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1.
Cent European J Urol ; 74(3): 429-436, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34729233

RESUMO

Introduction: Medical treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) targets prostate size, to prevent disease progression, and prostate smooth muscle tone for rapid relieve of LUTS. Holmium laser enucleation of the prostate (HoLEP) is a size-independent method for surgical treatment of LUTS/BPO in medication-refractory patients and offers durable long-term results with reduced perioperative morbidity. As up to 50% of patients receive medical treatment for LUTS/BPO prior to surgery, we analyzed the impact of alpha-blockers and 5-alpha reductase inhibitors (5-ARI) on outcomes and perioperative morbidity in patients undergoing HoLEP for LUTS. Material and methods: We retrospectively gathered data of 1,057 patients, who underwent HoLEP for LUTS/BPO from 2013-2018, and divided patients into group 1 (no medication), group 2 (α-blockers), and group 3 (5-ARI and α-blockers). Perioperative parameters, short-term functional outcomes and safety were assessed and statistical analysis was performed using SPSS V26.0 software. Results: Even though preoperative LUTS profile was significantly different between groups, all patients improved significantly after HoLEP, irrespective of preoperative LUTS medication. Median improvement of IPSS was 9, 8 and 7 points, of Qmax was 10, 12 and 9.5 ml/s, with significant improvement of quality of life (QoL) and reduction of post-void residual volume (PVR) for groups 1-3, respectively, 30 days after surgery. With only 4.0% (42/1,057) of patients experiencing a Clavien-Dindo grade ≥II complication, there was no difference in prevalence of perioperative complications between groups (p = 0.943). Conclusions: Although preoperative LUTS medication does not impair efficacy of HoLEP with acceptable perioperative morbidity, the time gap between medical therapy and surgical treatment may favor an earlier response.

2.
ACS Appl Mater Interfaces ; 13(45): 54439-54446, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34738782

RESUMO

Stimuli-responsive liquid crystal elastomers (LCEs), which exhibit sophisticated and versatile shape variations and functions upon stimulations, have constantly interested material science researchers. To date, many challenges still exist in scaling up orientated LCEs with sophisticated physical shapes and multi-functions. Herein, LCEs with various customizable conventional and exotic three-dimensional (3D) shapes and with sizes larger than those previously reported have been prepared by combining magnetic field alignment and soft lithography technology. These LCEs have film, cylinder, ellipsoid, hemispheroid, tube, pyramid, triangle and rectangle frame, grid pattern, cubic frame, and spring shapes. Meanwhile, diversified deformation behaviors such as contraction, expansion, bending, and twisting have been achieved by effectively controlling the alignment directions. Finally, the LCE actuator with hemispheroid shape has been explored for its possible applications in dynamic Braille displays or lenses with adjustable focal length. The simple strategy reported here provides a convenient way to customize multimorphological large-size 3D LCE actuators and their stimuli-responsive deformations. These systems will considerably enlarge the potential applications of LCEs and benefit the development of LCE soft robots and the future special bionic systems.

3.
Urology ; 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34339752

RESUMO

OBJECTIVE: To compare perioperative management and functional outcome of spinal anesthesia (SpA) to general anesthesia (GA) in high-risk patients treated for lower urinary tract symptoms with Holmium laser enucleation of the prostate (HoLEP). METHODS: In the current retrospective analysis, a propensity-score-matching of patients treated for lower urinary tract symptom with HoLEP (n = 300) in SpA with ASA>2 (n = 100), GA with ASA>2 (GA-high-risk) (n = 100) or GA with ASA≤2 (GA-low-risk) (n = 100) was performed. The impact of anesthesiologic mode on perioperative anesthesiologic outcome, early functional outcome and treatment related adverse events (according to Clavien Dindo), was evaluated. RESULTS: Hypotensive episodes were significantly less frequent in the SpA-cohort (9%) compared to the GA-high-risk cohort (32%) and the GA low-risk cohort (22%) (each P <.05 respectively). SpA-patients showed a significantly shorter median time in post anesthesia care unit (PACU-time: 135 minutes; 120-166.5) compared to GA-high-risk patients (186 minutes; 154-189.5), with significant less referrals to Intermediate care unit (1% vs 9 %); (each P <.05). PACU-time (99 minutes) and Intermediate care unit referrals (0%) for GA-low-risk were lower than for both other cohorts. Postoperative requirement for analgesics was significantly lower in the SpA-cohort (2%), compared to both GA-cohorts (74% and 61% respectively; P <.05). No significant difference was found regarding early functional outcome or treatment related adverse events (p-range: 0.201-1.000). CONCLUSION: For patients undergoing HoLEP, SpA provides greater hemodynamic stability and allows faster overall postoperative recovery with preferable pain management. Yielding a comparable functional outcome, it is a safe and efficient alternative to GA in high-risk patients.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34323002

