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1.
Wiad Lek ; 74(3 cz 1): 441-449, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813447

RESUMEN

OBJECTIVE: The aim is to determine the clinical and morphological dependencies, which are important for diagnostics, treatment and prediction of outcomes of pathological processes in the region of the LTM with complicated eruption, as based on the study of histopathological changes of paradental tissue (mucous membrane, walls of retromolar pocket, alveolar bone tissue). PATIENTS AND METHODS: Materials and methods: The materials of the study were 34 biopsy specimens of pathologically altered soft tissue and parodontium obtained as a result of pericoronectomy, extraction of the LTM and other surgical interferences performed based on the relevant indications in 28 patients in the region of the LTM with complicated eruption. Morphological and statistical research methods were used. RESULTS: Results: The local pathological processes, which chronologically precede the destructive changes in the hard tissue of a tooth (caries), are developed in patients of both genders with complicated LTM eruption in soft tissue of parodontium and the adjacent bone tissue of the alveolar wall in the majority of cases. As per biopsy examinations, the frequency of the main pathological processes in paradental tissue in case of complicated LTM eruption varies from 25 to 60 % of the number of biopsy specimens and occurs in various combinations in patients with different values of clinical parameters. The correlation relationships between the patients' clinical data and the morphological parameters of damage to paradental tissue are weak, multidirectional and uncertain in the majority of combinations (considering the available number of biopsy specimens studied). The close certain positive dependence between the damage of the squamous epithelium and the inflammation activity in the lamina propria mucosae, covering the tooth: in the vast majority of cases, the presence of damaged epithelium (within the biopsy specimen) is associated with the inflammation of high activity, was established as based on correlation relationships between the morphological parameters of damage to paradental tissue. CONCLUSION: Conclusions: The found pathological changes and the correlations justify surgical tactics on paradental soft and osseous tissues that are directed on the LTM sparing.


Asunto(s)
Tercer Molar , Erupción Dental , Femenino , Humanos , Masculino , Diente Molar , Tercer Molar/cirugía , Membrana Mucosa , Periodoncio
2.
Artículo en Inglés | MEDLINE | ID: mdl-33819335

RESUMEN

This study aimed to evaluate facial peri-implant tissue dimensions for implants connected to either convex or concave final abutments. Patients (n = 28) were randomly allocated to receive a single implant with an abutment of either convex (Group CX) or concave (Group CV) emergence shape. Twelve months after implant placement, CBCT scans were taken and reference points were identified: first visible bone-to-implant contact, implant shoulder (IS), bone crest (BC), and marginal mucosal level (MML). Mucosal thickness was evaluated at the level of IS (MT1), above the level of BC (MT2), and at the mid-distance of BC-MML (MT3). The mean total vertical peri-implant mucosa height was 3.26 ± 0.77 mm for Group CX and 3.70 ± 0.99 mm for Group CV (P = .23). The mean vertical peri-implant mucosa height below the bone crest was 0.62 ± 0.57 mm for Group CX and 1.26 ± 0.95 mm for Group CV (P = .04). Group CV had greater mean MT2 (4.09 ± 0.72 mm vs 3.36 ± 0.81 mm; P = .02) and MT3 (2.81 ± 0.66 mm vs 2.03 ± 0.60 mm; P = .005) compared to Group CX. Abutment macrodesign may have an effect on vertical and horizontal peri-implant tissue dimensions.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Coronas , Pilares Dentales , Implantación Dental Endoósea , Humanos , Membrana Mucosa
3.
Nat Commun ; 12(1): 2147, 2021 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-33846309

RESUMEN

Tissue mononuclear phagocytes (MNP) are specialised in pathogen detection and antigen presentation. As such they deliver HIV to its primary target cells; CD4 T cells. Most MNP HIV transmission studies have focused on epithelial MNPs. However, as mucosal trauma and inflammation are now known to be strongly associated with HIV transmission, here we examine the role of sub-epithelial MNPs which are present in a diverse array of subsets. We show that HIV can penetrate the epithelial surface to interact with sub-epithelial resident MNPs in anogenital explants and define the full array of subsets that are present in the human anogenital and colorectal tissues that HIV may encounter during sexual transmission. In doing so we identify two subsets that preferentially take up HIV, become infected and transmit the virus to CD4 T cells; CD14+CD1c+ monocyte-derived dendritic cells and langerin-expressing conventional dendritic cells 2 (cDC2).


