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1.
Acad Radiol ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32029375

RESUMO

RATIONALE AND OBJECTIVES: In this study, we assessed the radiation dose to the lens and the impacts of various eye shields using either a fixed or modulated tube current. MATERIALS AND METHODS: Patients undergoing head computed tomography (CT) examinations were recruited, and each was randomly assigned to one of five imaging groups, either without a CT eye shield or with one of two types of shielding and topogram-based tube current modulation (TCM). The radiation dose at the eye lens was estimated using Gafchromic films. All CT images were analyzed for quality in the orbit and brain areas. Two radiologists also qualitatively assessed image artifacts and their impacts on image quality using three-point Likert scales. RESULTS: Both barium sulfate and bismuth-antimony shields significantly reduced radiation dose to the lens (by 28.60%-31.92% and 43.87%-47.00%, respectively) while significantly inducing image artifacts. The image quality of the intraocular structure, but not the intracranial structure, was significantly degraded by shielding. In addition, discriminating the periocular tissues was improved using a bismuth-antimony shield and topogram-based TCM. Compared to fixed tube current, topogram-based TCM provided better signal-to-noise and contrast-to-noise ratios in the intracranial structures when the bismuth-antimony and barium sulfate shields were applied, respectively. CONCLUSION: Artifacts resulting from the application of eye shields during head CT examinations can be reduced by using topogram-based TCM instead of a fixed tube current. This could be an alternative approach for maintaining image quality in CT scans that do not encompass organ-based TCM.

2.
Int J Mol Sci ; 21(2)2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31963217

RESUMO

The main aim of this study is to develop a one-stage method to combine platelet-rich fibrin (PRF) and autologous cartilage autografts for porcine articular cartilage repair. The porcine chondrocytes were treated with different concentrations of PRF-conditioned media and were evaluated for their cell viability and extracellular glycosaminoglycan (GAG) synthesis during six day cultivation. The chemotactic effects of PRF on chondrocytes on undigested cartilage autografts were revealed in explant cultures. For the in vivo part, porcine chondral defects were created at the medial femoral condyles of which were (1) left untreated, (2) implanted with PRF combined with hand-diced cartilage grafts, or (3) implanted with PRF combined with device-diced cartilage grafts. After six months, gross grades, histological, and immunohistochemical analyses were compared. The results showed that PRF promotes the viability and GAG expression of the cultured chondrocytes. Additionally, the PRF-conditioned media induce significant cellular migration and outgrowth of chondrocytes from undigested cartilage grafts. In the in vivo study, gross grading and histological scores showed significantly better outcomes in the treatment groups as compared with controls. Moreover, both treatment groups showed significantly more type II collagen staining and minimal type I collagen staining as compared with controls, indicating more hyaline-like cartilage and less fibrous tissue. In conclusion, PRF enhances the viability, differentiation, and migration of chondrocytes, thus, showing an appealing capacity for cartilage repair. The data altogether provide evidences to confirm the feasibility of a one-stage, culture-free method of combining PRF and cartilage autografts for repairing articular cartilage defects. From translational standpoints, these advantages benefit clinical applications by simplifying and potentiating the efficacy of cartilage autograft transplants.

3.
J Chin Med Assoc ; 83(2): 164-169, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31834025

RESUMO

BACKGROUND: Deep-seated brain tumors can be difficult to differentiate. Three tumor types (primary central nervous system lymphoma [PCNSL], high-grade glioma, and metastatic brain tumors), identified by susceptibility-weighted imaging, have different relationships with small medullary veins, and these relationships can be used to enhance diagnostic accuracy. METHODS: Records of patients with pathology confirmed malignant brain tumors who received susceptibility-weighted imaging between 2009 and 2015 were reviewed. A total of 29 patients with deep-seated malignant brain tumors in the territory of small medullary veins were enrolled in this study. The sensitivity, specificity, and diagnostic accuracy of medullary vein blockage (MVB), defined as a small medullary vein terminating at the margin of the tumor, for indicating malignant brain tumors were analyzed. RESULTS: Of 11 patients with PCNSLs, 5 with high-grade gliomas, and 13 with metastases, only the latter presented MVBs. The sensitivity, specificity, and accuracy of using MVBs for diagnosing metastatic tumors were 76.9%, 100%, and 89.7%, respectively. CONCLUSION: An MVB is an accurate sign for differentiating metastatic brain tumors from two other common malignancies and thus provides a useful tool for preoperative planning.

