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1.
Nat Commun ; 15(1): 3219, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622143

RESUMO

Diverse aerobic bacteria use atmospheric hydrogen (H2) and carbon monoxide (CO) as energy sources to support growth and survival. Such trace gas oxidation is recognised as a globally significant process that serves as the main sink in the biogeochemical H2 cycle and sustains microbial biodiversity in oligotrophic ecosystems. However, it is unclear whether archaea can also use atmospheric H2. Here we show that a thermoacidophilic archaeon, Acidianus brierleyi (Thermoproteota), constitutively consumes H2 and CO to sub-atmospheric levels. Oxidation occurs across a wide range of temperatures (10 to 70 °C) and enhances ATP production during starvation-induced persistence under temperate conditions. The genome of A. brierleyi encodes a canonical CO dehydrogenase and four distinct [NiFe]-hydrogenases, which are differentially produced in response to electron donor and acceptor availability. Another archaeon, Metallosphaera sedula, can also oxidize atmospheric H2. Our results suggest that trace gas oxidation is a common trait of Sulfolobales archaea and may play a role in their survival and niche expansion, including during dispersal through temperate environments.


Assuntos
Acidianus , Archaea , Temperatura , Ecossistema , Oxirredução , Hidrogênio
2.
World Neurosurg ; 183: e658-e667, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38181875

RESUMO

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


Assuntos
Discotomia Percutânea , Deslocamento do Disco Intervertebral , Masculino , Humanos , Idoso , Feminino , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Estudos Retrospectivos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Discotomia Percutânea/métodos , Endoscopia/métodos , Dor/cirurgia , Resultado do Tratamento
3.
Plant Physiol ; 191(3): 2012-2026, 2023 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-36653329

RESUMO

Legumes acquire soil nutrients through nitrogen-fixing root nodules and lateral roots. To balance the costs and benefits of nodulation, legumes negatively control root nodule number by autoregulatory and hormonal pathways. How legumes simultaneously coordinate root nodule and lateral root development to procure nutrients remains poorly understood. In Medicago (Medicago truncatula), a subset of mature C-TERMINALLY ENCODED PEPTIDE (CEP) hormones can systemically promote nodule number, but all CEP hormones tested to date negatively regulate lateral root number. Here we showed that Medicago CEP7 produces a mature peptide, SymCEP7, that promotes nodulation from the shoot without compromising lateral root number. Rhizobial inoculation induced CEP7 in the susceptible root nodulation zone in a Nod factor-dependent manner, and, in contrast to other CEP genes, its transcription level was elevated in the ethylene signaling mutant sickle. Using mass spectrometry, fluorescence microscopy and expression analysis, we demonstrated that SymCEP7 activity requires the COMPACT ROOT ARCHITECTURE 2 receptor and activates the shoot-to-root systemic effector, miR2111. Shoot-applied SymCEP7 rapidly promoted nodule number in the pM to nM range at concentrations up to five orders of magnitude lower than effects mediated by root-applied SymCEP7. Shoot-applied SymCEP7 also promoted nodule number in White Clover (Trifolium repens) and Lotus (Lotus japonicus), which suggests that this biological function may be evolutionarily conserved. We propose that SymCEP7 acts in the Medicago shoot to counter balance the autoregulation pathways induced rapidly by rhizobia to enable nodulation without compromising lateral root growth, thus promoting the acquisition of nutrients other than nitrogen to support their growth.


Assuntos
Lotus , Medicago truncatula , Rhizobium , Trifolium , Nodulação/genética , Raízes de Plantas/metabolismo , Medicago truncatula/metabolismo , Rhizobium/fisiologia , Lotus/genética , Peptídeos/metabolismo , Trifolium/metabolismo , Hormônios/metabolismo , Nitrogênio/metabolismo , Nódulos Radiculares de Plantas/metabolismo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Simbiose , Regulação da Expressão Gênica de Plantas
4.
Medicines (Basel) ; 8(9)2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34564091

