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1.
J Clin Med ; 11(8)2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35456218

RESUMO

Traumatic intraventricular hemorrhage (tIVH) is associated with increased mortality and disability in traumatic brain injury (TBI). However, the significance of tIVH itself remains unclear. Our goal is to assess whether tIVH affects in-hospital mortality and short-term functional outcomes. We retrospectively reviewed the records of 5048 patients with TBI during a 5-year period, and 149 tIVH patients were analyzed. Confounding was reduced using the inverse probability of treatment weighting (IPTW) based on propensity score. The association between IVH and outcomes was investigated using logistic regression in the IPTW-adjusted cohort. In our study, after adjustment for analysis, the in-hospital mortality rate (11.4% vs. 9.2%) and the poor functional outcome rate (37.9% vs.10.6%) were significantly higher in the tIVH group than in the non-tIVH group. Factors independently associated with outcomes were age ≥ 65 years, Glasgow Coma Scale (GCS) severity score, and the Graeb score. The Traumatic Graeb Score, a novel scoring system for predicting functional outcomes associated with tIVH, comprised the sum of the following components: GCS scores of 3 to 4 (=2 points), 5 to 12 (=1 point), 13 to 15 (=0 points); age ≥ 65 years, yes (=1 point), no (=0 points); Graeb score (0-12 points). A Traumatic Graeb Score ≥ 4 is an optimal cutoff value for poor short-term functional outcomes.

2.
J Pers Med ; 12(4)2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35455628

RESUMO

OBJECTIVE: The chest tube drainage system (CTDS) of choice for the pleural cavity after pulmonary resection remains controversial. This systematic review and network meta-analysis (NMA) aimed to assess the length of hospital stay, chest tube placement duration, and prolonged air leak among different types of CTDS. METHODS: This systemic review and NMA included 21 randomized controlled trials (3399 patients) in PubMed and Embase until 1 June 2021. We performed a frequentist random effect in our NMA, and a P-score was adopted to determine the best treatment. We assessed the clinical efficacy of different CTDSs (digital/suction/non-suction) using the length of hospital stay, chest tube placement duration, and presence of prolonged air leak. RESULTS: Based on the NMA, digital CTDS was the most beneficial intervention for the length of hospital stay, being 1.4 days less than that of suction CTDS (mean difference (MD): -1.40; 95% confidence interval (CI): -2.20 to -0.60). Digital CTDS also had significantly reduced chest tube placement duration, being 0.68 days less than that of suction CTDSs (MD: -0.68; 95% CI: -1.32 to -0.04). Neither digital nor non-suction CTDS significantly reduced the risk of prolonged air leak. CONCLUSIONS: Digital CTDS is associated with better outcomes than suction and non-suction CTDS for patients undergoing pulmonary resections, specifically 0.68 days shorter chest tube duration and 1.4 days shorter hospital stay than suction CTDS.

3.
Obes Surg ; 32(4): 1397-1398, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35157196

RESUMO

In March 2020, the coronavirus disease 2019 (COVID-19) outbreak was declared as a pandemic by the World Health Organization. The COVID-19 breached the Taiwanese government's defense, and the Central Epidemic Command Center (CECC) announced a Nationwide Level 3 Alert on May 19, 2021. In summary, the residency training has been affected as follows: less exposure to elective surgeries and decreased training time. In the COVID-19 pandemic era, both my life and career as a surgical resident have been deeply affected. Worries, anxiety, and fear about insufficient training, unfulfilled career development, and unknown future have been prevalent daily. However, surgeons have always managed to confront and overcome difficulties and challenges with courage and fearlessness. Hence, it is also important that we face the COVID-19 pandemic situation and adapt wisely.


Assuntos
COVID-19 , Internato e Residência , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Pandemias , SARS-CoV-2
4.
J Nanobiotechnology ; 20(1): 6, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983543