4.
Clin Nutr ; 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31879077

RESUMO

BACKGROUND & AIMS: The beneficial effects of protein supplementation on aerobic exercise-induced gains in patients with stroke are currently unknown. This study evaluated the feasibility and potential value of protein supplementation with aerobic exercise among stroke survivors. METHODS: This double-blinded randomized controlled pilot study included 20 ambulatory persons with chronic (>6 months) stroke randomly assigned to either the protein (PRO) or carbohydrate (CHO) group. All participants received three 40-min cycling ergometric training sessions a week for 8 weeks. Training intensity at 60%-80% heart rate reserve was determined using cardiopulmonary exercise pretests. Immediately before and after each session, the PRO group received a 20-g protein-rich supplement, and the CHO group received a 20-g calorie-matched carbohydrate-rich supplement. Outcomes included changes in body composition, cardiopulmonary capacity, and clinical functional performance. RESULTS: Those completing the protocol (n = 18) received 18-24 cycling training sessions, achieving target training intensity without major adverse effects. Of the two groups, the PRO group tended to obtain greater aerobic capacity (effect size [ES]>0.5 in every cardiopulmonary index), greater improvements in functional performance (0.25 < ES < 1.00 in various clinical tests), and greater total lean mass versus total fat mass (ES = 0.52). CONCLUSIONS: Protein supplementation with aerobic exercise training tends to improve body composition, cardiopulmonary fitness, and function among persons with stroke. This study protocol is feasible, and future trials with larger sample sizes could confirm these results. TRIAL REGISTRATION: NCT03244527.

5.
Sci Rep ; 9(1): 17698, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31776349

RESUMO

Normal body mass index (BMI) is associated with lower risk for cardiometabolic diseases. However, there is a subset of individuals with BMI in this range who present with this metabolic abnormality (called metabolically unhealthy normal weight, MUHNW). Here we aimed to assess the adipose characteristics of people with MUHNW using dual-energy X-ray absorptiometry (DXA). This study included 3259 people with normal BMI who underwent health examinations from January 1, 2007 through December 31, 2016. Body fat percentage (%BF), android-gynoid percent fat ratio (AG ratio), and visceral adipose tissue (VAT) were measured simultaneously using DXA CoreScan software. Those with MUHNW comprised 12.67% of the sample. Among those with MUHNW, 71.6% of the women and 56.5% of the men showed high VAT amounts, but less than 40% of either showed high %BFs. Furthermore, considering the combined effects of fat amount and distribution, a normal BMI accompanied by high AG ratio and/or high VAT mass but low %BF presents a much higher risk for metabolic syndrome than when %BF is high, most predominantly in women. In conclusion, using DXA-measured abdominal fat, particularly VAT accumulation, is clinically more important than using %BF when assessing metabolic syndrome in those with normal BMI.

6.
Medicine (Baltimore) ; 98(44): e17800, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689859

RESUMO

RATIONALE: Human papillomavirus (HPV)-related oropharyngeal cancer is becoming more common, the primary cancer AQ4 usually occult and appearing only as cystic cervical lymph node (LN) metastasis. Distinguishing between a benign cystic lesion and cystic LN metastasis is challenging given their similar radiologic and histologic appearances. PATIENT CONCERNS: A 54-year-old man presented with a bulging cystic mass measuring 6.4cm on the right side of neck. DIAGNOSES: Postexcision diagnosis was second branchial cleft cyst. After 2 years, the cystic mass recurred, and HPV-related tonsillar squamous cell carcinoma with cystic metastatic LNs was confirmed after wide tonsillectomy and neck dissection. The previous cystic lesion proved to be a cystic metastatic LN from the same malignancy with additional p16 immunostain. INTERVENTIONS: The patient was treated with adjuvant concurrent chemoradiation therapy. OUTCOMES: The patient was followed up in the outpatient department with no evidence of recurrence after 1 year. LESSONS: When an adult has a cystic mass in the upper neck, we must rigorously exclude it as a cystic metastatic LN of occult HPV-related oropharyngeal cancer. Additional p16 staining might be helpful.


