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1.
Zhonghua Wai Ke Za Zhi ; 62(6): 549-555, 2024 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-38682626

RESUMO

Objective: To evaluate the short-term outcomes of all-inside endoscopic running locked stitch technique for acute Achilles tendon ruptures. Methods: This is a retrospective case series study. Forty-eight cases with acute Achilles tendon rupture were treated with the all-inside endoscopic running locked stitch technique from April 2020 to March 2022 at Department of Orthopaedics, General Hospital of Central Theater Command. There were 44 males and 4 females, aged (34.8±7.4) years (range: 24 to 50 years). Body mass index was (21.2±2.4)kg/m2 (range: 18 to 26 kg/m2); There were 29 cases (60.4%) on the left side and 19 cases (39.6%) on the right side. Under endoscopic control, the proximal tendon stumps were stitched with the running locked method using a semi-automatic flexible suture passer. The threads of the high-strength suture were grasped through the paratenon sub-space and then fixed into calcaneal insertion with a knotless anchor. MRI of Achilles tendon was performed to observe the regeneration of Achilles tendon during follow-up. Surgical time and complications were assessed. Achilles tendon total rupture score (ATRS), Achilles tendon resting angle, and heel rise height were utilized to evaluate final clinical outcomes. The differences of bilateral limbs were compared using the paired sample t test. Results: The follow-up time was (24.1±3.5)months (range:18 to 32 months). Appropriate tendon regeneration was observed on MRI at 12 months after operation. The median ATRS score (M(IQR)) was 95.0 (4.7) points. Furthermore, there was no significant difference between the injured and contralateral side in the Achilles tendon resting angle ((17.1±2.4)° vs. (17.4±2.6)°, t=1.92,P=0.062) and heel rise height ((14.2±1.7)cm vs. (14.4±1.5)cm, t=1.71,P=0.094). No nerve injury, infection, deep vein thrombosis and re-rupture was encountered. Sports activity resumed six months postoperative in 46 patients. One patient had a slight anchor cut-out, due to an addition injury, which was removed after 5 months. Conclusions: All-inside endoscopic running locked stitch technique for acute Achilles tendon ruptures shows promising results. It provides stable connection of the tendon stumps with a low risk of complications.


Assuntos
Tendão do Calcâneo , Endoscopia , Técnicas de Sutura , Humanos , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/lesões , Masculino , Feminino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Endoscopia/métodos , Ruptura/cirurgia , Resultado do Tratamento , Traumatismos dos Tendões/cirurgia , Adulto Jovem
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 57(11): 1882-1887, 2023 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-38008581

RESUMO

Glucose is the central nutrient for energy metabolism and life support in the human body. As the main energy substance of the body, glucose is essential for the normal function of immune cells and their proliferation; when glucose homeostasis is disrupted in the body, it may lead to impaired immune system function and pathological conditions. Exploring the relationship between glucose metabolism and immune regulation can help establish the gene regulatory network and figure out potential pathogenic mechanisms under physiological and pathological conditions. This article reviews the current scientific research progress on glucose metabolism and immunity, mainly focusing on the physiological regulatory functions of glucose in maintaining the homeostasis of innate and acquired immunity; and summarizes the research progress on the effects and mechanisms of glucose on tumor immunity and its related therapies under pathological conditions, taking tumors as an example.


Assuntos
Glucose , Humanos , Glucose/metabolismo , Homeostase/fisiologia
3.
Zhonghua Yi Xue Za Zhi ; 102(20): 1506-1511, 2022 May 31.
Artigo em Chinês | MEDLINE | ID: mdl-35692065

RESUMO

Objective: To explore the role and specific mechanism of glucocorticoids in preventing stenosis after esophageal endoscopic submucosal dissection (ESD). Methods: Data of 81 patients [51 cases were male and 30 cases were female, aged (62.09±7.95) years] undergoing early esophageal cancer or precancerous lesions with a stripping range ≥3/4 circle hospitalized from January 2019 to February 2021 in Department of Gastroenterology, Zhongda Hospital, Southeast University. They were randomly divided into the control group (n=23), oral prednisone acetate group (n=28) and/or combined with local injection Triamcinolone acetonide group (n=30). Analysis the stenosis rates, endoscopic stent dilatation times, the scores of the Atkinson classification and QLQ-OES18 after 12 weeks. Also the expression of carbohydrate sulfotransferase15 (CHST15) mRNA, TGF-ß1 and Collagen-Ⅰ protein were compared by real-time PCR or immunohistochemistry. Results: The stenosis rates of the control group, oral prednisone acetate group and/or combined with local injection Triamcinolone acetonide group were 82.6% (19/23), 46.4% (13/28) and 20.0% (6/30) (P<0.001); endoscopic stent dilatation times [M (Q1,Q3)] in these three groups were 2 (1, 3), 0 (0, 0) and 0 (0, 0) (P<0.001). After ESD, the scores of the Atkinson classification and QLQ-OES18 in the three groups were lower than before (P<0.001); and the expression of CHST15 mRNA in the three groups were 4.31±0.13, 3.44±0.07 and 2.84±0.21 respectively (P<0.001). Compared with the control group, the expression of CHST15 mRNA in oral prednisone acetate group was down-regulated (P<0.001), and was the lowest in oral prednisone acetate combined with local injection Triamcinolone acetonide group (P<0.001). As CHST15 mRNA was down-regulated, the expression of TGF-ß1 and Collagen-I protein was also down-regulated (P<0.05). Conclusions: Oral prednisone alone or combined with local injection of triamcinolone acetonide both can prevent esophageal stenosis effectively. Oral combined with local injection of glucocorticoid is particularly more effective. Glucocorticoid can reduce the expression of CHST15 mRNA, thereby inhibiting the expression of TGF-ß1 and Collagen-I protein.


