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1.
Interv Neuroradiol ; : 1591019919896940, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924102

RESUMO

PURPOSE: Diabetes mellitus indicated poor clinical prognosis for patients with acute ischemic stroke. Furthermore, diabetes mellitus could also impact the hemostatic system, while its influence on the histological composition of thrombus is unclear. METHODS: Consecutive patients with retrieved clots were included. Histologic staining for thrombus included hematoxylin and eosin, Martius Scarlet Blue, immunohistochemistry for von Willebrand factor. The differences in clot composition were compared according to diabetes mellitus history or hyperglycemia (≥7.8 mmol/L) on admission. RESULTS: A total of 52 patients were included; half of them were diagnosed as diabetes mellitus previously. Diabetic patients showed higher serum glucose on admission (8.90 vs. 7.40, p = 0.012). The baseline characteristics (expect smoking history and thrombus location), procedural, and clinical outcomes were similar between diabetic patients and nondiabetic patients. As for histologic composition, thrombus in patients with diagnosed diabetes mellitus had more fibrin (44.2% vs. 28.3%, p = 0.004) and fewer red blood cells (26.0% vs. 42.9%, p = 0.013) and equivalent content of platelets (24.0% vs. 21.5%, p = 0.694) and von Willebrand factor (0.041 vs. 0.031, p = 0.234) than patients without diabetes mellitus. However, there was no statistical difference in the content of red blood cells (41.6% vs. 27.3%, p = 0.105), fibrin (37.6% vs. 34.3%, p = 0.627), platelets (21.2% vs. 24.2%, p = 0.498), and von Willebrand factor (0.038 vs. 0.034, p = 0.284) between patients with or without hyperglycemia on admission. CONCLUSION: Clots in diabetic patients had more fibrin and fewer erythrocyte components compared with patients without diabetes mellitus, while hyperglycemia on admission did not show association with clot composition. Further studies are needed to confirm these results.

2.
J Reconstr Microsurg ; 35(7): 499-504, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30836413

RESUMO

BACKGROUND: End-to-end, end-to-side, and side-to-side microvascular anastomoses are the main types of vascular bypass grafting used in microsurgery and neurosurgery. Currently, there has been no animal model available for practicing all three anastomoses in one operation. The aim of this study was to develop a novel animal model that utilizes the rat abdominal aorta (AA), common iliac arteries (CIAs), and the median sacral artery (MSA) for practicing these three types of anastomosis. METHODS: Eight adult Sprague-Dawley rats were anesthetized and then laparotomized. The AA, MSA, and bilateral CIAs were exposed and separated from the surrounding tissues. The length and diameter of each artery were measured. The relatively long segment of the AA without major branches was selected to perform end-to-end anastomosis. One side of the CIAs (or AA) and MSA were used for end-to-side anastomosis. The bilateral CIAs were applied to a side-to-side and another end-to-side anastomosis. RESULTS: Anatomical dissection of the AA, CIAs, and MSA was successfully performed on eight Sprague-Dawley rats; four arterial-to-arterial anastomoses were possible for each animal. The AA trunk between the left renal artery and right iliolumbar arteries was 15.60 ± 0.76 mm in length, 1.59 ± 0.15 mm in diameter, for an end-to-end anastomosis. The left CIA was 1.06 ± 0.08 mm in diameter, for an end-to-side anastomosis with the right CIA. The MSA was 0.78 ± 0.07 mm in diameter, for another end-to-side anastomosis with the right CIA or AA. After finishing end-to-side anastomosis in the proximal part of bilateral CIAs, the distal portion was juxtaposed for an average length of 5.6 ± 0.25 mm, for a side-to-side anastomosis. CONCLUSION: This model can comprehensively and effectively simulate anastomosis used in revascularization procedures and can provide more opportunities for surgical education, which may lead to more routine use in microvascular anastomosis training.


Assuntos
Anastomose Cirúrgica/educação , Microcirurgia/educação , Procedimentos Cirúrgicos Vasculares/educação , Animais , Masculino , Modelos Animais , Ratos , Ratos Sprague-Dawley
3.
J Clin Neurosci ; 52: 41-49, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29550249

