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1.
Mater Today Bio ; 8: 100079, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33103105

RESUMO

Polyphenols can trigger immunity that activates intracellular anti-inflammatory signaling and prevents external infections. In this study, we report the fabrication of chitosan-based hydrogels with epigallocatechin gallate (EGCG) using enzyme-mediated one-pot synthesis. The tyrosinase-mediated oxidative reaction of the phenolic rings of EGCG with the primary amines on chitosan results in stable EGCG-chitosan hydrogels. The EGCG concentrations contributed to the cross-linking density and physical properties of EGCG-chitosan hydrogels. Furthermore, EGCG-chitosan hydrogels maintained intrinsic properties such as antibacterial and antioxidant effects. When endotoxin-activated RAW 264.7 macrophage cells were cultured with EGCG-chitosan hydrogels, the hydrogels reduced the inflammatory response of the RAW 264.7 cells. Furthermore, subcutaneous implantation of EGCG-chitosan hydrogels reduced endogenous macrophage and monocyte activation. When the EGCG-chitosan hydrogels were applied to a full-skin defect wound, they facilitated skin regeneration. Our study demonstrates that the one-pot synthesized EGCG-chitosan hydrogels can be applied in broad tissue regeneration applications that require immune modulation.

2.
J Prev Med Hyg ; 60(1): E36-E42, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31041409

RESUMO

INTRODUCTION: Since Vietnam has signed WHO framework on tobacco control (FCTC) in 2003 and has issued tobacco control law in 2013, there has been little research concerning about what impacts smoke-free regulations have had on public compliance. The objective of this study was to assess public exposure to secondhand smoke and reaction toward smoke-free policy regulations in Vietnam and the associated factor. METHODS: Using the design of GATS (Global Adult Tobacco Survey), a nationally representative sample of 8,996 adults were approached for data collection. Logistic regression was used to examine the associated factor. RESULTS: The study revealed that the prevalence of respondents exposed to secondhand smoke was much higher in bars/café/tea shops (90.07%) and restaurants (81.81%) than in any other public places, universities (36.70%), government buildings (31.12%), public transport (20.04%), healthcare facilities (17.85%) and schools (15.84%). 13.23% of respondents saw smokers violate smoke-free regulations. Among those who saw them violate smoke-free regulations, just one-third cautioned them to stop smoking. Strikingly, a higher rate of cautioning smokers to stop smoking was observed among the older, married, and better educated respondents. Respondents who were married, better educated and in lower economic status were more likely to remind smokers to stop smoking. CONCLUSIONS: The study has called for strengthening two of the six MPOWER (Monitor, Protect, Offer, Warn, Enforce and Raise) components of the tobacco free initiative introduced by WHO, Monitoring tobacco use and prevention policies and Protecting people from tobacco smoke.


Assuntos
Crime/estatística & dados numéricos , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Instalações de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Restaurantes , Instituições Acadêmicas , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Meios de Transporte , Universidades , Vietnã , Adulto Jovem
3.
World J Urol ; 37(2): 359-365, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29967948

RESUMO

PURPOSE: To compare between deep neuromuscular blockade (NMB) and moderate NMB with respect to endoscopic surgical conditions and recovery profiles in patients with general anesthesia for transurethral resection of bladder (TURB). METHODS: 108 patients undergoing elective TURB were randomized into two groups: the moderate NMB (n = 54) or deep NMB (n = 54) group. After the operation, NMB was reversed with 2 mg/kg sugammadex at a train-of-four (TOF) count of 1 or 2 (moderate NMB group) or with 4 mg/kg sugammadex at post-tetanic count (PTC) of 2 (deep NMB group). Surgeons, who were blinded to the study design, rated the endoscopic surgical condition on a 5-point scale (1 = extremely poor, 2 = poor, 3 = acceptable, 4 = good, 5 = optimal) immediately following the operation. Recovery profiles, including postoperative residual curarization (PORC), respiratory complication, and recovery time, were recorded. RESULTS: No difference was observed between the two groups regarding patients and anesthesia characteristics. There were statistically significant differences in endoscopic surgical conditions between the two groups (P < 0.001). Thirty-eight patients in the deep NMB group (74%) showed optimal surgical conditions, whereas 16 patients in the moderate NMB group (30%) showed optimal endoscopic surgical conditions. No PORC and respiratory complications occurred in both groups, and no difference was found between the two groups in terms of recovery profiles, including recovery time and other adverse events. CONCLUSIONS: Deep NMB and reversal with sugammadex improved the endoscopic surgical condition without complications compared with moderate NMB and reversal with sugammadex in patients undergoing TURB.