RESUMO

BACKGROUND: Gold nanoparticles (AuNPs) have been widely used in local surface plasmon resonance (LSPR) immunoassays for biomolecule sensing, which is primarily based on two conventional methods: absorption spectra analysis and colorimetry. The low figure of merit (FoM) of the LSPR and high-concentration AuNP requirement restrict their limit of detection (LOD), which is approximately ng to µg mL-1 in antibody detection if there is no other signal or analyte amplification. Improvements in sensitivity have been slow in recent for a long time, and pushing the boundary of the current LOD is a great challenge of current LSPR immunoassays in biosensing. RESULTS: In this work, we developed spectral image contrast-based flow digital nanoplasmon-metry (Flow DiNM) to push the LOD boundary. Comparing the scattering image brightness of AuNPs in two neighboring wavelength bands near the LSPR peak, the peak shift signal is strongly amplified and quickly detected. Introducing digital analysis, the Flow DiNM provides an ultrahigh signal-to-noise ratio and has a lower sample volume requirement. Compared to the conventional analog LSPR immunoassay, Flow DiNM for anti-BSA detection in pure samples has an LOD as low as 1 pg mL-1 within only a 15-min detection time and 500 µL sample volume. Antibody assays against spike proteins of SARS-CoV-2 in artificial saliva that contained various proteins were also conducted to validate the detection of Flow DiNM in complicated samples. Flow DiNM shows significant discrimination in detection with an LOD of 10 pg mL-1 and a broad dynamic detection range of five orders of magnitude. CONCLUSION: Together with the quick readout time and simple operation, this work clearly demonstrated the high sensitivity and selectivity of the developed Flow DiNM in rapid antibody detection. Spectral image contrast and digital analysis further provide a new generation of LSPR immunoassay with AuNPs.


Assuntos
Teste Sorológico para COVID-19/métodos , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , Ressonância de Plasmônio de Superfície/métodos , Anticorpos Antivirais/imunologia , COVID-19/imunologia , Teste Sorológico para COVID-19/instrumentação , Desenho de Equipamento , Ouro/química , Humanos , Imunoensaio/instrumentação , Imunoensaio/métodos , Nanopartículas Metálicas/química , SARS-CoV-2/imunologia , Saliva/virologia , Glicoproteína da Espícula de Coronavírus/imunologia , Ressonância de Plasmônio de Superfície/instrumentação
5.
World Neurosurg ; 157: e173-e178, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34610447

RESUMO

OBJECTIVE: To assess the predictive value of swab cultures of cryopreserved skull flaps during cranioplasties for surgical site infections (SSIs). METHODS: A retrospective review was conducted of consecutive patients who underwent delayed cranioplasties with cryopreserved autografts between 2009 and 2017. The results of cultures obtained from swabs and infected surgical sites were assessed. The accuracy, sensitivity, and specificity of swab cultures for SSIs were evaluated. RESULTS: The study included 422 patients categorized into two groups, swab and nonswab, depending on whether swab cultures were implemented during cranioplasties. The overall infection rate was 7.58%. No difference was seen in infection rates between groups. There were 18 false-positive and no true-positive swab culture results. All bacteria between swab cultures and SSI cultures were discordant. Meanwhile, there were 19 false-negative swab cultures. The results showed high specificity but low sensitivity for swab cultures to predict SSI occurrence and the pathogens. CONCLUSIONS: Owing to low accuracy and sensitivity, swab cultures of cryopreserved autografts should not be routinely performed during delayed cranioplasties.


Assuntos
Carga Bacteriana/métodos , Craniotomia/efeitos adversos , Criopreservação/métodos , Manejo de Espécimes/métodos , Retalhos Cirúrgicos/microbiologia , Infecção da Ferida Cirúrgica/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carga Bacteriana/tendências , Criança , Pré-Escolar , Craniotomia/tendências , Criopreservação/tendências , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Manejo de Espécimes/tendências , Retalhos Cirúrgicos/transplante , Infecção da Ferida Cirúrgica/etiologia , Técnicas de Cultura de Tecidos/métodos , Técnicas de Cultura de Tecidos/tendências , Adulto Jovem
6.
Sci Rep ; 11(1): 15217, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34312476

RESUMO

The standard size of bougie for laparoscopic sleeve gastrectomy (LSG) is not yet established. Therefore, a systematic review and network meta-analysis were conducted to assess the weight loss effects and associated complications of LSG for patients with morbid obesity, based on different bougie sizes. A total of 15 studies were reviewed in this systemic review and network meta-analysis (2,848 participants), including RCTs and retrospective studies in PubMed, and Embase until September 1, 2020. The effectiveness of different bougie calibration sizes was assessed based on excess weight loss (EWL), total complications, and staple line leak. Within this network meta-analysis, S-sized (≤ 32 Fr.) and M-sized (33-36 Fr.) bougies had similar effects and were associated with the highest EWL improvement among all different bougie sizes (S-sized: standardized mean difference [SMD], 10.52; 95% confidence interval [CI] - 5.59 to - 26.63, surface under the cumulative ranking curve [SUCRA], 0.78; and M-sized: SMD, 10.16; 95% CI - 3.04-23.37; SUCRA, 0.75). M-sized bougie was associated with the lowest incidence of total complications (M-sized: odds ratio, 0.43; 95% CI, 0.16-1.11; SUCRA, 0.92). Based on our network meta-analysis, using M-sized bougie (33-36 Fr.) is an optimal choice to balance the effectiveness and perioperative safety of LSG in the clinical practice.