RESUMO

Carotid stenosis (CS) and intracranial aneurysms (IAs) may concur in one person. We studied the prevalence of IAs in CS patients in our retrospectively collected database and systematically reviewed this issue. Five hundred and fifty-seven CS (≥50%) patients confirmed by DSA in our hospital from 2010-06 to 2015-06 were screened for coexistent IAs. After searching the related literatures from English and Chinese journal literature databases, a meta-analysis was performed to pool the prevalence of CS with coexistent IAs. Subgroup analyses were performed to explore the causes of heterogeneity among studies. IAs were detected in 98(17.0%) out of the 577 CS patients. 12 literatures and the present study including a total of 6965 CS patients and 446 cases with coexistent IAs. The pooled prevalence of CS with coexistent IAs was 6.3% (95%CI: 4.2-8.3%) in all the CS patients. The pooled RR for female to male CS patients to have coexistent IAs was 1.67 (95%CI: 1.34-2.08, P = 0.000). 3 studies and the present study were carried out in Asian countries with a pooled prevalence of 10.8% (95%CI: 5.3-16.3%); 6 studies in European countries with 3.0% (95%CI: 2.2-3.7%); and 3 studies in USA with 6.0% (95%CI: 2.2-9.7%). There was a statistically significant difference between the three subgroups (P < 0.001). The prevalence of IAs in CS patients seems higher in our clinical study and the meta-analysis than in the general population and previously reported. The eastern and the women CS patients have a higher risk for coexistent IAs.


Assuntos
Estenose das Carótidas/complicações , Estenose das Carótidas/epidemiologia , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/epidemiologia , Adulto , Idoso , Ásia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
4.
Front Neurol ; 8: 508, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28993755

RESUMO

BACKGROUND: Extracranial internal carotid artery (eICA) tortuosity may trigger cerebral ischemia, and body mass index (BMI) is a measure of body mass based on height and weight. The main purpose of this study is to determine the influence of BMI on the tortuosity of eICA. METHODS: A total of 926 carotid artery angiograms were performed in 513 patients, of which 116 cases and matched controls were selected. Arterial tortuosity was defined as simple tortuosity, kinking, or coiling. The severity of tortuosity was measured by tortuosity index, formula: [(actual length/straight-line length - 1) × 100]. RESULTS: BMIs were different between the two groups [tortuosity: 27.06 kg/m2 (SD 2.81 kg/m2) versus none: 23.3 kg/m2 (SD 2.78 kg/m2); p < 0.001]. BMI was independently and significantly associated with eICA tortuosity (odds ratio 1.59; 95% confidence interval, 1.35-1.86; p < 0.001). eICA tortuosity index is linearly associated with BMI (exponential coefficient ß = 1.067, p < 0.001). The optimal predictive threshold of BMI for eICA tortuosity was 25.04 kg/m2. The physiological mechanism underlying the reasons why higher BMI has negative influence on extracranial carotid artery tortuosity may be an intra-abdominal hypertension caused by a much higher amount of body fat stored in visceral adipose tissue. CONCLUSION: Our result reveals a novel role for greater BMI on the presence of eICA tortuosity. For each increase in BMI of 1 kg/m2, there is a corresponding 1.59-fold increase in the risk of developing eICA tortuosity. The severity of eICA tortuosity increases linearly with increased BMI.

5.
Can J Vet Res ; 81(1): 22-27, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28154458

RESUMO

The objective of this study was to assess the efficacy of a trivalent inactivated Haemophilus parasuis serovars 4, 5, and 12 vaccine with polymeric adjuvant gel (GEL) and commercial vaccines against Glässer's disease in piglets. Commercial vaccines containing inactivated H. parasuis serovars 4 and 5 (China), inactivated H. parasuis serovars 1 and 6 (Spain), and inactivated H. parasuis serovar 5 (USA) were also evaluated. Our results demonstrated that the trivalent inactivated H. parasuis serovars 4, 5, and 12 vaccine with GEL adjuvant can provide better protection against the 3 most common pathogenic serovars circulating in China than other commercial vaccines tested. Our findings also indicated that inactivated H. parasuis serovars 1 and 6 vaccine cross-protects piglets against H. parasuis serovars 4 and 5; inactivated H. parasuis serovar 5 vaccine cross-protects piglets against H. parasuis serovar 4 challenge; but none of the commercial vaccines tested in this study protected piglets against H. parasuis serovar 12. Our results provide a basis for further identification of common protective antigens that can induce cross-protection against heterogeneous serovars.


Assuntos
Vacinas Bacterianas/imunologia , Infecções por Haemophilus/veterinária , Haemophilus parasuis/classificação , Doenças dos Suínos/prevenção & controle , Animais , Anticorpos Antibacterianos/sangue , Vacinas Bacterianas/efeitos adversos , Feminino , Infecções por Haemophilus/microbiologia , Infecções por Haemophilus/prevenção & controle , Sorogrupo , Suínos , Vacinas de Produtos Inativados/efeitos adversos , Vacinas de Produtos Inativados/imunologia
6.
Can J Vet Res ; 80(4): 287-293, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27733783

RESUMO

The objective of this study was to assess the minimum dose, antigen content, and immunization duration of a trivalent vaccine containing inactivated Haemophilus parasuis serovars 4, 5, and 12 and the Montanide GEL 01 PR adjuvant in piglets and pregnant sows. Our results demonstrated that the minimum vaccine dose was 2 mL per pig and the optimal antigen content 2.0 × 109, 1.0 × 109, and 1.0 × 109 colony-forming units/mL of serovars 4, 5, and 12, respectively. The vaccine provided effective protection 14 d after the 2nd vaccination, and the period of immune protection was 180 d (6 mo) after the 2nd vaccination. Maternal antibodies provided early protection for the piglets, and vaccinating the sows before farrowing helped to control disease and protected the piglets during lactation; the piglets were protected during the finishing period by being vaccinated during lactation. Our findings provide a basis for developing a commercial trivalent vaccine of inactivated H. parasuis serovars 4, 5, and 12 against Glässer's disease.


