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1.
Aging (Albany NY) ; 11(22): 10684-10696, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31754082

RESUMO

There have been an increasing number of functional magnetic resonance imaging (fMRI) reports on brain abnormalities in mild traumatic brain injury (mTBI) at different phases. However, the neural bases and cognitive impairment after acute mTBI are unclear. This study aimed to identify brain functional hubs and connectivity abnormalities in acute mTBI patients and their correlations with deficits in cognitive performance. Within seven days after brain injury, mTBI patients (n=55) and age-, sex-, and educational -matched healthy controls (HCs) (n=41) underwent resting-state fMRI scans and cognitive assessments. We derived functional connectivity (FC) strength of the whole-brain network using degree centrality (DC) and performed Granger causality analysis (GCA) to analyze causal connectivity patterns in acute mTBI. Compared with HCs, acute mTBI patients had significantly decreased network centrality in the left middle frontal gyrus (MFG). Additionally, acute mTBI showed decreased inflows from the left MFG to bilateral middle temporal gyrus (MTG), left medial superior frontal gyrus (mSFG), and left anterior cingulate cortex (ACC). Correlation analyses revealed that changes in network centrality and causal connectivity were associated with deficits in cognitive performance in mTBI. Our findings may help to provide a new perspective for understanding the neuropathophysiological mechanism of acute cognitive impairment after mTBI.

2.
Gen Physiol Biophys ; 38(5): 389-397, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31595881

RESUMO

Stroke is a leading cause of disability and death in the worldwide. Therefore, prevention of stroke is critically important. Genistein, a natural phytoestrogen extracted from soybeans, has been found to be a potential neuroprotective agent for stroke prevention. However, the role of genistein and its underlying mechanism in ovariectomized rats has been rarely evaluated. In this study, ovariectomized rats were treated with genistein (10 mg/kg) or vehicle daily for two weeks before they received middle cerebral artery occlusion (MCAO) and reperfusion. Seventy-two hours after reperfusion, the neurological function was evaluated by Garcia test, infarct volumes were detected by 2,3,5-triphenyltetrazolium chloride staining; and neuronal damage and cell apoptosis were detected by Nissl and Tunel staining in the ischemic penumbra, respectively. In addition, Western blotting was used to detect the activity of PI3K-Akt-mTOR signal pathway in the ischemic penumbra in different groups. And we found that genistein treatment in ovariectomized rats significantly improved neurological outcomes, reduced infarct volumes, decreased neuronal damage and cell apoptosis, and increased the activity of PI3K-Akt-mTOR signal pathway. Our findings indicated that treatment genistein could alleviate neuronal apoptosis induced by cerebral ischemia in ovariectomized rats via promoting the activity of PI3K-Akt-mTOR signal pathway, which provides a new molecular mechanism for the neuroprotective effects of genistein against stroke.


Assuntos
Genisteína/uso terapêutico , Infarto da Artéria Cerebral Média/tratamento farmacológico , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Traumatismo por Reperfusão/tratamento farmacológico , Serina-Treonina Quinases TOR/metabolismo , Animais , Feminino , Infarto da Artéria Cerebral Média/metabolismo , Fármacos Neuroprotetores/uso terapêutico , Ovariectomia , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/metabolismo , Transdução de Sinais/efeitos dos fármacos
3.
Int J Oral Sci ; 11(2): 16, 2019 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-31068577

RESUMO

Opportunistic bacteria in apical periodontitis (AP) may pose a risk for systemic dissemination. Mucosal-associated invariant T (MAIT) cells are innate-like T cells with a broad and potent antimicrobial activity important for gut mucosal integrity. It was recently shown that MAIT cells are present in the oral mucosal tissue, but the involvement of MAIT cells in AP is unknown. Here, comparison of surgically resected AP and gingival tissues demonstrated that AP tissues express significantly higher levels of Vα7.2-Jα33, Vα7.2-Jα20, Vα7.2-Jα12, Cα and tumour necrosis factor (TNF), interferon (IFN)-γ and interleukin (IL)-17A transcripts, resembling a MAIT cell signature. Moreover, in AP tissues the MR1-restricted MAIT cells positive for MR1-5-OP-RU tetramer staining appeared to be of similar levels as in peripheral blood but consisted mainly of CD4+ subset. Unlike gingival tissues, the AP microbiome was quantitatively impacted by factors like fistula and high patient age and had a prominent riboflavin-expressing bacterial feature. When merged in an integrated view, the examined immune and microbiome data in the sparse partial least squares discriminant analysis could identify bacterial relative abundances that negatively correlated with Vα7.2-Jα33, Cα, and IL-17A transcript expressions in AP, implying that MAIT cells could play a role in the local defence at the oral tissue barrier. In conclusion, we describe the presence of MAIT cells at the oral site where translocation of oral microbiota could take place. These findings have implications for understanding the immune sensing of polymicrobial-related oral diseases.