Assuntos
Cirurgia Bariátrica/instrumentação , Gastrectomia/instrumentação , Laparoscopia/instrumentação , Cirurgia Bariátrica/métodos , Calibragem , Gastrectomia/métodos , Humanos , Laparoscopia/métodos
9.
Obes Surg ; 31(8): 3653-3659, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33982242

RESUMO

PURPOSE: Laparoscopic gastric clipping (LGC) is a relatively novel restrictive bariatric surgery wherein a horizontal metallic clip is applied to the gastric fundus. Its intraoperative complications or the difficulties associated with the applied gastric clip (GC) during revisional procedures have seldom been mentioned. Herein, the experience of revisional procedures after initial gastric clipping is reported. MATERIALS AND METHODS: A retrospective cohort review of LGC based on the Taiwan Bariatric Registry of Taiwan Society Metabolic and Bariatric Surgery was performed. Six patients with severe obesity presented for revisional surgery after initial LGC by other surgeons. Patients' characteristics, indications, and details of revisional surgery were recorded. RESULTS: Between 2012 and 2019, 39 patients who underwent pure LGC and six patients with previous LGC history were referred for revisional surgery. Their mean age and the mean body mass index were 34.7 ± 9.5 years and 38.4 ± 10.5 kg/m2, respectively. Three, two, and one patient underwent revisional surgery for insufficient weight loss, weight recidivism, and intractable belching, respectively. The mean interval between initial LGC and revisional surgery was 40.5 ± 22.4 months. Laparoscopic removal of the GC with concomitant revisional surgeries were collected, including a revision to sleeve gastrectomy (n = 5) and revision to Roux-en-Y gastric bypass (n = 1). Moreover, the mean operative time was 286.8 ± 78.2 min. All patients had uneventful recovery postoperatively but experienced significant adhesion around the GC and the left liver. CONCLUSION: Laparoscopic revisional surgery with concomitant GC removal for patients with severe obesity after gastric clipping could be feasibly conducted by experienced bariatric surgeons.


Assuntos
Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Gastrectomia , Humanos , Obesidade Mórbida/cirurgia , Reoperação , Estudos Retrospectivos , Taiwan/epidemiologia , Resultado do Tratamento
10.
Chem Commun (Camb) ; 57(28): 3468-3471, 2021 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-33688902

RESUMO

Herein, we applied PmST1 (a sialyltransferase) to achieve acceptor-mediated regioselective sialylation (AMRS) on the nonreducing end GalNH2 or GalAz (2-azido-2-deoxy galactose). Thus, C5 and C8-modified sialic acid was efficiently assembled on GalNH2 (or GalAz) to achieve the synthesis of the GAA-7 (one of the echinodermatous gangliosides with higher neuritogenic activity) glycan moiety.


Assuntos
Gangliosídeos/biossíntese , Ácido N-Acetilneuramínico/metabolismo , Polissacarídeos/biossíntese , Sialiltransferases/metabolismo , Biocatálise , Configuração de Carboidratos , Gangliosídeos/química , Ácido N-Acetilneuramínico/química , Polissacarídeos/química , Estereoisomerismo
11.
Eur J Phys Rehabil Med ; 57(4): 568-576, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33733719