Assuntos
Cistectomia/métodos , Bloqueio Neuromuscular/métodos , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Anestesia Geral , Cistoscopia , Método Duplo-Cego , Procedimentos Cirúrgicos Eletivos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recuperação de Função Fisiológica
4.
J Infect Dis ; 218(1): 95-108, 2018 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-29767739

RESUMO

Background: A 9-valent human papillomavirus-6/11/16/18/31/33/45/52/58 (9vHPV) vaccine extends coverage to 5 next most common oncogenic types (31/33/45/52/58) in cervical cancer versus quadrivalent HPV (qHPV) vaccine. We describe efficacy, immunogenicity, and safety in Asian participants (India, Hong Kong, South Korea, Japan, Taiwan, and Thailand) from 2 international studies: a randomized, double-blinded, qHPV vaccine-controlled efficacy study (young women aged 16-26 years; NCT00543543; Study 001); and an immunogenicity study (girls and boys aged 9-15 years; NCT00943722; Study 002). Methods: Participants (N = 2519) were vaccinated at day 1 and months 2 and 6. Gynecological samples (Study 001 only) and serum were collected for HPV DNA and antibody assessments, respectively. Injection-site and systemic adverse events (AEs) were monitored. Data were analyzed by country and vaccination group. Results: 9vHPV vaccine prevented HPV-31/33/45/52/58-related persistent infection with 90.4%-100% efficacy across included countries. At month 7, ≥97.9% of participants seroconverted for each HPV type. Injection-site AEs occurred in 77.7%-83.1% and 81.9%-87.5% of qHPV and 9vHPV vaccine recipients in Study 001, respectively, and 62.4%-85.7% of girls/boys in Study 002; most were mild to moderate. Conclusions: The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Asian participants. Data support 9vHPV vaccination programs in Asia. Clinical Trials Registration: NCT00543543; NCT00943722.


Assuntos
Papillomaviridae/classificação , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/efeitos adversos , Vacinas contra Papillomavirus/imunologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Ásia/epidemiologia , Criança , Método Duplo-Cego , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Genitália Feminina/virologia , Humanos , Masculino , Papillomaviridae/genética , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Resultado do Tratamento , Adulto Jovem
5.
Oncogene ; 37(2): 255-262, 2018 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-28925396

RESUMO

Endometrial cancer is the most common malignancy of the female genital tract. Progesterone (P4) has been used for several decades in endometrial cancer treatment, especially in women who wish to retain fertility. However, it is unpredictable which patients will respond to P4 treatment and which may have a P4-resistant cancer. Therefore, identifying the mechanism of P4 resistance is essential to improve the therapies for endometrial cancer. Mitogen-inducible gene 6 (Mig-6) is a critical mediator of progesterone receptor (PGR) action in the uterus. In order to study the function of Mig-6 in P4 resistance, we generated a mouse model in which we specifically ablated Mig-6 in uterine epithelial cells using Sprr2f-cre mice (Sprr2fcre+Mig-6f/f). Female mutant mice develop endometrial hyperplasia due to aberrant phosphorylation of signal transducers and activators of transcription 3 (STAT3) and proliferation of the endometrial epithelial cells. The results from our immunoprecipitation and cell culture experiments showed that MIG-6 inhibited phosphorylation of STAT3 via protein interactions. Our previous study showed P4 resistance in mice with Mig-6 ablation in Pgr-positive cells (Pgrcre/+Mig-6f/f). However, Sprr2fcre+Mig-6f/f mice were P4-responsive. P4 treatment significantly decreased STAT3 phosphorylation and epithelial proliferation in the uterus of mutant mice. We showed that Mig-6 has an important function of tumor suppressor via inhibition of STAT3 phosphorylation in uterine epithelial cells, and the antitumor effects of P4 are mediated by the endometrial stroma. These data help to develop a new signaling pathway in the regulation of steroid hormones in the uterus, and to overcome P4 resistance in human reproductive diseases, such as endometrial cancer.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Neoplasias do Endométrio/patologia , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Progesterona/farmacologia , Receptores de Progesterona/genética , Fator de Transcrição STAT3/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Animais , Linhagem Celular Tumoral , Resistencia a Medicamentos Antineoplásicos , Neoplasias do Endométrio/tratamento farmacológico , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Camundongos , Camundongos Knockout , Fosforilação , Progesterona/uso terapêutico , Receptores de Progesterona/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteínas Supressoras de Tumor/genética , Útero/efeitos dos fármacos , Útero/patologia
6.
World J Surg ; 42(7): 2094-2101, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29288309

