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1.
Artigo em Inglês | MEDLINE | ID: mdl-31477492

RESUMO

PURPOSE: The present study aimed to evaluate the symmetry of the orbital floor after maxillectomy and orbital floor reconstruction with individual titanium mesh using a computer-assisted navigation system. PATIENTS AND METHODS: Nineteen patients who underwent orbital floor reconstruction with individual titanium mesh were included in this study. Postoperative computed tomography scans recorded after three-dimensional (3D) reconstruction were used to evaluate the symmetry of the orbital floor, including orbital floor height, orbital floor eminence, globe projection, orbital volume, and surface deviation. RESULTS: The average orbital floor height of the reconstructed and the unaffected side was 37.7 ±â€¯2.3 and 37.8 ±â€¯2.7 mm, respectively (P = .47). The average orbital floor eminence of the reconstructed and the unaffected side was 40.1 ±â€¯5.5 and 39.6 ±â€¯5.3 mm, respectively (P = .17). The average globe projection of the reconstructed and the unaffected side was 15.5 ±â€¯3.2 and 15.3 ±â€¯3.0 mm, respectively (P = .27). The average orbital volume of the reconstructed and the unaffected side was 25.9 ±â€¯4.4 and 26.3 ±â€¯4.4 cm3, respectively (P = .29). Repeatability between the reconstructed and the unaffected side was 88.3% ± 2.6% at within 1 mm and 98.6% ± 0.9% at within 2 mm. The average of maximum deviation was 2.4 ±â€¯0.2 mm. CONCLUSION: Individual titanium mesh is one of the best techniques for orbital floor reconstruction, as it can be placed precisely and helps achieve desirable esthetic outcomes through virtual surgical planning and using a computer-assisted navigation system.

2.
Sensors (Basel) ; 19(16)2019 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-31405249

RESUMO

In this work, we report on the design of a wide-band digital lock-in amplifier (DLIA) of up to 65 MHz and its application for electrical impedance measurements in microfluidic devices. The DLIA is comprised of several dedicated technologies. First, it features a fully differential analog circuit, which includes a preamplifier with a low input noise of 4.4 nV/√Hz, a programmable-gain amplifier with a gain of 52 dB, and an anti-aliasing, fully differential low-pass filter with -76 dB stop-band attenuation. Second, the DLIA has an all-digital phase lock loop, which features a phase deviation of less than 0.02° throughout the frequency range. The phase lock loop utilizes an equally accurate period-frequency measurement, with a sub-ppm precision of frequency detection. Third, a modified clock link is implemented in the DLIA to improve the signal-to-noise ratio of the analog-to-digital converter affected by clock jitter of up to 20 dBc. A series of measurements were performed to characterize the DLIA, and the results showed an accurate performance. Additionally, impedance measurements of standard-size microparticles were performed by frequency sweep from 300 kHz to 30 MHz, using the DLIA in a microfluidic device. Different diameters of microparticle could be accurately distinguished according to the relative impedance at 2.5 MHz. The results confirm the promising applications of the DLIA in microfluidic electrical impedance measurements.

3.
Biosci Rep ; 39(7)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31273059

RESUMO

Botulinum toxin type A (BTXA) is a neurotoxic protein produced by Clostridium botulinum Our previous studies demonstrated that BTXA inhibits the secretory function of submandibular gland (SMG) and changes its structure. Several studies reported that SMG damage and repair often occur with autophagy in the rat. However, no studies reported whether secretory inhibition and structural changes of SMG after BTXA injection is related with autophagy. The present study was carried out to explore the association between BTXA injection and autophagy in rat SMG. Western blotting and immunofluorescence were used to detect the expression and distribution of light chain 3 (LC3) in rat SMG. MTS was used to detect the toxicity of BTXA on rat SMG-C6 cell line. GFP-LC3 and Lyso-Tracker Red fluorescence probe were used to assess the levels of autophagosomes and lysosome fusion and the effect of BTXA on autophagic flux in SMG-C6. Western blotting and immunofluorescence results showed that BTXA temporarily increased autophagosomes in rat SMG. MTS results showed that BTXA exerted its toxicity on SMG-C6 in a dose-dependent manner. BTXA increased the number of autophagosomes in SMG-C6; however, most autophagosomes did not colocalize with lysosome. Therefore, we presume that BTXA can change autophagic flux of SMG cells, the mechanism of which might relate with BTXA's disturbing autophagosome-lysosome fusion.