RESUMO

OBJECTIVES: To evaluate the impact of prostate size on functional outcomes and perioperative morbidity, we analyzed patients undergoing holmium laser enucleation of the prostate (HoLEP) for lower urinary tract symptoms (LUTS). As LUTS secondary to benign prostatic obstruction (BPO) are a chronic progressive disease, prevalence and prostate size increase with age. HoLEP is a size-independent method for surgical treatment of LUTS/BPO and can be offered in medication-refractory patients with durable long-term results and reduced perioperative morbidity. METHODS: We retrospectively collected data of 852 patients who underwent HoLEP for LUTS secondary to BPO between 2014-2018. Patients were divided into group 1 (≤60 cc), group 2 (>60 < 120 cc), group 3 (≥120 cc). Perioperative parameters, safety and short-term functional outcomes were assessed and analyzed. RESULTS: Patients in group 3 were significantly older and showed a significantly higher median prostate-specific antigen level. Perioperative parameters, such as enucleation time and morcellation time significantly differed in favor of smaller prostate sizes, while enucleation and morcellation speed showed favorable results for larger prostate sizes. Larger prostates ≥120 cc showed a significantly higher postoperative drop in hemoglobin. However, patients did not differ in postoperative functional outcomes or Clavien-Dindo grade ≥II complications (4.8% of all patients [41/852]). There was no difference in perioperative complications between all groups (P = 0.760). CONCLUSION: While larger prostates take significantly longer to operate on, postoperative functional outcomes show no difference between all sizes. In conclusion, HoLEP is a size-independent and effective method for surgical treatment of LUTS/BPO in prostates ≥30 cc.

5.
Aktuelle Urol ; 52(4): 338-344, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-34102684

RESUMO

The use of modern molecular technologies in the last decade has given us new insights into the complex interactions of the human microbiome in health and in the pathogenesis of diseases. Among other things, the sterility concept of the urinary tract has been discarded and the goal is now to identify the different microbial signatures associated with various diseases. Dysbalances of the microbiome are increasingly suspected of causing negative effects on various malignant and benign diseases. Recently, such associations have also been shown for prostate carcinoma, renal cell carcinoma and urinary bladder carcinoma. This may lead to the discovery of new potential biomarkers for the diagnosis and as a therapeutic target of the diseases mentioned. For the diagnosis of some benign diseases such as interstitial cystitis, urge incontinence and chronic prostatitis or chronic pelvic pain syndrome, microbial involvement was previously considered an exclusion criterion. However, current studies show that the individual patient's microbiome can have an influence on the development and severity of the respective disease.


Assuntos
Cistite Intersticial , Microbiota , Prostatite , Humanos , Masculino , Dor Pélvica
6.
Health Econ ; 30(9): 2092-2123, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34076325

RESUMO

This paper studies the effect of birth allowances (so-called baby bonus) on fertility, newborn health, and birth-scheduling in Switzerland. Switzerland provides an optimal quasi-experiment: 11 out of 26 cantons introduced a baby bonus during the last 50 years at different points in time. To identify the effect of changes in the baby bonus, we employ an event study with control groups using several administrative data sets on births, stillbirths, and infant deaths in Switzerland from 1969 to 2017. While there is no evidence for birth-scheduling, we find, however, a sizable but only temporary increase in the fertility rate of 5.5% and a permanent but diminishing increase in the birth weight of 2.8%. The latter effect is particularly strong at the lower end of the birth weight distribution. Furthermore, we document substantial heterogeneity by citizenship of mothers.