Asunto(s)
Canal Anal/citología , Antígenos CD/metabolismo , Células Dendríticas/metabolismo , Genitales/citología , VIH-1/fisiología , Lectinas Tipo C/metabolismo , Lectinas de Unión a Manosa/metabolismo , Monocitos/metabolismo , Linfocitos T CD4-Positivos/inmunología , Forma de la Célula , Colagenasas/metabolismo , Dermis/metabolismo , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Humanos , Receptores de Lipopolisacáridos/metabolismo , Membrana Mucosa/metabolismo , Fagocitos/metabolismo , Fenotipo , Receptores CCR5/metabolismo , Lectina 1 Similar a Ig de Unión al Ácido Siálico/metabolismo , Transcripción Genética
4.
AAPS PharmSciTech ; 22(3): 87, 2021 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-33665761

RESUMEN

The commitment of the existent study was to develop a mucoadhesive in situ gel systems of vitamin B12 for the management of dry eye disease. The gels were prepared using pluronic F-127 and either of chitosan, carbapol 971P, sodium alginate, or hydroxy propyl methyl cellulose. Drug-excipients compatibility was investigated by means of differential scanning calorimetry and Fourier transform infrared spectroscopy. The gels were characterized for pH, clarity, gelling capacity, viscosity, and adhesion. In vitro release of vitamin B12 from the selected gels was investigated. In vivo effectiveness of the selected gel was determined in rabbit models using Schirmer's and fluorescein tests. The compatibility studies revealed the possibility of incidence of drug/polymer interaction in some formulations. F2-containing pluronic F127 and hydroxypropyl methyl cellulose showed the most appropriate physical characterization and in vitro release profile. The prepared gels showed prolonged drug release with drug release mechanism of combined diffusion and erosion. The in vivo study revealed good effectiveness of the prepared mucoadhesive in situ gel system of vitamin B12 in the treatment of dry eye disease that was comparable to that of the marketed drops.


Asunto(s)
Síndromes de Ojo Seco/tratamiento farmacológico , Vitamina B 12/uso terapéutico , Vitaminas/uso terapéutico , Adhesivos , Animales , Composición de Medicamentos , Sistemas de Liberación de Medicamentos , Liberación de Fármacos , Excipientes , Femenino , Geles , Derivados de la Hipromelosa , Masculino , Membrana Mucosa , Poloxámero , Conejos , Viscosidad , Vitamina B 12/administración & dosificación , Vitaminas/administración & dosificación
5.
Nat Commun ; 12(1): 259, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431815

RESUMEN

Although identified as the key environmental driver of common cutaneous melanoma, the role of ultraviolet radiation (UVR)-induced DNA damage in mucosal melanoma is poorly defined. We analyze 10 mucosal melanomas of conjunctival origin by whole genome sequencing and our data shows a predominance of UVR-associated single base substitution signature 7 (SBS7) in the majority of the samples. Our data shows mucosal melanomas with SBS7 dominance have similar genomic patterns to cutaneous melanomas and therefore this subset should not be excluded from treatments currently used for common cutaneous melanoma.


Asunto(s)
Melanoma/genética , Membrana Mucosa/patología , Mutación/genética , Neoplasias Cutáneas/genética , Rayos Ultravioleta , Adulto , Anciano , Anciano de 80 o más Años , Conjuntiva/patología , Daño del ADN , Femenino , Genoma Humano , Humanos , Masculino , Persona de Mediana Edad
6.
J Laryngol Otol ; 135(1): 39-44, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33487180

RESUMEN

OBJECTIVE: To compare endoscopic epitympanic exploration with conventional canal wall up (cortical) mastoidectomy for mucosal chronic otitis media in terms of post-operative outcomes. METHODS: Seventy-six patients diagnosed with chronic otitis media (mucosal variety) were randomly assigned to two treatment groups: endoscopic epitympanic exploration and conventional canal wall up (cortical) mastoidectomy. The groups were compared in terms of: post-operative anatomical outcomes (graft uptake), middle-ear physiological outcomes (post-operative tympanometry), audiological outcomes (air-bone gap), surgical time, post-operative pain, vertigo, and long-term complications such as retraction pocket and re-perforation. RESULTS: There was a statistically significant difference between the groups in terms of mean air-bone gap at 12 months, surgical time, and median post-operative pain measured at 6 hours (p < 0.05). No statistically significant differences were noted in terms of: graft uptake at 1, 3 and 6 months, mean air-bone gap at 3 and 6 months, tympanometry at 3, 6 and 12 months, vertigo at 1 week, or long-term complications. CONCLUSION: Endoscopic epitympanic exploration resulted in significantly better long-term audiological outcomes, shorter operating time and less pain compared with conventional canal wall up (cortical) mastoidectomy.


