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1.
Cancers (Basel) ; 16(2)2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38254901

RESUMO

The aim of this study was to compare diagnostic performance for extra-prostatic extension (EPE) and image quality among three image datasets: conventional T2-weighted images (T2WIconv, slice thickness, 3 mm) and high-resolution thin-slice T2WI (T2WIHR, 2 mm), with and without deep learning reconstruction (DLR) in patients with prostatic cancer (PCa). A total of 88 consecutive patients (28 EPE-positive and 60 negative) diagnosed with PCa via radical prostatectomy who had undergone 3T-MRI were included. Two independent reviewers performed a crossover review in three sessions, in which each reviewer recorded five-point confidence scores for the presence of EPE and image quality using a five-point Likert scale. Pathologic topographic maps served as the reference standard. For both reviewers, T2WIconv showed better diagnostic performance than T2WIHR with and without DLR (AUCs, in order, for reviewer 1, 0.883, 0.806, and 0.772, p = 0.0006; for reviewer 2, 0.803, 0.762, and 0.745, p = 0.022). The image quality was also the best in T2WIconv, followed by T2WIHR with DLR and T2WIHR without DLR for both reviewers (median, in order, 3, 4, and 5, p < 0.0001). In conclusion, T2WIconv was optimal in regard to image quality and diagnostic performance for the evaluation of EPE in patients with PCa.

2.
Arch Pharm Res ; 46(7): 573-597, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37541992

RESUMO

As the ubiquitin-proteasome system (UPS) regulates almost every biological process, the dysregulation or aberrant expression of the UPS components causes many pathological disorders, including cancers. To find a novel target for anticancer therapy, the UPS has been an active area of research since the FDA's first approval of a proteasome inhibitor bortezomib in 2003 for treating multiple myeloma (MM). Here, we summarize newly described UPS components, including E3 ubiquitin ligases, deubiquitinases (DUBs), and immunoproteasome, whose malfunction leads to tumorigenesis and whose inhibitors have been investigated in clinical trials as anticancer therapy since 2020. We explain the mechanism and effects of several inhibitors in depth to better comprehend the advantages of targeting UPS components for cancer treatment. In addition, we describe attempts to overcome resistance and limited efficacy of some launched proteasome inhibitors, as well as an emerging PROTAC-based tool targeting UPS components for anticancer therapy.


Assuntos
Mieloma Múltiplo , Neoplasias , Humanos , Complexo de Endopeptidases do Proteassoma/metabolismo , Ubiquitina/metabolismo , Ubiquitina/uso terapêutico , Inibidores de Proteassoma/farmacologia , Inibidores de Proteassoma/uso terapêutico , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Bortezomib/farmacologia , Bortezomib/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico
3.
J Vet Diagn Invest ; 35(2): 209-211, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36645142

RESUMO

Splenic epithelial cysts are rare in humans and have not been reported in animals, to our knowledge. During a routine medical examination of a 12-y-old castrated male Maltese dog, a splenic mass was found and subsequently removed via splenectomy. Histologically, a well-defined multilocular cyst in the spleen was lined mostly by simple cuboidal, multifocally by stratified cuboidal, or occasionally by stratified squamous epithelium. Immunohistochemically, the lining cells were positive for cytokeratin and negative for vimentin, CD31, and Wilms tumor protein 1. The case was diagnosed as a primary splenic epidermoid cyst.


Assuntos
Doenças do Cão , Cisto Epidérmico , Esplenopatias , Animais , Cães , Masculino , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/cirurgia , Cisto Epidérmico/veterinária , Epitélio/patologia , Esplenectomia/veterinária , Esplenopatias/diagnóstico , Esplenopatias/cirurgia , Esplenopatias/veterinária
4.
J Prosthet Dent ; 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36372587

