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1.
Clin Radiol ; 76(8): 627.e13-627.e21, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33762138

RESUMEN

AIM: To develop and validate a radiomics-based model for predicting response to neoadjuvant chemotherapy (NAC) using baseline computed tomography (CT) images in patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: A radiomics signature for predicting pathological complete response (pCR) was developed using radiomics features selected by a random forest classifier on baseline CT images, and imaging predictors were identified in the training set (87 patients). By incorporating imaging predictors and radiomics signature, an imaging-based model was constructed using multivariate logistic regression analysis and validated in an independent validation set consisting of 48 patients with CT from outside institutions. The performance and clinical usefulness of the imaging-based model for predicting pCR were evaluated using area under the receiver operating characteristic curve (AUC) and decision curve analysis. Using a cut-off determined in the training set, the positive likelihood ratios of the imaging-based model were calculated and compared with imaging and histological predictors. RESULTS: The radiomics signature was developed based on six stable radiomics features. An imaging-based model incorporating radiomics signature, tumour shape, tumour size, and clinical stage showed good performance for predicting pCR in both the training (AUC, 0.85; 95% confidence interval [CI], 0.78-0.93) and validation (AUC, 0.75; 95% CI, 0.60-0.86) sets, providing a larger net benefit in decision curve analysis. The imaging-based model showed a higher positive likelihood ratio (1.91) for pCR than imaging and histological predictors (1.33-1.63). CONCLUSIONS: The radiomics-based model using baseline CT images may predict the response of patients with MIBC to NAC.


Asunto(s)
Terapia Neoadyuvante/métodos , Tomografía Computarizada por Rayos X/métodos , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/patología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/patología , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Resultado del Tratamiento , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen
2.
AJNR Am J Neuroradiol ; 41(8): 1487-1494, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32763895

RESUMEN

BACKGROUND AND PURPOSE: Clinical and imaging manifestations of idiopathic intracranial hypertension should prompt early diagnosis and treatment to avoid complications. Multiple diagnostic imaging criteria are reported to suggest the diagnosis of idiopathic intracranial hypertension with questionable sensitivity and/or specificity. Increased intracranial pressure results in dilation of the perineural cisternal spaces such as the optic nerve sheaths and the Meckel cave. It may also cause protrusion of cisternal structures of the Meckel cave through the skull base foramina, which could result in indentation or a bilobed appearance of the Meckel cave. We investigated the changes in the Meckel cave in patients with proved idiopathic intracranial hypertension versus healthy controls. MATERIALS AND METHODS: We studied 75 patients with a diagnosis of idiopathic intracranial hypertension and 75 age-and sex-matched healthy controls. The transverse diameter of Meckel cave was measured in the axial and coronal planes of T2-weighted MR imaging sequences, and comparison was made between the 2 groups. RESULTS: The mean diameters of the Meckel cave on the coronal T2 plane in patients with idiopathic intracranial hypertension were 5.21 ± 1.22 mm on the right side and 5.16 ± 0.90 mm on the left side, while in the control group, they measured 3.89 ± 0.62 mm and 4.09 ± 0.68 mm, respectively (P value < .001). Of 75 patients with an approved diagnosis of idiopathic intracranial hypertension, 57 (76%) showed an indented Meckel cave as opposed to 21 (28%) in the control group. CONCLUSIONS: Our results confirm for the first time that the shape and size of the Meckel cave can be used as sensitive and specific diagnostic imaging markers for the diagnosis of idiopathic intracranial hypertension.


Asunto(s)
Fosa Craneal Media/diagnóstico por imagen , Duramadre/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Seudotumor Cerebral/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
3.
BJOG ; 127(13): 1646-1654, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32536019

RESUMEN

OBJECTIVE: To compare the efficacy of two types of progestogen therapy for preventing preterm birth (PTB) and to review the relevant literature. DESIGN: A multicentre, randomised, open-label, equivalence trial and a meta-analysis. SETTING: Tertiary referral hospitals in South Korea. POPULATION: Pregnant women with a history of spontaneous PTB or short cervical length (<25 mm). METHODS: Eligible women were screened and randomised at 16-22 weeks of gestation to receive either 200 mg of vaginal micronised progesterone daily (vaginal group) or an intramuscular injection of 250 mg 17α-hydroxyprogesterone caproate weekly (IM group). Stratified randomisation was carried out according to participating centres and indications for progestogen therapy. This trial was registered at ClinicalTrials.gov (NCT02304237). MAIN OUTCOME MEASURE: Preterm birth (PTB) before 37 weeks of gestation. RESULTS: A total of 266 women were randomly assigned and a total of 247 women (119 and 128 women in the vaginal and IM groups, respectively) were available for the intention-to-treat analysis. Risks of PTB before 37 weeks of gestation did not significantly differ between the two groups (22.7 versus 25.8%, P = 0.571). The difference in PTB risk between the two groups was 3.1% (95% CI -7.6 to 13.8%), which was within the equivalence margin of 15%. The meta-analysis results showed no significant differences in the risk of PTB between the vaginal and IM progestogen treatments. CONCLUSION: Compared with vaginal progesterone, treatment with intramuscular progestin might increase the risk of PTB before 37 weeks of gestation by as much as 13.8%, or reduce the risk by as much as 7.6%, in women with a history of spontaneous PTB or with short cervical length. TWEETABLE ABSTRACT: Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation.