Asunto(s)
Endoscopía , Mastoidectomía , Otitis Media/patología , Otitis Media/cirugía , Adulto , Enfermedad Crónica , Endoscopía/métodos , Femenino , Humanos , Masculino , Membrana Mucosa/patología , Membrana Timpánica
7.
Methods Mol Biol ; 2183: 447-459, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32959259

RESUMEN

Lactic acid bacteria comprise a large group of Gram-positive organisms capable of converting sugar into lactic acid. They have been studied due to their therapeutic potential on the mucosal surface. Among the species, Lactococcus lactis is considered the model bacterium and it has been explored as an important vehicle for providing therapeutic molecules and antigens in the mucosa. They can be genetically engineered to produce a variety of molecules as well as deliver heterologous DNA and protein. DNA vaccines consist of the administration of a bacterial plasmid under the control of a eukaryotic promoter encoding the antigen of interest. The resulting proteins are capable of stimulating the immune system, becoming a promising technique for immunization against a variety of tumors and infection diseases and having several advantages compared to conventional nucleic acid delivery methods (such as bioballistic delivery, electroporation, and intramuscular administration).


Asunto(s)
Sistemas de Liberación de Medicamentos , Técnicas de Transferencia de Gen , Lactobacillales , Vacunación/métodos , Vacunas de ADN/administración & dosificación , Administración Intranasal , Administración Sublingual , Animales , Ratones , Membrana Mucosa/inmunología , Vacunas de ADN/genética , Vacunas de ADN/inmunología
8.
Otol Neurotol ; 42(1): e94-e100, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33201080

RESUMEN

IMPORTANCE: Surgery remains the gold standard in cholesteatoma treatment. However, the rate of recurrence is significant and the development of new nonsurgical treatment alternatives is warranted. One of the possible molecular pathways to target is the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. OBJECTIVE: To investigate the JAK/STAT pathway in the middle ear mucosa in patients with acquired cholesteatoma compared with middle ear mucosa from healthy controls. DESIGN: Case-control study. SETTING: Linköping University Hospital, Sweden, and Karolinska Institutet, Stockholm, Sweden. Sampling period: February 2011 to December 2016. PARTICIPANTS: Middle ear mucosa from 26 patients with acquired cholesteatoma undergoing tympanoplasty and mastoidectomy, and 27 healthy controls undergoing translabyrinthine surgery for vestibular schwannoma or cochlear implantation was investigated. MAIN OUTCOMES/MEASURES: The expression of Interleukin-7 receptor alpha, JAK1, JAK2, JAK3, STAT5A, STAT5B, and suppressor of cytokine signaling-1 (SOCS1) were quantified using quantitative polymerase chain reaction. In addition, expression level of cyclin D2, transforming growth factor beta 1, thymic stromal lymphopoietin, CD3, and CD19 was evaluated. RESULTS: In cholesteatoma-adjacent mucosa, SOCS1 was significantly upregulated (p= 0.0003) compared with healthy controls, whereas STAT5B was significantly downregulated (p = 0.0006). The expression of JAK1, JAK2, JAK3, and STAT5A did not differ significantly between groups. CONCLUSIONS AND RELEVANCE: To the best of our knowledge, this is the first article reporting dysregulation of the JAK/STAT pathway in cholesteatoma-adjacent mucosa. The main finding is that important players of the aforementioned pathway are significantly altered, namely SOCS1 is upregulated and STAT5B is downregulated compared with healthy controls.


