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1.
Med Sci Sports Exerc ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767985

RESUMO

INTRODUCTION: The effects of breaking up sitting on gut hormone responses and free-living energy compensatory behaviours are still unclear in people of Asian ethnicity. METHODS: 26 Asians including 13 lean individuals (Lean) and 13 individuals with centrally overweight/obesity (OW), aged between 20 to 45 years, completed a randomized crossover study with either 5.5-h uninterrupted sitting (SIT) or 5.5-h sitting with 2 min walking at 6.4 km/h every 20 min (ACTIVE) in the laboratory. Blood samples were collected at regular time-points to examine postprandial glucagon-like peptide 1 (GLP-1), peptide YY (PYY) and glucose-dependent insulinotropic polypeptide (GIP) concentrations. Free-living physical activity and energy intake were recorded using wearable devices and weighed food diaries outside the laboratory until midnight. Paired t-tests were conducted to compare responses between trials. RESULTS: Postprandial GLP-1 and PYY incremental area under curve values were higher in the ACTIVE trial versus SIT in both Lean and OW groups (all, p < 0.05), but there was no difference in GIP in either group (both, p > 0.05). There were no differences in free-living physical activity (volume and intensity) or energy intake (total and macronutrients) between trials in either group (all, p > 0.05), resulting in greater total physical activity over the 24-h monitoring period in ACTIVE trial versus SIT trial (both, p < 0.05). CONCLUSIONS: Breaking up sitting increases postprandial GLP-1 and PYY concentrations in Asians, but does not induce subsequent behavioural compensation, resulting in greater 24-h physical activity levels and lower relative energy intake, in inactive individuals irrespective of bodyweight status.

2.
Oncol Rep ; 51(3)2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38240107

RESUMO

Various types of human cancer may develop aberrant trophoblastic differentiation, including histological changes and altered expression of ß­human chorionic gonadotropin (ß­hCG). Aberrant trophoblastic differentiation in epithelial cancer is usually associated with poor differentiation, tumor metastasis, unfavorable prognosis and treatment resistance. Since ß­hCG­targeting vaccines have failed in an early phase II trial, it is crucial to obtain a better understanding of the molecular pathogenesis of trophoblastic differentiation in human cancer. The present review summarizes the clinical and translational research on this topic with the aim of accelerating the development of an effective targeted therapy. Ectopic expression of ß­hCG promotes proliferation, migration, invasion, vasculogenesis and epithelial­mesenchymal transition (EMT) in vitro, and enhances metastatic and tumorigenic capabilities in vivo. Signaling cascades modulated by ß­hCG include the TGF­ß receptor pathway, EMT­related pathways, the c­MET receptor tyrosine kinase and mitogen­activated protein kinase/ERK pathways, and the SMAD2/4 pathway. Taken together, these findings indicated that TGF­ß receptors, c­MET and ERK1/2 are potential therapeutic targets. Nevertheless, further investigation on the molecular basis of aberrant trophoblastic differentiation is mandatory to improve the design of precision therapy for this aggressive type of human cancer.


Assuntos
Gonadotropina Coriônica Humana Subunidade beta , Neoplasias , Humanos , Transdução de Sinais , Prognóstico , Sistema de Sinalização das MAP Quinases , Neoplasias/tratamento farmacológico , Neoplasias/genética , Transição Epitelial-Mesenquimal , Movimento Celular , Linhagem Celular Tumoral
3.
Nat Commun ; 14(1): 6569, 2023 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-37848444

RESUMO

While macrophage phagocytosis is an immune defense mechanism against invading cellular organisms, cancer cells expressing the CD47 ligand send forward signals to repel this engulfment. Here we report that the reverse signaling using CD47 as a receptor additionally enhances a pro-survival function of prostate cancer cells under phagocytic attack. Although low CD47-expressing cancer cells still allow phagocytosis, the reverse signaling delays the process, leading to incomplete digestion of the entrapped cells and subsequent tumor hybrid cell (THC) formation. Viable THCs acquire c-Myc from parental cancer cells to upregulate both M1- and M2-like macrophage polarization genes. Consequently, THCs imitating dual macrophage features can confound immunosurveillance, gaining survival advantage in the host. Furthermore, these cells intrinsically express low levels of androgen receptor and its targets, resembling an adenocarcinoma-immune subtype of metastatic castration-resistant prostate cancer. Therefore, phagocytosis-generated THCs may represent a potential target for treating the disease.