RESUMO

Purpose: This study aims to elucidate the radiological outcome after Cortical bone trajectory (CBT) screw fixation and whether dual-threaded (DT) screws should be used in the fusion surgery. Methods: 159 patients with degenerative lumbar disorder who had undergone midline lumbar inter-body fusion surgery by CBT screw-fixation technique (2014 to 2018). Patient subgroups were based on single-threaded (ST) or DT screw, fixation length, as well as whether fixation involved to sacrum level (S1). Serial dynamic plain films were reviewed and an appearance of a halo phenomenon between screw-bone interfaces was identified as a case of screw loosening. Results: 29 patients (39.7%) in ST group and 10 patients (11.6%) in DT group demonstrated a halo phenomenon (p < 0.0001 ****). After subgrouping with fixation length, the incidence rates of a halo phenomenon in each group were 11.1%:3% (ST-1L vs. DT-1L), 37%:13.8% (ST-2L vs. DT-2L), and 84.2%:23.5% (ST-3L vs. DT-3L). Among the 85 patients with a fixation involved in S1, 26 patients (52%) with single-threaded screw (STS group) and 8 patients (22.8%) with dual-threaded screw (DTS group) demonstrated a halo appearance (p = 0.0078 **). After subgrouping the fixation level, the incidence of a halo appearance in each group was 25%:0% (STS-1L vs. DTS-1L), 40.9%:26.3% (STS-2L vs. DTS-2L), and 87.5%: 30% (STS-3L vs. DTS-3L). Conclusion: Both fixation length and whether fixation involved to S1 contribute to the incidence of screw loosening, the data supports clinical evidence that DT screws had greater fixation strength with an increased fixative stability and lower incidence of screw loosening in CBT screw fixation compared with ST screws. Level of evidence: 2.

5.
Antioxidants (Basel) ; 10(6)2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200854

RESUMO

Kefir, a fermented probiotic drink was tested for its potential anti-oxidative, anti-apoptotic, and neuroprotective effects to attenuate cellular oxidative stress on human SH-SY5Y neuroblastoma cells. Here, the antioxidant potentials of the six different kefir water samples were analysed by total phenolic content (TPC), total flavonoid content (TFC), ferric reducing antioxidant power (FRAP), and 2,2'-diphenyl-1-picrylhydrazyl radical (DPPH) assays, whereas the anti-apoptotic activity on hydrogen peroxide (H2O2) induced SH-SY5Y cells was examined using MTT, AO/PI double staining, and PI/Annexin V-FITC assays. The surface and internal morphological features of SH-SY5Y cells were studied using scanning and transmission electron microscopy. The results indicate that Kefir B showed the higher TPC (1.96 ± 0.54 µg GAE/µL), TFC (1.09 ± 0.02 µg CAT eq/µL), FRAP (19.68 ± 0.11 mM FRAP eq/50 µL), and DPPH (0.45 ± 0.06 mg/mL) activities compared to the other kefir samples. The MTT and PI/Annexin V-FITC assays showed that Kefir B pre-treatment at 10 mg/mL for 48 h resulted in greater cytoprotection (97.04%), and a significantly lower percentage of necrotic cells (7.79%), respectively. The Kefir B pre-treatment also resulted in greater protection to cytoplasmic and cytoskeleton inclusion, along with the conservation of the surface morphological features and the overall integrity of SH-SY5Y cells. Our findings indicate that the anti-oxidative, anti-apoptosis, and neuroprotective effects of kefir were mediated via the upregulation of SOD and catalase, as well as the modulation of apoptotic genes (Tp73, Bax, and Bcl-2).

6.
Sci Rep ; 11(1): 3847, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33589712

RESUMO

Ruxolitinib is the first janus kinase 1 (JAK1) and JAK2 inhibitor that was approved by the United States Food and Drug Administration (FDA) agency for the treatment of myeloproliferative neoplasms. The drug targets the JAK/STAT signalling pathway, which is critical in regulating the gliogenesis process during nervous system development. In the study, we assessed the effect of non-maternal toxic dosages of ruxolitinib (0-30 mg/kg/day between E7.5-E20.5) on the brain of the developing mouse embryos. While the pregnant mice did not show any apparent adverse effects, the Gfap protein marker for glial cells and S100ß mRNA marker for astrocytes were reduced in the postnatal day (P) 1.5 pups' brains. Gfap expression and Gfap+ cells were also suppressed in the differentiating neurospheres culture treated with ruxolitinib. Compared to the control group, adult mice treated with ruxolitinib prenatally showed no changes in motor coordination, locomotor function, and recognition memory. However, increased explorative behaviour within an open field and improved spatial learning and long-term memory retention were observed in the treated group. We demonstrated transplacental effects of ruxolitinib on astrogenesis, suggesting the potential use of ruxolitinib to revert pathological conditions caused by gliogenic-shift in early brain development such as Down and Noonan syndromes.