Asunto(s)
Colesteatoma , Quinasas Janus , Estudios de Casos y Controles , Humanos , Quinasas Janus/metabolismo , Membrana Mucosa/metabolismo , Recurrencia Local de Neoplasia , Proteína 1 Supresora de la Señalización de Citocinas/genética , Suecia , Transductores
9.
J Am Acad Dermatol ; 84(4): 946-952, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33359476

RESUMEN

BACKGROUND: Limited information exists on mucocutaneous disease and its relation to course of COVID-19. OBJECTIVE: To estimate prevalence of mucocutaneous findings, characterize morphologic patterns, and describe relationship to course in hospitalized adults with COVID-19. METHODS: Prospective cohort study at 2 tertiary hospitals (Northwell Health) between May 11, 2020 and June 15, 2020. RESULTS: Among 296 hospitalized adults with COVID-19, 35 (11.8%) had at least 1 disease-related eruption. Patterns included ulcer (13/35, 37.1%), purpura (9/35, 25.7%), necrosis (5/35, 14.3%), nonspecific erythema (4/35, 11.4%), morbilliform eruption (4/35, 11.4%), pernio-like lesions (4/35, 11.4%), and vesicles (1/35, 2.9%). Patterns also showed anatomic site specificity. A greater proportion of patients with mucocutaneous findings used mechanical ventilation (61% vs 30%), used vasopressors (77% vs 33%), initiated dialysis (31% vs 9%), had thrombosis (17% vs 11%), and had in-hospital mortality (34% vs 12%) compared with those without mucocutaneous findings. Patients with mucocutaneous disease were more likely to use mechanical ventilation (adjusted prevalence ratio, 1.98; 95% confidence interval, 1.37-2.86); P < .001). Differences for other outcomes were attenuated after covariate adjustment and did not reach statistical significance. LIMITATIONS: Skin biopsies were not performed. CONCLUSIONS: Distinct mucocutaneous patterns were identified in hospitalized adults with COVID-19. Mucocutaneous disease may be linked to more severe clinical course.


Asunto(s)
/complicaciones , Enfermedades de la Piel/virología , Piel/patología , Lesión Renal Aguda/terapia , Lesión Renal Aguda/virología , Anciano , Vesícula/virología , Eritema Pernio/virología , Eritema/virología , Exantema/virología , Femenino , Mortalidad Hospitalaria , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Membrana Mucosa , Necrosis/virología , Estudios Prospectivos , Púrpura/virología , Diálisis Renal , Respiración Artificial , Úlcera Cutánea/virología , Trombosis/virología , Vasoconstrictores/uso terapéutico
10.
Int J Urol ; 28(3): 346-352, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33314337

RESUMEN

OBJECTIVE: To evaluate voiding behavior characteristics in intact and sham mice, and to examine whether intact mice show changes in "normal" micturition with aging. METHODS: A total of 72 8-week-old mice were divided into two groups - intact and sham - and the latter group was subjected to a sham of partial bladder outlet obstruction surgery. Urination frequency was evaluated (through metabolic cages) at 1, 2, 3, 6 and 12 months after the surgery (or at the equivalent time points for the intact mice). To address possible mechanisms for aging and surgical effects on urinary behavior, quantitative real-time polymerase chain reaction assays were carried out. Primary data were evaluated using scatter plots and descriptive statistics. RESULTS: In sham mice, urination frequency showed strong variation at the earlier post-surgical time points (especially at 1 month), with variation decreasing with time. Quantitative real-time polymerase chain reaction showed that the serotonin 2C receptor-encoding mRNA accumulated to >28-fold higher levels at 24 months compared with 3 months in intact mice. A major limitation of the quantitative real-time polymerase chain reaction experiments was that we did not separate whole bladder into muscle and mucosa. CONCLUSIONS: Although a sham operation is typically used in partial bladder outlet obstruction experiments to provide control animals, the sham group might itself show increased variation in micturition frequency at early times after surgery, compared with intact animals.


Asunto(s)
Obstrucción del Cuello de la Vejiga Urinaria , Animales , Ratones , Membrana Mucosa , ARN Mensajero , Micción
11.
Scand J Immunol ; 93(2): e13017, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33351196

RESUMEN

The neonatal Fc receptor (FcRn) was first recognized for its role in transfer of maternal IgG to the foetus or newborn, providing passive immunity early in life. However, it has become clear that the receptor is versatile, widely expressed and plays an indispensable role in both immunological and non-immunological processes throughout life. The receptor rescues immunoglobulin G (IgG) and albumin from intracellular degradation and shuttles the ligands across polarized cell barriers, in all cases via a pH-dependent binding-and-release mechanism. These processes secure distribution and high levels of both IgG and albumin throughout the body. At mucosal sites, FcRn transports IgG across polarized epithelial cells where it retrieves IgG in complex with luminal antigens that is delivered to tissue-localized immune cells. In dendritic cells (DCs), FcRn orchestrates processing of IgG-opsonized immune complexes (ICs) in concert with classical Fcγ receptors, which results in antigen presentation and cross-presentation of antigenic peptides on MHC class II and I to CD4+ and CD8+ T cells, respectively. Hence, FcRn regulates transport of the ligands within and across different types of cells, but also processing of IgG-ICs by immune cells. As such, the receptor is involved in immune surveillance and protection against infections. In this brief review, we highlight how FcRn expressed by hematopoietic and non-hematopoietic cells contributes to immune regulation at mucosal barriers-biology that can be utilized in development of biologics and subunit vaccines for non-invasive delivery.