Assuntos
Antígeno CD47 , Macrófagos , Metástase Neoplásica , Fagocitose , Proteínas Proto-Oncogênicas c-myc , Evasão Tumoral , Humanos , Masculino , Proteínas de Transporte , Antígeno CD47/metabolismo , Macrófagos/metabolismo , Neoplasias da Próstata/genética , Neoplasias da Próstata/imunologia , Neoplasias da Próstata/patologia , Proteínas Proto-Oncogênicas c-myc/genética , Proteínas Proto-Oncogênicas c-myc/imunologia , Transdução de Sinais , Evasão Tumoral/genética , Evasão Tumoral/imunologia , Metástase Neoplásica/genética , Metástase Neoplásica/imunologia , Células Tumorais Cultivadas
5.
Clin Genitourin Cancer ; 21(4): 508.e1-508.e10, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37183125

RESUMO

Introduction/Background To determine the clinical significance of micropapillary urothelial carcinoma (MPUC) of the upper urinary tract (UTUC) and a potential therapeutic strategy. Patients and Methods A retrospective cohort study was conducted to examine the incidence of micropapillary UTUC from 2010 to 2018 and its clinicopathological characteristics. Clinical outcomes and cancer-specific survival (CSS) were compared between MPUC and conventional UTUC matched by stage within a 6-month variation of receiving surgery. Results A total of 24 MPUC cases were identified out of 901 cases (2.7%) of urothelial carcinoma (UC) of the renal pelvis and ureter. MPUC was significantly smaller (<3 cm) and associated with nodal metastasis compared with conventional UTUC (P = .017 & 0.021, respectively); however, no significant difference was observed for lymphovascular invasion, distant metastasis, or CSS (P > 0.50, respectively) compared with match controls. Six MPUC patients (25%) developed metastasis to the liver, lymph nodes, and lung during follow-up. Patients with HER2-positive MPUC (3 of 4) had a significantly higher risk of metastasis compared with HER2-negative MPUC (3 of 20; P = 0.035). Conclusions MPUC is an aggressive variant of UTUC and usually presents as a small locally advanced disease. HER2 immunohistochemistry may identify the subset of patients with micropapillary UTUC that are candidates for targeted therapy.


Assuntos
Terapia de Alvo Molecular , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/tratamento farmacológico , Neoplasias Urológicas/fisiopatologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/fisiopatologia , Genes erbB-2/genética , Estudos de Casos e Controles , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Regulação Neoplásica da Expressão Gênica , Invasividade Neoplásica/genética , Imuno-Histoquímica , Biomarcadores Tumorais/metabolismo
6.
BMC Urol ; 23(1): 21, 2023 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-36803494

RESUMO

BACKGROUND: Paraganglioma of genitourinary tract is uncommon, and origin from ureter is even rarer. We aim to present a case of paraganglioma from ureter in a 48-year-old female patient, who presented with gross hematuria. CASE PRESENTATION: We present a 48-year-old female who complained of gross hematuria for one week. A left ureteral tumor was found by image study. However, hypertension was unexpectedly recorded during diagnostic ureteroscopy survey. Due to persisted gross hematuria and bladder tamponade, she underwent left nephroureterectomy with bladder cuff resection. Blood pressure surged again when the tumor was surgically approached. Ureteral paraganglioma was confirmed according to pathological report. After the surgery, the patient recovered well, and no more gross hematuria was noted. She is now under regular follow-up at our outpatient clinic. CONCLUSION: Ureteral paraganglioma should be kept in mind not only when blood pressure fluctuates during operation, but also before we manipulate the ureteral tumor when gross hematuria is the only sign. Whenever the presumption of paraganglioma is raised, laboratory evaluation and anatomical or even functional imaging should be considered. The concomitant anesthesia consultation before the surgery should not be deferred, either.


