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1.
J Formos Med Assoc ; 118(1 Pt 2): 362-370, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29937322

RESUMO

BACKGROUND/PURPOSE: Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth. METHODS: Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm-3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8-10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure. RESULTS: All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6-7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1-3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2-4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1-2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5-3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months. CONCLUSION: PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors.


Assuntos
Compostos de Alumínio/uso terapêutico , Apexificação , Compostos de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia , Óxidos/uso terapêutico , Poliésteres/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Criança , Combinação de Medicamentos , Feminino , Humanos , Incisivo , Masculino , Preparo de Canal Radicular/métodos , Taiwan , Resultado do Tratamento
3.
Chin J Physiol ; 60(3): 158-165, 2017 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-28628970

RESUMO

Hypertension and cardiovascular complications are the leading causes of death worldwide. Antihypertensive drugs often cause various side effects, and improper use of antihypertensive medications can result in irreparable damage. Edible fungi of the Monascus species have been used as traditional Chinese medicines in Southeast Asia for several centuries. The fermented products of Monascus purpureus NTU 568 (ANKASCIN 568) possess a number of functional secondary metabolites including the anti-inflammatory pigments monascin (MS) and ankaflavin (AK). In this study, a double-blind, placebo-controlled clinical trial was performed in which patients with mild to moderate hypertension were randomly assigned to receive placebo or two 500-mg capsules of Ankascin 568 for 8 weeks. The effects of this treatment on the regulation of blood pressure (BP) were then examined. The results showed that systolic blood pressure (SBP) decreased from 141.6 ± 12.0 to 133.9 ± 14.4 mmHg (P < 0.05), and diastolic blood pressure (DBP) decreased from 91.7 ± 8.1 to 84.8 ± 7.4 mmHg (P < 0.05). Moreover, Ankascin 568 treatment effectively reduced serum triglycerides and total cholesterol (TC), increased high-density lipoprotein cholesterol (HDL-C), and reduced low-density lipoprotein cholesterol (LDL-C) levels, thereby improving the serum lipid profile. Additionally, administration of Ankascin 568 did not cause significant rhabdomyolysis nor impaired the metabolic or physiological functions of the liver or kidney. In conclusion, patients administered Ankascin 568 for 8 weeks exhibited significant in reduction of SBP, serum TC and LDL-C levels, which should contribute to better cardiovascular health.


Assuntos
Anti-Hipertensivos/uso terapêutico , Fatores Biológicos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Lipídeos/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Método Duplo-Cego , Feminino , Humanos , Hipertensão/sangue , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Monascus/química , Triglicerídeos/sangue
5.
Artigo em Inglês | MEDLINE | ID: mdl-28124984

RESUMO

INTRODUCTION: In clinical settings, acute anterior uveitis (AAU) could be the first presentation of ankylosing spondylitis (AS). Based on this hypothesis, we investigate whether AAU is a risk factor in developing AS later by using National Health Insurance Research Database (NHIRD) in Taiwan. MATERIALS AND METHODS: This cohort comparison study used longitudinal Taiwanese NHIRD to probe the relative risk odds of AAU for AS development, and consisted of all patients diagnosed with AAU (n = 5621) (ICD-9-CM codes 364.00). The relative risks of AS between AAU patients and controls were compared by estimating the crude hazard ratio with logistic regression. Kaplan-Meier analysis was used to calculate the cumulative incidence rates of developing AS, and a log-rank test was used to analyze the differences between the survival curves. Separate Cox proportional hazard regressions were performed to compute the AS-free rate after adjusting for possible confounding factors such as age and sex. RESULTS: The crude hazard ratio was 2.667 for the AAU group, and the adjusted hazard ratio was 2.705 for the AAU group. The observation time of the AS-free group was shorter for AAU patients compared with the control group (1507 versus 1578 days). Moreover, in the AAU patients, the younger age onset of AAU (less than 30 years old here) would lead to an earlier diagnosis of AS later with a median of 1445.5 (742-2241) versus 1544 (819-2289) days of survival for the group of age onset of AAU greater than 30 years old. The difference is statistically significant (p < 0.05). CONCLUSIONS: AAU was a risk factor for AS. To identify AAU as an extra-articular manifestation is crucial for early diagnosis and treatment of AS and containing functional loss accordingly.


