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1.
J Stroke Cerebrovasc Dis ; 30(12): 106126, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34592610

RESUMO

BACKGROUND: Cancer-associated hypercoagulation is one of the major pathophysiological mechanisms of stroke in cancer patients. Carcinomatous mucins are considered to play an important role in cancer-associated hypercoagulation. Therefore, carbohydrate antigen-125 (CA125), which is a typical mucin molecule and mucin-producing tumor marker, may be related to stroke due to cancer-associated hypercoagulation. AIMS: We aimed to clarify the association of CA125 with a hypercoagulable state in acute stroke patients with active cancer. METHODS: We studied 77 acute ischemic stroke patients with active cancer who had undergone CA125 measurement. The study patients were categorized into hypercoagulation or non-hypercoagulation groups. The hypercoagulation group was defined as stroke patients with a D-dimer value exceeding 3 µg/mL and multiple vascular territory infarcts. Elevation of tumor markers was defined as values more than twice the upper limit of the normal range. RESULTS: Forty-five (58%) and 32 (42%) patients were classified into hypercoagulation and non-hypercoagulation groups, respectively. The hypercoagulation group showed elevated CA125 and CEA levels, no history of hypertension, and pancreatic cancer more frequently, and higher CRP values, lower hemoglobin values, longer prothrombin time and lower platelet counts than the non-hypercoagulation group. In multivariable analysis, only elevation of CA125 was independently associated with the hypercoagulation group (adjusted odds ratio: 5.59 [95% confidence interval]: 1.33-26.41). CONCLUSIONS: CA125, a tumor marker for mucin-producing tumors, was related to stroke due to cancer- associated hypercoagulation. CA125 may be a potential biomarker for cancer-associated hypercoagulation.

2.
Surg Case Rep ; 7(1): 90, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33847839

RESUMO

BACKGROUND: Pancreatic acinar cell carcinoma (PACC) is a rare exocrine malignant tumor. Its widespread intraductal extension into the main pancreatic duct (MPD) is also rare. CASE PRESENTATION: We report the case of a 71-year-old man with PACC with MPD extension. The patient was assessed with laboratory and radiographic investigations that facilitated a preoperative diagnosis. Endoscopic ultrasonography (EUS) and dynamic thin-slice multi-detector row computed tomography (MDCT) were useful for determining the resection line of the pancreas. EUS-guided fine needle aspiration (EUS-FNA) was also helpful in determining the tumor biology and treatment strategy. Distal pancreatectomy was performed. The MPD was occupied by the tumor 35 mm downstream and 5 mm upstream. Histopathologically, the pancreatic tail tumor extended continuously into the MPD. The tumor was solid with cells showing eosinophilic and granular cytoplasm, indicating the diagnosis of PACC. This is an interesting case of PACC with intraductal extension into the MPD. We discuss the possible mechanisms of tumor extension in this rare case together with a review of the literature. CONCLUSIONS: We describe a rare pancreatic acinar cell carcinoma that could be adequately treated using preoperative precise imaging and histopathological evaluations. When an intraductal tumor extension in the MPD is encountered, the diagnosis of a rare pancreatic tumor should be considered, as in our case.

3.
Ann Bot ; 128(1): 59-71, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-33608716

RESUMO

BACKGROUND AND AIMS: Condensed tannin (CT) is an important compound in plant biological structural defence and for tolerance of herbivory and environmental stress. However, little is known of the role and location of CT within the fine roots of woody plants. To understand the role of CT in fine roots across diverse species of woody dicot, we evaluated the localization of CT that accumulated in root tissue, and examined its relationships with the stele and cortex tissue in cross-sections of roots in 20 tree species forming different microbial symbiotic groups (ectomycorrhiza and arbuscular mycorrhiza). METHODS: In a cool-temperate forest in Japan, cross-sections of sampled roots in different branching order classes, namely, first order, second to third order, fourth order, and higher than fourth order (higher order), were measured in terms of the length-based ratios of stele diameter and cortex thickness to root diameter. All root samples were then stained with ρ-dimethylaminocinnamaldehyde solution and we determined the ratio of localized CT accumulation area to the root cross-section area (CT ratio). KEY RESULTS: Stele ratio tended to increase with increasing root order, whereas cortex ratio either remained unchanged or decreased with increasing order in all species. The CT ratio was significantly positively correlated to the stele ratio and negatively correlated to the cortex ratio in second- to fourth-order roots across species during the shift from primary to secondary root growth. Ectomycorrhiza-associated species mostly had a higher stele ratio and lower cortex ratio than arbuscular mycorrhiza-associated species across root orders. Compared with arbuscular mycorrhiza species, there was greater accumulation of CT in response to changes in the root order of ectomycorrhiza species. CONCLUSIONS: Different development patterns of the stele, cortex and CT accumulation along the transition from root tip to secondary roots could be distinguished between different mycorrhizal associations. The CT in tissues in different mycorrhizal associations could help with root protection in specific branching orders during shifts in stele and cortex development before and during cork layer formation.