Asunto(s)
Nacimiento Prematuro/prevención & control , Progestinas/administración & dosificación , Administración Intravaginal , Adulto , Femenino , Humanos , Inyecciones Intramusculares , Metaanálisis como Asunto , Embarazo , Embarazo de Alto Riesgo
4.
Malays J Pathol ; 41(2): 213-222, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31427559

RESUMEN

INTRODUCTION: Anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) with a non-common pattern can be diagnostic challenging. Pathologists can be unavoidably and unintentionally blind to non-descript tumor cells in a lymphohistiocytic- (LH) or small-cell (SC)-pattern. We report a case of primary systemic ALK+ ALCL with a SC pattern that presented as secondary gastric lesions with a mixed LH and SC pattern that was masqueraded as inflammatory lesions. CASE REPORT: A 34-year-old woman with intractable epigastric pain was referred to have repeated endoscopy with biopsy. She was found to multiple gastric erosions and nodules that were diagnosed as inflammatory lesions both endoscopically and histologically. Meanwhile, she developed an acute onset of severe back pain associated with a pathologic compression fracture in the T3 thoracic vertebral body. Imaging studies disclosed a disseminated systemic disease involving abdominopelvic lymph nodes and cervical and thoracic vertebral bodies. The needle biopsy of the pelvic lymph node disclosed diffuse proliferation of monomorphic small round cells that were diffusely positive for CD30 and ALK. A diagnosis of ALK+ ALCL with a monomorphic SC pattern was rendered. DISCUSSION: A retrospective review of the gastric biopsies with the aid of immunohistochemistry enabled us to recognise the presence of lymphomatous infiltrates with a mixed LH and SC pattern in every piece of gastric biopsies that were repeatedly misdiagnosed as inflammatory lesions. This case illustrates a significant diagnostic pitfall of the LH- and SC-patterns in ALK+ ALCL, in which the tumour cells featuring lymphoid, plasmacytoid or histiocytoid appearance can be masqueraded as inflammatory cells.


Asunto(s)
Linfoma Anaplásico de Células Grandes/patología , Neoplasias Gástricas/patología , Adulto , Quinasa de Linfoma Anaplásico , Diagnóstico Diferencial , Femenino , Gastritis/diagnóstico , Gastritis/patología , Humanos , Linfoma Anaplásico de Células Grandes/diagnóstico , Neoplasias Gástricas/diagnóstico
5.
Lupus ; 28(6): 722-730, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30971164

RESUMEN

BACKGROUND: Hydroxychloroquine (HCQ) is regarded as a mainstay in the treatment of systemic lupus erythematosus (SLE) because of its efficacy in preventing flares, achieving remission, and reducing overall mortality. However, the impact of HCQ on pregnancy outcomes remains controversial. OBJECTIVE: We aimed to investigate the effect of HCQ on pregnancy outcomes in patients with SLE. METHODS: We performed a retrospective cohort study of 151 pregnancies in 122 patients with SLE (80 pregnancies in the HCQ treatment group and 71 pregnancies in the HCQ nontreatment group). We reviewed baseline characteristics including maternal comorbidities such as antiphospholipid syndrome, lupus nephritis, and autoimmune hepatitis. Pregnancy outcomes (preeclampsia, preterm delivery, and fetal growth restriction) and neonatal outcomes (gestational age at delivery and birth weight) were compared between HCQ treatment and nontreatment groups. RESULTS: Preeclampsia was significantly less complicated (7.5% vs 19.7%, p = 0.032) and neonatal birth weight was significantly greater (2757.0 ± 583.5 g vs 2542.3 ± 908.3 g, p = 0.001) in the HCQ treatment group than in the HCQ nontreatment group. Multiple logistic analysis adjusting for body mass index (BMI), lupus nephritis, serum uric acid, and estimated glomerular filtration rate revealed HCQ treatment was associated with exceedingly lower risk of preeclampsia in SLE pregnancy (odds ratio (OR) 0.106 (confidence interval (CI) 0.017-0.671)). Other independent risk factors for preeclampsia were a high prepregnancy BMI (OR 1.575 (CI 1.114-2.227)) and low eGFR level (OR 0.931 (CI 0.886-0.979)) before pregnancy. CONCLUSION: Our data showed pregnancy outcomes in SLE patients can be improved in the HCQ treatment group with about 90% reduction of preeclampsia.


