Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33
Filtrar
Filtros adicionais











País/Região como assunto
Intervalo de ano
1.
Int J Mol Med ; 44(3): 797-812, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31257475

RESUMO

The present study investigated the methylation of CpG sites in the cyclooxygenase (COX)­2 promoter via nuclear factor (NF)­κB transcriptional regulation and elucidated its effect on the COX­2 transcriptional expression in a ketamine­induced ulcerative cystitis (KIC) animal model. The results of the present study revealed that ketamine treatment induced NF­κB p65 translocation to nuclei and activated COX­2 expression and prostaglandin (PGE)2 production in bladder tissue, whereas COX­2 inhibitor suppressed the inflammatory effect. Moreover, DNA hypomethylation of the COX­2 promoter region located from ­1,522 to ­829 bp might contribute to transcriptional regulation of COX­2 expression and induce a pro­inflammatory response in KIC. Ketamine treatment increased the binding of NF­κB and permissive histone H3 lysine­4 (H3K4)m3, but caused a decrease in the repressive histone H3K27m3 and H3K36m3 on the COX­2 promoter ranging from ­1,522 to ­1,331 bp as determined by a chromatin immunoprecipitation assay. Moreover, in the ketamine group, the level of Ten­Eleven­Translocation methylcytosine dioxygenase for demethylation as determined by reverse transcription­quantitative PCR assay was increased in comparison with the control group, but that was not the case for the level of DNA methyltransferases for methylation. The present findings revealed that there was a hypomethylation pattern of the COX­2 promoter in association with the level of COX­2 transcription in KIC.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31280617

RESUMO

Introduction: We compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and multiple-incision laparoscopic surgery for totally extraperitoneal (TEP) inguinal hernia repair. Material and methods: This retrospective study included 134 consecutive patients undergoing single-incision or multiple-incision laparoscopic surgery for inguinal hernia between January 2012 and December 2016 at our hospital. Results: In total, 62 patients undergoing SILS-TEP and 72 receiving multiple-incision laparoscopic surgery were included in this study. No significant differences in patients' characteristics between the two groups were noted. No patient required conversion to open surgery in either group. No significant differences were noted between the two groups in operative time, bleeding volume, post-operative hospital stay, and analgesics used. Postoperative complications were observed in 5.7% (4 of 62) of patients in the SILS group and 3.2% (2 of 72) of patients in the control group. Among the few patients who experienced complications, most had hematomas. No major complications or hernia recurrences were observed during the follow-up period in either group. Conclusions: SILS-TEP produced good cosmetic outcomes for patients regardless of previous surgery, and it could be safely performed with acceptable morbidity. It also does not increase the possibility of conversion to open surgery.

3.
Aging Male ; : 1-8, 2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30945953

RESUMO

PURPOSE: Applying low-intensity extracorporeal shockwave therapy (LI-ESWT) has been reported to improve symptoms of refractory chronic pelvic pain syndrome (CPPS) in short-term follow-up. This study aims to demonstrate the effect of LI-ESWT on refractory CPPS over the span of a 12-month follow-up. MATERIALS AND METHODS: This was an open-label, single-arm prospective study. LI-ESWT consisted of 3000 shock waves once weekly for 4 weeks (Duolith SD1 T-Top) were applied. Clinical symptoms were re-assessed at 1, 3, 6, and 12 months using NIH-CPSI score, visual analog scale, 5-item version of the International Index of Erectile Function and International Prostate Symptom Score. RESULTS: Thirty-one of the 43 patients enrolled had a successful response at the 1-month follow up after the treatment. Twenty-six of the 31 patients who responded successfully to LI-ESWT at the 1-month follow-up, maintained their response at the 6- and 12-month follow-up. The existence of psychosocial disorder at the baseline characteristics analysis was the only potential factor that may hinder the effectiveness of LI-ESWT. CONCLUSIONS: LI-ESWT has shown to be a safe and effective therapy for CPPS patients at the long-term follow-up. History of psychological disorders might be a significant predictor of a successful response.