RESUMO

BACKGROUND: Acute postoperative pain and chronic discomfort are reported after robotic or endoscopic thyroidectomy. The purpose of this prospective, randomized, and double-blinded clinical trial was to investigate whether intraoperative infusion of nefopam decreases acute postoperative pain and chronic discomfort following either a robotic or endoscopic thyroidectomy via the bilateral axillo-breast approach (BABA). METHODS: Patients were randomized into two groups: The control group (n = 29) or the nefopam group (n = 29). Patients in each group were infused with the same volume of saline or nefopam (0.2 mg/kg bolus, 120 µg/kg/h continuous infusion) during surgery. Acute postoperative pain, the need for rescue analgesics, and other postoperative adverse effects were assessed at 1, 6, 24, and 48 h postoperatively. Chronic pain and discomfort was recorded at 3 months after surgery. RESULTS: Patients in the nefopam group reported lower pain scores in the neck, as well as the axilla and anterior chest areas at 1, 6, 24, and 48 h postoperatively, when compared with the control group (P < 0.05 at each time points). Rescue analgesics were required less in the nefopam group than in the control group (1.4 [1] vs. 2.3 [1.5]; P = 0.001). The degree of chronic pain and discomfort were relatively lower in the nefopam group (P < 0.05). CONCLUSION: We report that intravenous nefopam infusion during surgery decreased acute postoperative pain and the need for rescue analgesics, as well as chronic discomfort, following BABA robotic or endoscopic thyroidectomy without adverse events.


Assuntos
Analgésicos não Narcóticos/uso terapêutico , Endoscopia/métodos , Nefopam/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Tireoidectomia/efeitos adversos , Adulto , Método Duplo-Cego , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
7.
Oncogene ; 36(33): 4732-4738, 2017 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-28394346

RESUMO

Microphthalmia transcription factor (MITF) is a basic helix-loop-helix leucine zipper (bHLH-Zip) DNA-binding protein. This transcription factor plays a crucial role in the physiological and pathological functions of distinct cell types. MITF transcriptional activity is inhibited by the histidine triad nucleotide-binding protein 1 (HINT1) through direct binding. We previously reported that this association is disrupted by the binding of the second messenger Ap4A to HINT1. Ap4A is mainly produced in the mammalian cells by S207-phosphorylated Lysyl-tRNA synthetase. In this study, we found first that HINT1 was subjected to K21 acetylation and Y109 phosphorylation in activated mast cells, together with the Ap4A-triggered HINT1 dissociation from MITF. Mutational analysis confirmed that these modifications promote MITF transcriptional and oncogenic activity in melanoma cell lines, derived from human melanoma patients. Thus, we provided here an example that manipulation of the LysRS-Ap4A-HINT1-MITF signalling pathway in melanoma through post-translational modifications of HINT1 can affect the activity of the melanoma oncogene MITF.