Assuntos
Imunidade nas Mucosas/imunologia , Microbiota , Células T Invariáveis Associadas à Mucosa , Periodontite Periapical/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células T Matadoras Naturais/imunologia , Periodontite Periapical/microbiologia
4.
Eur J Radiol ; 114: 69-75, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31005180

RESUMO

PURPOSE: Mild traumatic brain injury is known to have frequent cognitive impairment. Accumulating evidence is pointing to the malfunctioning of the substantia nigra (SN) as an important factor for head trauma. However, it remains unknown whether changes in the SN-based resting state functional connectivity following mTBI at acute stage and its relationship with cognitive function. MATERIALS AND METHODS: 58 patients with mTBI and 30 age-, gender-, and years of education-matched healthy controls were enrolled in the current study. All of participants received resting state functional magnetic resonance imaging as well as neuropsychological assessment. The resting state functional MR imaging data were analyzed by using a standard seed-based whole-brain correlation method to characterize SN resting state networks. Student t tests were used to perform comparisons. The association between SN resting state networks and performance on neuropsychological measures was also investigated in patients with mTBI by using Pearson rank correlation. RESULTS: Patients with mTBI at acute stage exhibited reduced left SN-based functional connectivity with right insula and caudate and increased left SN-based functional connectivity with left precuneus and left middle occipital gyrus, and reduced right SN-based functional connectivity with left insula. Increased functional connectivity of left precuneus was negatively associated with neurocognitive functions as well (r = -0.266; P = 0.049). CONCLUSION: The present study indicated that patients with acute mTBI suffer from disruption in their SN resting state networks. Moreover, abnormal functional connectivity significantly correlated with cognitive function. Taking together, these results may better improve our understanding of the neuropathological mechanism underlying the neurocognitive symptoms associated with acute mTBI.


Assuntos
Concussão Encefálica/fisiopatologia , Mapeamento Encefálico/métodos , Disfunção Cognitiva/patologia , Imagem por Ressonância Magnética , Substância Negra/patologia , Adulto , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Substância Negra/diagnóstico por imagem
5.
Gut ; 68(12): 2186-2194, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30872392

RESUMO

OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can progress to invasive pancreatic cancer. Associations between oncogenesis and oral microbiome alterations have been reported. This study aims to investigate a potential intracystic pancreatic microbiome in a pancreatic cystic neoplasm (PCN) surgery patient cohort. DESIGN: Paired cyst fluid and plasma were collected at pancreatic surgery from patients with suspected PCN (n=105). Quantitative and qualitative assessment of bacterial DNA by qPCR, PacBio sequencing (n=35), and interleukin (IL)-1ß quantification was performed. The data were correlated to diagnosis, lesion severity and clinical and laboratory profile, including proton-pump inhibitor (PPI) usage and history of invasive endoscopy procedures. RESULTS: Intracystic bacterial 16S DNA copy number and IL-1ß protein quantity were significantly higher in IPMN with high-grade dysplasia and IPMN with cancer compared with non-IPMN PCNs. Despite high interpersonal variation of intracystic microbiota composition, bacterial network and linear discriminant analysis effect size analyses demonstrated co-occurrence and enrichment of oral bacterial taxa including Fusobacterium nucleatum and Granulicatella adiacens in cyst fluid from IPMN with high-grade dysplasia. The elevated intracystic bacterial DNA is associated with, but not limited to, prior exposure to invasive endoscopic procedures, and is independent from use of PPI and antibiotics. CONCLUSIONS: Collectively, these findings warrant further investigation into the role of oral bacteria in cystic precursors to pancreatic cancer and have added values on the aetiopathology as well as the management of pancreatic cysts.