RESUMO

STATEMENT OF PROBLEM: Computer-guided implant surgery facilitated by intraoral scanning may enhance the efficiency of the digital workflow. However, it is necessary to assess technique accuracy to evaluate the accuracy of implant placement. PURPOSE: The purpose of this clinical study was to evaluate the accuracy of a virtual computer-aided design and computer-aided manufacturing (CAD-CAM) static guided surgery technique associated with intraoral scanning in partially edentulous participants by analyzing the overlap among preoperative and postoperative cone beam computed tomography (CBCT) scans, virtual planning, and the guided surgery performed. MATERIAL AND METHODS: Eleven partially edentulous participants underwent CBCT and intraoral scanning (TRIOS3). Data were integrated into a software program (ImplantViewer 3.5) for the virtual planning of implants and 3-dimensional (3D) printing of the prototype CAD-CAM surgical guide. A total of 18 implants were placed using the CAD-CAM static computer-aided implant surgery technique (Strong SW). After 15 days, postoperative CBCT scans were made and 4 variables (angular, coronal, apical, and vertical deviation) were measured to compare the virtually planned implants and the implants placed by analyzing the overlap between preoperative and postoperative of the virtual planning and guided surgery performed using the ImplantViewer 3.5 and Rhino 6 software programs. RESULTS: Deviations were found in all parameters analyzed. The mean angular deviation was 2.68 ±1.62 degrees; mean coronal deviation, 0.82 ±0.44 mm; mean apical deviation, 1.14 ±0.44 mm; and mean vertical deviation, 0.62 ±0.44 mm. CONCLUSIONS: The implants placed using the CAD-CAM static guided surgery technique associated with intraoral scanning in partially edentulous participants exhibited angular and linear deviations when compared with virtual planning implants. However, these deviations were not clinically significant.

5.
J Korean Soc Radiol ; 83(4): 898-903, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36238916

RESUMO

The incidence of ductal carcinoma in situ has increased with the rise in screening mammography; currently, ductal carcinoma in situ constitutes 20%-25% of all breast cancers, and up to half of them may become invasive. Its early detection is critical in improving the cure rate. Moreover, MRI has higher sensitivity for its detection than mammography. Herein, we report an unusual case of ductal carcinoma in situ presenting as a continuous, serpentine, linear enhancement with regional distribution on MRI.

6.
J Korean Soc Radiol ; 83(5): 1059-1070, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36276208

RESUMO

Purpose: To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods: Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm2), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results: The study population's Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240-0.603) and 0.495 (95% CI, 0.308-0.683), respectively. Conclusion: cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.

7.
Sci Rep ; 10(1): 19908, 2020 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-33199824

RESUMO

O-linked ß-N-acetylglucosamine (O-GlcNAc) is a post-translational modification which occurs on the hydroxyl group of serine or threonine residues of nucleocytoplasmic proteins. It has been reported that the presence of this single sugar motif regulates various biological events by altering the fate of target proteins, such as their function, localization, and degradation. This study identified SMAD4 as a novel O-GlcNAc-modified protein. SMAD4 is a component of the SMAD transcriptional complex, a major regulator of the signaling pathway for the transforming growth factor-ß (TGF-ß). TGF-ß is a powerful promoter of cancer EMT and metastasis. This study showed that the amount of SMAD4 proteins changes according to cellular O-GlcNAc levels in human lung cancer cells. This observation was made based on the prolonged half-life of SMAD4 proteins. The mechanism behind this interaction was that O-GlcNAc impeded interactions between SMAD4 and GSK-3ß which promote proteasomal degradation of SMAD4. In addition, O-GlcNAc modification on SMAD4 Thr63 was responsible for stabilization. As a result, defects in O-GlcNAcylation on SMAD4 Thr63 attenuated the reporter activity of luciferase, the TGF-ß-responsive SMAD binding element (SBE). This study's findings imply that cellular O-GlcNAc may regulate the TGF-ß/SMAD signaling pathway by stabilizing SMAD4.