Assuntos
Proteínas de Transporte/metabolismo , Proteínas de Ligação a DNA/metabolismo , Melanoma/metabolismo , Fator de Transcrição Associado à Microftalmia/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Processamento de Proteína Pós-Traducional , Neoplasias Cutâneas/metabolismo , Ativação Transcricional , Acetilação , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Linhagem Celular Tumoral , Quinase 2 Dependente de Ciclina/genética , Quinase 2 Dependente de Ciclina/metabolismo , Análise Mutacional de DNA , Humanos , Mastócitos/metabolismo , Melanoma/genética , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Fator de Transcrição Associado à Microftalmia/genética , Proteínas do Tecido Nervoso/genética , Fosforilação , Ligação Proteica , Transdução de Sinais , Neoplasias Cutâneas/genética
8.
Vet Comp Oncol ; 15(4): 1585-1589, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28185388

RESUMO

OBJECTIVE: Early and proper diagnosis of cancer is the most critical factor for the survival and treatment of veterinary cancer patients. In this study, we evaluated extracellular cyclic AMP-dependent protein kinase A (ECPKA) level in serum as a useful cancer biomarker in dogs. METHODS: ECPKA levels were detected in sera from dogs with cancers (n = 48), benign tumours (n = 18), and non-tumour diseases (n = 102) as well as healthy control dogs (n = 54) utilizing enzyme-linked immunosorbent assay (ELISA). RESULTS: Sera from dogs bearing various types of cancer exhibited markedly increased levels of ECPKA by up to 7.1-, 8.8-, and 10.9-fold compared with those from dogs harbouring benign tumours, dogs with non-tumour diseases, and healthy control dogs, respectively (P < .0001). In addition, serum ECPKA level did not show statistically significant correlation with gender, breed, or age of dogs or their non-cancerous disease conditions. CONCLUSION: Our data strongly propose that detection of serum ECPKA level is a potential and specific diagnostic tool for cancer in dogs.


Assuntos
Proteínas Quinases Dependentes de AMP Cíclico/sangue , Doenças do Cão/sangue , Neoplasias/veterinária , Animais , Biomarcadores Tumorais/sangue , Estudos de Casos e Controles , Doenças do Cão/diagnóstico , Cães , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Masculino , Neoplasias/sangue , Neoplasias/diagnóstico
9.
Acta Anaesthesiol Scand ; 61(4): 427-435, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28164268

RESUMO

BACKGROUND: In contrast to interscalene block, there was little information regarding the analgesic efficacy of supraclavicular block for shoulder surgery. This study aimed to compare the analgesic efficacy and side effects of interscalene and supraclavicular blocks for shoulder surgery. METHODS: Patients scheduled for shoulder surgery were assigned to receive either ultrasound-guided interscalene (n = 25) or supraclavicular block (n = 24) with 20 ml of 0.375% ropivacaine. We assessed the duration of post-operative analgesia as a primary outcome and pain scores, supplemental analgesia, diaphragmatic excursion, motor block, fingertip numbness, side effects, and patient satisfaction as secondary outcomes. RESULTS: The duration of post-operative analgesia was not statistically different between groups: 868 (800-1440) min for supraclavicular block vs. 800 (731-922) min for interscalene block (median difference -85 min, 95% CI, -283 to 3 min, P = 0.095). The incidence of diaphragmatic paresis was significantly lower in the supraclavicular block group compared with that in the interscalene block group, both at 30 min after the block (66.7% vs. 92%, P = 0.021) and in the post-anaesthesia care unit (62.5% vs. 92%, P = 0.024). Motor block was higher in the supraclavicular block group in the post-anaesthesia care unit, however, not at 24 h. Other secondary outcomes were similar for both groups. CONCLUSIONS: This study showed no statistically significant difference in the duration of post-operative analgesia between the supraclavicular and interscalene blocks. However, the supraclavicular block was associated with a lower incidence of diaphragmatic paresis compared with that of the interscalene block after shoulder surgery.


