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This technical innovation demonstrates the use of ImmersiveTouch Virtual Reality (VR) and Augmented Reality (AR)-guided total temporomandibular joint replacement (TJR) using Biomet stock prosthesis in 2 patients with condylar degeneration. TJR VR planning includes condylar resection, prosthesis selection and positioning, and interference identification. AR provides real-time guidance for osteotomies, placement of prostheses and fixation screws, occlusion verification, and flexibility to modify the surgical course. Radiographic analysis demonstrated high correspondence between the preoperative plan and postoperative result. The average differences in the positioning of the condylar and fossa prosthesis are 1.252 ± 0.269 mm and 1.393 ± 0.335 mm, respectively. The main challenges include a steep learning curve, intraoperative technical difficulties, added surgical time, and additional costs. In conclusion, the case report demonstrates the advantages of implementing AR and VR technology in TJR's using stock prostheses as a pilot study. Further clinical trials are needed prior to this innovation becoming a mainstream practice.
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Artroplastia de Substituição , Realidade Aumentada , Prótese Articular , Transtornos da Articulação Temporomandibular , Realidade Virtual , Humanos , Pessoa de Meia-Idade , Artroplastia de Substituição/métodos , Artroplastia de Substituição/instrumentação , Imageamento Tridimensional , Côndilo Mandibular/cirurgia , Côndilo Mandibular/diagnóstico por imagem , Desenho de Prótese , Cirurgia Assistida por Computador/métodos , Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgiaRESUMO
The reunion and restoration of large segmental bone defects pose significant clinical challenges. Conventional strategies primarily involve the combination of bone scaffolds with seeded cells and/or growth factors to regulate osteogenesis and angiogenesis. However, these therapies face inherent issues related to immunogenicity, tumorigenesis, bioactivity, and off-the-shelf transplantation. The biogenic micro-environment created by implanted bone grafts plays a crucial role in initiating the bone regeneration cascade. To address this, a highly porous bi-phasic ceramic synthetic bone graft, composed of hydroxyapatite (HA) and alumina (Al), was developed. This graft was employed to repair critical segmental defects, involving the creation of a 2 cm segmental defect in a canine tibia. The assessment of bone regeneration within the synthetic bone graft post-healing was conducted using scintigraphy, micro-CT, histology, and dynamic histomorphometry. The technique yielded pore sizes in the range of 230-430 µm as primary pores, 40-70 µm as secondary inner microchannels, and 200-400 nm as tertiary submicron surface holes. These three components are designed to mimic trabecular bone networks and to provide body fluid adsorption, diffusion, a nutritional supply, communication around the cells, and cell anchorage. The overall porosity was measured at 82.61 ± 1.28%. Both micro-CT imaging and histological analysis provided substantial evidence of robust bone formation and the successful reunion of the critical defect. Furthermore, an histology revealed the presence of vascularization within the newly formed bone area, clearly demonstrating trabecular and cortical bone formation at the 8-week mark post-implantation.
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Regeneração Óssea , Tíbia , Alicerces Teciduais , Animais , Cães , Alicerces Teciduais/química , Tíbia/diagnóstico por imagem , Projetos Piloto , Osteogênese , Porosidade , Microtomografia por Raio-X , Durapatita , Transplante Ósseo/métodos , Substitutos ÓsseosRESUMO
Membrane-based water treatment has emerged as a promising solution to address global water challenges. Graphene oxide (GO) has been successfully employed in membrane filtration processes owing to its reversible properties, large-scale production potential, layer-to-layer stacking, great oxygen-based functional groups, and unique physicochemical characteristics, including the creation of nano-channels. This review evaluates the separation performance of various GO-based membranes, manufactured by coating or interfacial polymerization with different support layers such as polymer, metal, and ceramic, for endocrine-disrupting compounds (EDCs) and pharmaceutically active compounds (PhACs). In most studies, the addition of GO significantly improved the removal efficiency, flux, porosity, hydrophilicity, stability, mechanical strength, and antifouling performance compared to pristine membranes. The key mechanisms involved in contaminant removal included size exclusion, electrostatic exclusion, and adsorption. These mechanisms could be ascribed to the physicochemical properties of compounds, such as molecular size and shape, hydrophilicity, and charge state. Therefore, understanding the removal mechanisms based on compound characteristics and appropriately adjusting the operational conditions are crucial keys to membrane separation. Future research directions should explore the characteristics of the combination of GO derivatives with various support layers, by tailoring diverse operating conditions and compounds for effective removal of EDCs and PhACs. This is expected to accelerate the development of surface modification strategies for enhanced contaminant removal.
