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1.
Int. braz. j. urol ; 45(3): 503-513, May-June 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1012320

RESUMO

ABSTRACT Purpose: The purposes of the present study were to evaluate growth rate of nonfunctioning adrenal incidentalomas (AIs) and their development to hormonal hypersecretion on follow-up. Materials and methods: A retrospective study was conducted from the electronic medical records. A total of 314 patients were diagnosed with adrenal tumors between 2000 and 2016. After excluding patients who had overt adrenal endocrine disorders or whose adrenal tumors were clinically diagnosed as metastatic malignancies, we investigated 108 patients with nonfunctioning AIs including characteristics, the treatment, the way of follow-up and pathology. Results: Fifteen patients received immediate adrenalectomy because of the initial tumor size or patient's preference. Pathological examination revealed malignancy in 2 patients. In the remaining 93 patients, radiological examinations were performed periodically. Tumor enlargement of ≥ 1.0cm was observed in 8.6% of the patients who were followed up as nonfunctioning AIs with a median follow-up period of 61.5 months (range: 4-192). Eleven patients underwent adrenalectomy. On the pathological examinations, all of the tumors, which showed a size increase, were diagnosed as benign tumors. Regarding the followed up patients without adrenalectomy, only 2.4% of the patients had tumor enlargement during the prolonged follow-up. Furthermore, none of the patients developed hormonal hypersecretion or clinical signs such as obesity, glucose intolerance or poorly controlled hypertension. Conclusions: Tumor enlargement of AIs did not correlate with malignancy. The value of repeat radiological and hormonal examinations may be limited in the long-term follow-up of patients whose AIs are not enlarged.

2.
Tokai J Exp Clin Med ; 44(2): 34-39, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31250424

RESUMO

OBJECTIVE: Post-stroke hemiplegic patients with a spastic clenched fist deformity that was caused by upper motor neuron syndrome often have problems with hygiene and nursing. Botulinum toxin-A (BTX-A) had been given for treatment of such patients to relieve spasticity by targeting finger joint muscles, such as the flexor digitorum superficialis and flexor digitorum profundus. However, some of these patients do not have satisfactory outcomes. Therefore, we aimed to examine the clinical efficacy and outcome of BTX-A treatment that targeted the upper lumbrical muscles (ULM) in patients with spastic clenched fist deformity caused by stoke. METHODS: Chronic stroke patients with spastic clenched fist deformity who received BTX-A treatment were evaluated retrospectively. We obtained data from medical records before and at 4 weeks after BTX-A injection to the ULM. The clinical data and outcome measures analyzed included range of motion, the Modified Ashworth Scale, the numeric graphic rating scale for pain, and 2 items from the disability assessment scale (ease of cleaning palm and trimming nail). RESULTS: Wilcoxon signed rank test showed that BTX-A treatment significantly improved all measures. CONCLUSION: BTX-A therapy to the ULM provided satisfactory outcomes in improving spastic clenched fist.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Articulações dos Dedos , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Músculo Esquelético , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Doença dos Neurônios Motores/etiologia , Espasticidade Muscular/fisiopatologia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
3.
Int Braz J Urol ; 45(3): 503-513, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785700

RESUMO

PURPOSE: The purposes of the present study were to evaluate growth rate of nonfunctioning adrenal incidentalomas (AIs) and their development to hormonal hypersecretion on follow-up. MATERIALS AND METHODS: A retrospective study was conducted from the electronic medical records. A total of 314 patients were diagnosed with adrenal tumors between 2000 and 2016. After excluding patients who had overt adrenal endocrine disorders or whose adrenal tumors were clinically diagnosed as metastatic malignancies, we investigated 108 patients with nonfunctioning AIs including characteristics, the treatment, the way of follow-up and pathology. RESULTS: Fifteen patients received immediate adrenalectomy because of the initial tumor size or patient's preference. Pathological examination revealed malignancy in 2 patients. In the remaining 93 patients, radiological examinations were performed periodically. Tumor enlargement of ≥ 1.0cm was observed in 8.6% of the patients who were followed up as nonfunctioning AIs with a median follow-up period of 61.5 months (range: 4-192). Eleven patients underwent adrenalectomy. On the pathological examinations, all of the tumors, which showed a size increase, were diagnosed as benign tumors. Regarding the followed up patients without adrenalectomy, only 2.4% of the patients had tumor enlargement during the prolonged follow-up. Furthermore, none of the patients developed hormonal hypersecretion or clinical signs such as obesity, glucose intolerance or poorly controlled hypertension. CONCLUSIONS: Tumor enlargement of AIs did not correlate with malignancy. The value of repeat radiological and hormonal examinations may be limited in the long-term follow-up of patients whose AIs are not enlarged.


