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1.
J Viral Hepat ; 25(8): 969-975, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29577495

RESUMO

Multiple direct-acting antiviral (DAA)-based regimens are now available for all hepatitis C virus (HCV) genotypes (GTs). Because HCV GT 4, 5 and 6 are less common in the United States (US) and worldwide, relatively small numbers of participants with these GTs were evaluated in individual clinical trials. To provide a comprehensive description of subtype diversity and treatment outcomes in clinical trials for these less common GTs, we analysed data from 744 participants with HCV GT4 (n = 573), GT5 (n = 81), or GT6 (n = 90) across 18 clinical trials of DAA regimens. These data are from US New Drug Applications submitted between 2014 and 2017, and our analyses included only approved regimens. Excluding unresolved or mixed subtypes, the distribution of reported GT4 subtypes was 49% 4a, 31% 4d and 16% for one of 14 other subtypes. The distribution of GT6 subtypes was 39% 6a, 27% 6e, 8% 6 L and 23% for one of 11 other subtypes. Across approved regimens, sustained virologic response rates 12 weeks post-treatment (SVR12) for GT 4, 5 and 6 ranged from 91% to 100%, 93% to 97% and 96% to 100%, respectively. SVR12 by GT4 subtype ranged from 96% to 100% for 4a and 81% to 100% for 4d. Virologic failures occurred in GT 4a, 4b, 4d and 4r. For GT6, SVR12 was 100% for all subtypes except 6 L, for which 1 of 7 participants experienced virologic failure. To our knowledge, this is the largest compilation of HCV GT 4, 5 or 6 clinical trial data. These analyses may be useful for clinicians treating HCV GT 4, 5 or 6.


Assuntos
Antivirais/administração & dosagem , Genótipo , Hepacivirus/classificação , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/virologia , Resposta Viral Sustentada , Ensaios Clínicos como Assunto , Hepacivirus/isolamento & purificação , Humanos , Resultado do Tratamento , Estados Unidos
2.
Anim Genet ; 46(5): 557-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25997367

RESUMO

Because fatty acid composition influences the flavor and texture of meat, controlling it is particularly important for cattle breeds such as the Japanese Black, characterized by high meat quality. We evaluated the predictive ability of single-step genomic best linear unbiased prediction (ssGBLUP) in fatty acid composition of Japanese Black cattle by assessing the composition of seven fatty acids in 3088 cattle, of which 952 had genome-wide marker genotypes. All sires of the genotyped animals were genotyped, but their dams were not. Cross-validation was conducted for the 952 animals. The prediction accuracy was higher with ssGBLUP than with best linear unbiased prediction (BLUP) for all traits, and in an empirical investigation, the gain in accuracy of using ssGBLUP over BLUP increased as the deviations in phenotypic values of the animals increased. In addition, the superior accuracy of ssGBLUP tended to be more evident in animals whose maternal grandsire was genotyped than in other animals, although the effect was small.


Assuntos
Bovinos/genética , Ácidos Graxos/química , Carne , Animais , Cruzamento , Bovinos/classificação , Feminino , Genoma , Genótipo , Masculino , Modelos Genéticos , Linhagem , Fenótipo , Característica Quantitativa Herdável
3.
Neoplasma ; 59(6): 650-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22862159