Assuntos
Paraganglioma , Ureter , Neoplasias Ureterais , Neoplasias da Bexiga Urinária , Feminino , Humanos , Pessoa de Meia-Idade , Ureter/patologia , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias Ureterais/complicações , Neoplasias Ureterais/diagnóstico , Neoplasias Ureterais/cirurgia , Paraganglioma/complicações , Paraganglioma/diagnóstico , Paraganglioma/cirurgia , Hematúria/diagnóstico , Hematúria/etiologia
8.
J Nanobiotechnology ; 20(1): 373, 2022 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-35953837

RESUMO

The escape of bladder cancer from immunosurveillance causes monotherapy to exhibit poor efficacy; therefore, designing a multifunctional nanoparticle that boosts programmed cell death and immunoactivation has potential as a treatment strategy. Herein, we developed a facile one-pot coprecipitation reaction to fabricate cluster-structured nanoparticles (CNPs) assembled from Fe3O4 and iron chlorophyll (Chl/Fe) photosensitizers. This nanoassembled CNP, as a multifunctional theranostic agent, could perform red-NIR fluorescence and change the redox balance by the photoinduction of reactive oxygen species (ROS) and attenuate iron-mediated lipid peroxidation by the induction of a Fenton-like reaction. The intravesical instillation of Fe3O4@Chl/Fe CNPs modified with 4-carboxyphenylboronic acid (CPBA) may target the BC wall through glycoproteins in the BC cavity, allowing local killing of cancer cells by photodynamic therapy (PDT)-induced singlet oxygen and causing chemodynamic therapy (CDT)-mediated ferroptosis. An interesting possibility is reprogramming of the tumor microenvironment from immunosuppressive to immunostimulatory after PDT-CDT treatment, which was demonstrated by the reduction of PD-L1 (lower "off" signal to the effector immune cells), IDO-1, TGF-ß, and M2-like macrophages and the induction of CD8+ T cells on BC sections. Moreover, the intravesical instillation of Fe3O4@Chl/Fe CNPs may enhance the large-area distribution on the BC wall, improving antitumor efficacy and increasing survival rates from 0 to 91.7%. Our theranostic CNPs not only demonstrated combined PDT-CDT-induced cytotoxicity, ROS production, and ferroptosis to facilitate treatment efficacy but also opened up new horizons for eliminating the immunosuppressive effect by simultaneous PDT-CDT.


Assuntos
Ferroptose , Nanopartículas , Neoplasias , Fotoquimioterapia , Neoplasias da Bexiga Urinária , Linfócitos T CD8-Positivos/metabolismo , Linhagem Celular Tumoral , Clorofila , Compostos Férricos , Humanos , Imunização , Imunoterapia , Ferro , Neoplasias/tratamento farmacológico , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Espécies Reativas de Oxigênio/metabolismo , Microambiente Tumoral , Neoplasias da Bexiga Urinária/tratamento farmacológico
9.
Transplant Proc ; 54(6): 1575-1578, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34702598

RESUMO

We report a case of a heart transplant recipient who presented with a rapidly growing Epstein-Barr virus (EBV)-positive, diffuse large B-cell lymphoma 7 days after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. Because of the atypical radiologic presentation, the initial tentative diagnosis was a mediastinal abscess. This observation indicates a potential risk of EBV reactivation after coronavirus disease 2019 (COVID-19) vaccination, which might lead to or aggravate the presentation of posttransplant lymphoproliferative disorder in transplantation patients. Transplant surgeons should be aware of the potential immunomodulatory effects of the COVID-19 vaccination.