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Disruptores Endócrinos , Grafite , Membranas Artificiais , Poluentes Químicos da Água , Purificação da Água , Grafite/química , Disruptores Endócrinos/química , Purificação da Água/métodos , Poluentes Químicos da Água/química , Filtração , Adsorção , Água/químicaRESUMO
Inorganic arsenic (As), a known carcinogen and major contaminant in drinking water, affects over 140 million people globally, with levels exceeding the World Health Organization's (WHO) guidelines of 10 µg L-1. Developing innovative technologies for effluent handling and decontaminating polluted water is critical. This paper summarizes the fundamental characteristics of chitosan-embedded composites for As adsorption from water. The primary challenge in selectively removing As ions is the presence of phosphate, which is chemically similar to As(V). This study evaluates and summarizes innovative As adsorbents based on chitosan and its composite modifications, focusing on factors influencing their adsorption affinity. The kinetics, isotherms, column models, and thermodynamic aspects of the sorption processes were also explored. Finally, the adsorption process and implications of functionalized chitosan for wastewater treatment were analyzed. There have been minimal developments in water disinfection using metal-biopolymer composites for environmental purposes. This field of study offers numerous research opportunities to expand the use of biopolymer composites as detoxifying materials and to gain deeper insights into the foundations of biopolymer composite adsorbents, which merit further investigation to enhance adsorbent stability.
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Arsênio , Quitosana , Ferro , Poluentes Químicos da Água , Purificação da Água , Quitosana/química , Arsênio/análise , Arsênio/química , Adsorção , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/química , Purificação da Água/métodos , Ferro/química , Polímeros/químicaRESUMO
In the scope, developed a novel copper molybdate decorated polymeric graphitic carbon nitride (CuMoO4@g-C3N4 or CMC) heterojunction nanocomposite in an easy solvothermal environment for the first time. The synthesized CMC improved the photocatalytic degradation of an antibiotic drug [ciprofloxacin (CIP)] and organic dye [Rhodamine B (RhB)]. Consequently, the CMC demonstrates a marvelous crystalline nature with â¼26 nm size, as obtained from XRD analysis. Besides, the surface morphology studies confirm the large-scale construction of flower-like CMC with a typical size of 10-15 nm. The CMC showed efficient catalytic activity for both the pollutants, achieving the degradation of 98% for RhB and 97% for CIP in 35 and 60 min, respectively. The reaction parameters including the concentration of pollutants, catalyst dosages, and scavengers are optimized for the best photocatalytic results. Notably, the trapping tests showed that the â¢OH and O2â¢- radicals are the primary oxidative species liable for the photocatalytic process. The recyclability test of the photocatalyst infers that the photocatalyst is highly stable up to the fifth recycle. Our work affords an efficient and ideal path to constructing the new g-C3N4-based architected photocatalyst for toxic wastewater treatment in the near future.