Assuntos
Acetilglucosamina/química , Neoplasias da Mama/patologia , Glicogênio Sintase Quinase 3 beta/metabolismo , Neoplasias Pulmonares/patologia , Processamento de Proteína Pós-Traducional , Proteólise , Proteína Smad4/química , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Feminino , Glicogênio Sintase Quinase 3 beta/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Serina , Transdução de Sinais , Proteína Smad4/genética , Proteína Smad4/metabolismo , Treonina , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismo , Células Tumorais Cultivadas , Ubiquitina/metabolismo
8.
Proc Natl Acad Sci U S A ; 117(25): 14259-14269, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32513743

RESUMO

The Hippo pathway controls organ size and tissue homeostasis by regulating cell proliferation and apoptosis. The LATS-mediated negative feedback loop prevents excessive activation of the effectors YAP/TAZ, maintaining homeostasis of the Hippo pathway. YAP and TAZ are hyperactivated in various cancer cells which lead to tumor growth. Aberrantly increased O-GlcNAcylation has recently emerged as a cause of hyperactivation of YAP in cancer cells. However, the mechanism, which induces hyperactivation of TAZ and blocks LATS-mediated negative feedback, remains to be elucidated in cancer cells. This study found that in breast cancer cells, abnormally increased O-GlcNAcylation hyperactivates YAP/TAZ and inhibits LATS2, a direct negative regulator of YAP/TAZ. LATS2 is one of the newly identified O-GlcNAcylated components in the MST-LATS kinase cascade. Here, we found that O-GlcNAcylation at LATS2 Thr436 interrupted its interaction with the MOB1 adaptor protein, which connects MST to LATS2, leading to activation of YAP/TAZ by suppressing LATS2 kinase activity. LATS2 is a core component in the LATS-mediated negative feedback loop. Thus, this study suggests that LATS2 O-GlcNAcylation is deeply involved in tumor growth by playing a critical role in dysregulation of the Hippo pathway in cancer cells.


Assuntos
Proteínas Serina-Treonina Quinases/metabolismo , Transdução de Sinais , Proteínas Supressoras de Tumor/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Apoptose , Proliferação de Células , Células HEK293 , Via de Sinalização Hippo , Homeostase , Humanos , Fosforilação
9.
Cerebrovasc Dis ; 49(3): 262-268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32526736

RESUMO

BACKGROUND: Genetic variants may play a role in determining the location of cerebral atherosclerosis. We aimed to investigate the association between RNF213, MMP2, and genetic polymorphisms linked to vascular tortuosity with the location of cerebral arterial atherosclerosis. METHODS: A prospective case-control study was conducted on patients with ischemic stroke and age- and sex-matched stroke-free controls. The stroke patients were categorized into those with intracranial artery atherosclerosis (ICAS), extracranial artery atherosclerosis (ECAS), and small vessel occlusion (SVO). Six single nucleotide polymorphisms (SNPs) including rs2118181 (FBN1), rs2179357 (SLC2A10), rs1036095 (TGFBR2), rs243865 (MMP2), rs1800470 (TGFB1), and rs112735431 (RNF213) were analyzed with the TaqMan Genotyping Assay, and the distribution of genotypes across groups was compared. RESULTS: None of the 6 SNPs were associated with stroke on comparing the 449 stroke patients (71 with ECAS, 169 with ICAS, and 209 with SVO) to the 447 controls. In the subgroup analysis, the adjusted odds ratios (aORs) for age and sex indicated a significant association between rs112735431 and ICAS in the allele comparison analysis and in the additive and dominant model analyses. rs112735431 was associated with anterior circulation involvement and increased burden of cerebral atherosclerosis. rs2179357 was significantly associated with ICAS in the recessive model analysis, and rs1800470 was significantly associated with ECAS in the recessive model analysis when compared to controls. CONCLUSION: rs112735431 was associated with ICAS and increased atherosclerosis burden in Korean stroke patients. Further studies are needed to elucidate the role of rs112735431 and to confirm the association of rs2179357 and rs1800470 with cerebral atherosclerosis.