Assuntos
Corticosteroides/sangue , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/metabolismo , Hormônio Adrenocorticotrópico/sangue , Neoplasias das Glândulas Suprarrenais/patologia , Adrenalectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Tomografia Computadorizada por Raios X , Carga Tumoral
4.
Tokai J Exp Clin Med ; 42(3): 139-142, 2017 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-28871583

RESUMO

BACKGROUND: Mirror feedback rehabilitation is effective in preventing the development of oro-ocular synkinesis following severe facial palsy. However, we do not have effective maneuvers to prevent the deterioration of oculo-oral synkinesis. We developed a new method of biofeedback rehabilitation using tape for the prevention of oculo-oral synkinesis. OBJECTIVE: The aim of the present study was to investigate the efficacy of taping feedback rehabilitation. METHODS: Twelve consecutive patients with peripheral facial nerve palsy who developed synkinesis were divided into 2 groups. Six patients were treated with the new training method, and the remaining 6 patients were treated with conventional therapy as controls. In the experiment group, tape was placed around the mouth, and the patient was instructed to close the eyes so that no movements of the mouth would be perceived from sensations of the taped skin. After 4 weeks of training, facial movements were recorded and movie images were graded for mouth synkinesis using the revised Sunnybrook facial grading system by examiners blinded to patient grouping. RESULTS: Mouth corner contraction during eye closure was significantly weaker in the experimental group than in the control group. CONCLUSIONS: Our new feedback method could help prevent the deterioration of oculo-oral synkinesis.


Assuntos
Biorretroalimentação Psicológica/métodos , Paralisia Facial/complicações , Modalidades de Fisioterapia , Fita Cirúrgica , Sincinesia/etiologia , Sincinesia/reabilitação , Adulto , Idoso , Olho , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca , Índice de Gravidade de Doença , Sincinesia/prevenção & controle , Resultado do Tratamento
5.
Tokai J Exp Clin Med ; 42(2): 71-78, 2017 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-28681366

RESUMO

OBJECTIVE: To verify the feasibility and effectiveness of a newly developed modified jaw opening exercise (MJOE) in post-stroke patients with pharyngeal residue who completed a sixweek exercise regimen. DESIGN: Double-blind, randomized, controlled trial. PARTICIPANTS: 16 patients with stroke-related dysphagia. INTERVENTIONS: Participants were allocated to an intervention group (MJOE: one set of five repetitions at 80% maximum voluntary contraction (MVC) for 6 seconds) or a control group (isometric jaw closing exercise: one set of five repetitions at 20% MVC for 6 seconds). Each group performed four sets a day, five times a week, for a total of six weeks. MAIN OUTCOME MEASURES: A videofluorographic swallowing study was performed before and after exercise. The distance between the mental spine and the hyoid bone (DMH) and hyoid displacement (HD) were measured. RESULTS: Twelve participants completed the study. No pain in the temporomandibular joint and/or anterior region of the neck occurred during the exercise period. In the intervention group (N=6), a decrease in DMH where anterior HD ended and an increase in anterior HD were seen. In the control group (N=6), no changes were seen. CONCLUSIONS: MJOE is feasible without any adverse events in poststroke patients, and it promotes anterior HD during swallowing.