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Cobre , Poluentes Ambientais , Ciprofloxacina , Polímeros , ÁguaRESUMO
STATEMENT OF PROBLEM: The properties of commercially pure titanium are better than those of cobalt chromium alloys in various ways. However, casting pure titanium is challenging because of its high melting point and chemical reactivity. Because of excellent mechanical strength, a titanium alloy, Ti-6Al-4V, has been commonly adopted, but the aluminum and vanadium ions released may be cytotoxic. PURPOSE: The purpose of the present study was to evaluate a new titanium alloy, Ti-7.5Mo, developed by the National Cheng Kung University for casting removable denture frameworks. The casting success rate, porosity, and guide plane or rest fit were compared among frameworks cast with Ti-7.5Mo alloy and pure titanium for 3 types of edentulism. MATERIAL AND METHODS: Ti-7.5Mo alloy and pure titanium were used to cast frameworks for Kennedy Class I and II and completely edentulous conditions, with 5 frameworks for each condition. Wax patterns of the frameworks were designed and fabricated by using computer-aided design and computer-aided manufacture (CAD-CAM) technology to ensure their geometrical consistency. They were then invested with aluminum oxide-based material and cast. The castings were examined with microcomputed tomography (µCT) for porosity, and fit was evaluated from the thickness of a vinyl polyether silicone material at the guide plane or the rest by using an optical microscope. The casting was determined to be successful if the frameworks were complete. The porosity and fit were statistically evaluated by using 2-way ANOVA (α=.05). RESULTS: Using pure titanium, the casting success rate was 80%, with only 64% of the major connectors in the deficient castings being complete. The µCT images showed that the percentage of casting defects in Ti-7.5Mo castings was one-third of the pure titanium castings. Furthermore, internal voids were detected in the clasps of the pure titanium castings, while the Ti-7.5Mo castings had few defects in the minor connectors and no radiographically detectable defects in the clasps. The fit analysis demonstrated smaller gaps over both guide planes and rests in the Ti-7.5Mo castings. CONCLUSIONS: Ti-7.5Mo alloy had better castability than pure titanium. Based on the results, Ti-7.5Mo alloy is suitable for dental casting and may provide better performance.
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BACKGROUND: Periodontal disease during pregnancy affects maternal oral health and increases the risk of adverse pregnancy outcomes. However, studies on the risk factors for periodontal disease and its impact on oral health-related quality of life in pregnant women in Taiwan are lacking. This present study aimed to identify the risk factors associated with periodontal disease during pregnancy and examine the relationship of periodontal disease with oral health-related quality of life among pregnant women. METHODS: This study was conducted in a large medical centre in northern Taiwan. Eighty-four participants completed a periodontal examination by dentists as well as structured questionnaires, including the Oral Health Impact Profile-14, demographics, obstetric history, dietary habits, and oral hygiene behaviours. Multivariate logistic regression was used to determine the risk factors associated with periodontal disease and a t-test was used to compare the difference in oral health-related quality of life between pregnant women with and without periodontal disease. RESULTS: Fifty participants (59.5%) had periodontal diseases. Risk factors for periodontal disease included eating out for lunch, consuming beverages, brushing less than three times per day, and not receiving regular professional dental cleanings. The oral health-related quality of life was significantly poorer in pregnant women with periodontal disease than in those without. CONCLUSIONS: The risk factors for periodontal disease, including eating out for lunch, drinking beverages, brushing teeth less, and not regular dental cleaning, provide convincing evidence for pregnant women to maintain good oral hygiene to prevent periodontal disease and improve oral health-related quality of life.
Pregnancy can cause poor mouth health. Expectant mothers with gum disease might face problems such as low birth weight and premature birth. This study found that certain factors can worsen gum disease during pregnancy. These include eating out for lunch, drinking sugary or acidic drinks, brushing their teeth less than three daily, and skipping regular teeth cleaning by a dentist. Pregnant women with gum disease also reported a lower quality of life related to oral health compared to those without it. Healthcare providers should educate pregnant women about oral health maintenance. Emphasize the importance of professional dental cleanings every three months, frequent tooth brushing, avoiding sugary and acidic drinks, and reducing eating out for lunch. Future research should explore additional ways to support pregnant women in this regard.
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Doenças Periodontais , Gestantes , Feminino , Humanos , Gravidez , Doenças Periodontais/complicações , Resultado da Gravidez , Qualidade de Vida , Fatores de Risco , Complicações na GravidezRESUMO
Measuring bone density (BD) is a common method of determining bone quality; however, the relationship between condylar BD and the occurrence of temporomandibular joint (TMJ) disorders has not been investigated. To address this knowledge gap, we aimed to investigate condylar BD in terms of TMJ disk displacement (TMJ DD) using computed tomography (CT) and magnetic resonance imaging (MRI). We classified TMJ MRI results according to the position of the disk: normal disk position (Normal), anterior disk displacement with reduction (ADDR), and anterior disk displacement without reduction (ADDNR). After retrospectively evaluating 86 female condyles, we determined the total, cortical, and trabecular BD in the upper-joint portion of the condyle and the whole condyle using CT data. To standardize condylar BD, we calculated the BD ratios by dividing the condylar BD by the cervical axis BD. The Kruskal-Wallis test analyzed the differences in BD measurements in the TMJ DD patient groups and showed significant between-group differences in condylar BD. The total and trabecular BD was significantly higher in ADDNR condyles than in Normal or ADDR condyles (Normalâ¯=â¯ADDR < ADDNR). However, there was no significant difference in the cortical BD among the three TMJ DD groups. The BD ratios showed a similar tendency with condylar BD. These results suggest that increased condylar BD - specifically total and trabecular BD - may be significantly associated with ADDNR condyles. Our findings will help clinicians determine the course of treatment for patients with disk-related TMJ disorders.