Assuntos
Micorrizas , Proantocianidinas , Florestas , Raízes de Plantas , Árvores
4.
Am J Case Rep ; 22: e927562, 2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33424018

RESUMO

BACKGROUND Type 1 neurofibromatosis (NF1) is known to be associated with not only neurogenic tumors but also gastrointestinal (GI) neoplasms. However, there are few reports on vascular lesions and the incidence is unknown. CASE REPORT We report here the case of a 45-year-old woman with a history of NF1 referred to our hospital for the purpose of detailed examination for positive fecal occult blood test. On the basis of the investigation reports, she was diagnosed with a neuroendocrine tumor (NET)-G1. We planned a subtotal stomach-preserving pancreaticoduodenectomy. The abdominal structures, including the vascular system, were abnormally fragile, and it was very difficult to achieve satisfactory hemostasis. The total amount of intraoperative blood loss was 7580 mL. Fulminant intra-abdominal bleeding occurred on postoperative day (POD) 3. Urgent angiography showed a rupture of the gastroduodenal artery. Transarterial embolization was performed, but the patient died of multiorgan failure on POD5. On histological examination, neurofibroma cells proliferating into the surrounding blood vessels were seen; moreover, immunohistochemistry staining with S-100 antibody showed positive neurofibroma cells surrounding the vascular wall. The pathological diagnosis was duodenal NET-G1 with multinodal involvement. CONCLUSIONS This case is a rare presentation of a NET with multiple gastrointestinal stromal tumors associated with NF1, which led to a fatal outcome due to the extreme fragility of the vessel walls. Since patients with NF1 might have vulnerable vessel walls, adequate surgical preparation for major surgical treatment is necessary.


Assuntos
Neoplasias Duodenais , Tumores do Estroma Gastrointestinal , Neoplasias Intestinais , Tumores Neuroendócrinos , Neurofibromatose 1 , Neoplasias Duodenais/complicações , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/cirurgia , Feminino , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/diagnóstico , Humanos , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico , Neurofibromatose 1/complicações , Neurofibromatose 1/diagnóstico
5.
Int J Surg Case Rep ; 79: 302-306, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33493860

RESUMO

INTRODUCTION AND IMPORTANCE: The incidence of intestinal malrotation is 1 in 6000 births, and 90% of cases occur within the first year of life. Adult cases are rare, with a reported incidence of 0.2%-0.5% of all cases. The significance of reporting this case is to recognize that some adult-onset cases require surgery even in the absence of intestinal necrosis. CASE PRESENTATION: A 36-year-old man was infected with streptococcus and treated with antibiotics. He developed appetite loss and his weight decreased 12 kg in 4 months. His abdomen was flat and soft with no tenderness. A computed tomography scan showed that the horizontal duodenal leg was not anchored to the retroperitoneum. Rotation of the mesentery, which was wrapped around the superior mesenteric artery in a clockwise direction, was observed, suggesting midgut volvulus. We performed emergency surgery and Ladd's procedure. CLINICAL DISCUSSION: A previous study reported that the most common symptom in the chronic course of intestinal malrotation was abdominal pain in 41.2% of cases, and weight loss was observed in only 2.6% of patients. The high degree of intestinal adhesion suggests that repeated torsion and release and the development of collateral vessels may have contributed to the asymptomatic course. CONCLUSION: Adult-onset intestinal malrotation should be considered as a differential diagnosis in the presence of weight loss and gastrointestinal symptoms. The timing of surgery is still controversial. In chronic cases, severe adhesion might be expected and laparoscopic surgery should be considered carefully.