4.
Eur Respir J ; 54(2)2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31164430

RESUMO

Although broad knowledge of influenza viral pneumonia has been established, the significance of non-influenza respiratory viruses in community-acquired pneumonia (CAP) and their impact on clinical outcomes remains unclear, especially in the non-immunocompromised adult population.Hospitalised immunocompetent patients with CAP were prospectively recruited from 34 hospitals in mainland China. Respiratory viruses were detected by molecular methods. Comparisons were conducted between influenza and non-influenza viral infection groups.In total, 915 out of 2336 adult patients with viral infection were enrolled in the analysis, with influenza virus (28.4%) the most frequently detected virus, followed by respiratory syncytial virus (3.6%), adenovirus (3.3%), human coronavirus (3.0%), parainfluenza virus (2.2%), human rhinovirus (1.8%) and human metapneumovirus (1.5%). Non-influenza viral infections accounted for 27.4% of viral pneumonia. Consolidation was more frequently observed in patients with adenovirus infection. The occurrence of complications such as sepsis (40.1% versus 39.6%; p=0.890) and hypoxaemia (40.1% versus 37.2%; p=0.449) during hospitalisation in the influenza viral infection group did not differ from that of the non-influenza viral infection group. Compared with influenza virus infection, the multivariable adjusted odds ratios of CURB-65 (confusion, urea >7 mmol·L-1, respiratory rate ≥30 breaths·min-1, blood pressure <90 mmHg (systolic) or ≤60 mmHg (diastolic), age ≥65 years) ≥3, arterial oxygen tension/inspiratory oxygen fraction <200 mmHg, and occurrence of sepsis and hypoxaemia for non-influenza respiratory virus infection were 0.87 (95% CI 0.26-2.84), 0.72 (95% CI 0.26-1.98), 1.00 (95% CI 0.63-1.58) and 1.05 (95% CI 0.66-1.65), respectively. The hazard ratio of 90-day mortality was 0.51 (95% CI 0.13-1.91).The high incidence of complications in non-influenza viral pneumonia and similar impact of non-influenza respiratory viruses relative to influenza virus on disease severity and outcomes suggest more attention should be given to CAP caused by non-influenza respiratory viruses.

5.
Ocul Surf ; 17(3): 470-475, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31015041

RESUMO

PURPOSE: Submandibular gland (SMG) transplantation improves the tear film and other ocular-surface features for patients with severe dry eye disease (DED). Using the dry eye-related quality of life (QOL) questionnaire, we aimed to evaluate whether DED patients' QOL would benefit from SMG transplantation and determine whether preoperative ophthalmologic and QOL measurements could predict which patients would be most satisfied with this surgery. METHODS: This prospective study included DED patients with successful SMG transplantation. Using the Chinese version of the Dry Eye Related Quality of Life (CDERQOL) instrument, QOL was measured before and 1-year after surgery. RESULTS: The QOL data of 51 consecutive patients were analyzed. Before surgery, all the patients had a poor QOL. One year after surgery, all five QOL domains (Dry Eye Symptom Bother, Impact on Daily Activities, Emotional Impact, Impact on Work, and Satisfaction with Treatment) showed significant improvement (P < 0.01). Unsuccessful treatment experience with cyclosporin eyedrops as well as pre-surgical low scores of visual acuity and all five QOL domains (except for "Satisfaction with Treatment") were found to significantly increase the post-surgical QOL scores (P < 0.01); however, pre-surgical Schirmer's test, break-up times of tear-film, and corneal fluorescein staining measurements showed no effects or contradictory correlations with post-surgical QOL scores. CONCLUSION: The life quality and satisfaction of DED patients showed significant improvement after SMG transplantation. Patients with severe and refractory DED could reap the benefits of surgery. A subjective QOL questionnaire is very valuable for predicting and evaluating the treatment effect.

