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1.
Artigo em Inglês | MEDLINE | ID: mdl-32235415

RESUMO

PURPOSE: Japan is one of few countries with a male life expectancy over 80 years. The gap between the healthy life span and the total life expectancy is large, highlighting the importance of maintaining physical performance. The present study aims to establish reference values for multiple physical performance measures among high-functioning oldest-old Japanese men and to investigate the correlations among these measurements to understand how these variables are related. METHODS: This study was conducted with 120 Japanese males aged 80 years or older who were able to walk independently. Seven measures of physical performance were assessed: handgrip strength, quadriceps strength, static balance ability (one-legged stance), dynamic balance ability (Functional Reach Test; FRT), walking ability (5-m walking time test), combined movement ability (Timed Up & Go test), and bone quality. Cognitive function was also measured (Mini-Mental State Examination; MMSE). RESULTS: Specific reference values are reported for each physical performance measurement explored in this study. Only six participants were classified as cognitively impaired, and 16 had mild cognitive impairment. There were significant correlations of varying levels among all of the measures of physical performance. Age was significantly correlated with all performance measures except FRT, and there was no correlation between age and MMSE. MMSE was weakly correlated with FRT and unrelated to the other performance measures. CONCLUSIONS: The reference ranges can be used by older men who have not yet reached 80 years and their health care providers as physical performance targets to facilitate the maintenance of independent mobility in later life.

2.
Dent Mater J ; 2020 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-32115491

RESUMO

This study aimed to determine the role of the 10-methacryloyloxydecyl dihydrogen phosphate (MDP) in dentin bond durability of universal adhesive in etch-&-rinse mode through bond strength tests after different degradation conditions. This study used the MDP-containing universal adhesive, Clearfil Universal Bond Quick (CU), and an experimental adhesive (NM) made with the same ingredients as CU, excluding MDP. Shear bond strength (SBS) to dentin were obtained in etch-&-rinse mode with or without MDP. CU in self-etch mode was used as a comparison. The groups were divided into three types: 1) subjected to thermal cycling; 2) subjected to long-term water storage; and 3) stored in water for 24 h, as a baseline. The discrepancies in the mean SBS of the CU and NM groups become prominent with prolonged degradation periods. This study indicates that the MDP in universal adhesive might play a key role in enhancing dentin bond quality even when etch-&-rinse mode is used.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32151036

RESUMO

Purpose: Muscle weakness and bone deterioration in the elderly are related to falls and fractures, resulting in decreased mobility. Knee osteoarthritis also may contribute to falls and fractures and thereby affect mortality rates. The Kellgren-Lawrence (KL) classification is widely used in the radiographic evaluation of knee osteoarthritis. Aims: This study aimed to evaluate the quadriceps strength and bone properties of the calcaneus for each KL grade, and to clarify the impact of knee osteoarthritis grade on quadriceps strength and bone properties. Methods: This prospective cross-sectional study included data on 108 male patients (213 knees), aged ≥80 years, who could walk independently. A handheld dynamometer was used to measure quadriceps strength. Bone properties were evaluated using broadband ultrasound attenuation with a portable bone densitometer. Weight-bearing standing knee radiographs were evaluated using KL classification. Quadriceps strength and bone properties were evaluated for each KL grade and the correlations between the grade and quadriceps strength and bone properties were assessed simultaneously. Results: The numbers of participants in KL grades I-IV were 46, 102, 45, and 20, respectively. There were no differences among grades for either quadriceps strength or bone properties. Conclusions: Participants exhibited good quadriceps strength and bone properties regardless of their KL grade. Relatively high mechanical loading of muscle and bone incurred while walking independently, likely explaining this result. Clinically, this study demonstrated the absence of correlations between KL grade and quadriceps strength and bone properties, as was previously reported in studies showing the absence of a correlation between KL grade and pain.