Assuntos
Ressecção Endoscópica de Mucosa , Neoplasias Esofágicas , Estenose Esofágica , Acetatos , Idoso , Constrição Patológica , Ressecção Endoscópica de Mucosa/efeitos adversos , Estenose Esofágica/etiologia , Estenose Esofágica/patologia , Estenose Esofágica/prevenção & controle , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Glicoproteínas de Membrana , Pessoa de Meia-Idade , Prednisona , RNA Mensageiro , Sulfotransferases , Fator de Crescimento Transformador beta1 , Triancinolona Acetonida
4.
Zhonghua Wai Ke Za Zhi ; 58(8): 626-630, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727195

RESUMO

Objective: To examine the value serum calcium and intact parathyroid hormone (iPTH) levels measured on the first day after total thyroidectomy on prediction for permanent hypoparathyroidism. Methods: Totally 546 patients with thyroid cancer and benign thyroid lesions who underwent total thyroidectomy at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from February 2008 to December 2018 were analyzed retrospectively. There were 158 males and 388 females aging (50.9±13.2) years (range: 19.0 to 79.2 years). Serum calcium and iPTH levels were collected before surgery, on the first day and 6 months after surgery. Logistic regression was used to analyze the correlation between each data and the occurrence of permanent hypoparathyroidism after surgery.The area under the receiver operating characteristic curve was used to evaluate the predictive power of iPTH for postoperative occurrence of permanent hypoparathyroidism. Results: Among the 546 cases of total thyroidectomy, 22 cases of permanent hypoparathyroidism occurred, with an incidence of 4.0% (22/546). Multivariate analysis showed that iPTH levels on the first day after total thyroidectomy (OR=2.932, 95%CI: 1.129 to 7.616, P=0.027) and serum calcium levels (OR=2.584, 95%CI: 1.017 to 6.567, P=0.046) were independent prognosis factors for postoperative permanent hypoparathyroidism. When the threshold value of iPTH at 24 hours after total thyroidectomy was 5.51 ng/L, the AUC was 0.956 (95%CI: 0.936 to 0.972, P=0.000), sensitivity was 100%, specificity was 85.1%, positive predictive value was 22%, negative predictive value was 100%. When the threshold value of serum calcium at 24 hours after total thyroidectomy was 1.93 mmol/L, the AUC was 0.733 (95%CI: 0.694 to 0.770, P=0.000), sensitivity was 63.6%, specificity was 78.1%, positive predictive value of 10.8% and negative predictive value of 98.1%. Conclusions: Serum iPTH and calcium levels on the first day after total thyroidectomy were related to the occurrence of permanent hypoparathyroidism postoperatively. The predictive value of iPTH level is higher than that of serum calcium level.


Assuntos
Cálcio/sangue , Hipoparatireoidismo/sangue , Hormônio Paratireóideo/sangue , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Hipoparatireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Doenças da Glândula Tireoide/sangue , Tireoidectomia/métodos , Adulto Jovem
5.
Anaesthesia ; 75(4): 464-471, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31573678

RESUMO

There is conflicting evidence whether allogeneic blood transfusion influences survival or cancer recurrence after resection of hepatocellular cancer. We followed up 1469 patients who had undergone hepatocellular resection for a median (IQR [range]) of 45 (21-78 [0-162]) months, of whom 626 (43%) had had blood transfusion within 7 days of surgery. Both disease-free survival and patient survival were measured using a proportional hazards regression model and inverse probability of treatment weighting. We used restricted cubic splines for the association of the number of packed red blood cell units transfused with cancer recurrence and survival. We found that peri-operative blood transfusion was independently associated with survival and cancer recurrence after resection of hepatocellular carcinoma. Adjusted hazard ratios (95%CI) for the association of blood transfusion with cancer recurrence and all-cause mortality were 1.3 (1.1-1.4) and 1.9 (1.6-2.3), p < 0.001 for both. With more units transfused cancer recurrence was more likely and survival was shorter. The association of the number of transfused units was non-linear for cancer recurrence and linear response for all-cause mortality.