Assuntos
Fertilidade , Saúde do Lactente , Coeficiente de Natalidade , Peso ao Nascer , Humanos , Lactente , Recém-Nascido , Suíça/epidemiologia
7.
Urology ; 154: 221-226, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33891930

RESUMO

OBJECTIVE: To evaluate efficacy and safety of holmium laser enucleation of the prostate (HoLEP), bipolar enucleation of the prostate (bTUEP) and transurethral resection of the prostate (TURP) in medium-sized prostates (50cc). METHODS: We present a retrospective analysis of 2230 patients treated for lower urinary tract symptoms. We analysed perioperative parameters, short-term clinical outcomes and adverse events in matched-pair cohorts. RESULTS: Both HoLEP and bTUEP were superior in terms of efficacy compared to TURP (surgery time: 51min and 50min vs. 60min; P < 0.001; tissue retrieval percentage: 71.4% and 70% vs. 50%; P < 0.001) and showed stronger improvement of LUTS (change IPSS: -15 and -14 vs. -10; P = 0.008). Furthermore, urodynamic parameters (Qmax: +15 ml/s and +19 ml/s vs. +12 ml/s; P < 0.001; PVR: -100 ml and -95 ml vs. - 80ml; P < 0.008) were significantly more improved after enucleation than after TURP. All techniques showed an equally low complication rate (6.9% and 6.9% vs. 10.3%; P = 0.743). No relevant difference of clinical outcomes was identified between HoLEP and bTUEP. CONCLUSION: Both resection and enucleation are efficient and safe procedures in patients with medium-sized prostates (50cc), but irrespective of the technical approach, transurethral enucleation is superior to TURP in terms of perioperative and functional outcomes.

8.
Artigo em Inglês | MEDLINE | ID: mdl-33682680

RESUMO

Summary: Struma ovarii is a teratoma of the ovaries predominantly composed of thyroid tissue. Hyperthyroidism associated with struma ovarii is rare, occurring in approximately 8% of cases. Due to the rarity of struma ovarii, available data are limited to case reports and small case series.We report on a 61-year-old female patient with known Hashimoto's thyroiditis on levothyroxine replacement therapy for years with transition to clinical and biochemical hyperthyroidism despite antithyroid medication with carbimazole (10 mg/day), new diagnosis of urothelial carcinoma and an adnexal mass suspicious of ovarian cancer. The patient underwent resection of the adnexal mass and histopathology revealed a mature teratoma predominantly composed of thyroid tissue showing high levels of sodium iodide symporter protein expression. Following struma ovarii resection and disappearance of autonomous production of thyroid hormones, the patient developed hypothyroidism with severely decreased thyroid hormone levels fT4 and fT3 (fT4 0.4 ng/dL, reference interval 0.9-1.7 and fT3 < 1.0 pg/mL, reference interval 2.0-4.4). This has previously been masked by continued thyroid-stimulating hormone suppression due to long-term hyperthyroidism pre-surgery indicating secondary hypothyroidism, in addition to primary hypothyroidism based on the known co-existing chronic lymphocytic thyroiditis of the orthotopic thyroid gland. Levothyroxine administration was started immediately restoring euthyroidism.This case illustrates possible diagnostic pitfalls in a patient with two concurrent causes of abnormal thyroid function. Learning points: Struma ovarii is an ovarian tumor containing either entirely or predominantly thyroid tissue and accounts for approximately 5% of all ovarian teratomas. In rare cases, both benign and malignant struma ovarii can secrete thyroid hormones, causing clinical and biochemical features of hyperthyroidism. Biochemical features of patients with struma ovarii and hyperthyroidism are similar to those of patients with primary hyperthyroidism. In such cases, thyroid scintigraphy should reveal low or absent radioiodine uptake in the thyroid gland, but the presence of radioiodine uptake in the pelvis in a whole body radioiodine scintigraphy. We give advice on possible diagnostic pitfalls in a case with two simultaneous causes of abnormal thyroid function due to the co-existence of struma ovarii.

9.
Soft Matter ; 17(11): 3037-3046, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33491729

RESUMO

Control of physical behaviors of nematic colloids and colloidal crystals has been demonstrated by tuning particle shape, topology, chirality and surface charging. However, the capability of altering physical behaviors of such soft matter systems by changing particle shape and the ensuing responses to external stimuli has remained elusive. We fabricated genus-one nematic elastomeric colloidal ring-shaped particles and various microstructures using two-photon photopolymerization. Nematic ordering within both the nano-printed particle and the surrounding medium leads to anisotropic responses and actuation when heated. With the thermal control, elastomeric microstructures are capable of changing from genus-one to genus-zero surface topology. Using these particles as building blocks, we investigated elastomeric colloidal crystals immersed within a liquid crystal fluid, which exhibit crystallographic symmetry transformations. Our findings may lead to colloidal crystals responsive to a large variety of external stimuli, including electric fields and light. Pre-designed response of elastomeric nematic colloids, including changes of colloidal surface topology and lattice symmetry, are of interest for both fundamental research and applications.