4.
Cereb Cortex ; 2020 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-32037455

RESUMO

Sleep exerts modulatory effects on the cerebral cortex. Whether sleep modulates local connectivity in the cortex or only individual neural activity, however, is poorly understood. Here we investigated functional connectivity, that is, covarying activity between neurons, during spontaneous sleep-wake states and during and after sleep deprivation using calcium imaging of identified excitatory/inhibitory neurons in the motor cortex. Functional connectivity was estimated with a statistical learning approach glasso and quantified by "the probability of establishing connectivity (sparse/dense)" and "the strength of the established connectivity (weak/strong)." Local cortical connectivity was sparse in non-rapid eye movement (NREM) sleep and dense in REM sleep, which was similar in both excitatory and inhibitory neurons. The overall mean strength of the connectivity did not differ largely across spontaneous sleep-wake states. Sleep deprivation induced strong excitatory/inhibitory and dense inhibitory, but not excitatory, connectivity. Subsequent NREM sleep after sleep deprivation exhibited weak excitatory/inhibitory, sparse excitatory, and dense inhibitory connectivity. These findings indicate that sleep-wake states modulate local cortical connectivity, and the modulation is large and compensatory for stability of local circuits during the homeostatic control of sleep, which contributes to plastic changes in neural information flow.

5.
J Youth Adolesc ; 49(1): 212-227, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31332604

RESUMO

Adolescents' depressive symptoms are affected by a number of factors including life stress, gender, socio-economic status, and parental depression symptoms. However, little is known about whether adolescent depressive symptoms are also affected by parental motivational characteristics. The current study explores the relationship between parental motivational perseverance (i.e., parents' persistency in the face of setbacks and difficulties) and children's depressive symptoms during the adolescence, given the critical role of perseverance in psychological well-being. The predictive utility of two motivational characteristics relevant to perseverance: parents' growth mindset (i.e., one's belief about the malleability of human competence) and grit (i.e., perseverance for long term goals) were examined. Four hundred pairs of Japanese parents (82% mothers) and their adolescent children (50% females; average age at the time of the first assessment = 14.05 years; SD = 0.84) independently completed surveys measuring their growth mindset, grit, and depressive symptoms at two time points (approximately one year apart; attrition rate = 25%). The Actor-Partner Independence Model, a statistical model that accounts for inter-dependence between dyads (e.g., parents and children), was used to examine how parental motivational perseverance predicts the long-term change in their offspring's depressive symptoms. The results showed that parental grit led to the decrease in adolescents' depressive symptoms through the changes in adolescents' grit. On the other hand, parental growth mindset directly predicted the adolescents' depressive symptoms, and this was not mediated by the adolescents' growth mindset. These findings underscore the importance of parental motivational characteristics in regards to adolescents' depressive symptoms.

6.
J Orthop Res ; 38(3): 639-644, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31709593

RESUMO

The severity of osteoarthritis (OA) has been related to osteophyte size. However, the effects on osteophyte size of repeated and increased loading associated with joint laxity and varus misalignment remain unclear. We investigated these relationships in patients with medial knee OA and compared the performances of computed tomography (CT) and radiography for assessing osteophyte parameters. We examined knee joint alignment on radiographs and knee laxity using arthrometry in 191 patients with medial knee OA who were undergoing total knee arthroplasty. We also measured femur and tibia osteophyte distance (largest perpendicular distance from the cortical line to outer margin of the osteophyte) using radiography and CT, osteophyte areas (largest area surrounded by the outer margin of an osteophyte) by CT and determined the locations of the osteophytes in the femur and tibia by CT. We then analyzed the correlations between the variables using Spearman's rank correlation tests. Osteophyte sizes in the femur and tibia as determined by radiography (distance) or CT (distance and area) were positively correlated with the degree of varus alignment but not with medial or lateral laxity. There was also a significant correlation between maximum osteophyte distances measured by radiography and CT. The greatest number and the largest osteophytes were located in the posterior third of the femur and middle third of the tibia, respectively. Osteophyte size was correlated with preoperative knee alignment but not with knee laxity in patients with medial knee OA. Osteophyte size can be evaluated using conventional radiography, without the need for CT. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:639-644, 2020.