Asunto(s)
Hidroxicloroquina/uso terapéutico , Lupus Eritematoso Sistémico/fisiopatología , Preeclampsia/prevención & control , Resultado del Embarazo , Adulto , Antirreumáticos/uso terapéutico , Femenino , Edad Gestacional , Humanos , Recién Nacido , Modelos Logísticos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/tratamiento farmacológico , Nefritis Lúpica/epidemiología , Masculino , Preeclampsia/epidemiología , Embarazo , Nacimiento Prematuro/epidemiología , República de Corea , Estudios Retrospectivos , Ácido Úrico/sangre
6.
Ann Oncol ; 30(7): 1104-1113, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-30977778

RESUMEN

BACKGROUND: Immune checkpoint blockade with Programmed cell death 1 (PD-1)/PD-L1 inhibitors has been effective in various malignancies and is considered as a standard treatment modality for patients with non-small-cell lung cancer (NSCLC). However, emerging evidence show that PD-1/PD-L1 blockade can lead to hyperprogressive disease (HPD), a flair-up of tumor growth linked to dismal prognosis. This study aimed to evaluate the incidence of HPD and identify the determinants associated with HPD in patients with NSCLC treated with PD-1/PD-L1 blockade. PATIENTS AND METHODS: We enrolled patients with recurrent and/or metastatic NSCLC treated with PD-1/PD-L1 inhibitors between April 2014 and November 2018. Clinicopathologic variables, dynamics of tumor growth, and treatment outcomes were analyzed in patients with NSCLC who received PD-1/PD-L1 blockade. HPD was defined according to tumor growth kinetics (TGK), tumor growth rate (TGR), and time to treatment failure (TTF). Immunophenotyping of peripheral blood CD8+ T lymphocytes was conducted to explore the potential predictive biomarkers of HPD. RESULTS: A total of 263 patients were analyzed. HPD was observed in 55 (20.9%), 54 (20.5%), and 98 (37.3%) patients according to the TGK, TGR, and TTF. HPD meeting both TGK and TGR criteria was associated with worse progression-free survival [hazard ratio (HR) 4.619; 95% confidence interval (CI) 2.868-7.440] and overall survival (HR, 5.079; 95% CI, 3.136-8.226) than progressive disease without HPD. There were no clinicopathologic variables specific for HPD. In the exploratory biomarker analysis with peripheral blood CD8+ T lymphocytes, a lower frequency of effector/memory subsets (CCR7-CD45RA- T cells among the total CD8+ T cells) and a higher frequency of severely exhausted populations (TIGIT+ T cells among PD-1+CD8+ T cells) were associated with HPD and inferior survival rate. CONCLUSION: HPD is common in NSCLC patients treated with PD-1/PD-L1 inhibitors. Biomarkers derived from rationally designed analysis may successfully predict HPD and worse outcomes, meriting further investigation of HPD.


Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Antígeno B7-H1/antagonistas & inhibidores , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Adulto , Anciano , Anciano de 80 o más Años , Linfocitos T CD8-positivos/inmunología , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/inmunología , Metástasis Linfática , Linfocitos Infiltrantes de Tumor/inmunología , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/inmunología , Recurrencia Local de Neoplasia/patología , Pronóstico , Tasa de Supervivencia , Carga Tumoral
7.
BJOG ; 126(7): 901-905, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30758126

RESUMEN

OBJECTIVES: To evaluate the association of a history of threatened preterm labour (TPL) followed by term delivery with the risk of spontaneous preterm delivery (PTD) in subsequent pregnancy. DESIGN: Population-based cohort study. SETTING: Data of the National Health Insurance Claims Database and a national health-screening programme for infants and children in South Korea. POPULATION: Women who had their first singleton delivery in 2010 and a subsequent second singleton delivery between 2011 and 2015. METHODS: Multivariable analysis adjusting for maternal age and interval between first and second deliveries was used to assess the risk of PTD based on PTD, TPL followed by term delivery, and term delivery in the first pregnancy. MAIN OUTCOME MEASURES: The risk of PTD during the second pregnancy. RESULTS: This study included 115 629 women with two consecutive deliveries during the study period. Spontaneous PTD rates in the second pregnancy were 7.71, 2.22 and 1.02% in women with PTD, TPL followed by term delivery, and term delivery in the first pregnancy, respectively. Threatened preterm labour followed by term delivery in the first pregnancy was associated with increased risk of PTD in the subsequent pregnancy after adjustment for potential confounding factors (adjusted odds ratio 2.21; 95% CI 1.76-2.78). CONCLUSION: Although women with a history of TPL followed by term delivery had a lower risk of PTD during a subsequent pregnancy compared with those with history of previous PTD, they still had a significantly increased risk of PTD compared with those who delivered at term without TPL. TWEETABLE ABSTRACT: The history of threatened preterm labour followed by term delivery is related to increased risk of subsequent spontaneous preterm delivery.


