Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 88
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Antibiotics (Basel) ; 9(6)2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32471292

RESUMO

The efficacy of fluoroquinolone-based eradication therapy largely depends on the fluoroquinolone resistance of H. pylori. The aim of this study was to investigate the changes in the primary resistance rate of H. pylori to fluoroquinolone and the mechanism of resistance in Korea. A total of 153 strains and 48 strains of H. pylori were isolated at a tertiary hospital in 2005/2006 and 2017/2018, respectively. The minimum inhibitory concentrations (MICs) of fluoroquinolone were determined by the serial 2-fold agar dilution method. DNA sequences in the quinolone resistance-determining regions of gyrA/gyrB were analyzed in resistant strains. Subsequent natural transformation study was performed to determine the association between gyrase mutation and resistance. The resistance rates increased from 19.0% (29/153) to 43.8% (21/48) both for levofloxacin and moxifloxacin. The MIC values for resistant strains increased from 2-8 µg/mL to 4-16 µg/mL over time. Mutation of gyrA was detected in 93.1% (27/29) and 100% (21/21) among the resistant strains in both periods, respectively. A novel Gly-85 mutation of gyrA was found and confirmed to be associated with fluoroquinolone resistance. Fluoroquinolone resistance rate of H. pylori has markedly increased over time in Korea. The resistance is mostly due to the point mutation of gyrA. Fluoroquinolone-containing regimens should be carefully selected in Korea, considering the increasing fluoroquinolone resistance.

2.
Sci Rep ; 10(1): 6747, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32317745

RESUMO

After endoscopic resection (ER) of gastric dysplasia, metachronous gastric neoplasm (MGN) appears to have an incidence rate similar to that detected after ER of early gastric cancer (EGC). We investigated whether the risk of MGN after ER for gastric dysplasia is different between patients with low-grade dysplasia (LGD) and high-grade dysplasia (HGD). Between March 2011 and December 2016, 198 patients with LGD (LGD group) and 46 patients with HGD (HGD group) who underwent ER were included in the study. During a median follow-up of 2.5 years, MGNs developed in 21 patients (10.6%) in the LGD group and in 6 patients (13.0%) in the HGD group. Hazard ratios (HRs) for MGNs (HR, 1.45; P = 0.425) and for metachronous HGD or gastric cancer (HR, 2.41; P = 0.214) in the HGD group were not different than those of the LGD group. However, considering patients without Helicobacter pylori infection, those in the HGD group had a significantly increased risk of metachronous HGD or gastric cancer compared to those in the LGD group (HR in HGD-group, 5.23; P = 0.044). These results indicate that meticulous surveillance endoscopy is needed to detect MGNs after ER of gastric dysplasia, especially in patients with HGD, including those without H. pylori infection.

3.
Adv Healthc Mater ; : e2000416, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32342647

RESUMO

Selectively targeting the endoplasmic reticulum (ER) of cancer cells, though promising a new strategy for cancer therapy, remains underdeveloped. Enzyme-instructed self-assembly (EISA) is emerging as a promising approach for selectively targeting ER of cancer cells. This work reports an easily accessible branched peptide that consists of a D-tetrapeptide backbone and a branch with the sequence of KYDKKKKDG (K: lysine; Y: tyrosine; D: aspratic acid; G: glycine), being an EISA substrate of typsin-1 (PRSS1), selectively inhibits cancer cells. Depending on the type of cells, the level of PRSS1 expression dictates the cytotoxicity of the branched peptide. Moreover, immunostaining and fluorescent imaging reveal that PRSS1 overexpresses on the ER of a high-grade serous ovarian cancer cell line (OVSAHO). The overexpression of PRSS1 renders the branched peptide to exhibit high selectivity against OVSAHO by the in situ formation of the peptide assemblies on the ER of OVSAHO cells, which causes ER stress and eventual cell death. This work, illustrating trypsin-guided EISA for inhibiting cancer cells by enzymatic reaction on ER for the first time, offers a new way to target the subcellular organelles of cancer cells for potential cancer therapy.