Assuntos
COVID-19 , ChAdOx1 nCoV-19 , Infecções por Vírus Epstein-Barr , Transplante de Coração , Transtornos Linfoproliferativos , Humanos , ChAdOx1 nCoV-19/efeitos adversos , COVID-19/prevenção & controle , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Herpesvirus Humano 4 , Transtornos Linfoproliferativos/induzido quimicamente , Transtornos Linfoproliferativos/diagnóstico
10.
BMC Neurol ; 21(1): 388, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34615473

RESUMO

BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease involving the neuromuscular junction. Myasthenic crisis (MC), which is characterized by respiratory failure and the requirement of mechanical ventilation in patients with MG, is still a medical emergency despite the decrease in mortality with the advances in acute management. Hemogram is a cost-effective test for evaluating hematological complications and systemic inflammation, and hemogram data have been used to predict various clinical outcomes of several diseases. The relationship between hemogram and MG has been discussed, but the role of hemogram data in predicting the prognosis of MC patients has not been established. METHODS: To identify whether hemogram data can predict in-hospital mortality in patients with MC, we retrospectively investigated 188 myasthenic crisis events from the Chang Gung Research Database between April 2001 and March 2019. Demographic and clinical characteristics were collected, as well as hemogram data before intubation and extubation. The endpoints were mortality during mechanical ventilation and mortality after extubation. RESULTS: The overall in-hospital mortality rate was 22%. Multivariate logistic regression analysis for predicting mortality during mechanical ventilation showed that old age at MC onset (OR = 1.039, p = 0.022), moderate-to-severe anemia (OR = 5.851, p = 0.001), and extreme leukocytosis (OR = 5.659, p = 0.022) before intubation were strong predictors of mortality, while acute management with plasma exchange or double-filtration plasmapheresis (PE/DFPP) significantly decreased mortality (OR = 0.236, p = 0.012). For predicting mortality after extubation, moderate-to-severe anemia before extubation (OR = 8.452, p = 0.017) and non-treated with disease-modifying therapy before MC (OR = 5.459, p = 0.031) were crucial predictive factors. CONCLUSION: This study demonstrated that both old age at MC onset and moderate-to-severe anemia are important predictors of in-hospital mortality in patients with MC, and extreme leukocytosis is another crucial predictor of mortality during mechanical ventilation. The suggested mechanism is that anemia-induced hypoxia may enhance the release of proinflammatory cytokines, exacerbate systemic inflammation, and lead to multiple organ dysfunction syndrome and, finally, mortality.


Assuntos
Miastenia Gravis , Insuficiência Respiratória , Mortalidade Hospitalar , Humanos , Miastenia Gravis/complicações , Miastenia Gravis/terapia , Respiração Artificial , Estudos Retrospectivos
11.
Thorac Cancer ; 12(22): 3068-3071, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34623764

RESUMO

C-ros oncogene 1 receptor tyrosine kinase (ROS1) rearrangement has been detected in patients with advanced non-small cell lung cancer (NSCLC). Although ROS1 tyrosine kinase inhibitors (TKIs) provide a survival benefit for patients with ROS1-rearranged advanced NSCLC, subsequent therapy remains limited. Small cell transformation is an important mechanism of drug resistance in epidermal growth factor receptor-mutant NSCLC. However, its significance in mediating ROS1 resistance has not been determined yet. Here, we present the case of a 63-year-old man with ROS1-rearranged advanced NSCLC who had disease progression with small cell transformation of the mediastinal lymph node after 8 months of treatment with crizotinib. More importantly, fluorescence in situ hybridization of post-progression tumor biopsy demonstrated retention of ROS1 rearrangement. Tissue biopsy remains indispensable for patients who acquire resistance to ROS1 TKIs.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/patologia , Crizotinibe/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/patologia , Carcinoma Pulmonar de Células não Pequenas/genética , Transformação Celular Neoplásica/genética , Resistencia a Medicamentos Antineoplásicos/genética , Rearranjo Gênico , Humanos , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/uso terapêutico , Proteínas Tirosina Quinases/genética , Proteínas Proto-Oncogênicas/genética , Carcinoma de Pequenas Células do Pulmão/genética
12.
BMC Urol ; 20(1): 91, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641099