Assuntos
Espondilite Anquilosante/epidemiologia , Uveíte Anterior/epidemiologia , Doença Aguda , Adulto , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Razão de Chances , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan/epidemiologia
6.
Oncotarget ; 8(9): 14666-14679, 2017 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-28108734

RESUMO

We studied the potential mechanisms of valproic acid (VPA) in the treatment of glioblastoma multiforme (GBM). Using the human U87, GBM8401, and DBTRG-05MG GBM-derived cell lines, VPA at concentrations of 5 to 20 mM induced G2/M cell cycle arrest and increased the production of reactive oxygen species (ROS). Stress-related molecules such as paraoxonase 2 (PON2), cyclin B1, cdc2, and Bcl-xL were downregulated, but p27, p21 and Bim were upregulated by VPA treatment. VPA response element on the PON2 promoter was localized at position -400/-1. PON2 protein expression was increased in GBM cells compared with normal brain tissue and there was a negative correlation between the expression of PON2 and Bim. These findings were confirmed by the public Bredel GBM microarray (Gene Expression Omnibus accession: GSE2223) and the Cancer Genome Atlas GBM microarray datasets. Overexpression of PON2 in GBM cells significantly decreased intracellular ROS levels, and PON2 expression was decreased after VPA stimulation compared with controls. Bim expression was significantly induced by VPA in GBM cells with PON2 silencing. These observations were further shown in the subcutaneous GBM8401 cell xenograft of BALB/c nude mice. Our results suggest that VPA reduces PON2 expression in GBM cells, which in turn increases ROS production and induces Bim production that inhibits cancer progression via the PON2-Bim cascade.


Assuntos
Arildialquilfosfatase/metabolismo , Neoplasias Encefálicas/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Glioblastoma/tratamento farmacológico , Ácido Valproico/farmacologia , Animais , Arildialquilfosfatase/genética , Proteína 11 Semelhante a Bcl-2/genética , Proteína 11 Semelhante a Bcl-2/metabolismo , Western Blotting , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/genética , GABAérgicos/farmacologia , Perfilação da Expressão Gênica/métodos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Glioblastoma/genética , Glioblastoma/metabolismo , Humanos , Camundongos Endogâmicos BALB C , Camundongos Nus , Regiões Promotoras Genéticas/genética , Interferência de RNA , Espécies Reativas de Oxigênio/metabolismo , Elementos de Resposta/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Ensaios Antitumorais Modelo de Xenoenxerto
7.
J Formos Med Assoc ; 116(6): 448-456, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27745799

RESUMO

BACKGROUND/PURPOSE: Bacteria in the tooth root canal may cause apical periodontitis. This study examined the bacterial species present in the apical root canal of teeth with apical periodontitis. Antibiotic sensitivity tests were performed to evaluate whether these identified bacterial species were susceptible to specific kinds of antibiotics. METHODS: Selective media plating and biochemical tests were used first to detect the bacterial species in samples taken from the apical portion of root canals of 62 teeth with apical periodontitis. The isolated bacterial species were further confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry. RESULTS: We found concomitant presence of two (32 teeth) or three species (18 teeth) of bacteria in 50 (80.6%) out of 62 tested teeth. However, only 34 bacterial species were identified. Of a total of 118 bacterial isolates (83 anaerobes and 35 aerobes), Prophyromonas endodontalis was detected in 10; Bacteroides, Dialister invisus or Fusobacterium nucleatum in 9; Treponema denticola or Enterococcus faecalis in 8; Peptostreptococcus or Olsenella uli in 6; and Veillonella in 5 teeth. The other 25 bacterial species were detected in fewer than five teeth. Approximately 80-95% of bacterial isolates of anaerobes were sensitive to ampicillin/sulbactam (Unasyn), amoxicillin/clavulanate (Augmentin), cefoxitin, and clindamycin. For E. faecalis, 85-90% of bacterial isolates were sensitive to gentamicin and linezolid. CONCLUSION: Root canal infections are usually caused by a mixture of two or three species of bacteria. Specific kinds of antibiotic can be selected to control these bacterial infections after antibiotic sensitivity testing.