RESUMO

We investigated the prognostic factors after radiotherapy for bone metastasis from lung cancer while taking the recent findings in the treatment of such cases into consideration. A total of 132 patients with bone metastases from pathologically confirmed lung cancer were evaluated regarding the following potential prognostic factors: treatment for primary site (surgery vs. other), treatment site (spine vs. other), number of bone metastases (solitary vs. multiple), number of metastatic organs (0 vs. 1 vs. ≥2), neurological symptoms (no symptoms vs. numbness vs. paresis), degree of pain (no pain vs. mild pain vs. severe pain), performance status [PS] (0-1 vs. ≥2), biological effective dose [BED] (≥40 Gy vs. <40Gy), time to distant metastasis (≥1 year vs. <1 year), histology (adenocarcinoma vs. others), and use of epidermal growth factor receptor [EGFR]-targeted agents (Yes vs. No). The univariate analysis demonstrated that all factors except for the treatment site were significant. Surgery as treatment for primary site, solitary bone metastasis, no visceral organ metastasis, no symptoms or numbness, no pain, PS<2, BED≥40 Gy, time to distant metastasis ≥ 1year, adenocarcinoma histology, and use of EGFR-targeted agents were correlated with a favorable prognosis. In a multivariate analysis, solitary bone metastasis, PS<2, BED≥40 Gy, adenocarcinoma histology, and the use of EGFR-targeted agents were significantly correlated with a better survival (p = 0.038, 0.006, 0.003, 0.014, and <0.001, respectively). A contingency table to assess the relationship between each variable and the median survival time of the patients according to the administered BED showed that in patients with the time to distant metastasis ≥ 1year and the use of EGFR-targeted agents, the subgroups treated with BED≥40 Gy had a favorable prognosis. Our study suggests that high-dose radiotherapy is associated with a better prognosis in combination with other favorable prognostic factors.


Assuntos
Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Neoplasias Pulmonares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/mortalidade , Receptores ErbB/antagonistas & inibidores , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida
4.
Heliyon ; 8(11): e11468, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36406717

RESUMO

Background: We previously reported a novel technique for fabricating dermo-epidermal junction (DEJ)-like micropatterned collagen scaffolds to manufacture an ex vivo produced oral mucosa equivalent (EVPOME) for clinical translation; however, more biomimetic micropatterns are required to promote oral keratinocyte-based tissue engineering/regenerative medicine. In addition, in-process monitoring for quality control of tissue-engineered products is key to successful clinical outcomes. However, evaluating three-dimensional tissue-engineered constructs such as EVPOME is challenging. This study aimed to update our technique to fabricate a more biomimetic DEJ structure of oral mucosa and to investigate the efficacy of optical coherence tomography (OCT) in combination with deep learning for non-invasive EVPOME monitoring. Methods: A picosecond laser-textured microstructure mimicking DEJ on stainless steel was used as a negative mould to fabricate the micropatterned collagen scaffold. During EVPOME manufacturing, OCT was applied twice to monitor the EVPOME and evaluate its epithelial thickness. Findings: Our moulding system resulted in successful micropattern replication on the curved collagen scaffold. OCT imaging visualised the epithelial layer and the underlying micropatterned scaffold in EVPOME, enabling to non-invasively detect specific defects not found before the histological examination. Additionally, a gradual increase in epithelial thickness was observed over time. Conclusion: These findings demonstrate the feasibility of using a stainless-steel negative mould to create a more biomimetic micropattern on collagen scaffolds and the potential of OCT imaging for quality control in oral keratinocyte-based tissue engineering/regenerative medicine.

5.
Ann Oncol ; 22(9): 2121-2128, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21285135

RESUMO

BACKGROUND: We developed an e-learning system, which is based on an interactive animation video that assists anesthesiologists in preanesthetic interviews. MATERIALS AND METHODS: First, the feasibility of the system was investigated in 18 anesthesiologists and 95 volunteers from the general public. Content/quantity, operability, and satisfaction were assessed with a five-point scale. Secondly, a randomized controlled trial was conducted on 211 cancer patients who were scheduled to undergo general anesthesia. They were divided into an e-learning group (n = 106) and a control group (n = 105). The patients in the e-learning group watched the interactive animation before a preanesthetic interview by an anesthesiologist. RESULTS: In 10 of the 11 items for content/quantity, operability, and satisfaction, the average score for both anesthesiologists and volunteers was ≥3.0 in feasibility study. Then, the level of patient comprehension of preoperative rounds and postoperative complications in the e-learning group was significantly higher than that in the control group (mean: 4.4 ± 0.5 versus 4.1 ± 0.7, P = 0.003, and 4.3 ± 0.5 versus 4.2 ± 0.5, P = 0.02); however, no significant difference in anxiety was seen between the two groups. Patient satisfaction in the e-learning group was significantly higher (mean: 4.3 ± 0.5 versus 4.0 ± 0.6, P = 0.002). CONCLUSION: The e-learning system is an effective supplementary tool for preanesthetic interviews in cancer patients.