Assuntos
Transtornos de Deglutição/terapia , Exercício/fisiologia , Arcada Osseodentária/fisiologia , Idoso , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Método Duplo-Cego , Estudos de Viabilidade , Feminino , Humanos , Osso Hioide/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral
6.
Int J Surg Case Rep ; 34: 115-118, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28384558

RESUMO

INTRODUCTION: Infected periprosthetic femoral fractures are among the most complex and significant complications of total hip arthroplasty (THA). We report the novel use of a temporary THA-like spacer for treating an infected periprosthetic femoral fracture after revision surgery using a long stem. CASE PRESENTATION: We present a 72-year-old woman sustained a left infected periprosthetic femoral fracture after revi - streptococci in the culture sample. On suspicion of a periprosthetic joint infection, we planned a two-stage procedure. We used a temporary THA-like spacer comprising the removed femoral long stem, which was autoclaved and then reimplanted, and applied a new polyethylene acetabular liner. Both components were cemented in place with antibioticloaded bone cement, without applying strong pressure. Pain control waseasily achieved postoperatively because the fracture had been stabilized early. The THA-like spacer was stable, and allowed a good range of motion without pain. She was allowed to move with a wheelchair and was walk with partial weight bearing without pain. Seven week after the initial THAlike spacer placement, we performed a revision THA after successful control of infection. At the 1-year follow-up, the patient remained free of infection. CONCLUSIONS: Temporary antibiotic-loaded cement-coated THA-like spacer using a long stem facilitated the eradication of infection, fracture stabilization, and enables partial weight bearing without pain.

7.
Nihon Hinyokika Gakkai Zasshi ; 108(4): 210-214, 2017.
Artigo em Japonês | MEDLINE | ID: mdl-30333444

RESUMO

A 56-year-old woman had complained of two year's consecutive left-side abdominal pain. Retroperitoneal tumor was diagnosed and the patient was referred to our institute in December 2014. Laboratory data including endocrinological activity and serological markers were within the normal ranges. Imaging studies showed that the solid tumor measuring 5 cm in diameter was uncovered in the retroperitoneum, between the abdominal aorta and left kidney. The patient underwent surgical removal of the tumor with the left kidney because the mass was highly adhesive to the left ovarian vessels and left renal vein. Histological examination showed proliferating spindle cells in the tumor, and immunoreactivity for desmin and alfa-smooth muscle actin in tumor cells confirmed the diagnosis of leiomyosarcoma originated in left ovarian vein with left renal vein invasion. The patient has been free of disease 21 months after the surgery. Ovarian vein leiomyosarcoma is extremely rare and we have found 18 cases in literature. Furthermore, only three cases of leiomyosarcoma arising from the ovarian vein with the renal vein invasion were reported including our case.

8.
Tokai J Exp Clin Med ; 41(3): 143-6, 2016 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-27628607

RESUMO

Bickerstaff's brainstem encephalitis is an autoimmune disease with the primary lesion situated in the brainstem and three cardinal signs: ophthalmoplegia; ataxia; and impaired consciousness. A 68-year-old man was started on rehabilitation exercise 3 months after onset of Bickerstaff's brainstem encephalitis, due to remnant dysarthria and dysphagia (Functional Oral Intake Scale, level 5) after the cardinal signs of Bickerstaff's brainstem encephalitis resolved. Exercise involved using a straw in the anterior midline between the dorsal tongue and hard palate. While the patient was inhaling through the straw, the straw was blocked. After strengthening suction as much as possible, the patient was asked to immediately dry swallow at the same time that suction was stopped. Effects of exercise were examined using videofluorographic swallowing studies before and after 6 weeks of training to compare posterior and superior velar displacements and the presence of nasopharyngeal reflux. No adverse effects of exercise were encountered, and Functional Oral Intake Scale improved to level 7, with significant increases in posterior and superior velar displacement during swallowing compared with before training. In addition, nasopharyngeal reflux that had consistently been seen on swallowing before training was absent after 6 weeks of exercise. This exercise method may prove useful.