6.
Tree Physiol ; 41(7): 1143-1160, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-33440427

RESUMO

Winter precipitation and soil freeze-thaw events have been predicted to increase in boreal regions with climate change. This may expose tree roots to waterlogging (WL) and soil freezing (Fr) more than in the current climate and therefore affect tree growth and survival. Using a whole-tree approach, we studied the responses of silver birch (Betula pendula Roth.) saplings, growing in mineral soil, to 6-week Fr and WL in factorial combinations during dormancy, with accompanying changes in soil gas concentrations. Physiological activation (dark-acclimated chlorophyll fluorescence and chlorophyll content index) and growth of leaves and shoot elongation and stem diameter growth started earlier in Fr than NoFr (soil not frozen). The starch content of leaves was temporarily higher in Fr than NoFr in the latter part of the growing season. Short and long root production and longevity decreased, and mortality increased by soil Fr, while there were no significant effects of WL. Increased fine root damage was followed by increased compensatory root growth. At the beginning of the growing season, stem sap flow increased fastest in Fr + WL, with some delay in both NoWL (without WL) treatments. At the end of the follow-up growing season, the hydraulic conductance and impedance loss factor of roots were higher in Fr than in NoFr, but there were no differences in above- and belowground biomasses. The concentration of soil carbon dioxide increased and methane decreased by soil Fr at the end of dormancy. At the beginning of the growing season, the concentration of nitrous oxide was higher in WL than in NoWL and higher in Fr than in NoFr. In general, soil Fr had more consistent effects on soil greenhouse gas concentrations than WL. To conclude, winter-time WL alone is not as harmful for roots as WL during the growing season.


Assuntos
Betula , Solo , Congelamento , Gases , Árvores
7.
Tree Physiol ; 40(8): 1071-1079, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32333786

RESUMO

Plant roots can exude organic compounds into the soil that are useful for plant survival because they can degrade microorganisms around the roots and enhance allelopathy against other plant invasions. We developed a method to collect carbon (C) exudation on a small scale from tree fine roots by C-free filter traps. We quantified total C through root exudation in four conifers from different microbial symbiotic groups (ectomycorrhiza (ECM) and arbuscular mycorrhiza (AM)) in a cool-temperate forest in Japan. We determined the relationship of mass-based exudation rate from three diameter classes (<0.5, 0.5-1.0, and 1.0-2.5 mm) of the intact root system with root traits such as morphological traits including root diameter, specific root length (SRL), specific root area (SRA), root tissue density (RTD) and chemical traits including root nitrogen (N) content and C/N. Across species, the mass-based root exudation rate was found to correlate with diameter, SRA, RTD, N and C/N. When comparing mycorrhizal types, there were significant relationships between the exudation and diameter, SRL, SRA, root N and C/N in ECM species; however, these were not significant in AM species. Our results show that relationships between in situ root exudation and every measured trait of morphology and chemistry were strongly driven by ECM roots and not by AM roots. These differences might explain the fact that ECM roots in this study potentially covaried by optimizing the exudation and root morphology in forest trees, while exudation in AM roots did not change with changes in root morphology. In addition, the contrasting results may be attributable to the effect of degree and position of ECM and AM colonization in fine root system. Differences in fine root exudation relationships to root morphology for the two types of mycorrhizae will help us better understand the underlying mechanisms of belowground C allocation in forest ecosystems.


Assuntos
Micorrizas , Traqueófitas , Ecossistema , Japão , Nitrogênio , Raízes de Plantas , Solo , Microbiologia do Solo , Árvores
8.
Tree Physiol ; 40(2): 272-283, 2020 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-31860713

RESUMO

Scots pine (Pinus sylvestris L.) is one of the most important conifers in Northern Europe. In boreal forests, over one-third of net primary production is allocated to roots. Pioneer roots expand the horizontal and vertical root systems and transport nutrients and water from belowground to aboveground. Fibrous roots, often colonized by mycorrhiza, emerge from the pioneer roots and absorb water and nutrients from the soil. In this study, we installed three flatbed scanners to detect the daily growth of both pioneer and fibrous roots of Scots pine during the growing season of 2018, a year with an unexpected summer drought in Southern Finland. The growth rate of both types of roots had a positive relationship with temperature. However, the relations between root elongation rate and soil moisture differed significantly between scanners and between root types indicating spatial heterogeneity in soil moisture. The pioneer roots were more tolerant to severe environmental conditions than the fibrous roots. The pioneer roots initiated elongation earlier and ceased it later than the fibrous roots. Elongation ended when the temperature dropped below the threshold temperature of 4 °C for pioneer roots and 6 °C for fibrous roots. During the summer drought, the fibrous roots halted root surface area growth at the beginning of the drought, but there was no drought effect on the pioneer roots over the same period. To compare the timing of root production and the aboveground organs' production, we used the CASSIA model, which estimates the aboveground tree carbon dynamics. In this study, root growth started and ceased later than growth of aboveground organs. Pioneer roots accounted for 87% of total root productivity. We suggest that future carbon allocation models should separate the roots by root types (pioneer and fibrous), as their growth patterns are different and they have different reactions to changes in the soil environment.