Asunto(s)
Antígenos de Histocompatibilidad Clase I/inmunología , Membrana Mucosa/inmunología , Receptores Fc/inmunología , Animales , Presentación de Antígeno/inmunología , Complejo Antígeno-Anticuerpo/inmunología , Antígenos/inmunología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Humanos , Inmunoglobulina G/inmunología , Factores Inmunológicos/inmunología
12.
Zhongguo Zhong Yao Za Zhi ; 45(20): 4991-4996, 2020 Oct.
Artículo en Chino | MEDLINE | ID: mdl-33350274

RESUMEN

To investigate the effect of butyl alcohol extract of Baitouweng Decoction(BAEB) on the epithelial barrier of vaginal mucosa in mice with vulvovaginal candidiasis(VVC). Seventy-two female SPF Kunming mice were randomly divided into blank group, VVC model group, fluconazole group, and BAEB treatment groups(high, middle and low dose groups). Estradiol benzoate was injected subcutaneously qd alt, and Candida albicans(2×10~6 CFU·mL~(-1)) was inoculated into the vagina of mice during the pseudo estrus period for 7 days to construct a VVC model, followed by drug treatment for 7 days. Gram staining was used to observe the morphology of C. albicans in the vaginal secretions of mice; the amount of fungal load on the vaginal mucosa of mice was detected on agar plate; the pathological status of murine vaginal mucosa was observed by hematoxylin-eosin staining(HE); the integrity of mice vaginal mucosal epithelial barrier was observed by Masson's trichrome staining(MT), HE and periodic acid-schiff staining(PAS). Mucin-1 and mucin-4 protein expression levels of vaginal mucosal epithelial cells in mice were detected by immunohistochemistry; mucin-1 and mucin-4 protein expression levels on mucosal epithelial cells at 0 d, 3 d, and 7 d were determined by Western blot. The results showed that, in VVC model group, there were a large number of C. albicans hyphae and higher fungal load in vagina, within complete mucosal structure, cornified layer shed off, and the protein expression levels of mucin-1 and mucin-4 were significantly increased. After BAEB treatment, the hyphae in the vagina decreased; the fungal load decreased; the vaginal mucosal tissue damages were improved; the epithelial barrier was repaired, and mucin-1 and mucin-4 protein expression levels were down-regulated. The above results indicated that BAEB may play a role in the treatment of VVC by remodeling the integrity of the vaginal mucosal epithelial barrier.


Asunto(s)
Candidiasis Vulvovaginal , 1-Butanol , Animales , Antifúngicos , Candida albicans , Candidiasis Vulvovaginal/tratamiento farmacológico , Femenino , Humanos , Ratones , Membrana Mucosa , Vagina
13.
PLoS Pathog ; 16(12): e1009097, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33362285

RESUMEN

Alterations to the mucosal environment of the female genital tract, such as genital inflammation, have been associated with increased HIV acquisition in women. As the microbiome and hormonal contraceptives can affect vaginal mucosal immunity, we hypothesized these components may interact in the context of HIV susceptibility. Using previously published microbiome data from 685 women in the CAPRISA-004 trial, we compared relative risk of HIV acquisition in this cohort who were using injectable depot medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN), and combined oral contraceptives (COC). In women who were Lactobacillus-dominant, HIV acquisition was 3-fold higher in women using DMPA relative to women using NET-EN or COC (OR: 3.27; 95% CI: 1.24-11.24, P = 0.0305). This was not observed in non-Lactobacillus-dominant women (OR: 0.95, 95% CI: 0.44-2.15, P = 0.895) (interaction P = 0.0686). Higher serum MPA levels associated with increased molecular pathways of inflammation in the vaginal mucosal fluid of Lactobacillus-dominant women, but no differences were seen in non-Lactobacillus dominant women. This study provides data suggesting an interaction between the microbiome, hormonal contraceptives, and HIV susceptibility.