Asunto(s)
Amenaza de Aborto/epidemiología , Nacimiento Prematuro/epidemiología , Nacimiento a Término/fisiología , Adulto , Estudios de Cohortes , Femenino , Humanos , Edad Materna , Embarazo , Recurrencia , República de Corea/epidemiología , Factores de Riesgo
8.
Transplant Proc ; 50(10): 3673-3680, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30577254

RESUMEN

BACKGROUND: Multidetector computerized tomography (MDCT) is considered to be a fast noninvasive diagnostic technique for the evaluation of postoperative complications in patients with liver transplantation (LT). However, its role has not been fully established in the diagnosis for detecting complications after liver transplantation. The aim of this work was to evaluate the diagnostic performance of MDCT for detecting abdominal complications in the early and late periods after LT. METHODS: We retrospectively enrolled 75 patients who had undergone LT from March 2006 to January 2010, followed by MDCT from March 2006 to November 2017. Patients were divided into 2 groups according to the timing after LT: within the first 3 months (early period) or ≥3 months after LT (late period). We evaluated vascular, biliary, and other complications on MDCT. Angiography, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography were used as reference standards. RESULTS: We initially found 77 complications in 45 patients (60.0%) with the use of MDCT. After comparison with the reference standards, 83 complications were diagnosed in 49 patients (65.3%). Forty-seven complications (34 vascular, 10 biliary, 3 other complications) were diagnosed in 33 patients (44.0%) during the early period, and 36 complications (6 vascular, 20 biliary, 10 other complications) were detected in 27 patients (36.0%) in the late period. The sensitivity, specificity, and diagnostic accuracy of MDCT for diagnosing overall complications were, respectively, 93.6%, 90.2%, and 92.0% in the early period (for vascular complications: 97.1%, 92.6%, and 94.3%,; for biliary complications: 80.0%, 100%, and 97.7%) and 77.8%, 98.1%, and 89.8% in the late period (for vascular complications: 83.3%, 100%, and 98.9%; for biliary complications: 65.0%, 98.6%, and 90.9%). CONCLUSIONS: Although MDCT in the late period should be interpreted with caution in patients with suspected biliary complication, MDCT is a reliable diagnostic technique for the identification of early and late abdominal complications after LT.


Asunto(s)
Trasplante de Hígado/efectos adversos , Tomografía Computarizada Multidetector/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Sensibilidad y Especificidad
9.
Transplant Proc ; 50(4): 1172-1177, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29731088

RESUMEN

Apoptotic signal pathways are delivered to caspase-3, caspase-9, or both in different cells via the death receptor pathway, mitochondrial pathway, or by the endoplasmic reticulum (ER) pathway through initiators of caspase-3, -8, -9, or -12. Tacrolimus (Tac)-induced apoptosis was characterized by nuclear fragmentation and caspase-3 activation. We examined the effect of tacrolimus on ER-derived calcium and caspase-3,-12-mediated apoptosis on Jurkat human T lymphocyte. Tac decreased the viability of Jurkat cells in a dose-dependent manner. Tac also increased continuously intracellular concentration of calcium from 24 hours to 72 hours. We did not find intracellular calcium changes on the treatment of calcium ionorpore (A23187) regardless of 1 nmol/L Tac concentration level. However, calcium adenosine triphosphatase inhibitor (thapsigargin) increased intracellular calcium accumulation and co-treating 1 nmol/L Tac further induced intracellular calcium accumulation. Interestingly, we found that 1 nmol/L Tac treatment induced activation of caspase-12 protease as well as the catalytic activity of caspase-3 but not catalytic activation of caspase-6, -8, and -9 proteases in Jurkat cells. These data advance our understanding of Tac-induced apoptosis is ER-derived calcium and caspases-3,-12- mediated apoptosis in human Jurkat cell line.


Asunto(s)
Apoptosis/efectos de los fármacos , Caspasa 12/metabolismo , Caspasa 3/metabolismo , Inmunosupresores/farmacología , Transducción de Señal/efectos de los fármacos , Tacrolimus/farmacología , Animales , Calcio/metabolismo , Caspasa 12/efectos de los fármacos , Caspasa 3/efectos de los fármacos , Retículo Endoplásmico/efectos de los fármacos , Retículo Endoplásmico/metabolismo , Humanos , Células Jurkat
10.
Clin Exp Dermatol ; 43(6): 708-712, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29744907

RESUMEN

Sugar is a well-known cosmetic ingredient for moisturizing skin with minimal side-effects. Several reports have demonstrated an antimelanogenic effect of sugar in melanocytes. We evaluated the whitening efficacy of galacturonic acid (GA), the main component of pectin, as an anti-melanogenic agent. GA significantly suppressed melanin synthesis and secretion in a concentration-dependent manner in α-melanocyte stimulating hormone-treated B16 melanoma cells, and inhibited tyrosinase activity and expression at a dose of 10 mmol/L. In a three-dimensional human skin equivalent (MelanoDerm), GA clearly brightened tissue colour. Haematoxylin and eosin and Fontana-Masson (F&M) staining of tissue sections revealed decreased melanin production without skin tissue collapse in the presence of GA. Interestingly, GA dramatically suppressed gene expression of the melanogenic proteins tyrosinase, tyrosinase-related protein (TYRP)-1 and microphthalmia-associated transcription factor, but not TYRP-2. The results support the utility of GA as an effective candidate antimelanogenic agent.