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Luxações Articulares , Transtornos da Articulação Temporomandibular , Densidade Óssea , Feminino , Humanos , Luxações Articulares/patologia , Imageamento por Ressonância Magnética , Masculino , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Estudos Retrospectivos , Articulação Temporomandibular/patologia , Disco da Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/patologiaRESUMO
BACKGROUND & AIMS: Nucleotides with add-on interferon treatment (NUC-IFN) provide significantly higher rates of hepatitis B surface antigen (HBsAg) loss in patients with chronic hepatitis B (CHB). This study aimed to investigate the sustainability of HBsAg loss and the prevention of clinical relapse. METHODS: Patients with CHB who achieved HBsAg loss and HBV DNA levels <20 IU/ml after IFN or NUC-IFN therapy were enrolled and followed up for 96 weeks. The primary outcome was HBsAg negativity without viremia at week 96. Secondary outcomes included virological or clinical relapse and predictors of relapse. RESULTS: 420 patients were included in intention-to-treat analysis with 290 and 130 in the IFN and NUC-IFN groups respectively. At week 96, the intention-to-treat analysis revealed similar outcomes between groups, including HBsAg seroreversion (24.83% vs. 23.08%, P = .70), viremia (16.90% vs 13.08%, P = .32) and clinical relapse (11.38% vs 10.00%, P = .68); the per-protocol analyses also showed HBsAg seroreversion, viremia and clinical relapse in IFN group (15.50%, 6.59% and 0.39%) did not differ from those in NUC-IFN group (15.25%, 4.24% and 0.85%, P > .05). These outcomes were similar between patients who received entecavir and those who received telbivudine/lamivudine/adefovir before the combination therapy. In NUC-IFN-treated patients, fibrosis regression was observed at week 96. Baseline HBsAb negativity was independent predictors of HBsAg sero-reversion and recurrence of viremia in IFN treated group. CONCLUSION: NUC-IFN and IFN therapies are equally effective in achieving sustained functional cure and fibrosis regression. (ClinicalTrials.gov, Number NCT02336399).
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Hepatite B Crônica , Hepatite B , Antivirais/uso terapêutico , China , DNA Viral , Hepatite B/tratamento farmacológico , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B/genética , Hepatite B Crônica/tratamento farmacológico , Humanos , Interferon-alfa/uso terapêutico , Recidiva Local de Neoplasia , Polietilenoglicóis/uso terapêutico , Resultado do TratamentoRESUMO
The objective of this study was to evaluate the efficacy of an imidacloprid 10% and flumethrin 4.5% polymer matrix collar against the developmental stages of Haemaphysalis longicornis infesting dogs using the hair from treated dogs in a semi-in-vitro assay set. When incubated with 0.5 g of the hair collected from the dogs installed with the drug-embedded collar after 10 days, average death rate of the larval, nymphal, and adult H. longicornis was 21.5%, 77.9%, and 100% at 30 min, 1 hr, and 2 hr, respectively. This study showed the larval stages as well as the nymphal and adult stages of H. longicornis ticks are killed upon contact with the hair from dogs treated with the collar within 2 hr.