10.
iScience ; 24(1): 101880, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33458605

RESUMO

In adult males, spermatogonia maintain lifelong spermatozoa production for oocyte fertilization. To understand spermatogonial metabolism we compared gene profiles in rat spermatogonia to publicly available mouse, monkey, and human spermatogonial gene profiles. Interestingly, rat spermatogonia expressed metabolic control factors Foxa1, Foxa2, and Foxa3. Germline Foxa2 was enriched in Gfra1Hi and Gfra1Low undifferentiated A-single spermatogonia. Foxa2-bound loci in spermatogonial chromatin were overrepresented by conserved stemness genes (Dusp6, Gfra1, Etv5, Rest, Nanos2, Foxp1) that intersect bioinformatically with conserved glutathione/pentose phosphate metabolism genes (Tkt, Gss, Gc l c , Gc l m, Gpx1, Gpx4, Fth), marking elevated spermatogonial GSH:GSSG. Cystine-uptake and intracellular conversion to cysteine typically couple glutathione biosynthesis to pentose phosphate metabolism. Rat spermatogonia, curiously, displayed poor germline stem cell viability in cystine-containing media, and, like primate spermatogonia, exhibited reduced transsulfuration pathway markers. Exogenous cysteine, cysteine-like mercaptans, somatic testis cells, and ferroptosis inhibitors counteracted the cysteine-starvation-induced spermatogonial death and stimulated spermatogonial growth factor activity in vitro.

11.
J Endourol ; 35(3): 328-334, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32940051

RESUMO

Introduction: To compare holmium laser enucleation of the prostate (HoLEP) with transurethral resection of the prostate (TURP) in patients under continuous antithrombotic therapy with regard to bleeding complications. Materials and Methods: We conducted a retrospective matched-pair analysis of 221 patients with continuous antiplatelet therapy or anticoagulative medication, who were treated with HoLEP (n = 111) or TURP (n = 110). Matching criteria were prostate size (50 cc) and total surgical time (60 minutes). Patients were further stratified by their antithrombotic medication. We evaluated functional outcomes, perioperative morbidity, and bleeding complications according to Clavien-Dindo (CD). Results: Our perioperative assessment showed a significantly higher percentage of resected tissue for HoLEP (median 71.43%; interquartile range [IQR]: 61.82-78.57) than for TURP (median 45.45% IQR: 39.02-56.20) (p < 0.001). Total perioperative hemoglobin drop was significantly lower for the HoLEP cohort (median 0.7 g/dL; IQR: 0.3-1.1 g/dL) than for the TURP cohort (median 2.20 g/dL; IQR: 1.18-2.80 g/dL) (p < 0.001). For all subgroups, perioperative blood loss was always significantly lower for HoLEP than for TURP. The median hemoglobin drop was 0.5 g/dL vs 1.1 g/dL for the acetylsalicylic acid 100 mg (ASS) subgroup, 0.70 g/dL vs 2.95 g/dL for the ASS+ADP-receptor inhibitor subgroup, 0.65 g/dL vs 2.4 g/dL for the vitamin K antagonist subgroup, and 0.90 g/dL vs 2.70 g/dL for the direct oral anticoagulant subgroup (all, p < 0.001). Perioperative adverse events were significantly less frequent after HoLEP (5.4%) than after TURP (16.4%) (p < 0.05). Conclusion: HoLEP is an efficient and safe procedure for patients under diverse continuous antithrombotic regimens. It provides a superior perioperative hemostatic control and causes less bleeding complications in this high-risk population.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Fibrinolíticos , Hólmio , Humanos , Lasers de Estado Sólido/uso terapêutico , Masculino , Análise por Pareamento , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/cirurgia , Estudos Retrospectivos , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento
12.
Surg Endosc ; 35(1): 415-422, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32030548