Assuntos
Carcinoma Ductal Pancreático/microbiologia , DNA Bacteriano/genética , Microbiota/genética , Boca/microbiologia , Ductos Pancreáticos/microbiologia , Neoplasias Pancreáticas/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma Ductal Pancreático/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Pancreatectomia , Ductos Pancreáticos/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos
6.
Brain Imaging Behav ; 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30734204

RESUMO

Cognitive impairment is a major cause of disability and decline in quality of life in mild traumatic brain injury (mTBI) survivors, but the underlying pathophysiology is still poorly understood. The insula has extensive connections to other cortex and is believed to responsible for integrating external and internal processes and controlling cognitive functions. To explore this hypothesis, we investigated early alterations in the gray matter volume (GMV) and brain functional connectivity (FC) of insula in mTBI patients within 7 days after injury and any possible correlations with cognitive function. A total of 58 mTBI patients at the acute stage and 32 matched healthy controls were recruited and underwentT1-weighted magnetic resonance imaging (MRI)andresting-state functional MRI scans within 7 days of injury. FC was characterized using seed-based region of interest analysis method. The patients' cognitive function was evaluated with Montreal Cognitive Assessment (MoCA) score. The resulting of GMV and FC of insula were correlated with cognitive alterations. We found that the GMV was significantly reduced only in the right insula in mTBI patients and no significant GMV increase was observed in either hemisphere. mTBI patients demonstrated decreased FC in the right parahippocampal gyrus and increased FC in the right supramargianl gyrus. In addition, compared to the healthy controls, the mTBI patients in the acute stage presented a decline in the visuospatial/executive (p = 0.013) and attention (p = 0.038) subcategories. In the mTBI group, the changes in GMV in the right insula were positively correlated with poor attention performance (r = 0.316, p = 0.016). Our data demonstrated alterations of the GMV and resting-stateFC of the right insula in mTBI patients at the acute stage. These early changes in GMV and resting-state FC perhaps serve as a potential biomarker for improving the understanding of cognitive decline for mTBI in the acute setting.

7.
Front Aging Neurosci ; 10: 207, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30061822

RESUMO

Recent studies have implicated 20-HETE as a vasoconstrictive mediator in trauma, the purpose of this study was to determine whether administration of HET0016, the 20-HETE inhibitor, could protect neurons from trauma and the effect of HET0016 on the blood-brain barrier (BBB) and brain edema in experimental traumatic brain injury (TBI). Rat models with TBI were established. Brain edema was measured according to the wet and dry weight method at 3, 24, and 72 h after injury. The BBB permeability was quantified by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Superoxide production, the activity of superoxide dismutase (SOD) and total antioxidative capability (T-AOC) in traumatic brain tissues were also measured. Western blot analysis was used to analyze the expression of the occludin, ZO-1, Matrix metalloproteinase-9 (MMP-9), and c-Jun N-terminal protein kinase (JNK) pathways. At 24 and 72 h after administration of HET0016 following TBI, the BBB permeability and brain edema decreased. The decrease in superoxide production and the increase in the activity of SOD and T-AOC were measured in this study. Western blot analysis showed that the expression of MMP-9 and JNK pathways was suppressed, but the expression of ZO-1 and occludin was increased. These results suggest that the administration of HET0016 could protect the BBB function and decrease brain edema after experimental traumatic injury by suppressing the expression of MMP-9 and activating the expression of tight junction proteins via suppressing the JNK pathway and oxidative stress.

8.
Front Aging Neurosci ; 10: 239, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30154712

RESUMO

[This corrects the article DOI: 10.3389/fnagi.2018.00207.].

9.
Medicine (Baltimore) ; 97(25): e11159, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29924023

RESUMO

RATIONALE: Small cell lung cancer accounts for 15-20% of all lung cancers and is the most common pulmonary neuroendocrine neoplasm. Most small cell lung cancers arise from lobar or main bronchi, the most common manifestations of small cell lung cancer is a large mass centrally located within the lung parenchyma or a mediastinal mass involving the hilus. Small cell lung cancer is easily ignored by clinicians without lung parenchyma and hilus involvement. Here, we report a case of small cell lung cancer, which was misdiagnosed as the lymphoma in contrast enhanced CT and Ga-DOTA-NOC PET/CT imagings. PATIENT CONCERNS: A 49-year-old male with chief complaint of discontinuous cough for 1 month. DIAGNOSES: Small cell lung cancer. INTERVENTIONS: Radiotherapy and chemotherapy were given thereafter. OUTCOMES: The case had multiple enlarged lymph nodes due to tumor progression. LESSONS: Small cell lung cancer is a malignant and progressive disease, and easy to be ignored in clinical. The case of small cell lung cancer without parenchyma and hilus involvement has never been reported before. Here, we report it and hope it provides a differential diagnosis for clinicians in the following similar cases.