Assuntos
Adenosina Trifosfatases/genética , Doenças de Pequenos Vasos Cerebrais/genética , Arteriosclerose Intracraniana/genética , Polimorfismo de Nucleotídeo Único , Acidente Vascular Cerebral/genética , Ubiquitina-Proteína Ligases/genética , Idoso , Estudos de Casos e Controles , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Feminino , Fibrilina-1/genética , Predisposição Genética para Doença , Proteínas Facilitadoras de Transporte de Glucose/genética , Humanos , Arteriosclerose Intracraniana/diagnóstico por imagem , Masculino , Metaloproteinase 2 da Matriz/genética , Pessoa de Meia-Idade , Fenótipo , Receptor do Fator de Crescimento Transformador beta Tipo II/genética , Medição de Risco , Fatores de Risco , Seul , Acidente Vascular Cerebral/diagnóstico por imagem , Fator de Crescimento Transformador beta1/genética
10.
Odontology ; 108(4): 560-568, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32076883

RESUMO

Previous studies have shown that topical application of lectin Artin-M accelerates wound healing in the rat oral mucosa. The aim of this study was to evaluate, by means of histology and immunohistochemistry (IHC) the effects of Artin-M on wound healing in the palatal mucosa in dogs. Three full thickness wounds of 6 mm diameter were surgically created in the palatal mucosa of twenty dogs and randomly divided into three groups according to one of the treatment assigned: Group C-Control (coagulum); Group A-Artin-M gel; Group V-Vehicle (carboxymethylcellulose 3%). Each animal received all the three experimental treatments. Afterwards, four animals were killed at 2, 4, 7, 14 and 21 days post-surgery. Wounded areas were photographed and scored for macroscopic evaluation. Biopsies were harvested and used for descriptive histological analysis, proliferating cell nuclear antigen IHC and measurement of myeloperoxidase activity. The results demonstrated faster wound closure in group A in comparison to the other groups in all the periods evaluated. Histological analyses exhibited improved re-epithelialization and collagen fiber formation resulting in faster maturation of granulation tissue in group A compared to the other groups by day 14. Treatment with Artin-M gel significantly induced cell proliferation and increased volumetric density of fibroblasts at day 2 and 4 (p < 0.05). Neutrophil infiltration in group A was significantly higher than the other groups (p < 0.05) at the same time points. Collectively, our findings demonstrated that Artin-M may potentially favor wound healing on palatal mucosa lesions via recruitment of neutrophils and promotion of cell proliferation.


Assuntos
Palato , Cicatrização , Animais , Cães , Fibroblastos , Lectinas , Mucosa Bucal , Ratos
11.
Case Rep Dent ; 2019: 9712816, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31583140

RESUMO

A 30-year-old Caucasian man presented with an 18-month history of an asymptomatic calcified mass, located on the buccal side of the alveolar ridge. Medical records did not present any underlying conditions. On intraoral examination, the lesion was located on the right side of the maxilla, showing mucosal fenestration with mineralized tissue measuring approximately 1 cm in diameter. Radiographic examination showed multiple radiopaque masses. Incisional biopsy was performed, and histological analysis revealed a presence of enamel matrix, dentin, and cementum, resembling tooth-like structures. Surgical removal was offered after the diagnostic confirmation of peripheral odontoma, but the patient refused because of the asymptomatic nature of the lesion.

12.
Neurointervention ; 14(1): 43-52, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30827064

RESUMO

PURPOSE: Cigarette smoking (CS) is one of the major risk factors of cerebral atherosclerotic disease, however, its level of contribution to extracranial and intracranial atherosclerotic stenosis (ECAS and ICAS) was not fully revealed yet. The purpose of our study was to assess the association of CS to cerebral atherosclerosis along with other risk factors. MATERIALS AND METHODS: All consecutive patients who were angiographically confirmed with severe symptomatic cerebral atherosclerotic disease between January 2002 and December 2012 were included in this study. Multivariate logistic regression analyses were performed to identify risk factors for ECAS and ICAS. Thereafter, CS group were compared to non-CS group in the entire study population and in a propensity-score matched population with two different age-subgroups. RESULTS: Of 1709 enrolled patients, 794 (46.5%) had extracranial (EC) lesions and the other 915 (53.5%) had intracranial (IC) lesions. CS group had more EC lesions (55.8% vs. 35.3%, P<0.001) whereas young age group (<50 years) had more IC lesion (84.5% vs. 47.6%, P<0.001). In multivariate analysis, seven variables including CS, male, old age, coronary heart disease, higher erythrocyte sedimentation rate, multiple lesions, and anterior lesion were independently associated with ECAS. In the propensity-score matched CS group had significant more EC lesion compared to non-CS group (65.7% vs. 47.9%) only in the old age subgroup. CONCLUSION: In contrast to a significant association between CS and severe symptomatic ECAS shown in old population, young patients did not show this association and showed relatively higher preference of ICAS.

