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1.
Front Immunol ; 15: 1427970, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39221246

RESUMO

Hypertrophy of ligamentum flavum (LF) is a significant contributing factor to lumbar spinal canal stenosis (LSCS). lncRNA plays a vital role in organ fibrosis, but its role in LF fibrosis remains unclear. Our previous findings have demonstrated that Hedgehog-Gli1 signaling is a critical driver leading to LF hypertrophy. Through the RIP experiment, our group found lnc-RMRP was physically associated with Gli1 and exhibited enrichment in Gli1-activated LF cells. Histological studies revealed elevated expression of RMRP in hypertrophic LF. In vitro experiments further confirmed that RMRP promoted Gli1 SUMO modification and nucleus transfer. Mechanistically, RMRP induced GSDMD-mediated pyroptosis, proinflammatory activation, and collagen expression through the Hedgehog pathway. Notably, the mechanical stress-induced hypertrophy of LF in rabbit exhibited analogous pathological changes of LF fibrosis occurred in human and showed enhanced levels of collagen and α-SMA. Knockdown of RMRP resulted in the decreased expression of fibrosis and pyroptosis-related proteins, ultimately ameliorating fibrosis. The above data concluded that RMRP exerts a crucial role in regulating GSDMD-mediated pyroptosis of LF cells via Gli1 SUMOylation, thus indicating that targeting RMRP could serve as a potential and effective therapeutic strategy for LF hypertrophy and fibrosis.


Assuntos
Hipertrofia , Ligamento Amarelo , Piroptose , Sumoilação , Proteína GLI1 em Dedos de Zinco , Humanos , Animais , Proteína GLI1 em Dedos de Zinco/metabolismo , Proteína GLI1 em Dedos de Zinco/genética , Ligamento Amarelo/metabolismo , Ligamento Amarelo/patologia , Coelhos , Proteínas de Ligação a Fosfato/metabolismo , Proteínas de Ligação a Fosfato/genética , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/genética , Masculino , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Fibrose , Modelos Animais de Doenças , Gasderminas
2.
Georgian Med News ; (351): 44-48, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39230219

RESUMO

INTRODUCTION: The adenoids and palatine tonsils, part of the lymphoid tissue, act as a first line of defense protecting the lower airways and gastrointestinal tract. Adenotonsillar hypertrophy in children may lead to airway obstruction. This study aims to demonstrate the association between adenotonsillar hypertrophy and decreased blood oxygen saturation. METHODS: A retrospective cohort study was conducted among children aged 7-12 years with adenotonsillar hypertrophy and obstructive symptoms, admitted to King Fahad Hospital and Prince Mishari Hospital, Saudi Arabia, for tonsillectomy between July 2023 and January 2024. Exclusion criteria included respiratory diseases, cardiac disease, nasal polyps, nasal septum deviation, chest wall abnormality, and lower airway diseases. The control group included 56 healthy children. An otolaryngologist determined the severity of airway obstruction using the tonsil size. Oxygen saturation was measured using pulse oximetry. The determinants of oxygen saturation were assessed using multiple linear regression, with significance set at p<0.05. RESULTS: The study included 357 participants, with an even age distribution between 7-9 years (49.6%) and 10-12 years (50.4%), and 52% males. Diagnoses included adenoid hypertrophy (30%), tonsil hypertrophy (35%), both conditions (19%), and the control group (16%). Tonsil sizes ranged from Grade 1 (48%) to Grade 4 (8.4%), with 17% normal. The median oxygen saturation was 96.0% for the adenotonsillar hypertrophy group and 99.0% for the control. Oxygen saturation levels differed significantly across groups (p<0.0001), with lower median saturation in hypertrophy groups than controls. Males had a lower oxygen than females (estimate: -0.338, 95% CI [--0.640, -0.036], p=0.028). Adenoid hypertrophy (estimate: -3.863, 95% CI [-5.241, -2.484], p<0.001), tonsil hypertrophy (estimate: -3.631, 95% CI [-5.053, -2.208], p<0.001) and having both conditions (estimate: -3.777, 95% CI [-5.3.7, -2.247], p<0.001) was associated with lower oxygen saturation. Grade 1 tonsil size was associated with an increase in oxygen saturation (estimate = 2.905, 95% CI [1.616, 4.194], p<0.001). In contrast, Grade 4 tonsil size was linked to lower oxygen saturation (estimate=-4.848, 95% CI [-6.367, -3.329], p<0.001). Grades 2 and 3 were not significantly associated with changes in oxygen saturation. CONCLUSION: Adenotonsillar hypertrophy is significantly associated with decreased blood oxygen saturation and related cardiopulmonary complications in children. Early adenotonsillectomy may be of benefit in preventing these complications and improving oxygen saturation levels.