Asunto(s)
Ácidos Hexurónicos/farmacología , Melaninas/biosíntesis , Melanoma Experimental/metabolismo , Trastornos de la Pigmentación/tratamiento farmacológico , Animales , Línea Celular Tumoral , Expresión Génica , Ácidos Hexurónicos/uso terapéutico , Humanos , Melaninas/metabolismo , Melanocitos/efectos de los fármacos , Melanocitos/metabolismo , Ratones , Piel/efectos de los fármacos , Piel/metabolismo
11.
Transplant Proc ; 49(8): 1815-1819, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28923631

RESUMEN

A characteristic pattern of hemodynamic changes that may occur after reperfusion during liver transplantation (LT) is known as postreperfusion syndrome (PRS). We investigated the effect of prophylactic ephedrine administration on PRS and postoperative laboratory results in living donor LT. The medical records of adult recipients who underwent living donor LT were reviewed. A total of 308 recipients were divided into the prophylaxis group and the nonprophylaxis group. Graft factors, preoperative and intraoperative recipient factors, and postoperative laboratory results were compared between the 2 groups. Graft factors and preoperative and intraoperative recipient factors did not differ between the 2 groups, except the prevalence of diabetes mellitus and etiology of liver disease. After reperfusion, PRS occurred more frequently (43.2% vs 25.0%; P = .006), and mean arterial pressure was more reduced compared with prereperfusion values (33.7 ± 15.8% vs 22.3 ± 23.5%; P < .001) in the nonprophylaxis group than the prophylaxis group. Postoperative laboratory results did not differ between the 2 groups. In conclusion, prereperfusion administration of ephedrine reduced the incidence and severity of PRS. Further prospective studies on the relationship between prophylactic medication and posttransplantation outcomes are needed.


Asunto(s)
Efedrina/uso terapéutico , Hepatopatías/cirugía , Trasplante de Hígado/efectos adversos , Premedicación , Daño por Reperfusión/prevención & control , Vasoconstrictores/uso terapéutico , Adulto , Femenino , Hemodinámica , Humanos , Incidencia , Hepatopatías/complicaciones , Hepatopatías/fisiopatología , Donadores Vivos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Daño por Reperfusión/epidemiología , Estudios Retrospectivos , Síndrome
12.
Orthop Traumatol Surg Res ; 103(4): 499-504, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28359839

RESUMEN

We have developed a flexible drill device that makes arthroscopic transosseous repair possible, and report preliminary results. Twelve patients with post-traumatic anterior inferior glenohumeral instability were selected. SURGICAL TECHNIQUE: the flexible drill device is inserted into the shoulder joint through the posterior portal and the guide pipe unit is placed 5mm posterior to the margin of the anterior glenoid rim. The flexible drill is driven through the glenoid with the power drill, creating a hole in the glenoid. A non-absorbable suture is passed through the hole and a sliding knot tying is performed over the capsule and labrum after completing stitches with the suture hook loaded. The same procedures are repeated in the 2, 3 and 4 o'clock positions of the glenoid. There was no recurrence of dislocation at the mean follow-up period of 52.3 months. The mean Rowe score was 89.5.


Asunto(s)
Artroscopía/instrumentación , Lesiones de Bankart/cirugía , Inestabilidad de la Articulación/cirugía , Articulación del Hombro/cirugía , Adolescente , Adulto , Artroscopía/métodos , Lesiones de Bankart/diagnóstico por imagen , Femenino , Humanos , Inestabilidad de la Articulación/diagnóstico por imagen , Masculino , Rango del Movimiento Articular , Recuperación de la Función , Articulación del Hombro/diagnóstico por imagen , Adulto Joven
13.
Clin Exp Allergy ; 47(7): 937-945, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28294434

RESUMEN

BACKGROUND: Mesenchymal stem cells (MSCs) have multiple immunomodulatory properties and hold therapeutic potential for inflammatory diseases. However, the therapeutic and immunologic effects of human umbilical cord blood-derived MSCs (huMSCs) remain largely unexamined for asthma. OBJECTIVE: This study was to investigate the immunomodulatory properties of huMSCs in an ovalbumin (OVA)-induced murine asthma model. METHODS: Mice were injected intraperitoneally with OVA and an aluminium hydroxide adjuvant. huMSCs were administered via the tail vein (5×105 cells/100 uL) to female BALB/c mice prior to the initial OVA challenge. The effects of huMSCs were assessed by investigating airway hyperresponsiveness, histological changes, inflammatory cell numbers, serum allergen-specific antibodies, cytokine production in spleen, lung tissue, and bronchoalveolar lavage (BAL) fluid as well as expansion of regulatory T cells. RESULTS: Administration of huMSCs significantly reduced methacholine bronchial hyperresponsiveness and eosinophil counts in BAL cells. Similarly, there was a significant decrease in serum OVA-specific IgE and IgG1 levels along with Th2 cytokine production (IL-4, IL-5, and IL-13) in the lung and spleen tissues, whereas increased percentage of regulatory T cells was observed after treatment with huMSCs. CONCLUSIONS: Our results suggest that huMSC treatment reduces OVA-induced allergic inflammation, which could be mediated by regulatory T cells.


