RESUMO
OBJECTIVE: Familial Dysautonomia (FD) disease, lacks a useful biomarker for clinical monitoring. In this longitudinal study we characterized the structural changes in the macula, peripapillary and the optic nerve head (ONH) regions in subjects with FD. METHODS: Data was consecutively collected from subjects attending the FD clinic between 2012 and 2019. All subjects were imaged with spectral-domain Optical Coherence Tomography (OCT). Global and sectoral measurements of mean retinal nerve fiber layer (RNFL) and macular ganglion cell and inner plexiform layer (GCIPL) thickness, and ONH parameters of rim area, average cup-to-disc (C:D) ratio, and cup volume were used for the analysis. The best fit models (linear, quadratic and broken stick linear model) were used to describe the longitudinal change in each of the parameters. RESULTS: 91 subjects (149 eyes) with FD of ages 5-56 years were included in the analysis. The rate of change for average RNFL and average GCIPL thicknesses were significant before reaching a plateau at the age of 26.2 for RNFL and 24.8 for GCIPL (- 0.861 µm/year (95% CI - 1.026, - 0.693) and - 0.553 µm/year (95% CI - 0.645, - 0.461), respectively). Significant linear rate of progression was noted for all ONH parameters, except for a subset of subjects (24%), with no cupping that did not show progression in any of the ONH parameters. CONCLUSIONS: The rapidly declining RNFL and GCIPL can explain the progressive visual impairment previously reported in these subjects. Among all structural parameters, ONH parameters might be most suitable for longitudinal follow-up, in eyes with a measurable cup.
Assuntos
Disautonomia Familiar , Macula Lutea , Disco Óptico , Adolescente , Adulto , Criança , Pré-Escolar , Disautonomia Familiar/complicações , Disautonomia Familiar/diagnóstico por imagem , Humanos , Estudos Longitudinais , Macula Lutea/diagnóstico por imagem , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Adulto JovemRESUMO
BACKGROUND/AIM: Percutaneous thermal ablation combined with transarterial chemoembolization (TACE) becomes a treatment option for unresectable hepatocellular carcinoma (HCC). This study aims to investigate the safety and feasibility of percutaneous thermal ablation combined with simultaneous TACE for patients with HCC ≤ 5 cm. MATERIALS AND METHODS: From June 2010 to February 2017, a total of 280 patients with HCC ≤ 5 cm who underwent percutaneous thermal ablation combined with simultaneous TACE were included in our study. Their clinical data were collected and analyzed. RESULTS: Major complications occurred in five cases (1.8%). The complete necrosis rate was 91.9%. The median overall survival (OS) was 66.5 months (95% confidence interval [CI] = 57.7-75.2). The OS rates in 1-, 3-, 5-, and 7-year were 96.7%, 76.0%, 59.7%, and 31.1%, respectively. Tumor size (hazard ratio = 1.826; 95% CI = 1.131-2.947; P = 0.014) was considered as independent prognostic factors of long-term survival. CONCLUSION: Percutaneous thermal ablation combined with simultaneous TACE is a safe and effective treatment for HCC ≤ 5 cm.
Assuntos
Carcinoma Hepatocelular/terapia , Ablação por Cateter/mortalidade , Quimioembolização Terapêutica/mortalidade , Hipertermia Induzida/mortalidade , Neoplasias Hepáticas/terapia , Recidiva Local de Neoplasia/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/patologia , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
INTRODUCTION: Abnormal inflammation mediated by Toll-like receptor 4 (TLR4) signaling pathway contributes to preeclampsia (PE). Because curcumin can inhibit TLR4 signaling pathway, we investigated its effects on a PE rat model. METHODS: Twenty-one pregnant rats were randomly divided into three groups: 1) seven rats were injected 0.5 µg/kg lipopolysaccharide (LPS) on gestational day (GD) 5 to create a PE model (LPS-treated group), 2) seven rats were injected with a similar dosage of LPS and further treated with curcumin (0.36 mg/kg) (LPS-curcumin-treated group), 3) seven rats received saline (control group). Blood pressure and urinary protein level were observed. Immunostaining and periodic acid-Schiff staining of placenta were conducted. TLR4 and downstream Nuclear Factor-κB (NF-κB) expressions of placenta were analyzed by Western blot and immunohistochemistry. IL-6 and MCP-1 in rat serum and placenta were determined by ELISA and qRT-PCR. RESULTS: Compared to LPS-treated group, LPS-curcumin-treated group had decreased blood pressure and urinary protein level, similar to control group. Furthermore, deficient trophoblast invasion and spiral artery remodeling induced by LPS were improved by curcumin. Increased TLR4, NF-κB and IL-6, MCP-1 protein expressions in LPS-treated group were significantly decreased after curcumin administration. DISCUSSION: Curcumin improves the PE-like phenotype in rat model by reducing abnormal inflammation related to TLR4 signaling pathway.