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1.
Liver Int ; 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32239602

RESUMO

BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) risk in chronic hepatitis B (CHB) substantially decreased in the era of potent antiviral therapy. We developed an optimized HCC risk prediction model for CHB with well-controlled viremia by nucelos(t)ide analogs (NUCs). METHOD: We analyzed those who achieved virological response (VR; serum HBV-DNA<2,000 IU/ml on two consecutive assessments) by NUCs. Liver stiffness by transient elastography, ultrasonography, and laboratory tests were performed at the time of confirmed VR. Patients with decompensated cirrhosis or HCC at baseline were excluded. Multivariate Cox-regression analysis was used to determine key variables to construct a novel risk-scoring model. RESULTS: Among 1511 patients, 9.5% developed HCC. Cirrhosis on ultrasonography (adjusted HR [aHR] 2.47), Age (aHR 1.04), Male (aHR 1.9), Platelet count<135,000/uL (aHR 1.57), Albumin<4.5 g/dL (aHR 1.77), and liver Stiffness≥11 kPa (aHR 6.09) were independently associated with HCC. Using these, CAMPAS model was developed with c-index of 0.874. The predicted and observed HCC probabilities were calibrated with a reliable agreement. Such results were reproduced from internal validation and external validation among the independent cohort (n=252). The intermediate-risk (CAMPAS model score 75~161) and high-risk (score>161) groups were more likely to develop HCC compared to the low-risk group (score≤75) with statistical significances (HRs; 4.43 and 47.693, respectively; both p<0.001). CONCLUSION: CAMPAS model derived through comprehensive clinical evaluation of liver disease allowed the more delicate HCC prediction for CHB patients with well-controlled viremia by NUCs.

2.
JMIR Mhealth Uhealth ; 8(2): e14487, 2020 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-32130157

RESUMO

BACKGROUND: Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. OBJECTIVE: For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. METHODS: This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors' log frequencies were obtained from the mobile EMR, and we merged data using doctors' deidentification numbers. Pearson's product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests. RESULTS: A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=-0.19; 95% CI -0.32 to -0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors' mobile EMR usage and the response time to consultation requests (coefficient=-0.18; 95% CI -0.30 to -0.04; P=.009). CONCLUSIONS: Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

4.
Sci Total Environ ; 719: 137476, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32114236

RESUMO

Despite the advances in restoration methods for newly created road habitats such as roadcuts and embankments, implementation in different parts of the world is limited by high cost and lack of knowledge of naturally formed plant communities. However, a cheaper alternative is to relay in natural successional process in sites under optimal conditions. Thus, the first steps should focus on identifying plant species that colonize roadways and road habitats as well as optimal colonization sites. Our study aimed to describe species composition, exotic species presence, and diversity among four roadways (Jeongok-Youngjung, JG; Seolma-Gueup, SM; Singal, SG; and Samga-Daechon, DC) and three habitat types (embankments, plain areas, and roadcuts) in South Korean peninsula. The effect of some environmental factors on plant composition was also examined (soil type, soil slope, and surrounding landscape). Our results showed that established plant species composition was influenced by the interaction between roadways and habitats types, which was also the main interaction affecting plant richness and evenness. Surprisingly, environmental variables had no effect on plant species composition, with a residual amount of explained variation. A total of 48 plant species were described as indicator of different roadways and habitat types, and 50% of them were invasive or cultivated species. It appeared that different regional-dependent processes, such as northern vs. southern roadways, interact with local process in new-road habitats, producing complex patterns of plant species colonization and composition. Thus, ecological restoration solutions should be targeted at site-specific needs (local) while taking into consideration the differences between northern and southern roadways (regional). Here, regional-pool and local-constraints interaction controls plant composition and diversity during road construction in South Korea. Finally, new restoration actions should be based on plant species that have been established spontaneously in these degraded areas.