Assuntos
Astrócitos/efeitos dos fármacos , Aprendizagem/efeitos dos fármacos , Exposição Materna , Memória/efeitos dos fármacos , Neurogênese/efeitos dos fármacos , Nitrilas/administração & dosagem , Inibidores de Proteínas Quinases/administração & dosagem , Pirazóis/administração & dosagem , Pirimidinas/administração & dosagem , Fatores Etários , Animais , Astrócitos/metabolismo , Comportamento Animal/efeitos dos fármacos , Biomarcadores , Feminino , Janus Quinases/antagonistas & inibidores , Masculino , Exposição Materna/efeitos adversos , Camundongos , Neurogênese/genética , Nitrilas/efeitos adversos , Especificidade de Órgãos/efeitos dos fármacos , Gravidez , Inibidores de Proteínas Quinases/efeitos adversos , Pirazóis/efeitos adversos , Pirimidinas/efeitos adversos
7.
Medicine (Baltimore) ; 99(40): e22186, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019393

RESUMO

This study aimed to verify the relationship between the number of fusion level and the risk of screw loosening by using cortical bone trajectory (CBT) screws in patients with lumbar degenerative disease.We retrospectively reviewed the serial plain radiograph images of lumbar degenerative disease patients who had undergone posterior fixation and fusion surgery with CBT from 2014. All included patients should have been followed-up with computed tomography scan or plain radiograph for at least 6 months after operation. We individually evaluated the prevalence of screw loosening according to each vertebral level. We also determined whether the number of screw fixation affected the prevalence of screw loosening and whether S1 fixation increased the risk of screw loosening.The screw-loosening rates were high at the S1 level. Moreover, although fixation involved to S1, the loosening rates evidently increased (Fisher exact test, P = .002). The screw-loosening rate was 6.56% in 2 level fusion. However, it increased with the number of fusion levels (3 level: 25.00%, 4 level: 51.16%, and 5 level: 62.50%). To investigate if the number of fusion level affected the S1 screw loosening, we classified the cohort of patients into either involving S1 (S1+ group) or not (S1- group) according to different fusion levels (). The screw loosening between 2 group in 2 (5.56% vs 6.98%) and 3 fusion level (26.32% vs 22.73%) did not exhibit any significant difference. Interestingly, significantly high screw loosening was found in 4 fusion level (60.00% vs 15.38%), indicating that the higher fusion level (4 level) can directly increase the risk of S1 screw loosening.Our data confirmed that the screw-loosening rate increases rate when long segment CBT fixation involves to S1. Therefore, in case of long-segment fixation by using CBT screw, surgeons should be aware of the fusion level of S1.


Assuntos
Parafusos Ósseos , Degeneração do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/cirurgia , Fusão Vertebral/instrumentação , Osso Cortical/diagnóstico por imagem , Análise de Falha de Equipamento/métodos , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
Molecules ; 25(16)2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32781747

RESUMO

Glioblastoma is one of the most common and most aggressive brain cancers. The current treatment is mainly surgery, chemotherapy, and radiation therapy, but the results are not satisfactory. Ganoderma lucidum (G. lucidum), also called "Lingzhi", is a medicinal mushroom that has been used as a therapeutic agent for the treatment of numerous diseases, including cancer. However, whether it is effective for treating cancer is still unclear. In the present study, the anti-tumor effect of a water extract of G. lucidum was investigated using brain tumor cells. We used an analysis of cell viability, flow cytometry, the IncuCyte live-cell analysis system, and Western blotting to study its effects. The water extract from G. lucidum inhibited cell proliferation in a dose- and time-dependent manner, and it induced mitochondria-mediated apoptosis and cell cycle arrest at S phase via the cyclin-CDK2 pathway in human brain tumor cells. In addition, the G. lucidum extract significantly inhibited cell migration and mesenchymal marker expression based on the IncuCyte live-cell assay and qRT-PCR analysis. In summary, these anti-tumor effects in brain tumor cells suggest that G. lucidum may be useful for treating brain tumors.