13.
Int J Oral Maxillofac Implants ; 33(3): 512­522, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29543927

RESUMO

PURPOSE: The objective of this investigation was to assess vertical bone augmentation using deproteinized bovine bone mineral (DBBM) infused or not with recombinant human bone morphogenetic protein (rhBMP-2) in rabbit tibiae. MATERIALS AND METHODS: A total of 18 female rabbits (New Zealand) received two blocks of DBBM in each tibia. The DBBM blocks were randomly assigned into four experimental groups: DBBM (only the bone graft); DBBM associated with absorbable collagen sponge (ACS); DBBM plus rhBMP-2 (1.5 mg/mL); and DBBM infused with rhBMP-2 (1.5 mg/mL) in an ACS carrier. Animals were sacrificed after 12 weeks, and the tibiae containing the DBBM blocks were dissected and analyzed radiographically (microcomputed tomography [micro-CT]), histologically, and immunohistochemically. RESULTS: Micro-CT analysis showed a considerable increase in bone volume (BV) and BV/tissue volume in the rhBMP-2/ACS group compared with all the others. Trabeculae thickness also increased in the rhBMP-2/ACS group compared with the DBBM/ACS group. Trabecular number, separation, and bone mineral density were not different among groups. Histomorphometric evaluation showed increased newly formed bone in the rhBMP-2/ACS group compared with the DBBM and DBBM/ACS groups. The amount of residual bone graft was statistically higher in the rhBMP-2 groups compared with the DBBM/ACS group. Immunohistochemical analysis showed that the vascular endothelial growth factor (VEGF) expression was more intense in the rhBMP-2/ACS group compared with the DBBM/ACS group. The immunopositivity for type 1 collagen tended to be higher in the two groups with rhBMP-2. CONCLUSION: Collectively, the results of this study suggest that the addition of rhBMP-2 in an ACS carrier placed on top of the DBBM graft enhanced bone formation in this animal model.


Assuntos
Implantes Absorvíveis , Aumento do Rebordo Alveolar/métodos , Proteína Morfogenética Óssea 2/farmacologia , Regeneração Óssea/efeitos dos fármacos , Transplante Ósseo/métodos , Colágeno/farmacologia , Minerais/farmacologia , Fator de Crescimento Transformador beta/farmacologia , Animais , Produtos Biológicos/farmacologia , Densidade Óssea , Proteína Morfogenética Óssea 2/uso terapêutico , Bovinos , Colágeno/administração & dosagem , Modelos Animais de Doenças , Feminino , Coelhos , Proteínas Recombinantes/farmacologia , Proteínas Recombinantes/uso terapêutico , Tíbia/metabolismo , Tíbia/patologia , Tíbia/cirurgia , Fator de Crescimento Transformador beta/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/metabolismo , Microtomografia por Raio-X
14.
J Craniomaxillofac Surg ; 46(1): 142-147, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29198577

RESUMO

OBJECTIVE: This study compared stability, removal torque, bone implant contact (BIC) and area (BA) of implants installed simultaneously with onlay autografts or allografts in rabbits' tibias. MATERIAL AND METHODS: Total of 18 rabbits were used in this study. Fresh frozen allografts were obtained from six animals at T(-6). Two implants with autogenous grafts (Group 1) or allografts (Group 2) were simultaneously inserted into both sides of the tibiae in a vertical periimplant defect model at T0. The resonance frequency (ISQ) was measured in implant proximal epiphysis on the day of installation of T0 and T18 (18 weeks post-surgery). At T18 the removal torque was assessed at the distal implants, the implants' proximal epiphysis and surrounding bone were harvested to perform histomorphometric analysis. The BIC and BA within the limits of the implants threads were evaluated. RESULTS: The ISQ revealed a statistically significant difference between T0 and T18 in each group (p = 0.024, p = 0.003). The removal torque indicates that there was no significant difference between the two groups (p = 0.47). No significant differences were observed between the groups regarding both BIC (p = 0.3713) and the BA (p = 0.3883). CONCLUSION: Both grafts and implants demonstrated the same stability, torque removal and the BIC and BA.