Assuntos
Bloqueio Nervoso/métodos , Dor Pós-Operatória/tratamento farmacológico , Ombro/diagnóstico por imagem , Ombro/cirurgia , Adulto , Idoso , Amidas , Anestésicos Locais , Plexo Braquial/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso/efeitos adversos , Medição da Dor/efeitos dos fármacos , Satisfação do Paciente , Paralisia Respiratória/induzido quimicamente , Paralisia Respiratória/epidemiologia , Ropivacaina , Resultado do Tratamento , Ultrassonografia de Intervenção
10.
Ann Oncol ; 28(4): 702-710, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28119296

RESUMO

This manuscript reports the consensus statements regarding the design and conduct of clinical trials in patients with newly diagnosed and recurrent epithelial ovarian cancer (EOC), following deliberation at the Fifth Ovarian Cancer Consensus Conference (OCCC), held in Tokyo in November 2015. Three important questions were identified for discussion prior to the meeting and achieved consensus during the meeting: (i) What are the most important factors to be evaluated prior to initial therapy? (ii) What are the most important factors to be evaluated specifically in recurrent disease? (iii) Are there specific considerations for special patient subpopulations? In addition, we report a list of important unmet needs compiled during the consensus process, which is intended to guide future research initiatives.


Assuntos
Neoplasias Epiteliais e Glandulares/terapia , Neoplasias Ovarianas/terapia , Medicina de Precisão/métodos , Carcinoma Epitelial do Ovário , Feminino , Humanos
11.
Anaesthesia ; 71(9): 1030-6, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27396474

RESUMO

In clinical practice, both a thin-walled introducer needle and catheter-over-needle technique can be used to allow insertion of a guidewire during central venous catheterisation using the Seldinger technique. We compared the incidence of catheterisation-related complications (arterial puncture, haemothorax, pneumothorax, haematoma and catheter tip malposition) and insertion success rate for these two techniques in patients requiring right-sided subclavian central venous catheterisation. A total of 414 patients requiring infraclavicular subclavian venous catheterisation were randomly allocated to either a thin-walled introducer needle (needle group, n = 208) or catheter-over-needle technique (catheter group, n = 206). The catheterisation-related complication rate was lower in the needle group compared with the catheter group (5.8% vs. 15.5%; p = 0.001). Overall insertion success rates were similar (97.1% and 92.7% in the needle and catheter groups respectively; p = 0.046), although the first-pass success rate was higher in the needle group (62.0% vs. 35.4%; p < 0.001). We recommend the use of a thin-walled introducer needle technique for right-sided infraclavicular subclavian venous catheterisation.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Hemorragia/epidemiologia , Erros Médicos/estatística & dados numéricos , Pneumotórax/epidemiologia , Veia Subclávia , Cateterismo Venoso Central/instrumentação , Catéteres , Feminino , Hematoma/epidemiologia , Hemotórax/epidemiologia , Humanos , Incidência , Pessoa de Meia-Idade , Agulhas , Estudos Prospectivos , Método Simples-Cego
12.
Surg Endosc ; 30(11): 4976-4984, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26969660

RESUMO

BACKGROUND: The degree of neuromuscular blockade is one of the important factors that determine the condition of surgical space during laparoscopic surgery. Magnesium sulfate potentiates the actions of neuromuscular blocking agent, and we hypothesized that intraoperative magnesium sulfate infusion may improve surgical space condition during laparoscopic surgery. METHODS: Eighty-four patients undergoing elective laparoscopic gastrectomy were randomized to receive isotonic saline (group C) or magnesium sulfate (group M, loading dose with 50 mg/kg over 10 min and then 15 mg/kg/h by continuous infusion) to maintain the moderate neuromuscular blockade using rocuronium. Two experienced surgeons scored the quality of surgical space condition using a 5-point surgical rating scale (SRS). The secondary outcomes included recovery profiles, postoperative pain and adverse events. RESULTS: The SRS in group M was higher than that of group C. The proportion of patients with a SRS of 5 (optimal) was 2.7 % in the group C and 40.5 % in the group M (P < 0.0001) although a lower amount of rocuronium was required in group M than group C [24.2 (6.5) mg/h for group M vs. 27.5 (6) mg/h for group C; P = 0.017]. Pain after operation site was less severe in group M than in group C at postoperative 24 h (P = 0.009). Recovery profiles and adverse events were similar between the two groups. CONCLUSION: Intraoperative administration of magnesium sulfate improved the quality of surgical space conditions and decreased neuromuscular blocking agent requirement and postoperative pain in patients undergoing laparoscopic gastrectomy.