Assuntos
Anestesia Geral/métodos , Anestesiologia/métodos , Instrução por Computador/métodos , Neoplasias/cirurgia , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/prevenção & controle , Recursos Audiovisuais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Interface Usuário-Computador , Gravação em Vídeo , Adulto Jovem
6.
Kyobu Geka ; 64(7): 574-8, 2011 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-21766711

RESUMO

A 79-year-old female who had been observed for an intrapericardial cyst for 3 years was admitted due to severe dyspnea and back pain. During 3 years observation, there were no symptoms and no growth of the cyst. Computed tomography scans showed rapid expansion of the cyst compared with an magnetic resonance imaging (MRI) taken 9-days before when she visited our hospital for the 1st time. Urgent complete extirpation of the tumor was successfully done and a histological diagnosis found it was an intrapericardial bronchogenic cyst. This is a 1st report of intrapericardial bronchogenic cyst of which rapid expansion is clearly demonstrated by radiology. It is suggested that complete surgical excision of intrapericardial bronchogenic cysts at the time of diagnosis even if asymptomatic.


Assuntos
Cisto Broncogênico/complicações , Cisto Broncogênico/patologia , Insuficiência Respiratória/etiologia , Idoso , Feminino , Humanos , Pericárdio
7.
Clin Exp Immunol ; 162(1): 169-77, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20659123

RESUMO

Administration of bacterial lipopolysaccharide (LPS) known as endotoxin into α-galactosylceramide (α-GalCer)-sensitized mice causes severe lung lesions but few hepatic lesions in lethal shock, and interferon (IFN)-γ is suggested to play a pivotal role in preparation of the lung lesions. In order to clarify the mechanism of how α-GalCer sensitization causes lung lesions exclusively in mice, we examined the differential responsiveness of lungs and livers to α-GalCer sensitization. Although lung and liver natural killer T (NK T) cells both produced IFN-γ in response to α-GalCer, IFN-γ signalling was triggered only in the lungs of α-GalCer-sensitized mice. Lung NK T cells did not produce interleukin (IL)-4 in response to α-GalCer and it did not induce the expression of suppressor of cytokine signalling 1 (SOCS1) in the lungs. Conversely, IL-4 produced by liver NK T cells led to the expression of SOCS1 in the livers of the mice. Neutralization of IL-4 reduced SOCS1 expression in the livers and exacerbated LPS-induced hepatic lesions. IL-10 was produced by liver NK T cells but not lung NK T cells. However, IL-10 was produced constitutively by alveolar epithelial cells in normal lung. Lung NK T cells and liver NK T cells might express CD8 and CD4, respectively. Based on the fact that IL-4 inhibited IFN-γ signalling in the livers of α-GalCer-sensitized mice via SOCS1 expression and signal transducer and activator of transcription 1 (STAT-1) activation, no inhibition of the IFN-γ signalling in the lungs caused LPS-induced lung lesions in α-GalCer-sensitized mice. The detailed mechanism of development of the lung lesions in α-GalCer-sensitized mice is discussed.


Assuntos
Galactosilceramidas/imunologia , Interleucina-4/biossíntese , Células Matadoras Naturais/imunologia , Lesão Pulmonar/imunologia , Animais , Antígenos CD4/imunologia , Antígenos CD4/metabolismo , Antígenos CD8/imunologia , Antígenos CD8/metabolismo , Células Cultivadas , Endotoxinas/toxicidade , Citometria de Fluxo , Galactosilceramidas/administração & dosagem , Immunoblotting , Interferon gama/biossíntese , Interferon gama/imunologia , Interleucina-10/biossíntese , Interleucina-4/imunologia , Células Matadoras Naturais/citologia , Células Matadoras Naturais/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Lesão Pulmonar/etiologia , Lesão Pulmonar/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator de Transcrição STAT1/genética , Fator de Transcrição STAT1/metabolismo , Proteína 1 Supressora da Sinalização de Citocina , Proteínas Supressoras da Sinalização de Citocina/genética , Proteínas Supressoras da Sinalização de Citocina/metabolismo
8.
Endoscopy ; 42(12): 1021-9, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21120775