Assuntos
Cavidade Pulpar/microbiologia , Periodontite Periapical/microbiologia , Antibacterianos/farmacologia , Humanos
9.
Arch Toxicol ; 90(1): 181-90, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25270622

RESUMO

Di-(2-ethylhexyl) phthalate (DEHP) is associated with atherosclerosis-related cardiovascular disease complications, but we lack direct evidence of its unfavorable effect on atherogenesis. In this study, we aimed to clarify in vivo and in vitro the contribution of DEHP to the development of atherosclerosis and its underlying mechanisms. Apolipoprotein E-deficient (apoE(-/-)) mice chronically treated with DEHP for 4 weeks showed exacerbated hyperlipidemia, systemic inflammation, and atherosclerosis. In addition, DEHP promoted low-density lipoprotein (LDL) oxidation, which led to inflammation in endothelial cells as evidenced by increased protein expression of pro-inflammatory mediators. Furthermore, chronic DEHP treatment increased hepatic cholesterol accumulation by downregulating the protein expression of key regulators in cholesterol clearance including LDL receptor, cholesterol 7α-hydrolase, ATP-binding cassette transporter G5 and G8, and liver X receptor α. Moreover, the adiposity and inflammation of white adipose tissues were promoted in DEHP-treated apoE(-/-) mice. In conclusion, DEHP may disturb cholesterol homeostasis and deregulate the inflammatory response, thus leading to accelerated atherosclerosis.


Assuntos
Apolipoproteínas E/deficiência , Aterosclerose/induzido quimicamente , Dietilexilftalato/toxicidade , Plastificantes/toxicidade , Tecido Adiposo Branco/efeitos dos fármacos , Tecido Adiposo Branco/metabolismo , Adiposidade/efeitos dos fármacos , Animais , Apolipoproteínas E/genética , Aterosclerose/sangue , Aterosclerose/genética , Aterosclerose/patologia , Linhagem Celular , Colesterol/sangue , Modelos Animais de Doenças , Progressão da Doença , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Predisposição Genética para Doença , Humanos , Mediadores da Inflamação/sangue , Lipoproteínas LDL/sangue , Fígado/efeitos dos fármacos , Fígado/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Masculino , Camundongos Knockout , Fenótipo , Medição de Risco , Fatores de Tempo
10.
Sci Rep ; 5: 13524, 2015 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-26304753

RESUMO

Soluble epoxide hydrolase (sEH) has C-terminal epoxide hydrolase and N-terminal lipid phosphatase activity. Its hydrolase activity is associated with endothelial nitric oxide synthase (eNOS) dysfunction. However, little is known about the role of sEH phosphatase in regulating eNOS activity. Simvastatin, a clinical lipid-lowering drug, also has a pleiotropic effect on eNOS activation. However, whether sEH phosphatase is involved in simvastatin-activated eNOS activity remains elusive. We investigated the role of sEH phosphatase activity in simvastatin-mediated activation of eNOS in endothelial cells (ECs). Simvastain increased the phosphatase activity of sEH, which was diminished by pharmacological inhibitors of sEH phosphatase. In addition, pharmacological inhibition of sEH phosphatase or overexpressing the inactive phosphatase domain of sEH enhanced simvastatin-induced NO bioavailability, tube formation and phosphorylation of eNOS, Akt, and AMP-activated protein kinase (AMPK). In contrast, overexpressing the phosphatase domain of sEH limited the simvastatin-increased NO biosynthesis and eNOS phosphorylation at Ser1179. Simvastatin evoked epidermal growth factor receptor-c-Src-increased Tyr phosphorylation of sEH and formation of an sEH-Akt-AMPK-eNOS complex, which was abolished by the c-Src kinase inhibitor PP1 or c-Src dominant-negative mutant K298M. These findings suggest that sEH phosphatase activity negatively regulates simvastatin-activated eNOS by impeding the Akt-AMPK-eNOS signaling cascade.