Asunto(s)
Anticonceptivos Femeninos/efectos adversos , Agentes Anticonceptivos Hormonales/efectos adversos , Infecciones por VIH/transmisión , Microbiota/efectos de los fármacos , Vagina/microbiología , Adulto , Femenino , Humanos , Persona de Mediana Edad , Membrana Mucosa/efectos de los fármacos , Membrana Mucosa/microbiología , Proteoma/efectos de los fármacos
14.
Stomatologiia (Mosk) ; 99(5): 46-49, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33034176

RESUMEN

The results of a comparative assessment of the state of hemomicrocirculation and oxygen metabolism in the mucous membrane of the alveolar crest after contour plastics of the gums during dental implantation using a connective tissue graft from the upper jaw, a connective tissue transplant from the palate and the collagen matrix collagen matrix are presented. During contouring with the use of connective tissue graft (CTG) from the upper jaw and collagen matrix in the mucous membrane of the alveolar mandible, the level of tissue blood flow decreases, which characterizes the development of ischemia, which is stopped after 3 weeks, when using a connective tissue graft (CTG) from the palatine, the level of tissue blood flow rises, which indicates the development of hyperemia, which is stopped for more than 3 weeks. According to oximetry data after contouring with the use of various surgical techniques, the level of oxygenation and oxygen metabolism is reduced by 8-38%, which characterizes the development of hypoxia, which is stopped after 3 weeks when using CTG from the hillock of the upper jaw and collagen matrix for more than 3 weeks when applying CTG from the palatine.


Asunto(s)
Recesión Gingival , Proceso Alveolar/cirugía , Tejido Conectivo , Implantación Dental , Recesión Gingival/cirugía , Humanos , Membrana Mucosa
15.
Artículo en Chino | MEDLINE | ID: mdl-33040496

RESUMEN

Objective:Analyze the relationship between the change of mucosal wave and the infiltrating level of early laryngeal carcinoma so as to guide the cordectomy. Method:Retrospective research on patients of 1a stage without anterior commissure invasion who received simple CO2 laser therapy because of primary glottic laryngeal squamous cell carcinoma. Result:Records of 320 patients including 22 patients who have slightly reduced according to the mucosal wave prompts before operation, 49 patients mucosal wave moderately reduced, 151 patients mucosal wave severely reduced, and 98 patients have mucosal wave disappeared according to stroboscopic assessment. Post-pathological evidence shows that 16 patients had their tumor infiltration into the epithelial layer, of which, 15 received the Ⅲ type laser surgery, 1 patient received the Ⅳ type laser surgery; 189 patients had their tumor infiltration into the lamina propria, of which, 148 received the Ⅲ type laser surgery, 41 received the Ⅳ type laser surgery; and 115 patients had their tumor infiltration into the vocal cord muscle layer, of which, 77 received the Ⅲ type laser surgery, 38 received the Ⅳ type laser surgery. Analyzed according to the Kaplan-Meier method, it shows that their five-year overall survival rate was 94.0%, the five-year disease-specific survival rate was 98.4%; and five-year local-region control rate was 91.2%. Change of the mucosal wave and the tumor infiltrating level have significant correlation; patients whose tumor infiltration had reached the lamina propria received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no obvious difference; patients whose tumor infiltration have reached the muscular layer received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no significant difference. Conclusion:This research shows that, change of the mucosal wave can, to a certain extent, prompt the tumor infiltration degree and guide in operation; for patients who are suspected of laryngeal carcinoma, when mucosal wave before operation prompts moderate-sever reduction or disappearance, to ensure bottom incisal margin clean, it should be cut at least to the muscular layer; for laryngeal cancer patients whose infiltrating mucosal wave disappears, it prompts that the tumor may have infiltrated to the muscular layer, and the Ⅲ and Ⅳ type laser surgery will have no significant prognostic influence.


Asunto(s)
Neoplasias Laríngeas , Terapia por Láser , Glotis , Humanos , Neoplasias Laríngeas/cirugía , Membrana Mucosa , Estudios Retrospectivos
16.
Surg Clin North Am ; 100(6): 1169-1182, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33128886

RESUMEN

Intramural surgery is a minimally invasive surgical technique based on flexible endoscopy. The first step involves the initial mucosal incision for entry point. Then a submucosal tunnel is dissected to the site of the target anatomy. The procedure performed may include myotomy or lesion removal. When complete, the initial mucosal incision is closed. This technique separates the mucosal flap from the surgical site, minimizing the risk of full-thickness perforation and gastrointestinal leakage. Peroral endoscopic myotomy is the most studied application of intramural surgery but other procedures have emerged. This article explores principles of intramural surgery and summarizes its applications.