Assuntos
Tronco Encefálico , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/reabilitação , Encefalite/complicações , Terapia por Exercício/métodos , Insuficiência Velofaríngea/etiologia , Idoso , Ataxia/complicações , Transtornos da Consciência/complicações , Transtornos de Deglutição/fisiopatologia , Humanos , Masculino , Oftalmoplegia/complicações
9.
J Radiat Res ; 57(3): 280-7, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26983988

RESUMO

We investigated the outcomes of treatment for patients with localized prostate cancer (PCa) treated with 3D conformal radiation therapy (3D-CRT) followed by two-fraction high-dose-rate brachytherapy within a single day (2-fr.-HDR-BT/day) at a single institution. A total of 156 consecutive Asian males (median age, 67 years) were enrolled. To compare our findings with those of other studies, we analyzed our results using the D'Amico classification, assigning the patients to low- ( N =: 5; 3.2%), intermediate- ( N =: 36; 23.1%) and high-risk ( N =: 115; 73.7%) groups (Stage T3 PCa patients were classified as high-risk). One patient in the D'Amico low-risk group (20%), 13 intermediate-risk patients (36.1%) and 99 high-risk patients (86.1%) underwent androgen deprivation therapy. We administered a prescription dose of 39 Gy in 13 fractions of 3D-CRT combined with 18 Gy of HDR-BT in two 9-Gy fractions delivered within a single day. We did not distinguish between risk groups in determining the prescription dose. The median follow-up period was 38 months. Of the 156 patients, one died from primary disease and five died from other diseases. The 3-year overall survival (OS) rates were 100%, 100% and 93.7%, and the 3-year 'biochemical no evidence of disease (bNED)' rates were 100%, 100% and 96.9% for the D'Amico low-, intermediate- and high-risk groups, respectively. No patient developed ≥ Grade 3 early toxicity. The Grade 3 late genitourinary toxicity rate was 2.6%, and no ≥ Grade 3 late gastrointestinal toxicity occurred. The efficacy and safety of this study were satisfactory, and longer-term follow-up is necessary.


Assuntos
Braquiterapia/métodos , Fracionamento da Dose de Radiação , Neoplasias da Próstata/radioterapia , Idoso , Braquiterapia/efeitos adversos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Resultado do Tratamento
10.
Sci Rep ; 5: 14822, 2015 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-26439164

RESUMO

We demonstrated a novel microfluidic white organic light-emitting diode (microfluidic WOLED) based on integrated sub-100-µm-wide microchannels. Single-µm-thick SU-8-based microchannels, which were sandwiched between indium tin oxide (ITO) anode and cathode pairs, were fabricated by photolithography and heterogeneous bonding technologies. 1-Pyrenebutyric acid 2-ethylhexyl ester (PLQ) was used as a solvent-free greenish-blue liquid emitter, while 2,8-di-tert-butyl-5,11-bis(4-tert-butylphenyl)-6,12-diphenyltetracene (TBRb)-doped PLQ was applied as a yellow liquid emitter. In order to form the liquid white light-emitting layer, the greenish-blue and yellow liquid emitters were alternately injected into the integrated microchannels. The fabricated electro-microfluidic device successfully exhibited white electroluminescence (EL) emission via simultaneous greenish-blue and yellow emissions under an applied voltage of 100 V. A white emission with Commission Internationale de l'Declairage (CIE) color coordinates of (0.40, 0.42) was also obtained; the emission corresponds to warm-white light. The proposed device has potential applications in subpixels of liquid-based microdisplays and for lighting.

11.
Tokai J Exp Clin Med ; 39(4): 172-7, 2014 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-25504204

RESUMO

OBJECTIVE: To compare sensitivities between 7 principal nerve conduction studies (NCS) for diagnosing carpal tunnel syndrome (CTS). METHOD: In 104 CTS and 64 control hands, following "Standard" NCSs were examined simultaneously: (1) Median sensory NCS; (2) segmental wrist-palm sensory NCS; (3) 4th digit latency difference; (4) 1st digit latency difference and (5) palmar mixed nerve latency difference. As "Guideline" and "Option" NCSs, we also examined: (6) Median motor distal latency and (7) second lumbrical-interossei latency difference (2LILD). Forty-nine CTS hands were divided into a milder subgroup only if action potentials could be recorded using all tests applied; that is, those with any absent potentials were excluded from the subgroup. Sensitivities and specificities were compared to each other. RESULTS: In all CTS hands, the sensitivity of test (1), (2), (3), (4), (5), (6) and (7) was 83, 87, 92, 90, 90, 70 and 92%, respectively. In the milder subgroup, it was 67, 78, 84, 82, 84, 43, and 84% in the same order. There was no statistical difference between Standard tests and 2LILD. Specificities of all tests were over 95%. CONCLUSIONS: All "Standard" tests and 2LILD have high comparable sensitivities. Therefore, 2LILD should be recommended as "Standard" NCS detecting CTS.