Assuntos
Tonsila Faríngea , Hipertrofia , Saturação de Oxigênio , Tonsila Palatina , Humanos , Tonsila Faríngea/patologia , Criança , Masculino , Feminino , Arábia Saudita , Tonsila Palatina/patologia , Estudos Retrospectivos , Saturação de Oxigênio/fisiologia , Tonsilectomia , Obstrução das Vias Respiratórias/sangue , Obstrução das Vias Respiratórias/patologia , Oximetria
3.
Spine (Phila Pa 1976) ; 49(17): E284-E290, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39133228

RESUMO

STUDY DESIGN: Experimental study. OBJECTIVE: We sought to elucidate the association between ligamentum flavum thickening and tissue buckling, and the clinical and imaging factors related to buckling by comparing the ligamentum flavum thickness on MRI images and within the actual tissue. SUMMARY OF BACKGROUND DATA: Ligamentum flavum thickening is a main contributor to lumbar spinal canal stenosis. Buckling of the tissue may contribute to ligamentum flavum thickening along with tissue hypertrophy; however, this association has not been established conclusively. MATERIALS AND METHODS: Ligamentum flavum samples (135 ligament samples) from 70 patients with lumbar spinal canal stenosis were evaluated. The ligamentum flavum thicknesses on magnetic resonance imaging (MRI) and in the tissue samples were compared to assess for the presence of buckling. The ligamentum flavum samples were divided into groups with or without buckling based on the difference between their thicknesses on MRI and in the tissues. The Pearson correlation coefficient test was used to assess the relationships between the LF thicknesses on MRI and in the tissues, MRI-tissue difference and LF thickness in the tissues, and MRI-tissue difference and LF thickness on MRI. Further, differences between the buckling+ and buckling- groups were compared using the unpaired t-test (LF thickness on MRI, LF thickness in the tissues, age, disc angle, and disc height) and χ2 (disc level, disc degeneration, and receival/nonreceival of dialysis) test. RESULTS: The ligamentum flavum thickness on MRI and in the tissues had a positive linear relationship, although the thickness was estimated to be significantly larger on MRI than in the tissues themselves. The ligamentum flavum with buckling had a larger thickness on MRI, less tissue hypertrophy, more severe disc degeneration, and was present in patients with a higher rate of dialysis. There were no differences in age and disc height, angle, or level between the two groups. CONCLUSIONS: Buckling of the ligamentum flavum coexists with tissue hypertrophy and contributes to perceived ligamentum thickening on imaging. Buckling of the ligamentum flavum tends to occur in less hypertrophied tissues and is associated with the grade of disc degeneration and the presence of other characteristics associated with spinal degeneration.


Assuntos
Ligamento Amarelo , Vértebras Lombares , Imageamento por Ressonância Magnética , Estenose Espinal , Humanos , Ligamento Amarelo/patologia , Ligamento Amarelo/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/patologia , Masculino , Feminino , Idoso , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Pessoa de Meia-Idade , Adulto , Idoso de 80 Anos ou mais , Canal Medular/diagnóstico por imagem , Canal Medular/patologia , Hipertrofia
5.
BMC Pediatr ; 24(1): 521, 2024 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-39134977

RESUMO

BACKGROUND: The adenoids act as a reservoir of bacterial pathogens and immune molecules, and they are significantly involved in children with otitis media with effusion (OME). As an essential carrier of intercellular substance transfer and signal transduction, exosomes with different biological functions can be secreted by various types of cells. There remains significant uncertainty regarding the clinical relevance of exosomes to OME, especially in its pathophysiologic development. In this study, we will seek to determine the biological functions of exosomes in children with adenoid hypertrophy accompanied by OME (AHOME). METHODS: The diagnostic criteria for OME in children aged 4-10 years include a disease duration of at least 3 months, type B or C acoustic immittance, and varying degrees of conductive hearing loss. Adenoidal hypertrophy is diagnosed when nasal endoscopy shows at least 60% adenoidal occlusion in the nostrils or when nasopharyngeal lateral X-ray shows A/N > 0.6. Children who meet the indications for adenoidectomy surgery undergo adenoidectomy. Peripheral blood, nasopharyngeal swab, and adenoid tissue will be collected from patients, and the exosomes will be isolated from the samples. Following the initial collection, patients will undergo adenoidectomy and peripheral blood and nasopharyngeal swabs will be collected again after 3 months. EXPECTED RESULTS: This study aims to identify differences in exosomes from preoperative adenoid tissue and peripheral blood samples between children with AHOME and those with adenoid hypertrophy alone. Additionally, it seeks to determine changes in microbial diversity in adenoid tissue between these groups. CONCLUSIONS: The findings are expected to provide new insights into the diagnosis and treatment of OME, to identify novel biomarkers, and to enhance our understanding of the pathophysiology of OME, potentially leading to the development of innovative diagnostic and therapeutic approaches.