Asunto(s)
Endoscopía del Sistema Digestivo/métodos , Enfermedades Gastrointestinales/cirugía , Tracto Gastrointestinal/cirugía , Membrana Mucosa/cirugía , Disección , Endoscopía del Sistema Digestivo/normas , Humanos , Cirugía Endoscópica por Orificios Naturales/métodos , Cirugía Endoscópica por Orificios Naturales/normas
17.
Surg Clin North Am ; 100(6): 1201-1214, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33128889

RESUMEN

Minimally invasive endoscopic resection procedures continue to evolve, with submucosal tunneling endoscopic resection (STER) being a durable option for en bloc resection of submucosal tumors. Whether STER can be effectively used for larger (>3.5 cm) lesions remains to be seen. STER-ET is a novel approach for removal of extraluminal tumors, but data are currently limited to support its use.


Asunto(s)
Resección Endoscópica de la Mucosa/métodos , Tumores del Estroma Gastrointestinal/cirugía , Membrana Mucosa/cirugía , Tracto Gastrointestinal Superior/cirugía , Mucosa Esofágica/cirugía , Mucosa Gástrica/cirugía , Neoplasias Gastrointestinales/cirugía , Humanos
18.
Arch. esp. urol. (Ed. impr.) ; 73(8): 689-698, oct. 2020. tab, graf, ilus
Artículo en Español | IBECS | ID: ibc-197468

RESUMEN

La enucleación endoscópica de próstata fue descrita por primera vez por Hiraoka en 1986, usando un resector monopolar. Su aportación pasó desapercibida hasta que Gilling y Fraundorfer publicaron su técnica de enucleación en tres lóbulos con láser de Holmio en 1998, que se estableció como una opción de tratamiento de la obstrucción prostática benigna ampliamente respaldada por la evidencia científica. Posteriormente se ha estudiado el uso de otros láseres así como de la energía bipolar para realizar enucleación endoscópica y se ha observado una concordancia en los resultados de estas técnicas, independientemente de la fuente de energía utilizada, que ha conducido a englobarlas bajo el acrónimo EEAP (enucleación endoscópica anatómica de próstata). En los últimos años se han producido avances muy relevantes en dos ámbitos: Uno, el ámbito tecnológico, con el desarrollo de la tecnología de modulación del pulso del láser de Holmio (MOSES) y de los morceladores de alto rendimiento. Otro, el desarrollo de nuevas técnicas quirúrgicas, que reconocen la importancia de liberar precozmente el esfínter del ápex del adenoma en la intervención y de preservar escrupulosamente la mucosa del esfínter externo, para evitar la incontinencia urinaria precoz postoperatoria. En este artículo se revisa la evolución reciente de la tecnología y de la técnica quirúrgica que han elevado a la enucleación endoscópica de próstata a otro nivel, reduciendo significativamente el tiempo operatorio, normalmente inferior a una hora, disminuyendo radicalmente la incontinencia precoz postoperatoria y probablemente, facilitando el aprendizaje de la técnica


Endoscopic enucleation of the prostate was first described by Hiraoka in 1986, using a monopolar resectoscope. His contribution was largely ignored until Gilling and Fraundorfer published their three-lobe enucleation technique with the Holmium laser in 1998, that ended establishing itself as a reliable option for the treatment of HBP, backed by ample scientific evidence. Later on, enucleation performed with other lasers, as well as bipolar energy, have shown concordance in their clinical results. As a result, the term AEEP (anatomic endoscopic enucleation of the prostate) emerged to encompass all these techniques. During the last few years there have been significant advances in two areas: first, technology, with the development of pulse modulation for Holmium generators (MOSES) as well as high-speed morcellators. Second, the development of new surgical techniques that recognize the importance of the early release of the sphincter from the apex of the adenoma during the operation as well as the careful preservation of the external sphincter's mucosa, to avoid early stress incontinence. In this paper, we review the recent evolution of both technology and surgical technique. AEEP has been risen to a new level, reducing operative time significantly, usually under one hour, and radically reducing the incidence of early temporary stress incontinence, and maybe also facilitating the learning curve of AEEP