Assuntos
Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Quinase 2 Dependente de Ciclina/metabolismo , Ciclinas/metabolismo , Glioblastoma/patologia , Reishi/química , Pontos de Checagem da Fase S do Ciclo Celular/efeitos dos fármacos , Antineoplásicos/química , Antineoplásicos/isolamento & purificação , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Humanos , Água/química
9.
Cancers (Basel) ; 12(7)2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32635336

RESUMO

Glioblastoma (GBM) is the most common primary brain tumor in adults. Tumor invasion is the major reason for treatment failure and poor prognosis in GBM. Inhibiting migration and invasion has become an important therapeutic strategy for GBM treatment. Enhancer of zeste homolog 2 (EZH2) and C-X-C motif chemokine receptor 4 (CXCR4) have been determined to have important roles in the occurrence and development of tumors, but the specific relationship between EZH2 and CXCR4 expression in GBM is less well characterized. In this study, we report that EZH2 and CXCR4 were overexpressed in glioma patients. Furthermore, elevated EZH2 and CXCR4 were correlated with shorter disease-free survival. In three human GBM cell lines, EZH2 modulated the expression of miR-9, which directly targeted the oncogenic signaling of CXCR4 in GBM. The ectopic expression of miR-9 dramatically inhibited the migratory capacity of GBM cells in vitro. Taken together, our results indicate that miR-9, functioning as a tumor-suppressive miRNA in GBM, is suppressed through epigenetic silencing by EZH2. Thus, miR-9 may be an attractive target for therapeutic intervention in GBM.

10.
Medicina (Kaunas) ; 56(2)2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32079310

RESUMO

BACKGROUND: Osteoporotic spinal fractures commonly occur in elderly patients with low bone mineral density. In these cases, percutaneous vertebroplasty or percutaneous kyphoplasty can provide significant pain relief and improve mobility. However, studies have reported both the recurrence of vertebral compression fractures at the index level after vertebroplasty and the development of new vertebral fractures at the adjacent level that occur without any additional trauma. Pedicle screw fixation combined with percutaneous vertebroplasty has been proposed as an effective procedure for addressing osteoporotic thoracolumbar fractures. However, in osteoporotic populations, pedicle screws can loosen, pullout, or migrate. Currently, the efficacy of cortical bone trajectory screw fixation for osteoporotic fractures remains unclear. Thus, we assessed the effects of using cortical bone trajectory instrumentation with vertebroplasty on patient outcomes. METHOD: We retrospectively reviewed data from 12 consecutively sampled osteoporotic thoracolumbar fracture patients who underwent cortical bone trajectory instrumentation with vertebroplasty. Patients were enrolled beginning in October 2015 and were followed for >24 months. RESULT: The average age was 74 years, and the average dual-energy x-ray absorptiometry T-score was -3.6. The average visual analog scale pain scores improved from 8 to 2.5 after surgery. The average blood loss was 36.25 mL. All patients regained ambulation and experienced reduced pain post-surgery. No recurrent fractures or instrument failures were recorded during follow-up. CONCLUSIONS: Our findings suggest that cortical bone trajectory instrumentation combined with percutaneous vertebroplasty may be a good option for treating osteoporotic thoracolumbar fractures, as it can prevent recurrent vertebral fractures or related kyphosis in sagittal alignment.


Assuntos
Osso Cortical/cirurgia , Fraturas por Compressão/cirurgia , Osteoporose/complicações , Vertebroplastia/instrumentação , Idoso , Idoso de 80 Anos ou mais , Osso Cortical/lesões , Feminino , Fraturas por Compressão/etiologia , Fraturas por Compressão/fisiopatologia , Humanos , Vértebras Lombares/lesões , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/cirurgia , Estudos Retrospectivos , Taiwan , Vértebras Torácicas/lesões , Vértebras Torácicas/fisiopatologia , Resultado do Tratamento , Vertebroplastia/métodos
11.
J Clin Neurosci ; 55: 103-108, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30257804