RESUMO

BACKGROUND: Intravesical bacillus Calmette-Guerin (BCG) therapy is the treatment of choice for patients with T1 or high-grade superficial bladder cancer or those with carcinoma in situ after transurethral resection. A personal history of tuberculosis infection has been viewed as a relative contraindication for BCG therapy, because it may increase the risk of complications or decrease the treatment effectiveness. We determined the safety and efficacy of intravesical BCG treatment for patients with prior tuberculosis infection by analyzing the data obtained from the National Health Insurance Research Database in Taiwan. METHODS: We included patients who were newly diagnosed with bladder cancer from 2000 to 2009 and who received adjuvant intravesical BCG therapy within 3 months after the surgery. We excluded those who developed upper urinary tract cancer during the study period. Disease recurrence, disease progression, and major adverse effects were compared between patients with and without a prior diagnosis of tuberculosis infection until December 31, 2011. RESULTS: Among the 3915 patients included, 187 (4.8%) had been previously diagnosed with tuberculosis infection. The proportion of men (84.0% versus 76.9%) and older patients was higher in the group with a prior tuberculosis infection than in those without a prior tuberculosis infection. Significant differences in disease recurrence (20.3% versus 22.8%; hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.63-1.21, p = 0.404) or disease progression (10.2% versus 12.8%, HR, 0.74; 95% CI, 0.46-1.17, p = 0.191) were not observed between the two groups. None of the patients with a prior tuberculosis infection had severe urinary tract infections, whereas four (0.1%) patients without such an infection developed severe urinary tract infections. CONCLUSION: A prior tuberculosis infection did not affect the treatment efficacy or safety of intravesical BCG treatment. The efficacy and safety of intravesical BCG therapy are comparable between bladder cancer patients with and without prior tuberculosis infections.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Vacina BCG/administração & dosagem , Neoplasias da Bexiga Urinária/tratamento farmacológico , Administração Intravesical , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Taiwan , Resultado do Tratamento , Tuberculose
13.
Nanomaterials (Basel) ; 10(7)2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664275

RESUMO

Photodynamic therapy (PDT) is a promising treatment for malignancy. However, the low molecular solubility of photosensitizers (PSs) with a low accumulation at borderline malignant potential lesions results in the tardy and ineffective management of recurrent urothelial carcinoma. Herein, we used tannic acid (TNA), a green precursor, to reduce HAuCl4 in order to generate Au@TNA core-shell nanoparticles. The photosensitizer methylene blue (MB) was subsequently adsorbed onto the surface of the Au@TNA nanoparticles, leading to the incorporation of a PS within the organic shell of the Au nanoparticle nanosupport, denoted as Au@TNA@MB nanoparticles (NPs). By modifying the surface of the Au@TNA@MB NPs with the ligand folate acid (FA) using NH2-PEG-NH2 as a linker, we demonstrated that the targeted delivery strategy achieved a high accumulation of PSs in cancer cells. The cell viability of T24 cells decreased to 87.1%, 57.1%, and 26.6% upon treatment with 10 ppm[Au] Au@TNA/MB NPs after 45 min, 2 h, and 4 h of incubation, respectively. We also applied the same targeted PDT treatment to normal urothelial SV-HUC-1 cells and observed minor phototoxicity, indicating that this safe photomedicine shows promise for applications aiming to achieve the local depletion of cancer sites without side effects.