Asunto(s)
Humanos , Masculino , Hiperplasia Prostática/cirugía , Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Endoscopía/métodos , Uretra/cirugía , Ilustración Médica , Membrana Mucosa/cirugía , Resultado del Tratamiento , Reproducibilidad de los Resultados , Tempo Operativo
19.
PLoS One ; 15(9): e0239161, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32915926

RESUMEN

The middle ear is a small and hard to reach compartment, limiting the amount of tissue that can be extracted and the possibilities for studying the molecular mechanisms behind diseases like cholesteatoma. In this paper 14 reference gene candidates were evaluated in the middle ear mucosa of cholesteatoma patients and two different control tissues. ACTB and GAPDH were shown to be the optimal genes for the normalisation of target gene expression when investigating middle ear mucosa in multiplex qPCR analysis. Validation of reference genes using c-MYC expression confirmed the suitability of ACTB and GAPDH as reference genes and showed an upregulation of c-MYC in middle ear mucosa during cholesteatoma. The occurrence of participants of the innate immunity, TLR2 and TLR4, were analysed in order to compare healthy middle ear mucosa to cholesteatoma. Analysis of TLR2 and TLR4 showed variable results depending on control tissue used, highlighting the importance of selecting relevant control tissue when investigating causes for disease. It is our belief that a consensus regarding reference genes and control tissue will contribute to the comparability and reproducibility of studies within the field.


Asunto(s)
Colesteatoma del Oído Medio/genética , Oído Medio/patología , Membrana Mucosa/patología , Reacción en Cadena en Tiempo Real de la Polimerasa/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Colesteatoma del Oído Medio/inmunología , Colesteatoma del Oído Medio/patología , Colesteatoma del Oído Medio/cirugía , Oído Medio/inmunología , Oído Medio/cirugía , Femenino , Regulación de la Expresión Génica/inmunología , Humanos , Masculino , Persona de Mediana Edad , Membrana Mucosa/inmunología , Membrana Mucosa/cirugía , Proteínas Proto-Oncogénicas c-myc/genética , Proteínas Proto-Oncogénicas c-myc/inmunología , Estándares de Referencia , Reproducibilidad de los Resultados , Receptor Toll-Like 2/genética , Receptor Toll-Like 2/inmunología , Receptor Toll-Like 4/genética , Receptor Toll-Like 4/inmunología , Adulto Joven
20.
Aquat Toxicol ; 227: 105625, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32927179

RESUMEN

Here we report the molecular networks associated with the mucosal and systemic responses to peracetic acid (PAA), a candidate oxidative chemotherapeutic in Atlantic salmon (Salmo salar). Smolts were exposed to different therapeutic doses (0, 0.6 and 2.4 mg/L) of PAA for 5 min, followed by a re-exposure to the same concentrations for 30 min 2 weeks later. PAA-exposed groups have higher external welfare score alterations, especially 2 weeks after the re-exposure. Cases of fin damage and scale loss were prevalent in the PAA-exposed groups. Transcriptomic profiling of mucosal tissues revealed that the skin had 12.5 % more differentially regulated genes (DEGs) than the gills following PAA exposure. The largest cluster of DEGs, both in the skin and gills, were involved in tissue extracellular matrix and metabolism. There were 22 DEGs common to both mucosal tissues, which were represented primarily by genes involved in the biophysical integrity of the mucosal barrier, including cadherin, collagen I α 2 chain, mucin-2 and spondin 1a. The absence of significant clustering in the plasma metabolomes amongst the three treatment groups indicates that PAA treatment did not induce any global metabolomic disturbances. Nonetheless, five metabolites with known functions during oxidative stress were remarkably affected by PAA treatments such as citrulline, histidine, tryptophan, methionine and trans-4-hydroxyproline. Collectively, these results indicate that salmon were able to mount mucosal and systemic adaptive responses to therapeutic doses of PAA and that the molecules identified are potential markers for assessing the health and welfare consequences of oxidant exposure.


Asunto(s)
Metaboloma , Transcriptoma , Contaminantes Químicos del Agua/toxicidad , Animales , Biomarcadores/metabolismo , Enfermedades de los Peces/genética , Perfilación de la Expresión Génica , Branquias/efectos de los fármacos , Membrana Mucosa/metabolismo , Oxidantes/metabolismo , Estrés Oxidativo , Salmo salar/metabolismo
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