7.
Am J Mens Health ; 12(2): 441-452, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29072124

RESUMO

Managing patients with chronic pelvic pain syndrome (CPPS) refractory to the traditional 3-As therapy (antibiotics, alpha-blockers, and anti-inflammatories) is a challenging task. Low-intensity extracorporeal shock wave therapy (LI-ESWT) was recently reported to be able to improve pain, urinary symptoms, and even sexual function by inducing neovascularization and anti-inflammation, reducing muscle tone, and influencing nerve impulses. This study evaluates whether combined treatment with LI-ESWT can restore clinical ability and quality of life (QoL) in patients refractory to 3-As therapy. This was an open-label, single-arm prospective study. Patients with CPPS without more than a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score under the maximal dosage of 3-As therapy were enrolled. LI-ESWT treatment consisted of 3,000 shock waves administered once weekly for 4 weeks. The NIH-CPSI, visual analog scale (VAS) score, International Prostate Symptom Score (IPSS), and the five-item version of the International Index of Erectile Function (IIEF-5) were used to evaluate efficacy at 1, 4, and 12 weeks after LI-ESWT. Thirty-three patients were enrolled in this study. After LI-ESWT treatment, 27 of the 33 patients (81.82%) had a successful response to LI-ESWT, with a decrease of 3.29 and 5.97 in the VAS score and total IPSS at the 3-month follow-up. Waist circumference was the only significant predictor of a successful response to LI-ESWT. LI-ESWT can serve as a salvage therapy for patients with CPPS refractory to traditional 3-As therapy. Further studies are needed to determine an adequate therapeutic protocol and important predictors in patients with different CPPS etiologies.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Dor Pélvica/tratamento farmacológico , Antagonistas Adrenérgicos alfa/administração & dosagem , Antagonistas Adrenérgicos alfa/farmacologia , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/farmacologia , Dor Crônica , Tratamento por Ondas de Choque Extracorpóreas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taiwan , Falha de Tratamento
8.
Am J Mens Health ; 11(6): 1781-1790, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28884638

RESUMO

Managing patients with erectile dysfunction (ED) who failed to respond to phosphodiesterase type 5 inhibitors (PDE5is) is a challenging task. Recently, low-intensity extracorporeal shockwave therapy (LI-ESWT) was reported to improve ED by enhancing perfusion of the penis. The current study was performed to evaluate whether combined treatment with LI-ESWT and PDE5is can restore erectile function in patients who failed to respond to PDE5is alone. This was an open-label single-arm prospective study. ED patients with an erection hardness score (EHS) ≦2 under a maximal dosage of PDE5is were enrolled. Sociodemographic information and detailed medical history were recorded. LI-ESWT treatment consisted of 3,000 shockwaves once weekly for 12 weeks. All patients continued their regular PDE5is use. The EHS and the 5-item version of the International Index of Erectile Function (IIEF-5) were used to evaluate the change in erectile function 1 and 3 months after LI-ESWT. A total of 52 patients were enrolled. After LI-ESWT treatment, 35 of the 52 patients (67.3%) could achieve an erection hard enough for intercourse (EHS ≧ 3) under PDE5is use at the 1-month follow-up. Initial severity of ED was the only significant predictor of a successful response (EHS1: 35.7% vs. EHS2: 78.9%, p = .005). Thirty-three of the 35 (94.3%) subjects who responded to LI-ESWT could still maintain their erectile function at the 3-month follow-up. LI-ESWT can serve as a salvage therapy for ED patients who failed to respond to PDE5is. Initial severity of ED was an important predictor of a successful response.


Assuntos
Disfunção Erétil/tratamento farmacológico , Tratamento por Ondas de Choque Extracorpóreas , Inibidores da Fosfodiesterase 5/administração & dosagem , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados (Cuidados de Saúde) , Estudos Prospectivos , Falha de Tratamento
9.
Sci Rep ; 7(1): 2727, 2017 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-28577342

RESUMO

In addition to testosterone (T), the emerging role of sex hormone-binding globulin (SHBG) in pathogenesis of metabolic syndrome (MetS) has been noted recently. However, reports of associations with serum adipocytokine levels are still limited. Therefore, we conducted this study to evaluate whether serum T and SHBG levels are independent predictors for the risk of MetS that are associated with adiponectin and leptin levels in 614 Taiwanese men over 40 years old collected from a free health screening. Subjects in the lowest quartile of TT and SHBG levels are exposed to a 1.58 and 3.22 times risk of developing MetS, as compared to those in the highest quartile of TT and SHBG levels. However, SHBG retains its significance independent of TT as a MetS risk predictor, but not vice versa. In addition, SHBG was significantly correlated with both adiponectin and leptin levels even after adjusting for TT levels. In conclusion, SHBG served as a major predictor for the risk of MetS and was correlated with serum adiponectin and leptin levels that are independent of T. Further studies are needed to elucidate the true role of SHBG in the pathogenesis of MetS and possible mechanisms associated with serum adiponectin and leptin levels.