Assuntos
Síndrome do Túnel Carpal/diagnóstico , Técnicas de Diagnóstico Neurológico , Eletrodiagnóstico/métodos , Condução Nervosa , Adulto , Síndrome do Túnel Carpal/fisiopatologia , Técnicas de Diagnóstico Neurológico/normas , Eletrodiagnóstico/normas , Feminino , Humanos , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Sensibilidade e Especificidade
12.
Nihon Hinyokika Gakkai Zasshi ; 105(3): 139-43, 2014 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-25158557

RESUMO

A 36-year-old female received protocol biopsy at 1 month after living donor kidney transplantation. At 3 months post-transplantation, presence of a growing cystic mass in the kidney graft which had not been detected preoperatively, was demonstrated by ultrasound and computed tomography. The patient had an abdominal pain around the graft. Percutaneous drainage and sclerotherapy with minocyclin were performed twice, but the cystic mass, nevertheless, became enlarged and the abdominal pain recurred again. Laparoscopic fenestration was then performed. Immunohistochemistry of the cystic mass wall showed that it was CD34 (-), EMA (-), Megalin (-), but D2-40 (+). These results suggested that the cystic mass was derived from lymphatic vessels, which developed into lymphocele in the graft. We concluded that lymphatic vessels could have been injured and obstructed by the protocol biopsy. This is the first report of successful laparoscopic fenestration for lymphocele in the kidney graft.


Assuntos
Transplante de Rim , Linfocele/etiologia , Linfocele/cirurgia , Adulto , Feminino , Humanos , Laparoscopia , Doadores Vivos , Complicações Pós-Operatórias
13.
Angew Chem Int Ed Engl ; 53(27): 6993-6, 2014 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24853608

RESUMO

The electrochemistry and electrogenerated chemiluminescence (ECL) of four kinds of electron donor-acceptor molecules exhibiting thermally activated delayed fluorescence (TADF) is presented. TADF molecules can harvest light energy from the lowest triplet state by spin up-conversion to the lowest singlet state because of small energy gap between these states. Intense green to red ECL is emitted from the TADF molecules by applying a square-wave voltage. Remarkably, it is shown that the efficiency of ECL from one of the TADF molecule could reach about 50%, which is comparable to its photoluminescence quantum yield.

14.
Urology ; 82(4): 846-51, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24074981

RESUMO

OBJECTIVE: To investigate the prognosis and prognostic factors of patients with metastatic renal cell carcinoma who underwent metastasectomy. METHODS: We sent questionnaires to Japanese hospitals. The questionnaires included data of patients with metastatic renal cell carcinoma who had their metastatic lesions removed between January 1988 and December 2009. We collected them and retrospectively analyzed these data and calculated the overall survival from the first metastasectomy until death or last follow-up. We also analyzed the relationship between survival and clinico-pathologic features and determined adverse prognostic factors. Furthermore, we identified a poor prognostic group by counting the number of prognostic factors. RESULTS: A sample size of 556 patients from 48 institutions was studied. The median overall survival was 80 months. Four adverse prognostic factors were detected: incomplete resection by metastasectomy (hazard ratio [HR], 2.15), brain metastasis (HR, 3.73), >1.0 mg/dL C-reactive protein (HR, 2.45), and the highest histologic grade in Japanese classification (nuclei of tumor cells are larger than nuclei of normal tubular cells; HR, 1.88). The median overall survivals of patients with 3 or 4 prognostic factors, 2 factors, and 0 and 1 factors were 10 months, 42 months, and 105 months, respectively. CONCLUSION: Four adverse prognostic factors for predicting the survival of patients with removed metastases were identified. Patients with 3 or 4 of these adverse prognostic factors had a worse prognosis.