Assuntos
Gastrectomia , Laparoscopia , Sulfato de Magnésio/administração & dosagem , Bloqueadores Neuromusculares/administração & dosagem , Androstanóis/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Bloqueio Neuromuscular , Fármacos Neuromusculares não Despolarizantes/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Pneumoperitônio Artificial , Estudos Prospectivos , Rocurônio
13.
Surg Endosc ; 30(10): 4598-606, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26895920

RESUMO

BACKGROUND: Respiratory functions are usually impaired during pneumoperitoneum for laparoscopic surgery. This randomized, controlled and single-blinded study was performed to evaluate whether intraoperative protective lung ventilation influences postoperative pulmonary complications after laparoscopic hepatobiliary surgery. METHODS: Sixty-two patients were randomized to receive either conventional ventilation with alveolar recruitment maneuver (tidal volume of 10 ml/kg with inspiratory pressure of 40 cmH2O for 30 s after the end of pneumoperitoneum, group R), or protective lung ventilation (low tidal volume of 6 ml/kg with positive end-expiratory pressure [PEEP] of 5 cmH2O, group P). Induction and maintenance of anesthesia were done with balanced anesthesia. Respiratory complications such as atelectasis, pneumonia or desaturation were observed postoperatively. The length of hospital stay, arterial blood gas analysis, peak inspiratory pressure and hemodynamic variables were also recorded. Results are presented as mean ± SD or number of patients (%). RESULTS: Postoperative pulmonary complications (P = 0.023) and desaturation below 90 % (P = 0.016) occurred less frequently in group P than in group R. Eight patients of group R and 3 patients of group P showed atelectasis. Pneumonia was diagnosed in 1 patient of group R. No differences were observed in the length of hospital stay, arterial blood gas analysis (pH, PaO2, PaCO2 and PAO2) and hemodynamic variables except PAO2, AaDO2 and peak inspiratory pressure between the two groups. CONCLUSION: Protective lung ventilation (low tidal volume with PEEP) during pneumoperitoneum was associated with less incidences of pulmonary complications than conventional ventilation with alveolar recruitment maneuver after laparoscopic hepatobiliary surgery.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Hipóxia/epidemiologia , Laparoscopia/métodos , Pneumonia/epidemiologia , Pneumoperitônio Artificial/métodos , Complicações Pós-Operatórias/epidemiologia , Atelectasia Pulmonar/epidemiologia , Respiração Artificial/métodos , Adulto , Idoso , Gasometria , Feminino , Hemodinâmica , Humanos , Incidência , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Respiração com Pressão Positiva/métodos , Estudos Prospectivos , Volume de Ventilação Pulmonar
14.
Clin Pharmacol Ther ; 98(1): 96-106, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25786663

RESUMO

We retrospectively investigated whether palonosetron administered during the induction of general anesthesia is associated with an increased risk of perioperative cardiovascular complications in a single tertiary center cohort consisting of 4,517 palonosetron-exposed patients and 4,517 propensity score-matched patients without palonosetron exposure. The primary endpoint was a composite of perioperative cardiovascular complications, including intraoperative cardiac arrhythmia, intraoperative cardiac death, and myocardial injury within the first postoperative week, and there was no significant difference between the groups (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 0.92-1.19). As secondary endpoints, intraoperative cardioversion, cardiac compression, use of cardiovascular drugs, postoperative hospital stay, and in-hospital mortality showed no differences between the groups. However, the palonosetron group showed decreased intraoperative hypotension (OR = 0.88; 95% CI = 0.79-0.97) and length of postoperative intensive care unit (ICU) stay (4.26 ± 9.86 vs. 6.14 ± 16.75; P = 0.026). Palonosetron did not increase the rate of perioperative cardiovascular complications, and can therefore be used safely during anesthetic induction.


