos/efeitos dos fármacos , Antagonistas do Ácido Fólico/farmacologia , Proteômica/métodos , Biologia de Sistemas/métodos , Adenina/farmacologia , Aminopterina , Animais , Preservação de Sangue , Proteínas Sanguíneas/metabolismo , Transfusão de Sangue , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Análise por Conglomerados , Relação Dose-Resposta a Droga , Estabilidade de Medicamentos , Eletroforese em Gel Bidimensional , Humanos , Estimativa de Kaplan-Meier , Metotrexato , Camundongos , Conservantes Farmacêuticos , Estudos Retrospectivos , Regulação para Cima
18.
Eur J Neurosci ; 32(5): 725-35, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20673311

RESUMO

Astrocytes function as spatial K(+) buffers by expressing a rich repertoire of K(+) channels. Earlier studies suggest that acid-sensitive tandem-pore K(+) channels, mainly TWIK-related acid-sensitive K(+) (TASK) channels, mediate part of the passive astroglial membrane conductance. Here, using a combination of electrophysiology and pharmacology, we investigated the presence of TASK-like conductance in hippocampal astrocytes of rat brain slices. Extracellular pH shifts to below 7.4 (or above 7.4) induced a prominent inward (or outward) current in astrocytes in the presence of tetrodotoxin, a Na(+) channel blocker, and 4,4'-diisothiocyanatostilbene-2,2'-disulfonate, a co-transporter blocker. The pH-sensitive current was insensitive to quinine, a potent blocker of tandem-pore K(+) channels including TWIK-1 and TREK-1 channels. Voltage-clamp analysis revealed that the pH-sensitive current exhibited weak outward rectification with a reversal potential of -112 mV, close to the Nernst equilibrium potential for K(+) . Furthermore, the current-voltage relationship was well fitted with the Goldman-Hodgkin-Katz current equation for the classical open-rectifier 'leak' K(+) channel. The pH-sensitive K(+) current was potentiated by TASK channel modulators such as the volatile anesthetic isoflurane but depressed by the local anesthetic bupivacaine. However, unlike TASK channels, the pH-sensitive current was insensitive to Ba(2+) and quinine. Thus, the molecular identity of the pH-sensitive leak K(+) channel is unlikely to be attributable to TASK channels. Taken together, our results suggest a novel yet unknown leak K(+) channel underlying the pH- and anesthetic-sensitive background conductance in hippocampal astrocytes.


Assuntos
Astrócitos/fisiologia , Hipocampo/fisiologia , Canais de Potássio de Domínios Poros em Tandem/fisiologia , Ácido 4,4'-Di-Isotiocianoestilbeno-2,2'-Dissulfônico/análogos & derivados , Ácido 4,4'-Di-Isotiocianoestilbeno-2,2'-Dissulfônico/farmacologia , Animais , Bário/farmacologia , Bupivacaína/farmacologia , Hipocampo/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Isoflurano/farmacologia , Masculino , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Proteínas do Tecido Nervoso , Técnicas de Patch-Clamp/métodos , Canais de Potássio de Domínios Poros em Tandem/antagonistas & inibidores , Quinina/farmacologia , Ratos , Ratos Sprague-Dawley , Tetrodotoxina/farmacologia
19.
J Arthropod Borne Dis ; 13(2): 177-184, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31803778

RESUMO

BACKGROUND: House Dust Mite (HDM) is associated with hypersensitivity such as asthma. Patients with asthma benefit from improved living environment by reducing HDM exposure. In this study, we examined the effects of commercialized diatomaceous earth product, Casaggia® used as construction materials, on hypersensitivity in HDM-sensitized mice. METHODS: Male mice were sensitized with house dust mite extract for 7d and then housed in diatomaceous earth (DE)-coated cages for 14 days at Animal Center of the Taichung Veterans General Hospital, Taichung, Taiwan in 2014. Levels of cytokine were determined using ELISA. White blood cell counts were recorded over 21d. Histological analysis was conducted to determine the remodeling of respiratory tract. RESULTS: Exposure to DE resulted in a suppression in elevated eosinophilia induced by HDM in mice. In addition, elevated serum IgE responding to HDM sensitization were restored in the presence of DE. DE ameliorated the inflammation progression in airway. CONCLUSION: Environmental exposure to DE is suggested to benefit patients with hypersensitivity through relieving inflammatory symptoms. In a sense of prevention, DE represents a potential material against development of asthma.

20.
J Chin Med Assoc ; 82(1): 55-59, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30839405

RESUMO

BACKGROUND: Hyperkalemia is a risky and potentially life-threatening condition in pre-term infants. Glucose-insulin infusion has been considered a major therapeutic way for non-oligouric hyperkalemia but affects the stability of blood sugar level. We aimed to evaluate the effectiveness of salbutamol nebulization compared to glucose-insulin infusion for the treatment of non-oliguric hyperkalemia in premature infants. METHODS: Forty premature infants (gestation age ≤36 weeks) with non-oliguric hyperkalemia (central serum potassium level greater than 6.0 mmol/L) within 72 h of birth were enrolled in this study. These infants were randomly assigned into two groups. One group received a regular insulin bolus with glucose infusion (Group A; n = 20), and the other received salbutamol (Ventolin) by nebulization (Group B; n = 20). Potassium level, blood sugar, heart rate, and blood pressure were recorded for each group before treatment and at 3, 12, 24, 48, and 72 h post-treatment. RESULTS: The serum potassium levels were reduced after treatment in both groups. No significant changes in heart rate or blood pressure were observed in either group. The fluctuation in glucose levels was gentler in the salbutamol-treated group than in the glucose-insulin infusion group. CONCLUSION: Salbutamol nebulization is not only as effective as glucose-insulin infusion for treating non-oliguric hyperkalemia in premature infants but can avoid potential side effects such as vigorous blood glucose fluctuations.


Assuntos
Albuterol/administração & dosagem , Glicemia/análise , Hiperpotassemia/tratamento farmacológico , Pressão Sanguínea/efeitos dos fármacos , Método Duplo-Cego , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hiperpotassemia/sangue , Hiperpotassemia/fisiopatologia , Recém-Nascido , Recém-Nascido Prematuro , Nebulizadores e Vaporizadores , Estudos Prospectivos
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