Assuntos
Branquioma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Metástase Linfática/diagnóstico , Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/virologia , Diagnóstico Diferencial , Humanos , Linfonodos/patologia , Linfonodos/virologia , Masculino , Pessoa de Meia-Idade , Pescoço/patologia , Pescoço/virologia , Esvaziamento Cervical , Neoplasias Císticas, Mucinosas e Serosas/secundário , Neoplasias Císticas, Mucinosas e Serosas/virologia , Neoplasias Primárias Desconhecidas/patologia , Neoplasias Primárias Desconhecidas/virologia , Neoplasias Orofaríngeas/secundário , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Neoplasias Tonsilares/diagnóstico , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/virologia
7.
J Magn Reson Imaging ; 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31625643

RESUMO

BACKGROUND: Adipose tissue is closely related to bone mass, bone quality, and bone fractures, but the connection between fat and bone is complex and gender-related. Fat-water magnetic resonance imaging (MRI) and MR spectroscopy (MRS) are very useful tools for identifying tissue fat. PURPOSE: To assess gender interactions between bone mineral density (BMD), bone marrow fat, and body mass index (BMI) in the elderly using fat-water MRI and MRS. STUDY TYPE: Prospective/cohort. POPULATION: Sixty-six women and 38 men (mean age, 62.3 years; range, 50-75 years), Asian. FIELD STRENGTH: A 1.5T MR equipped with a body and spine array coil. STEAM MRS and T2 * Dixon were performed. ASSESSMENT: Vertebral bone marrow fat ratio (MFR), BMI, and BMD were measured. Correlations between these variables and differences in bone density in MFR were assessed between participants, divided into three groups based on bone density. STATISTICAL TESTS: Multiple regression; Pearson tests; analysis of covariance; analysis of variance. RESULTS: Multiple regression analysis identified gender, vertebral bone MFR, and BMI as significant predictors of vertebral BMD (P < 0.001). Among the women, vertebral BMD was negatively correlated with vertebral MFR (P = 0.011), but among the men, it was positively correlated with BMI (P = 0.048), although this relationship was confounded by age and MFR. Moreover, vertebral bone marrow fat and BMI were indeed statistically uncorrelated in the elderly (P = 0.357 in women; P = 0.961 in men). DATA CONCLUSION: We found gender interactions between fat and bone in the elderly. Higher bone marrow fat was correlated with lower trabecular BMD in older women but not in men. On the other hand, the positive correlation between BMI and BMD was more pronounced in men than in women. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019.

8.
Semin Musculoskelet Radiol ; 23(4): 453-464, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31509872

RESUMO

Osteoporosis will become even more prevalent as the world population ages. Radiologists are well placed to recognize this disease that often first manifests on routine imaging studies. Most radiologists encounter patients with osteoporosis during their normal daily reporting. Osteoporosis is prone to potential pitfalls on imaging, and the more common of these are outlined in this review.

9.
Quant Imaging Med Surg ; 9(3): 521-529, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31032198

RESUMO

This special report introduces native flow quantitative imaging for evaluating stroke risk. Moreover, the advantage of combining three imaging techniques [magnetic resonance angiography (MRA), phase-contrast (PC) flow imaging, and arterial spin-labeling imaging] is shown to be beneficial for responding to ischemia and preserving viable neurons. These quantitative imaging techniques provide authoritative information for diagnosing impending stroke and selecting appropriate treatment.

10.
Eur Radiol ; 29(9): 4999-5006, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30847590

RESUMO

OBJECTIVE: To investigate the relationship between paraspinal and psoas muscle volumes and acute osteoporotic or low-bone-mass compression fractures of the lumbar spine in postmenopausal women. METHODS: Patient data were retrieved retrospectively for postmenopausal women with L-spine magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry showing osteoporosis/low bone mass. Group 1 comprised eight women aged 60-80 years with MRI showing a single acute compression fracture. The age-matched group 2a (N = 12) and younger group 2b (N = 12) comprised of women whose MRIs showed no fractures. Cross-sectional MRIs of the paraspinal and psoas muscles and intramuscular fat volume for each muscle group were measured. Operator repeatability and reproducibility were obtained. RESULTS: Group 1 showed significantly smaller lean muscle volume for all muscle groups at L5/S1. Intramuscular fat volume was also smaller in most muscle groups in group 1, though only reaching statistical significance at variable muscle groups and levels. Measurements show both good intrarater repeatability and interrater reproducibility of lean muscle volume estimations (intraclass correlation coefficient (ICC), 0.999 for rater A and 0.997 for rater B; Cronbach's alpha 0.995) and intramuscular fat volume estimations (ICC, 0.995 for rater A and 0.982 for rater B; Cronbach's alpha was 0.981). CONCLUSIONS: This study provides the first quantitative evidence that compression fractures in postmenopausal women with underlying osteoporosis/low bone mass are associated with less paraspinal and psoas muscle volumes. Further longitudinal studies with larger cohorts are needed to verify this relationship. KEY POINTS: • The risk of osteoporotic compression fractures is higher in older women with smaller paraspinal muscle volume. • Older women show smaller paraspinal muscle volume and more intramuscular fat compared to younger controls.