Assuntos
Erros de Diagnóstico/prevenção & controle , Neoplasias Pulmonares , Linfoma/diagnóstico , Neoplasias do Mediastino , Carcinoma de Pequenas Células do Pulmão , Diagnóstico Diferencial , Radioisótopos de Gálio/farmacologia , Humanos , Biópsia Guiada por Imagem/métodos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares/terapia , Masculino , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/fisiopatologia , Neoplasias do Mediastino/terapia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organometálicos/farmacologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Intensificação de Imagem Radiográfica/métodos , Compostos Radiofarmacêuticos/farmacologia , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Carcinoma de Pequenas Células do Pulmão/patologia , Carcinoma de Pequenas Células do Pulmão/fisiopatologia , Carcinoma de Pequenas Células do Pulmão/terapia , Tomografia Computadorizada por Raios X/métodos
10.
Mol Med Rep ; 17(5): 7339-7345, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29568904

RESUMO

Breakdown of the blood brain barrier (BBB) is a secondary injury following traumatic brain injury (TBI) and can lead to the development of brain edema. However, the factors that contribute to the disruption of the BBB and increase the severity of brain edema in TBI remain to be elucidated. 20­hydroxyeicosatetraenoic acid (20­HETE) is a metabolite of arachidonic acid. The inhibition of 20­HETEsynthesis by HET0016 has been suggested as a strategy to decrease brain edema. The present study aimed to investigate whether the elevated production of 20­HETE in cerebral tissue may contribute to BBB breakdown and increase the severity of brain edema in rats with TBI. BBB permeability was quantified using dynamic contrast­enhanced magnetic resonance imaging and brain edema was measured according to brain water content. Superoxide production in injured tissue was also assessed. Liquid chromatography­mass spectrometry was used to evaluate 20­HETE production in injured tissue. Western blot analysis was used to assess the expression of occludin, zonula occludens (ZO)­1, matrix metalloproteinase (MMP)­9, and proteins of the c­Jun N­terminal kinase (JNK) pathway. A total of 3, 24 and 72 h following the induction of TBI, 20­HETE levels, BBB permeability and brain edema were identified to be increased, accompanied by an increase in superoxide production. Conversely, superoxide dismutase levels, in addition to the total antioxidative capability were decreased. In addition, the expression of MMP­9 and proteins of the JNK pathway was upregulated, whereas the expression of occludin and ZO­1 was observed to be suppressed. These results suggested that 20­HETE may aggravate BBB disruption following TBI, via enhancing the expression of MMP­9 and tight junction proteins. Furthermore, oxidative stress and the JNK signaling pathway may be involved in BBB dysregulation. In conclusion, the results of the present demonstrated that the production of 20­HETE was increased in cerebral tissue following traumatic injury, thus suggesting that it may contribute to the compromise of BBB integrity and the development of brain edema.


Assuntos
Barreira Hematoencefálica/patologia , Edema Encefálico/patologia , Lesões Encefálicas Traumáticas/patologia , Ácidos Hidroxieicosatetraenoicos/metabolismo , Animais , Barreira Hematoencefálica/metabolismo , Edema Encefálico/complicações , Edema Encefálico/metabolismo , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/metabolismo , Permeabilidade Capilar , Masculino , Metaloproteinase 9 da Matriz/análise , Metaloproteinase 9 da Matriz/metabolismo , Ocludina/análise , Ocludina/metabolismo , Estresse Oxidativo , Ratos Sprague-Dawley , Proteína da Zônula de Oclusão-1/análise , Proteína da Zônula de Oclusão-1/metabolismo
11.
Curr Stem Cell Res Ther ; 13(7): 490-496, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28606044