Assuntos
Transfusão de Sangue/métodos , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Artigo em Chinês | MEDLINE | ID: mdl-31315361

RESUMO

Objective: To compare the carcinogenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells and to identify the mechanism underlying the action of miRNAs. Methods: Solid tumor-derived laryngeal carcinoma stem cells and Hep-2-derived laryngeal carcinoma stem cells were cultured, and CD133(+)CD44(+) laryngeal cancer stem cells were sorted by flow cytometry. Boden chamber invasion assay, cell migration assay and tumor formation assay were then performed to compare the invasion, migration and tumorigenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells. And then, miRNAs isolated from two laryngeal cancer stem cells were detected and analysed with miRNA chip. Results: (1)In Boyden chamber invasion assay, the cell invasion rate of CD133(+)CD44(+) laryngeal cancer stem cells was obviously higher (80.2%±2.3% vs. 63.9%±3.2%, t=5.011, P=0.027); (2)CD133(+)CD44(+) laryngeal cancer stem cells also had higher mobility in cell migration assay (82.9%±1.1% vs. 70.9%±0.6%, t=4.514, P=0.031); (3)In tumor formation assay, the tumor formation rate of CD133(+)CD44(+) laryngeal cancer stem cells was also higher (80% vs. 50%). What's more, we identified 15 miRNAs that were significantly upregulated in CD133(+)CD44(+) laryngeal cancer stem cells and 3 miRNAs that were significantly downregulated in CD133(+)CD44(+) laryngeal cancer stem cells, compared with normal laryngeal cancer stem cells. Conclusions: CD133(+)CD44(+) laryngeal cancer stem cells have stronger invasion, migration and tumorigenic abilities compared with normal laryngeal cancer stem cells, and the difference of miRNAs' expression is one of the possible causes.


Assuntos
Neoplasias Laríngeas/fisiopatologia , MicroRNAs/biossíntese , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Antígeno AC133/biossíntese , Carcinogênese/metabolismo , Linhagem Celular Tumoral , Movimento Celular/fisiologia , Humanos , Receptores de Hialuronatos/biossíntese , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/patologia , Laringe/metabolismo , Laringe/patologia , Laringe/fisiopatologia , Invasividade Neoplásica/fisiopatologia , Processos Neoplásicos
7.
Dis Esophagus ; 30(1): 1-5, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27061221

RESUMO

The aims of this study were to investigate intrapapillary capillary loops (IPCLs) of superficial esophageal lesions changes in different types classified by the Japan Esophageal Society classification. The calibers, areas, and densities of IPCLs were detected in 34 cases of esophageal lesions using immunohistochemical analysis. Statistically significant differences in calibers, areas, and densities of IPCLs were observed between type A, type B1/B2, and type B3 area (P < 0.001). In conclusion, the results of this observation showed the Japan Esophageal Society classification of IPCL would help endoscopists to diagnose the type and the invasion depth of lesion in esophagus, and decide the treatment strategy.


Assuntos
Capilares/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Idoso , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/cirurgia , Ressecção Endoscópica de Mucosa , Neoplasias Esofágicas/irrigação sanguínea , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago , Esofagoscopia , Esôfago/patologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Imagem de Banda Estreita , Estudos Retrospectivos
8.
Clin Exp Obstet Gynecol ; 43(5): 742-746, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-30074330

RESUMO

OBJECTIVES: To analyze clinical efficacy between fiberoptic ductoscopy plus ultrasound-guided minimally invasive irrigation and lesion resection in treating plasma cell mastitis (PCM), aiming to provide clinical evidence for treating PCM. MATERIALS AND METHODS: 119 patients undergoing fiberoptic ductoscopy plus ultrasound-guided minimally invasive surgery in Ningxia People's Hospital were allocated into the breast duct irrigation group, and 95 counterparts receiving lesion resection in the Affiliated Hospital of Ningxia Medical University into the control group. Clinico-pathological characteristics and therapeutic effect were compared between two groups. RESULTS: The cure rate in the breast duct irrigation group was 98.31% (117/119), significantly higher than 90.53% in the control group (p < 0.05). In the breast duct irrigation group, overall treatment time was 20.13 days, significantly longer than 15.15 days in the control group (p < 0.05). During postoperative follow-up, no recurrence was observed, significantly lower compared with 48.8% (42/86) in the control group. The degree of satisfaction in the breast duct irrigation group was 95.79% (114/119), significantly higher compared with 74.74% (71/95) in the control group. CONCLUSIONS: Fiberoptic ductoscopy plus with ultrasound-guided minimally invasive drainage is a novel and effective treatment of PCM with high cure rate, low recurrence rate, slight pain, and effectively maintains breast integrity.