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Ixodidae , Infestações por Carrapato , Animais , Cães , Imidazóis , Larva , Neonicotinoides , Nitrocompostos , Polímeros , Piretrinas , Infestações por Carrapato/veterináriaRESUMO
BACKGROUND: Antiviral therapy is recommended for patients with immune-active chronic hepatitis B (CHB) to decrease the risk of liver-related complications. However, the outcomes of the pegylated IFN-α (PEG-IFN-α) therapy vary among CHB patients. We aimed to identify factors that can influence the outcomes in CHB patients who received antiviral PEG-IFN-α monotherapy. METHODS: Thirty-two CHB patients who received PEG-IFN-α monotherapy were enrolled in this study. All of the patients underwent two liver biopsies at baseline and 6 months after the initiation of the therapy. CD8+ T cells, CD4+ T cells, CD68+ mononuclear cells, and PD-1 levels in the 64 liver biopsy specimens were examined via immunofluorescence. RESULTS: The overall median frequency of CD8+ T cells in the liver tissues of 32 CHB patients significantly decreased at 6 months after the therapy initiation (p < 0.01). In the FIER (fibrosis and inflammation response with HBeAg seroconversion) group, CD8+PD-1+ T cells significantly decreased at 6 months (p < 0.05), while CD8+PD-1- T cells had no significant difference. On the contrary, in the FIENR (no fibrosis and inflammation response and HBeAg seroconversion) group, CD8+PD-1- T cells significantly decreased after 6 months of PEG-IFN-α treatment (p < 0.05), while CD8+PD-1+ T cells had no significant difference. In addition, the levels of CD68+ mononuclear cells in the FIER group showed an overall increasing trend after treatment (p < 0.05). CONCLUSIONS: The changes in the levels of CD8+PD-1+ T cells and CD68+ mononuclear cells may be related to the response to PEG-IFN-α therapy.
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Antivirais/uso terapêutico , Linfócitos T CD8-Positivos/metabolismo , Hepatite B Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Fígado/patologia , Polietilenoglicóis/uso terapêutico , Adulto , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Linfócitos T CD8-Positivos/citologia , Linfócitos T CD8-Positivos/imunologia , Feminino , Antígenos E da Hepatite B/sangue , Antígenos E da Hepatite B/imunologia , Humanos , Leucócitos Mononucleares/citologia , Leucócitos Mononucleares/metabolismo , Fígado/metabolismo , Masculino , Receptor de Morte Celular Programada 1/metabolismo , Proteínas Recombinantes/uso terapêutico , Adulto JovemRESUMO
Cold atmospheric plasma (CAP) has been extensively investigated in the local treatment of cancer due to its potential of reactive oxygen species (ROS) generation in biological systems. In this study, we examined the synergistic effect of combination of CAP and cisplatin-mediated chemotherapy of oral squamous cell carcinoma (OSCC) in vitro. SCC-15 OSCC cells and human gingival fibroblasts (HGF-1) cells were treated with cisplatin, and then, the cells were irradiated with CAP. Following this, viability and apoptosis behavior of the cells were investigated. The viability of SCC-15 cells was inhibited by cisplatin with a dose-dependent manner and CAP treatment time. HGF-1 cells also showed decreased viability by treatment with cisplatin and CAP. Combination of 1 µM cisplatin plus 3 min of CAP treatment or 3 µM cisplatin plus 1 min of CAP treatment showed a synergistic anticancer effect with appropriate cytotoxicity against normal cells. ROS generation and dead cell staining were also increased by the increase in CAP treatment time. Furthermore, tumor-suppressor proteins and apoptosis-related enzymes also increased according to the treatment time of CAP. We showed the synergistic effect of cisplatin and CAP treatment against SCC-15 cells with low cytotoxicity against normal cells.
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Antineoplásicos/farmacologia , Carcinoma de Células Escamosas/metabolismo , Cisplatino/farmacologia , Neoplasias Bucais/metabolismo , Gases em Plasma/farmacologia , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Sinergismo Farmacológico , Humanos , Espécies Reativas de Oxigênio/metabolismoRESUMO
PURPOSE: A temporary loop stoma is often created after laparoscopic colorectal cancer surgery. Peristomal adhesions may make stoma closure into a complicated operation. We demonstrated how to place the SurgiWrap® adhesion barrier film and evaluated the peristomal adhesion severity and feasibility of stoma closure. METHODS: This is a retrospective case-control study. Patients were divided into a study group (placement of adhesion barrier film) and a control group (no placement). Patient characteristics, operative data, and severity of adhesions were recorded. We used logistic regression to probe the association between the variables and the adhesion severity. RESULTS: A total of 180 patients were identified with 60 in the study group and 120 in the control group. In the study group, the adhesion severity (p < 0.001), operative time (p = 0.025), and time to flatus (p = 0.042) are significantly reduced. In logistic regression analysis, placement of the film (p < 0.001), neoadjuvant concurrent chemoradiotherapy (p = 0.041), and time interval between stoma creation and closure ⧠12 weeks (p = 0.038) are three significant factors influencing the peristomal adhesion. CONCLUSION: The placement of SurgiWrap® adhesion barrier film around the loop stoma after laparoscopic colorectal cancer surgery may reduce the peristomal adhesion severity and facilitate the stoma closure in terms of operative time and time to flatus.