Assuntos
Pinus sylvestris , Pinus , Europa (Continente) , Finlândia , Raízes de Plantas , Temperatura , Árvores
9.
Gan To Kagaku Ryoho ; 47(13): 2038-2040, 2020 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-33468793

RESUMO

An 86-year-old woman underwent mastectomy with sentinel lymph node biopsy for cStage ⅡA breast cancer. The subtype of tumor was triple negative breast cancer. Pulmonary metastasis was found 1 month after surgery. Chemotherapy was done because of her good performance status(PS)and her hope. Administration of S-1 produced SD status of tumor for 8 months. However, NCC-ST-439 was increased and tumor size was enlarged. Therefore, the second line of chemotherapy by low-dose- biweekly paclitaxel and bevacizumab was planned because of her high age and good PS. Thereafter, tumor maker levels dramatically decreased and lung metastasis turned to be small. This therapy had been continued without any severe adverse events for 9 months. Unfortunately, this therapy was failed because of proteinuria, but pulmonary metastasis kept favorable efficacy during administration. Biweekly low-dose paclitaxel and bevacizumab therapy can be safe and effective therapy even for elderly patient with recurrent and metastatic breast cancer.


Assuntos
Neoplasias da Mama , Paclitaxel , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Recidiva Local de Neoplasia/tratamento farmacológico , Paclitaxel/uso terapêutico
10.
Oecologia ; 191(4): 983-993, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31679040

RESUMO

Understanding the differences in fine-root traits among different species is essential to gain a detailed understanding of resource conservation and acquisition strategies of plants. We aimed to explore whether certain root traits are consistent among subsets of species and characterize species together into meaningful community groups. We selected 11 woody species from different microbial symbiotic groups (ectomycorrhiza, arbuscular mycorrhiza, and rhizobia) and phylogenetic groups (broad-leaved angiosperms and coniferous gymnosperms) from the cool temperate forests of Nagano, Japan. We measured root architectural (branching intensity), morphological (root tissue density and specific root length), chemical (N and K concentrations), and anatomical (total stele and total cortex) traits. Significant differences were observed in all root traits, although many species did not differ from one another. Branching intensity was found to be the greatest variation in the measured root traits across the 11 woody species. The results of a principal component analysis of root traits showed a distinct separation between angiosperms and gymnosperms. We identified clusters of species based on their multidimensional root traits that were consistent with the different phylogenetic microbial association groups. Gymnosperm roots may be more resource conservative, while angiosperm roots may be more acquisitive for water and nutrients. We consider that the advances in root traits combination will make a breakthrough in our ability to differentiate the community groups rather than individual root trait.


Assuntos
Raízes de Plantas , Simbiose , Florestas , Japão , Filogenia
11.
J Control Release ; 307: 261-271, 2019 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-31260756

RESUMO

Here we report a novel poly(2-oxazoline)-based block copolymer with the aromatic heterocyclic side chains in one block, poly(2-methyl-2-oxazoline)-b-poly(2-N,N-dimethyl-1,3,5-triazine-2,4-diamine-6-ethyl-2-oxazoline) (PMeOx-PcBOx), and demonstrate its potential application as a drug delivery platform. The copolymer was synthesized via the condensation of N,N-dimethylbiguanide with the methyl ester side chain in poly(2-methoxycarboxyethyl-2-oxazoline) block (PMestOx) of the PMeOx-PMestOx diblock copolymer. We confirmed the N,N-dimethylbiguanide condensation with PMestOx and the complete conversion of the side chain to the N,N-dimethyl-1,3,5-triazine-2,4-diamine-6-ethyl moiety by NMR spectroscopy, MALDI-TOF mass spectroscopy, UV-Vis spectroscopy, and titration analysis. The PMeOx-PcBOx copolymer self-assemble into polymeric micelles in aqueous solution. Successful encapsulation into these micelles has been demonstrated for 1) several poorly soluble drugs, such as bruceantin and LY2109761, and 2) dichloro(1,2-diaminocyclohexane)platinum(II) (DachPt). The first class of drugs is incorporated possibly via hydrogen bonding and pi-pi interactions with the PcBOx side groups, while the second one is likely forms coordination bonds with the same side groups. The capability of this new copolymer to solubilize a uniquely diverse set of active pharmaceutical ingredients suggests potential applications in drug delivery.