4.
Adv Healthc Mater ; 9(5): e1901072, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31957248

RESUMO

Astrocytes, the most representative glial cells in the brain, play a multitude of crucial functions for proper neuronal development and synaptic-network formation, including neuroprotection as well as physical and chemical support. However, little attention has been paid, in the neuroregenerative medicine and related fields, to the cytoprotective incorporation of astrocytes into neuron-culture scaffolds and full-fledged functional utilization of encapsulated astrocytes for controlled neuronal development. In this article, a 3D neurosupportive culture system for enhanced induction of neuronal circuit generation is reported, where astrocytes are confined in hydrogel microfibers and protected from the outside. The astrocyte-encapsulated microfibers significantly accelerate the neurite outgrowth and guide its directionality, and enhance the synaptic formation, without any physical contact with the neurons. This astrocyte-laden system provides a pivotal culture scaffold for advanced development of cell-based therapeutics for neural injuries, such as spinal cord injury.

5.
Bioconjug Chem ; 31(3): 492-500, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-31995365

RESUMO

Enzymatic reactions and self-assembly are two fundamental attributes of cells. It is not surprising that one can use enzyme-instructed self-assembly (EISA)-the integration of enzymatic transformation and molecular self-assembly-to modulate the emergent properties of supramolecular assemblies for controlling cell behaviors. The exploration of EISA for developing cancer therapy and imaging has made considerable progress over the last five years. In this Topical Review, we discuss these exciting results and the future promise of EISA. After describing several key studies to illustrate the progress of EISA in developing cancer therapy, we discuss the use of EISA for molecular imaging. Then, we give the outlook of EISA for developing supramolecular anticancer medicine that inhibits multiple hallmark capabilities of cancer.

6.
Gut Liver ; 14(1): 57-66, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30974930

RESUMO

Background/Aims: Although acid suppressants are widely used for the prevention or treatment of drug-induced upper gastrointestinal bleeding (GIB), evidence regarding the prevention of anticoagulant-related GIB is scarce. The aim of this study was to evaluate the protective effect of acid suppressants against anticoagulant-related GIB. Methods: A systematic review was conducted of studies that evaluated the protective effect of acid suppressants against anticoagulant-related GIB found in PubMed, the Cochrane library, Embase, and KoreaMed from the date of database inception to April 2018. Random effect model meta-analyses with sensitivity analyses were conducted. The methodological quality of each included publication was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies. Publication bias was assessed. Results: In total, six nested case-control or cohort studies were identified and analyzed. Proton-pump inhibitors (PPI) had a protective effect against upper GIB in patients on dicumarinics (risk ratio [RR], 0.56; 95% confidence interval [CI], 0.38 to 0.83; I2, 0%); however, the histamine-2 receptor antagonist did not have the same effect (RR, 0.97; 95% CI, 0.52 to 1.81; I2, 0%). Acid suppressants did not have a protective effect against GIB in patients on dabigatran (hazard ratio, 0.78; 95% CI, 0.44 to 1.37; I2, 81.8%). Conclusions: The protective effect of PPIs against dicumarinics-related upper GIB was clear, while there was no evidence supporting the protective effect of acid suppressants against dabigatran-related GIB. However, in the absence of randomized trials demonstrating a lack of bias, solid conclusions cannot be drawn.

7.
Sci Rep ; 9(1): 16001, 2019 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690757

RESUMO

Genetic polymorphism can result in abnormal pharmacodynamics that subsequently leads to the individual variance in sedative effects and adverse reactions. The aim of this study was to elucidate the association between midazolam-related genetic polymorphism and sedative effects, including adverse reactions, under conscious sedation during upper gastrointestinal endoscopy. We prospectively enrolled 100 eligible patients undergoing upper gastrointestinal endoscopy. The efficacy of the sedation, adverse reactions, plasma concentration of midazolam and 1-hydroxymidazolam were investigated as well as the genetic polymorphism of MDR1 and CYP3A5. The correlation between genetic polymorphism and sedative effects was assessed. Regarding MDR1 gene, the plasma concentration of midazolam was greater in patients with CGC haplotype (P = 0.012), while it was lower in patients with CAC haplotype (P = 0.005) than in those with other haplotypes. However, genetic polymorphism of neither MDR1 nor CYP3A5 correlated with the plasma concentration of 1-hydroxymidazolam. CGT haplotype of MDR1 was significantly correlated with sedation grade after midazolam administration (P = 0.042). In contrast, genetic polymorphism of CYP3A5 was not correlated with sedation grade. There was no association between genetic polymorphism of MDR1 or CYP3A5 and selected adverse reactions related to midazolam. Genetic polymorphism of MDR1 influences the concentration of midazolam and the sedation grade. However, it is not associated with adverse reactions such as paradoxical response and retrograde amnesia.