RESUMO

Hydrogels are degradable polymeric networks, in which cross-links play a vital role in structure formation and degradation. Cross-linking is a stabilization process in polymer chemistry that leads to the multi-dimensional extension of polymeric chains, resulting in network structures. By crosslinking, hydrogels are formed into stable structures that differ from their raw materials. Generally, hydrogels can be prepared from either synthetic or natural polymers. Based on the types of cross-link junctions, hydrogels can be categorized into two groups: the chemically cross-linked and the physically cross-linked. Chemically cross-linked gels have permanent junctions, in which covalent bonds are present between different polymer chains, thus leading to excellent mechanical strength. Although chemical cross-linking is a highly resourceful method for the formation of hydrogels, the cross-linkers used in hydrogel preparation should be extracted from the hydrogels before use, due to their reported toxicity, while, in physically cross-linked gels, dissolution is prevented by physical interactions, such as ionic interactions, hydrogen bonds or hydrophobic interactions. Physically cross-linked methods for the preparation of hydrogels are the alternative solution for cross-linker toxicity. Both methods will be discussed in this review.


Assuntos
Reagentes para Ligações Cruzadas/química , Preparações de Ação Retardada/química , Portadores de Fármacos/química , Glutaral/química , Hidrogéis/química , Polímeros/química , Aldeídos , Cristalização , Raios gama , Humanos , Ligações de Hidrogênio , Interações Hidrofóbicas e Hidrofílicas , Raios Ultravioleta
12.
Neuroradiology ; 59(3): 221-229, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28255901

RESUMO

PURPOSE: This study aims to elucidate the frequency, nondetection rate, and clinical importance of incidental extracerebral findings (IECFs) on brain nonenhanced magnetic resonance imaging (MRI). METHODS: A total of 8284 brain MRIs performed between January 1, 2015 and December 31, 2015 were evaluated for the presence of IECFs and the distribution of IECFs was analyzed. IECFs were categorized as E1 (clinically unimportant, e.g., sinus mucosal thickening); E2 (likely unimportant, e.g., pharyngeal mucosal symmetrical thickening); and E3 (potentially important, e.g., pharyngeal mucosal asymmetrical thickening). The nondetection rate was determined by comparing the results of the structured approach with the initial MRI reports. The medical records were examined for patients with E3 IECFs to assess clinical importance and outcome of these lesions. RESULTS: A total of 5992 IECFs were found in 4469 of the 8284 patients (54.0%). E1 findings constituted 82.2% (4924/5992) of all IECFs; E2 constituted 16.6% (995/5992) and E3 constituted 1.2% (73/5992). Overall IECFs and E1 findings were significantly more common in male patients (P < 0.05). Statistically significant difference was also seen between the different age groups (P < 0.001). The nondetection rate was 56.9% (3409/5992) for overall IECFs and 32.9% (24/73) for E3 IECFs. Of the 73 patients with E3 IECFs, 34 (46.6%) received final diagnosis and appropriate treatment during the study period. CONCLUSIONS: IECFs are prevalent in clinical patients on brain MR images with a nondetection rate of 32.9% for potentially important (E3) findings. The reporting of IECFs according to clinical importance is helpful for patients' management.


Assuntos
Encefalopatias/diagnóstico por imagem , Achados Incidentais , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade
13.
J Craniofac Surg ; 28(2): 366-371, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27997447

RESUMO

As the most effective surgical technique maxillomandibular advancement (MMA) has been used to treat severe obstructive sleep apnea (OSA) in adults, particularly for those who are intolerant of continuous positive airway pressure. Yet for large-scale advancement, it is faced with esthetic problems with marked skeletal protrusion especially for people with convex facial profile. In this study, the authors performed counterclockwise MMA combined with quantified uvulopalatopharyngoplasty (UPPP) surgeries on Chinese adult patients with severe OSA, in order to initially explore the efficacy of these procedures on Chinese populations and provide evidence for esthetic advantages. As the primary procedure counterclockwise MMA was applied on 10 patients, achieving a forward distance of the mandible and the maxilla for 10.6 and 6.7 mm, respectively, and the occlusion plane rotated counterclockwise of 6.2°. After a follow-up of beyond 12 months, polysomnography results showed the apnea-hypopnea index (AHI) significantly decreased from 64.3 to 11.0 per hour, achieving surgical success of 90%. Upper airway measurements demonstrated that the retropalatal and retrolingual spaces got enlarged greatly, resulting in significant AHI reduction and oxygen saturation elevation. More importantly, cephalometric analysis revealed that SNA and SNB were enlarged but in well control without visual abnormalities. Follow-up results showed large-scale advancement of the maxilla and mandible were stable in treating severe OSA. Quantified UPPP surgeries guaranteed no functional insufficiency in pronouncing and swallowing and played auxiliary role in enlarging the upper airway. Thus, procedures of counterclockwise MMA combined with quantified UPPP surgeries might find more application especially in patients with severe OSA with convex facial profile in future.