6.
Respiration ; 97(5): 484-494, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970361

RESUMO

Malignant central airway stenosis refers to airway stenosis caused by primary or metastatic malignant tumors which may lead to different levels of dyspnea or asphyxia in patients. With the rapid development of interventional pulmonology, therapeutic bronchoscopy has become one of the main methods for the diagnosis and treatment of malignant central airway stenosis. However, the level of diagnosis and treatment of respiratory intervention techniques in China is uneven at present, the treatment methods are not uniform, the treatment effects vary greatly, and some treatments even lead to serious complications. The interventional treatment technology for malignant central airway stenosis in China needs to be standardized. Therefore, the relevant experts of the Beijing Health Promotion Association Respiratory and Oncology Intervention and Treatment Alliance have formulated this consensus after several rounds of full discussion.

7.
Int J Oral Maxillofac Implants ; 34(5): 1223­1230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30892283

RESUMO

PURPOSE: To evaluate effects of preoperative virtual planning and jaw reconstruction guided by dental implant rehabilitation on dental prosthesis rehabilitation after jaw reconstruction. MATERIALS AND METHODS: Patients indicated for segmental jaw resection and who agreed to receive jaw reconstruction procedures were enrolled in the study. Appropriate surgical procedures were determined by a maxillofacial surgeon and a prosthodontist before surgery. The virtual design was created according to preoperative computed tomography. Patients were divided into navigation and non-navigation groups. Implant surgery was performed 6 months after reconstruction surgery. After treatment completion, factors such as survival rate of implants, site of reconstruction, type of graft, and type of prosthesis were compared. RESULTS: In total, 29 patients were included in the study, with 16 patients in the non-navigation group and 13 in the navigation group. A total of 101 implants were inserted, and the implant success rate was 98.02% (2 implants extracted due to peri-implantitis). All patients received prosthetic treatment. Of the 13 navigation group patients, 9 received fixed implant-supported prostheses, whereas the other 4 received removable dentures. Of the 16 non-navigation group patients, 9 eventually received fixed implant-supported prostheses and 7 received removable dentures. There were no significant intergroup differences in terms of prosthesis type (P = .702). However, the proportion of fixed implant-supported prostheses in the navigation group was higher compared with the non-navigation group. CONCLUSION: Preoperative virtual planning and dental implant rehabilitation-guided jaw reconstruction through preoperative designing can provide a good opportunity to achieve high rates of implant success and dental rehabilitation. This method can also benefit fixed implant-supported prosthetic restorations. Moreover, the use of navigation after virtual planning has no effect on the type of prosthetic reconstruction.

8.
Med. oral patol. oral cir. bucal (Internet) ; 24(2): e236-e242, mar. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-180648

RESUMO

Background: The purpose of the study was to compare the differences of the subjective satisfaction of the donor site morbidity between the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) for tongue reconstruction. Material and Methods: One hundred and nineteen patients underwent FRFF or ALTF reconstruction were retrospectively evaluated by a standardized self-established donor site morbidity questionnaire which included 5 domains, sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life. Results: The Cronbach's coefficient alpha of the questionnaire was 0.707. The exploratory factor analysis revealed that the 5 items of the questionnaire might load onto two distinct subscales. Patients with ALTF had higher scores in the sensibility, cosmetics and the composite score (P < 0.05). No significant differences were found in the movement disabilities, social activities and general impacts on the quality of life between the two groups (P > 0.05). Conclusions: ALTF has the advantage of better results of donor site morbidity, such as sensibility and cosmetics, over FRFF


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Língua/cirurgia , Retalhos Cirúrgicos , Transplante de Pele/métodos , Carcinoma de Células Escamosas/cirurgia , Sítio Doador de Transplante , Procedimentos Cirúrgicos Reconstrutivos/métodos , Satisfação do Paciente/estatística & dados numéricos , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos
9.
Acta Otolaryngol ; 139(5): 444-450, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30806131

RESUMO

BACKGROUND: Intraparotid facial nerve schwannoma (IFNS) is rare and its definite preoperative diagnosis is challenging. OBJECTIVE: To improve available knowledge regarding the diagnosis of IFNS and to suggest an appropriate treatment plan. MATERIAL AND METHODS: We retrospectively analyzed medical records of IFNS patients at our hospital. Inclusion criteria were surgery (from January 2000, to December 2016) for a parotid mass, pathologically diagnosed as a schwannoma. RESULTS: The study included 42 eligible patients who had undergone tumor resection from 5977 parotid tumor patients. Mostly presented hard-textured (18/39) or medium-textured (15/39), with limited mobility (21/39) mass (three tumors were not palpable). Their facial nerve function outcomes were House-Brackmann Grade I (n = 14), Grade II (n = 7), Grade III (n = 11), Grade IV (n = 5), Grade V (n = 3), and Grade VI (n = 2). Significant differences were noted in results based on different surgical methods used (p = .000) and tumor involvement (p = .002). CONCLUSIONS AND SIGNIFICANCE: A hard-textured tumor with limited mobility mass in the parotid gland should prompt the diagnosis of a schwannoma. Tumors involving main trunk usually lead to unsatisfactory facial nerve outcomes. Facial nerve preservation should always be essential, and stripping surgery or intracapsular enucleation could be the preferred surgical methods of choice.