Assuntos
Adenoidectomia , Tonsila Faríngea , Exossomos , Hipertrofia , Otite Média com Derrame , Humanos , Tonsila Faríngea/patologia , Otite Média com Derrame/etiologia , Otite Média com Derrame/diagnóstico , Criança , Pré-Escolar , Masculino , Feminino
6.
BMC Neurol ; 24(1): 283, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39138403

RESUMO

Hypertrophic pachymeningitis (HP) is a rare disorder marked by thickening of the dura mater due to diverse etiologies. MPO-ANCA-positive HP represents a variant of AAV confined to the central nervous system, distinguished by the presence of serum MPO antibodies. Distinguishing HP triggered by MPO-ANCA from other causes can be challenging.In this study, we present two cases of MPO-ANCA-positive HP initially misdiagnosed as intracranial infections. Case 1 underwent surgery for chronic suppurative otitis media, with histopathological findings revealing inflammatory changes without definitive suppuration. He was presumed to have a secondary intracranial infection resulting from the surgery. However, his condition deteriorated despite two weeks of antibiotic and antiviral treatment. Case 2 presented with headache and was initially suspected of having intracranial Brucellosis given his serum Brucella positivity. Despite treatment for brucellosis, his symptoms persisted, and he developed visual and hearing impairments. Both patients were ultimately diagnosed with MPO-ANCA-positive HP, exhibiting serum MPO antibody positivity. Their symptoms showed improvement with glucocorticoid and immunosuppressive therapy.Based on these observations, we propose that MPO-ANCA-positive HP may initially present as intracranial infection. For HP patients presenting with headache, mastoiditis, otitis media, and visual loss, it is imperative to conduct ANCA antibody-related tests to enhance diagnostic precision.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos , Meningite , Humanos , Masculino , Meningite/diagnóstico , Meningite/imunologia , Anticorpos Anticitoplasma de Neutrófilos/sangue , Diagnóstico Diferencial , Pessoa de Meia-Idade , Peroxidase/imunologia , Hipertrofia/diagnóstico , Adulto , Brucelose/diagnóstico , Brucelose/complicações
7.
Vestn Otorinolaringol ; 89(4): 26-29, 2024.
Artigo em Russo | MEDLINE | ID: mdl-39171873

RESUMO

The article presents the results of a study that included 127 children aged 8 to 17 years with a diagnosis of turbinate hypertrophy. The children are divided into three groups depending on the chosen vasotomy method. The methods of vasotomy were determined, after which there was a faster restoration of mucociliary clearance of the mucous membrane of the lower nasal concha.


Assuntos
Hipertrofia , Depuração Mucociliar , Mucosa Nasal , Conchas Nasais , Humanos , Depuração Mucociliar/fisiologia , Conchas Nasais/cirurgia , Criança , Feminino , Masculino , Adolescente , Mucosa Nasal/cirurgia , Mucosa Nasal/fisiopatologia , Hipertrofia/fisiopatologia , Hipertrofia/cirurgia , Resultado do Tratamento , Obstrução Nasal/cirurgia , Obstrução Nasal/fisiopatologia , Obstrução Nasal/diagnóstico , Obstrução Nasal/etiologia
8.
Int J Mol Sci ; 25(16)2024 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-39201664

RESUMO

Eccentric training induces greater hypertrophy while causing more muscle damage than concentric training. This study examined the effects of small-range eccentric contractions (SR-ECCs) and large-range eccentric contractions (LR-ECCs) on muscle morphology, contractility, and damage in rats. Thirty male Fischer 344 rats were divided into five groups: small-range ECC single-bout (SR-ECCSB, n = 4), large-range ECC single-bout (LR-ECCSB, n = 4), SR-ECC intervention (SR-ECCIntv, n = 7), LR-ECC intervention (LR-ECCIntv, n = 8), and control (Cont, n = 7). These groups underwent transcutaneous electrical stimulation involving 80 ECCs twice a week for four weeks. The results indicated that the LR-ECCSB group had more Evans blue dye-positive fibers than other groups. The SR-ECCIntv group showed no increase in the mean myofiber cross-sectional area. However, Pax7+ and Ki67+ cells significantly increased in both ECCIntv groups compared to the Cont group, and the connective tissue area was significantly greater in the LR-ECCIntv than in others. Muscle force was lower in both ECCIntv groups compared to the Cont group. These findings suggest that SR-ECC intervention may induce a smaller increase in the number of fibers with a large myofiber cross-sectional area and satellite cell proliferation with less muscle damage and myofibrosis compared to LR-ECCs.