Assuntos
Fraturas por Compressão/patologia , Vértebras Lombares/lesões , Imagem por Ressonância Magnética , Fraturas por Osteoporose/patologia , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/patologia , Fraturas da Coluna Vertebral/patologia , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fraturas por Compressão/diagnóstico por imagem , Humanos , Estudos Longitudinais , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/diagnóstico por imagem , Fraturas por Osteoporose/diagnóstico por imagem , Músculos Psoas/patologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fraturas da Coluna Vertebral/diagnóstico por imagem
11.
Eur Radiol ; 29(8): 4514-4522, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30617477

RESUMO

OBJECTIVES: Our aim was to investigate the role of age, sex, and location on MR T2* values of the knee cartilage in asymptomatic controls and patients with osteoarthritis (OA). METHODS: A total of 100 participants, including 40 with OA and 60 asymptomatic controls, were enrolled in this study. Patients with OA were compared to age- (≥ 41 years old) and sex-matched controls. Controls were divided by age (aged 21-40 years, 41-60, ≥ 61). T2* values were acquired using a T2*-weighted fast gradient-echo sequence and a 1.5-T MRI scanner. T2* values of the femoral and tibial cartilages at the weight-bearing areas were obtained for comparisons. RESULTS: The T2* values significantly increased with age and were significantly higher in the medial femoral cartilage (35.96 ± 4.06 and 31.85 ± 2.44 ms), medial tibial cartilage (30.95 ± 2.87 and 28.24 ± 1.74 ms), and lateral femoral cartilage (33.90 ± 3.15 and 31.51 ± 2.28 ms) in OA patients versus age- and sex-matched controls. Among OA patients, the T2* values for women exceed those in men in the medial femoral cartilage (37.59 ± 4.43 and 34.16 ± 2.63 ms) and medial tibial cartilage (32.17 ± 2.59 and 29.62 ± 2.53 ms; p < 0.01). Correlations were found between the Lequesne index and the T2* values for the medial femoral cartilage (r = 0.636, p < 0.001) and the medial tibial cartilage (r = 0.433, p = 0.005). CONCLUSION: Cartilage T2* values tend to increase with age and are useful in assessing cartilage degeneration in early OA. KEY POINTS: • Age, sex, and location have important effects on cartilage T2* values at the knee. • MR T2* measurements are useful toward assessing cartilage degeneration. • The medial femoral and tibial cartilage T2* values correlate well with disease severity.


Assuntos
Cartilagem Articular/patologia , Articulação do Joelho/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Osteoartrite do Joelho/diagnóstico , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
12.
Acta Radiol ; 60(1): 61-67, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29665705

RESUMO

BACKGROUND: Multiple rounds of head computed tomography (CT) scans increase the risk of radiation-induced lens opacification. PURPOSE: To investigate the effects of CT eye shielding and topogram-based tube current modulation (TCM) on the radiation dose received by the lens and the image quality of nasal and periorbital imaging. MATERIAL AND METHODS: An anthropomorphic phantom was CT-scanned using either automatic tube current modulation or a fixed tube current. The lens radiation dose was estimated using cropped Gafchromic films irradiated with or without a shield over the orbit. Image quality, assessed using regions of interest drawn on the bilateral extraorbital areas and the nasal bone with a water-based marker, was evaluated using both a signal-to-noise ratio (SNR) and contrast-noise ratio (CNR). Two CT specialists independently assessed image artifacts using a three-point Likert scale. RESULTS: The estimated radiation dose received by the lens was significantly lower when barium sulfate or bismuth-antimony shields were used in conjunction with a fixed tube current (22.0% and 35.6% reduction, respectively). Topogram-based TCM mitigated the beam hardening-associated artifacts of bismuth-antimony and barium sulfate shields. This increased the SNR by 21.6% in the extraorbital region and the CNR by 7.2% between the nasal bones and extraorbital regions. The combination of topogram-based TCM and barium sulfate or bismuth-antimony shields reduced lens doses by 12.2% and 27.2%, respectively. CONCLUSION: Image artifacts induced by the bismuth-antimony shield at a fixed tube current for lenticular radioprotection were significantly reduced by topogram-based TCM, which increased the SNR of the anthropomorphic nasal bones and periorbital tissues.