14.
Biomed Res Int ; 2020: 2923907, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32280685

RESUMO

BACKGROUND: Myasthenia gravis (MG) is an immune-mediated disorder characterized by muscle fatigue and fluctuating weakness. Impairment in respiratory strength and endurance has been described in patients with generalized MG. We tested the hypothesis that respiratory muscle training (RMT) can improve functional outcomes and reduce fatigue in patients with MG. METHODS: Eighteen patients with mild to moderate MG participated in this study. The training group underwent home-based RMT three times a week for 12 weeks. Sixteen patients with MG without RMT were enrolled as a disease control group. Lung function, autonomic testing, Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), and functional outcome measurement by using quantitative myasthenia gravis (QMG) score and myasthenia gravis composite (MGC) scale were measured before and after the 12-week RMT. RESULTS: The 12-week RMT significantly increased forced vital capacity (FVC) from 77.9 ± 12.6% to 83.8 ± 17.7% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (p = 0.03), forced expiratory volume in one second (FEV1) from 75.2 ± 18.3% to 83.3 ± 19.0% (. CONCLUSION: The home-based RMT is an effective pulmonary function training for MG patients. The RMT can not only improve short-term outcomes but also reduce fatigue in patients with mild to moderate generalized MG.


Assuntos
Exercícios Respiratórios/métodos , Fadiga/terapia , Miastenia Gravis/complicações , Adulto , Idoso , Exercícios Respiratórios/instrumentação , Feminino , Volume Expiratório Forçado , Hospitais , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fadiga Muscular , Miastenia Gravis/fisiopatologia , Pacientes , Estudos Prospectivos , Testes de Função Respiratória , Músculos Respiratórios , Volume de Ventilação Pulmonar , Capacidade Vital
15.
ACS Omega ; 5(10): 4991-5000, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32201785

RESUMO

Iron pentacarbonyl (Fe(CO)5) is a versatile material that is utilized as an inhibitor of flame, shows soot suppressibility, and is used as a precursor for focused electron-beam-induced deposition (FEBID). X-ray absorption near-edge structure (XANES) of the K edge, which is a powerful technique for monitoring the oxidation states and coordination environment of metal sites, can be used to gain insight into Fe(CO)5-related reaction mechanisms in in situ experiments. We use a finite difference method (FDM) and molecular-orbital-based time-dependent density functional theory (TDDFT) calculations to clarify the Fe K-edge XANES features of Fe(CO)5. The two pre-edge peaks P1 and P2 are mainly the Fe(1s) → Fe-C(σ*) and Fe(1s) → Fe-C(π*) transitions, respectively. When the geometry transformed from D 3h to C 4v symmetry, a ∼30% decrease of the pre-edge P2 intensity was observed in the simulated spectra. This implies that the π bonding of Fe and CO is sensitive to changes in geometry. The following rising edge and white line regions are assigned to the Fe(1s) → Fe(4p)(mixing C(2p)) transitions. Our results may provide useful information to interpret XANES spectra variations of in situ reactions of metal-CO or similar compounds with π acceptor ligandlike metal-CN complexes.

16.
J Clin Neurosci ; 55: 57-61, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30042070

RESUMO

The prognostic significance of clinical characteristics and neuroimaging features, especially cranial magnetic resonance imaging (MRI)-based neuroimaging features, in patients with human immunodeficiency virus (HIV)-negative cryptococcal meningitis (CM) has rarely been examined in the literature. We analyzed the clinical characteristics and MRI findings of 65 HIV-negative patients (43 men, 22 women, age 19-86 years) collected during a study period of 15 years (January 2001-December 2015). Their underlying conditions included diabetes mellitus, liver cirrhosis, hematologic disorders, autoimmune disorders, malignancy, chronic obstructive pulmonary disease, adrenal insufficiency and organ transplantation, and their clinical presentations included headache, altered consciousness, fever, seizure, visual disturbance and hearing impairment. The main cranial MRI findings were basal meningeal enhancement (44.6%, 29/65), dilated Virchow-Robin space/pseudocyst (43.1%, 28/65), "dirty" cerebrospinal fluid sign (38.5%, 25/65), hydrocephalus (36.9%, 21/65), acute/subacute cerebral infarct (ASCI, 21.5%, 14/65), cryptococcoma (9.2%, 6/65), and hazy brain base (1.5%, 1/65). The therapeutic results of the 65 patients were evaluated using the Glasgow Outcome Scale (GOS). A comparison of the good outcome group (GOS score = 4-5, n = 37) and poor outcome group (GOS score = 1-3, n = 28) revealed that both the presence of seizures and ASCI were significantly associated with the prognosis. A comparison of the groups with ASCI (n = 14) and without ASCI (n = 51) revealed that the presence of basal meningeal enhancement was a significant factor for the development of ASCI, and that this correlation may be associated with intense basal meningeal inflammation in adjacent small vessels.