5.
Sci Rep ; 10(1): 3497, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32103031

RESUMO

The delta neutrophil index (DNI), which reflects the ratio of circulating immature neutrophils, has been reported to be highly predictive of mortality in systemic inflammation. We investigated the prognostic significance of DNI value for early mortality and neurologic outcomes after pediatric cardiac arrest (CA). We retrospectively analyzed the data of eligible patients (<19 years in age). Among 85 patients, 55 subjects (64.7%) survived and 36 (42.4%) showed good outcomes at 30 days after CA. Cox regression analysis revealed that the DNI values immediately after the return of spontaneous circulation, at 24 hours and 48 hours after CA, were related to an increased risk for death within 30 days after CA (P < 0.001). A DNI value of higher than 3.3% at 24 hours could significantly predict both 30-day mortality (hazard ratio: 11.8; P < 0.001) and neurologic outcomes (odds ratio: 8.04; P = 0.003). The C statistic for multivariable prediction models for 30-day mortality (incorporating DNI at 24 hours, compression time, and serum sodium level) was 0.799, and the area under the receiver operating characteristic curve of DNI at 24 hours for poor neurologic outcome was 0.871. Higher DNI was independently associated with 30-day mortality and poor neurologic outcomes after pediatric CA.

6.
Br J Haematol ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900937

RESUMO

Care of patients with chronic immune thrombocytopenia (ITP) who are refractory to available treatments can be quite challenging. Fostamatinib, an oral Syk inhibitor, is the newest FDA-approved agent for ITP. Phase 3 clinical trials demonstrated an overall response in 43% of patients treated with fostamatinib and use for two years has been reported. Herein, we report two patients with long histories of ITP without lasting responses to numerous first-, second- and third-line therapies with prolonged responses to ongoing fostamatinib. This shows that patients unresponsive to other agents may respond to fostamatinib and can have sustained benefit.

7.
Cells ; 9(1)2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31936886

RESUMO

The S100A1 protein, involved in various physiological activities through the binding of calcium ions (Ca2+), participates in several protein-protein interaction (PPI) events after Ca2+-dependent activation. The present work investigates Ca2+-dependent conformational changes in the helix-EF hand-helix using the molecular dynamics (MD) simulation approach that facilitates the understanding of Ca2+-dependent structural and dynamic distinctions between the apo and holo forms of the protein. Furthermore, the process of ion binding by inserting Ca2+ into the bulk of the apo structure was simulated by molecular dynamics. Expectations of the simulation were demonstrated using cluster analysis and a variety of structural metrics, such as interhelical angle estimation, solvent accessible surface area, hydrogen bond analysis, and contact analysis. Ca2+ triggered a rise in the interhelical angles of S100A1 on the binding site and solvent accessible surface area. Significant configurational regulations were observed in the holo protein. The findings would contribute to understanding the molecular basis of the association of Ca2+ with the S100A1 protein, which may be an appropriate study to understand the Ca2+-mediated conformational changes in the protein target. In addition, we investigated the expression profile of S100A1 in myoblast differentiation and muscle regeneration. These data showed that S100A1 is expressed in skeletal muscles. However, the expression decreases with time during the process of myoblast differentiation.

8.
Cancer Epidemiol Biomarkers Prev ; 29(4): 832-837, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31988073

RESUMO

BACKGROUND: Long-term antiviral therapy (AVT) for chronic hepatitis B (CHB) reduces the risk of hepatocellular carcinoma (HCC). We assessed the temporal trends in the incidence of HCC over time during long-term AVT among Asian patients with CHB. METHODS: Patients with CHB receiving entecavir/tenofovir (ETV/TDF) as a first-line antiviral were recruited from four academic hospitals in the Republic of Korea. We compared the incidence of HCC during and after the first 5 years of ETV/TDF treatment. RESULTS: Among 3,156 patients, the median age was 49.6 years and males predominated (62.4%). During the follow-up, 9.0% developed HCC. The annual incidence of HCC per 100 person-years during the first 5 years (n = 1,671) and after the first 5 years (n = 1,485) was statistically similar (1.93% vs. 2.27%, P = 0.347). When the study population was stratified according to HCC prediction model, that is, modified PAGE-B score, the annual incidence of HCC was 0.11% versus 0.39% in the low-risk group (<8 points), 1.26% versus 1.82% in the intermediate-risk group (9-12 points), and 4.63% versus 5.24% in the high-risk group (≥13 points; all P > 0.05). A Poisson regression analysis indicated that the duration of AVT did not significantly affect the overall trend of the incidence of HCC (adjusted annual incidence rate ratio = 0.85; 95% confidence interval, 0.66-1.11; P = 0.232). CONCLUSIONS: Despite long-term AVT, the risk of HCC steadily persists over time among patients with CHB in the Republic of Korea, in whom HBV genotype C2 predominates. IMPACT: Careful HCC surveillance is still essential.