Assuntos
Encéfalo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Cristalino , Proteção Radiológica/métodos , Tomografia Computadorizada por Raios X/métodos , Cabeça/diagnóstico por imagem , Neuroimagem/métodos , Imagens de Fantasmas , Doses de Radiação
13.
Korean J Radiol ; 19(6): 1147-1160, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30386146

RESUMO

Soft-tissue calcification refers to a broad category of lesions. Calcifications are frequently identified by radiologists in daily practice. Using a simple algorithm based on the distribution pattern of the lesions and detailed clinical information, these calcified lesions can be systematically evaluated. The distribution pattern of the calcific deposits enables initial division into calcinosis circumscripta and calcinosis universalis. Using laboratory test results (serum calcium and phosphate levels) and clinical history, calcinosis circumscripta can be further categorized into four subtypes: dystrophic, iatrogenic, metastatic, and idiopathic calcification. This pictorial essay presents a systematic approach to the imaging features of soft-tissue calcifications and related diseases.


Assuntos
Calcinose/diagnóstico , Insuficiência Venosa/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico por imagem , Cálcio/sangue , Feminino , Humanos , Artropatias/diagnóstico , Artropatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Esclerose Calcificante da Média de Monckeberg/diagnóstico , Esclerose Calcificante da Média de Monckeberg/diagnóstico por imagem , Fosfatos/sangue , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/diagnóstico por imagem , Malformações Vasculares/diagnóstico , Malformações Vasculares/diagnóstico por imagem , Insuficiência Venosa/diagnóstico por imagem , Adulto Jovem
14.
J Chin Med Assoc ; 81(12): 1017-1026, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30017809

RESUMO

Renal cysts are common incidental findings in clinical practice. Most renal cysts detected in medical imaging are benign simple cysts. However, some are complicated by hemorrhage or infection or are associated with calcification. In these instances, difficulties can be encountered distinguishing the complicated cysts from cystic renal tumors such as cystic renal cell carcinoma, multilocular cystic nephroma, and mixed epithelial and stromal tumors. The Bosniak classification is widely used to categorize cystic renal lesions but is used to classify those discovered via computed tomography. Ultrasonography (US) and color Doppler US are the most frequently used imaging techniques for abdominal surveys and long-term follow-up because of their noninvasiveness, relatively low cost, wide availability, and frequently, lack of contrast medium. Herein, we review the features of various cystic lesions of the kidney that can be found using US, discuss differential diagnoses using US, and propose a feature-oriented algorithmic approach to classifying renal cystic lesions using US.


Assuntos
Doenças Renais Císticas/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Doenças Renais Císticas/patologia , Doenças Renais Císticas/terapia , Masculino , Pessoa de Meia-Idade
15.
Sci Rep ; 8(1): 10642, 2018 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-30006555

RESUMO

We aimed to determine relationships between age and sex with cytokine content and distribution in human platelet-rich fibrin (PRF) gel. Rabbit PRF was harvested from whole blood (n = 6). Human PRF was collected from 36 healthy volunteers (1:1 men:women) without systemic diseases and not current undergoing medical treatment. Histological analysis and optical microscopy were used to assess the three-dimensional structure of the PRF network. Enzyme-linked immunosorbent assays, quantification of adenosine triphosphate, and bioluminescence imaging of PRF sections were used to assess cytokine and entrapped platelet distribution. Three-dimensional structures of fibrin networks revealed concentration gradients of the platelet-derived growth factor beta beta homodimer and the transforming growth factor-beta 1. Histological analysis of PRF sections (from the red blood cell end to the plasma end of a clot) showed a gradual increase in average porosity, most prominently in PRF clots from young and middle-aged men and women, and a decrease in compactness along the longitudinal axis of the PRF gel. The end of the PRF gel closest to the red blood cell layer is the essence of the PRF clot, and the ability to generate platelets depends on sex and age in humans.