Assuntos
Transplante Ósseo , Implantação Dentária Endóssea , Aloenxertos , Animais , Autoenxertos , Coelhos , Tíbia
15.
J Intensive Care Med ; 33(5): 310-316, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28523953

RESUMO

BACKGROUND: Decompressive hemicraniectomy reduces secondary brain injury related to brain edema and increased intracranial pressure (ICP) in patients with malignant middle cerebral artery infarction (MMI). However, a substantial proportion of patients still die despite hemicraniectomy due to refractory brain swelling. OBJECTIVE: We aim to investigate whether ICP measured immediately after hemicraniectomy may indicate decompression effects and predict survival in patients with MMI. METHODS: We included 25 patients with MMI who underwent ICP monitoring and brain computed tomography within the first hour of hemicraniectomy. Midline shifts were measured as radiological surrogates of decompression. The Glasgow Coma Scale and pupillary enlargements during the first day after hemicraniectomy were assessed as clinical surrogates of decompression. Long-term survival status at 6 months was used as the final outcome. We analyzed the relationships between early ICP and findings of midline shift, Glasgow Coma Scale, pupillary enlargement, and survival. RESULTS: Initial ICP was correlated with mean ICP ( P < .001) and maximal ICP ( P < .001) during the first postoperative day. Intracranial pressure was associated with midline shifts ( P = .009), lower Glasgow Coma Scale scores ( P = .025), and the pupillary enlargement ( P = .015). Sixteen (64.0%) patients survived at 6 months. In a Cox proportional hazard model, elevated ICP was associated with mortality at 6 months (hazard ratio: 1.13; 95% confidence interval: 1.03-1.24; P = .008). CONCLUSION: Increase in ICP soon after hemicraniectomy was associated with midline shift, poor neurological status, and mortality in patients with MMI. Measurements of ICP soon after hemicraniectomy may permit earlier interventions as well as more refined clinical assessments.


Assuntos
Edema Encefálico/mortalidade , Neoplasias Encefálicas/mortalidade , Craniectomia Descompressiva/mortalidade , Infarto da Artéria Cerebral Média/mortalidade , Hipertensão Intracraniana/mortalidade , Pressão Intracraniana/fisiologia , Complicações Pós-Operatórias/mortalidade , Idoso , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/etiologia , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/cirurgia , Craniectomia Descompressiva/métodos , Feminino , Escala de Coma de Glasgow , Humanos , Infarto da Artéria Cerebral Média/fisiopatologia , Infarto da Artéria Cerebral Média/cirurgia , Hipertensão Intracraniana/diagnóstico por imagem , Hipertensão Intracraniana/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Taxa de Sobrevida , Tomografia Computadorizada por Raios X
16.
Braz. j. oral sci ; 17: e18224, 2018. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-970619

RESUMO

The most commonly performed surgical procedure in Oral and Maxillofacial Surgery practices are the removal of impacted third molars. Extensive training, skill and experience allow this procedure to be performed in an atraumatic approach. The aim of this study was to drawing attention to the importance of the correct management of the complications cases of foreign body inside maxillary sinus after surgical removal of maxillary third molars. This is an unusual clinical case of a dental surgical bur accidentally displacement into the maxillary sinus during an upper third molar extraction surgery. After removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical examination to achieve a correct diagnosis and an appropriate treatment plan, which is essential for a favorable prognosis


Assuntos
Humanos , Masculino , Adulto , Cirurgia Bucal , Corpos Estranhos , Seio Maxilar , Dente Serotino
17.
J Stroke ; 19(3): 312-322, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28877565