Assuntos
Células Endoteliais/enzimologia , Epóxido Hidrolases/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Monoéster Fosfórico Hidrolases/metabolismo , Sinvastatina/administração & dosagem , Relação Dose-Resposta a Droga , Células Endoteliais/efeitos dos fármacos , Ativação Enzimática/efeitos dos fármacos , Solubilidade
11.
J Endod ; 41(5): 628-36, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25687364

RESUMO

INTRODUCTION: Mineral trioxide aggregate (MTA) is a biocompatible material for direct pulp capping. This study was designed to compare the clinical outcomes of pulp-exposed teeth treated with either poly(ε-caprolactone) fiber mesh (PCL-FM) as a barrier for MTA (so-called PCL-FM/MTA) or MTA direct pulp capping. METHODS: Sixty human vital teeth were evenly divided into 4 groups (n = 15 in each group). Teeth in groups 1 and 3 had pulp exposure <1 mm in diameter, whereas teeth in groups 2 and 4 had pulp exposure of 1-1.5 mm in diameter. Teeth in groups 1 and 2 were treated with PCL-FM/MTA direct pulp capping, and those in groups 3 and 4 were treated with MTA direct pulp capping. RESULTS: Teeth treated with PCL-FM/MTA direct pulp capping needed a significantly shorter mean duration for dentin bridge formation than teeth treated with MTA direct pulp capping. Moreover, teeth with pulp exposure <1.0 mm in diameter needed a significantly shorter mean duration for dentin bridge formation than teeth with pulp exposure of 1-1.5 mm in diameter after either PCL-FM/MTA or MTA direct pulp capping treatment. In addition, teeth treated with PCL-FM/MTA direct pulp capping formed an approximately 3-fold thicker dentin bridge than teeth treated with MTA direct pulp capping 8 weeks or 3 months later. Furthermore, none of the teeth treated with PCL-FM/MTA direct pulp capping showed tooth discoloration after treatment for 3 months. CONCLUSIONS: PCL-FM/MTA is a better combination material than MTA alone for direct pulp capping of human permanent teeth.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Capeamento da Polpa Dentária/métodos , Óxidos , Poliésteres , Agentes de Capeamento da Polpa Dentária e Pulpectomia , Silicatos , Adolescente , Adulto , Idoso , Materiais Biocompatíveis , Criança , Combinação de Medicamentos , Feminino , Humanos , Masculino , Teste de Materiais , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
12.
J Formos Med Assoc ; 114(2): 139-46, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25124888