RESUMO

BACKGROUND AND STUDY AIMS: Carbon dioxide (CO (2)) insufflation for endoscopy has been reported to provide superior recovery and is expected to reduce the risk of serious complications, including air embolism and tension pneumothorax, whereas general anesthesia offers some advantages not found under intravenous sedation. Little is known about the effect of prolonged CO (2) insufflation into gastrointestinal tracts on arterial CO (2) tension (PaCO (2)). Here we introduce the use of general anesthesia with CO (2) insufflation for esophagogastroduodenal endoscopic submucosal dissection (ESD). PATIENTS AND METHODS: A prospective observational study was conducted in a university-affiliated hospital. A total of 100 patients were scheduled for esophagogastroduodenal ESD under general anesthesia with CO (2) insufflation, using standardized anesthesia techniques and unchanged ventilatory settings. Arterial blood gas analyses were repeated at predetermined time intervals. RESULTS: Of the initial 100 participants, 94 patients undergoing ESD and four patients undergoing endoscopic mucosal resection completed the study. The median procedure time was 122 minutes (range 29 - 309 minutes). The median baseline PaCO (2) of 28 mmHg increased to a median peak PaCO (2) of 39 mmHg ( P < 0.001), with marked inter-individual variability in the time courses of changes in PaCO (2). The correlation coefficient of PaCO (2) with the procedure time was low (r = 0.194; n = 577, P < 0.0001). FEV (1.0) % (forced expiratory volume in 1 second/forced vital capacity) of < 70 % and esophagoscopy vs. gastroduodenoscopy were relative enhancement factors of PaCO (2). CONCLUSION: Increases of PaCO (2) during esophagogastroduodenal ESD under general anesthesia with CO (2) insufflation remained within acceptable or readily controllable ranges, and are little enhanced by prolongation of the procedure. Esophagogastroduodenal ESD can be performed safely and feasibly with this procedure.


Assuntos
Dióxido de Carbono/administração & dosagem , Duodenoscopia/métodos , Esofagoscopia/métodos , Gastroscopia/métodos , Insuflação , Idoso , Idoso de 80 Anos ou mais , Anestesia Geral , Dióxido de Carbono/efeitos adversos , Dióxido de Carbono/fisiologia , Dissecação , Duodenoscopia/efeitos adversos , Esofagoscopia/efeitos adversos , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Mucosa Gástrica/cirurgia , Gastroscopia/efeitos adversos , Humanos , Mucosa Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Pressão Parcial , Estudos Prospectivos , Estatísticas não Paramétricas , Fatores de Tempo
9.
Horm Metab Res ; 42(9): 632-6, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20560107

RESUMO

Metformin is reported to ameliorate inflammation in diabetic patients. The effect of metformin on lipopolysaccharide-induced nitric oxide production was studied by using RAW 264.7 macrophage-like cells. The action of metformin was analyzed by dividing lipopolysaccharide signaling into the MyD88-dependent and -independent pathways. Metformin significantly reduced the expression of an inducible type of nitric oxide synthase and inhibited lipopolysaccharide-induced nitric oxide production. On the other hand, metformin did not inhibit lipopolysaccharide-induced tumor necrosis factor-alpha production. The expression levels of interferon-beta protein and mRNA, which is a key molecule in MyD88-independent pathway, were significantly inhibited by metformin. Compound C, a specific AMP-activated protein kinase inhibitor, did not affect the inhibitory action of metformin. Metformin was suggested to inhibit lipopolysaccharide-induced nitric oxide production via inhibition of interferon-beta production in MyD88-independent pathway. Metformin might exhibit an anti- inflammatory action on diabetic complications as well as the antidiabetic action.