Assuntos
Contração Muscular , Músculo Esquelético , Condicionamento Físico Animal , Ratos Endogâmicos F344 , Animais , Masculino , Ratos , Músculo Esquelético/fisiologia , Músculo Esquelético/metabolismo , Força Muscular , Fibras Musculares Esqueléticas/metabolismo , Fibras Musculares Esqueléticas/fisiologia , Hipertrofia
9.
JAAPA ; 37(9): 1-3, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39190413

RESUMO

ABSTRACT: Lipomatous hypertrophy of the interatrial septum (LHIS) is a rare but benign cardiac tumor that can be found on cardiac imaging such as echocardiogram, or during surgery or an autopsy. Cardiac MRI is the best imaging modality to determine the borders of the tumor and its extension into the intraventricular septum and ventricular free wall. Patients require close monitoring because LHIS may cause right or left outflow tract obstruction or superior vena cava obstruction, requiring cardiac surgical intervention. This article describes a patient with LHIS who underwent cardiac surgery because of her increasing symptomatology.


Assuntos
Septo Interatrial , Neoplasias Cardíacas , Lipomatose , Humanos , Feminino , Septo Interatrial/diagnóstico por imagem , Septo Interatrial/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patologia , Lipomatose/diagnóstico por imagem , Lipomatose/diagnóstico , Lipomatose/cirurgia , Imageamento por Ressonância Magnética , Hipertrofia , Ecocardiografia , Pessoa de Meia-Idade , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/diagnóstico
10.
Artigo em Chinês | MEDLINE | ID: mdl-39193744

RESUMO

Objective:To investigate the long-term effect of partial tonsillectomy in children with tonsil hypertrophy. Methods:A total of 146 children with obstructive sleep apnea(OSA) who received surgical treatment for tonsil hyperplasia from January 2010 to January 2013 were selected and divided into the observation group(n=69) and the control group(n=77). The observation group was received tonsillotomy(TT), and the control group was received total tonsillectomy(TE). Parental satisfaction and OSA quality of life questionnaire for children(OSA-18) were surveyed. Residual tonsil size was measured, and polysomnography(PSG) was monitored after 10 years. HE and immunohistochemical analysis were performed on tonsil tissues of one patient who performed a second operation after TT in 2017 year. Results:The results of questionnaire survey showed that the symptoms of respiratory obstruction were significantly improved in both groups, and the satisfaction of TT group was higher than that in the TE group. No increase in the number of respiratory tract infections was observed in all patients. In the TT group, nine cases(13.04%) had tonsil hyperplasia toⅡ°, and the remaining patients had tonsil hyperplasia to Ⅰ°. In addition, one case hadtonsil suppurative infection at the 14th month after surgery, and no recurrence or reoperation was found after treatment. There were seven cases in the TT group and eight cases in the TE group with occasional snoring and mouth breathing after surgery, but the PSG examination of the patients did not meet the diagnosis of OSA. The main causes were obesity and allergic rhinitis. Compared with the first operation, the cicatricial obstruction and infection of tonsil tissue in the second operation were not significantly changed, and the immunohistochemical results also demonstrated that the expression of CD20 was not changed, and the expression of CD3 was decreased. Conclusion:Both TT and TE can effectively improve the symptoms of OSA obstruction in children. TT has less trauma, less postoperative pain, faster recovery and lower rate of hyperplasia, which can be used as one of the main methods for the treatment of tonsil hypertrophy in children.


Assuntos
Hiperplasia , Hipertrofia , Tonsila Palatina , Apneia Obstrutiva do Sono , Tonsilectomia , Humanos , Tonsilectomia/métodos , Apneia Obstrutiva do Sono/cirurgia , Criança , Masculino , Feminino , Hiperplasia/cirurgia , Tonsila Palatina/cirurgia , Tonsila Palatina/patologia , Hipertrofia/cirurgia , Resultado do Tratamento , Qualidade de Vida , Inquéritos e Questionários , Polissonografia , Pré-Escolar , Satisfação do Paciente , Reoperação
11.
Exerc Sport Sci Rev ; 52(4): 117-125, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39190607

RESUMO

We review the evidence indicating that endogenous changes in these hormones, including testosterone, growth hormone, insulin growth factor-1, and estrogen, and their proposed anabolic effects contribute to and augment resistance exercise training (RET)-induced hypertrophy. Additionally, we provide recommendations for gold-standard methodological rigor to establish best practices for verifying menstrual phases as part of their research, ultimately enhancing our understanding of the impact of ovarian hormones on RET-induced adaptations.