RESUMO

Midline lumbar inter-body fusion (MIDLF) surgery with cortical bone trajectory (CBT) screw insertion is a modern fusion technique for spinal surgery. The difference in entry point of this trajectory from conventional pedicle screw surgery offers the potential benefits of less soft tissue dissection and reduced blood loss, post-operative wound pain, and infection risks. Because this is a newly developed technique first announced by Santoni in 2009, most surgeons perform this surgery in a mini-open fashion and require more intra-operative fluoroscopy and ionizing radiation exposure during screw placement. In this article, we demonstrate a minimally invasive midline lumbar interbody fusion (MIS-MIDLF) technique with percutaneous CBT screw placement. Using a designed cannulated awl, we only need a single dimensional fluoroscopy view from anterior to posterior (AP view) to achieve an accurate trajectory and therefore reduce radiation exposure. We report our first ten consecutive patients with degenerative spondylolithesis who underwent MISS-MIDLF and were followed up for more than 18 months. The procedure required a single wound of about 3 cm in length in one to two level fusion surgery and only three to four shots of fluoroscopy were needed for each screw placement. There were no screws malpositioned in subsequent plain films or computer tomography scans. We demonstrate a case with detailed surgical procedures and provide this technique as an alternative approach for surgeons performing MILDF surgery.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Adulto , Idoso , Feminino , Fluoroscopia/métodos , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Parafusos Pediculares , Tomografia Computadorizada por Raios X
12.
Atherosclerosis ; 277: 42-46, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30172083

RESUMO

BACKGROUND AND AIMS: Cervical spondylosis (CS) is reported to be associated with vertebrobasilar insufficiency. However, few cohort studies have investigated the association between CS and posterior circulation ischemic stroke. METHODS: The study cohort comprised 27,990 patients aged ≥18 years with a first diagnosis of CS. The controls consisted of patients with propensity score matched for age, sex, and comorbidities at a ratio of 1:1. We investigated the relationships of CS with ischemic stroke and all-cause mortality. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The average follow-up duration was 6.13 (SD = 3.18) and 6.07 (SD = 3.19) years in the CS and non-CS cohorts, respectively. RESULTS: The mean age of CS patients and non-CS patients was 54.9 ±â€¯13.4 and 55.1 ±â€¯14.9 years. Fifty-eight point five percent of CS patients and 59.2% of non-CS patients were women. CS patients were 1.46 folds more likely to develop a posterior circulation ischemic stroke (95% CI, 1.23-1.72) than non-CS patients. CS patients with myelopathy exhibited a 1.50-fold risk (95% CI, 1.21-1.86) of posterior circulation ischemic stroke compared with non-CS patients; CS patients without myelopathy were at a 1.43-fold risk (95% CI, 1.18-1.73) of posterior ischemic stroke compared with non-CS patients. The risk of posterior ischemic stroke was non-significant between non-CS patients and CS patients who had received spinal anterior decompression (adjusted HR, 1.66; 95% CI, 0.78-3.52), while receiving posterior decompression was associated with a 4.23-fold risk of posterior ischemic stroke (95% CI, 1.05-17.0). CONCLUSIONS: This population-based study showed that CS is associated with an increased risk of posterior circulation ischemic stroke. Surgical posterior decompression was associated with the highest risk of posterior ischemic stroke.


Assuntos
Isquemia Encefálica/epidemiologia , Espondilose/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/mortalidade , Isquemia Encefálica/fisiopatologia , Circulação Cerebrovascular , Comorbidade , Bases de Dados Factuais , Descompressão Cirúrgica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/efeitos adversos , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Espondilose/diagnóstico , Espondilose/mortalidade , Espondilose/cirurgia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/fisiopatologia , Taiwan/epidemiologia , Fatores de Tempo
13.
Atherosclerosis ; 271: 136-141, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29518745