Assuntos
Tecnologia de Fibra Óptica , Mastite/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Plasmócitos/patologia , Ultrassonografia de Intervenção , Adolescente , Adulto , Criança , Endoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
9.
Br Poult Sci ; 55(6): 720-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25347433

RESUMO

1. Vasoactive intestinal peptide (VIP) is involved in the control of prolactin (PRL) release and plays a pivotal role as a regulator of reproductive behaviour and neuroendocrine secretion in birds. 2. In this study, a 941-bp cDNA fragment covering the complete coding region (CDS) of goose VIP gene was identified. The cDNA contains a 32-bp 5'-untranslated region (UTR), a 603-bp CDS and a 306-bp 3'-UTR containing two ATTTA sequence elements, two polyadenylation signals (AATAAA) and a 25-bp poly (A) tail. 3. Seven exons and 6 introns were identified, and both the cDNA and genomic DNA sequences showed high identity with those of other species. 4. The sequence analysis indicated that there were two alternatively spliced transcripts the long transcript (VIP-1) encoded both VIP and peptide histidine isoleucine exons and the short one (VIP-2) only encoded VIP. 5. RT-PCR analysis indicates that the expression level of the VIP-1 is much lower than that of VIP-2, and that VIP-1 is negligible or absent in muscle, abdominal fat, ovary and spleen, whereas VIP-2 is widely distributed in all the examined tissues. 6. A total of 12 single nucleotide polymorphisms (SNPs), including 2 SNPs located in the coding region and 10 variations in intron regions, were identified in goose VIP gene.


Assuntos
Gansos/genética , Peptídeo Intestinal Vasoativo/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Clonagem Molecular , Feminino , Dados de Sequência Molecular , Filogenia , Polimorfismo de Nucleotídeo Único/genética , Distribuição Tecidual , Peptídeo Intestinal Vasoativo/análise
10.
Addict Behav ; 39(10): 1491-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24949950

RESUMO

If adolescents do not receive appropriate assistance in quitting smoking, they are highly likely to become regular smokers when they enter adulthood. Thus, an effective smoking-cessation program is required. A program was designed based on both the smoking-cessation barriers reported by students and effective strategies derived from the literature. We assigned 143 student smokers from 6 vocational high schools to intervention (n=78) and comparison groups (n=65). Data were collected at the baseline, the end of the program, and 1- and 4-month follow-up time points. For the intervention group, the smoking-abstinence rates confirmed using the urine cotinine test were 22.73% at the end of the program and 20.75% at the 4-month follow-up point. Days smoked in the past month, number of cigarettes smoked per day, and the Fagerström Test for Nicotine Dependence score of the intervention group decreased at all of the time points. The group differences in these variables were statistically significant; the magnitude of effect sizes ranged from 0.44 to 0.95. Multicomponent programs addressing smoking-cessation barriers that students encounter can help adolescents quit smoking.


Assuntos
Acupressão/métodos , Educação de Pacientes como Assunto/métodos , Serviços de Saúde Escolar , Autocuidado/métodos , Abandono do Hábito de Fumar/métodos , Adolescente , Terapia Combinada , Aconselhamento , Feminino , Humanos , Masculino , Motivação , Recompensa , Taiwan , Telefone , Resultado do Tratamento
11.
Ann Oncol ; 25(8): 1584-90, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24928833

RESUMO

BACKGROUND: The aim of this study was to evaluate whether genetic variations in the transforming growth factor-ß (TGF-ß) pathway influenced clinical outcome of advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations treated with gefitinib. PATIENTS AND METHODS: Two hundred six patients with advanced lung adenocarcinomas were enrolled in this study. EGFR mutation in these tumors was detected. Among them, 106 patients with EGFR mutation and 37 of 100 patients with wild type were treated with gefitinib. Genotype of 33 single-nucleotide polymorphisms (SNPs) from 13 genes involved in the TGF-ß signaling pathway was determined, and their association with survival time was analyzed. Univariate and multivariate analyses were carried out to assess the role of biological/clinical parameters in progression-free survival (PFS) and overall survival (OS) using Pearson's χ(2) test, log-rank test, and Cox proportional hazards model. RESULTS: Among SNPs analyzed, multivariate analysis showed the cytidylate and thymidine (CT) genotype of SMAD3: rs11632964 was associated with a longer OS and PFS when the entire cohort of 143 patients were included; the association was significant in the patients with EGFR mutant tumors (30.8 versus 17.5 months; log-rank P = 0.020; and 20.8 versus 9.4 months; log-rank P = 0.001), when compared with patients with wild-type EGFR tumors. In patients with mutant EGFR, the CT genotype of SMAD3: rs11071938 and the cytidylate and cytidylate genotype of SMAD3: rs6494633 were also found to be associated with better PFS. Dual luciferase reporter assays showed gefitinib-resistant PC9/G cells transfected with SMAD3: rs11632964T allelic reporter construct showed significantly lower luciferase activities compared with cells expression C allelic reporter construct. There was significantly decreased expression of SMAD3 and pi-SMAD3 in the PC-9/G cells compared with PC-9. CONCLUSIONS: Among the candidate genes involved in the TGF-ß pathway, the polymorphisms of SMAD3 appear to be highly predictive of outcome of patients with lung adenocarcinoma after gefitinib treatment, especially in those with EGFR mutations.


Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/uso terapêutico , Receptores ErbB/genética , Neoplasias Pulmonares/tratamento farmacológico , Polimorfismo de Nucleotídeo Único , Quinazolinas/uso terapêutico , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismo , Adenocarcinoma/genética , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão , Adulto , Idoso , Progressão da Doença , Feminino , Gefitinibe , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Mutação , Prognóstico , Transdução de Sinais/genética , Proteína Smad3/genética , Resultado do Tratamento
12.
Eur J Appl Physiol ; 113(3): 753-62, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22945269

RESUMO

Knowing the inter-unit variability, especially the technological error, is important when using many physiological measurement systems, yet no such inter-unit analysis has been undertaken on duplicate automated gas analysis systems. This study investigated the inter-unit performance of two identical ParvoMedics TrueOne 2400 automated gas analysis systems during a range of submaximal steady-state exercises performed on an electromagnetic cycle ergometer. Fifteen adult males were tested on two separate days a rest, 30, 60, 90, and 120 Watts with the duplicate gas analysis units arranged (1) collaterally (2 min of steady-state expired gas was alternately passed through each system), and (2) simultaneously (identical steady-state expired gas was passed simultaneously through both systems). Total within-subject variation (biological + technological) was determined from the collateral tests, but the unique inter-unit variability (technological error between identical systems) was shown by the simultaneous tests. Absolute percentage errors (APE), coefficient of variations (CV), effect sizes and Bland-Altman analyses were undertaken on the metabolic data, including expired ventilation (V (E)), oxygen consumption (VO(2)) and carbon dioxide production (VCO(2)). The few statistically significant differences detected between the two duplicate systems were determined to have small or trivial effect sizes, and their magnitudes to be of little physiological importance. The total within-subject variations for VO(2), VCO(2) and V (E) each equated to a mean CV and mean APE value of ~4 and ~6 %, whilst the respective inter-unit technological errors equated to ~1.5 and ~2.1 %. The two ParvoMedics TrueOne 2400 systems demonstrated excellent inter-unit agreement.


Assuntos
Testes Respiratórios/instrumentação , Teste de Esforço , Gases/análise , Troca Gasosa Pulmonar , Adulto , Dióxido de Carbono/análise , Dióxido de Carbono/metabolismo , Processamento Eletrônico de Dados , Gases/metabolismo , Humanos , Masculino , Modelos Biológicos , Variações Dependentes do Observador , Oxigênio/análise , Oxigênio/metabolismo , Espirometria/instrumentação , Espirometria/métodos , Adulto Jovem
13.
Aesthetic Plast Surg ; 36(5): 1175-8, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22836875

RESUMO

Reconstruction of defects in the midface near the nasolabial fold or the inner canthus of the eye can be a challenge for plastic surgeons. Many methods such as skin grafting and skin flaps have been proposed for reconstruction of these defects. This report presents the results of using a contralateral nasolabial flap with a pedicle containing the lateral nasal branch of the angular artery. A flap with a pedicle approximately 10 mm wide was transferred to the opposite side through a tunnel at the nasion near the inner canthus for reconstruction of defects with surface areas ranging from 5.3 to 31.0 cm(2) and depths ranging 2.2-6.5 mm. Since 2008, with careful design, eight patients with skin tumor excisions have obtained effective functional and aesthetic results. This method is a suitable surgical procedure for reconstruction of moderate to wide side defects in the special midface area of the nasal sidewall toward the medial canthus. Level of Evidence V This journal requires that authors assign a level of evidence to each article.