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Neoplasias Colorretais/cirurgia , Cirurgia Colorretal , Laparoscopia , Estomas Cirúrgicos/patologia , Aderências Teciduais/cirurgia , Adesivos Teciduais/farmacologia , Cavidade Abdominal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
BACKGROUND: Conventional procedures including botulinum toxin and filler injections have their limitations in improving deep wrinkles and decreasing tissue laxity, and possess the propensity for vascular accidents. Absorbable thread is a recently commercialized field, but there is little evidence on comparative superiority. OBJECTIVES: We observed the effects of polydiaxanone (PDO) threads with different number of strands in relation to collagen production and histopathology in a rat model. MATERIALS AND METHODS: Dorsal skin of rat was divided into five different compartments and four different PDO threads and monofilament poly-lactic acid (PLA) thread were inserted. Tissue samples were obtained at week 1, 2, and 12 after the procedure for histopathologic review and real-time PCR for quantification of collagen. RESULTS: Multiple PDO filaments produced more collagen at 2 weeks. Single-stranded PLA thread insertion resulted in more Col1α1 levels than the double PDO thread and also showed the most Col1α3 production at week 2. The amount of collagen showed a sharp decline at week 12. Histologic evaluation showed retained threads surrounded by fibrous capsule-like structure at week 12. CONCLUSION: We were able to observe more collagen production in multiple stranded PDO threads compared to a single strand and that increasing number of threads leads to more collagen synthesis.
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Polidioxanona/efeitos adversos , Polidioxanona/uso terapêutico , Poliésteres/efeitos adversos , Poliésteres/uso terapêutico , Rejuvenescimento , Ritidoplastia/métodos , Envelhecimento da Pele , Animais , Biópsia , Toxinas Botulínicas/efeitos adversos , Toxinas Botulínicas/uso terapêutico , Colágeno/biossíntese , Preenchedores Dérmicos/efeitos adversos , Preenchedores Dérmicos/uso terapêutico , Seguimentos , Granuloma de Corpo Estranho/diagnóstico por imagem , Granuloma de Corpo Estranho/etiologia , Modelos Animais , Ratos , Ratos Sprague-Dawley , Pele/patologiaRESUMO
Purpose/Aim: Macroglossia is a rare condition, especially in patients with motor neuron disease. In this case report, we describe a patient with macroglossia in the early stages of motor neuron disease. Case report: A 62-year-old woman presented with macroglossia in the early stages of motor neuron disease. She was referred to the department of physical medicine and rehabilitation of a university hospital for rehabilitation with the diagnosis of motor neuron disease, most likely primary lateral sclerosis. Her speech was incomprehensible, and she also showed significant sialorrhea and had difficulty in chewing large solid food. Her tongue was enlarged on examination, and she could not close her mouth fully. No other possible causes of macroglossia were found. She showed nocturnal hypercapnia on overnight capnography examination coupled with desaturation, which was believed to result from the macroglossia. After commencing non-invasive ventilation with pressure control mode, follow-up overnight capnography revealed EtCO2 values within the normal range. Conclusions: To the best of our knowledge, this is the first report of macroglossia in PLS. Further study would be needed to ascertain the pathogenesis of this phenomenon.