RESUMO

BACKGROUND: Motor impairments in children with cerebral palsy significantly reduce their ability to learn and adapt bimanual actions into their life roles. The current evidence on bimanual coordination performance in children with hemiplegic cerebral palsy were mostly drawn from kinematic studies. Whether these kinematic findings on bimanual motor performance can be observed when performing daily life activities in a natural environment is not clear. Further, there is no evidence what and how the verbal prompting influences bilateral motor performance. We intend to explore its role on bimanual motor performance as well. AIM: This study aimed to investigate the bimanual motor performance in everyday life activities of children with hemiplegic cerebral palsy and the role of verbal prompts in facilitating affected hand use. DESIGN: This is an observational study. SETTING: Local medical center and community. POPULATION: Twenty-five children with hemiplegic cerebral palsy and 25 age-matched typically developing children. METHODS: The Observation-based Test of Capacity, Performance, and Developmental Disregard and Melbourne Assessment 2 were used to assess the quantitative and qualitative use of hands in everyday activities. RESULTS: Children with hemiplegic cerebral palsy, demonstrated different motor coordination patterns in daily bimanual activities compared with their counterparts. With verbal prompts, children with hemiplegic cerebral palsy significantly increased the use of their affected hands in bimanual activities. However, the increases were observed only in basic motor components, such as reaching and grasping, and not in complex motor components such as manipulation. CONCLUSIONS: These findings will assist researchers and clinicians to develop and refine intervention programs that maximize rehabilitation benefits in improving bimanual hand coordination performance for children with hemiplegic cerebral palsy. CLINICAL REHABILITATION IMPACT: This study increased our understanding of bimanual motor performance of children with hemiplegic cerebral palsy in everyday life activities. The results demonstrated children with cerebral palsy rely more on their less-affected hand to perform bimanual activities with or without verbal prompts. Incorporating bimanual activities and verbal prompts during intervention may only be effective on facilitating basic hand movements but not on improving complex movements of affected hands. Further research is needed to explore other intervention strategies to facilitate complex bilateral hand movements.


Assuntos
Atividades Cotidianas , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/reabilitação , Terapia por Exercício/métodos , Hemiplegia/fisiopatologia , Hemiplegia/reabilitação , Extremidade Superior/fisiopatologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos
12.
Oncogenesis ; 10(1): 11, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33446631

RESUMO

The metabolic changes in melanoma cells that are required for tumor metastasis have not been fully elucidated. In this study, we show that the increase in glucose uptake and mitochondrial oxidative phosphorylation confers metastatic ability as a result of aryl hydrocarbon receptor nuclear translocator (ARNT) deficiency. In clinical tissue specimens, increased ARNT, pyruvate dehydrogenase kinase 1 (PDK1), and NAD(P)H quinine oxidoreductase-1 (NQO1) was observed in benign nevi, whereas lower expression was observed in melanoma. The depletion of ARNT dramatically repressed PDK1 and NQO1 expression, which resulted in an increase of ROS levels. The elimination of ROS using N-acetylcysteine (NAC) and inhibition of oxidative phosphorylation using carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and rotenone inhibited the ARNT and PDK1 deficiency-induced cell migration and invasion. In addition, ARNT deficiency in tumor cells manipulated the glycolytic pathway through enhancement of the glucose uptake rate, which reduced glucose dependence. Intriguingly, CCCP and NAC dramatically inhibited ARNT and PDK1 deficiency-induced tumor cell extravasation in mouse models. Our work demonstrates that downregulation of ARNT and PDK1 expression serves as a prognosticator, which confers metastatic potential as the metastasizing cells depend on metabolic changes.

13.
Obes Surg ; 30(10): 4081-4090, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32734569

RESUMO

We conducted a systematic review and meta-analysis to assess the efficacy of intragastric BTA injection in patients with obesity and morbid obesity. Five RCTs were identified. Intragastric BTA injection was no superior to saline in absolute weight loss or BMI change, but significantly lengthened the gastric emptying time (MD, 15.57; 95% CI, 8.75 to 22.38). In meta-regression analysis, the absolute weight loss was lower in the patients with high baseline BMI. In subgroup analysis, the use of BTA in absolute weight loss was significantly lower among the patients with baseline BMI more than 40 kg/m2 (MD, - 5.31; 95% CI, - 6.17 to - 4.45). The benefit of intragastric BTA injection in reduction of absolute weight was observed in patients with baseline BMI more than 40 kg/m2.