RESUMO

BACKGROUND: Mesh repair of parastomal hernia is widely accepted as superior to non-mesh repair, yet the most favorable surgical approach is a subject of continued debate. The aim of this study was to compare the clinical outcomes of open versus laparoscopic parastomal hernia repair. METHODS: An IRB-approved retrospective review was conducted comparing laparoscopic (LPHR) or open (OPHR) parastomal hernia repair performed between 2009 and 2017 at our facilities. Patient demographics, preoperative characteristics, operative details, and clinical outcomes were compared by surgical approach. Subgroup analysis was performed by location of mesh placement. Repair longevity was measured using Kaplan-Meier method and Cox proportional hazards regression. Intention to treat analysis was used for this study based on initial approach to the repair. RESULTS: Sixty-two patients (average age of 61 years) underwent repair (31 LPHR, 31 OPHR). Patient age, gender, BMI, ASA Class, and comorbidity status were similar between OPHR and LPHR. Stoma relocation was more common in OPHR (32% vs 7%, p = .022). Open sublay subgroup was similar to LPHR in terms of wound class and relocation. Open "Other" and Sublay subgroups resulted in more wound complications compared to LPHR (70% and 48% vs 27%, p = .036). Operative duration and hospital length of stay were less with LPHR (p < .001). After adjustment for prior hernia repair, risk of recurrence was higher for OPHR (p = .022) and Open Sublay and Other subgroups compared to LPHR (p = .005 and p = .027, respectively). CONCLUSIONS: Laparoscopic repair of parastomal hernias is associated with shorter operative duration, decreased length of stay, fewer short-term wound complications, and increased longevity of repair compared to open repairs. Direct comparison of repair longevity between LPHR and OPHR with mesh using Kaplan-Meier estimate is unique to this study. Further study is warranted to better understand methods of parastomal hernia repair associated with fewer complications and increased durability.


Assuntos
Herniorrafia/métodos , Hérnia Incisional/cirurgia , Laparoscopia/métodos , Complicações Pós-Operatórias/etiologia , Idoso , Herniorrafia/efeitos adversos , Herniorrafia/instrumentação , Humanos , Hérnia Incisional/etiologia , Laparoscopia/efeitos adversos , Laparoscopia/instrumentação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Recidiva , Estudos Retrospectivos , Telas Cirúrgicas , Estomas Cirúrgicos , Resultado do Tratamento
13.
World J Urol ; 39(5): 1481-1487, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32588205

RESUMO

PURPOSE: To evaluate the diagnostic value of a high preoperative PSA level for the detection of incidental prostate cancer (iPCa) in LUTS patients with very large prostates (> 100 cc). METHODS: We conducted a retrospective analysis of 1125 men treated for LUTS with holmium laser enucleation of the prostate (HoLEP). Patients were stratified according to a preoperative PSA level higher (high PSA; n = 365) or lower than 10 ng/ml (low PSA; n = 760). Preoperative and histopathological parameters were compared between both cohorts. Logistic regression models were used to identify independent predictors of iPCa. RESULTS: Demographic parameters were similar between both cohorts. The median PSA levels were 14.2 ng/ml (11.5-19.9) and 4 ng/ml (2.4-6.0). The prostate volume was significantly higher in the high PSA group (105 cc vs. 75 cc; p < 0.001). Correspondingly, the PSA density was significantly increased in the high PSA cohort compared to the low PSA cohort (0.14 vs. 0.05; p < 0.001). The overall detection rate of iPCa showed no difference between groups (9.5% vs. 9.9%). More preoperative prostate biopsies were performed in the high PSA group compared to the low PSA group (46.8% vs. 17.6%; p < 0.001). However, the rate of false negative results was comparable between groups (12.7% vs. 11.1%; p = 0.726). In logistic regression models all PSA-related parameters failed to predict iPCa. CONCLUSIONS: PSA-guided approaches to predict iPCa in LUTS patients with very large prostates are not accurate. This finding is useful in clinical practice for counselling our patients and to prevent unwarranted diagnostic procedures.