7.
ACS Omega ; 4(17): 17251-17256, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31656899

RESUMO

In this study, a simple formulation of softwood-derived glycol lignin (GL)-based epoxy resin with a high GL content of greater than 50 wt % was demonstrated by direct mixing with poly(ethylene glycol) diglycidyl ether (PEGDGE), an aliphatic epoxide, without using any solvent. Because the GL powder produced from poly(ethylene glycol) (PEG400) solvolysis of Japanese cedar softwood meal was a PEG400-modified lignin (GL400), a strong affinity between PEG counterparts facilitates the uniform mixing of GL400 with PEGDGE, and one component uncured GL400/PEGDGE epoxy resin was prepared at a relatively lower temperature (100 °C) than the curing temperature (130 °C). The epoxy curing reaction was monitored by 1H NMR and Fourier transform infrared spectroscopies. The physical and mechanical properties of the epoxy resins with different GL400 contents were then evaluated. The developed resins exhibited good flexibility and elasticity depending on the GL400 content.

8.
J Oral Sci ; 61(2): 276-283, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31217376

RESUMO

The purpose of this study was to examine the effect of desensitizing dentifrices containing stannous fluoride (SnF2) on dentinal tubule occlusion. Two experimental dentifrices with the same ingredients but different SnF2 concentrations (Group II, 0.4% w/w; Group III, 0.454% w/w) were used; distilled water was used in the control group (Group I). Third molars were collected from Japanese and American dental patients. The crowns were removed and sectioned to obtain dentin discs, which were further cut into quarters. Thirty-six specimens each from Japanese and American patients were divided into three sets (n = 12 each) and assigned to each of the three treatment groups. The specimens were brushed for 10 s twice per day for 4 days. After treatment, the discs were observed by scanning electron microscopy, and the extent of dentinal tubule occlusion in the images was expressed on a five-point categorical scale. Group II and III specimens from Japanese and American patients showed greater dentinal tube occlusion than those from Group I, but the differences were not statistically significant. The present results suggest that both SnF2 concentrations mitigate dentin hypersensitivity, regardless of patient ethnicity.


Assuntos
Dentifrícios , Sensibilidade da Dentina , Dentina , Humanos , Microscopia Eletrônica de Varredura , Fluoreto de Sódio , Fluoretos de Estanho
9.
Dent Mater J ; 38(5): 728-737, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31231107

RESUMO

We investigated the influence of different curing modes on the mechanical properties and wear behavior of dual-cure provisional resin-based composites (DCPRs). Three DCPRs and a self-curing bis-acryl provisional resin-based composite were used. Flexural strength (σF), elastic modulus (E), resilience (R), and fracture toughness (KIC) were measured. The specimens were fabricated with and without light irradiation, stored in distilled water at 37°C for 24 h, and subjected to 5,000 or 10,000 thermal cycles. For sliding impact wear testing, 12 specimens were prepared with and without light irradiation. The maximum facet depth and volume loss were determined using a noncontact profilometer. Some of the mechanical properties and wear behavior of DCPRs are affected by light irradiation. This study indicated that proper light irradiation is important in polymerization process of the DCPRs to enhance the wear resistance and some mechanical properties.


Assuntos
Resinas Compostas , Resistência à Flexão , Materiais Dentários , Módulo de Elasticidade , Teste de Materiais , Maleabilidade , Propriedades de Superfície
10.
Knee Surg Sports Traumatol Arthrosc ; 27(7): 2181-2188, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31016360

RESUMO

PURPOSE: Very little is known about the use of combined surface cementation (only tibial tray) and mobile-bearing tibial components in total knee arthroplasty (TKA). This study was investigated whether the index combinations show satisfactory clinical outcomes after mobile-bearing TKA using posterior cruciate ligament (PCL)-retaining meniscal-bearing (MB) and PCL-substituting rotating-platform (RP) TKA designed using different anteroposterior constraints. METHODS: This study is a retrospective evaluation of a prospective database. Five-year postoperative clinical outcomes were assessed in 127 patients (127 knees) and 122 patients (122 knees) who underwent TKA with an MB and RP design, respectively. The Hospital for Special Surgery (HSS) score, range of motion, loosening/radiolucency, and subsidence around both components were evaluated in the two designs. RESULTS: The postoperative median HSS score was excellent in both the MB and RP groups (93 and 92, respectively). Postoperative flexion and extension did not differ between the two designs. Neither design showed > 2-mm radiolucencies raising concern for femoral or tibial implant stability. Five (2%) of 249 patients (5 knees) (MB, n = 4; RP, n = 1) showed detectable subsidence of the tibial component. However, no revision TKA had been performed by the 5-year follow-up because no patients had complaints severe enough to necessitate revision surgery. CONCLUSIONS: Clinically good outcomes comparable with previous studies were obtained 5 years after mobile-bearing TKA with surface cementation using both MB and RP implant designs. Thus, equivalent mid-term clinical outcomes of the index combination can be obtained with other implant designs and cementation techniques. LEVEL OF EVIDENCE: Level II.