Assuntos
Toxinas Botulínicas Tipo A , Obesidade Mórbida , Índice de Massa Corporal , Humanos , Injeções , Obesidade Mórbida/cirurgia , Perda de Peso
14.
Cancer Sci ; 111(6): 2004-2015, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32227417

RESUMO

Epidermal growth factor receptor (EGFR) expression and activation are the major causes of metastasis in cancers such as head and neck squamous cell carcinoma (HNSCC). However, the reciprocal effect of EGF-induced COX-2 and angiopoietin-like 4 (ANGPTL4) on HNSCC metastasis remains unclear. In this study, we revealed that the expression of ANGPTL4 is essential for COX-2-derived prostaglandin E2 (PGE2 )-induced tumor cell metastasis. We showed that EGF-induced ANGPTL4 expression was dramatically inhibited with the depletion and inactivation of COX-2 by knockdown of COX-2 and celecoxib treatment, respectively. Prostaglandin E2 induced ANGPTL4 expression in a time- and dose-dependent manners in various HNSCC cell lines through the ERK pathway. In addition, the depletion of ANGPTL4 and MMP1 significantly impeded the PGE2 -induced transendothelial invasion ability of HNSCC cells and the binding of tumor cells to endothelial cells. The induction of molecules involved in the regulation of epithelial-mesenchymal transition was also dependent on ANGPTL4 expression in PGE2 -treated cells. The depletion of ANGPTL4 further blocked PGE2 -primed tumor cell metastatic seeding of lungs. These results indicate that the EGF-activated PGE2 /ANGPTL4 axis enhanced HNSCC metastasis. The concurrent expression of COX-2 and ANGPTL4 in HNSCC tumor specimens provides insight into potential therapeutic targets for the treatment of EGFR-associated HNSCC metastasis.


Assuntos
/metabolismo , Ciclo-Oxigenase 2/metabolismo , Fator de Crescimento Epidérmico/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Animais , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica/fisiologia , Neoplasias de Cabeça e Pescoço/metabolismo , Xenoenxertos , Humanos , Masculino , Camundongos , Camundongos SCID , Invasividade Neoplásica/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Regulação para Cima
15.
PLoS One ; 14(5): e0216946, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31083701

RESUMO

Antimicrobial peptides (AMPs) are important components of the host innate defense mechanism against invading microorganisms. Although AMPs are known to act on bacterial membranes and increase membrane permeability, the action mechanism of most AMPs still remains unclear. In this report, we found that the TP4 peptides from Nile tilapia anchored on E. coli cells and enabled them permeable to SYTOX Green in few minutes after TP4 addition. TP4 peptides existed in small dots either on live or glutaraldehyde-fixed cells. TP4 peptides were driven into oligomers either in soluble or insoluble form by a membrane-mimicking anionic surfactant, sarkosyl, depending on the concentrations employed. The binding forces among TP4 components were mediated through hydrophobic interaction. The soluble oligomers were negatively charged on surface, while the insoluble oligomers could be fused with each other or piled on existing particles to form larger particles with diameters 0.1 to 20 µm by hydrophobic interactions. Interestingly, the morphology and solubility of TP4 particles changed with the concentration of exogenous sarkosyl or trifluoroethanol. The TP4 peptides were assembled into oligomers on or in bacterial membrane. This study provides direct evidence and a model for the oligomerization and insertion of AMPs into bacterial membrane before entering into cytosol.


Assuntos
Antibacterianos/química , Peptídeos Catiônicos Antimicrobianos/química , Membrana Celular/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Proteínas de Peixes/química , Tensoativos/farmacologia , Animais , Antibacterianos/isolamento & purificação , Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/isolamento & purificação , Peptídeos Catiônicos Antimicrobianos/farmacologia , Transporte Biológico , Membrana Celular/metabolismo , Permeabilidade da Membrana Celular/efeitos dos fármacos , Ciclídeos/fisiologia , Escherichia coli/metabolismo , Proteínas de Peixes/isolamento & purificação , Proteínas de Peixes/farmacologia , Corantes Fluorescentes/metabolismo , Interações Hidrofóbicas e Hidrofílicas , Compostos Orgânicos/metabolismo , Ligação Proteica , Multimerização Proteica , Sarcosina/análogos & derivados , Sarcosina/farmacologia , Eletricidade Estática , Trifluoretanol/farmacologia
16.
World Neurosurg ; 128: e276-e282, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31026655