8.
Gut Liver ; 13(5): 531-540, 2019 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-31505907

RESUMO

Background/Aims: This nationwide, multicenter prospective randomized controlled trial aimed to compare the efficacy and safety of 10-day concomitant therapy (CT) and 10-day sequential therapy (ST) with 7-day clarithromycin-containing triple therapy (TT) as first-line treatment for Helicobacter pylori infection in the Korean population. Methods: Patients with H. pylori infection were assigned randomly to 7d-TT (lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for 7 days), 10d-ST (lansoprazole 30 mg and amoxicillin 1 g twice daily for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg twice daily for the remaining 5 days), or 10d-CT (lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 10 days). The primary endpoint was eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. Results: A total of 1,141 patients were included. The 10d-CT protocol achieved a markedly higher eradication rate than the 7d-TT protocol in both the ITT (81.2% vs 63.9%) and PP analyses (90.6% vs 71.4%). The eradication rate of the 10d-ST protocol was superior to that of the 7d-TT protocol (76.3% vs 63.9%, ITT analysis; 85.0% vs 71.4%, PP analysis). No significant differences in adherence or serious side effects were found among the three treatment arms. Conclusions: The 10d-CT and 10d-ST regimens were superior to the 7d-TT regimen as standard first-line treatment in Korea.


Assuntos
Antibacterianos/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Inibidores da Bomba de Prótons/administração & dosagem , Amoxicilina/administração & dosagem , Claritromicina/administração & dosagem , Erradicação de Doenças/métodos , Esquema de Medicação , Quimioterapia Combinada , Feminino , Infecções por Helicobacter/prevenção & controle , Humanos , Lansoprazol/administração & dosagem , Masculino , Adesão à Medicação , Metronidazol/administração & dosagem , Pessoa de Meia-Idade , Estudos Prospectivos , República da Coreia , Resultado do Tratamento
9.
Helicobacter ; 24(5): e12646, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31368629

RESUMO

BACKGROUND: The Helicobacter pylori eradication rate has decreased with increasing antibiotic resistance. We conducted a prospective, nationwide, multicenter registry study to monitor the real status of H. pylori eradication therapy and to investigate the association between eradication success and antibiotic use density in Korea. MATERIALS AND METHODS: We enrolled 9318 patients undergoing H. pylori eradication therapy from 37 hospitals through "on-line database registry" from October 2010 to July 2015. Demographic data, detection methods, treatment indications, regimens, durations, compliance, adverse events, and eradication results were collected. The use of all commercially available eradication antibiotics was analyzed through the Korean National Health Insurance data of the Health Insurance Review and Assessment Service. The defined daily dose of antibiotics was used to standardize drug use comparisons. RESULTS: Finally, 6738 patients were analyzed. The overall eradication rate of first-line therapy was 71.8%. The eradication success rates were 71.7%, 86.9%, and 74.0% for standard triple therapy for 7 days, quadruple therapy, and concomitant therapy, respectively. The eradication success rate in naive patients was higher than that in those who previously underwent H. pylori eradication. Eradication success was significantly associated with younger age, female sex, and high compliance. Regional differences in eradication rates were observed. The yearly use density of clarithromycin increased statistically in seven regions across the country from 2010 to 2015. The yearly use density of amoxicillin in the Gyeongsang and Chungcheong areas was significantly increased (P < .01), whereas that of other macrolides was significantly lower in the Gyeonggi area than in other areas (P = .01). The overall use of eradication antibiotics has increased while the eradication rate steadily decreased for 5 years. However, there was no significant correlation between antibiotic use density and eradication. CONCLUSION: There was no relationship between the eradication rate and antibiotic use density in Korea.