RESUMO

BACKGROUND/PURPOSE: Traumatic injury often results in pulp necrosis of immature permanent incisors in children. This study compared clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide [Ca(OH)2] or mineral trioxide aggregate (MTA) apexification/apexogenesis. METHODS: Forty necrotic open-apex incisors from 40 children aged 6.5-10 years were divided evenly into four groups with each group containing teeth of similar type and similar root apex width in patients of similar age. Group 1 incisors were treated with ultrasonic filing and MTA placement; Group 2 were treated with ultrasonic filing and Ca(OH)2 medication; Group 3 were treated with hand filing and MTA placement; and Group 4 were treated with hand filing and Ca(OH)2 medication. RESULTS: Group 1 incisors needed the shortest mean duration (5.4 ± 1.1 weeks) for apical hard tissue barrier formation, followed by Group 3 incisors (7.8 ± 1.8 weeks), Group 2 incisors (11.3 ± 1.3 weeks), and Group 4 incisors (13.1 ± 1.5 weeks). Group 1 incisors had a significantly shorter mean elongated root length (2.1 ± 0.2 mm) after treatment than Group 2 incisors (3.5 ± 0.3 mm, p < 0.001), and Group 3 incisors had a significantly shorter mean elongated root length (2.1 ± 0.1 mm) after treatment than Group 4 incisors (3.7 ± 0.3 mm, p < 0.001). CONCLUSION: Necrotic open-apex incisors treated with ultrasonic filing plus MTA placement need the shortest mean duration for apical hard tissue barrier formation. For elongation of apical root length, Ca(OH)2 apexification/apexogenesis is better than MTA apexification/apexogenesis, regardless if either ultrasonic or hand filing are used.


Assuntos
Compostos de Alumínio/uso terapêutico , Apexificação/métodos , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia , Incisivo/lesões , Óxidos/uso terapêutico , Silicatos/uso terapêutico , Raiz Dentária/diagnóstico por imagem , Criança , Combinação de Medicamentos , Feminino , Humanos , Masculino , Materiais Restauradores do Canal Radicular/uso terapêutico
13.
Biomed Res Int ; 2014: 218646, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25295251

RESUMO

Chronic subdural hematoma (CSDH) is one of the major comorbidities in elderly resulting in disability and death. Early recognition of CSDH is important for early management. However, manifestations of CSDH are nonspecific and subtle. Therefore, identification of risk factors of CSDH can offer clinical follow-up strategies for patients after episodes of head injury. The purpose of the study aimed at identifying risk factors of CSDH of Taiwanese. Analysis of data from the National Health Insurance provides important information on predictive factors influencing the early diagnosis of CSDH in elderly patients following minor head injuries. The current study is the first nationwide population-based study in Taiwan, showing that old age (≥75 years), male gender, and coexisting hydrocephalus are significantly predictive factors, irrespective to their medical comorbidities.


Assuntos
Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/patologia , Hematoma Subdural Crônico/epidemiologia , Hematoma Subdural Crônico/patologia , Idoso , Idoso de 80 Anos ou mais , Traumatismos Craniocerebrais/complicações , Hematoma Subdural Crônico/complicações , Humanos , Masculino , Medição de Risco , Fatores de Risco , Fatores Sexuais
14.
J Clin Exp Neuropsychol ; 36(4): 399-409, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24702428

RESUMO

PRIMARY OBJECTIVE: Postconcussion symptoms (PCS) are common following mild traumatic brain injury (mTBI). A psychological misperception, the "good-old-days" bias, has been indicated as one of the influencing factors on symptom reporting after injury. To date, this response bias has only been examined in a small number of cross-sectional studies. This study thus prospectively evaluated the "good-old-days" bias in patients with mTBI. RESEARCH DESIGN: A prospective follow-up study. METHOD AND PROCEDURES: Fifty-three patients with mTBI were recruited in this study. The PCS was evaluated by the modified Checklist of Postconcussion Symptoms (mCPCS) at 1 month post injury. Twenty-five patients were evaluated again at 3 months after injuries. In addition, 53 healthy participants were also evaluated for the PCS, and 23 of them underwent a second evaluation at 2 months after the first one. MAIN OUTCOMES AND RESULTS: Patients with mTBI showed significantly higher PCS reporting at 1 month post injury than healthy participants did, but not at 3 months post injury. Consistent with the "good-old-days" bias, patients remarkably underestimated their preinjury PCS at 1 month post injury. Interestingly, our results further revealed that this response bias diminished more at 3 months than at 1 month after mTBI. CONCLUSIONS: This study thus might be the first one to prospectively reveal the progression of the "good-old-days" bias in patients with mTBI.