Assuntos
Sistemas de Liberação de Medicamentos , Oxazóis/administração & dosagem , Polímeros/administração & dosagem , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/química , Linhagem Celular Tumoral , Liberação Controlada de Fármacos , Humanos , Camundongos , Micelas , Oxazóis/química , Polímeros/química
12.
J Stroke Cerebrovasc Dis ; 28(8): 2201-2206, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31122713

RESUMO

BACKGROUND: The purpose of this study was to assess whether carotid ultrasonography indices detect arterial stenosis progression in patients with vertebral artery (VA) dissection. METHODS: This was a retrospective, single-center, observational study that enrolled patients with intracranial VA dissection who were admitted from January 2011 to June 2017. Magnetic resonance angiography (MRA) was done on admission and followed up at a median 20 days after onset (interquartile range [IQR] 9-58 days), and ultrasonography was performed at a median of 22 (interquartile range 7-56) days. Peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), and pulsatility index (PI) were measured by ultrasonography, and the ratio of each follow-up value to the baseline (follow-up/baseline) value was calculated. Two stroke neurologists categorized into 3 groups by morphological changes of the dissected vessel: patients with stenosis progression (progression group: P-group); those with no remarkable change or dilatation improved (stable group: S-group); and those with stenosis regression or dilatation enlargement (enlargement group: E-group). Ultrasonography indices were compared among the groups. RESULTS: Of the 42 patients who were enrolled to this study, 39 patients underwent ultrasonography and MRA on both admission and follow-up. The PI ratio was significantly higher in the P-group than in the S-group (1.96 ± .80 versus .98 ± .44, P = .02) and in the E-group (versus .65 ± .35, P < .01). There were no significant differences in the PSV ratio, EDV ratio, and MV ratio. CONCLUSIONS: In patients with VA dissection, the PI ratio on ultrasonography is a promising index to detect stenosis progression.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Ultrassonografia/métodos , Dissecação da Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Artérias Carótidas/fisiopatologia , Angiografia Cerebral/métodos , Circulação Cerebrovascular , Constrição Patológica , Progressão da Doença , Feminino , Humanos , Japão , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fluxo Pulsátil , Sistema de Registros , Estudos Retrospectivos , Índice de Gravidade de Doença , Artéria Vertebral/fisiopatologia , Dissecação da Artéria Vertebral/fisiopatologia
13.
J Neurol Sci ; 400: 1-6, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30875528

RESUMO

PURPOSE: To study the stroke mechanism of medullary infarction (MI) and their correlation with prognosis. METHODS: We collected 81 consecutive patients with acute isolated MI including 50 patients with lateral MI (LMI), 30 with medial MI (MMI) and one with combined MI. The stroke mechanisms were defined as follows: 1. Large artery atherosclerotic occlusive disease (LAOD): with severe stenosis (>50%) or occlusion on the relevant arteries. 2. Penetrating artery disease (PAD): occlusion of penetrating arteries that arise from vertebral artery or basilar artery with no significant stenosis of the vertebro-basilar artery. 3. Dissection: angiographic findings met the criteria. 4. Cardiogenic embolism: abrupt onset with atrial fibrillation. The poor outcome was defined as a condition that includes the mRS ≥2 and/or dysphagia at one year after onset. RESULTS: There were 20 patients with PAD (40%), 18 with dissection (36.0%) and 11 with LAOD (22.0%) in LMI and 17 with PAD (56.6%), 10 with LAOD (33.3%) in MMI. LAOD and dissection compared with PAD were independently correlated with poor outcome in LMI (OR: 12.8, p = 0.029 and OR: 14.9, p = 0.035). LAOD was significantly correlated with poor outcome in MMI (OR: 13.4, p = 0.014). CONCLUSIONS: PAD was the most predominant stroke mechanism in MI and generally showed favorable outcome. Patients with LAOD and dissection showed worse outcome than those with PAD.