Assuntos
Neoplasias Faciais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Eur J Vasc Endovasc Surg ; 42(5): 617-24, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21843956

RESUMO

OBJECTIVES: To review our surgical experience of primary infected abdominal aortic aneurysms, with the aim of assessing the safety and durability of in situ prosthetic replacement. DESIGN: Retrospective study in a university hospital. MATERIALS AND METHODS: Thirty-four patients who underwent surgery for primary infected abdominal aortic aneurysms over the past 18 years were reviewed. Operative details and outcomes were recorded for analysis. RESULTS: There were six suprarenal and 28 infrarenal infections. Salmonellae (18 patients) were the most common pathogens. Thirty patients underwent in situ prosthetic replacement, two underwent extra-anatomic bypass and two underwent endovascular repair. The surgical mortality for overall patients was 18%, and for patients reconstructed in situ, 17%. Among the 30 patients reconstructed in situ, four patients who underwent concomitant gastrointestinal procedures (e.g., repair of the duodenal defect) died. By contrast, 25 of 26 patients without gastrointestinal involvement survived surgery. After a median follow-up period of 58 months, two discharged patients who underwent in situ reconstruction died of late graft infection. CONCLUSIONS: Our experience suggests that in situ prosthetic replacement can be performed safely with durable outcomes in the majority of patients with infected abdominal aortic aneurysms. Nevertheless, we advise caution when considering this technique with concomitant gastrointestinal procedures.


Assuntos
Aneurisma Infectado/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Infecções por Bactérias Gram-Negativas/cirurgia , Infecções por Bactérias Gram-Positivas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneurisma Infectado/microbiologia , Aneurisma Infectado/patologia , Aneurisma da Aorta Abdominal/microbiologia , Aneurisma da Aorta Abdominal/patologia , Feminino , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/patologia , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Reoperação , Estudos Retrospectivos
15.
J Thromb Haemost ; 8(8): 1773-83, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20492477

RESUMO

BACKGROUND: Hemophilia B is an X-linked inherited disorder caused by the lack of functional factor IX (FIX). Currently, treatment of hemophilia B is performed by intravenous infusion of plasma-derived or recombinant FIX. OBJECTIVE: In an effort to reduce factor usage and cost, we investigated the potential use of FIX variants with enhanced specific clotting activity. METHODS: Seven recombinant FIX variants using alanine replacement were generated and assayed for their activity in vitro and in vivo. RESULTS: One variant containing three substitutions (V86A/E277A/R338A, FIX-Triple) exhibited 13-fold higher specific clotting activity and a 10-fold increased affinity for human FVIIIa compared with FIX-wild-type (FIX-WT) and was thus investigated systematically in vivo. Liver-specific FIX-Triple gene expression following hydrodynamic plasmid delivery revealed a 3.5-fold higher specific clotting activity compared with FIX-WT. Human FIX-Triple and FIX-WT knock-in mice were generated and it was confirmed that FIX-Triple has 7-fold higher specific clotting activity than FIX-WT under normal physiological conditions. Protein infusion of FIX-Triple into hemophilia B mice resulted in greater improvement of hemostasis than that achieved with FIX-WT. Moreover, tail-vein administration of a serotype 8 recombinant Adeno-associated vector (AAV8) expressing either FIX-WT or FIX-Triple in hemophilia B mice demonstrated a 7-fold higher specific clotting activity of FIX-Triple than FIX-WT. CONCLUSIONS: Our results indicate that the FIX-Triple variant exhibits significantly enhanced clotting activity relative to FIX-WT due to tighter binding to FVIIIa, as demonstrated both in vitro and in vivo. Therefore, FIX-Triple is a good candidate for further evaluation in protein replacement therapy as well as gene-based therapeutic strategies.


Assuntos
Fator IX/química , Animais , Coagulação Sanguínea , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática/métodos , Fator VIIIa/genética , Fator X/genética , Variação Genética , Hemofilia B/genética , Humanos , Técnicas In Vitro , Masculino , Camundongos , Camundongos Knockout , Mutagênese , Tempo de Tromboplastina Parcial , Proteínas Recombinantes/química , Ressonância de Plasmônio de Superfície
16.
J Thromb Haemost ; 8(1): 194-201, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19874473

RESUMO

BACKGROUND: Activation of vascular endothelial cells plays an important role in atherogenesis and plaque instability. Recent research has demonstrated that late-stage inhibition of plaque angiogenesis by angiostatin (kringle 1-4) reduces macrophage accumulation and slows the progression of advanced atherosclerosis. Kringle 1-5 (K(1-5)) is a variant of angiostatin that contains the first five kringle domains of plasminogen. OBJECTIVE: To investigate whether K(1-5) has an inhibitory effect on early-stage atherosclerosis, using the apolipoprotein E (ApoE)-deficient mouse model and a carotid artery ligation model. METHODS: ApoE-deficient mice received K(1-5) treatment for 4 weeks, and the severity of aortic atherosclerosis was measured. In the ligation model, the left common carotid arteries of C57BL/6 mice were ligated near the carotid bifurcation, and the mice received K(1-5) for 4 weeks. Human umbilical vein endothelial cells were pretreated with K(1-5) before tumor necrosis factor-alpha (TNF-alpha) treatment to explore the anti-inflammatory effect of K(1-5). RESULTS: The areas of the lesion in the aortas of ApoE-deficient mice that received K(1-5) treatment were notably decreased, and the formation of carotid neointima in the C57BL/6 mice was decreased by treatment with K(1-5). Expression of TNF-alpha-induced intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 was inhibited by K(1-5) treatment, possibly via downregulation of translocation of nuclear factor-kappaB and expression of reactive oxygen species. CONCLUSIONS: K(1-5) reduced atherosclerosis and neointima formation in mice, possibly through inhibition of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression in endothelial cells.