Assuntos
Estrogênios , Fator de Crescimento Insulin-Like I , Músculo Esquelético , Treinamento Resistido , Testosterona , Humanos , Treinamento Resistido/métodos , Músculo Esquelético/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Testosterona/sangue , Exercício Físico/fisiologia , Feminino , Hipertrofia , Hormônio do Crescimento , Ciclo Menstrual/fisiologia , Adaptação Fisiológica
12.
Biochem Soc Trans ; 52(4): 1921-1926, 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39136196

RESUMO

Skeletal muscle stem cells (MuSCs) display distinct behavior crucial for tissue maintenance and repair. Upon activation, MuSCs exhibit distinct modes of division: symmetric division, facilitating either self-renewal or differentiation, and asymmetric division, which dictates divergent cellular fates. This review explores the nuanced dynamics of MuSC division and the molecular mechanisms governing this behavior. Furthermore, it introduces a novel phenomenon observed in a subset of MuSCs under hypertrophic stimuli termed division-independent differentiation. Insights into the underlying mechanisms driving this process are discussed, alongside its broader implications for muscle physiology.


Assuntos
Diferenciação Celular , Hipertrofia , Músculo Esquelético , Células Satélites de Músculo Esquelético , Células Satélites de Músculo Esquelético/metabolismo , Células Satélites de Músculo Esquelético/fisiologia , Humanos , Animais , Divisão Celular
13.
J Plast Reconstr Aesthet Surg ; 96: 175-185, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39094372

RESUMO

BACKGROUND: Reduction mammaplasty improves the quality of life by providing functional and aesthetic benefits to women with macromastia. This study contributes to the existing literature on socioeconomic and clinical barriers to referral for plastic surgery procedures by focusing specifically on reduction mammaplasty. METHODS: Patients with macromastia were identified via a chart review in a single institution from 2021-2022. The treatment pathway for each patient was characterized by reception of referral, completion of plastic surgery consultation, and eventual reception of surgery. After controlling for clinical covariates, multivariate logistic regression was applied to quantify the independent impact of race, insurance, and language status on the completion of surgery (p < 0.05). RESULTS: The final patient cohort included 425 women with macromastia. Among the 151 patients who were first seen by a primary care physician, 64 (42%) completed an initial plastic surgery consultation. Among all patients, 160 (38%) eventually underwent reduction mammaplasty. Multivariate regression predictions indicated a lower likelihood of completing breast reduction surgery in patients with current smoking history (OR: 0.08, 95% CI: 0.01-0.59) and higher body mass index (BMI) (OR: 0.94, 95% CI: 0.90-0.97) (p < 0.05). Minority race and ethnicity, private insurance status, and primary language status were not significant predictors of this outcome (p > 0.05). CONCLUSIONS: In this study, the socioeconomic variables were not independent predictors of breast reduction surgery completion. However, the association of minority race and ethnicity and nonprivate insurance status with the most common reasons for breast reduction deferral suggest an indirect influence of socioeconomic status on the treatment pathway.


Assuntos
Mama , Hipertrofia , Mamoplastia , Humanos , Mamoplastia/métodos , Feminino , Hipertrofia/cirurgia , Adulto , Mama/anormalidades , Mama/cirurgia , Pessoa de Meia-Idade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Procedimentos Clínicos
14.
Int J Pediatr Otorhinolaryngol ; 184: 112079, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39173268

RESUMO

OBJECTIVE: In recent years, the clinical efficacy of medications for adenoid hypertrophy has been demonstrated. Topical nasal steroids have effects to shrink hypertrophic adenoids and improve symptoms of associated diseases. However, the mechanism which topical steroid administrations cause adenoid shrinkage remains unclear, herein, sensitivity for topical steroids in the mucosal epithelium of adenoids was evaluated histologically by comparing with tonsils. METHODS: Histological analysis was performed on adenoids and tonsils removed from 32 pediatric patients with adenoid hypertrophy. In hematoxylin-eosin-stained specimens, the morphology of the mucosal epithelium and eosinophil infiltration were evaluated. The expression of the glucocorticoid receptor (GR), interleukin (IL)-4, and IL-25 in the mucosal epithelium was evaluated, and the staining intensity was scored as 0 (none), 1 (weak), and 2 (strong). The number of eosinophils and expression scores of GR, IL-4, and IL-25 were statistically compared between adenoids and tonsils and analyzed correlations with adenoids sizes. RESULTS: Adenoids were covered with ciliated epithelium, and eosinophils in the mucosal epithelium and submucosal area was higher than tonsils (p < 0.05). GR expression in the most superficial layer of the mucosal epithelium was observed in adenoids, and the expression intensity score was higher than that in tonsils (p < 0.05). IL-4 and IL-25 were more widely expressed in the mucosal epithelium of adenoids than in tonsils, and their expression intensity scores were also higher than in tonsils (p < 0.05). A correlation was found between adenoid size and the intensity of IL-25 expression in the adenoid epithelium (p < 0.05). CONCLUSION: Eosinophilic inflammations in adenoids mucosal epithelium could be one of etiology of adenoid hypertrophy, and the GR and eosinophilic inflammation in the adenoids mucosal epithelium might be target of topical nasal steroids to shrink hypertrophic adenoids.