Assuntos
Infartos do Tronco Encefálico/diagnóstico por imagem , Bulbo/diagnóstico por imagem , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Artéria Basilar/diagnóstico por imagem , Artéria Basilar/fisiologia , Infartos do Tronco Encefálico/fisiopatologia , Feminino , Humanos , Masculino , Bulbo/fisiopatologia , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Acidente Vascular Cerebral/fisiopatologia , Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/fisiologia
14.
J Stroke Cerebrovasc Dis ; 28(6): 1691-1702, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30898444

RESUMO

BACKGROUND: Data on the clinical and radiological characteristics of intracranial artery dissection (IAD) have remained limited. Our purpose was to reveal the clinical and radiological characteristics of IAD according to diagnostic criteria for IAD as recently reported by a group of international experts. METHODS: Patients were retrospectively enrolled using a prospective single-center stroke registry between 2011 and 2016. Baseline characteristics and radiological findings including conventional magnetic resonance imaging (MRI) sequences, magnetic resonance angiography (MRA), high-resolution 3-dimensional T1-weighted imaging (HR-3D-T1WI), and digital subtraction angiography were reviewed. We performed statistical comparisons to determine which findings from which modalities are useful. RESULTS: We identified 118 patients with suspected artery dissection, with 64 patients (median age, 51 [interquartile range, 45-56) years; 16 women) finally meeting the criteria for definite (n = 47), probable (n = 15), or possible (n = 2) idiopathic IAD. Ischemic stroke alone was found in 31 patients (48%) on admission. There were 36 patients (56%) suffering from hypertension and 39 (61%) with smoking history. The vertebral artery alone was the most affected in 42 patients (66%). Intramural hematoma (IMH) was more frequently detected on HR-3D-T1WI than on conventional MRI/MRA (odds ratio, 4.72; 95% confidence interval, 1.71-13.00). In 54 patients (84%), the modified Rankin Scale score after 3 months was 0-1. CONCLUSIONS: Male dominance and age at IAD onset were similar to previous studies, and more than half had hypertension and smoking history. We confirmed that HR-3D-T1WI is useful for detecting IMH in the diagnostic criteria.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Angiografia Digital , Angiografia Cerebral/métodos , Imagem de Difusão por Ressonância Magnética , Aneurisma Intracraniano/diagnóstico por imagem , Angiografia por Ressonância Magnética , Idade de Início , Aneurisma Dissecante/etiologia , Avaliação da Deficiência , Feminino , Humanos , Hipertensão/complicações , Aneurisma Intracraniano/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos
15.
Intern Med ; 58(7): 1011-1015, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30449776

RESUMO

Two patients who showed transient lesions in the splenium of the corpus callosum (SCC) secondary to acute ischemic stroke are reported. Both patients had embolic strokes and showed an isolated lesion in the SCC on magnetic resonance imaging (MRI) 1-2 weeks after the onset of stroke, with a hyperintense lesion on diffusion-weighted imaging and decreased apparent diffusion coefficient values, with no symptoms related to the lesion. In both cases, the lesion disappeared on MRI approximately 1 week later. Clinicians should note that transient SCC lesions can occur following acute ischemic stroke and avoid misdiagnosing them and performing unnecessary examinations or treatment.


Assuntos
Isquemia Encefálica/complicações , Corpo Caloso/diagnóstico por imagem , Encefalite/diagnóstico , Doença Aguda , Adulto , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Imagem de Difusão por Ressonância Magnética , Encefalite/etiologia , Feminino , Humanos , Masculino
16.
Biomaterials ; 192: 1-14, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30415101

RESUMO

Concurrent delivery of multiple drugs using nanoformulations can improve outcomes of cancer treatments. Here we demonstrate that this approach can be used to improve the paclitaxel (PTX) and alkylated cisplatin prodrug combination therapy of ovarian and breast cancer. The drugs are co-loaded in the polymeric micelle system based on amphiphilic block copolymer poly(2-methyl-2-oxazoline-block-2-butyl-2-oxazoline-block-2-methyl-2-oxazoline) (P(MeOx-b-BuOx-b-MeOx). A broad range of drug mixing ratios and exceptionally high two-drug loading of over 50 wt.% drug in a stable micellar solution is demonstrated. The drugs co-loading in the micelles result in a slowed-down release to serum, improved pharmacokinetics and increased tumor distribution for both drugs. A superior anti-tumor activity of co-loaded PTX/CP drug micelles compared to single drug micelles or their mixture was demonstrated in cisplatin-resistant human ovarian carcinoma A2780/CisR xenograft tumor and multidrug resistant breast cancer LCC-6-MDR orthotopic tumor models. The improved tumor delivery of co-loaded drugs was related to decreased drug release rates as confirmed by simulation for micelle, serum and tumor compartments in a three-compartmental model. Overall, the results provide support for the use of PTX and cisplatin co-loaded micelles as a strategy for improved chemotherapy of ovarian and breast cancer and potential for the clinical translation.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Cisplatino/administração & dosagem , Neoplasias Ovarianas/tratamento farmacológico , Oxazóis/química , Paclitaxel/administração & dosagem , Animais , Antineoplásicos/farmacocinética , Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Cisplatino/farmacocinética , Cisplatino/uso terapêutico , Portadores de Fármacos/química , Liberação Controlada de Fármacos , Feminino , Humanos , Camundongos Nus , Micelas , Paclitaxel/farmacocinética , Paclitaxel/uso terapêutico
17.
Tree Physiol ; 38(12): 1927-1938, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30452737