Assuntos
Aorta/metabolismo , Aterosclerose/prevenção & controle , Artérias Carótidas/metabolismo , Mediadores da Inflamação/metabolismo , Inflamação/prevenção & controle , Fragmentos de Peptídeos/metabolismo , Plasminogênio/metabolismo , Transdução de Sinais , Túnica Íntima/metabolismo , Animais , Aorta/imunologia , Aorta/patologia , Apolipoproteínas E/deficiência , Apolipoproteínas E/genética , Aterosclerose/imunologia , Aterosclerose/metabolismo , Aterosclerose/patologia , Artérias Carótidas/imunologia , Artérias Carótidas/patologia , Células Cultivadas , Modelos Animais de Doenças , Células Endoteliais/imunologia , Células Endoteliais/metabolismo , Humanos , Hiperplasia , Proteínas I-kappa B/metabolismo , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/patologia , Molécula 1 de Adesão Intercelular/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Inibidor de NF-kappaB alfa , NF-kappa B/metabolismo , Fragmentos de Peptídeos/administração & dosagem , Plasminogênio/administração & dosagem , Espécies Reativas de Oxigênio/metabolismo , Proteínas Recombinantes/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Túnica Íntima/imunologia , Túnica Íntima/patologia , Molécula 1 de Adesão de Célula Vascular/metabolismo
17.
Genes Immun ; 10(1): 27-36, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18971938

RESUMO

The eastern woodchuck, Marmota monax, represents a useful animal model to study hepatitis B virus infection in humans. However, immunological studies in this model have been impeded by a lack of basic information about the components of the immune system such as cytokines and chemokines. To clarify the role(s) of interleukin 8 (IL-8) in chronic hepatitis B and hepatocellular carcinoma (HCC) in the woodchuck model, we cloned and characterized the woodchuck IL-8 cDNA and genomic DNA. Sequence analysis revealed that the organization of the wk-IL-8 gene is similar to that of the human IL-8 gene and consists of four exons and three introns. Woodchuck IL-8 protein exhibits the conserved ELRCXC motif of IL-8 and shows 87, 82, 82 and 79% similarity with rabbit, ovine, bovine and human IL-8 proteins, respectively. The biological activity of wk-IL-8 was demonstrated using neutrophil chemotaxis assays. Wk-IL-8 could be readily detected in both tumor and non-tumor tissues with higher expression in the non-tumor tissues in most cases. The results from this study will facilitate the investigation of IL-8 in the immunopathogenesis of hepadnavirus-related diseases by the woodchuck model.


Assuntos
Carcinoma Hepatocelular/genética , Vírus da Hepatite B da Marmota/genética , Hepatite B/genética , Interleucina-8/genética , Neoplasias Hepáticas Experimentais/genética , Marmota/genética , Motivos de Aminoácidos , Sequência de Aminoácidos , Animais , Sequência de Bases , Carcinoma Hepatocelular/virologia , Linhagem Celular , Células Cultivadas , Sequência Conservada , DNA Complementar/genética , DNA Viral/sangue , Modelos Animais de Doenças , Éxons , Hepatite B/metabolismo , Hepatite B/virologia , Vírus da Hepatite B da Marmota/imunologia , Hepatite Viral Animal/genética , Humanos , Interleucina-8/metabolismo , Íntrons , Rim/citologia , Marmota/imunologia , Marmota/virologia , Dados de Sequência Molecular , Homologia de Sequência de Aminoácidos , Carga Viral
18.
J Thromb Haemost ; 6(11): 1953-61, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18761727