Assuntos
Mandíbula/cirurgia , Avanço Mandibular/métodos , Maxila/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Músculos Faríngeos/cirurgia , Apneia Obstrutiva do Sono , Úvula/cirurgia , Adulto , Cefalometria/métodos , China , Pressão Positiva Contínua nas Vias Aéreas , Feminino , Humanos , Masculino , Polissonografia/métodos , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/cirurgia , Resultado do Tratamento
14.
Sleep Breath ; 20(3): 1119-29, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27424047

RESUMO

PURPOSE: Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA. METHODS: In this paper, we have introduced four Crouzon syndrome children of different severity in suffering from OSA and maxillofacial deformities. Detailed information was given including clinical manifestations, radiological findings, and polysomnography detections. Based on the above findings, different but effective treatment options for these children's OSA problems were adopted, either by surgeries including distraction osteogenesis and craniomaxillofacial surgeries with or without tonsillectomy or by noninvasive continuous positive airway pressure (CPAP) therapy. RESULTS: Follow-up studies for more than 1 year showed problems of OSA and nocturnal hypoxia of those four patients were all alleviated greatly, as well as maxillofacial deformities. Combined with pre-operative and post-operative orthodontics, one patient also got optimal results in better facial profile and dental occlusion. CONCLUSION: Thus, based on adequate clinical evaluations and patients' conditions including age, disease severity, and esthetic considerations, individualized therapy should be made and performed carefully to obtain optimized results in treating OSA for pediatric Crouzon syndrome patients.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Disostose Craniofacial/complicações , Disostose Craniofacial/terapia , Comunicação Interdisciplinar , Colaboração Intersetorial , Medicina de Precisão/métodos , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/terapia , Cirurgia Bucal , Adolescente , Criança , China , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Ortodontia Corretiva , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico
15.
Adv Ther ; 33(7): 1158-68, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27294489

RESUMO

INTRODUCTION: Pilot studies have suggested potential clinical applications for intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in head and neck cancers. This study aimed to characterize metastatic lymph nodes using IVIM MRI, and to evaluate the role of IVIM MRI in the prediction of the early treatment response of lymph node metastasis from nasopharyngeal carcinoma (NPC). METHODS: A total of 122 patients with metastatic lymph nodes from NPC underwent two MRI examinations, pre-treatment and post-treatment (at 4 weeks and at ≥2 years from the end of chemoradiotherapy). Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. Differences in the initial IVIM parameters [pure molecular diffusion (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f)] between nodes with a partial response (PR) and a complete response (CR) were analyzed in 102 patients after the exclusion of 20. RESULTS: The initial D*, D, and apparent diffusion coefficient (ADC) did not reveal a significant difference between nodes showing a PR or a CR. The mean initial f value was significantly higher in patients with a PR relative to patients with a CR (p = 0.003), and its sensitivity and specificity in predicting treatment response to chemoradiotherapy were 86.7% and 100%, respectively. CONCLUSIONS: The present study indicated that the initial f value may be more accurate than the initial D*, D, and ADC in the early prediction of treatment response to chemoradiotherapy for metastatic lymph nodes in patients with NPC.


Assuntos
Carcinoma/terapia , Quimiorradioterapia/métodos , Linfonodos/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias Nasofaríngeas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Feminino , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/patologia , Sensibilidade e Especificidade , Adulto Jovem
16.
Biomed Res Int ; 2016: 4376720, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26989683