9.
Mol Ther ; 28(1): 142-156, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31606324

RESUMO

Hypoxic microenvironments exist in developing embryonic tissues and determine stem cell fate. We previously demonstrated that hypoxic priming plays roles in lineage commitment of embryonic stem cells. In the present study, we found that hypoxia-primed embryoid bodies (Hyp-EBs) efficiently differentiate into the myogenic lineage, resulting in the induction of the myogenic marker MyoD, which was not mediated by hypoxia-inducible factor 1α (HIF1α) or HIF2α, but rather by Sp1 induction and binding to the MyoD promoter. Knockdown of Sp1 in Hyp-EBs abrogated hypoxia-induced MyoD expression and myogenic differentiation. Importantly, in the cardiotoxin-muscle injury mice model, Hyp-EB transplantation facilitated muscle regeneration in vivo, whereas transplantation of Sp1-knockdown Hyp-EBs failed to do. Moreover, we compared microRNA (miRNA) expression profiles between EBs under normoxia versus hypoxia and found that hypoxia-mediated Sp1 induction was mediated by the suppression of miRNA-92a, which directly targeted the 3' untranslated region (3' UTR) of Sp1. Further, the inhibitory effect of miRNA-92a on Sp1 in luciferase assay was abolished by a point mutation in specific sequence in the Sp1 3' UTR that is required for the binding of miRNA-92a. Collectively, these results suggest that hypoxic priming enhances EB commitment to the myogenic lineage through miR-92a/Sp1/MyoD regulatory axis, suggesting a new pathway that promotes myogenic-lineage differentiation.

10.
Sci Rep ; 9(1): 18000, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31784598

RESUMO

To prevent spinal progression in ankylosing spondylitis, initiating TNF-inhibitor treatment as early as possible is suggested. However, the outcomes are inconsistent in previous clinical studies. Here, we investigated the effect of TNF inhibition alone on spinal progression when used during arthritis development in a murine model. We injected 8-week-old SKG mice with curdlan (curdlan group). We injected adalimumab at 3 and 9 weeks after the first curdlan injection (ADA group). The clinical scores of peripheral arthritis decreased in the ADA group at 3 weeks after first adalimumab injection. Using positron emission tomography-magnetic resonance imaging and histologic examination, spinal inflammation was observed in the curdlan group, and was significantly deceased in the ADA group. However, spinal osteoblast activities by imaging using OsteoSense 680 EX and bone metabolism-related cytokines such as receptor activator of nuclear factor-kappa B ligand, osteoprotegerin, Dickkopf-1, and sclerostin levels except IL-17A level were not different between the two groups. We conclude that treating TNF inhibitor alone reduced peripheral arthritis score and spinal inflammation in curdlan-injected SKG mice but did not decrease the spinal osteoblast activity, suggesting little effect on spinal ankylosis.

11.
Cells ; 8(12)2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31817149

RESUMO

Skeletal muscle, the largest part of the total body mass, influences energy and protein metabolism as well as maintaining homeostasis. Herein, we demonstrate that during murine muscle satellite cell and myoblast differentiation, transthyretin (TTR) can exocytose via exosomes and enter cells as TTR- thyroxine (T4) complex, which consecutively induces the intracellular triiodothyronine (T3) level, followed by T3 secretion out of the cell through the exosomes. The decrease in T3 with the TTR level in 26-week-old mouse muscle, compared to that in 16-week-old muscle, suggests an association of TTR with old muscle. Subsequent studies, including microarray analysis, demonstrated that T3-regulated genes, such as FNDC5 (Fibronectin type III domain containing 5, irisin) and RXRγ (Retinoid X receptor gamma), are influenced by TTR knockdown, implying that thyroid hormones and TTR coordinate with each other with respect to muscle growth and development. These results suggest that, in addition to utilizing T4, skeletal muscle also distributes generated T3 to other tissues and has a vital role in sensing the intracellular T4 level. Furthermore, the results of TTR function with T4 in differentiation will be highly useful in the strategic development of novel therapeutics related to muscle homeostasis and regeneration.

12.
Sci Rep ; 9(1): 19608, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31863000

RESUMO

Anxiety, depression, and insomnia are highly prevalent among migraineurs and are associated with negative health consequences. Anxiety and depression, however, unlike insomnia, are usually underdiagnosed, due to less self-reporting of these two conditions. The aim of the present study was to evaluate the risk of anxiety and depression in migraineurs with self-reported insomnia, using a general population-based sample. We used data from a nationwide population-based survey on headache and sleep, the Korean Headache-Sleep Study. Of all 2,695 participants, 143 (5.3%), 268 (10.0%), 116 (4.3%), and 290 (10.8%) were classified as having migraine, anxiety, depression, and self-reported insomnia, respectively. The risk of anxiety (odds ratio [OR] = 7.0, 95% confidence interval [CI] = 3.0-16.7) and depression (OR = 3.3, 95% CI = 1.3-8.5) was significantly increased in migraineurs with self-reported insomnia. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for anxiety in migraineurs with self-reported insomnia were 46.5%, 89.0%, 64.5%, and 79.5%, respectively. For depression, the sensitivity, specificity, PPV, and NPV were 41.7%, 82.4%, 32.3%, and 87.5%, respectively. Self-reported insomnia is likely to be comorbid with anxiety and depression in migraineurs and could thus be a useful predictor of anxiety and depression in migraine.

13.
BMC Urol ; 19(1): 109, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703581

RESUMO

BACKGROUND: The prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB. METHODS: A non-equivalent control group pre-/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher's exact test, Mann-Whitney test, and Wilcoxon test. RESULTS: After the 12-week BBSI program, significant improvements were found in the intervention group's the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group. CONCLUSIONS: The BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program. TRIAL REGISTRATION: KCT0003882. Date of registration: 02/05/2019. Retrospectively registered.

14.
Sci Rep ; 9(1): 15846, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31676809

RESUMO

Chondroitin sulfate (CS) is the most abundant glycosaminoglycan (GAG) in articular cartilage and the loss of CS-GAG occurs early in OA. As a major component of perichondral matrix interacting directly with chondrocytes, the active turnover of CS can affect to break the homeostasis of chondrocytes. Here we employ CS-based 3-dimensional (3D) hydrogel scaffold system to investigate how the degradation products of CS affect the catabolic phenotype of chondrocytes. The breakdown of CS-based ECM by the chondroitinase ABC (ChABC) resulted in a hypertrophy-like morphologic change in chondrocytes, which was accompanied by catabolic phenotypes, including increased MMP-13 and ADAMTS5 expression, nitric oxide (NO) production and oxidative stress. The inhibition of Toll-like receptor 2 (TLR2) or TLR4 with OxPAPC (TLR2 and TLR4 dual inhibitor) and LPS-RS (TLR4-MD2 inhibitor) ameliorated these catabolic phenotypes of chondrocytes by CS-ECM degradation, suggesting a role of CS breakdown products as damage-associated molecular patterns (DAMPs). As downstream signals of TLRs, MAP kinases, NF-kB, NO and STAT3-related signals were responsible for the catabolic phenotypes of chondrocytes associated with ECM degradation. NO in turn reinforced the activation of MAP kinases as well as NFkB signaling pathway. Thus, these results propose that the breakdown product of CS-GAG can recapitulate the catabolic phenotypes of OA.

15.
J Emerg Med ; 57(6): 798-804, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31740158

RESUMO

BACKGROUND: Despite the widespread use of computed tomography pulmonary angiography with contrast media for the diagnosis of acute pulmonary embolism, high-quality evidence on risk factors for postcontrast acute kidney injury related to its use is lacking. OBJECTIVE: The present study aimed to investigate whether the level of estimated glomerular filtration rate observed in the emergency department (ED) is significantly associated with the occurrence of postcontrast acute kidney injury in patients undergoing computed tomography pulmonary angiography. METHODS: We performed a retrospective observational study using data automatically collected by a clinical data retrieval system from 1300 patients who underwent computed tomography pulmonary angiography for suspected acute pulmonary embolism in the ED. A total of 632 patients were selected for the study after exclusion. Univariate analyses were performed to identify significant risk factors for postcontrast acute kidney injury (the primary outcome). Multivariate logistic regression analysis was used to confirm the effect of estimated glomerular filtration rate in the ED on the occurrence of postcontrast acute kidney injury after adjustment for confounding variables. RESULTS: The total incidence rate of postcontrast acute kidney injury was 6.49% (41/632 patients). No statistically significant association between estimated glomerular filtration rate and the risk of postcontrast acute kidney injury was observed. CONCLUSION: Our study findings could serve as useful reference for physicians who are concerned about performing computed tomography pulmonary angiography for fear of renal function deterioration.

16.
Arthritis Rheumatol ; 2019 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-31762216

RESUMO

OBJECTIVE: Increased protein phosphatase magnesium-dependent 1A (PPM1A) levels in patients with ankylosing spondylitis regulate osteoblast differentiation in bony ankylosis; however, the potential mechanisms that regulate osteoclast (OC) differentiation in relation to abnormal bone formation remain unclear. Therefore, we generated conditional gene knockout (PPM1Afl/fl ;LysM-Cre) mice and evaluated their bone phenotype. METHODS: The bone phenotypes of LysM-Cre (n=6) and PPM1Afl/fl ;LysM-Cre mice (n=6) were assessed via micro-computed tomography. OC differentiation was induced by culturing bone marrow-derived macrophages in the presence of the RANKL and M-CSF, and was evaluated by counting tartrate-resistant acid phosphatase-positive multinucleated cells. The mRNA expressions of PPM1A, RANK and OC-specific genes were examined by quantitative real-time PCR, and protein levels were determined using Western blotting. Surface RANK expression was analysed by fluorescent flow cytometry. RESULTS: The PPM1Afl/fl ;LysM-Cre mice displayed reduced bone mass (p<0.001) and increased OC differentiation (p<0.001) and OC-specific gene expression (p<0.05) compared with their LysM-Cre littermates. Mechanistically, reduced PPM1A function in OC precursors in PPM1Afl/fl ;LysM-Cre mice induced OC lineage commitment by up-regulating RANK expression (p<0.01) via p38 MAPK activation in response to M-CSF. PPM1A expression in macrophages was decreased by TLR4 activation (p<0.05). The ankylosing spondylitis disease activity score was negatively correlated with the expression of PPM1A in peripheral blood mononuclear cells from Ax SpA patients (γ=-0.7072, p<0.0001). CONCLUSION: The loss of PPM1A function in OC precursors driven by inflammatory signals contributes to OC lineage commitment and differentiation by elevating RANK expression, reflecting a potential role of PPM1A in dynamic bone metabolism in Ax SpA.

17.
Artigo em Inglês | MEDLINE | ID: mdl-31746292

RESUMO

Skeletal muscle is the largest organ in the body and constitutes almost 40% of body mass. It is also the primary site of insulin-mediated glucose uptake, and skeletal muscle insulin resistance, that is, diminished response to insulin, is characteristic of Type 2 diabetes (T2DM). One of the foremost reasons posited to explain the etiology of T2DM involves the modification of proteins by dicarbonyl stress due to an unbalanced metabolism and accumulations of dicarbonyl metabolites. The elevated concentration of dicarbonyl metabolites (i.e., glyoxal, methylglyoxal, 3-deoxyglucosone) leads to DNA and protein modifications, causing cell/tissue dysfunctions in several metabolic diseases such as T2DM and other age-associated diseases. In this review, we recapitulate reported effects of dicarbonyl stress on skeletal muscle and associated extracellular proteins with emphasis on the impact of T2DM on skeletal muscle and provide a brief introduction to the prevention/inhibition of dicarbonyl stress.

18.
In Vivo ; 33(6): 2191-2198, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31662555

RESUMO

BACKGROUND/AIM: This study evaluated whether the lymphocyte tolerance factor (LTF) was an indicator of radiation tolerance of lymphocytes (RTL) using the relative lymphocyte count (RLC), and considering clinical outcomes. PATIENTS AND METHODS: A total of 92 cervical cancer patients treated with concurrent chemoradiotherapy (CCRT) were analysed. RLC0 was pre-treatment RLC, and RLC1, and RLC2 were at the first and second week of CCRT, respectively. LTF1 was RLC1:RLC2. LTF2 was the dimension of the convex or concave shape comprising the three RLC vertexes. Patients were divided into three groups: good RTL group, low LTF1; moderate RTL group, high LTF1 and low LTF2; and poor RTL group, high LTF1 and high LTF2. RESULTS: Patients with good tumour response to radiotherapy were mostly included in the good RTL group than in the other groups. The poor RTL group had lower 3-year progression-free survival (57.1% vs. 83.8% and 82%, p=0.01) and 5-year disease-specific survival (71.8% vs. 90.4% and 94.9%, p=0.062) rates than the moderate and good RTL groups. Multivariate analyses showed that poor RTL was a significant survival predictor. CONCLUSION: The poor RTL group according to LTF is a potential predictor of clinical outcome.

19.
J Clin Med ; 8(10)2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31640240

RESUMO

BACKGROUND: Currently, proposed nomograms are mainly based on post-operative histopathology. The purpose of this study was to identify preoperative computed tomography (CT) and clinical information that allow prediction of disease-free (DFS) and overall survival (OS) of patients surgically treated for pancreatic head cancer. METHODS: A total of 136 patients who underwent curative-intent surgery were retrospectively reviewed. Based on results from multivariate Cox regression analysis, a prediction model was constructed with preoperative CT features and clinical information. Overall performance of the nomogram was calculated by Harrell's C-index. RESULTS: Symptoms at diagnosis, preoperative serum CA 19-9 ≥ 34 U/mL, and four imaging features (necrosis (DFS, P = 0.066; OS, P = 0.002), possible venous invasion (DFS, P = 0.150, OS, P = 0.055), suspected metastatic regional lymph node (DFS, P = 0.001; OS, P = 0.099), and associated pancreatitis or pseudocyst (DFS, P = 0.013; OS, P = 0.041)) were included to build the nomogram. The c-statistics for the discrimination power of the proposed nomogram was 0.6496 for DFS and 0.6746 for OS. CONCLUSION: A nomogram derived from preoperative CT and clinical information could estimate the risk of recurrence and all-cause death after curative-intent surgery for radiologically resectable pancreatic head cancer.

20.
Front Neurosci ; 13: 1021, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31616244

RESUMO

Human decision-making that involves moral dilemmas is a complex process, as individuals try to adhere to their moral values while their actual decisions can be influenced by several situational constraints. When facing a moral conflict that can bring a gain or loss for a decision-maker but a corresponding loss or gain for others, the decision-maker's choice of resolution strategy lies in its relating to gain-loss asymmetry by placing greater utility weight on his or her immediate gains and delayed losses. Although many neuroimaging studies have unveiled the neural mechanisms that underlie moral decision-making, little attention has been paid to the temporal dynamics of how a decision-maker assesses utility weights differently for a moral (or adaptive) choice that will bring loss (or gain) to himself (and others) when the outcome will be realized in the near versus distant future. This study identifies the electrophysiological mechanisms of time-dependent assessment in individuals' moral conflict resolution strategies. Twenty-two participants were given a set of moral dilemmas with time intervals that varied from the near future to the distant future. Participants chose between two conflicting options: a self-interest-seeking immoral choice (adaptive) and a principled moral choice (moral). Event-related potentials (ERPs) were recorded, and movement-related potentials (MRPs) were analyzed by being response-locked to individual moral choices. Behavioral results showed that participants took more time to respond and were more likely to make adaptive choices under the near-future condition. When the participants faced moral dilemmas, their brain waves manifested medial frontal negativity (MFN) at early stage ERP of 200-400 ms, possibly reflecting an internal moral conflict. Participants then exhibited larger late positive potentials (LPP) under the near-future condition. In addition, greater effort in implementing motor preparation was found under the near-future condition than under the distant future condition, as supported by the larger Bereitschaftspotential (BP) in the anterior areas. Our results illustrate the temporal dynamics of the electrophysiological mechanisms that underlie time-dependent assessments in moral decision-making, as human brains discount the decision utility of the moral outcomes that will occur in the distant future.

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