RESUMO

BACKGROUND AND AIMS: Cervical spondylosis (CS) is reported to be associated with increased sympathetic activity and hypertension. However, the cardiovascular (CV) outcomes of patients with CS are largely unknown. METHODS: A national insurance claims dataset of 22 million enrollees in Taiwan during 1999-2010 was used as the research database. We identified 27,948 patients with CS and age-, sex-, and comorbidity-matched controls. By using multivariate logistic regression analysis after adjustment for potential cardiovascular (CV) confounders, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) to quantify the association between CS and acute coronary syndrome (ACS). RESULTS: A total of 744 ACS events were identified among the 27,948 patients with CS. The overall incidence of ACS was 4.27 per 1000 person-years in the CS cohort and 3.90 per 1000 person-years in the non-CS cohort, with an adjusted hazard ratio (aHR) of 1.13 (95% CI = 1.08-1.18). The aHRs of ACS were 1.08 (95% CI = 1.03-1.15) in the CS cohort without myelopathy and 1.20 (95% CI = 1.13-1.28) in the CS cohort with myelopathy, compared with the non-CS cohort. Compared with patients with CS without neurological signs, patients with CS receiving rehabilitation exhibited a 0.67 aHRs of ACS (95% CI = 0.59-0.76), whereas those with neurological signs receiving spinal decompression exhibited 0.73 aHRs of ACS (95% CI = 0.63-0.84). CONCLUSIONS: CS is associated with an increased risk of ACS. Receiving treatment for CS, either rehabilitation or spinal decompression, is associated with less risk of ACS.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Vértebras Cervicais , Espondilose/epidemiologia , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/prevenção & controle , Demandas Administrativas em Assistência à Saúde , Idoso , Vértebras Cervicais/fisiopatologia , Vértebras Cervicais/cirurgia , Comorbidade , Bases de Dados Factuais , Descompressão Cirúrgica , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodos , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Espondilose/mortalidade , Espondilose/fisiopatologia , Espondilose/terapia , Taiwan/epidemiologia , Fatores de Tempo
14.
Sci Rep ; 7: 45628, 2017 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-28361971

RESUMO

PG2 is an infusible polysaccharide extracted from Astragalus membranaceus, which is a Chinese herb traditionally used for stroke treatment. We investigated the effect of PG2 on patients with spontaneous acute intracerebral hemorrhage (ICH). A total of 61 patients with acute spontaneous ICH were randomized to either the treatment group (TG, 30 patients), which received 3 doses of PG2 (500 mg, IV) per week for 2 weeks, or the control group (CG, 31 patients), which received PG2 placebo. At 84 days after PG2 administration, the percentage of patients with a good Glasgow outcome scale (GOS 4-5) score in the TG was similar to that in the CG (69.0% vs. 48.4%; p = 0.2). The percentage of good mRS scores (0-2) in the TG was similar to that in the CG (62.1% vs. 45.2%; p = 0.3). In addition, no significant differences were seen when comparing differences in the C-reactive protein, erythrocyte sedimentation rate, interleukin-6 (IL-6), IL-1ß, tumor necrosis factor-α, and S100B levels between baseline and days 4, 7, and 14 after PG2 administration (all p > 0.05). The results are preliminary, necessitating a more thorough assessment.


Assuntos
Hemorragia Cerebral/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Astragalus propinquus , Método Duplo-Cego , Feminino , Escala de Resultado de Glasgow , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Polissacarídeos/administração & dosagem , Polissacarídeos/isolamento & purificação , Resultado do Tratamento
15.
Turk Neurosurg ; 27(1): 155-159, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27349395

RESUMO

Primitive neuroectodermal tumors (PNETs) are easily detected, and the diagnosis made by neuroradiologic imaging. Leptomeningeal seeding is a common complication and carries a poor prognosis. Primary leptomeningeal PNETs are rarer and difficult to diagnose on magnetic resonance imaging (MRI) or cerebrospinal fluid (CSF) studies. We encountered a rare case of primary leptomeningeal primitive neuroectodermal tumor without intracranial mass lesion which was diagnosed by spinal lesion biopsy. This 25-year-old woman presented with worsening headaches and progressive visual impairment.The initial diagnosis was tubercle bacillus (TB) meningitis, and the final diagnosis of primary leptomeningeal PNET was made by spinal biopsy. We present this illustrative case, review previous cases in the literature, and suggest that diagnosis is considered in mildly affected patients with similar symptoms.


Assuntos
Neoplasias Meníngeas/diagnóstico , Tumores Neuroectodérmicos Primitivos/diagnóstico , Tuberculose Meníngea/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Meníngeas/complicações , Tumores Neuroectodérmicos Primitivos/complicações
16.
Surg Neurol Int ; 6(Suppl 7): S275-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26069849