Assuntos
Tonsila Faríngea , Eosinófilos , Hipertrofia , Tonsila Palatina , Receptores de Glucocorticoides , Humanos , Tonsila Faríngea/patologia , Tonsila Faríngea/metabolismo , Receptores de Glucocorticoides/metabolismo , Masculino , Criança , Feminino , Eosinófilos/metabolismo , Pré-Escolar , Tonsila Palatina/patologia , Interleucina-17/metabolismo , Mucosa/patologia , Mucosa/metabolismo , Interleucina-4/metabolismo , Epitélio/patologia , Epitélio/metabolismo , Glucocorticoides , Citocinas/metabolismo , Adolescente
15.
Sci Rep ; 14(1): 18619, 2024 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-39127777

RESUMO

Adenoid hypertrophy can lead to adenoidal mouth breathing, which can result in "adenoid face" and, in severe cases, can even lead to respiratory tract obstruction. The Fujioka ratio method, which calculates the ratio of adenoid (A) to nasopharyngeal (N) space in an adenoidal-cephalogram (A/N), is a well-recognized and effective technique for detecting adenoid hypertrophy. However, this process is time-consuming and relies on personal experience, so a fully automated and standardized method needs to be designed. Most of the current deep learning-based methods for automatic diagnosis of adenoids are CNN-based methods, which are more sensitive to features similar to adenoids in lateral views and can affect the final localization results. In this study, we designed a local attention-based method for automatic diagnosis of adenoids, which takes AdeBlock as the basic module, fuses the spatial and channel information of adenoids through two-branch local attention computation, and combines the downsampling method without losing spatial information. Our method achieved mean squared error (MSE) 0.0023, mean radial error (MRE) 1.91, and SD (standard deviation) 7.64 on the three hospital datasets, outperforming other comparative methods.


Assuntos
Tonsila Faríngea , Hipertrofia , Tonsila Faríngea/patologia , Tonsila Faríngea/diagnóstico por imagem , Humanos , Criança , Masculino , Feminino , Aprendizado Profundo , Pré-Escolar , Cefalometria/métodos
16.
EBioMedicine ; 107: 105315, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39216230

RESUMO

BACKGROUND: Genetic variants in COL4A1 and COL4A2 (encoding collagen IV alpha chain 1/2) occur in genetic and sporadic forms of cerebral small vessel disease (CSVD), a leading cause of stroke, dementia and intracerebral haemorrhage (ICH). However, the molecular mechanisms of CSVD with ICH and COL4A1/COL4A2 variants remain obscure. METHODS: Vascular function and molecular investigations in mice with a Col4a1 missense mutation and heterozygous Col4a2 knock-out mice were combined with analysis of human brain endothelial cells harboring COL4A1/COL4A2 mutations, and brain tissue of patients with sporadic CSVD with ICH. FINDINGS: Col4a1 missense mutations cause early-onset CSVD independent of hypertension, with enhanced vasodilation of small arteries due to endothelial dysfunction, vascular wall thickening and reduced stiffness. Mechanistically, the early-onset dysregulated endothelium-dependent hyperpolarization (EDH) is due to reduced collagen IV levels with elevated activity and levels of endothelial Ca2+-sensitive K+ channels. This results in vasodilation via the Na/K pump in vascular smooth muscle cells. Our data support this endothelial dysfunction preceding development of CSVD-associated ICH is due to increased cytoplasmic Ca2+ levels in endothelial cells. Moreover, cerebral blood vessels of patients with sporadic CSVD show genotype-dependent mechanisms with wall thickening and lower collagen IV levels in those harboring common non-coding COL4A1/COL4A2 risk alleles. INTERPRETATION: COL4A1/COL4A2 variants act in genetic and sporadic CSVD with ICH via dysregulated EDH, and altered vascular wall thickness and biomechanics due to lower collagen IV levels and/or mutant collagen IV secretion. These data highlight EDH and collagen IV levels as potential treatment targets. FUNDING: MRC, Wellcome Trust, BHF.