10.
J Oral Maxillofac Surg ; 77(6): 1286-1292, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30735641

RESUMO

PURPOSE: Condylar position can change after mandibular reconstruction using the free fibula flap. The present study evaluated changes in condylar position using computed tomography (CT) after mandibular reconstruction with condylar head preservation. MATERIALS AND METHODS: This retrospective study consisted of 16 patients. CT data of 32 temporomandibular joints (TMJs) were recorded before surgery (T0), 7 to 10 days after surgery (T1), and 16.8 ± 7.4 months after surgery (T2). The anteroposterior condylar position was evaluated using the method of Pullinger and Hollender (Oral Surg Oral Med Oral Pathol 62:719, 1986). Repeated-measures analysis of variance (P = .05) was performed. RESULTS: Data of 16 patients were obtained for statistical analysis. Condylar position changed over time after mandibular reconstruction. The ipsilateral condyles moved anteroinferiorly after surgery (T0 to T1) and tended to move anterosuperiorly during follow-up (T1 to T2). No major changes were noted in the contralateral condyles. CONCLUSION: Condylar positions showed obvious changes over time after mandibular reconstruction with condylar preservation. Nevertheless, additional studies are warranted to further evaluate the relation between condylar position and TMJ function.

11.
Tissue Eng Part A ; 25(17-18): 1261-1271, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30648467

RESUMO

IMPACT STATEMENT: Bone loss due to trauma, inflammation, and surgical processes has posed great difficulty in the aesthetic reconstruction of a functional alveolar bone. Tissue engineering and biomaterials, which can promote alveolar bone regeneration, have become a popular focus of current studies. Three-dimensional (3D) printing provides a novel approach to repair bone defects using customized biomimetic tissue scaffolds. Nano hydroxyapatite (nHA) and deproteinized bovine bone (DBB) are two materials mainly used in clinical practice, particularly DBB are widely used in dentistry and craniomaxillofacial orthosis because of the porosity characteristic. To make a bone substitute closest to natural bone structure and composition, nHA and DBB were dispersed into collagen (CoL) to prepare the bioink for 3D printing. The physicochemical and biological properties between the two 3D printing scaffolds were compared. Both nHA/CoL and DBB/CoL 3D printing scaffold would be promising candidate for the clinical applications in the future.

12.
ACS Synth Biol ; 8(1): 70-81, 2019 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-30543412

RESUMO

Menaquinone-7 (MK-7), a valuable vitamin K2, plays an important role in the prevention of osteoporosis and cardiovascular calcification. We chose B. subtilis 168 as the chassis for the modular metabolic engineering design to promote the biosynthesis of MK-7. The biosynthetic pathway of MK-7 was categorized into four modules, namely, the MK-7 pathway (Module I), the shikimate (SA) pathway (Module II), the methylerythritol phosphate (MEP) pathway (Module III), and the glycerol metabolism pathway (Module IV). Overexpression of menA (Module I) resulted in 6.6 ± 0.1 mg/L of MK-7 after 120 h fermentation, which was 2.1-fold that of the starting strain BS168NU (3.1 ± 0.2 mg/L). Overexpression of aroA, aroD, and aroE (Module II) had a negative effect on the synthesis of MK-7. Simultaneous overexpression of dxs, dxr, yacM, and yacN (Module III) enabled the yield of MK-7 to 12.0 ± 0.1 mg/L. Moreover, overexpression of glpD (Module IV) resulted in an increase of the yield of MK-7 to 13.7 ± 0.2 mg/L. Furthermore, deletion of dhbB reduced the consumption of the intermediate metabolite isochorismate, thus promoting the yield of MK-7 to 15.4 ± 0.6 mg/L. Taken together, the final resulting strain MK3-MEP123-Gly2-Δ dhbB with simultaneous overexpression of menA, dxs, dxr, yacM-yacN, glpD and deletion of dhbB enabled the yield of MK-7 to 69.5 ± 2.8 mg/L upon 144 h fermentation in a 2 L baffled flask.