Assuntos
Artroplastia do Joelho/instrumentação , Prótese do Joelho/estatística & dados numéricos , Idoso , Artroplastia do Joelho/métodos , Artroplastia do Joelho/estatística & dados numéricos , Cimentação , Feminino , Fêmur/cirurgia , Seguimentos , Humanos , Prótese do Joelho/efeitos adversos , Masculino , Menisco , Ligamento Cruzado Posterior/cirurgia , Período Pós-Operatório , Desenho de Prótese , Radiografia , Amplitude de Movimento Articular , Estudos Retrospectivos , Tíbia/cirurgia
11.
J Mech Behav Biomed Mater ; 89: 72-80, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30265868

RESUMO

OBJECTIVES: This study investigates the handling, mechanical, and wear properties of the newly developed flowable resin composites and elucidate the interrelations among the tested parameters. METHODS: Six flowable and two conventional resin composites are used. Five measurements are performed per resin composite to obtain the average inorganic filler content. Ten specimens per material are used to obtain the flexural strength, flexural modulus, and resilience. For sliding impact wear testing, twelve specimens are prepared. Noncontact profilometer and confocal laser scanning microscopy are used to determine the maximum facet depth and volume loss. Extrusion force and thread formation are used to measure the handling properties of the flowable resin composites. Six measurements are performed per flowable resin composite. Data evaluation is performed using analysis of variance and Tukey's honestly significant difference test at an α-level of 0.05. The correlation between the tested parameters is verified using the Pearson product-moment correlation coefficient. RESULTS: A subset of flowable resin composites exhibits higher flexural properties and wear resistance as compared to the conventional resin composites. The handling properties of the flowable resin composites are material dependent. CONCLUSION: While the resilience parameters exhibit an extremely strong and statistically significant correlation with the wear parameters, the handling properties exhibit no interrelation with the remaining parameters. SIGNIFICANCE: While the handling properties of the newly developed flowable resin composites did not correlate with the mechanical and wear properties, some new flowable resin composites have the potential for use in high-stress bearing areas, such as posterior lesions, because of the enhanced mechanical properties and wear resistance.


Assuntos
Resinas Compostas , Teste de Materiais , Fenômenos Mecânicos , Propriedades de Superfície
12.
Surg Oncol ; 27(3): 490-494, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30217307

RESUMO

OBJECTIVE: Surgery for locally advanced oral cancer often requires wide resections of multiple subsites of the oral cavity, including the oral tongue, floor of the mouth, and lower gingiva, and it causes chewing and swallowing disorders. The aim of this prospective, observational study was to determine which subsites have a greater impact on chewing and swallowing disorders after surgery. METHODS: A prospective, observational study was conducted involving 52 patients who underwent surgery for locally advanced oral cancer with free flap reconstruction. The patients' Functional Oral Intake Scale scores were measured before surgery and 1 and 3 months after surgery. Possible predictors of chewing and swallowing disorders were subjected to univariate analysis and multivariate logistic regression analysis. Age, sex, preoperative body mass index, clinical stage, extent of mandibular bone resection, floor of the mouth resection, total or subtotal glossectomy, laryngeal suspension, bilateral neck dissection, and postoperative radiation therapy were the variables evaluated. RESULTS: Multivariate logistic regression analysis showed that both anterior or extensive mandibular bone resection and postoperative radiation therapy were independently associated with poor oral intake after surgery. CONCLUSIONS: The identified predictors will be helpful for better management of patients identified as being at high risk of chewing and swallowing disorders.