Assuntos
Plaquetas , Citocinas/análise , Fibrina Rica em Plaquetas/química , Adulto , Fatores Etários , Animais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Coelhos , Fatores Sexuais , Engenharia Tecidual , Adulto Jovem
17.
Eur Radiol ; 28(12): 5376-5383, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29948071

RESUMO

OBJECTIVES: Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated contrast medium (CM) extravasation in our institution and to compare our management protocol to current practice. METHODS: Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. RESULTS: The incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20-40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. CONCLUSIONS: Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. KEY POINTS: • The incidence of large-volume contrast medium extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.


Assuntos
Tratamento Conservador/métodos , Meios de Contraste/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/epidemiologia , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , China , Extravasamento de Materiais Terapêuticos e Diagnósticos/terapia , Feminino , Humanos , Incidência , Injeções Intravenosas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
J Tradit Complement Med ; 8(2): 289-295, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29736384

RESUMO

Under the concept of meridian channels that belongs to traditional Chinese medicine, BIOCERAMIC Resonance (BR) has already been applied to many clinical medical research projects with functions mimicking of traditional acupuncture. Forty-five patients were recruited with chronic sleep disorders; 36 patients were given, applied to the device with BIOCERAMIC material and sound rhythm on chest skin surface; 9 patients were included as controls. All study participants completed a sleep pattern and quality of life questionnaire (assessment on psychological and physical causes of sleep disturbances), which was repeated before, during and after treatment. Electroencephalograph (EEG) recordings were analyzed before, during and after treatment. Functional MRI (fMRI) was also used for demonstration of BR effect for another 8 candidates. During the first 3 days of treatment, sleep quality improved in all 36 patients especially to psychological reasons; in 91.7% (33/36) treatment was associated with an elevation in the beta spectrum of the EEG (at 15-27 Hz). The result of fMRI found corresponding cerebral and cerebellar areas of activation and deactivation. BIOCERAMIC Resonance can improve sleep disorder due to psychological causes, with transient alter brain wave activity and functional activation on specific locations of brain.

20.
Oncotarget ; 9(1): 1169-1186, 2018 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-29416685

RESUMO

Estrogen deficiency usually leads to bone loss and osteoporosis in postmenopausal women. Osteoblasts play crucial roles in bone formation. However, osteoblast functions are influenced by mitochondrial bioenergetic conditions. In this study, we investigated the roles of the estrogen and estrogen receptor alpha (ERα) axis in mitochondrial energy metabolism and subsequent osteoblast mineralization. Exposure of rat calvarial osteoblasts to estradiol caused substantial improvements in alkaline phosphatase activities and cell calcification. In parallel, treatment of human osteoblast-like U2OS cells, derived from a female osteosarcoma patient, with estradiol specifically augmented ERα levels. Sequentially, estradiol stimulated translocation of ERα to nuclei in human osteoblasts and induced expressions of genomic respiratory chain complex NDUFA10, UQCRC1, cytochrome c oxidase (COX)8A, COX6A2, COX8C, COX6C, COX6B2, COX412, and ATP12A genes. Concurrently, estradiol stimulated translocation of ERα to mitochondria from the cytoplasm. A bioinformatic search found the existence of four estrogen response elements in the 5'-promoter region of the mitochondrial cox i gene. Interestingly, estradiol induced COX I mRNA and protein expressions in human osteoblasts or rat calvarial osteoblasts. Knocking-down ERα translation concurrently downregulated estradiol-induced COX I mRNA expression. Consequently, exposure to estradiol led to successive increases in the mitochondrial membrane potential, the mitochondrial enzyme activity, and cellular adenosine triphosphate levels. Taken together, this study showed the roles of the estradiol/ERα signaling axis in improving osteoblast maturation through upregulating the mitochondrial bioenergetic system due to induction of definite chromosomal and mitochondrial complex gene expressions. Our results provide novel insights elucidating the roles of the estrogen/ERα alliance in regulating bone formation.

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