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Macroglossia/complicações , Doença dos Neurônios Motores/complicações , Feminino , Humanos , Macroglossia/patologia , Macroglossia/fisiopatologia , Pessoa de Meia-Idade , Doença dos Neurônios Motores/patologia , Doença dos Neurônios Motores/fisiopatologiaRESUMO
OBJECTIVE: To explore the predictive value of baseline HBsAg level and early response for HBsAg loss in patients with HBeAg-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. METHODS: A total of 121 patients with HBeAg-positive chronic hepatitis B who achieved HBsAg loss were enrolled; all patients were treated with PEG-IFNα-2a 180 µg/week. Serum HBV DNA and serological indicators (HBsAg, anti-HBs, HBeAg, and anti-HBe) were determined before and every 3 months during treatment. RESULTS: The median treatment time for HBsAg loss was 84 weeks (7-273 weeks), and 74.38% (90 cases) of the patients needed extended treatment (> 48 weeks). The correlation between baseline HBsAg levels and the treatment time of HBsAg loss was significant (B = 14.465, t = 2.342, P = 0.021). Baseline HBsAg levels together with the decline range of HBsAg at 24 weeks significantly correlated with the treatment time of HBsAg loss (B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005). CONCLUSION: Baseline HBsAg levels and extended therapy are critical steps toward HBsAg loss. Baseline HBsAg levels together with early response determined the treatment time of HBsAg loss in patients with HBeAg-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.
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Antivirais/uso terapêutico , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/sangue , Hepatite B Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Polietilenoglicóis/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , DNA Viral/sangue , Esquema de Medicação , Feminino , Humanos , Interferon-alfa/administração & dosagem , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/administração & dosagem , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêutico , Estudos Retrospectivos , Adulto JovemRESUMO
The performance of an ultrafiltration (UF)-biochar process was evaluated in comparison with a UF membrane process for the removal of humic acid (HA). Bench-scale UF experiments were conducted to study the rejection and flux trends under various hydrodynamic, pH, ionic strength, and pressure conditions. The resistance-in-series model was used to evaluate the processes and it showed that unlike stirred conditions, where low fouling resistance was observed (28.7 × 1012 m-1 to 32.5 × 1012 m-1), higher values and comparable trends were obtained for UF-biochar and UF alone for unstirred conditions (28.7 × 1012 m-1 to 32.5 × 1012 m-1). Thus, the processes were further evaluated under unstirred conditions. Additionally, total fouling resistance was decreased in the presence of biochar by 6%, indicating that HA adsorption by biochar could diminish adsorption fouling on the UF membrane and thus improve the efficiency of the UF-biochar process. The rejection trends of UF-biochar and UF alone were similar in most cases, whereas UF-biochar showed a noticeable increase in flux of around 18-25% under various experimental conditions due to reduced membrane fouling. Three-cycle filtration tests further demonstrated that UF-biochar showed better membrane recovery and antifouling capability by showing more HA rejection (3-5%) than UF membrane alone with each subsequent cycle of filtration. As a result of these findings, the UF-biochar process may potentially prove be a viable treatment option for the removal of HA from water.
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Carvão Vegetal , Substâncias Húmicas , Purificação da Água , Hidrodinâmica , Concentração de Íons de Hidrogênio , Membranas Artificiais , Concentração Osmolar , UltrafiltraçãoRESUMO
Reported here is a new theranostic agent, 1, which consists of a Gd3+-texaphyrin core conjugated to a doxorubicin prodrug via a disulfide bond. Conjugate 1 was designed to undergo cleavage in the presence of glutathione (GSH), a species typically upregulated in cancer cells. As prepared, conjugate 1 displays no appreciable fluorescence. However, when exposed to excess GSH an increase in the fluorescence intensity at 592 nm is observed that is ascribed to release of free doxorubicin. To improve the solubility and enhance the tumor targeting of 1, it was loaded into folate-receptor-targeted liposomes to produce FL-1 (for folate liposome loaded with 1). As inferred from both fluorescence turn on studies and independent HPLC analyses, FL-1 was found to undergo selective uptake and cleavage to release free Dox in the KB and CT26 cell lines, which express folate receptors on the cell surface, relative to the HepG2 and NIH3T3 cell lines, which show low expression of those receptors. FL-1 was found to produce a greater antiproliferative effect in the case of the KB and CT26 cell lines as compared to that in the HepG2 and NIH3T3 cell lines. FL-1 was also found to provide enhanced magnetic resonance imaging in vivo under conditions of T1 contrast in the early stage of metastatic cancer progression. Finally, time-dependent tumor regrowth studies involving both subcutaneous and metastatic liver cancer mouse models revealed that FL-1 is capable of reducing the tumor burden in vivo.