Assuntos
Transtornos de Deglutição/diagnóstico , Retalhos de Tecido Biológico/efeitos adversos , Glossectomia/efeitos adversos , Mastigação , Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Idoso , Transtornos de Deglutição/etiologia , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos
13.
J Oral Sci ; 60(3): 367-373, 2018 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-29984784

RESUMO

We used optical coherence tomography to examine the effect of a coating material containing surface reaction-type pre-reacted glass-ionomer (S-PRG) filler on primary enamel demineralization in 18 extracted human primary teeth. The pulp was removed, and each tooth was ultrasonically cleaned with distilled water. Six teeth were treated with 0.1-M lactic acid buffer solution (De group). In the second group (n = 6), a thin film of coating material was applied before demineralization (PRG group). A third group (Control group; n = 6) was maintained in artificial saliva. Using optical coherence tomography, we measured peak signal intensity (dB) and width at 1/e2 (µm) at predetermined locations on the enamel surface and calculated integrated values. All data were analyzed with ANOVA and the Tukey-Kramer test (α = 0.05). Although changes in integrated values differed between groups, there was a small but significant increase in the Control group and a small but significant decrease in the De group. In the PRG group, integrated values were significantly higher at 7 days after the start of the experiment and significantly increased thereafter. Our findings indicate that a coating material containing S-PRG fillers may prevent primary enamel demineralization.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Cimentos de Ionômeros de Vidro/química , Tomografia de Coerência Óptica , Desmineralização do Dente/diagnóstico por imagem , Desmineralização do Dente/prevenção & controle , Humanos , Técnicas In Vitro , Teste de Materiais , Saliva Artificial/farmacologia , Propriedades de Superfície
14.
Eur Arch Otorhinolaryngol ; 275(6): 1613-1621, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29623392

RESUMO

PURPOSE: To improve the diagnoses of the salivary gland tumors, a dynamic-enhanced MRI (dMRI) was investigated. METHODS: We conducted a retrospective chart review of 93 cases of salivary gland tumors. The histological diagnoses were obtained from all patients using a surgical specimen and/or an open biopsy specimen. The dMRI as well as fine-needle aspiration cytology (FNAC) and intraoperative frozen section (IFS) were analyzed. This study focused on the time-intensity curve (TIC) after injection, peak time (Tpeak), washout ratio (WR) as well as the gradient of enhancement and washout profile. RESULTS: The histological diagnoses included pleomorphic adenoma (PMA) in 53 cases, the Warthin tumors (WT) in 14 cases and malignant tumors (MT) in 26 cases. Incorrect diagnosis rate of FNAC and IFS were 5.2 and 8.3%, respectively. The TIC revealed differences among the three types of tumors. Tpeak as well as WR also revealed significant differences (p < 0.001). Tpeak were lower in order of WT, MT, PMA, respectively. WR of TICs at 30, 45 and 105 s after Tpeak were higher in order of WT, MT, PMA, respectively (p < 0.001). The gradient of increment and washout in the TIC curve was also an important parameter to distinguish the three types of tumors. In MT, the rapid enhancement pattern was found in high or intermediate histological grade tumors, whereas the slow enhancement pattern was exhibited in low grade tumors. CONCLUSIONS: Our findings indicate that using Tpeak and WR, it is possible to distinguish between WT, PMA and MT. Additionally, a rapid enhancement pattern may be a potential marker for these tumors.