Assuntos
Antibacterianos/uso terapêutico , Bases de Dados Factuais , Uso de Medicamentos/estatística & dados numéricos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Internet , Sistema de Registros , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
10.
Gut Liver ; 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31327184

RESUMO

Background/Aims: This nationwide multicenter, prospective, randomized, controlled trial aimed to compare the efficacy and safety of the 10-day concomitant therapy (CT) and 10-day sequential therapy (ST) with those of the 7-day clarithromycin-containing triple therapy (TT) as first-line treatment for Helicobacter pylori infection in the Korean population. Methods: Patients with H. pylori infection were assigned randomly to 7d-TT (lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for 7 days), 10d-ST (lansoprazole 30 mg and amoxicillin 1 g twice daily for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg twice daily for the remaining 5 days), or 10d-CT (lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 10 days). The primary endpoint was eradication rates of treatments by intention-to-treat (ITT) and per-protocol (PP) analysis. Results: A total of 1141 patients were included. The 10d-CT achieved a markedly higher eradication rate than the 7d-TT, using both the ITT (81.2% versus 63.9%) and PP analysis (90.6% versus 71.4%). The eradication rate of the 10d-ST was superior to that of 7d-TT (76.3% versus 63.9%, ITT analysis; 85.0% versus 71.4%, PP analysis). No significant difference in adherence and serious side effects was found among the three treatment arms. Conclusion: 10d-CT and 10d-ST regimens were superior to 7d-TT as standard first-line treatment in Korea.

11.
Medicine (Baltimore) ; 98(24): e15860, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192917

RESUMO

BACKGROUND: Vonoprazan, a novel potassium-competitive acid blocking agent, has been used in the management of endoscopic submucosal dissection (ESD)-induced artificial ulcers. This study aimed to perform a systematic review and meta-analysis for the comparison of the effects of vonoprazan and proton pump inhibitors (PPIs) in treating ESD-induced artificial ulcers and preventing delayed bleeding in randomized controlled trial and cohort studies. METHODS: We searched OVID-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and clinical trial registries in April 2018 to identify all studies that assess and compare the effects of vonoprazan and PPI in treating ESD-induced artificial ulcers and preventing delayed bleeding. Primary outcome of ulcer healing rate and secondary outcomes of shrinkage rate, ulcer size, and delayed bleeding were studied. RESULTS: A total of 1265 patients from 12 studies were included in the final analysis. Healing rate at 4 weeks post-ESD was significantly higher in the vonoprazan group than in the PPI group (relative ratio [RR] 1.20 [1.03-1.40]). However, healing rate at 8 weeks post-ESD was significantly higher in the PPI group than in the vonoprazan group (RR 0.68 [0.48-0.97]).There was no evidence of significant difference between groups in shrinkage rate at 4 weeks post-ESD, shrinkage rate at 8 weeks post-ESD, delayed bleeding, ulcer size at 0 weeks post-ESD, and ulcer size at 8 weeks post-ESD. CONCLUSIONS: There was no substantial difference in ulcer healing and post-ESD bleeding between vonoprazan and PPIs. However, vonoprazan more rapidly and effectively treated artificial ulcers after ESD than did PPIs.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Ressecção Endoscópica de Mucosa/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Pirróis/uso terapêutico , Sulfonamidas/uso terapêutico , Úlcera/tratamento farmacológico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Úlcera/etiologia
12.
Surg Innov ; 26(5): 536-544, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31132924