13.
Cell Stem Cell ; 23(6): 833-849.e5, 2018 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-30526882

RESUMO

Inflammation is a risk factor for cancer development. Individuals with preleukemic TET2 mutations manifest clonal hematopoiesis and are at a higher risk of developing leukemia. How inflammatory signals influence the survival of preleukemic hematopoietic stem and progenitor cells (HSPCs) is unclear. We show a rapid increase in the frequency and absolute number of Tet2-KO mature myeloid cells and HSPCs in response to inflammatory stress, which results in enhanced production of inflammatory cytokines, including interleukin-6 (IL-6), and resistance to apoptosis. IL-6 induces hyperactivation of the Shp2-Stat3 signaling axis, resulting in increased expression of a novel anti-apoptotic long non-coding RNA (lncRNAs), Morrbid, in Tet2-KO myeloid cells and HSPCs. Expression of activated Shp2 in HSPCs phenocopies Tet2 loss with regard to hyperactivation of Stat3 and Morrbid. In vivo, pharmacologic inhibition of Shp2 or Stat3 or genetic loss of Morrbid in Tet2 mutant mice rescues inflammatory-stress-induced abnormalities in HSPCs and mature myeloid cells, including clonal hematopoiesis.

14.
Cell Biol Int ; 2018 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-29972265

RESUMO

Epithelial mesenchymal transformation (EMT) plays fundamental roles in tumor metastasis. MiRNAs function as powerful regulators of EMT. The function and mechanism of miRNAs in EMT of lung cancers remains to be elucidated. Here, we explored the roles and mechanisms of miR-26a in EMT. A cellular EMT model was firstly established by TGFß incubation with A549 cells. Compared with control, the expression of miR-26a was down-regulated by 60% in EMT model. Down-regulation of miR-26a was further revealed to increase the expression of mesenchymal markers (N-cadherin, Vimentin, a-Sma and Twist1) and decrease epithelial marker (E-cadherin). Consistently, over-expression of miR-26a partially attenuated the regulatory activity of TGFß on the expression of EMT markers in A549 cells. These results indicate that down-regulation of miR-26a plays essential functions in TGFß-induced EMT. Furthermore, Smad1 and Smad4 were predicted to be potential targets of miR-26a. Over-expression of miR-26a suppressed the luciferase activity of Renilla whose 3' UTR harbors the sequences of Smad1 or Smad4 that might bind to miR-26a, indicating that miR-26a can directly bind to 3' UTR of Smad1 and Smad4. Accordingly, the protein levels of SMAD1 and SMAD4 were significantly suppressed by miR-26a over-expression in A549 cells. Interestingly, the suppressing effects of miR-26a on EMT were totally rescued by over-expression of SMAD1 and SMAD4 in TGFß-treated A549 cells. Collectively, down-regulation of miR-26a plays essential roles in TGFß-induced EMT, which might provide important implications for the therapeutics of lung cancers.

15.
J Craniomaxillofac Surg ; 46(8): 1263-1267, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29803367

RESUMO

When combined with iliac bone, perforator flaps are more chimeric, and there is increased mobile skin island to reconstruct soft tissue defects in the oral and maxillofacial region. This study examined oromandibular defects reconstructed using deep circumflex iliac artery perforator flap with iliac crest (DCIAPF). We retrospectively reviewed records of 23 patients with mandibular defects received DCIAPFs after oncological resection for oromandibular reconstruction from November 2015 to August 2016. All perforators, identified before surgery by Doppler examination, were terminal perforators of DCIA. DCIAPFs were successfully harvested in all patients. The flap survival rate was 95.6% (22/23); one flap failed due to artery spasm. Three patients developed slight skinedge necrosis in the skin island. Anatomical reconstruction contour of the mandible and sufficient bone length and height were achieved, with no serious donor-site complications during the follow-up period. The results demonstrated that DCIAPF is a favorable single-flap option for oromandibular reconstruction after oncological resection with fewer donor-site complications because of its adequate bone tissue and satisfactory soft tissue, with a constant location of the perforator.