RESUMO

Clarifying the dynamics of fine roots is critical to understanding carbon and nutrient cycling in forest ecosystems. An optical scanner can potentially be used in studying fine-root dynamics in forest ecosystems. The present study examined image analysis procedures suitable for an optical scanner having a large (210 mm × 297 mm) root-viewing window. We proposed a protocol for analyzing whole soil images obtained by an optical scanner that cover depths of 0-210 mm. We tested our protocol using six observers with different experience in studying roots. The observers obtained data from the manual digitization of sequential soil images recorded for a Bornean tropical forest according to the protocol. Additionally, the study examined the potential tradeoff between the soil image size and accuracy of estimates of fine-root dynamics in a simple exercise. The six observers learned the protocol and obtained similar temporal patterns of fine-root growth and biomass with error of 10-20% regardless of their experience. However, there were large errors in decomposition owing to the low visibility of decomposed fine roots. The simple exercise revealed that a smaller root-viewing window (smaller than 60% of the original window) produces patterns of fine-root dynamics that are different from those for the original window size. The study showed the high applicability of our image analysis approach for whole soil images taken by optical scanners in estimating the fine-root dynamics of forest ecosystems.


Assuntos
Processamento de Imagem Assistida por Computador , Variações Dependentes do Observador , Raízes de Plantas/crescimento & desenvolvimento , Floresta Úmida , Biomassa , Diagnóstico por Imagem/métodos , Solo
18.
J Med Case Rep ; 12(1): 314, 2018 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-30367665

RESUMO

BACKGROUND: Most colorectal cancer liver metastases form nodules within the hepatic parenchyma, and hepatectomy is the only radical treatment for synchronous metastases. There is concern about intrabiliary tumor growth which may affect the surgical margin, resulting in local recurrence after hepatectomy for colorectal cancer liver metastasis; however, there has been no report of the dissemination in the bile duct after hepatectomy. Here, we report an unusual case of biliary dissemination of colorectal cancer that caused recurrent intrabiliary growth after hepatectomy, and discuss the management of intrabiliary metastasis of colorectal cancer. CASE PRESENTATION: A 69-year-old Japanese man underwent treatment for liver dysfunctions 3 years after aortic valve replacement. Computed tomography revealed an enhanced tumor within the hilar bile duct and dilatation of the left hepatic duct, typical of hilar cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography revealed tumor shadow in his bile duct, and the cytology confirmed malignant cells in the bile. We performed extended left hepatectomy with bile duct resection; his postoperative course remained good without acute complications. After 3 months postoperatively, he was readmitted for subacute cholangitis and obstructive jaundice. Immediately, percutaneous transhepatic cholangiography drainage was performed, followed by cholangiography that exhibited intrabiliary tumor growth in the remnant liver. On immunohistochemical examination, tumor cells were positive for cytokeratin 20 and CDX2 but negative for cytokeratin 7. Then, computed tomography revealed an enhanced tumor-like lesion at the descending colon. After 3 months, left hemicolectomy was performed. Meanwhile, the percutaneous transhepatic cholangiography drainage fluid turned bloody, which was considered to be bleeding from a residual bile duct tumor. Accordingly, radiotherapy was initiated to prevent tumor bleeding around the hilar bile duct, but, unfortunately, the effects were short-lived, and cholangitis rebooted after 1 month leading to our patient's death due to septic liver failure. Autopsy revealed a remnant tumor in the bile duct, but no noticeable nodular metastasis was observed, except for a single small metastasis in the lower lobe of the left lung. CONCLUSIONS: The intrabiliary growth of metastatic colorectal cancer mimics cholangiocarcinoma occasionally. To date, as the effect of chemotherapy or radiotherapy remains uncertain, the complete resection of a bile duct tumor is the only method which could result in a better prognosis.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Ductos Biliares/patologia , Colangiocarcinoma/patologia , Neoplasias do Colo/patologia , Hepatectomia , Neoplasias Hepáticas/secundário , Fígado/patologia , Idoso , Neoplasias dos Ductos Biliares/cirurgia , Neoplasias do Colo/cirurgia , Evolução Fatal , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia , Tomografia Computadorizada por Raios X
19.
Cerebrovasc Dis ; 46(1-2): 46-51, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30064137