Assuntos
Anestesia Geral , Antieméticos/efeitos adversos , Sistema Cardiovascular/efeitos dos fármacos , Isoquinolinas/efeitos adversos , Quinuclidinas/efeitos adversos , Antagonistas do Receptor 5-HT3 de Serotonina/efeitos adversos , Adulto , Idoso , Arritmias Cardíacas/induzido quimicamente , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/induzido quimicamente , Palonossetrom , Período Perioperatório , Estudos Retrospectivos
16.
Br J Cancer ; 110(2): 278-85, 2014 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-24357798

RESUMO

BACKGROUND: In this study, we sought to identify a criterion for the intermediate-risk grouping of patients with cervical cancer who exhibit any intermediate-risk factor after radical hysterectomy. METHODS: In total, 2158 patients with pathologically proven stage IB-IIA cervical cancer with any intermediate-risk factor after radical hysterectomy were randomly assigned to two groups, a development group and a validation group, at a ratio of 3 : 1 (1620 patients:538 patients). To predict recurrence, multivariate models were developed using the development group. The ability of the models to discriminate between groups was validated using the log-rank test and receiver operating characteristic (ROC) analysis. RESULTS: Four factors (histology, tumour size, deep stromal invasion (DSI), and lymphovascular space involvement (LVSI)) were significantly associated with disease recurrence and included in the models. Among the nine possible combinations of the four variables, models consisting of any two of the four intermediate-risk factors (tumour size ≥3 cm, DSI of the outer third of the cervix, LVSI, and adenocarcinoma or adenosquamous carcinoma histology) demonstrated the best performance for predicting recurrence. CONCLUSION: This study identified a 'four-factor model' in which the presence of any two factors may be useful for predicting recurrence in patients with cervical cancer treated with radical hysterectomy.


Assuntos
Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Histerectomia/efeitos adversos , Histerectomia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , República da Coreia , Risco , Adulto Jovem
17.
J Anim Sci ; 92(1): 106-18, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24166994

RESUMO

Undifferentiated germ cells have the capacity to develop into sperm capable of fertilizing oocytes and contributing genetic material to subsequent generations. The most primitive prepubertal undifferentiated germ cells include gonocytes and undifferentiated spermatogonia, including spermatogonial stem cells (SSC). Gonocytes, present in the testis at birth, differentiate into SSC, which maintain spermatogenesis for the remainder of the male's life. Because of their capacity to contribute to lifelong spermatogenesis, undifferentiated germ cells are attractive targets for genetic modification to produce transgenic animals, including cattle. To maximize the efficiency of genetic modification of bovine gonocytes and SSC, effective enrichment techniques need to be developed. Selection of bovine gonocytes using differential plating was improved 8-fold (P < 0.001) when using a combination of extracellular matrix proteins, including laminin, fibronectin, collagen type IV, and gelatin, compared to using laminin and gelatin alone. Selected cells labeled with PKH26 formed colonies of donor-derived germ cells after transplantation into recipient mouse testes, indicating putative stem cell function. Significantly more colonies (P < 0.001) per 1 × 10(5) viable transplanted cells were formed from isolated nonadherent cells (203 ± 23.2) compared to adherent (20 ± 2.7) or Percoll (45.5 ± 4.5) selected cells. After selection, some gonocytes were transduced using a lentiviral vector containing the transgene for the enhanced green fluorescent protein. Transduction efficiency was 17%. Collectively, these data demonstrate effective methods for the selection and genetic modification of bovine undifferentiated germ cells.


Assuntos
Bovinos , Separação Celular/métodos , Lentivirus , Espermatogônias/metabolismo , Células-Tronco/metabolismo , Transdução Genética/métodos , Animais , Animais Geneticamente Modificados , Vetores Genéticos , Proteínas de Fluorescência Verde/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Espermatogônias/citologia , Células-Tronco/citologia , Transdução Genética/veterinária
18.
Oncogenesis ; 2: e64, 2013 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-23958854

RESUMO

Dishevelled (Dvl) is a key regulator of Wnt signaling both in the canonical and non-canonical pathways. Here we report the identification of a regulatory domain of ubiquitination (RDU) in the C-terminus of Dvl. Mutations in the RDU resulted in accumulation of polyubiquitinated forms of Dvl, which were mainly K63 linked. Small interfering RNA-based screening identified Usp14 as a mediator of Dvl deubiquitination. Genetic and chemical suppression of Usp14 activity caused an increase in Dvl polyubiquitination and significantly impaired downstream Wnt signaling. These data suggest that Usp14 functions as a positive regulator of the Wnt signaling pathway. Consistently, tissue microarray analysis of colon cancer revealed a strong correlation between the levels of Usp14 and ß-catenin, which suggests an oncogenic role for Usp14 via enhancement of Wnt/ß-catenin signaling.