Assuntos
Meningite Criptocócica/diagnóstico por imagem , Meningite Criptocócica/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infarto Cerebral/epidemiologia , Infarto Cerebral/etiologia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Meningite Criptocócica/complicações , Pessoa de Meia-Idade , Neuroimagem/métodos , Prognóstico , Estudos Retrospectivos , Convulsões/epidemiologia , Convulsões/etiologia , Adulto Jovem
17.
Epilepsy Behav ; 59: 92-7, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27116537

RESUMO

BACKGROUND: Status epilepticus (SE) is a neurological emergency associated with a high mortality rate and long-term cognitive sequelae. Status epilepticus in pregnancy poses a tremendous threat to both mother and fetus, making a correct diagnosis and treatment a challenging task for clinicians. The prevalence, underlying etiology, and outcomes of pregnancy-related SE remain largely unknown. METHODS: We retrospectively studied all SE episodes (n=366) in patients admitted to our neurological ICU over a period of 8.5years. The patients who developed SE during pregnancy and within 6months after delivery were considered to have pregnancy-related SE. Patients with eclampsia were not included as they were usually cared for in our obstetric unit. RESULTS: Seven patients with pregnancy-related SE were identified (2.1% of all cases of SE), with the majority (85%) occurring de novo except for one patient who had a previous history of epilepsy-related SE due to withdrawal of antiepileptic medication. In terms of etiology, limbic encephalitis and cerebral venous sinus thrombosis were the two main etiologies of de novo SE associated with pregnancy. The overall mortality rate was 28.5% at discharge, and poor outcomes were especially noted in the patients with limbic encephalitis compared to other etiologies. CONCLUSIONS: Pregnancy-associated SE is rare and predominantly occurs in patients without a history of epilepsy. An autoimmune etiology should be considered in pregnant patients with de novo SE, which was associated with poor outcomes. Thorough investigations and prompt treatment according to the etiology may be required to improve the final outcomes of both mother and fetus.


Assuntos
Encefalite Límbica/diagnóstico , Complicações na Gravidez/diagnóstico , Estado Epiléptico/diagnóstico , Adulto , Anticonvulsivantes/uso terapêutico , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/terapia , Estudos de Coortes , Feminino , Hospitalização/tendências , Humanos , Recém-Nascido , Encefalite Límbica/epidemiologia , Encefalite Límbica/terapia , Masculino , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/terapia , Estudos Retrospectivos , Estado Epiléptico/epidemiologia , Estado Epiléptico/terapia , Adulto Jovem
18.
Biosens Bioelectron ; 51: 16-21, 2014 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-23920091