RESUMO

BACKGROUND AND PURPOSE: Troponin, a marker of myocardial injury, frequently increases and is related with poor outcome in ischemic stroke patients. However, the long-term outcome of this elevation remains uncertain. We, therefore, investigated the prognostic significance of troponin elevation for long-term mortality, and explored factors affecting troponin elevation after ischemic stroke. METHODS: We retrospectively analyzed the medical data of stroke patients who were admitted within 24 hours of symptom onset and underwent a serum cardiac troponin I test at admission during a five-year period. Information on mortality as the outcome was obtained from the National Death Certificate system. RESULTS: A total of 1,692 patients were eligible for inclusion with 33 months of median follow-up. Troponin elevation that exceeded the 99th percentile (>0.04 ng/mL) of values was detected in 166 patients (9.8%). After adjusting for baseline characteristics, troponin elevation was associated with previous ischemic heart disease and congestive heart failure, comorbid atrial fibrillation and active cancer, and increased National Institutes of Health Stroke Scale score. Patients with troponin elevation had a high risk of overall death (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.40-2.40), including stroke-related (HR 1.71, 95% CI 1.14-2.55), cardiac-related (HR 3.17, 95% CI 1.49-6.74), and cancer-related (HR 1.98, 95% CI 1.14-3.45) death than those without troponin elevation. CONCLUSIONS: Troponin elevation in the acute stage of ischemic stroke was associated with long-term mortality, mainly due to increased stroke- and cancer-related death in the first year and cardiacrelated death in the later period.

18.
Einstein (Säo Paulo) ; 15(2): 173-177, Apr.-June 2017. tab
Artigo em Inglês | LILACS | ID: biblio-891372

RESUMO

ABSTRACT Objective To establish a profile of periodontal conditions in chronic kidney disease patients on hemodialysis and their periodontal risk. Methods We included 115 patients on hemodialysis. Clinical periodontal parameters assessed were: plaque index, gingival index, probing depth and clinical attachment level. Patients were classified according to presence/absence and severity of periodontal disease and periodontal risk. Results In 107 dentate patients (93%) the plaque index was 1.53±0.78, the gingival index was 0.95±0.85, the probing depth was 2.2±0.6mm and the clinical attachment level was 3.18±1.75mm. We observed that 1 patient (0.94%) did not have periodontal disease, 55 patients (51.40%) had slight, 28 (26.17%) moderate and 23 (21.49%) severe periodontal disease. Among 107 patients, 37 (34.58%) had low risk, 35 (32.71%) moderate risk and 35 (32.71%) high risk. Patients with severe periodontal disease showed 104.5 more chance of high risk compared with low risk individuals (odds ratio: 104.5; 95%CI: 10.7-1017.2; p<0.0001). Conclusion Most of patients with chronic renal disease presented periodontal disease, indicating the presence of chronic inflammatory and infection process that may influence in systemic conditions. A prevention and interventionist approach in this population is needed, especially to emphasize the importance of oral health. The periodontal risk assessment is a useful tool to create individualized periodontal therapies and to improve general health condition.


RESUMO Objetivo Traçar um perfil das condições periodontais de pacientes com doença renal crônica em hemodiálise e seu risco periodontal. Métodos Foram incluídos no estudo 115 pacientes em hemodiálise. Os parâmetros clínicos periodontais avaliados foram: índice de placa, índice gengival, profundidade de sondagem e perda de nível de inserção clínico. Os pacientes foram classificados de acordo com a presença e a gravidade da doença periodontal, bem como de acordo com o risco periodontal. Resultados Quanto aos parâmetros clínicos, 107 pacientes dentados (93%) apresentaram média de índice de placa de 1,53±0,78 e gengival de 0,95±0,85, profundidade de sondagem de 2,2±0,6mm e nível de inserção clínica de 3,18±1,75mm. Em relação à doença periodontal, 1 (0,94%) era saudável, 55 (51,40%) apresentavam periodontite leve, 28 (26,17%) moderada e 23 (21,49%) avançada. Com relação ao risco, dos 107 pacientes, 37 apresentavam risco baixo, 35 moderado e 35 alto. Os pacientes com doença periodontal avançada apresentaram 104,5 vezes mais chance de ter alto risco comparado ao baixo (odds ratio: 104,5; IC95%: 10,7-1017,2; p<0,0001). Conclusão A maioria dos pacientes com doença renal crônica apresentou doença periodontal, indicando um processo infeccioso e inflamatório crônico, que pode influenciar na condição sistêmica. Evidencia-se a necessidade de uma abordagem preventiva e intervencionista nesta população, enfatizando a importância da saúde bucal. A avaliação do risco periodontal seria uma ferramenta na elaboração de terapias periodontais individualizadas para uma melhor condição de saúde geral.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Periodontais/complicações , Diálise Renal/efeitos adversos , Medição de Risco , Insuficiência Renal Crônica/complicações , Doenças Periodontais/diagnóstico , Índice de Gravidade de Doença , Índice Periodontal , Índice de Placa Dentária , Estudos Transversais , Perda da Inserção Periodontal/diagnóstico
19.
Clin Nutr Res ; 6(2): 122-129, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28503508