RESUMO

OBJECTIVE: Acquired pial arteriovenous fistula (pAVF) is an extremely rare intracranial vascular malformation, with few case reports in the English literature. This study presents a thorough review and analysis of all acquired pAVF cases from the literature in addition to an illustrated case. METHODS: We report a case with de novo development of intracranial pAVF after craniotomy. A medical literature database search between 1975 and 2018, including the Medline, Ovid, and PubMed databases, was performed to identify all reports with possible acquired lesions. Differences between these acquired lesions and previously reported primary lesions were evaluated. RESULTS: A total of 8 patients with de novo formation of acquired pAVF were included in this series. Most of these pAVFs were fed and drained via a similar arteriovenous pattern, from distal/cortical branches of the middle cerebral artery (6/8, 75%) to the superficial middle cerebral vein (6/8, 75%). Compared with a previously reported primary pAVF series, acquired pAVF tended to be asymptomatic (P < 0.0001) and found essentially in adults (P = 0.0061). Fewer venous varices (P = 0.0049) and associated intracranial mass effect (P = 0.0189) were found in the cases of acquired pAVF. All 4 reported acquired pAVFs that were treated microsurgically resulted in complete angiographic obliteration (4/4, 100%). The overall outcome was good or stable even with observation only (7/8, 87.5%). CONCLUSIONS: Acquired pAVF is highly correlated with sentinel neurosurgical procedures or venous occlusion events. These lesions should be regarded as a different disease entity from primary pAVF because of the relatively low-flow shunting and benign clinical course.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Hemorragia Cerebral/cirurgia , Veias Cerebrais/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/cirurgia , Artéria Cerebral Média/diagnóstico por imagem , Pia-Máter , Complicações Pós-Operatórias/diagnóstico por imagem , Adulto , Angiografia Digital , Fístula Arteriovenosa/cirurgia , Angiografia Cerebral , Hemorragia Cerebral/etiologia , Veias Cerebrais/anormalidades , Angiografia por Tomografia Computadorizada , Humanos , Malformações Arteriovenosas Intracranianas/complicações , Masculino , Artéria Cerebral Média/anormalidades , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/cirurgia
17.
Expert Rev Vaccines ; 18(5): 433-437, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30920859

RESUMO

INTRODUCTION: Acne vulgaris afflicts many people, and despite the multitude of the anti-acne products on the market, there is still no effective treatment that can prevent and cure this disease. The severity of acne vulgaris is highly associated with the inflammatory response to Propionibacterium acnes (P. acnes) now referred to as Cutibacterium acnes (C. acnes), an opportunistic skin bacterium in the human skin microbiome. Areas covered: We here provide the prospects of creating acne vaccines targeting secreted virulence factors of C. acnes including secretory Christie-Atkins-Munch-Peterson (CAMP) factor. Neutralization of secreted virulence factors by either active or passive vaccination may have a lower risk of disturbing the microbial ecosystem in the human skin microbiome. Expert opinion: Major steps could be taken to start a public vaccination program at an early age to prevent the future occurrence of acne vulgaris. Future therapeutic monoclonal antibodies can be designed to specifically neutralize virulence factors of C. acnes including CAMP factors without disrupting the optimal balance of C. acnes in the human skin microbiome and lowering the risk of creating drug-resistant C. acnes. Targeting secreted virulence factors without disturbing the commensal relationship of host can be a novel gateway towards the therapeutic treatment of acne vulgaris.


Assuntos
Acne Vulgar/prevenção & controle , Acne Vulgar/terapia , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Vacinas Bacterianas/imunologia , Propionibacterium acnes/imunologia , Fatores de Virulência/imunologia , Acne Vulgar/imunologia , Anticorpos Antibacterianos/administração & dosagem , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Neutralizantes/imunologia , Vacinas Bacterianas/administração & dosagem , Humanos , Resultado do Tratamento , Fatores de Virulência/antagonistas & inibidores
18.
World Neurosurg ; 126: e1293-e1301, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30898758

RESUMO

BACKGROUND: Little is known about the state of medical education (ME) research in neurosurgery. As ME started to develop in neurosurgery in recent years, it is important to understand the current status and develop the theory for advancement in neurosurgery. The aim of this study was to undertake a scoping review of neurosurgery literature on ME research. METHODS: MEDLINE, SCOPUS, and PubMed databases were searched. Inclusion criteria were full-text articles in English published from January 2006 to December 2017. Research aspects included country of publication, annual number of publications, journal types, type of participants, frequently researched topics, and research design. Search terms included neurosurgery, medical education, teaching, training, learning, and curriculum. RESULTS: A total of 9863 references were found across 3 databases. After duplicate removal and further screening, 533 references remained for coding analysis. ME research activity in neurosurgery is increasing and commonly observed in Western countries. Identified articles were mostly quantitative, with curriculum, assessment (especially simulation), and teaching and learning being the most dominant research themes. CONCLUSIONS: This study highlights the need for enhanced quantity and quality of ME research in neurosurgery. It identifies areas of highest priority and aspects to be improved and provides us with a rationale for future development in ME in neurosurgery. These findings reveal future education research direction and programmatic research areas, while also establishing a benchmark to assess changes in educational scholarship over time.