Assuntos
Hemorragia Cerebral , Doenças de Pequenos Vasos Cerebrais , Colágeno Tipo IV , Colágeno Tipo IV/metabolismo , Colágeno Tipo IV/genética , Hemorragia Cerebral/metabolismo , Hemorragia Cerebral/patologia , Hemorragia Cerebral/genética , Doenças de Pequenos Vasos Cerebrais/genética , Doenças de Pequenos Vasos Cerebrais/metabolismo , Doenças de Pequenos Vasos Cerebrais/patologia , Doenças de Pequenos Vasos Cerebrais/etiologia , Humanos , Animais , Camundongos , Camundongos Knockout , Modelos Animais de Doenças , Endotélio Vascular/metabolismo , Endotélio Vascular/patologia , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Mutação de Sentido Incorreto , Masculino , Vasodilatação , Feminino , Hipertrofia
17.
Sports Med ; 54(9): 2209-2231, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38970765

RESUMO

BACKGROUND: The proximity to failure in which sets are terminated has gained attention in the scientific literature as a potentially key resistance training variable. Multiple meta-analyses have directly (i.e., failure versus not to failure) or indirectly (e.g., velocity loss, alternative set structures) evaluated the effect of proximity to failure on strength and muscle hypertrophy outcomes categorically; however, the dose-response effects of proximity to failure have not been analyzed collectively in a continuous manner. OBJECTIVE: To meta-analyze the aforementioned areas of relevant research, proximity to failure was quantified as the number of repetitions in reserve (RIR). Importantly, the RIR associated with each effect in the analysis was estimated on the basis of the available descriptions of the training interventions in each study. Data were extracted and a series of exploratory multilevel meta-regressions were performed for outcomes related to both strength and muscle hypertrophy. A range of sensitivity analyses were also performed. All models were adjusted for the effects of load, method of volume equating, duration of intervention, and training status. RESULTS: The best fit models for both strength and muscle hypertrophy outcomes demonstrated modest quality of overall fit. In all of the best-fit models for strength, the confidence intervals of the marginal slopes for estimated RIR contained a null point estimate, indicating a negligible relationship with strength gains. However, in all of the best-fit models for muscle hypertrophy, the marginal slopes for estimated RIR were negative and their confidence intervals did not contain a null point estimate, indicating that changes in muscle size increased as sets were terminated closer to failure. CONCLUSIONS: The dose-response relationship between proximity to failure and strength gain appears to differ from the relationship with muscle hypertrophy, with only the latter being meaningfully influenced by RIR. Strength gains were similar across a wide range of RIR, while muscle hypertrophy improves as sets are terminated closer to failure. Considering the RIR estimation procedures used, however, the exact relationship between RIR and muscle hypertrophy and strength remains unclear. Researchers and practitioners should be aware that optimal proximity to failure may differ between strength and muscle hypertrophy outcomes, but caution is warranted when interpreting the present analysis due to its exploratory nature. Future studies deliberately designed to explore the continuous nature of the dose-response effects of proximity to failure in large samples should be considered.


Assuntos
Força Muscular , Músculo Esquelético , Treinamento Resistido , Treinamento Resistido/métodos , Humanos , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Hipertrofia , Análise de Regressão , Aumento do Músculo Esquelético
18.
Nat Commun ; 15(1): 5827, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992008

RESUMO

The liver has the remarkable capacity to regenerate. In the clinic, regeneration is induced by portal vein embolization, which redirects portal blood flow, resulting in liver hypertrophy in locations with increased blood supply, and atrophy of embolized segments. Here, we apply single-cell and single-nucleus transcriptomics on healthy, hypertrophied, and atrophied patient-derived liver samples to explore cell states in the regenerating liver. Our data unveils pervasive upregulation of genes associated with developmental processes, cellular adhesion, and inflammation in post-portal vein embolization liver, disrupted portal-central hepatocyte zonation, and altered cell subtype composition of endothelial and immune cells. Interlineage crosstalk analysis reveals mesenchymal cells as an interaction hub between immune and endothelial cells, and highlights the importance of extracellular matrix proteins in liver regeneration. Moreover, we establish tissue-scale iterative indirect immunofluorescence imaging for high-dimensional spatial analysis of perivascular microenvironments, uncovering changes to tissue architecture in regenerating liver lobules. Altogether, our data is a rich resource revealing cellular and histological changes in human liver regeneration.