Assuntos
Lesões Encefálicas/fisiopatologia , Nível de Saúde , Síndrome Pós-Concussão/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Pós-Concussão/complicações , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
15.
Brain Inj ; 28(8): 1082-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24701968

RESUMO

PURPOSE: The purpose of this study was to establish a quantitative method with which to assess the post-operative recurrence of chronic subdural haematoma (CSDH). METHODS: CT scans were reviewed from 44 consecutive patients with CSDHs who underwent burr hole drainage between July 2008 and January 2012. The area of the haematoma was quantified according to the mean haematoma density (MHD) using computer-based image analysis of pre-operative brain CT scans. MHD as well as other variables of patients with and without post-operative recurrences was statistically compared. RESULTS: Post-operative recurrence was noted in six of the 44 patients that underwent surgical procedures. Among these variables, high MHD, separated type and bilateral and skull base involvement of CSDHs were shown to be significantly related to post-operative recurrence (p < 0.05). Controlling for separated type in logistic regression analysis revealed the OR of MHD as statistically significant indicators with a p value of less than 0.05 (OR = 1.243; 95% CI = 1.003-1.54). CONCLUSION: This study provides statistical proof that MHD is a significant, independent, prognostic factor for the post-operative recurrence of CSDH. As such, consideration of MHD could aid in the prediction of post-operative prognosis of CSDHs.


Assuntos
Craniectomia Descompressiva , Hematoma Subdural Crônico/patologia , Hematoma Subdural Crônico/cirurgia , Adulto , Craniectomia Descompressiva/métodos , Feminino , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/prevenção & controle , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Período Pós-Operatório , Valor Preditivo dos Testes , Prognóstico , Recidiva , Prevenção Secundária , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
J Formos Med Assoc ; 113(3): 166-72, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24630034

RESUMO

BACKGROUND/PURPOSE: Bisphosphonates (BPs) are used to treat osteoporosis and bone metastases from malignancy. They may result in BPs-related osteonecrosis of the jaws (BRONJ) in a subset of patients receiving BPs. This study examined whether conservative or aggressive surgical approach could result in successful treatment of BRONJ lesions and assessed whether concomitant steroid administration or tobacco smoking habit might hinder the remission of BRONJ lesions. METHODS: The 40 BRONJ patients were evenly divided into four different groups. Group 1 contained 10 patients with concomitant corticosteroid medication but without smoking habit. Group 2 contained 10 patients with smoking habit but without concomitant corticosteroid medication. Groups 3 and 4 each consisted of 10 patients without concomitant corticosteroid medication and smoking habit. To avoid bias, each group contained equal number of patients with different stages of BRONJ. Patients in Groups 1, 2, and 3 received conservative treatment, including antibiotic coverage, antibacterial solution irrigation, and minor surgical debridement. Patients in Group 4 were treated with aggressive surgical excision of necrotic bone segment. RESULTS: The mean duration to achieve complete remission of BRONJ lesion was 19.7±0.6, 18.2±0.5, 13.0±1.0, and 7.6±1.1 months for patients in Groups 1, 2, 3 and 4, respectively. Student's t-test showed significant differences in the mean duration to achieve complete remission of BRONJ lesion between Groups 1 and 3, between Groups 2 and 3, between Groups 3 and 4, between Groups 1 and 4, and between Groups 2 and 4 (all p values < 0.001). CONCLUSION: Although both conservative and aggressive surgical approaches can result in successful treatment of BRONJ lesions, aggressive surgical treatment needs a shorter mean duration to achieve complete remission of BRONJ lesion than conservative treatment. Concomitant corticosteroid administration or tobacco smoking may prolong the duration for complete remission of BRONJ lesion.