Assuntos
Lipopolissacarídeos/farmacologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Metformina/farmacologia , Óxido Nítrico/biossíntese , Transdução de Sinais/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/antagonistas & inibidores , Animais , Linhagem Celular , Regulação da Expressão Gênica/efeitos dos fármacos , Interferon beta/genética , Interferon beta/metabolismo , Macrófagos/enzimologia , Camundongos , Camundongos Endogâmicos C57BL , Fator 88 de Diferenciação Mieloide/metabolismo , Poli I-C/farmacologia , Inibidores de Proteínas Quinases/farmacologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator de Necrose Tumoral alfa/biossíntese
10.
Clin Exp Immunol ; 155(3): 552-8, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19220841

RESUMO

U18666A is a cholesterol transport-inhibiting agent that is used widely to mimic Niemann-Pick type C disease. The effect of U18666A on tumour necrosis factor (TNF)-alpha production in mouse macrophage cell line, RAW 264.7 cells and peritoneal macrophages was examined. U18666A induced TNF-alpha mRNA expression 48 h after the treatment, and TNF-alpha production 48 and 72 h after stimulation in RAW 264.7 cells. U18666A accumulated intracellular free cholesterol in the culture of normal medium but not cholesterol-free medium. U18666A also induced reactive oxygen species (ROS) generation in normal medium but much less in cholesterol-free medium. Anti-oxidant N-acetyl-L-cysteine (NAC) abolished U18666A-induced TNF-alpha production. U18666A led to the phosphorylation of p38 mitogen-activated protein kinase 24 and 48 h after the stimulation and the p38 activation was inhibited in presence of cholesterol-free medium or NAC. A p38 inhibitor reduced U18666A-induced TNF-alpha production. Taken together, U18666A was suggested to induce TNF-alpha production in RAW 264.7 cells via free cholesterol accumulation-mediated ROS generation.


Assuntos
Androstenos/farmacologia , Anticolesterolemiantes/farmacologia , Macrófagos/metabolismo , Fator de Necrose Tumoral alfa/biossíntese , Animais , Linhagem Celular , Colesterol/metabolismo , Ativação Enzimática , Macrófagos/efeitos dos fármacos , Camundongos , Doenças de Niemann-Pick/imunologia , Espécies Reativas de Oxigênio/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
11.
Science ; 229(4718): 1090-3, 1985 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-2412292

RESUMO

Mutations have been identified in variants of poliovirus, type 1 (Mahoney) on the basis of their resistance to neutralization by individual monoclonal antibodies. The phenotypes of these variants were defined in terms of antibody binding; the pattern of epitopes expressed or able to be exploited for neutralization were complex. Single amino acid changes can have distant (in terms of linear sequence) and generalized effects on the antigenic structure of poliovirus and similarly constituted virions.


Assuntos
Epitopos/análise , Poliovirus/imunologia , Sequência de Aminoácidos , Aminoácidos/análise , Anticorpos Monoclonais , Imunidade Inata , Mutação , Fenótipo , Poliovirus/genética , Vírion/imunologia
12.
Acta Anaesthesiol Scand ; 53(4): 476-82, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19226297

RESUMO

BACKGROUND: Although many investigators previously reported the sympathovagal effect of spinal anaesthesia, there is no information about the sympathovagal effects of supplementation with fentanyl. The aim of this study was to evaluate the sympathovagal effects of intrathecal or intravenous fentanyl added to spinal anaesthesia. METHODS: One hundred and twenty patients undergoing elective transurethral surgery under spinal anaesthesia were randomly allocated to receive intrathecally either isobaric bupivacaine alone (Group B), bupivacaine supplemented with intrathecal (Group Ft) or with intravenous fentanyl (Group Fv). Heart rate variability was estimated using the MemCalc method (Tarawa, Suwa Trust, Japan) before and after spinal anaesthesia. RESULTS: In all groups, spinal anaesthesia significantly decreased low frequency/high frequency (LF/HF) as a marker of sympathovagal balance. However, patients in Group B with a low block height developed a marked increase in LF/HF after spinal anaesthesia, which was attenuated in Group Ft. Meanwhile, intravenous fentanyl did not attenuate this response. CONCLUSION: We conclude that sympathetic activation observed in patients with a low block height was attenuated by intrathecal fentanyl but not by intravenous fentanyl.