RESUMO

Background. Technical difficulties and pain from large wounds have prevented the widespread use of single-incision laparoscopic appendectomy (SILA). This study aimed to evaluate the efficacy of our newly developed needle grasper (Endo Relief)-assisted SILA (NASILA). Methods. For NASILA, about a 12-mm umbilical incision was made, and a glove port was introduced. A needle grasper was then introduced through a 2.5-mm wound on the suprapubic area. For SILA, a 2.5-cm transumbilical wound was made. The medical records of patients who underwent SILA or NASILA from June 2017 to September 2017 were retrospectively reviewed. Operative and short-term postoperative outcomes and results of telephone interviews for scars were compared. Results. A total of 49 patients in the SILA group (male: 40.8%) and 12 in the NASILA group (male: 50.0%) were included. Appendicitis status (not perforated:perforated without abscess:perforated with abscess) was significantly different between the 2 groups (SILA vs NASILA, 30:18:1 vs 4:6:2, P = .027). Additional trocars were inserted in 9 patients (18.4%) of the SILA group. The operative time was significantly shorter (43.3 ± 33.6 vs 54.1 ± 15.6 minutes, P = .012), and the highest numerical pain intensity score during the first 24 hours after surgery was significantly lower (2.4 ± 0.7 vs 3.0 ± 0.9, P = .038) in the NASILA group than in the SILA group. Hospital stay, postoperative complications, and complaint of scar were not significantly different between the 2 groups. Conclusions. NASILA was not inferior to SILA regarding cosmetic results. Operative convenience is higher in NASILA than in SILA, and the smaller surgical wound in NASILA minimizes postoperative pain.


Assuntos
Apendicectomia/instrumentação , Apendicite/cirurgia , Laparoscopia/instrumentação , Agulhas , Dor Pós-Operatória/prevenção & controle , Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Desenho de Equipamento , Feminino , Humanos , Masculino , Manejo da Dor/métodos , Estudos Retrospectivos
13.
Surg Endosc ; 33(4): 1342-1348, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30604267

RESUMO

BACKGROUND: Colon perforation is the most serious complication associated with colonoscopic procedures. We performed a novel purse-string suture technique to close the iatrogenic colonic perforation using dual-channel endoscope with an endoloop and clips. METHODS: Iatrogenic colon perforations developed during diagnostic colonoscopy referred to a tertiary hospital over 10 years were considered for this endoscopic closure. An endoloop was inserted through the left channel of the endoscope and placed around the defect. The first clip was placed at the proximal site of the defect through the other channel of the endoscope, and the endoloop was anchored on the mucosa around the defect. Then, subsequent clips were placed next to previous clips and the endoloop was fixed. After the defect was encircled by the endoloop and clips, the rim of the opening was approximated by fastening the endoloop with a purse-string technique. RESULTS: A total of 8 patients were admitted to our hospital because of iatrogenic colon perforations during diagnostic colonoscopy. Of these, 2 underwent laparoscopic surgery and 6 underwent endoscopic closure by this novel purse-string suture technique. The estimated diameters of the perforations were 20 mm. All cases were successfully treated in the endoscopy unit without sedation or general anesthesia, and recovered without any complication or subsequent operation. Abdominal pain had nearly resolved within 3 days after the procedure in all patients, and only mild peritonitis was observed. CONCLUSIONS: Iatrogenic colon perforation can be treated with a purse-string suture technique using dual-channel endoscope with an endoloop and clips. This technique can be useful for relatively large colon perforations associated with diagnostic colonoscopy.


Assuntos
Colo , Colonoscopia , Perfuração Intestinal , Complicações Intraoperatórias , Técnicas de Sutura , Colo/lesões , Colo/cirurgia , Colonoscopia/efeitos adversos , Colonoscopia/instrumentação , Colonoscopia/métodos , Endoscópios Gastrointestinais , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/cirurgia , Masculino , Pessoa de Meia-Idade , República da Coreia , Instrumentos Cirúrgicos/efeitos adversos , Resultado do Tratamento
14.
Chem Commun (Camb) ; 55(15): 2142-2145, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30607413

RESUMO

Inspiration from the iron gall ink leads to the efficient formation of Fe(iii)-tannic acid coacervate particles inside the phase-separated microdroplets that are derived from the aqueous PEG/dextran liquid-liquid phase separation system. This hierarchical self-assembly, in aid of the protein affinity of tannic acid, makes it possible to compartmentalize and condense proteins into a localized, compact space in the microdroplets.