Assuntos
Adenolinfoma/diagnóstico por imagem , Adenoma Pleomorfo/diagnóstico por imagem , Imagem por Ressonância Magnética , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Adenolinfoma/patologia , Adenoma Pleomorfo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Feminino , Secções Congeladas , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/patologia , Adulto Jovem
15.
Eur Arch Otorhinolaryngol ; 275(6): 1607-1611, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29610959

RESUMO

PURPOSE: To identify precipitating factors responsible for enteral nutrition (EN) dependency after concomitant chemoradiotherapy (CCRT) of head and neck cancers and to examine their statistical correlations. METHODS: Factors related to feeding condition, nutritional status, disease, and treatment of 26 oropharyngeal and hypopharyngeal cancer patients who received definitive CCRT were retrospectively investigated by examining their medical records. The days of no oral intake (NOI) during hospitalization and the months using enteral nutrition after CCRT were counted as representing the feeding condition, and the changes in body weight (BW) were examined as reflecting nutritional status. The factors related to EN dependency after CCRT were analyzed. RESULTS: Long duration of total NOI (≥ 30 days) and maximum NOI ≥ 14 days were significant predictors of EN dependency. Decreased BW (≥ 7.5 kg) was the next predictor identified, but it was not significant. Multivariate analysis showed that the total duration of NOI was more correlated with EN dependency than changes in BW. CONCLUSIONS: A long duration of NOI was more strongly related to EN dependency than nutritional factors.


Assuntos
Quimiorradioterapia , Nutrição Enteral , Neoplasias Hipofaríngeas/terapia , Estado Nutricional , Neoplasias Orofaríngeas/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
16.
J Adhes Dent ; 20(1): 65-77, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29507919

RESUMO

PURPOSE: To investigate the influence of application time and etching mode of universal adhesives on enamel adhesion. MATERIALS AND METHODS: Five universal adhesives, Adhese Universal, Bondmer Lightless, Clearfil Universal Bond Quick, G-Premio Bond, and Scotchbond Universal, were used. Bovine incisors were prepared and divided into four groups of ten teeth each. SBS, Ra, and SFE were determined after the following procedures: 1. self-etch mode with immediate air blowing after application (IA); 2. self-etch mode with prolonged application time (PA); 3. etch-and-rinse mode with IA; 4. etch-and-rinse mode with PA. After 24-h water storage, the bonded assemblies were subjected to shear bond strength (SBS) tests. For surface roughness (Ra) and surface free energy (SFE) measurements, the adhesives were simply applied to the enamel and rinsed with acetone and water before the measurements were carried out. RESULTS: Significantly higher SBS and Ra values were obtained with etch-and-rinse mode than with self-etch mode regardless of the application time or type of adhesive. Although most adhesives showed decreased SFE values with increased application time in self-etch mode, SFE values in etch-and-rinse mode were dependent on the adhesive type and application time. CONCLUSIONS: Etching mode, application time, and type of adhesive significantly influenced the SBS, Ra, and SFE values.


Assuntos
Condicionamento Ácido do Dente , Adesivos Dentinários , Animais , Bovinos , Colagem Dentária , Cimentos Dentários , Esmalte Dentário , Teste de Materiais
17.
J Am Heart Assoc ; 7(7)2018 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-29599211

RESUMO

BACKGROUND: Development of right ventricular (RV) hypertension eventually contributes to RV and left ventricular (LV) myocardial fibrosis and dysfunction. The molecular mechanisms are not fully elucidated. METHODS AND RESULTS: Pulmonary artery banding was used to induce RV hypertension in rats in vivo. Then, we evaluated cardiac function and regional remodeling 6 weeks after pulmonary artery banding. To further elucidate mechanisms responsible for regional cardiac remodeling, we also mimicked RV hypertensive stress by cyclic mechanical stretching applied to confluent cultures of cardiac fibroblasts, isolated from the RV free wall, septal hinge points, and LV free wall. Echocardiography and catheter evaluation demonstrated that rats in the pulmonary artery banding group developed RV hypertension with leftward septal displacement, LV compression, and increased LV end-diastolic pressures. Picrosirius red staining indicated that pulmonary artery banding induced marked RV fibrosis and dysfunction, with prominent fibrosis and elastin deposition at the septal hinge points but less LV fibrosis. These changes were associated with proportionally increased expressions of integrin-ß1 and profibrotic signaling proteins, including phosphorylated Smad2/3 and transforming growth factor-ß1. Moreover, mechanically stretched fibroblasts also expressed significantly increased levels of α-smooth muscle actin, integrin-ß1, transforming growth factor-ß1, collagen I deposition, and wrinkle formation on gel assays, consistent with myofibroblast transformation. These changes were not observed in parallel cultures of mechanically stretched fibroblasts, preincubated with the integrin inhibitor (BTT-3033). CONCLUSIONS: Experimentally induced RV hypertension triggers regional RV, hinge-point, and LV integrin ß1-dependent mechanotransduction signaling pathways that eventually trigger myocardial fibrosis via transforming growth factor-ß1 signaling. Reduced LV fibrosis and preserved global function, despite geometrical and pressure aberrations, suggest a possible elastin-mediated protective mechanism at the septal hinge points.