Assuntos
Analgésicos Opioides/farmacologia , Raquianestesia , Fentanila/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Sistema Nervoso Simpático/efeitos dos fármacos , Nervo Vago/efeitos dos fármacos , Adulto , Idoso , Eletroencefalografia/efeitos dos fármacos , Feminino , Fentanila/administração & dosagem , Humanos , Injeções Intravenosas , Injeções Espinhais , Masculino , Pessoa de Meia-Idade
13.
Acta Anaesthesiol Scand ; 53(5): 607-10, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19419354

RESUMO

BACKGROUND: Maternal distress would correlate with the children's mental status, thereby influencing the activity of the autonomic nervous system (ANS) of the children and mothers. We hypothesized that pre-anesthetic maternal ANS activity, when approaching close to their children's operation time, would correlate with children's ANS activity, and that the values of heart rate variability (HRV) would correlate. METHODS: We calculated maternal and children's HRVs and analyzed the relationship between the two. A total of 24 pairs of mother and child were analyzed. Maternal and children's HRVs were recorded from the night before the child's surgery to the arrival to the operation room. RESULTS: The ratios of low-frequency components (LF) to high-frequency components (HF) (LF/HF ratio) of children's and maternal HRVs obtained during the immediate pre-operative period (06:00-08:00 hours) showed a significantly, positive correlation, but no correlation was found for the LF/HF ratios obtained during the pre-operative night. CONCLUSION: The LF/HF ratios of HRV immediately before surgery in children and mothers showed a significant positive correlation.


Assuntos
Ansiedade/fisiopatologia , Frequência Cardíaca/fisiologia , Mães/psicologia , Adulto , Criança , Pré-Escolar , Eletrocardiografia , Feminino , Humanos , Lactente , Masculino , Cuidados Pré-Operatórios , Análise de Regressão , Resultado do Tratamento
14.
Kyobu Geka ; 62(9): 812-5, 2009 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-19670785

RESUMO

A 78-year-old man had non-small cell lung cancer (NSCLC) in the left upper lobe (squamous cell carcinoma, cT1N0M0). He preferred less invasive treatment and undertook stereotactic radiotherapy (SRT)[48 Gy/4 Fr] because his forced expiratory volume in 1 second percent (FEV1.0%) was 53.50%. The therapeutic effect was partial response and the adverse reaction was dermatitis (grade 1). Seven months after SRT, local recurrence was detected. The tumor was growing from 3 x 5 mm to 25 x 25 mm in size. Nine months after SRT, left upper lobectomy was performed successfully unaffected by SRT. He is doing well 14 months after the operation without any signs of recurrence. This case might help develop a new strategy for the treatment of stage I NSCLC. It is that patients with stage I NSCLC have SRT as 1st line treatment, and if local recurrence is observed after SRT, lobectomy may be performed.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia/cirurgia , Pneumonectomia , Idoso , Humanos , Masculino , Técnicas Estereotáxicas
16.
Br J Anaesth ; 100(1): 78-81, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17959591

RESUMO

BACKGROUND: Despite prophylactic measures, hypotension remains a common side-effect of spinal anaesthesia for parturients. Electroacupuncture at the Neiguan (PC-6) and Jianshi (PC-5) points influences haemodynamics. We thus hypothesized that transcutaneous electrical nerve stimulation (TENS) at traditionally used acupuncture points would reduce the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section. METHODS: After obtaining approval from the local ethics committee and written informed patient consent, 36 singleton parturients undergoing Caesarean section under spinal anaesthesia were randomized into three groups. The control group received no treatment, and the acupoint and non-acupoint groups received TENS at the PC-5 and PC-6 points of both arms and non-acupoints of both shoulders, respectively. RESULTS: The median (range) of the lowest recorded systolic blood pressure was significantly higher in the acupoint group compared with the other groups and that of the non-acupoint group was higher than that of the control group [control, 70 (68-82) mm Hg; acupoint, 94 (84-109) mm Hg; non-acupoint, 81 (70-92) mm Hg: P<0.001]. Significantly more parturients in the control and non-acupoint groups experienced hypotension [control, 10 (83%); acupoint, 4 (33%); non-acupoint, 10 (83%): P=0.013]. More ephedrine was required to maintain arterial blood pressure in the control and non-acupoint groups. CONCLUSIONS: TENS on the traditional acupuncture points reduced the severity and incidence of hypotension after spinal anaesthesia in parturients.