RESUMO

OBJECTIVES: I-131 therapy for differentiated thyroid cancer (DTC) could induce adverse effects. The purpose of this study was to report and analyze symptoms after I-131 treatment within the hospitalization and present relevant medical intervention. METHODS: I-131 doses ranging from 3.7 to 9.25 GBq (100-250 mCi) were administrated for thyroid remnant ablation or treating DTC metastases. 117 patients with DTC for I-131 therapy were monitored through the video and intercommunicating with standardized questionnaire at different time points after I-131 oral administration. Adverse effects were recorded and relevant clinical factors were analyzed. RESULTS: Among all the 117 patients, 55 cases complained of neck's pain or swelling and 79 cases presented with gastrointestinal symptoms. Pain or swelling of salivary gland occurred in 15 patients, headache and vertigo in 10, insomnia in 9, vocal cord paralysis in 6, fatigue or general malaise in 6, and foreign body sensation in 5. Body numbness and urinary symptoms were observed in only 1 case, respectively. Those side effects were related with sex, pre-I-131 treatment TSH levels, frequency of I-131 therapy, and lymph node metastases. CONCLUSIONS: Short-term side effects after I-131 therapy for DTC patients varied individually; severe symptoms were not uncommon but generally did not need emergent medical intervention.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Radioisótopos do Iodo/efeitos adversos , Compostos Radiofarmacêuticos/efeitos adversos , Neoplasias da Glândula Tireoide/radioterapia , Adolescente , Adulto , Idoso , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/classificação , Feminino , Humanos , Radioisótopos do Iodo/uso terapêutico , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Dor/etiologia , Dor/patologia , Glândulas Salivares/patologia , Glândulas Salivares/efeitos da radiação , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/patologia
17.
J Neurochem ; 136(3): 581-93, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26546505

RESUMO

Sirtuin 2 (SIRT2) is a member of the sirtuin family of NAD(+) -dependent protein deacetylases. In recent years, SIRT2 inhibition has emerged as a promising treatment for neurodegenerative diseases. However, to date, there is no evidence of a specific role for SIRT2 in traumatic brain injury (TBI). We investigated the effects of SIRT2 inhibition on experimental TBI using the controlled cortical impact (CCI) injury model. Adult male mice underwent CCI or sham surgery. A selective brain-permeable SIRT2 inhibitor, AK-7, was administrated 30 min before injury. The volume of the brain edema lesion and the water content of the brain were significantly increased in mice treated with AK-7 (20 mg/kg), compared with the vehicle group, following TBI (p < 0.05 at 1 day and p < 0.05 at 3 days, respectively). Concomitantly, AK-7 administration greatly worsened neurobehavioral deficits on days 3 and 7 after CCI. Furthermore, blood-brain barrier disruption and matrix metalloproteinases (MMP)-9 activity increased following SIRT2 inhibition. AK-7 treatment increased TBI-induced microglial activation both in vivo and in vitro, accompanied by a large increase in the expression and release of inflammatory cytokines. Mechanistically, SIRT2 inhibition increased both K310 acetylation and nuclear translocation of NF-κB p65, leading to enhanced NF-κB activation and up-regulation of its target genes, including aquaporin 4 (AQP4), MMP-9, and pro-inflammatory cytokines. Together, these data demonstrate that SIRT2 inhibition exacerbates TBI by increasing NF-κB p65 acetylation and activation. Our findings provide additional evidence of an anti-inflammatory effect of SIRT2. SIRT2 is a member of the sirtuin family of NAD+-dependent protein deacetylases. Our study suggests that the SIRT2 inhibitor AK-7 exacerbates traumatic brain injury (TBI) via a potential mechanism involving increased acetylation and nuclear translocation of NF-κB p65, resulting in up-regulation of NF-κB target genes, including aquaporin 4 (AQP4), matrix metalloproteinase 9 (MMP-9), and pro-inflammatory cytokines. Our findings provide additional evidence of an anti-inflammatory effect of SIRT2.


Assuntos
Barreira Hematoencefálica/patologia , Lesões Encefálicas/complicações , Lesões Encefálicas/patologia , Encefalite/induzido quimicamente , Sirtuína 2/metabolismo , Fator de Transcrição RelA/metabolismo , Acetilação/efeitos dos fármacos , Animais , Edema Encefálico/diagnóstico , Edema Encefálico/etiologia , Citocinas/metabolismo , Modelos Animais de Doenças , Proteína Glial Fibrilar Ácida/metabolismo , Masculino , Metaloproteinase 8 da Matriz/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Fatores de Tempo , Regulação para Cima/efeitos dos fármacos , Proteína da Zônula de Oclusão-1/metabolismo
18.
Dent Traumatol ; 31(1): 24-8, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25236939