Assuntos
Educação Médica , Neurocirurgia/educação , Humanos
19.
Br J Neurosurg ; 32(5): 501-508, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29749277

RESUMO

PURPOSE: Pituicytoma is a rare low-grade glioma arising from the pituicytes of the posterior pituitary. To date, the clinical and pathological correlates of pituicytoma have not been investigated. This study was thus designed to examine the correlation between pituicytoma and the normal pituitary gland. METHODS: The records of patients who underwent pituitary surgery at Chang Gung Memorial Hospital in Linkou, Taiwan between 2000 and 2016 were reviewed. Patients who received a pathological diagnosis of pituicytoma were included; however, those with inadequate specimens for pathological study were excluded. Clinical information, including patients' presenting symptoms, serum hormone levels, neuroimages, and specimens, were collected. Hematoxylin and eosin stains and immunohistochemical (IHC) stains were performed for differential diagnosis. RESULTS: Among the 1532 patients who underwent pituitary surgery, nine (0.59%) received a pathological diagnosis of pituicytoma. Two patients were excluded due to inadequate specimens. Among the seven remaining patients, six presented with hormone changes. The IHC stains revealed that pituicytoma has no secretory function; however, the resected pituitary glands showed positive results for hormone change. Coexisting pituicytoma and adrenocorticotropic hormone adenoma were identified in one patient with a diagnosis of Cushing disease. CONCLUSIONS: Pituicytoma revealed a negative endocrine secretory function through IHC staining. Additionally, pituicytoma is associated with hypersecretion of the pituitary gland both clinically and pathologically. Diagnosing pituicytoma before pathological confirmation is difficult because the tumour may present with hormone dysfunction. Therefore, IHC staining of specimens is useful to exclude the possibility of coexisting pituicytoma and pituitary adenoma.


Assuntos
Glioma/patologia , Neuro-Hipófise/patologia , Hormônios Hipofisários/metabolismo , Neoplasias Hipofisárias/patologia , Adenoma/patologia , Adulto , Craniofaringioma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipersecreção Hipofisária de ACTH/patologia
20.
Int J Mol Sci ; 19(5)2018 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-29693635

RESUMO

Unlike USA300, a strain of community-acquired methicillin-resistant Staphylococcus aureus (MRSA), commensal Staphylococcus aureus (S. aureus) bacteria isolated from human skin demonstrated the ability to mediate the glycerol fermentation to produce short-chain fatty acids (SCFAs). Quantitative proteomic analysis of enzymes involved in glycerol fermentation demonstrated that the expression levels of six enzymes, including glycerol-3-phosphate dehydrogenase (GPDH) and phosphoglycerate mutase (PGM), in commensal S. aureus are more than three-fold higher than those in USA300. Western blotting validated the low expression levels of GPDH in USA300, MRSA252 (a strain of hospital-acquired MRSA), and invasive methicillin-susceptible S. aureus (MSSA). In the presence of glycerol, commensal S. aureus effectively suppressed the growth of USA300 in vitro and in vivo. Active immunization of mice with lysates or recombinant α-hemolysin of commensal S. aureus or passive immunization with neutralizing sera provided immune protection against the skin infection of USA300. Our data illustrate for the first time that commensal S. aureus elicits both innate and adaptive immunity via glycerol fermentation and systemic antibody production, respectively, to fight off the skin infection of pathogenic MRSA.


Assuntos
Staphylococcus aureus Resistente à Meticilina/imunologia , Microbiota/imunologia , Infecções Cutâneas Estafilocócicas/imunologia , Animais , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Células Cultivadas , Feminino , Glicerol/metabolismo , Glicerolfosfato Desidrogenase/genética , Glicerolfosfato Desidrogenase/metabolismo , Imunização Passiva , Camundongos , Camundongos Endogâmicos ICR , Fosfoglicerato Mutase/genética , Fosfoglicerato Mutase/metabolismo , Pele/imunologia , Pele/microbiologia , Infecções Cutâneas Estafilocócicas/prevenção & controle
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