16.
Cell Physiol Biochem ; 46(3): 1065-1077, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29669315

RESUMO

BACKGROUND/AIMS: Giant pandas, an endangered species, are a powerful symbol of species conservation. Giant pandas may suffer from a variety of diseases. Owing to their highly specialized diet of bamboo, giant pandas are thought to have a relatively weak ability to resist diseases. The spleen is the largest organ in the lymphatic system. However, there is little known about giant panda spleen at a molecular level. Thus, clarifying the regulatory mechanisms of spleen could help us further understand the immune system of the giant panda as well as its conservation. METHODS: The two giant panda spleens were from two male individuals, one newborn and one an adult, in a non-pathological condition. The whole transcriptomes of mRNA, lncRNA, miRNA, and circRNA in the two spleens were sequenced using the Illumina HiSeq platform. EBseq and IDEG6 were used to observe the differentially expressed genes (DEGs) between these two spleens. Gene Ontology and KEGG analyses were used to annotate the function of DEGs. Furthermore, networks between non-coding RNAs and protein-coding genes were constructed to investigate the relationship between non-coding RNAs and immune-associated genes. RESULTS: By comparative analysis of the whole transcriptomes of these two spleens, we found that one of the major roles of lncRNAs could be involved in the regulation of immune responses of giant panda spleens. In addition, our results also revealed that microRNAs and circRNAs may have evolved to regulate a large set of biological processes of giant panda spleens, and circRNAs may function as miRNA sponges. CONCLUSION: To our knowledge, this is the first report of lncRNAs and circRNAs in giant panda, which could be a useful resource for further giant panda research. Our study reveals the potential functional roles of miRNAs, lncRNAs, and circRNAs in giant panda spleen.


Assuntos
Sistema Imunitário/metabolismo , RNA Longo não Codificante/metabolismo , Baço/metabolismo , Transcriptoma , Ursidae/genética , Animais , MicroRNAs/metabolismo , RNA/química , RNA/isolamento & purificação , RNA/metabolismo , RNA Mensageiro/metabolismo , Análise de Sequência de RNA , Ursidae/metabolismo
17.
J Craniomaxillofac Surg ; 46(5): 825-830, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29606544

RESUMO

BACKGROUND: Submandibular gland (SMG) transplantation is a successful treatment approach for patients with severe dry eye. However, duct obstruction can occur post-transplant. METHODS: We studied nineteen patients with duct obstruction of transplanted SMGs, including five interventional modalities: stone removal; secretory stimulation (to mimic "internal irrigation" with substantial secretory flow); irrigation; surgical opening of stenosis and orifice reconstruction; cephalic vein bypass and Wharton's duct reconstruction. RESULTS: A solitary stone was found and removed in one patient. Duct blockages like mucus plug were cleared by secretory stimulation in three patients, and by normal saline irrigation in two grafts. In the remaining 13 patients, irrigation failed and surgical opening was performed. Orifice reconstruction succeeded in six of the eight patients, whose stenosis was near the orifice. Wharton's duct reconstruction was successful in two of the five cases where stenosis was located in the middle segment of the duct. CONCLUSION: Transplanted SMGs obstruct for various reasons. Stone, which is easy to diagnose and treat, should be excluded first. Non-organic blockage and stenosis were semblable in clinic. Therefore, subsequent steps should be a diagnostic/therapeutic trial of secretory stimulation, followed by irrigation; failure of these interventions suggests the diagnosis of duct stenosis, necessitating surgical recanalization.


Assuntos
Ductos Salivares , Doenças das Glândulas Salivares/cirurgia , Glândula Submandibular/transplante , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Salivares/cirurgia , Doenças das Glândulas Salivares/etiologia , Adulto Jovem
18.
Arthritis Res Ther ; 20(1): 12, 2018 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-29382364