Assuntos
Carcinoma de Células Renais/secundário , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/patologia , Metastasectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Carcinoma de Células Renais/mortalidade , Feminino , Humanos , Neoplasias Renais/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
15.
BMC Urol ; 13: 7, 2013 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-23374442

RESUMO

BACKGROUND: The hand-assisted technique enables the rapid extraction of the graft, shortening the warm ischemia time (WIT), and the retroperitoneoscopic approach is potentially associated with a less incidence of postoperative ileus in donor nephrectomy for living kidney transplantation. The aim of this study was to assess the efficacy and safety of retroperitoneoscopic donor nephrectomy with a gel-sealed hand-assist access device (GelPort), which is a wound sealing device that permits the access of the hand to the surgical field, free trocar site choice within it, and rapid conversion to open surgery if necessary, while preserving the pneumoperitoneum/pneumoretroperitoneum. METHODS: Seventy-five consecutive donors receiving this procedure were retrospectively studied. A 2-cm skin incision was made at the midpoint between the tip of the 12th rib and superior border of the iliac bone in the midaxillary line, through which retroperitoneal space was made. Preperitoneal wound with a 6 - 7-cm pararectal incision in the upper abdominal region was connected to the retroperitoneal space. A GelPort was put inside the pararectal surgical wound. The principle was pure retroperitoneoscopic surgery; hand-assist was applied for retraction of the kidney in the renal vessel control and graft extraction. RESULTS: The mean operation time including waiting time for recipient preparation was 242.2±37.0 (range: 214.0-409.0) min, and the mean amount of blood loss was 164.3±146.6 (range: 10.0-1020.0) ml. The mean WIT was 2.8±1.0 (range: 1.0-6.0) min. The shortage of renal vessels or ureter was observed in none of the grafts. No donor experienced blood transfusion, open conversion, or injury of other organs. Blood loss was greater in patients with body mass index (BMI) of 25 kg/m2 or higher than in those with BMI of <25 kg/m2 (218.4±98.8 vs. 154.8±152.1 ml, P=0.031). No donor had postoperative ileus or reported wound pain leading to decreased activity of daily life or wound cosmetic problem. CONCLUSIONS: Retroperitoneoscopic hand-assisted donor nephrectomy with the mentioned approach was suggested to be a feasible option without compromising safety, although further improvement in surgical techniques is warranted.


Assuntos
Laparoscopia Assistida com a Mão/métodos , Transplante de Rim , Doadores Vivos , Nefrectomia/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Espaço Retroperitoneal , Estudos Retrospectivos , Isquemia Quente
16.
Muscle Nerve ; 46(6): 879-84, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23018900

RESUMO

INTRODUCTION: Premotor potentials (PMPs) precede compound muscle action potentials evoked from the second lumbrical muscle after median nerve stimulation. Although PMP has been identified as a median sensory nerve action potential, few reports have documented the significance of PMP parameters for diagnosing carpal tunnel syndrome (CTS). METHODS: We investigated the relationships between PMP parameters and results of 6 standard median nerve conduction studies in 74 CTS hands. RESULTS: Significant correlations were noted in all comparisons. PMP conduction velocity was strongly correlated with the sensory conduction velocity between wrist and digit 2 (r(2) = 0.91). Moreover, PMP parameters were significantly correlated with neurophysiological severity of CTS. CONCLUSION: Measuring PMP parameters with a second lumbrical-interosseous study may be useful for diagnosing CTS.