Assuntos
Sintomas do Trato Urinário Inferior/sangue , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Humanos , Achados Incidentais , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Estudos Retrospectivos
14.
Low Urin Tract Symptoms ; 13(2): 279-285, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33260275

RESUMO

OBJECTIVES: With holmium laser enucleation of the prostate (HoLEP) a size-independent method for surgical treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) has been introduced. HoLEP offers durable long-term results with reduced perioperative morbidity. As the risk of disease progression increases with age, the main goals, when offering surgery to an elderly population, are reducing perioperative morbidity and preserving quality of life (QoL). We therefore analyzed the impact of age on outcomes and perioperative morbidity in patients undergoing HoLEP for LUTS at our tertiary referral center. METHODS: We retrospectively collected data of 487 patients who underwent HoLEP for LUTS secondary to BPO between 2018 and 2019. Patients were divided into group 1 (<70 years), group 2 (70-79 years), and group 3 (≥80 years). Perioperative parameters, safety, and short-term functional outcomes were assessed and analyzed. RESULTS: Perioperative Clavien-Dindo grade ≥II complications were seen in 4.1% of patients (20/487). There was no difference in perioperative complications between all age groups (P = .176). Functional outcome was assessed 30 days post surgery. There was significant improvement in median International Prostate Symptom Score of 14, 10, and 8 points for groups 1, 2, and 3 (P < .001), respectively, with constant improvement of median QoL of 3 points for all groups. Median maximum flow rate (Qmax ) showed significant improvement of 14.5, 10.5, and 13 mL/s for groups 1 to 3 (P = .467), respectively. CONCLUSION: HoLEP offers acceptable perioperative complication rates even in the oldest patient cohort (≥80 years). Therefore, HoLEP is a safe and efficient option even in oldest patients.

16.
Macromol Rapid Commun ; 41(19): e2000385, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32812328

RESUMO

The research on soft actuators including liquid crystal elastomers (LCEs) becomes more and more appealing at a time when the expansion of artificial systems is blooming. Among the various LCE actuators, the bending deformation is often in the origin of many actuation modes. Here, a new strategy with plasma technology is developed to prepare single-layer main-chain LCEs with thermally actuated bending and contraction deformations. Two distinct reactions, plasma polymerization and plasma-induced photopolymerization, are used to polymerize in one step the nematic monomer mixture aligned by magnetic field. The plasma polymerization forms cross-linked but disoriented structures at the surface of the LCE film, while the plasma-induced photopolymerization produces aligned LCE structure in the bulk. The actuation behaviors (bending and/or contraction) of LCE films can be adjusted by plasma power, reaction time, and sample thickness. Soft robots like crawling walker and flower mimic are built by LCE films with bending actuation.


Assuntos
Cristais Líquidos , Robótica , Elastômeros , Campos Magnéticos , Polimerização
17.
Lab Anim ; 54(6): 559-567, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32070181

RESUMO

Rabbits are commonly used for sciatic nerve injuries larger than 1.5 cm. This report provides insight into risks and benefits associated with using rabbit models in sciatic nerve injury models and proposes interventions that researchers can use to prevent experimental complications. Fifty-six rabbits from a sciatic nerve injury study that involved a 40 mm sciatic nerve injury were analyzed to examine postoperative complication rates. Autophagy of the phalanges and plantar pressure ulcer development were the most common and serious complications faced. These complications led to 23.2% (n = 13) of rabbits not being used for data in the original experiment due to euthanasia outside of intended postoperative time points. This increased the cost needed to complete the experiment by $25,038.44. It is our recommendation that alternative models be used instead of rabbits for sciatic nerve injuries. If rabbits must be used, a treatment protocol for preventing autophagy and pressure ulcers is outlined below.


Assuntos
Modelos Animais de Doenças , Manejo da Dor , Traumatismos dos Nervos Periféricos/prevenção & controle , Nervo Isquiático/lesões , Animais , Feminino , Humanos , Masculino , Coelhos
18.
Reprod Sci ; 27(3): 895-904, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32046444