Asunto(s)
Asma/inmunología , Asma/metabolismo , Sangre Fetal/citología , Inmunomodulación , Células Madre Mesenquimatosas/metabolismo , Ovalbúmina/inmunología , Alérgenos/inmunología , Animales , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Humanos , Inmunización , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Mediadores de Inflamación/metabolismo , Ganglios Linfáticos/inmunología , Cloruro de Metacolina/metabolismo , Ratones , Bazo/inmunología , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/metabolismo
14.
BJOG ; 124(5): 775-783, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27365145

RESUMEN

OBJECTIVE: To re-evaluate the utility of the conventional criteria for clinical chorioamnionitis in the prediction of early-onset neonatal sepsis (EONS) in preterm birth. DESIGN: Retrospective cohort study. SETTING: Seoul, Republic of Korea. SAMPLE: A total of 1468 singleton births between 24 and 34 weeks due to preterm labour (n = 713) or preterm prelabour rupture of membranes (n = 755). METHOD: We evaluated three diagnostic categories of clinical chorioamnionitis: Criteria 1, conventional criteria; Criteria 2, combination of any three conventional parameters without prerequisite fever; Criteria 3, Criteria 1 plus positive maternal C-reactive protein and neutrophil left-shift into minor criteria. EONS included proven or suspected sepsis within 7 days following birth. Neonatal morbidity and mortality of EONS were also reviewed. MAIN OUTCOME MEASURES: Diagnostic performance of three combinations. RESULTS: The prevalence of EONS was 13.8%. Among 203 cases of EONS, maternal manifestation of clinical chorioamnionitis by criteria 1 was evident in only one out of seven, indicating 15.3% sensitivity for EONS prediction. However, with application of criteria 2, sensitivity significantly increased to 34.0%, while compromising specificity from 92.3% to 78.7%. Criteria 3 showed similar diagnostic performance compared with criteria 1 (sensitivity 16.7%, specificity 91.6%). Overall, neonatal mortality and neonatal composite morbidity in EONS were 14.9% and 67.8%, respectively, and there was no difference in neonatal morbidity and mortality between neonates whose mothers showed fever as a sign of clinical chorioamnionitis and those whose mothers did not. CONCLUSION: The renouncement of fever as a prerequisite for the criteria of clinical chorioamnionitis could increase sensitivity for the identification of EONS, a serious outcome of preterm birth. TWEETABLE ABSTRACT: The renouncement of fever as an essential can increase sensitivity for prediction of neonatal sepsis.


Asunto(s)
Corioamnionitis/diagnóstico , Sepsis Neonatal/diagnóstico , Adolescente , Adulto , Estudios de Cohortes , Femenino , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Masculino , Persona de Mediana Edad , Trabajo de Parto Prematuro , Embarazo , Nacimiento Prematuro , Prevalencia , República de Corea , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
15.
Z Rheumatol ; 76(1): 64-70, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27052299

RESUMEN

OBJECTIVE: The aim of this study was to determine whether polymorphisms in solute carrier family 2 and facilitated glucose transporter member 9 (SLC2A9) are associated with susceptibility to gout. METHODS: A meta-analysis was conducted on associations between the rs12510549, rs16890979, and rs1014290 polymorphisms of SLC2A9 and gout susceptibility using fixed and random effects models. RESULTS: Eleven comparative studies comprising 1,472 patients and 3,269 controls from Caucasian and Asian populations were included in this meta-analysis. The meta-analysis identified a significant negative association between gout and allele 2 (minor) of the rs12510549 polymorphism in the overall population (OR = 0.641, 95 % CI = 0.540-0.761, P = 4.1 × 10-7). Stratification by ethnicity identified a significant negative association between this polymorphism and gout in Caucasians (OR = 0.647, 95 % CI = 0.542-0.771, P = 1.2 × 10-6) but not in Asians (OR = 0.515, 95 % CI = 0.214-1.236, P = 0.137). The meta-analysis showed a significant negative association between gout and allele 2 of the rs16890979 polymorphism in all study subjects (OR = 0.229, 95 % CI = 0.084-0.628, P = 0.004). Stratification by ethnicity identified a significant negative association between this polymorphism and gout in Caucasians (OR = 0.469, 95 % CI = 0.317-0.695, P = 1.6 × 10-6) and in Asians (OR = 0.192, 95 % CI = 0.072-0.513, P = 0.001). A significant negative association was found between allele 2 of the rs1014290 polymorphism and gout susceptibility in Asians (OR = 0.597, 95 % CI = 0.478-0.746, P = 5.4 × 10-6) but not in Caucasians (OR = 0.778, 95 % CI = 0.595-1.043, P = 0.095). CONCLUSIONS: This meta-analysis shows that the rs12510549, rs16890979, and rs1014290 polymorphisms of SLC2A9 protect against the development of gout in Caucasians and/or Asians.