Assuntos
Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/fisiopatologia , Potencial Evocado Motor/fisiologia , Condução Nervosa/fisiologia , Adulto , Idoso , Estimulação Elétrica/métodos , Eletromiografia , Feminino , Mãos/inervação , Humanos , Modelos Lineares , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Estudos Prospectivos , Tempo de Reação/fisiologia , Estudos Retrospectivos , Índice de Gravidade de Doença
17.
BMC Neurosci ; 13: 66, 2012 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-22703383

RESUMO

BACKGROUND: The event-related desynchronization (ERD) in EEG is known to appear during motor imagery, and is thought to reflect cortical processing for motor preparation. The aim of this study is to examine the modulation of ERD with motor impairment in ALS patients. ERD during hand motor imagery was obtained from 8 ALS patients with a variety of motor impairments. ERD was also obtained from age-matched 11 healthy control subjects with the same motor task. The magnitude and frequency of ERD were compared between groups for characterization of ALS specific changes. RESULTS: The ERD of ALS patients were significantly smaller than those of control subjects. Bulbar function and ERD were negatively correlated in ALS patients. Motor function of the upper extremities did was uncorrelated with ERD. CONCLUSIONS: ALS patients with worsened bulbar scales may show smaller ERD. Motor function of the upper extremities did was uncorrelated with ERD.


Assuntos
Esclerose Amiotrófica Lateral/complicações , Sincronização Cortical/fisiologia , Transtornos dos Movimentos/etiologia , Desempenho Psicomotor/fisiologia , Estatística como Assunto , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Eletroencefalografia , Feminino , Mãos , Humanos , Imagens (Psicoterapia)/métodos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
18.
PLoS One ; 7(5): e37163, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22623989

RESUMO

Stromal cell-derived factor 1 (SDF-1/CXCL12/PBSF) plays important roles in the biological and physiological functions of haematopoietic and mesenchymal stem cells. This chemokine regulates the formation of multiple organ systems during embryogenesis. However, its roles in skeletal development remain unclear. Here we investigated the roles of SDF-1 in chondrocyte differentiation. We demonstrated that SDF-1 protein was expressed at pre-hypertrophic and hypertrophic chondrocytes in the newly formed endochondral callus of rib fracture as well as in the growth plate of normal mouse tibia by immunohistochemical analysis. Using SDF-1(-/-) mouse embryo, we histologically showed that the total length of the whole humeri of SDF-1(-/-) mice was significantly shorter than that of wild-type mice, which was contributed mainly by shorter hypertrophic and calcified zones in SDF-1(-/-) mice. Actin cytoskeleton of hypertrophic chondrocytes in SDF-1(-/-) mouse humeri showed less F-actin and rounder shape than that of wild-type mice. Primary chondrocytes from SDF-1(-/-) mice showed the enhanced formation of philopodia and loss of F-actin. The administration of SDF-1 to primary chondrocytes of wild-type mice and SDF-1(-/-) mice promoted the formation of actin stress fibers. Organ culture of embryonic metatarsals from SDF-1(-/-) mice showed the growth delay, which was recovered by an exogenous administration of SDF-1. mRNA expression of type X collagen in metatarsals and in primary chondrocytes of SDF-1(-/-) mouse embryo was down-regulated while the administration of SDF-1 to metatarsals recovered. These data suggests that SDF-1 regulates the actin organization and stimulates bone growth by mediating chondrocyte hypertrophy.


Assuntos
Actinas/metabolismo , Cartilagem/embriologia , Quimiocina CXCL12/metabolismo , Condrócitos/citologia , Consolidação da Fratura/fisiologia , Lâmina de Crescimento/embriologia , Fraturas das Costelas/metabolismo , Tíbia/embriologia , Actinas/ultraestrutura , Animais , Bromodesoxiuridina , Cartilagem/metabolismo , Quimiocina CXCL12/genética , Primers do DNA/genética , Lâmina de Crescimento/metabolismo , Hipertrofia/metabolismo , Imuno-Histoquímica , Camundongos , Camundongos Knockout , Reação em Cadeia da Polimerase em Tempo Real , Tíbia/metabolismo
19.
Arthritis Rheum ; 64(4): 1024-34, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22076918