RESUMO

BACKGROUND: Perimedullary arteriovenous fistula (AVF) is rare. There are three subtypes, and the treatment strategies for each are different. Subtype B (multiple fistulas) can be treated by either embolization or surgery. On the basis of a case from our treatment experience, we propose a method for achieving optimal outcome while minimizing nerve injury. CASE DESCRIPTION: A 51-year-old female was admitted to our hospital with acute myelopathy caused by a perimedullary AVF. Initially, we treated her by embolization using the chemical agent Onyx. Her symptoms improved immediately but gradually returned beginning 1 week later. Two months later, the symptoms had returned to pretreatment status, so we removed the fistulas surgically. Severe adhesions between nerve and occult venous varices were noted during the operation. Afterward, the patient's symptoms improved significantly. Histopathological sections showed an inflammatory reaction around the varices. CONCLUSIONS: We initially considered several possible reasons for the return of symptoms: (a) Hypoperfusion of the spinal cord; (b) mass effect of the occult vein varices; (c) residual AVF or vascular remodeling resulting in recurrent cord hypertension; (d) Onyx-induced perivascular inflammation resulting in nerves adhering to each other and to occult venous varices. Clinical, surgical, and pathological findings ruled out the first three, leaving Onyx-induced perivascular inflammation as the probable reason. Given our treatment experience and the pros and cons of the two methods, we propose that initial embolization followed by surgery after 5 days to remove occult venous varices is the ideal strategy for treating perimedullary AVF of subtype B.

17.
Am J Chin Med ; 43(2): 215-30, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25787300

RESUMO

We assessed the therapeutic effects of lumbrokinase, a group of enzymes extracted from the earthworm, on peripheral-nerve regeneration using well-defined sciatic nerve lesion paradigms in diabetic rats induced by the injection of streptozotocin (STZ). We found that lumbrokinase therapy could improve the rats' circulatory blood flow and promote the regeneration of axons in a silicone rubber conduit after nerve transection. Lumbrokinase treatment could also improve the neuromuscular functions with better nerve conductive performances. Immunohistochemical staining showed that lumbrokinase could dramatically promote calcitonin gene-related peptide (CGRP) expression in the lamina I-II regions in the dorsal horn ipsilateral to the injury and cause a marked increase in the number of macrophages recruited within the distal nerve stumps. In addition, the lumbrokinase could stimulate the secretion of interleukin-1 (IL-1), nerve growth factor (NGF), platelet-derived growth factor (PDGF), and transforming growth factor-ß (TGF-ß) in dissected diabetic sciatic nerve segments. In conclusion, the administration of lumbrokinase after nerve repair surgery in diabetic rats was found to have remarkable effects on promoting peripheral nerve regeneration and functional recovery.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/fisiopatologia , Endopeptidases/administração & dosagem , Endopeptidases/farmacologia , Regeneração Nervosa/efeitos dos fármacos , Nervo Isquiático/fisiologia , Administração Oral , Animais , Circulação Sanguínea/efeitos dos fármacos , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Endopeptidases/isolamento & purificação , Interleucina-1/metabolismo , Macrófagos , Masculino , Fator de Crescimento Neural/metabolismo , Condução Nervosa/efeitos dos fármacos , Oligoquetos/enzimologia , Fator de Crescimento Derivado de Plaquetas/metabolismo , Ratos Sprague-Dawley , Nervo Isquiático/irrigação sanguínea , Nervo Isquiático/metabolismo , Estreptozocina , Fator de Crescimento Transformador beta/metabolismo
18.
J Neuroinflammation ; 11: 134, 2014 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-25074682

RESUMO

BACKGROUND: We report a novel method of culturing microglia in three dimension (3D) using collagen as a substrate. By culturing microglia within a matrix, we aim to emulate the physical state of microglia embedded within parenchyma. METHODS: BV2 microglia cell suspensions were prepared with type I collagen and cast into culture plates. To characterise the BV2 microglia cultured in 3D, the cultures were evaluated for their viability, cell morphology and response to lipopolysaccharide (LPS) activation. Conventional monolayer cultures (grown on uncoated and collagen-coated polystyrene) were set up concurrently for comparison. RESULTS: BV2 microglia in 3D collagen matrices were viable at 48 hrs of culture and exhibit a ramified morphology with multiplanar cytoplasmic projections. Following stimulation with 1 µg/ml LPS, microglia cultured in 3D collagen gels increase their expression of nitric oxide (NO) and CD40, indicating their capacity to become activated within the matrix. Up to 97.8% of BV2 microglia grown in 3D cultures gained CD40 positivity in response to LPS, compared to approximately 60% of cells grown in a monolayer (P<.05). BV2 microglia in 3D collagen gels also showed increased mRNA and protein expression of inflammatory cytokines IL-6, TNF-α and the chemoattractant MCP-1 following LPS stimulation. CONCLUSIONS: In summary, BV2 microglia cultured in 3D collagen hydrogels exhibit multiplanar cytoplasmic projections and undergo a characteristic and robust activation response to LPS. This culture system is accessible to a wide range of analyses and provides a useful new in vitro tool for research into microglial activation.