Assuntos
Compostos Férricos/química , Proteínas/química , Taninos/química , Dextranos/química , Tinta , Micelas , Microfluídica , Microscopia Confocal , Tamanho da Partícula , Polietilenoglicóis/química , Proteínas/metabolismo
15.
J Neurogastroenterol Motil ; 25(1): 27-35, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30509017

RESUMO

Gastroparesis and functional dyspepsia are 2 of the most common gastric neuromuscular disorders. These disorders are usually confused, having both similarities and differences. The pathophysiology of these disorders involves abnormal gastric motility, visceral hypersensitivity, mucosal inflammation, and various cellular changes. Both disorders have similar symptoms such as epigastric pain or discomfort, early satiety, and bloating. If patients suspected of having either gastroparesis or functional dyspepsia present with upper gastrointestinal symptoms, they should undergo upper endoscopy to exclude an alternative organic cause. Although the gastric emptying rate is frequently assessed during the clinical workup of patients with gastroparesis or functional dyspepsia, the correlation between gastric emptying and the symptoms is generally poor. Once the diagnosis of gastroparesis or functional dyspepsia is made, treatment should focus on the predominant symptom. Recently, various treatment modalities have been developed and validated. Prokinetic agents are generally used as treatment for both gastroparesis and functional dyspepsia. Acid-suppressive therapy, Helicobacter pylori eradication, and use of drugs that enhance gastric accommodation are employed for functional dyspepsia. Psychoactive drugs are also effective in symptom control. For gastroparesis, antiemetic agents, ghrelin receptor agonists, and serotonergic agents are used aside from prokinetic agents. Acupuncture and gastric electrical stimulation can be attempted. In severe cases, endoscopic and surgical interventions are considered for symptom control.

16.
Medicine (Baltimore) ; 97(44): e13032, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30383666

RESUMO

RATIONALE: Merkel cell carcinoma (MCC) is an aggressive, rare neuroendocrine skin cancer. MCC metastasis to the heart is exceedingly rare and gastric metastases from MCC have rarely been reported. PATIENT CONCERNS: We described the case of an 82-year-old man diagnosed with recurrent MCC with cardiac and gastric metastasis who presented with poor oral intake and severe weight loss. The patient was diagnosed with MCC 3 years ago and treated with surgical resection and radiation. INTERVENTIONS: We performed stomach biopsy in edematous lesion. And fluoroscopy and ultrasound guided biopsy of the cardiac mass was performed. DIAGNOSES: MCC with synchronous metastases to the heart and stomach. OUTCOMES: The primary lesion had complete resolution and the patient remained disease free on regular follow-up every 6 months for 2 and half years. After MCC recurred, palliative anti-cancer therapy was considered but could not be performed due to the patient's poor performance status involved elderly, combined recurrent pneumonia. LESSONS: To our best knowledge, this is the first report of synchronous cardiac and gastric metastasis from cutaneous MCC worldwide. Although uncommon, MCC should be considered in clinical cases of synchronous metastasis.


Assuntos
Carcinoma de Célula de Merkel/patologia , Neoplasias Cardíacas/secundário , Neoplasias Cutâneas/patologia , Neoplasias Gástricas/secundário , Idoso de 80 Anos ou mais , Carcinoma de Célula de Merkel/terapia , Fluoroscopia , Humanos , Biópsia Guiada por Imagem , Masculino , Recidiva Local de Neoplasia , Neoplasias Cutâneas/terapia , Estômago/patologia
17.
Medicine (Baltimore) ; 97(39): e12574, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30278564