RESUMO

A perfusion three-dimensional (3D) cell culture microfluidic chip has been developed for real-time and non-invasive impedimetric monitoring of cell proliferation and chemosensitivity. In this study, human oral cancer cells (OEC-M1) were encapsulated in 3D agarose scaffold and cultured in a miniaturized chamber under perfusion of tested substance. This setting provides a more in vitro physiologically relevant microenvironment to better mimic the complex in vivo microenvironment. A pair of vertical electrodes was embedded at the opposite sidewalls of the culture chamber for the on-site impedance measurement. Cell density in the 3D construct was shown to be proportional to the impedance magnitude of the entire construct. Therefore, perfusion 3D cell culture was performed for up to 5 days and cell proliferation can be monitored by the impedimetric analysis. Moreover, real-time impedimetric monitoring of cell viability under the perfusion of anti-cancer drug in different concentrations was conducted and the impedance magnitude was directly correlated with the cell viability. From the confirmation of the endpoint cell viability assays, a concentration-dependent effect was shown; however, the response of cell viability during the drug treatment was able to be traced by the impedance measurement. The experimental results showed that cell proliferation and chemosensitivity in 3D cell culture format can be monitored by impedance measurement. This microfluidic chip has a high potential to develop a powerful analytical platform for cancer research.


Assuntos
Técnicas de Cultura de Células/instrumentação , Ensaios de Seleção de Medicamentos Antitumorais/instrumentação , Técnicas Analíticas Microfluídicas/instrumentação , Antineoplásicos/farmacologia , Técnicas Biossensoriais/instrumentação , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Impedância Elétrica , Desenho de Equipamento , Humanos , Neoplasias Bucais/tratamento farmacológico , Sefarose/química , Alicerces Teciduais/química
19.
Artigo em Inglês | MEDLINE | ID: mdl-24109654

RESUMO

In this work, a non-invasive measurement technique for the quantitative determination of cell viability in a three-dimensional (3D) cell culture construct is proposed. This technique is based on on-site electrical impedance measurement. A microfluidic chip with a 3D culture chamber is fabricated to demonstrate this technique. In vitro 3D cell culture has been interpreted for faithfully representation of the in vivo cellular responses in 3D cell culture construct is normally time-consuming and labor-intensive. In this study, the microfluidic chip consists of a culture chamber, in which a pair of vertical electrodes at its opposite sidewalls was embedded, and a fluidic channel for drug perfusion. Cancer cells encapsulated in agarose gel were loaded into the culture chamber to perform 3D cell culture under the perfusion of culture medium and anti-cancer drug in different concentrations (6, 12, 18, and 24 µg/ml) for 2 days. Since higher drug concentration led to more cell damage or death, the total impedance magnitude of the culture construct was shown to be reasonably proportional to the anti-cancer drug concentration. Moreover, cell proliferation can be also monitored using this technique. The proposed measurement method can determine cell viability without affecting the cellular behaviors during culture. It has a high potential to develop a fast and easy measurement compared with the conventional cellular analysis techniques.


Assuntos
Técnicas de Cultura de Células/métodos , Técnicas Analíticas Microfluídicas/métodos , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Impedância Elétrica , Humanos , Microtecnologia , Sefarose
20.
Artigo em Inglês | MEDLINE | ID: mdl-21804859

RESUMO

We have investigated the anticancer effects of the dietary isothiocyanate sulforaphane (SFN) on colorectal cancer (CRC), using primary cancer cells lines isolated from five Taiwanese colorectal cancer patients as the model for colorectal cancer. SFN-treated cells accumulated in metaphase (SFN 6.25 µM) and subG1 (SFN 12.5 and 25 µM) as determined by flow cytometry. In addition, treated cells showed nuclear apoptotic morphology that coincided with an activation of caspase-3, and loss of mitochondrial membrane potential (ΔΨm). Incubations at higher SFN doses (12.5 and 25 µM) resulted in cleavage of procaspase-3 and elevated caspase-2, -3, -8, and -9 activity, suggesting that the induction of apoptosis and the sulforaphane-induced mitosis delay at the lower dose are independently regulated. Daily SFN s.c. injections (400 micromol/kg/d for 3 weeks) in severe combined immunodeficient mice with primary human CRC (CP1 to CP5) s.c. tumors resulted in a decrease of mean tumor weight by 70% compared with vehicle-treated controls. Our findings suggest that, in addition to the known effects on cancer prevention, sulforaphane may have antitumor activity in established colorectal cancer.

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