RESUMO

BACKGROUND: This study assessed the incidence and predictors of short-term stroke recurrence in ischemic stroke patients with active cancer, and elucidated whether cancer-associated hypercoagulation is related to early recurrent stroke. METHODS: We retrospectively enrolled acute ischemic stroke patients with active cancer admitted to our hospital between 2006 and 2017. Active cancer was defined as diagnosis or treatment for any cancer within 12 months before stroke onset, known recurrent cancer or metastatic disease. The primary clinical outcome was recurrent ischemic stroke within 30 days. RESULTS: One hundred ten acute ischemic stroke patients with active cancer (73 men, age 71.3 ± 10.1 years) were enrolled. Of those, recurrent stroke occurred in 12 patients (11%). When patients with and without recurrent stroke were compared, it was found that those with recurrent stroke had a higher incidence of pancreatic cancer (33 vs. 10%), systemic metastasis (75 vs. 39%), multiple vascular territory infarctions (MVTI; 83 vs. 40%), and higher -D-dimer levels (16.9 vs. 2.9 µg/mL). Multivariable logistic regression analysis showed that each factor mentioned above was not significantly associated with stroke recurrence independently, but high D-dimer (hDD) levels (≥10.4 µg/mL) and MVTI together were significantly associated with stroke recurrence (OR 6.20, 95% CI 1.42-30.7, p = 0.015). CONCLUSIONS: Ischemic stroke patients with active cancer faced a high risk of early recurrent stroke. The concurrence of hDD levels (≥10.4 µg/mL) and MVTI was an independent predictor of early recurrent stroke in active cancer patients. Our findings suggest that cancer-associated hypercoagulation increases the early recurrent stroke risk.


Assuntos
Coagulação Sanguínea , Neoplasias/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Trombofilia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/diagnóstico , Neoplasias/terapia , Prognóstico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/diagnóstico , Trombofilia/sangue , Trombofilia/diagnóstico , Fatores de Tempo
20.
J Neurol Sci ; 388: 23-27, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-29627025

RESUMO

BACKGROUND AND PURPOSE: Stanford type A aortic dissection (AAD) sometimes causes acute ischemic stroke (AIS) or transient ischemic attack (TIA). There is little understanding of cerebrovascular imaging of AIS or TIA in patients with AAD. METHODS: Consecutive AIS/TIA patients with AAD who were admitted within 4.5 h of onset were reviewed. We compared findings of MRI/MRA between these and consecutive AIS/TIA patients without AAD within 4.5 h of onset. RESULTS: Seventeen AAD and 249 non-AAD patients were identified. Compared to non-AAD patients, AAD patients had infarcts more frequently in the right anterior cerebral artery (ACA) territory (18% vs. 2%, P = 0.007) and the right middle cerebral artery (MCA) territory (71% vs. 29%, P < 0.001). There was no difference between the groups regarding whether it was perforator or cortical infarct, single or multiple infarcts, unilateral or bilateral infarcts, or ischemic change extension. On the MRA imaging, the AAD patients more frequently had poor visualization of the right internal carotid artery (ICA) (47% vs. 6%, P < 0.001). After adjustment for sex, age and confounding factors, the right ACA territory infarct [odds ratio (OR), 12.2; 95% confidence interval (CI), 1.4-119.4], the MCA territory infarct (OR, 4.9; 95% CI, 1.0-25.0) and poor visualization of the right ICA (OR, 18.1; 95% CI, 4.0-101.9) were independently associated with AAD. CONCLUSION: In emergency AIS/TIA patients, right anterior circulation infarct and poor visualization of the right ICA on cerebrovascular imaging are potential imaging markers of AAD.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Aórtico/diagnóstico por imagem , Angiografia Cerebral , Artérias Cerebrais/diagnóstico por imagem , Ataque Isquêmico Transitório/diagnóstico por imagem , Angiografia por Ressonância Magnética , Idoso , Aneurisma Dissecante/complicações , Aneurisma Dissecante/terapia , Aneurisma Aórtico/complicações , Aneurisma Aórtico/terapia , Artéria Carótida Interna/diagnóstico por imagem , Ensaios Clínicos como Assunto , Imagem de Difusão por Ressonância Magnética , Serviços Médicos de Emergência , Feminino , Humanos , Imageamento Tridimensional , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/terapia , Ataque Isquêmico Transitório/complicações , Ataque Isquêmico Transitório/terapia , Masculino , Estudos Retrospectivos
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