Assuntos
Lipossomos/química , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Porfirinas/química , Nanomedicina Teranóstica/métodos , Linhagem Celular Tumoral , Doxorrubicina/química , Doxorrubicina/metabolismo , Doxorrubicina/uso terapêutico , Transportadores de Ácido Fólico/metabolismo , Glutationa/metabolismo , Humanos , Neoplasias Hepáticas/patologia , Metástase Neoplásica , Pró-Fármacos/metabolismoRESUMO
Stents are promising medical devices widely used in the prevention of cerebral aneurysm rupture. As the performance of stents depends on their mechanical properties and cell configuration, the aim of this study was to optimize the stent design and test the hemodynamic properties by using computational solid mechanics and computational fluid dynamics. In order to test their performance, computer-based cerebral aneurysm models that mimic the conditions present after implantation into the human brain were tested. The strut configuration selected was the closed-cell type, and nitinol was chosen as the material for stent manufacture because the innate characteristics of this material increase stent flexibility. Three ideal sample stent types with different cell configurations were manufactured. Computational solid mechanics analysis of the sample stents showed over 30% difference in flexibility between stents. Furthermore, using a cerebral aneurysm model simulation, we found that the stents eased the hemodynamic factors of the cerebral aneurysm and lessened the flow velocity influx into the sac. A decrease in flow velocity led to a 50-60% reduction in wall shear stress, which is expected to prevent aneurysm rupture under clinical conditions. Stent design optimization was carried out by simulation and electropolishing. Corrosion resistance and surface roughness were evaluated after electropolishing performed under variable conditions, but 40 V and 10 s were the most optimal.
Assuntos
Ligas/química , Simulação por Computador , Desenho Assistido por Computador , Procedimentos Endovasculares/instrumentação , Aneurisma Intracraniano/terapia , Modelos Cardiovasculares , Stents , Velocidade do Fluxo Sanguíneo , Circulação Cerebrovascular , Elasticidade , Hemodinâmica , Humanos , Aneurisma Intracraniano/fisiopatologia , Teste de Materiais , Desenho de Prótese , Falha de Prótese , Estresse Mecânico , Propriedades de SuperfícieRESUMO
OBJECTIVE: To investigate the efficacy and related factors of pegylated-interferon alpha-2a (PEG-IFN-2a) treatment in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) who achieved partial viral response with nucleoside analogue (NA) therapy. METHODS: Patients with HBeAg-positive CHB and partial viral response to NA treatment were administered a PEG-IFN-2a therapy regimen of 180 g subcutaneous injection once weekly for a personlized duration of time. The existing NA therapy was continued in combination with the new PEG-IFN-2a treatment for 12 weeks. Measurements of serum HBV DNA load, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HBeAg and hepatitis B e antibody (anti-HBe) were taken at baseline (prior to addition of the PEG-IFN-2a therapy) and every 3 months afterwards.For determining response to treatment, primary efficacy was defined as undetectable HBsAg and seroconversion, and secondary efficacy was defined as HBsAg less than 10 IU/mL and HBeAg seroconversion.Statistical analysis was carried out using SPSS statistical software. RESULTS: A total of 81 consecutive patients with an average of 12.0 months (range: 6.0-24.0 months) of NA therapy were included in the study and received an average of 19.6 months (range: 15.5-33.3 months) of PEG-IFN-2a treatment. At the end of PEG-IFN-2a therapy, 7 (8.6%) of the patients achieved undetectable HBsAg and seroconversion, and 14 (17.3%) showed HBsAg less than 10IU/mL. In addition, 40.7% achieved undetectable HBeAg and seroconversion, a rate that was slightly higher than that (38.3%) seen in treatment-naive patients who received PEG-IFN-2a. Statistical analyses suggest that baseline level of HBsAg at less than 1500 IU/mL may predict end of PEG-IFN-2a treatment response for HBsAg less than 10 IU/mL, as evidenced by the area under the curve measure of 0.747, sensitivity measure of 87.3%, specificity measure of 33.3%, positive predictive value of 82.1% and negative predictive value of 42.8%. CONCLUSION: Patients with HBeAg-positive CHB and partial viral response to NA therapy can achieve undetectable HBsAg and HBeAg seroconversion after switching to PEG-IFN-2a treatment. Baseline HBsAg level may be predictive of response to this therapeutic strategy.