RESUMO

BACKGROUND AND AIM: Vonoprazan, a novel potassium-competitive acid blocking agent, is used in the management of gastroesophageal reflux disease (GERD). We aim to perform a systematic review and meta-analysis for the comparison of the effects of vonoprazan and proton pump inhibitors (PPIs) in GERD in randomized controlled trials (RCTs). METHODS: A systematic and comprehensive search will be performed using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and clinical trial registries, for studies published up to September 2018. Only randomized clinical trials will be included. Primary outcomes of symptoms and esophageal erosion improvement in the intention-to-treat analysis, and secondary outcomes of symptoms and esophageal erosion improvement rate in the per protocol analysis, the comparative efficacy in terms of healing rate of esophageal erosion on endoscopy, the comparative efficacy in terms of improvement of esophageal impedance-pH study, adverse events, long-term safety, and the comparative efficacy in terms of CYP2C19 metabolite levels will be studied. The quality of included studies will be assessed using the modified risk of bias tool. Heterogeneity of estimates across studies as well as publication bias will be assessed. This systematic review and meta-analysis will be performed according to the protocol recommended by the Cochrane Collaboration and reported according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. All statistical analyses will be conducted using Stata SE version 15.0. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION: To our knowledge, this systematic review and meta-analysis will be the first to evaluate existing research comparing Vonoprazan and PPIs in GERD. Our study will provide information about the effect of vonoprazan and PPIs in GERD in RCTs. The review will benefit patients, healthcare providers, and policymakers.


Assuntos
Refluxo Gastroesofágico/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Pirróis/uso terapêutico , Sulfonamidas/uso terapêutico , Citocromo P-450 CYP2C19/sangue , Esôfago/patologia , Refluxo Gastroesofágico/enzimologia , Refluxo Gastroesofágico/patologia , Humanos , Inibidores da Bomba de Prótons/efeitos adversos , Pirróis/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulfonamidas/efeitos adversos , Revisões Sistemáticas como Assunto
18.
Langmuir ; 34(41): 12318-12323, 2018 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-30226386

RESUMO

One-step assembly of iron(III)-tannic acid (Fe3+-TA) complex forms nanothin (∼10 nm) films on various substrates within minutes. In this deposition scheme, however, the film does not grow continuously over time even though Fe3+-TA complex is still abundant in the coating solution. In this paper, we report that the salt addition dramatically changes the one-off coating characteristic to continuous one, and each salt has its optimum concentration ( CMFT) that produces maximum film thickness. For detailed investigation of the salt effects, we employed various salts, including LiCl, NaCl, KCl, CaCl2, SrCl2, BaCl2, NaBr, and NaNO3, and found that only cations played an important role in the continuous deposition of the Fe3+-TA complex, with smaller CMFT values for the cations of higher valency and larger size. On the basis of the results, we suggested that the positively charged cations screened the negative surface charges of Fe3+-TA complex particles, leading to coagulation and continuous deposition, further supported by the ζ-potential measurement and time-resolved dynamic light-scattering analysis.

19.
Adv Healthc Mater ; 7(18): e1800289, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30088694

RESUMO

In this work, the use of scaffolds is reported, templated from live neurons as an advanced culture platform for primary neurons. Hippocampal neurons cultured on neurotemplated scaffolds exhibit an affinity for templated somas, revealing a preference for micrometric structures amidst nanotopographical features. It is also reported, for the first time, that neurite complexity can be topographically controlled by increasing the density of nanometric features on neurotemplated scaffolds. Neurotemplated scaffolds are versatile, hierarchical topographies that feature biologically relevant structures, in both form and scale, and capture the true complexity of an in vivo environment. The introduction and implementation of neurotemplated scaffolds is sure to advance research in the fields of neurodevelopment, network development, and neuroregeneration.


Assuntos
Hipocampo/citologia , Neuritos/fisiologia , Neurônios/citologia , Tecidos Suporte/química , Animais , Células Cultivadas , Humanos , Nanoestruturas/química
20.
Nanoscale ; 10(28): 13351-13355, 2018 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-29995030

RESUMO

An enzyme-instructed method is developed for material-independent, cytocompatible coating of phenolic amines, inspired by melanogenesis found in nature. Tyrosinase-based film formation proceeds smoothly in an aqueous solution at neutral pH, and can use various phenolic amines including catecholamines, such as tyrosine, tyramine, dopamine, norepinephrine, and DOPA, as a coating precursor. Compared with polydopamine coating, the method is fast and efficient, and forms uniform films. Its high cytocompatibility is advantageously applied to cell-surface engineering, where chemically labile Jurkat cells are coated individually without any noticeable decrease in viability. Considering the huge potential of polyphenolic-based coatings, the strategy developed herein will provide an advanced tool for manipulating biological entities, including living cells, in biomedical and medicinal applications.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA