Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 108
Filtrar
1.
J Affect Disord ; 298(Pt A): 308-315, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752806

RESUMO

BACKGROUND: Research in Asian cultures regarding the association between employment status and health has been limited. The current study investigated the association between depression and employment status in Korea, moderated by gender. METHODS: Data from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were analysed. In total, 11,157 participants aged ≥ 19 years responded to the survey. The Korean version of the PHQ-9 was utilised in addition to questions assessing employment status. RESULTS: Precarious employment indicated a greater prevalence of depression in comparison to permanent employment (14.9% vs 10.8%, p < 0.001; 22.6% vs 20.2%, p < 0.001). Precariously employed men were 1.40 times more likely to have depression (adjusted Odds Ratio (OR): 1.40; 95% Confidence Interval (CI): 1.15-1.70; p= 0.001) while no such association existed among women (adjusted OR: 1.06; 95% CI: 0.89-1.27; p= 0.493). The subgroup analyses revealed that men working day shifts in a precarious employment were 1.48 times more likely to be depressed than those with permanent employment. In contrast, precarious employed women working night shifts were 2.13 times more likely to be depressed than those permanently employed counterparts. LIMITATIONS: Current research did not investigate the causality of the variables hence was unable to identify whether employment instability from precarious engagements preceded the onset of depression. CONCLUSIONS: These findings suggest gender can independently modify the relationship between employment stability and depression, as well as in association with additional variables - including work shift type and income.

2.
Psychol Med ; : 1-14, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34749836

RESUMO

BACKGROUND: Accumulating evidence suggests that alterations in inflammatory biomarkers are important in depression. However, previous meta-analyses disagree on these associations, and errors in data extraction may account for these discrepancies. METHODS: PubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from database inception to 14 January 2020. Meta-analyses of observational studies examining the association between depression and levels of tumor necrosis factor-α (TNF-α), interleukin 1-ß (IL-1ß), interleukin-6 (IL-6), and C-reactive protein (CRP) were eligible. Errors were classified as follows: incorrect sample sizes, incorrectly used standard deviation, incorrect participant inclusion, calculation error, or analysis with insufficient data. We determined their impact on the results after correction thereof. RESULTS: Errors were noted in 14 of the 15 meta-analyses included. Across 521 primary studies, 118 (22.6%) showed the following errors: incorrect sample sizes (20 studies, 16.9%), incorrect use of standard deviation (35 studies, 29.7%), incorrect participant inclusion (7 studies, 5.9%), calculation errors (33 studies, 28.0%), and analysis with insufficient data (23 studies, 19.5%). After correcting these errors, 11 (29.7%) out of 37 pooled effect sizes changed by a magnitude of more than 0.1, ranging from 0.11 to 1.15. The updated meta-analyses showed that elevated levels of TNF- α, IL-6, CRP, but not IL-1ß, are associated with depression. CONCLUSIONS: These findings show that data extraction errors in meta-analyses can impact findings. Efforts to reduce such errors are important in studies of the association between depression and peripheral inflammatory biomarkers, for which high heterogeneity and conflicting results have been continuously reported.

3.
Yonsei Med J ; 62(11): 1042-1051, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34672138

RESUMO

PURPOSE: Indocyanine green (ICG) is a promising agent for intraoperative visualization of tumor tissues and sentinel lymph nodes in early-stage gynecological cancer. However, it has some limitations, including a short half-life and poor solubility in aqueous solutions. This study aimed to enhance the efficacy of near-infrared (NIR) fluorescence imaging by overcoming the shortcomings of ICG using a nano-drug delivery system and improve target specificity in cervical cancer. MATERIALS AND METHODS: ICG and poly(lactic-co-glycolic acid) (PLGA) conjugated with polyethylenimine (PEI) were assembled to enhance stability. Hyaluronic acid (HA) was coated on PEI-PLGA-ICG nanoparticles to target CD44-positive cancer cells. The manufactured HA-ICG-PLGA nanoparticles (HINPs) were evaluated in vitro and in vivo on cervical cancer cells (SiHa; CD44+) and human dermal cells (ccd986sk; CD44-), respectively, using NIR imaging to compare intracellular uptake and to quantify the fluorescence intensities of cells and tumors. RESULTS: HINPs were confirmed to have a mean size of 200 nm and a zeta-potential of 33 mV using dynamic light scattering. The stability of the HINPs was confirmed at pH 5.0-8.0. Cytotoxicity assays, intracellular uptake assays, and cervical cancer xenograft models revealed that, compared to free ICG, the HINPs had significantly higher internalization by cervical cancer cells than normal cells (p<0.001) and significantly higher accumulation in tumors (p<0.001) via CD44 receptor-mediated endocytosis. CONCLUSION: This study demonstrated the successful application of HINPs as nanocarriers for delivering ICG to CD44-positive cervical cancer, with improved efficacy in NIR fluorescence imaging.


Assuntos
Nanopartículas , Neoplasias do Colo do Útero , Feminino , Humanos , Ácido Hialurônico , Verde de Indocianina , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/tratamento farmacológico
4.
Sci Rep ; 11(1): 15952, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354166

RESUMO

Research regarding the association between depression and exercise has been limited regarding precariously employed individuals. The current study investigated the association between exercise variations and depressive symptoms among precarious employees in South Korea. Data from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. In total, 13,080 participants aged ≥ 19 years responded to the survey. The Korean version of the PHQ-9 was utilized in addition to questions assessing regular exercise. Precariously employed men engaging in two or more variations of exercise each week were significantly less likely to report depressive symptoms (adjusted (OR): 0.78; 95% CI 0.62-0.97; p = 0.025), and the likelihood of depression was also lower for women who engaged in one or more forms of exercise (adjusted OR: 0.82; 95% CI 0.71-0.94; p = 0.006). These findings support the association between depression and exercise and suggest that greater variations in regular exercise are associated with a reduction in depression for men whereas any form of exercise reduces the risk of depression in women.


Assuntos
Depressão/terapia , Emprego/psicologia , Terapia por Exercício/métodos , Adulto , Idoso , Estudos Transversais , Depressão/psicologia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Inquéritos e Questionários
5.
Ann Transl Med ; 9(14): 1127, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34430568

RESUMO

Background: After endoscopic submucosal dissection of gastric neoplasms, surveillance endoscopy is required for patients with synchronous or metachronous neoplasms. We aimed to evaluate the risk factors associated with surveillance loss in patients who underwent endoscopic submucosal dissection. Methods: Ninety-five patients treated with endoscopic submucosal dissection for gastric neoplasms between May 2015 and June 2016 were retrospectively reviewed. Clinicopathologic factors, sociodemographic factors, psychiatric measures, and associated risk factors for surveillance loss were evaluated. The chi-square or Fisher exact test, t-test, and logistic regression analysis were used in data analysis. Results: Twenty-five (26.3%) patients were identified as having surveillance loss. Compared to the surveillance group, the surveillance loss group was old and had dysplasia, and a healthy American Society of Anesthesiologists physical status. Similarly, surveillance loss was related to low symptom perception, low incidence of alexithymia, mindful awareness, and high trait forgiveness. Logistic regression analysis showed that dysplasia (odds ratio, 15.23; 95% CI, 1.56-149.09, P=0.019), old age (odds ratio, 7.14; 95% CI, 1.90-26.88, P=0.004), and American Society of Anesthesiologists physical status 1 (odds ratio, 3.99; 95% CI, 1.09-14.60, P=0.037) were associated with surveillance loss. Conclusions: Dysplasia, old age, and the American Society of Anesthesiologists physical status 1 were associated with surveillance loss in patients who underwent gastric endoscopic submucosal dissection. It could be helpful to proactively monitor patients with such conditions after gastric endoscopic submucosal dissection.

6.
BMC Pregnancy Childbirth ; 21(1): 511, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34271867

RESUMO

BACKGROUND: Although the World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. This study aimed to investigate (1) the proportion of pregnant women who received an influenza vaccination and influencing factors and (2) the proportion of obstetrics and gynecology (OBGYN) doctors who routinely recommend influenza vaccination to pregnant women and influencing factors. METHODS: Two separate, anonymized questionnaires were developed for physicians and pregnant and postpartum women and were distributed to multicenters and clinics in South Korea. The proportions of women who received influenza vaccination during pregnancy and OBGYN doctors who routinely recommend the influenza vaccine to pregnant women were analyzed. Independent influencing factors for both maternal influenza vaccination and OBGYN doctors' routine recommendations to pregnant women were analyzed using log-binomial regression analysis. RESULTS: The proportion of self-reported influenza vaccination during pregnancy among 522 women was 63.2%. Pregnancy-related independent factors influencing maternal influenza vaccination were "(ever) received information about influenza vaccination during pregnancy" (OR 8.9, 95% CI 4.17-19.01), "received vaccine information about from OBGYN doctors" (OR 11.44, 95% CI 5.46-24.00), "information obtained from other sources" (OR 4.38, 95% CI 2.01-9.55), and "second/third trimester" (OR 2.41, 95% CI 1.21-4.82).. Among 372 OBGYN doctors, 76.9% routinely recommended vaccination for pregnant women. Independent factors effecting routine recommendation were "working at a private clinic or hospital" (OR 5.33, 95% CI 2.44-11.65), "awareness of KCDC guidelines" (OR 3.11, 95% CI 1.11-8.73), and "awareness of the 2019 national free influenza vaccination program for pregnant women" (OR 4.88, 95% CI 2.34-10.17). OBGYN doctors most commonly chose 'guidelines proposed by the government or public health (108, 46%) and academic committees (59, 25%), as a factor which expect to affect the future recommendation CONCLUSION: This study showed that providing information about maternal influenza vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Closer cooperation between the government and OBGYN academic societies to educate OBGYN doctors might enhance routine recommendations.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Médicos/estatística & dados numéricos , Complicações Infecciosas na Gravidez/prevenção & controle , Gravidez/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Feminino , Ginecologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Influenza Humana/imunologia , Masculino , Pessoa de Meia-Idade , Obstetrícia , Complicações Infecciosas na Gravidez/imunologia , República da Coreia , Inquéritos e Questionários , Cobertura Vacinal/estatística & dados numéricos
7.
BMC Pulm Med ; 21(1): 180, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049523

RESUMO

BACKGROUND: Although depression is a common comorbidity of chronic obstructive pulmonary disease (COPD), the role of sex remains unexplored. We evaluated sex differences of risk factors of depressive symptoms in adults with COPD. METHODS: This was a population-based cross-sectional study using data from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. Spirometry was used to identify patients with COPD, defined as a FEV1/FVC ratio < 0.7. Presence of depressive symptoms was defined as a total score ≥ 5 on the Patient Health Questionnaire-9. RESULTS: 17.8% of participants expressed depressive symptoms. Relative regression analysis revealed that female sex (RR 2.38; 95% CI 1.55-3.66; p < 0.001), living alone (RR 1.46; 95% CI 1.08-1.97; p = 0.013), current smoker (RR 1.70; 95% CI 1.15-2.52; p = 0.008), underweight (RR 1.58 95% CI 1.00-2.49; p = 0.049), and GOLD Stage III/IV (RR 1.92; 95% CI 1.19-3.09; p = 0.007) were the risk factors for depressive symptoms. Low income, living alone, multiple chronic disorders, and low BMI were risk factors of depressive symptoms in male, whereas low educational attainment, urban living, and current smoking were risk factors in female. CONCLUSIONS: Female sex is a main risk factor of depressive symptoms in adults with COPD. As risk factors of depressive symptoms in COPD patients vary according to their sex, different approaches are needed to manage depression in males and females with COPD.


Assuntos
Depressão/epidemiologia , Depressão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Caracteres Sexuais , Adulto , Idoso , Estudos Transversais , Depressão/diagnóstico , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Doença Pulmonar Obstrutiva Crônica/complicações , Análise de Regressão , República da Coreia , Fatores de Risco , Espirometria
8.
Biomed Res Int ; 2021: 9820145, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33748284

RESUMO

Accurate quantification of brain tissue is a fundamental and challenging task in neuroimaging. Over the past two decades, statistical parametric mapping (SPM) and FMRIB's Automated Segmentation Tool (FAST) have been widely used to estimate gray matter (GM) and white matter (WM) volumes. However, they cannot reliably estimate cerebrospinal fluid (CSF) volumes. To address this problem, we developed the TRIO algorithm (TRIOA), a new magnetic resonance (MR) multispectral classification method. SPM8, SPM12, FAST, and the TRIOA were evaluated using the BrainWeb database and real magnetic resonance imaging (MRI) data. In this paper, the MR brain images of 140 healthy volunteers (51.5 ± 15.8 y/o) were obtained using a whole-body 1.5 T MRI system (Aera, Siemens, Erlangen, Germany). Before classification, several preprocessing steps were performed, including skull stripping and motion and inhomogeneity correction. After extensive experimentation, the TRIOA was shown to be more effective than SPM and FAST. For real data, all test methods revealed that the participants aged 20-83 years exhibited an age-associated decline in GM and WM volume fractions. However, for CSF volume estimation, SPM8-s and SPM12-m both produced different results, which were also different compared with those obtained by FAST and the TRIOA. Furthermore, the TRIOA performed consistently better than both SPM and FAST for GM, WM, and CSF volume estimation. Compared with SPM and FAST, the proposed TRIOA showed more advantages by providing more accurate MR brain tissue classification and volume measurements, specifically in CSF volume estimation.


Assuntos
Algoritmos , Substância Cinzenta/diagnóstico por imagem , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Neuroimagem , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Sci Rep ; 10(1): 21412, 2020 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-33293585

RESUMO

Stemness factors control microRNA expression in cancer stem cells. Downregulation of miR-100 and miR-125b is associated with tumor progression and prognosis of various cancers. Comparing miRNA profiling of patient-derived tumorsphere (TS) and adherent (2D) hepatocellular carcinoma cells, miR-100 and miR-125b are identified to have association with stemness. In TS cells, miR-100 and miR-125b were downregulated comparing to 2D cells. The finding was reproduced in Hep3B cells. Overexpression of stemness factors NANOG, OCT4 and SOX2 by introduction of gene constructs in Hep3B cells suppressed these two miRNA expression levels. Treatment of chromeceptin, an IGF signaling pathway inhibitor, decreased numbers of TS and inhibited the AKT/mTOR pathway. Stable cell line of miR-100 and miR-125b overexpression decreased IGF2 expression and inhibited tumor growth in the xenograft model. In conclusion, miR-100 and miR-125b have tumor suppressor role in hepatocellular carcinoma through inhibiting IGF2 expression and activation of the AKT/mTOR pathway.


Assuntos
Carcinoma Hepatocelular/genética , Fator de Crescimento Insulin-Like II/genética , Neoplasias Hepáticas/genética , MicroRNAs/genética , Células-Tronco Neoplásicas/metabolismo , Regulação para Cima , Benzopiranos/farmacologia , Biomarcadores Tumorais/metabolismo , Carcinoma Hepatocelular/metabolismo , Técnicas de Cultura de Células , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Progressão da Doença , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Células Hep G2 , Humanos , Fator de Crescimento Insulin-Like II/metabolismo , Neoplasias Hepáticas/metabolismo , Células-Tronco Neoplásicas/efeitos dos fármacos , Prognóstico
11.
Sci Rep ; 10(1): 20911, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33262411

RESUMO

We propose a novel method, the epinephrine compression method (Epi-pledget), as a hemostasis method for ovarian cystectomy. A total of 179 patients undergoing laparoscopic ovarian cystectomy with stripping were randomly allocated into three groups: the bipolar coagulation group, the Epi-pledget group, and the coagulation after Epi-pledget (Epi & Coagulation) group. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) by ultrasonography were measured to determine the preservation of ovarian function. To evaluate the postoperative ovarian cellular proliferative activity and tissue damage in a mouse model, we operated on the ovaries of mice with an artificial incision injury and applied two hemostatic methods: coagulation and Epi-pledget. Eight weeks after surgery, the AMH rate significantly decreased in the bipolar coagulation group compared with the Epi-pledget group. The AFC decline rate was also significantly greater in the coagulation group than the Epi-pledget group. Specifically, patients with endometrioma had a significantly greater decline of serum AMH in the coagulation group than the Epi-pledget group. In a histopathological analysis in mice, the Epi-pledget group showed ameliorated fibrotic changes and necrotic findings in the injured lesion compared with the bipolar coagulation group. The Epi-pledget method for ovarian stripping has an additional benefit of maximizing the preservation of the ovarian reserve, especially for the endometriotic ovarian cyst type.


Assuntos
Epinefrina/farmacologia , Reserva Ovariana/efeitos dos fármacos , Ovário/cirurgia , Adulto , Hormônio Antimülleriano/sangue , Coagulação Sanguínea , Perda Sanguínea Cirúrgica/prevenção & controle , Feminino , Hemostasia , Humanos , Laparoscopia/efeitos adversos , Ovário/fisiopatologia , Adulto Jovem
12.
Lancet Psychiatry ; 7(11): 955-970, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33069318

RESUMO

BACKGROUND: Many potential environmental risk factors, environmental protective factors, and peripheral biomarkers for ADHD have been investigated, but the consistency and magnitude of their effects are unclear. We aimed to systematically appraise the published evidence of association between potential risk factors, protective factors, or peripheral biomarkers, and ADHD. METHODS: In this umbrella review of meta-analyses, we searched PubMed including MEDLINE, Embase, and the Cochrane Database of Systematic Reviews, from database inception to Oct 31, 2019, and screened the references of relevant articles. We included systematic reviews that provided meta-analyses of observational studies that examined associations of potential environmental risk factors, environmental protective factors, or peripheral biomarkers with diagnosis of ADHD. We included meta-analyses that used categorical ADHD diagnosis criteria according to DSM, hyperkinetic disorder according to ICD, or criteria that were less rigorous than DSM or ICD, such as self-report. We excluded articles that did not examine environmental risk factors, environmental protective factors, or peripheral biomarkers of ADHD; articles that did not include a meta-analysis; and articles that did not present enough data for re-analysis. We excluded non-human studies, primary studies, genetic studies, and conference abstracts. We calculated summary effect estimates (odds ratio [OR], relative risk [RR], weighted mean difference [WMD], Cohen's d, and Hedges' g), 95% CI, heterogeneity I2 statistic, 95% prediction interval, small study effects, and excess significance biases. We did analyses under credibility ceilings, and assessed the quality of the meta-analyses with AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). This study is registered with PROSPERO, number CRD42019145032. FINDINGS: We identified 1839 articles, of which 35 were eligible for inclusion. These 35 articles yielded 63 meta-analyses encompassing 40 environmental risk factors and environmental protective factors (median cases 16 850, median population 91 954) and 23 peripheral biomarkers (median cases 175, median controls 187). Evidence of association was convincing (class I) for maternal pre-pregnancy obesity (OR 1·63, 95% CI 1·49 to 1·77), childhood eczema (1·31, 1·20 to 1·44), hypertensive disorders during pregnancy (1·29, 1·22 to 1·36), pre-eclampsia (1·28, 1·21 to 1·35), and maternal acetaminophen exposure during pregnancy (RR 1·25, 95% CI 1·17 to 1·34). Evidence of association was highly suggestive (class II) for maternal smoking during pregnancy (OR 1·6, 95% CI 1·45 to 1·76), childhood asthma (1·51, 1·4 to 1·63), maternal pre-pregnancy overweight (1·28, 1·21 to 1·35), and serum vitamin D (WMD -6·93, 95% CI -9·34 to -4·51). INTERPRETATION: Maternal pre-pregnancy obesity and overweight; pre-eclampsia, hypertension, acetaminophen exposure, and smoking during pregnancy; and childhood atopic diseases were strongly associated with ADHD. Previous familial studies suggest that maternal pre-pregnancy obesity, overweight, and smoking during pregnancy are confounded by familial or genetic factors, and further high-quality studies are therefore required to establish causality. FUNDING: None.


Assuntos
Acetaminofen/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Pré-Eclâmpsia/epidemiologia , Complicações na Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Biomarcadores , Feminino , Humanos , Gravidez , Fatores de Proteção , Fatores de Risco
13.
Alcohol ; 89: 57-62, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32860858

RESUMO

BACKGROUND: Alcohol use among adults with mild to severe disability is an under-researched topic in the literature. Few studies have attempted to assess the impact of alcohol misuse, abuse, and chronic alcoholism among this target group. Thus, we investigated the association between chronic alcoholism and mortality among disabled individuals in South Korea. METHODS: We used data from the National Health Insurance Service National Sample Cohort (NHIS-NSC) for the years 2003-2013, which included data on 61,013 disabled individuals. Among these patients, a multivariate Cox proportional hazards model was used to estimate the hazard ratio of mortality associated with chronic alcoholism. RESULTS: A total of 800 individuals died during the study period. Individuals who had medical claims for chronic alcoholism following their disability diagnosis had greater risk of mortality than individuals without chronic alcoholism (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.06-2.31, p = 0.0244). Individuals with a physical disability (HR: 2.30, 95% CI: 1.06-4.95, p = 0.0342), brain lesion (HR: 1.96, 95% CI: 1.03-3.74, p = 0.0405), and/or kidney failure (HR: 4.98, 95% CI: 1.07-23.25, p = 0.0411) had greatest mortality risk when diagnosed with chronic alcoholism, compared to individuals who were not diagnosed with chronic alcoholism. CONCLUSIONS: Chronic alcoholism following disability diagnosis was associated with greater mortality risk in a nationally representative population of disabled individuals, especially among individuals with a physical disability, brain lesion, and/or kidney failure. Such findings reveal that certain social and political measures must be implemented to help disabled individuals suffering from alcoholism, especially according to disability diagnosis.


Assuntos
Alcoolismo , Pessoas com Deficiência , Mortalidade , Adulto , Alcoolismo/epidemiologia , Estudos de Coortes , Humanos , Programas Nacionais de Saúde , República da Coreia/epidemiologia , Fatores de Risco
14.
Curr Med Imaging ; 16(5): 469-478, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484081

RESUMO

BACKGROUND: According to the Standards for Reporting Vascular Changes on Neuroimaging, White Matter Hyperintensities (WMHs) are cerebral white matter lesions that are characterized by abnormal tissues of variable sizes and appear hyperintense in T2-weighted Magnetic Resonance (MR) measurements without cavitation (i.e., their tissue signals differ from those of Cerebrospinal Fluid or CSF). Such abnormal tissue regions are typically observed in the MR images of brains of healthy older adults and are associated with a number of geriatric neurodegenerative diseases. Explanations of the exact causes and mechanisms of these diseases remain inconclusive. Moreover, WMHs are typically identified by visual assessment and manual examination, both of which require considerable time. This brings up a need of developing a method for detecting WMHs more objectively and enabling patients to be treated early. As a consequence, damages on nerve cells can be limited and the severity of patients' conditions can be contained. AIMS: This paper presents a computer-aided technique for automatically detecting and segmenting anomalies in MR images. METHODS: The method has two steps: (1) a Band Expansion Process (BEP) to expand the dimensions of brain MR images nonlinearly and (2) anomaly detection algorithms to detect WMHs. Synthesized MR images provided by BrainWeb were used as benchmarks against which the detection performance of the algorithms was determined. RESULTS: The most notable findings are as follows: Firstly, compared with the other anomaly detection algorithms and the Lesion Segmentation Tool (LST), BEP-anomaly detection is shown to be the most effective in detecting WMHs. Secondly, across all levels of background noise and inhomogeneity, the mean Similarity Index (SI) produced by our proposed algorithm is higher than that produced by LST, indicating that the algorithm is more effective than LST in segmenting WMHs from brain MR images. CONCLUSION: Experimental results demonstrated a significantly high accuracy of the BEP-K/R-RX method in detection of synthetic brain MS lesion data. In the meantime, it also effectively enhances the detection of brain lesions.


Assuntos
Simulação por Computador , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Humanos
15.
Obstet Gynecol Sci ; 63(3): 379-386, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32489984

RESUMO

Objective: To compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH). Methods: A total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or adenomyosis (uterine weight ≥500 g) between March 2013 and July 2017 were included. For specimen retrieval, TUM was performed for 30 patients and TVM for 27 patients. Results: Perioperative outcomes, including total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, postoperative pain, and uterine weight, were compared between the 2 groups. No significant differences were observed in the baseline characteristics except for a history of cesarean section (TUM vs. TVM: 83.3% vs. 14.8%, P=0.002) and history of vaginal delivery (TUM vs. TVM: 6.7% vs. 88.8%, P=0.001). The total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, and postoperative pain did not significantly differ between the two groups. The uterine weight was significantly higher for patients who underwent TUM than for those who had TVM (median [range]: 735 g [520-1,380 g] vs. 622 g [514-975 g]; P=0.042). Conclusion: TUM during SPA-TLH is a feasible technique for extracting large uteri weighing ≥500 g. This procedure is suitable for patients without a history of vaginal delivery or a narrow vaginal cavity.

16.
BMC Cancer ; 20(1): 385, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375688

RESUMO

BACKGROUND: Primary debulking surgery (PDS) and adjuvant chemotherapy is the standard treatment for advanced ovarian, fallopian or primary peritoneal cancer. However, neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) has been introduced as an alternative, showing similar efficacy and decreased postoperative complications compared with PDS. Although there is still no evidence for whether three or four cycles of NAC used clinically could be adequate, reducing one cycle of NAC is expected to remove more visible tumours and thereby improve prognosis. Thus, we proposed with this study to evaluate the efficacy and safety of reducing one cycle of NAC for advanced ovarian, fallopian or primary peritoneal cancer. METHODS: This study is a prospective, multi-centre, open-label, randomized phase III trial. A total of 298 patients with advanced ovarian, fallopian or primary peritoneal cancer will be recruited and randomly assigned to either three (control group) or two cycles of NAC (experimental group). After the NAC, we will conduct IDS with maximal cytoreduction and then administer the remaining three or four cycles for a total of six cycles of adjuvant chemotherapy. The primary end point is progression-free survival, and the secondary end points are time to tumour progression, overall survival, tumour response after NAC, IDS and adjuvant chemotherapy, radiologic investigation after IDS, tumour response by positron emission tomography-computed tomography after NAC, quality of life, adverse events, success rate of optimal cytoreduction, surgical complexity, postoperative complications and safety of IDS. We will assess these factors at screening, at every cycle of chemotherapy, at IDS, after the completion of chemotherapy, every 3 months for the first 2 years after the planned treatment and every 6 months thereafter for 3 years. DISCUSSION: We hypothesize that reducing one cycle of NAC will contribute to more resection of visible tumours despite 10% reduction of optimal cytoreduction, which could improve survival. Moreover, two cycles of NAC may increase postoperative complications by 5% compared with three cycles, which may be acceptable. TRIAL REGISTRATION: This study has been prospectively registered at ClinicalTrials.gov on Oct. 2nd, 2018 (NCT03693248, URL: https://clinicaltrials.gov/ct2/show/NCT03693248).


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Epitelial do Ovário/tratamento farmacológico , Quimioterapia Adjuvante/mortalidade , Neoplasias das Tubas Uterinas/tratamento farmacológico , Terapia Neoadjuvante/mortalidade , Neoplasias Peritoneais/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carboplatina/administração & dosagem , Carcinoma Epitelial do Ovário/patologia , Estudos de Casos e Controles , Neoplasias das Tubas Uterinas/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Neoplasias Peritoneais/patologia , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida , Adulto Jovem
17.
Eur J Cancer ; 133: 56-65, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32442924

RESUMO

BACKGROUND: This study assessed the effects of gonadotropin-releasing hormone agonists (GnRHa) on the prevention of chemotherapy-induced ovarian insufficiency among young patients with malignant ovarian germ cell tumour (MOGCT) receiving chemotherapy. METHODS: This multicentre, retrospective study was conducted at 15 sites affiliated with the Korean Gynecologic Oncology Group and enrolled 354 patients between January 1995 and September 2018. Among them, 227 patients were included in this study and divided into two groups according to the use of GnRHa during chemotherapy (GnRHa versus no GnRHa groups). The primary objective was to compare the rates of menstrual resumption between the two groups. We also assessed the clinical determinants affecting menstrual resumption among the study groups. RESULTS: There were no significant differences between the GnRHa (n = 63) and no GnRHa (n = 164) groups regarding age at diagnosis, parity, ethnicity, age at menarche, body mass index, International Federation of Gynecology and Obstetrics stage, mode of surgery and surgery type. The rate of menstrual resumption after chemotherapy was 100% (63 of 63) in the GnRHa group and 90.9% (149 of 164) in the no GnRHa group (p = 0.013). The mean periods from last chemotherapy to menstrual resumption were 7.4 and 7.3 months in the GnRHa and no GnRHa groups, respectively. GnRHa co-administration during chemotherapy reduced the likelihood of amenorrhoea after chemotherapy, although statistical significance was not confirmed in the univariate analysis (odds ratio: 0.276; 95% confidence interval, 0.004-1.317; p = 0.077). CONCLUSION: Temporary ovarian suppression with GnRHa during chemotherapy does not significantly increase the chances of menstrual resumption in young patients with MOGCT.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Fármacos para a Fertilidade Feminina/uso terapêutico , Hormônio Liberador de Gonadotropina/agonistas , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/prevenção & controle , Adolescente , Adulto , Amenorreia/induzido quimicamente , Amenorreia/epidemiologia , Amenorreia/prevenção & controle , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Bleomicina/administração & dosagem , Bleomicina/efeitos adversos , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Etoposídeo/administração & dosagem , Etoposídeo/efeitos adversos , Estudos de Viabilidade , Feminino , Preservação da Fertilidade/métodos , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/prevenção & controle , Menopausa Precoce/efeitos dos fármacos , Menstruação/efeitos dos fármacos , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Ovarianas/epidemiologia , Ovário/efeitos dos fármacos , Gravidez , Insuficiência Ovariana Primária/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
18.
Opt Express ; 28(6): 7786-7798, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32225416

RESUMO

The performance of a photonic functional device in bulk CMOS has been limited by the high propagation loss in polysilicon strip waveguide. Based on the zero-process-change methodology, we successfully reduce the propagation loss of polysilicon waveguide from 112 dB/cm to only 38 dB/cm by solely engineering the waveguide geometry for the first time. Low propagation loss is attributed to a significantly reduced optical overlap factor of 0.09 to bulk polysilicon using subwavelength grating (SWG) waveguide design. These findings prompt us to demonstrate a narrowband SWG-based cladding-modulated Bragg reflector in bulk CMOS, which provides a full-width at half maximum (FWHM) of 1.63 nm, an extinction ratio of 24.5 dB, and a reduced temperature sensitivity of 27.3 pm/°C. Further reducing the FWHM to 0.848 nm is also achieved by decreasing the grating coupling strength. We believe the achievements made in this work validate a promising design path towards practical photonic-electronic applications in bulk CMOS.

19.
Asian J Psychiatr ; 50: 101982, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32126521

RESUMO

BACKGROUND: A growing body of literature has suggested that effective emotion regulation is influenced by cognitive function. Maintenance and manipulation of internal representations occur in working memory (WM), and impairments of WM have been reported in patients with bipolar disorder. METHODS: We examined the manipulation ability of internal representations in WM using mental rotation (MR) tasks, and compared the task performances of euthymic bipolar I disorder patients to those of schizophrenia patients and healthy controls. In this study, 20 euthymic bipolar I disorder patients, 20 schizophrenia patients, and 38 healthy controls were recruited. People and letter MR tasks were employed to evaluate the ability of WM manipulation. RESULTS: Compared to healthy controls, euthymic bipolar I disorder patients showed substantially higher error rates of people MR task and slower responses in both people and letter MR tasks. Schizophrenia patients showed no difference in error rate and response time in MR tasks compared to healthy controls; however, they showed significantly slower responses in people MR task compared to controls. MR task performance was not different between euthymic bipolar and schizophrenia patients. CONCLUSION: Our study results indicate that manipulation of internal representation, especially in the egocentric MR, is impaired in bipolar disorder even in the emotionally-stable state. We speculate that impaired imagery manipulation might be related to alterations in empathic ability, susceptibility of mental imagery, and emotion regulation strategies observed in bipolar disorder.


Assuntos
Transtorno Bipolar/psicologia , Testes Neuropsicológicos , Psicologia do Esquizofrênico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Memória de Curto Prazo , Rotação
20.
Eur J Obstet Gynecol Reprod Biol ; 247: 181-185, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32120179

RESUMO

OBJECTIVE: To compare the surgical outcomes between Reduced-Port Robotic Surgery (RPRS) using the Octo-Port system and conventional 2 port laparoscopy for myomectomy. STUDY DESIGN: This is a prospective, non-randomized study, which compared and analyzed data from 41 patients who underwent RPRS myomectomy and 22 patients who underwent conventional 2 port laparoscopic myomectomy from April 2016 through July 2019. We compared the myoma enucleation time, suture time, myoma type, and the location of the largest myoma between the two groups. RESULTS: The patients were not different between the two groups. The myoma enucleation time (26.7 ± 20.9 vs. 22.0 ± 13.7, p = 0.380), hemoglobin drop (2.38 ± 0.9 vs 2.1 ± 0.8, p = 0.280), weight of the myomas (205.3 ± 161.5 vs. 163.4 ± 89.1, p = 0.261), and estimated blood loss (181.1 ± 163.4 vs. 187.3 ± 77.5, p = 0.840) were not significantly different between the two groups. Notably, only the suture time (15.5 (10-21.5) vs. 20 (18-27), p = 0.005) was lesser in women who underwent RPRS myomectomy than in those who underwent conventional 2 port myomectomy. CONCLUSION: Our data suggest that RPRS myomectomy is comparable to conventional 2 port laparoscopic myomectomy in terms of safety and feasibility and may be more advantageous for suturing after myoma enucleation.


Assuntos
Laparoscopia/estatística & dados numéricos , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Miomectomia Uterina/estatística & dados numéricos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Miomectomia Uterina/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...