RESUMO

The aim of this study was to investigate the association between macronutrient composition and metabolic syndrome (MetS) incidence in Korean adults. Data were obtained from a cohort of 10,030 members aged 40 to 69 years who were enrolled from the 2 cities (Ansung and Ansan) between 2001 and 2002 to participate in the Korean Genome Epidemiology Study. Of these members, 5,565 participants, who were free of MetS and reported no diagnosis of cardiovascular disease at baseline, were included in this study. MetS was defined using the criteria of the National Cholesterol Education Program-Adult Treatment Panel III and Asia-Pacific criteria for waist circumference. MetS incidence rate were identified during a 2-year follow-up period. Baseline dietary information was obtained using a semi-quantitative food frequency questionnaire. Multivariate logistic regression analysis was used to evaluate the association between the quartiles of percentages of total calorie from macronutrients consumed and MetS incidence. In analyses, baseline information, including age, sex, body mass index, income status, educational status, smoking status, alcohol drinking status, and physical activity level was considered as confounding variables. Participants with the second quartile of the percentages of carbohydrate calorie (67%-70%) had a 23% reduced odds ratio (95% confidence interval, 0.61-0.97) for MetS incidence compared with those with the fourth quartile after adjusting for confounding variables. The findings suggest that middle aged or elderly Korean adults who consume approximately 67%-70% of calorie from carbohydrate have a reduced risk of MetS.

20.
PLoS One ; 12(4): e0175681, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28406950

RESUMO

The objective of this study is to find single nucleotide polymorphisms (SNPs) associated with a risk of Type 2 diabetes (T2D) in Korean adults and to investigate the longitudinal association between these SNPs and T2D and the interaction effects of iron intake and average hemoglobin level. Data from the KoGES_Ansan and Ansung Study were used. Gene-iron interaction analysis was conducted using a two-step approach. To select candidate SNPs associated with T2D, a total of 7,935 adults at baseline were included in genome-wide association analysis (step one). After excluding T2D prevalent cases, prospective analyses were conducted with 7,024 adults aged 40-69 (step two). The association of selected SNPs and iron status with T2D and their interaction were determined using a Cox proportional hazard model. A total of 3 SNPs [rs9465871 (CDKAL1), rs10761745 (JMJD1C), and rs163177 (KCNQ1)] were selected as candidate SNPs related to T2D. Among them, rs10761745 (JMJD1C) and rs163177 (KCNQ1) were prospectively associated with T2D. High iron intake was also prospectively associated with the risk of T2D after adjusting for covariates. Average hemoglobin level was positively associated with T2D after adjusting for covariates in women. We also found significant interaction effects between rs10761745 (JMJD1C) and average hemoglobin levels on the risk of T2D among women with normal inflammation and without anemia at baseline. In conclusion, KCNQ1 and JMJD1C may prospectively contribute to the risk of T2D incidence among adults over the age of 40 and JMJD1C, but CDKAL1 may not, and iron status may interactively contribute to T2D incidence in women.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Ferro/metabolismo , Histona Desmetilases com o Domínio Jumonji/genética , Canal de Potássio KCNQ1/genética , Oxirredutases N-Desmetilantes/genética , Polimorfismo de Nucleotídeo Único , tRNA Metiltransferases/genética , Adulto , Fatores Etários , Idoso , Povo Asiático/genética , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Hemoglobinas/metabolismo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , República da Coreia/epidemiologia , Fatores Sexuais
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