Assuntos
Embolização Terapêutica , Regeneração Hepática , Fígado , Veia Porta , Humanos , Regeneração Hepática/fisiologia , Embolização Terapêutica/métodos , Hepatócitos/metabolismo , Análise de Célula Única , Transcriptoma , Masculino , Células Endoteliais/metabolismo , Feminino , Hipertrofia , Pessoa de Meia-Idade
19.
BMC Urol ; 24(1): 154, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39069606

RESUMO

OBJECTIVES: To investigate the effects of bladder neck incision (BNI) and primary valves ablation on long-term kidney and bladder function in children with posterior urethral valves (PUV) and bladder neck hypertrophy (BNH). PATIENTS AND METHODS: From 1997 to 2016, a total of 1381 children with PUV were referred to our tertiary hospital. Of these patients, 301 PUV patients with bladder neck hypertrophy need concurrent BNI and valve ablation. All patients were followed up every 3-6 months on regular basis in first 2 post-surgical years and annually then after. The paired t-test and chi-square test were used to perform statistical analysis with p value < 0.05 defined as the level of significance. RESULTS: Mean age at diagnosis was 7.22 ± 2.45 months (ranging from 7 days to 15 months) with a mean follow-up of 5.12 ± 2.80 years. The incidence of hydronephrosis was decreased from 266 (88.3%) at the baseline to 73 (24.3%) patients in long-term follow-up. At baseline, 188 (62.5%) patients were diagnosed with VUR, which decreased to 20 (6.6%) individuals at the end of follow-up. Bladder and renal function were improved in follow-ups following concomitant PUV ablation and BNI. No Myogenic failure was depicted in all patients with BNH. No ureteric reimplantation was needed during the two decades follow-up. CONCLUSION: Simultaneous valve ablation with BNI may present further profits in children with PUV and BNH particularly cases of BNH with poor bladder function at the time of presentation. This method can improve the results of urodynamic and imaging studies after the surgery. We hypothesize every child with PUV presentation who has concurrent vesicoureteral reflux, CKD or persistent hydrourethronephrosis may suffer from secondary bladder neck obstruction. This secondary bladder outlet obstruction must be managed through BNI as the surgical relief.


Assuntos
Hipertrofia , Uretra , Bexiga Urinária , Humanos , Uretra/anormalidades , Uretra/cirurgia , Lactente , Masculino , Seguimentos , Bexiga Urinária/cirurgia , Recém-Nascido , Fatores de Tempo , Estudos Retrospectivos , Obstrução do Colo da Bexiga Urinária/cirurgia , Obstrução do Colo da Bexiga Urinária/etiologia , Técnicas de Ablação/métodos , Feminino , Procedimentos Cirúrgicos Urológicos/métodos , Insuficiência Renal/etiologia , Insuficiência Renal/epidemiologia
20.
Obesity (Silver Spring) ; 32(8): 1508-1517, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-39045668

RESUMO

OBJECTIVE: We aimed to examine the effect of age of obesity onset, sex, and their interaction on abdominal and femoral subcutaneous adipose tissue (SAT) morphology (degree of adipocyte hyperplasia or hypertrophy). METHODS: In this cross-sectional study, we isolated adipocytes via collagenase digestion from abdominal and femoral SAT biopsies taken from male and female adults with childhood-onset obesity (CO; n = 8 males, n = 16 females) or adult-onset obesity (AO; n = 8 males, n = 13 females). Regional body composition was measured with dual-energy x-ray absorptiometry and a single-slice abdominal computed tomography scan. Mean adipocyte size was measured in abdominal and femoral SAT and was used to quantify morphology in android and gynoid subcutaneous fat, respectively. RESULTS: Abdominal SAT morphology was more hyperplastic in females with CO than females with AO (p = 0.004) but did not differ between males with CO and males with AO (p = 0.996). Conversely, femoral SAT morphology was more hypertrophic in males and females with CO than those with AO. CONCLUSIONS: Age of obesity onset appears to affect SAT morphology differently in the abdominal and femoral regions of male and female adults. Our findings challenge the notion that SAT is uniformly hyperplastic in CO and hypertrophic in AO.


Assuntos
Absorciometria de Fóton , Adipócitos , Fêmur , Obesidade , Gordura Subcutânea , Humanos , Masculino , Feminino , Estudos Transversais , Adulto , Fêmur/patologia , Fêmur/diagnóstico por imagem , Gordura Subcutânea/patologia , Obesidade/patologia , Adipócitos/patologia , Idade de Início , Fatores Sexuais , Pessoa de Meia-Idade , Composição Corporal , Adulto Jovem , Hiperplasia , Hipertrofia , Adolescente , Criança , Índice de Massa Corporal
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