RESUMO

BACKGROUND: The viability of periodontal ligament fibroblasts (PDLF) can affect the long-term prognosis of replanted avulsed teeth. When immediate replantation of an avulsed tooth is not possible, the cells should be incubated in a physiological storage medium instantly to maintain their biological activity. The ability of different storage media to preserve PDLF viability has been previously evaluated. However, few studies have showed the effect of temperature on the viability of PDLF cultured with various storage media in vitro. MATERIAL AND METHODS: This study was designed to measure PDLF activity by CCK-8 assay to compare the effectiveness at 4, 22 (room temperature), and 37°C under various storage media. RESULTS: Statistical analysis demonstrated that tap water, saline, and saliva decreased cell viability as the storage temperature increased. But the temperature played only a minor role on cell viability when cells were incubated in Hank's balanced salt solution (HBSS), Dubelco's modified Eagle's medium (DMEM), or milk. CONCLUSIONS: Within the parameters of this study, it seems that room temperature is adequate for storing the avulsed teeth in HBSS, DMEM, or milk in the extra-alveolar period.


Assuntos
Fibroblastos/fisiologia , Soluções para Preservação de Órgãos/farmacologia , Ligamento Periodontal/citologia , Preservação de Tecido/métodos , Animais , Sobrevivência Celular , Células Cultivadas , Humanos , Técnicas In Vitro , Soluções Isotônicas/farmacologia , Leite , Saliva , Cloreto de Sódio/farmacologia , Temperatura Ambiente , Água/farmacologia
19.
Biomed Res Int ; 2015: 470676, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26798636

RESUMO

BACKGROUND: This study aimed to evaluate the usability of SWI in assessment of brain iron to detect cognitive dysfunction in patients with chronic mild traumatic brain injury (mTBI). METHODS: 39 patients with mTBI and 37 normal controls were given the Mini-Mental State Examination (MMSE) and underwent SWI scanning at least 6 months after injury. Angle radian values were calculated with phase images. The angle radian values were compared between groups using analysis of covariance, and their association with MMSE scores was analyzed using Spearman correlations. RESULTS: Significantly higher angle radian values (p < 0.05) were found in the head of the caudate nucleus, the lenticular nucleus, the hippocampus, the thalamus, the right substantia nigra, the red nucleus, and the splenium of the corpus callosum (SCC) in the mTBI group, compared to the control group. MMSE scores were negatively correlated with angle radian values in the right substantia nigra (r = -0.685, p < 0.001). CONCLUSIONS: Patients with chronic mTBI might have abnormally high accumulations of iron, and their MMSE scores are negatively associated with angle radian values in the right substantia nigra, suggesting a role of SWI in the assessment of cognitive impairments of these patients.


Assuntos
Lesões Encefálicas , Encéfalo , Transtornos Cognitivos , Ferro/metabolismo , Imagem por Ressonância Magnética , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/metabolismo , Transtornos Cognitivos/diagnóstico por imagem , Transtornos Cognitivos/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Fatores de Tempo
20.
Neurol India ; 62(5): 487-91, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25387616

RESUMO

Traumatic brain injury (TBI) is one of the leading causes of death worldwide, and mild traumatic brain injury (mTBI) is the most common traumatic injury. It is difficult to detect mTBI using a routine neuroimaging. Advanced techniques with greater sensitivity and specificity for the diagnosis and treatment of mTBI are required. The aim of this review is to offer an overview of various emerging neuroimaging methodologies that can solve the clinical health problems associated with mTBI. Important findings and improvements in neuroimaging that hold value for better detection, characterization and monitoring of objective brain injuries in patients with mTBI are presented. Conventional computed tomography (CT) and magnetic resonance imaging (MRI) are not very efficient for visualizing mTBI. Moreover, techniques such as diffusion tensor imaging, magnetization transfer imaging, susceptibility-weighted imaging, functional MRI, single photon emission computed tomography, positron emission tomography and magnetic resonance spectroscopy imaging were found to be useful for mTBI imaging.


Assuntos
Lesões Encefálicas/diagnóstico , Imagem por Ressonância Magnética , Neuroimagem , Lesões Encefálicas/metabolismo , Humanos , Processamento de Imagem Assistida por Computador , Imagem Multimodal , Tomografia por Emissão de Pósitrons
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