Assuntos
Pressão Arterial , Ventrículos do Coração/metabolismo , Hipertensão Pulmonar/complicações , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Direita/etiologia , Integrina beta1/metabolismo , Artéria Pulmonar/fisiopatologia , Função Ventricular Esquerda , Função Ventricular Direita , Remodelação Ventricular , Animais , Células Cultivadas , Colágeno Tipo I/metabolismo , Modelos Animais de Doenças , Elastina/metabolismo , Fibrose , Ventrículos do Coração/patologia , Ventrículos do Coração/fisiopatologia , Hipertensão Pulmonar/metabolismo , Hipertensão Pulmonar/patologia , Hipertensão Pulmonar/fisiopatologia , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/patologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Hipertrofia Ventricular Direita/metabolismo , Hipertrofia Ventricular Direita/patologia , Hipertrofia Ventricular Direita/fisiopatologia , Masculino , Mecanotransdução Celular , Ratos Sprague-Dawley , Fator de Crescimento Transformador beta1/metabolismo
18.
Am J Otolaryngol ; 39(2): 77-81, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29395281

RESUMO

PURPOSE: In this article, a simple, new laryngeal suspension procedure is described. The effect of hyoid bone suspension by suturing the digastric muscle to the periosteum of the mandible is analyzed. MATERIALS AND METHODS: To elucidate the effect of hyoid bone suspension, CT scans of 26 patients who underwent ipsilateral neck dissection with primary resection of tongue cancer were retrospectively reviewed, and the distance between the hyoid bone and the mandible was measured on the operated and unoperated sides of the neck. A total of 14 patients who underwent suturing of the digastric muscle to the mandible (digastric muscle-sutured group) and the 12 patients who did not (control group) were compared. RESULTS: In the digastric muscle-sutured group, the average distance between the hyoid bone and the mandible was significantly smaller on the operated side (17.8 ±â€¯0.57 mm) than on the unoperated side (19.8 ±â€¯0.93 mm; p < 0.05). In the control group, there was no significant difference between the operated side (21.0 ±â€¯1.42 mm) and the unoperated side (19.7 ±â€¯1.39 mm). The difference in the distance between the operated and unoperated sides was significantly larger in the digastric muscle-sutured group (1.97 ±â€¯0.79 mm) than in the control group (-1.32 ±â€¯0.61; p < 0.05). CONCLUSIONS: It was shown for the first time that suturing of the digastric muscle to the periosteum of the mandible in neck dissection with primary resection of tongue cancer resulted in hyoid bone suspension. This simple procedure can be useful for laryngeal suspension.


Assuntos
Mandíbula/cirurgia , Esvaziamento Cervical/métodos , Músculos do Pescoço/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Periósteo/cirurgia , Técnicas de Sutura/instrumentação , Neoplasias da Língua/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Suturas , Neoplasias da Língua/diagnóstico , Adulto Jovem
19.
Am J Physiol Heart Circ Physiol ; 314(3): H542-H551, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29146614