19.
Endoscopy ; 45(8): 655-60, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23881806

RESUMO

BACKGROUND AND STUDY AIMS: Endoscopic surgical technology has been developing rapidly. Although several successful endoscopic closure devices have already been introduced, only a few of them have demonstrated improvements in closure strength and reproducibility over conventional endoscopic clip closures or hand sutures. The objective of this study was to test the feasibility of a novel successive suturing device (SSD) by measuring closure strength and reproducibility. MATERIAL AND METHODS: Porcine stomach models were used in this study. Endoclips, full-thickness hand sutures, and the novel SSD sutures were used to close a perforation in the stomach wall, with 10 stomachs being tested for each closure method. Endoclips and SSD sutures were performed using a two-channel endoscope, and the hand sutures were performed from outside of the stomach wall. Air leakage pressure was measured to determine the closure strength and reproducibility of each method. RESULTS: The mean air leakage pressure of the SSD closure was 62.7 ± 8.2 mmHg. SSD-treated stomachs exhibited significantly greater air leakage pressure than Endoclip-treated stomachs. The standard deviation of bursting pressure in SSD stomachs was found to be significantly smaller than that of hand-sewn stomachs but was not different from that of Endoclip stomachs. CONCLUSIONS: The consistent closure strength of SSD stomachs demonstrated the reliability and reproducibility of this new closure method. These promising results in closure strength and reproducibility suggest the feasibility of the proposed device for clinical applications.


Assuntos
Estômago/cirurgia , Técnicas de Sutura/instrumentação , Animais , Gastroscopia/instrumentação , Gastrostomia , Pressão , Reprodutibilidade dos Testes , Suínos
20.
J Anim Sci ; 91(7): 3143-54, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23572256

RESUMO

The objective of this study was to use fluorescence-activated cell sorting (FACS) and spermatogonial stem cell (SSC) xenotransplantation to identify cell surface markers of putative porcine SSC. Analysis of porcine testis cells enriched for spermatogonia using FACS indicated that nearly half of stage-specific embryonic antigen-1 (SSEA-1) expressing testis cells expressed the undifferentiated spermatogonia marker protein gene product 9.5 (PGP 9.5) whereas significantly fewer (P < 0.05) cells selected for thymus cell antigen-1 (Thy-1), also known as cluster of differentiation 90 (CD90), cluster of differentiation 9 (CD9), or other SSC markers expressed PGP 9.5. Immunocytochemical analysis indicated that promyelocytic leukemia zinc finger (PLZF) protein and germ cell lineage marker VASA homolog (VASA), also known as DEAD box protein 4 (DDX4), were expressed by SSEA-1 expressing germ cells. Spermatogonial stem cell xenotransplantation of testis cell populations enriched for cells expressing SSEA-1 generated significantly (P < 0.05; greater than 15-fold) more colonies of donor derived germ cells than unselected testis cells. In conclusion, these data indicate that SSC markers identified in rodents are likely not entirely conserved in pigs and that SSEA-1 is a marker for porcine undifferentiated spermatogonia including SSC in prepubertal boars and its expression may serve as a target for the further study of porcine germ cells.


Assuntos
Células-Tronco Adultas/metabolismo , Regulação da Expressão Gênica , Antígenos CD15/genética , Sus scrofa/genética , Testículo/metabolismo , Células-Tronco Adultas/citologia , Animais , Biomarcadores , Citometria de Fluxo , Antígenos CD15/metabolismo , Masculino , Camundongos Endogâmicos BALB C , Camundongos Nus , Sus scrofa/crescimento & desenvolvimento , Sus scrofa/metabolismo , Testículo/citologia , Testículo/crescimento & desenvolvimento , Transplante Heterólogo
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