Asunto(s)
Predisposición Genética a la Enfermedad/etnología , Predisposición Genética a la Enfermedad/genética , Proteínas Facilitadoras del Transporte de la Glucosa/genética , Gota/etnología , Gota/genética , Polimorfismo de Nucleótido Simple/genética , Pueblo Asiatico/estadística & datos numéricos , Femenino , Estudios de Asociación Genética , Marcadores Genéticos/genética , Gota/diagnóstico , Humanos , Masculino , Prevalencia , Reproducibilidad de los Resultados , República de Corea/epidemiología , Medición de Riesgo , Sensibilidad y Especificidad , Población Blanca/estadística & datos numéricos
16.
Lupus ; 26(3): 282-288, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27510600

RESUMEN

Objective We aimed to evaluate the relationship between telomere length and systemic lupus erythematosus (SLE). Methods PUBMED and EMBASE databases were searched; meta-analyses were performed comparing telomere length in SLE patients and healthy controls, and on SLE patients in subgroups based on ethnicity, sample type, assay method and data type. Results Eight studies including 472 SLE patients and 365 controls were ultimately selected which showed that telomere length was significantly shorter in the SLE group than in the control group (standardized mean difference (SMD) = -0.835, 95% confidence interval (CI) = -1.291 to -0.380, p = 3.3 × 10-4). Stratification by ethnicity showed significantly shortened telomere length in the SLE group in Caucasian, Asian and mixed populations (SMD = -0.455, 95% CI = -0.763 to -0.147, p = 0.004; SMD = -0.887, 95% CI = -1.261 to -0.513, p = 3.4 × 10-4; SMD = -0.535, 95% CI = -0.923 to -0.147, p = 0.007; respectively). Furthermore, telomere length was significantly shorter in the SLE group than in the control group in whole blood and peripheral blood mononuclear cell groups (SMD = -0.361, 95% CI = -0.553 to -0.169, p = 2.3 × 10-4; SMD = -1.546, 95% CI = -2.583 to -0.510, p = 0.003; respectively); a similar trend was observed in leukocyte groups (SMD = -0.699, 95% CI = -1.511 to -0.114, p = 0.092). Meta-analyses based on assay method or data type revealed similar associations. Conclusions Our meta-analysis demonstrated that telomere length was significantly shorter in patients with SLE, regardless of ethnicity, sample type or assay method evaluated.


Asunto(s)
Lupus Eritematoso Sistémico/genética , Acortamiento del Telómero/genética , Telómero/genética , Predisposición Genética a la Enfermedad , Humanos
17.
Malays J Pathol ; 38(3): 295-304, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28028300

RESUMEN

BACKGROUND: Immunocytochemistry (ICC) on formalin-fixed paraffin embedded cell blocks is an ancillary tool commonly recruited for differential diagnoses of fine needle aspiration cytology (FNAC) samples. However, the quality of conventional cell blocks in terms of adequate cellularity and evenness of distribution of cytologic material is not always satisfactory for ICC. We introduce a modified agarose-based cytoscrape cell block (CCB) technique that can be effectively used for the preparation of cell blocks from scrapings of conventional FNAC slides. METHODS: A decoverslipped FNAC slide was mounted with a small amount of water. The cytological material was scraped off the slide into a tissue mold by scraping with a cell scraper. The cytoscrape material was pelleted by centrifugation and pre-embedded in ultra-low gelling temperature agarose and then re-embedded in conventional agarose. The final agarose gel disk was processed and embedded in paraffin. RESULTS: The quality of the ICC on the CCB sections was identical to that of the immunohistochemical stains on histological sections. By scrapping and harvesting the entirety of the cytological material off the cytology slide into a compact agarose cell button, we could avoid the risk of losing diagnostic material during the CCB preparation. CONCLUSION: This modified CCB technique enables concentration and focusing of minute material while maintaining the entire amount of the cytoscrape material on the viewing spot of the CCB sections. We believe this technique can be effectively used to improve the level of confidence in diagnosis of FNAC especially when the FNAC slides are the only sample available.


Asunto(s)
Citodiagnóstico/métodos , Técnicas de Preparación Histocitológica , Adulto , Anciano , Biopsia con Aguja Fina , Citodiagnóstico/instrumentación , Femenino , Técnicas de Preparación Histocitológica/instrumentación , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad
18.
Scand J Immunol ; 84(5): 272-277, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27500787

RESUMEN

The aim of this study was to perform a meta-analysis of eligible studies and to derive a precise estimate of the association between interleukin 10 (IL10) polymorphisms and susceptibility to autoimmune thyroid disease (AITD). Meta-analyses were conducted on the associations between AITD and the -1082 G/A (rs1800896), -819 C/T (rs1800871) and -592 C/A (rs1800872) polymorphisms in IL10, and the haplotype of these polymorphisms and AITD. A total of 2903 AITD patients and 3060 controls in 10 eligible studies were included in the meta-analysis. This meta-analysis showed significant associations between IL10 at the -1082 G allele and overall AITD (OR: 1.44, 95% CI 1.13-1.82, P = 0.003), but no association between the IL10 -592 C allele and the -819 C allele and AITD. Subgroup studies demonstrated significant associations between the -1082 G allele and susceptibility to Graves' disease. Ethnicity-specific meta-analysis revealed significant associations between the -1082 G allele and AITD susceptibility in Asian populations; however, in Middle Eastern populations, no association was evident. Meta-analysis of the IL10 haplotype revealed an association between the ATA haplotype and AITD (OR: 1.17, 95% CI 1.00-1.36, P = 0.04). Meta-analysis demonstrates that the IL10 polymorphisms are associated with susceptibility to AITD.