RESUMO

OBJECTIVE: To determine whether lectin-like oxidized low-density lipoprotein (ox-LDL) receptor 1 (LOX-1) and the soluble form of LOX-1 (sLOX-1) are novel target molecules for the diagnosis and treatment of rheumatoid arthritis (RA). METHODS: Expression of ox-LDL and LOX-1 proteins in human RA synovium was evaluated by immunohistochemistry. Human RA fibroblast-like synoviocytes (FLS) were assessed for ox-LDL-induced expression of LOX-1 and ox-LDL-induced production of matrix metalloproteinase 1 (MMP-1) and MMP-3. Levels of sLOX-1 in the plasma and synovial fluid of patients with RA, compared with patients with osteoarthritis (OA), were determined by a specific chemiluminescence enzyme-linked immunoassay. In animal experiments, ox-LDL was injected into the knee joints of mice, with or without an anti-LOX-1 neutralizing antibody or sLOX-1, and the severity of arthritis was analyzed by histology and immunohistochemistry. RESULTS: Oxidized LDL and LOX-1 proteins were detected in the RA synovial tissue. Levels of MMP-1 and MMP-3 were enhanced by stimulation of RA FLS with ox-LDL, and the production of both MMPs was inhibited by blockade of the ox-LDL-LOX-1 interaction with the anti-LOX-1 neutralizing antibody or sLOX-1. Levels of sLOX-1 in the plasma and synovial fluid of RA patients were significantly higher than those in OA patients and healthy controls and were positively correlated with inflammation markers and the extent of RA disease activity. In the knees of mice, blockade of the ox-LDL-LOX-1 interaction suppressed arthritic changes and reduced the expression of MMP-3 induced by ox-LDL. CONCLUSION: These findings strongly indicate that sLOX-1 is a novel biomarker that may be useful for the diagnosis of RA and for the evaluation of disease activity in RA. Furthermore, the results suggest that LOX-1 may be a potent therapeutic target for RA.


Assuntos
Artrite Reumatoide/diagnóstico , Osteoartrite/diagnóstico , Receptores Depuradores Classe E/metabolismo , Líquido Sinovial/metabolismo , Animais , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Biomarcadores/metabolismo , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Condrócitos/metabolismo , Condrócitos/patologia , Diagnóstico Diferencial , Humanos , Articulação do Joelho/metabolismo , Articulação do Joelho/patologia , Metaloproteinase 3 da Matriz/biossíntese , Camundongos , Osteoartrite/metabolismo , Osteoartrite/patologia , Membrana Sinovial/metabolismo , Membrana Sinovial/patologia
20.
Jpn J Clin Oncol ; 41(11): 1259-64, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21940731

RESUMO

OBJECTIVE: In 2005, the University of California, San Francisco developed the Cancer of the Prostate Risk Assessment (UCSF-CAPRA) score as a new risk stratification tool. The UCSF-CAPRA, which ranges from 0 to 10 points, consists of five clinical variables, prostate-specific antigen, Gleason score, T stage, percent of positive biopsies and age. The aim of this study was to validate the UCSF-CAPRA score for Japanese prostate cancer patients receiving radical prostatectomy using the contemporary Gleason grading. METHODS: From 1999 to 2010, 211 men who underwent radical prostatectomy were used for validation. Biochemical progression-free survival was calculated using the Kaplan-Meier method and the UCSF-CAPRA and D'Amico risk categories were compared using the log-rank method. The concordance index (c-index) for the UCSF-CAPRA and D'Amico risk classification was calculated. RESULTS: Using the UCSF-CAPRA score, 85 (40.3%), 106 (50.2%) and 20 (9.5%) subjects were stratified as 0-2 points (low risk), 3-5 points (intermediate risk) and 6-10 points (high risk). Using the D'Amico risk criteria, 66 (31.3%), 89 (42.2%) and 56 (26.5%) were stratified as low-, intermediate- and high-risk groups, respectively. The Kaplan-Meier analysis showed that the UCSF-CAPRA divided the patients significantly into each risk category. There was no significant difference between low and intermediate in the D'Amico risk classification. The c-index of the UCSF-CAPRA and D'Amico classification was 0.755 and 0.713, respectively. CONCLUSION: The UCSF-CAPRA is an acceptable risk category tool comparable to that of the D'Amico risk classification for Japanese prostate cancer patients receiving radical prostatectomy in the contemporary Gleason grading era.


Assuntos
Recidiva Local de Neoplasia/diagnóstico , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Grupo com Ancestrais do Continente Asiático , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , São Francisco , Taxa de Sobrevida
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