Assuntos
Pontos de Acupuntura , Anestesia Obstétrica/efeitos adversos , Raquianestesia/efeitos adversos , Cesárea , Hipotensão/prevenção & controle , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Anestesia Obstétrica/métodos , Pressão Sanguínea , Feminino , Frequência Cardíaca , Humanos , Hipotensão/etiologia , Hipotensão/fisiopatologia , Gravidez
17.
Clin Nephrol ; 70(3): 203-9, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18793561

RESUMO

BACKGROUND: This study was made to present our experience and results with transperitoneal laparoscopic-assisted renal biopsy (LARB) in Nagoya University Hospital as a good alternative for open renal biopsy. METHODS: 21 patients (14 male, 7 female, mean age 58 years, range 21-83 years) were unsuitable for percutaneous renal biopsy. Therefore, they underwent laparoscopic-assisted renal biopsy. The kidney was approached transperitoneally via three ports, cortical tissue was obtained using a 16-gauge gun-mounted semiautomatic biopsy needle. Hemostasis was obtained by applying pressure on the renal puncture using gauze until bleeding had been stopped (range 5-20 min). RESULTS: Adequate cortical tissue and accurate diagnoses were obtained in all patients. Mean operative time was 83 min (range 65-120 min) and mean estimated blood loss was 5.5 ml (range 1-10 ml). There were no intraoperative complications: no open conversion, blood transfusions or gross hematuria. All patients walked about freely and could tolerate regular food on the first postoperative day. The only postoperative complication was a hernia formation at the place of trocar insertion 3 months after the operation in one patient who previously underwent multiple surgery for 3 arterial grafts and appendicitis. CONCLUSIONS: LARB is a safe and accurate procedure for obtaining cortical biopsies with minimal blood loss. Although LARB remains a surgical procedure which requires general anesthesia, LARB to date may be considered as a good alternative to open renal biopsy for patients in whom a closed percutaneous approach is either a relative or absolute contraindication.


Assuntos
Biópsia/métodos , Rim/patologia , Laparoscopia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/efeitos adversos , Feminino , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade
18.
Acta Anaesthesiol Scand ; 52(2): 285-8, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18005374

RESUMO

BACKGROUND: The parents of the children who undergo surgery experience stress during the pre-anesthetic period. Such stress influences the mental status of their children, thereby inducing their pre-anesthetic anxiety and problematic behavior at emergence. Recently, measurement of salivary biomarkers was evaluated as stress biomarkers. Especially, alpha-amylase is utilized as an excellent index for psychological stress. In the present study, we tested whether salivary amylase activity of mothers before the surgery of their children correlates with the peri-operative children's behaviors. METHODS: A total of 22 pairs of mothers and children were analyzed. Maternal salivary amylase activity was evaluated at the entrance of the operation room. The children underwent minor plastic surgery under general anesthesia, and induction and emergence behaviors were assessed. RESULTS: The higher the maternal salivary amylase activity, the severer the children's induction anxiety (r(s)=-0.667, n=22, P<0.0001), and the higher the maternal amylase activity, the severer the children's emergence agitation (r(s)=0.705, n=22, P<0.0001). CONCLUSION: Induction and emergence behaviors of children undergoing general anesthesia significantly correlated with their respective maternal salivary amylase activity during the pre-anesthetic period.


Assuntos
Amilases/biossíntese , Anestesia Geral/psicologia , Comportamento Infantil/psicologia , Mães/psicologia , Mães/estatística & dados numéricos , Saliva/enzimologia , Adulto , Período de Recuperação da Anestesia , Anestesia Geral/métodos , Ansiedade/etiologia , Ansiedade/psicologia , Biomarcadores/análise , Comportamento Infantil/efeitos dos fármacos , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Cuidados Pré-Operatórios , Agitação Psicomotora/etiologia , Agitação Psicomotora/psicologia , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
19.
Nucleic Acids Res ; 29(10): 2154-62, 2001 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-11353085