RESUMO

BACKGROUND: Angiostatin, a circulating angiogenic inhibitor, is an internal fragment of plasminogen and consists of several isoforms, K1-3 included. We previously showed that K1-3 was the most potent angiostatin to induce E-selectin mRNA expression. The purpose of this study was to identify the mechanism responsible for K1-3-induced E-selectin expression and investigate the role of E-selectin in the anti-angiogenic action of K1-3. METHODS AND RESULTS: Quantitative real time RT-PCR and Western blotting analyses confirmed a time-dependent increase of E-selectin mRNA and protein induced by K1-3. Subcellular fractionation and immunofluorescence microscopy showed the co-localization of K1-3-induced E-selectin with caveolin 1 (Cav1) in lipid rafts in which E-selectin may behave as a signaling receptor. Promoter-driven reporter assays and site-directed mutagenesis showed that K1-3 induced E-selectin expression via promoter activation and AP1 and Ets-1 binding sites in the proximal E-selectin promoter were required for E-selectin induction. The in vivo binding of both protein complexes to the proximal promoter was confirmed by chromatin immunoprecipitation (ChIP). Although K1-3 induced the activation of ERK1/2 and JNK, only repression of JNK activation attenuated the induction of E-selectin by K1-3. A modulatory role of E-selectin in the anti-angiogenic action of K1-3 was manifested by both overexpression and knockdown of E-selectin followed by cell proliferation assay. CONCLUSIONS: We show that K1-3 induced E-selectin expression via AP1 and Ets-1 binding to the proximal E-selectin promoter (-356/+1), which was positively mediated by JNK activation. Our findings also demonstrate E-selectin as a novel target for the anti-angiogenic therapy.


Assuntos
Angiostatinas/fisiologia , Selectina E/genética , Proteína Proto-Oncogênica c-ets-1/fisiologia , Fator de Transcrição AP-1/fisiologia , Ativação Transcricional , Sítios de Ligação , Caveolina 1/metabolismo , Linhagem Celular , Linhagem Celular Tumoral , Selectina E/metabolismo , Humanos , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Cinética , Microdomínios da Membrana/química , Regiões Promotoras Genéticas , Ligação Proteica , Isoformas de Proteínas/fisiologia , RNA Mensageiro
19.
J Thromb Haemost ; 6(10): 1685-92, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18647232

RESUMO

BACKGROUND: Dextromethorphan (DM) is reported to reduce the inflammation-mediated degeneration of dopaminergic neurons. OBJECTIVE: The goal of this study was to test if DM can improve the endothelial dysfunction and inflammatory markers in heavy smokers. PATIENTS AND METHODS: Forty habitual smoking healthy male volunteers (mean age, 31.5 +/- 1.4 years) were randomly given either DM (120 mg day(-1)) or a placebo for 6 months. We determined endothelial function using the brachial artery diameter changes in flow-mediated dilatation (FMD) and measured their inflammatory and oxidative markers. A sex-and-age matched non-smoking group (n = 20) was compared as normal parameters. RESULTS: Habitual smokers showed impaired baseline endothelial function in FMD (smoking vs. non-smoking: 6.3 +/- 1.8 vs. 10.2 +/- 2.3% respectively, P < 0.01). Without change in smoking behavior, lipid and metabolic parameters, a significant increase in FMD was found in the DM-treated group (32%), accompanied by a decrease in high-sensitivity C-reactive protein (hs-CRP), phospholipase A(2), matrix metalloproteinase-3, interleukin 6 (IL-6) and tumor necrosis factor-alpha receptor II (TNF-alpha RII) (all P < 0.05), but unchanged in von Willebrand factor (VWF)and plasminogen activator inhibitor-1 (PAI-1). An increase in plasma glutathione peroxidase and a decrease in spot urinary excretion of 8-epi-prostaglandin F(2a) were found in DM-treated smokers. CONCLUSIONS: Our study suggests that a 6-month treatment with DM can improve endothelial function and attenuate vascular oxidative stress and inflammation markers in habitual smokers.


Assuntos
Dextrometorfano/administração & dosagem , Endotélio Vascular/efeitos dos fármacos , Inflamação/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Fumar/tratamento farmacológico , Adulto , Método Duplo-Cego , Humanos , Masculino , Resultado do Tratamento , Vasodilatação/efeitos dos fármacos , Adulto Jovem
20.
Aesthetic Plast Surg ; 32(4): 641-4, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18224270

RESUMO

Severely inverted nipples are invaginated deeply and present many aesthetic, functional, and psychological problems. Many methods have been proposed for correction of this deformity. The authors describe a new simple method using two broad triangular areolar dermofibrous flaps. This method affords sufficient tissue to fill the dead space. Furthermore, it furnishes bulk to drive up the nipple, and because the cross lay of the flap and the epidermis make the areola circular and small, it provides sufficient areolar tissue for reconstruction of the defective nipple. The manipulation of postoperative "donut" traction is simple and useful. This method was used to correct 14 nipples of 9 patients successfully without any postoperative problems and with minimal scars and no recurrence of inversion. It is an ideal surgical procedure for the severely inverted nipple.


Assuntos
Mamilos/anormalidades , Mamilos/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Feminino , Humanos
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