RESUMO

The objective of the present study was to investigate mechanisms of heart rate (HR) reduction on biventricular function and interactions in experimental pulmonary arterial hypertension (PAH). We compared cardiac cycle mechanics and interventricular interactions in 15 sham, 8 monocrotaline-PAH, 9 PAH + carvedilol, and 8 PAH + ivabradine rats. We used echocardiography to assess biventricular function, timing of cardiac cycle events, and septal position in PAH rats and related HR reduction effects on biventricular function measured by echocardiography and conductance catheter. HR was 302 beats/min in PAH + carvedilol rats and 303 beats/min in PAH + ivabradine rats versus 359 beats/min in PAH rats ( P < 0.01). Sham rats showed temporal alignment between right ventricular (RV) and left ventricular (LV) events, whereas PAH rats showed increased biventricular isovolumic contraction times (ICTs), delayed RV peak radial motion, and impaired early relaxation. Temporal malalignment was associated with decreased tricuspid and mitral diastolic annular peak velocities (3.7 vs. 6.4 and 3.4 vs. 5.3 cm/s, respectively, P < 0.001), delayed and shortened biventricular filling, and reduced early diastolic LV filling velocity (0.56 vs. 0.81 cm/s, P < 0.01). LV eccentricity index was increased at systole (2.0 vs. 1.2, P < 0.001), early diastole (2.1 vs. 1.1, P < 0.001), and end diastole (1.6 vs. 1.1, P < 0.001) in PAH versus sham rats. HR reduction with carvedilol and ivabradine shortened biventricular ICTs and the time to biventricular peak radial motion, improved RV relaxation, and increased early diastolic LV filling through reduced interventricular interaction and improved timing. These improvements corresponded with enhanced hemodynamics (increased cardiac output, RV contractility, and diastolic relaxation). In conclusion, HR reduction by carvedilol and ivabradine improves biventricular filling and hemodynamics in experimental PAH through realignment of RV-LV cardiac cycle events and improved interventricular interactions. NEW & NOTEWORTHY Carvedilol improves biventricular function in experimental pulmonary arterial hypertension, but the mechanisms of heart rate reduction versus ß-blocker effect are inadequately defined. Here, we demonstrate that reducing heart rate using either carvedilol or ivabradine (hyperpolarization-activated current inhibitor without ß-blocker effect) improves right ventricular filling and biventricular hemodynamics through the realignment of right ventricular-left ventricular cardiac cycle events and improved interventricular interactions.


Assuntos
Antagonistas Adrenérgicos beta/farmacologia , Antiarrítmicos/farmacologia , Carvedilol/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Hipertensão Pulmonar/tratamento farmacológico , Ivabradina/farmacologia , Função Ventricular Esquerda/efeitos dos fármacos , Função Ventricular Direita/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Quimioterapia Combinada , Hipertensão Pulmonar/induzido quimicamente , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/fisiopatologia , Masculino , Monocrotalina , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Fatores de Tempo
20.
Auris Nasus Larynx ; 45(1): 186-189, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28365065

RESUMO

Here we present an extremely rare case of giant infantile hemangiopericytoma (HPC) of the tongue diagnosed prenatally by fetal ultrasonography and MR imaging. Due to airway stenosis, the patient was delivered by the ex utero intrapartum treatment (EXIT) procedure at 36 weeks of pregnancy. Initial diagnosis was infantile hemangioma based on physical examination, diagnostic imaging and the high incidence of hemangioma. The tumor was resistant to conservative treatments. Due to severe tumor hemorrhage, the nutrient vessel was embolized by endovascular treatment on the 73th day after birth. Two days after embolization, a hemiglossectomy was performed. Histological analysis after surgery diagnosed infantile HPC with microscopically positive stumps. After receiving adjuvant chemotherapy, the patient has had no recurrence after 53 months with normal speech and swallowing function resulting in normal growth. Our findings support that infantile HPC is one of the differential diagnosis of infantile hemangioma. The EXIT procedure could be effective for infants with upper respiratory stenosis by head and neck tumor diagnosed prenatally. Though complete resection is required for infantile HPC, our report suggests that a conservative surgical approach followed by adjuvant chemotherapy should be used for giant head and neck infantile HPC.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Embolização Terapêutica , Hemangiopericitoma/terapia , Neoplasias da Língua/terapia , Língua/cirurgia , Antagonistas Adrenérgicos beta/uso terapêutico , Terapia Combinada , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Doenças Fetais/diagnóstico por imagem , Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/patologia , Humanos , Recém-Nascido , Masculino , Gravidez , Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/patologia , Ultrassonografia Pré-Natal , Vincristina/uso terapêutico
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