Assuntos
Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Desbridamento , Procedimentos Ortopédicos , Fumar/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Resultado do Tratamento
17.
Chem Biol Interact ; 205(1): 20-8, 2013 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-23774672

RESUMO

Glioblastomas, the most common primary gliomas, are characterized by increased invasion and difficult therapy. Major clinical medicines for treating gliomas merely extend the survival time for a number of months. Therefore, development of new agents against gliomas is important. Autophagy, a process for degrading damaged organelles and proteins, is an adaptive response to environmental stress. However, the role of autophagy in glioblastoma development still needs to be further investigated. Evodiamine, a major alkaloid isolated from Evodia rutaecarpa Bentham, has various pharmacological activities, such as inhibiting tumor growth and metastatic properties. However, the effects of evodiamine on glioblastomas and their detailed molecular mechanisms and autophagy formation are not well understood. In this study, we observed that evodiamine induced dose- and time-dependent apoptosis in glioma cells. Blockade of calcium channels in endoplasmic reticulum (ER) significantly reduced evodiamine-induced cytosolic calcium elevation, apoptosis, and mitochondrial depolarization, which suggests that evodiamine induces a calcium-mediated intrinsic apoptosis pathway. Interestingly, autophagy was also enhanced by evodiamine, and had reached a plateau by 24h. Pharmacological inhibition of autophagy resulted in increased apoptosis and reduced cell viability. Inhibition of ER calcium channel activation also significantly reduced evodiamine-induced autophagy. Inactivation of c-Jun N-terminal kinases (JNK) suppressed evodiamine-mediated autophagy accompanied by increased apoptosis. Furthermore, evodiamine-mediated JNK activation was abolished by BAPTA-AM, an intracellular calcium scavenger, suggesting that evodiamine mediates autophagy via a calcium-JNK signaling pathway. Collectively, these results suggest that evodiamine induces intracellular calcium/JNK signaling-mediated autophagy and calcium/mitochondria-mediated apoptosis in glioma cells.


Assuntos
Alcaloides/farmacologia , Antineoplásicos Fitogênicos/farmacologia , Glioblastoma/tratamento farmacológico , Quinazolinas/farmacologia , Apoptose/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Cálcio/metabolismo , Linhagem Celular Tumoral , Evodia , Glioblastoma/metabolismo , Glioblastoma/patologia , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Modelos Biológicos
18.
Artigo em Inglês | MEDLINE | ID: mdl-24454492

RESUMO

Cerebral ischemia is a leading cause of mortality and morbidity worldwide, which results in cognitive and motor dysfunction, neurodegenerative diseases, and death. Evodiamine (Evo) is extracted from Evodia rutaecarpa Bentham, a plant widely used in Chinese herbal medicine, which possesses variable biological abilities, such as anticancer, anti-inflammation, antiobesity, anti-Alzheimer's disease, antimetastatic, antianoxic, and antinociceptive functions. But the effect of Evo on ischemic stroke is unclear. Increasing data suggest that activation of autophagy, an adaptive response to environmental stresses, could protect neurons from ischemia-induced cell death. In this study, we found that Evo induced autophagy in U87-MG astrocytes. A scavenger of extracellular calcium and an antagonist of transient receptor potential vanilloid-1 (TRPV-1) decreased the percentage of autophagy accompanied by an increase in apoptosis, suggesting that Evo may induce calcium-mediated protective autophagy resulting from an influx of extracellular calcium. The same phenomena were also confirmed by a small interfering RNA technique to knock down the expression of TRPV1. Finally, Evo-induced c-Jun N-terminal kinases (JNK) activation was reduced by a TRPV1 antagonist, indicating that Evo-induced autophagy may occur through a calcium/c-Jun N-terminal kinase (JNK) pathway. Collectively, Evo induced an influx of extracellular calcium, which led to JNK-mediated protective autophagy, and this provides a new option for ischemic stroke treatment.