RESUMO

The expression of liver-specific genes is regulated by unequivocally allocated transcription factors via proper responsible elements within their promoters. We identified a novel transcription factor, CREB-H, and found that its expression was restricted in the liver among 16 human tissues tested. A region of CREB-H exhibited significant homology to the basic leucine zipper (b-Zip) domain of members of the CREB/ATF family: mammalian LZIP and Drosophila BBF-2 that binds to box-B, a Drosophila enhancer modulating the fat-body-specific gene expression. CREB-H contained a hydrophobic region representing a putative transmembrane domain, like LZIP. Constructing a variety of CREB-H fusion proteins with the GAL4 DNA-binding domain disclosed that CREB-H functioned as a transcriptional activator and its N-terminal 149 amino acids accounted for the activation ability. Gel mobility sift assays revealed that CREB-H did not bind to the C/EBP, AP-1 and NF-kappaB elements but specifically bound to CRE and the box-B element. Luciferase reporter assays demonstrated that like BBF-2, CREB-H activated transcription via the box-B element and that a deletion of the putative transmembrane domain increased the activation of reporter expression significantly. Furthermore, a fusion protein of GFP and full-length CREB-H was localized in reticular structures surrounding the nucleus, whereas a fusion protein of GFP and a deletion mutant lacking the putative transmembrane domain was mainly in the nucleus. These findings suggest that CREB-H plays an important role in transcriptional regulation of genes specifically expressed in the liver, and that the putative transmembrane domain may be associated with modulation of its function as the transcriptional activator.


Assuntos
Proteínas Sanguíneas/química , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/química , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Zíper de Leucina , Fígado/metabolismo , Elementos de Resposta/genética , Fatores de Transcrição/química , Fatores Ativadores da Transcrição , Sequência de Aminoácidos , Animais , Sequência de Bases , Células COS , Núcleo Celular/metabolismo , Clonagem Molecular , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/genética , Citoplasma/metabolismo , Sondas de DNA/genética , Sondas de DNA/metabolismo , Proteínas de Ligação a DNA/química , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Éxons/genética , Humanos , Dados de Sequência Molecular , Especificidade de Órgãos , Estrutura Terciária de Proteína , Transporte Proteico , RNA Mensageiro/análise , RNA Mensageiro/genética , Proteínas Recombinantes de Fusão/química , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Deleção de Sequência/genética , Transativadores/química , Transativadores/genética , Transativadores/metabolismo , Ativação Transcricional
20.
Anim Reprod Sci ; 95(1-2): 134-43, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16289554

RESUMO

The Japanese black bear (Ursus thibetanus japonicus) is an endangered species in some areas of Japan, and semen collection and cryopreservation are important means to preserve genetic resources and prevent extinction. The aim of the present study was to improve the methods for electroejaculation and cryopreservation in these bears. We collected the semen from captive mature Japanese black bears during the mating season by the electroejaculation method using maximum stimulus voltages of 10 V (n=9) and 7 V (n=15), and compared the characteristics of fresh semen after collection. None of the variables examined (i.e. total sperm count, motility, viability, morphology, and rate of urine contamination) were statistically different between the two electro-stimulus voltages. After the semen obtained was cryopreserved, the effects of three different diluents (egg yolk-TRIS-citrate-glucose, egg yolk-TRIS-citrate-fructose, and egg yolk-TRIS-citrate-fructose-lactose-raffinose; n=10) and two different incubation times (1-1 and 3-0 h of cooling-glycerol equilibration times; n=12) on frozen-thawed spermatozoa. None of the variables examined (i.e. motility, viability and morphology) were statistically different among the three diluents and between the two incubation times. The results indicate that, in the collection and cryopreservation of Japanese black bear semen: (1) a maximum voltage of 7 V may be enough to obtain ejaculates; (2) the three diluents examined were useful; and (3) glycerol equilibration time may be omitted with prior cooling for 3h.


Assuntos
Criopreservação/veterinária , Preservação do Sêmen/veterinária , Sêmen , Ursidae/fisiologia , Acrossomo/fisiologia , Animais , Sobrevivência Celular/fisiologia , Conservação dos Recursos Naturais , Criopreservação/métodos , Ejaculação/fisiologia , Estimulação Elétrica , Japão , Masculino , Preservação do Sêmen/métodos , Contagem de Espermatozoides/veterinária , Motilidade dos Espermatozoides/fisiologia
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