Assuntos
Colágeno/metabolismo , Imageamento Tridimensional , Lipopolissacarídeos/farmacologia , Microglia/citologia , Microglia/efeitos dos fármacos , Modelos Biológicos , Animais , Antígenos CD40/metabolismo , Linhagem Celular Transformada , Colágeno/ultraestrutura , Citocinas/genética , Citocinas/metabolismo , L-Lactato Desidrogenase/metabolismo , Lectinas/metabolismo , Camundongos , Microglia/ultraestrutura , Microscopia Eletrônica de Varredura
19.
Clin Neurol Neurosurg ; 124: 85-9, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25019457

RESUMO

OBJECTIVE: Decompressive craniectomy is performed to treat malignant brain hypertension. Surgical site infection (SSI) and bone resorption are common complications following cranioplasty, and the storage method that minimizes such complication has yet to be identified. METHODS: Over a 10-year period, the details of 290 decompressive craniectomy procedures performed at our trauma and stroke center were recorded. Bone flaps from 110 patients were preserved in subcutaneous pockets (SPs), and 180 were preserved via cryopreservation (CP). RESULTS: SSIs occurred in 20 cases (18.2%) in the SP group and 20 cases (11.1%) in the CP group (P=0.129). After dividing each group according to the traumatic brain injury (TBI) etiologies, we found that in the SP group, the SSI rates in the TBI and non-TBI patients were 17.3% and. 20.7% (P=0.899), respectively, and in the TBI- and non-TBI CP-group patients, the SSI rates were 11.9% and. 9.7% (P=0.864), respectively. The average decrease in bone flap thicknesses were 1.14 mm in the SP group (n=34) and 1.89 mm in the CP group (n=57), and this difference was significant (P=0.039). CONCLUSIONS: In this series, the SSI rates were similar in the SP and CP groups. There was no significant difference when the patients were grouped by TBI etiology. The incidence of bone flap resorption in the CP group was higher than that in the SP group. However, identifying of the method that yields superior results might depend on the individual surgeon's preference and the available equipment.


Assuntos
Reabsorção Óssea/epidemiologia , Craniectomia Descompressiva/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Reimplante/estatística & dados numéricos , Tela Subcutânea/cirurgia , Retalhos Cirúrgicos/estatística & dados numéricos , Infecção da Ferida Cirúrgica/epidemiologia , Preservação de Tecido/estatística & dados numéricos , Adulto , Idoso , Criopreservação/estatística & dados numéricos , Craniectomia Descompressiva/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reimplante/efeitos adversos
20.
Turk Neurosurg ; 24(3): 363-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24848175

RESUMO

AIM: Matrix metalloproteinase 9 (MMP-9) has been shown to be a potential biomarker for outcome prediction after neuron damage. This study investigated whether MMP-9 could be used for outcome prediction after traumatic brain injury (TBI). MATERIAL AND METHODS: For the TBI group, cerebrospinal fluid (CSF) was collected at different days after surgery from 6 head injury patients who had received surgical intervention with external ventricular drainage insertion. CSF collected from non-TBI patients (N=85) diagnosed with isolated hydrocephalus by a ventricular puncture during a ventriculo-peritoneal shunt surgery was used as control. RESULTS: The mean concentration of MMP-9 in the CSF of 85 non-TBI patients was determined to be 1.172 ± 0.859 ng/mL. We found that the CSF MMP-9 concentration from TBI patients was elevated immediately after head injury with a median of 1.926 ng/mL (range, 0.673 to 24.990). Despite an early increase in the concentration of MMP-9, levels decreased within 72 hrs and nearly reached the normal range. Nevertheless, the concentration of MMP-9 was negatively correlated with the Glasgow Coma Scale (γ = - 0.337, p = 0.013). CONCLUSION: MMP-9 concentration in the CSF of TBI patients correlated with neurological outcome and may represent an early indicator for the prognosis of this condition.


Assuntos
Lesões Encefálicas/líquido cefalorraquidiano , Metaloproteinase 9 da Matriz/líquido cefalorraquidiano , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Escala de Coma de Glasgow , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
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