Asunto(s)
Encefalitis/genética , Enfermedad de Graves/genética , Enfermedad de Hashimoto/genética , Interleucina-10/genética , Polimorfismo de Nucleótido Simple , Tiroiditis Autoinmune/genética , Alelos , Pueblo Asiatico , Encefalitis/diagnóstico , Encefalitis/etnología , Encefalitis/inmunología , Expresión Génica , Predisposición Genética a la Enfermedad , Enfermedad de Graves/diagnóstico , Enfermedad de Graves/etnología , Enfermedad de Graves/inmunología , Haplotipos , Enfermedad de Hashimoto/diagnóstico , Enfermedad de Hashimoto/etnología , Enfermedad de Hashimoto/inmunología , Humanos , Interleucina-10/inmunología , Tiroiditis Autoinmune/diagnóstico , Tiroiditis Autoinmune/etnología , Tiroiditis Autoinmune/inmunología , Población Blanca
19.
Nanotechnology ; 27(29): 295704, 2016 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-27285674

RESUMEN

The interface trap density in single-walled carbon nanotube (SWNT) network thin-film transistors (TFTs) is a fundamental and important parameter for assessing the electronic performance of TFTs. However, the number of studies on the extraction of interface trap densities, particularly in SWNT TFTs, has been insufficient. In this work, we propose an efficient technique for extracting the energy-dependent interface traps in SWNT TFTs. From the measured dispersive, frequency-dependent capacitance-voltage (C-V) characteristics, the dispersive-free, frequency-independent C-V curve was obtained, thus enabling the extraction and analysis of the interface trap density, which was found to be approximately 8.2 × 10(11) eV(-1) cm(-2) at the valence band edge. The frequency-independent C-V curve also allows further extraction of the quantum capacitance in the SWNT network without introducing any additional fitting process or parameters. We found that the extracted value of the quantum capacitance in SWNT networks is lower than the theoretical value in aligned SWNTs due to the cross point of SWNTs on the SWNT network. Therefore, the method proposed in this work indicates that the C-V measurement is a powerful tool for obtaining deep physical insights regarding the electrical performance of SWNT TFTs.

20.
Transplant Proc ; 48(4): 1292-6, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320607

RESUMEN

BACKGROUND: FK506-induced apoptotic endoplasmic reticulum (ER)-mediated stress protein expression was investigated in Jurkat human T-lymphocytes. METHODS: The effect of FK506 on apoptosis and cell viability were examined. FK506-induced apoptosis was confirmed by nuclear fragmentation after DAPI staining. Expression of apoptotic ER-mediated stress proteins was examined by means of Western blotting of Grp78/BiP, Grp94, double-stranded RNA-dependent protein kinase (PKR)-like ER kinase (PERK), phosphor-PERK, CHOP/GADD153, and Bak. A flow cytometry analysis was performed after DAF-DA or DCF-DA staining. FK506-induced apoptosis was dose-dependent (10 nmol/L) and time-dependent (72 hours). RESULTS: Grp78/BiP and Grp94 expressions were increased 36 hours after FK506 treatment. Increased phospho-PERK expression was observed 6 hours after FK506 treatment and peak activation of phospho-PERK was observed at 36 hours. CHOP/GADD153 expression was increased 48 hours after FK506 treatment. Expression of iNOS after FK506 treatment began to increase at 12 hours, peaked at 24 hours, and decreased after 36 hours. CONCLUSIONS: From these results, we confirmed that FK506 induces apoptosis and acts dose- and time-dependently to decrease the viability of Jurkat cells through activation of apoptosis signaling and expression of apoptotic ER-mediated stress proteins.


Asunto(s)
Estrés del Retículo Endoplásmico/efectos de los fármacos , Inmunosupresores/farmacología , Tacrolimus/farmacología , Apoptosis/efectos de los fármacos , Proteínas Portadoras/metabolismo , Supervivencia Celular/efectos de los fármacos , Retículo Endoplásmico/metabolismo , Chaperón BiP del Retículo Endoplásmico , Proteínas HSP70 de Choque Térmico/metabolismo , Proteínas de Choque Térmico/metabolismo , Humanos , Células Jurkat/fisiología , Proteínas de la Membrana/metabolismo , Transducción de Señal/efectos de los fármacos , Factor de Transcripción CHOP/metabolismo , eIF-2 Quinasa/metabolismo
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