RESUMO

BACKGROUND: Immunoglobulin G4-related sialadenitis (IgG4-RS) is a newly recognized immune-mediated systemic disease. Despite its good response to steroid therapy, its treatment protocol is not standardized and the long-term outcome is controversial. The study was conducted to determine the short-term and long-term outcomes of IgG4-RS patients treated with glucocorticoids and steroid-sparing immunosuppressive agents, to analyze secretory function, serological and radiological changes in salivary glands and to assess the usefulness of serum IgG4 level as an indicator of disease activity. METHODS: IgG4-RS patients who were treated for more than 3 months were enrolled. Serological tests, salivary gland function assessment and computed tomography (CT) were performed before treatment and during follow up. The treatment outcomes in the short and the long term were evaluated, and the relationship between serum IgG4 level and salivary gland volume was analyzed. RESULTS: Glucocorticoids were used in all 43 patients and steroid-sparing immunosuppressive agents in 38 patients (88.4%). The follow-up period was 24.6 ± 14.9 months. Clinical remission was achieved in all patients after induction therapy. During short-term observation, salivary gland secretion significantly increased, and the serum IgG4 levels, the volumes and CT values of submandibular and parotid gland decreased significantly (P < 0.001). For long term, relapse occurred in 32.5% patients within 55 months in the regularly treated group, while all seven irregularly treated patients relapsed. However, the relapse-free survival curves were not significantly different between the steroid monotherapy and the combination therapy groups (P = 0.566). Submandibular glands, lacrimal glands, sublingual glands, nasal and paranasal cavity were commonly relapsing organs. In clinically stable patients, a serologically unstable condition occurred in 54.9% patients within 55 months and medication adjustment was performed accordingly. Volume changes in the submandibular and parotid glands were associated with serum IgG4 levels and time of follow up (R2adjusted = 0.905, P < 0.0001 and R2adjusted = 0.9334, P < 0.0001, respectively). CONCLUSIONS: The combination of glucocorticoid and steroid-sparing agents could be effective for treating IgG4-RS, and restoring salivary gland function. Serum IgG4 levels could predict disease activity.

19.
J Cancer ; 8(17): 3592-3597, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29151945

RESUMO

BACKGROUND: Ossifying fibroma in the jaws is a benign tumor and easily recurs in children, of which the treatment methods and prognosis still remain controversial. In this study, we aimed to review the clinicopathological characteristics, treatment, and prognosis of ossifying fibroma in the jaws of children, and offer recommendations for clinical decision-making. METHODS: A retrospective study was carried out on patients below the age of 18 years with ossifying fibroma in the jaws. Patients with complete clinical, pathological, and radiological records were included and followed-up. RESULTS: Sixty-three cases were collected with a preliminary search. After screening, fifty patients were included for general information analysis, of which forty-two patients were included in the recurrence analysis. Twelve patients showed a relapse, with a recurrence rate of 28.6% (12/42). The recurrence rates in cases with different surgical approaches and different X-ray boundaries were statistically different. Besides, twenty-three patients underwent reconstruction by free tissue grafting and the success rate was 96% (22/23). CONCLUSIONS: There was significant difference in the recurrence rates among different X-ray manifestations and surgical methods. An extended resection and reconstruction with free tissue grafting was a reliable method with a 96% success rate.

20.
J Craniomaxillofac Surg ; 45(10): 1692-1697, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28838839

RESUMO

BACKGROUND: A reliable anterior facial vein (AFV, donor vein) is cardinal for the success of submandibular gland (SMG) transplantation. This study determined the impact of computed tomographic (CT) venography in identifying AFV variations for SMG transplantation. METHODS: CT venography was performed in consecutive patients with severe dry eye prior to SMG transplantation in order to identify disadvantageous AFV variations for vascular anastomosis, namely, AFVs that did not drain the SMG and those that did not match the superficial temporal vein (STV, recipient vein; AFV:STV caliber ratio, ≥3). The CT results were compared with the intraoperative findings for the diagnostic accuracy. RESULTS: Forty-two donors were included. Compared with the intraoperative findings, the CT results accurately identified AFV-STV caliber mismatches (P = 1.00; sensitivity and specificity, 100%). In the identification of AFVs not draining the SMG, CT showed 94.7% sensitivity and 100% specificity (P = 0.25). According to the CT findings, 10 contralateral SMGs with AFVs (23.8%), instead of ipsilateral donors, were selected for transplantations (conventionally ipsilateral donor was the first choice). The surgical success rate was 95.2% (40/42). CONCLUSION: CT venography is valuable in determining disadvantageous AFV variations for anastomosis and choosing a reliable donor for SMG transplantation.


Assuntos
Seleção do Doador/métodos , Síndromes do Olho Seco/cirurgia , Flebografia/métodos , Glândula Submandibular/transplante , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Adulto Jovem
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