RESUMO

Although it is well appreciated that ovarian stimulation protocols for in vitro fertilization (IVF) alter endometrial receptivity, the precise cellular mechanisms are not known. To gain insights into potential mechanisms by which different ovarian stimulation protocols alter the endometrium, we compared histologic and gene expression profiles of endometrium from women undergoing conventional ovarian stimulation for IVF (C-IVF) with those undergoing minimal stimulation with clomiphene citrate (MS-IVF). Sixteen women undergoing MS-IVF (n = 8) or C-IVF (n = 8) were recruited for endometrial biopsy at the time of oocyte retrieval. Endometrial glands were large, tortuous, and secretory with C-IVF but small and undifferentiated with MS-IVF. Whereas RNA sequencing did not reveal changes in estrogen receptor or its co-regulators or classic proliferation associated genes in MS-IVF, together with immunohistochemistry, Wnt signaling was disrupted in endometrium from MS-IVF cycles with significant upregulation of Wnt inhibitors. Secreted frizzled-related protein 1 (sFRP1) was increased fourfold (p < 0.01), and sFRP4 was upregulated sixfold (p < 0.01) relative to C-IVF. Further these proteins were localized to subepithelial endometrial stroma. These data indicate that MS-IVF protocols with CC do not seem to impact endometrial estrogen signaling as much as would be expected from the reported antiestrogenic properties of CC. Rather, the findings of this study highlight Wnt signaling as a major factor for endometrial development during IVF cycles.


Assuntos
Endométrio/metabolismo , Endométrio/patologia , Infertilidade Feminina/genética , Infertilidade Feminina/patologia , Indução da Ovulação/métodos , Transcriptoma , Adulto , Clomifeno/uso terapêutico , Feminino , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Recuperação de Oócitos
19.
Neuron ; 105(5): 867-881.e9, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-31883789

RESUMO

The human-specific gene ARHGAP11B is preferentially expressed in neural progenitors of fetal human neocortex and increases abundance and proliferation of basal progenitors (BPs), which have a key role in neocortex expansion. ARHGAP11B has therefore been implicated in the evolutionary expansion of the human neocortex, but its mode of action has been unknown. Here, we show that ARHGAP11B is imported into mitochondria, where it interacts with the adenine nucleotide translocase (ANT) and inhibits the mitochondrial permeability transition pore (mPTP). BP expansion by ARHGAP11B requires its presence in mitochondria, and pharmacological inhibition of ANT function or mPTP opening mimic BP expansion by ARHGAP11B. Searching for the underlying metabolic basis, we find that BP expansion by ARHGAP11B requires glutaminolysis, the conversion of glutamine to glutamate for the tricarboxylic acid (TCA) cycle. Hence, an ARHGAP11B-induced, mitochondria-based effect on BP metabolism that is a hallmark of highly mitotically active cells appears to underlie its role in neocortex expansion.


Assuntos
Proteínas Ativadoras de GTPase/metabolismo , Glutamina/metabolismo , Mitocôndrias/metabolismo , Neocórtex/metabolismo , Células-Tronco Neurais/metabolismo , Células 3T3 , Animais , Evolução Biológica , Proliferação de Células/genética , Ciclo do Ácido Cítrico , Proteínas Ativadoras de GTPase/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Ácido Glutâmico/metabolismo , Humanos , Camundongos , Translocases Mitocondriais de ADP e ATP/metabolismo , Proteínas de Transporte da Membrana Mitocondrial/metabolismo , Poro de Transição de Permeabilidade Mitocondrial , Neocórtex/embriologia , Neurogênese/genética
20.
Am Surg ; 85(7): 738-741, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405419

RESUMO

Parastomal hernias (PHs) frequently complicate enterostomy creation. Decision for PH repair (PHR) is driven by patient symptoms due to the frequency of complications and recurrences. The European Hernia Society (EHS) PH classification is based on the PH defect size and the presence/absence of concomitant incisional hernia. The aim of this study was to evaluate PHR outcomes based on EHS classification. An Institutional Review Board-approved retrospective review of a prospective database between 2009 and 2017 was performed. Patient demographics, enterostomy type, EHS classification, operative technique, and clinical outcomes (postoperative complications, 30-day readmission, and PH recurrence) were obtained. Cases were analyzed by EHS classifications I and II (SmallPH) versus III and IV (LargePH). Sixty-two patients underwent PHR (35: SmallPH, 27: LargePH). Patient groups (SmallPH vs LargePH) were similar based on American Society of Anesthesiologists Class III and obesity. Hernia recurrence was seen in 26 per cent of repairs with no difference between groups. The median recurrence-free survival was 3.9 years. There was no difference in superficial SSI, deep SSI, nonwound complications, or readmission between SmallPH and LargePH. Both small and large PHs experience similar outcomes after repair. Strategies to improve outcomes should be developed and implemented universally across all EHS PH classes.


Assuntos
Hérnia , Herniorrafia , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Hérnia/complicações , Hérnia/diagnóstico , Herniorrafia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos
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