Assuntos
Antígenos de Bactérias/química , Vacinas Bacterianas/imunologia , Infecções por Haemophilus/veterinária , Haemophilus parasuis , Animais , Antígenos de Bactérias/imunologia , Relação Dose-Resposta Imunológica , Feminino , Infecções por Haemophilus/microbiologia , Infecções por Haemophilus/prevenção & controle , Imunização , Gravidez , Suínos , Vacinas de Produtos Inativados/imunologia
7.
J Clin Neurosci ; 34: 202-206, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27658574

RESUMO

This study reports our experience of balloon-in-stent assisted coiling for the treatment of morphologically unfavorable aneurysms located in the internal carotid artery (ICA). From July 2007 to April 2014, twelve patients with twelve aneurysms located in the ICA were coil embolized by simultaneously using balloon and stent assistance. Five aneurysms were ruptured and seven were unruptured. All the aneurysms were overwide (dome-to-neck ratio ⩽1.2) and undertall (aspect ratio ⩽1.2) anatomically. The procedure-related adverse events, clinical and angiographic results were retrospectively analyzed. Intraprocedural aneurysmal bleeding occurred for one unruptured aneurysm but was stopped immediately after the balloon was inflated. Periprocedural thromboembolism occurred for two ruptured aneurysms, leading to death in one patient and severe neurological deficit for the other one. Procedure-related permanent morbidity and mortality rates were 8.3% (1/12) and 8.3% (1/12). Satisfactory (total and subtotal) occlusion was obtained immediately in 11 (91.7%) cases. Nine aneurysms received digital subtraction angiography follow-up (mean 25.1months, range 6-55), and all of them except one were totally obliterated. No aneurysmal bleeding occurred during a mean period of 59.1months, clinical follow-up for eleven patients. Balloon-in-stent assisted coiling might be a therapeutic alternative to prevent growth or rupture of overwide and undertall aneurysms. Nevertheless, it should be used prudently for ruptured ICA aneurysms, for its disadvantage of technical complexity and relatively high rate of adverse events.


Assuntos
Oclusão com Balão/métodos , Aneurisma Intracraniano/terapia , Stents , Adulto , Idoso , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Angiografia Digital , Dissecação da Artéria Carótida Interna/complicações , Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Dissecação da Artéria Carótida Interna/terapia , Angiografia Cerebral , Embolização Terapêutica , Feminino , Seguimentos , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tromboembolia/complicações , Tromboembolia/diagnóstico por imagem , Resultado do Tratamento
8.
Vet Immunol Immunopathol ; 168(3-4): 153-8, 2015 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-26672914

RESUMO

Haemophilus parasuis has had a huge impact in the swine industry throughout the world. Inactivated bacterium for H. parasuis is a traditional vaccine that can elicit efficient protection against homologous challenges. The objective of this study was to screen for the adjuvant-enhanced immune effect of trivalent inactivated H. parasuis serovars 4, 5 and 12 (prevalent serovars in China) vaccines against Glässer's disease. The adjuvants of mineral oil, aluminum hydroxide, Montanide GEL 01 PR, Montanide IMS 1313N VG and Montanide ISA 760 VG were used to make emulsified inactivated H. parasuis serovars 4, 5 and 12, respectively. Safety, antibody titer and protective efficacy of these vaccines were examined separately in piglets, and the feasibility of microagglutination test for detecting antibody titer of H. parasuis was confirmed for the first time. Due to easy of injection, high safety, rapidly immune responses, high concentrations of antibody, and 100% of protective efficacy for piglets, Montanide GEL 01 PR adjuvant can provide more homologous serovar protection than other domestically developed inactivated vaccines and should be used as a candidate adjuvant.


Assuntos
Vacinas Bacterianas/imunologia , Infecções por Haemophilus/veterinária , Haemophilus parasuis/classificação , Doenças dos Suínos/prevenção & controle , Animais , Anticorpos Antibacterianos , Vacinas Bacterianas/efeitos adversos , Tecido de Granulação/patologia , Infecções por Haemophilus/microbiologia , Infecções por Haemophilus/prevenção & controle , Haemophilus parasuis/imunologia , Suínos , Doenças dos Suínos/microbiologia
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