19.
J Neurotrauma ; 29(11): 2030-7, 2012 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-22452382

RESUMO

Functional and aesthetic reconstruction after wide decompressive craniectomy directly correlates with subsequent quality of life. Advancements in the development of biomaterials have now made three-dimensional (3-D) titanium mesh a new option for the repair of skull defects after craniectomy. The purpose of this study was to review aesthetic and surgical outcomes and complications of patients who had skull defects repaired with 3-D titanium mesh. The records of 40 adult patients (31 unilateral craniectomies and 9 bilateral craniectomies) who underwent a computer-assisted designed titanium mesh implant at a university hospital from January 2008 to January 2010 were retrospectively reviewed. Aesthetic outcomes, cranial nerve V and VII function, and complications (hardware extrusions, meningitis, osteomyelitis, brain abscess, and pneumocephalus) were evaluated. The craniofacial symmetry, implant stability, and functional outcomes were excellent for all patients. No patients had trigeminal or facial dysfunction. All had excellent cosmetic results as measured by post-reduction radiographs and personal and family perceptions of the forehead contour. Two patients had delayed wound healing and subsequent subclinical wound infections, which resolved after treatment with antibiotics for 2 weeks. Craniofacial skeletal reconstruction with 3-D titanium mesh results in excellent forehead contour and cosmesis, and subsequently a better quality of life with few complications. Titanium mesh reconstruction offers a favorable alternative to other graft materials in the repair of large skull defects.


Assuntos
Lesões Encefálicas/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Telas Cirúrgicas , Titânio/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Projeto Auxiliado por Computador , Craniectomia Descompressiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
J Formos Med Assoc ; 109(8): 596-602, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20708511

RESUMO

BACKGROUND/PURPOSE: Traumatic injury usually results in pulp necrosis of immature permanent incisors in children aged 7-10 years. Calcium hydroxide apexification is the most common treatment for necrotic, immature permanent teeth. This study compared the duration for apical barrier formation in necrotic immature permanent incisors treated with calcium hydroxide apexification using ultrasonic or hand filing. METHODS: Thirty-two trauma-induced necrotic immature permanent incisors with or without a periapical lesion (PL) were selected from children aged 7-10 years. They were evenly divided into four groups. Teeth in groups 1 (with PL) and 2 (without PL) were treated with ultrasonic filing, and teeth in groups 3 (with PL) and 4 (without PL) were treated with hand filing. The canals were cleaned with 0.2% chlorhexidine solution during treatment and then compactly filled with calcium hydroxide. The patients were followed up once every 1-3 weeks to change the intracanal medication and to detect when the apical barrier formed. RESULTS: The mean duration for apical barrier formation was 11.1 +/- 1.1 weeks, 11.8 +/- 1.0 weeks, 13.3+/-0.9 weeks and 13.4 +/- 0.7 weeks for groups 1, 2, 3 and 4, respectively. Student's t test showed significant differences in the mean duration for apical barrier formation between groups 1+2 and 3 + 4 (p = 0.000), groups 1 and 3 (p = 0.000), and groups 2 and 4 (p = 0.002). These results indicated that teeth treated with ultrasonic filing required a shorter mean duration for apical barrier formation than teeth treated with hand filing regardless of the presence of PL or not. CONCLUSION: Ultrasonic filing with 0.2% chlorhexidine as an irrigant is effective for disinfection of the root canal and can shorten the duration for apical barrier formation in necrotic permanent incisors treated with calcium hydroxide apexification.


Assuntos
Apexificação , Hidróxido de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia , Incisivo/efeitos dos fármacos , Materiais Restauradores do Canal Radicular/uso terapêutico , Ápice Dentário/efeitos dos fármacos , Criança , Clorexidina , Necrose da Polpa Dentária/patologia , Feminino , Seguimentos , Humanos , Incisivo/lesões , Incisivo/patologia , Masculino , Antissépticos Bucais , Radiografia , Tratamento do Canal Radicular/métodos , Taiwan , Fatores de Tempo , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/crescimento & desenvolvimento , Odontopatias/diagnóstico por imagem , Odontopatias/tratamento farmacológico , Resultado do Tratamento
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