10.
J Sex Med ; 14(4): 510-517, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28364978

RESUMO

BACKGROUND: Repeated evidence from animal models suggests a strong link between vascular endothelial growth factor (VGEF) and penile vasculature and erectile function because VEGF can alter the physiologic pathways involved in the regulation of penile vasomotor tone. AIM: To investigate three VEGF polymorphisms and their link to erectile dysfunction (ED). METHODS: We enrolled 688 Taiwanese men with a mean age of 55.6 years (SD = 4.5) during a free health screening. All participants provided complete medical histories and underwent physical examinations. Fasting blood samples were obtained for biochemical analysis and hormone profiling. The allelic discrimination of three VEGF gene polymorphisms (460T/C [rs833061], 1154G/A [rs1570360], and 2578A/C [rs699947]) was performed using validated TaqMan single-nucleotide polymorphism genotyping assays. OUTCOMES: Subjects underwent assessment using the simplified five-item International Index of Erectile Function to diagnose and assess ED severity. RESULTS: The results showed that diabetes mellitus (odds ratio [OR] = 3.27, P < .01), hypertension (OR = 3.47, P < .01), and having the VEGF 2578A allele (OR = 1.54, P = .01) were the three most independent risk factors for ED. In univariate analysis, all three VEGF polymorphisms (460C, 1154A, and 2578A) were significantly associated with a higher prevalence of coronary artery disease (P < .01) and greater frequencies of hypertension were found in carriers of the 1154A allele and the 2578A allele (P = .01). Multiple logistic regression analysis showed a significant association between VEGF 2578A allele carrier status and ED (OR = 1.54, 95% CI = 1.10∼2.15, P = .01). Furthermore, the prevalence and severity of ED were significantly increased with an increment of the 2578A allele number (P < .05). CLINICAL IMPLICATIONS: VEGF 2578C/A gene polymorphisms could be a genetic susceptibility factor for the development of ED. STRENGTH AND LIMITATION: This is the first study to investigate the genetic susceptibility of VEGF polymorphisms to ED. This study was cross-sectional with a lack of functional and molecular production investigations. Data on the association among conditions might not allow definitive conclusions about causal links. CONCLUSION: This study showed that VEGF 2578A allele carriers in a Taiwanese population are at greater risk for ED. Lee Y-C, Huang S-P, Tsai C-C, et al. Associations of VEGF Gene Polymorphisms With Erectile Dysfunction and Related Risk Factors. J Sex Med 2017;14:510-517.


Assuntos
Disfunção Erétil/genética , Polimorfismo Genético/genética , Polimorfismo de Nucleotídeo Único/genética , Fator A de Crescimento do Endotélio Vascular/genética , Adulto , Estudos Transversais , Predisposição Genética para Doença/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Taiwan
11.
Aging Male ; 20(1): 33-38, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28067607

RESUMO

INTRODUCTION: Androgen-deprivation therapy (ADT) is recognized to be the preferred first-line treatment for advanced prostate cancer. However, the risk-benefit ratio of ADT remains poorly defined and the relationship between androgen depletion and dementia is not clear. AIM: To investigate the risk of developing Alzheimer's disease (AD) in patients undergoing ADT for prostate cancer. METHODS: Data from 24 360 prostate cancer patients were collected from the Longitudinal Health Insurance Database of Taiwan. In total, 15 959 patients who underwent ADT were included in the study cohort, and another 8401 patients who did not receive ADT were included as a non-ADT cohort. RESULTS: During the average 4-year follow-up period, the incidence of AD was 2.78 per 1000 person-years in the non-ADT cohort and 5.66 per 1000 person-years in the ADT cohort. After adjusting for age and all comorbidities, the combined ADT cohort was found to be 1.84 times more likely to develop AD than the non-ADT control group (95%CI 1.33-2.55, p < 0.001). CONCLUSIONS: The present results suggest that ADT use is associated with an increased risk of developing AD.


Assuntos
Doença de Alzheimer/epidemiologia , Antagonistas de Androgênios/efeitos adversos , Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/epidemiologia , Idoso , Doença de Alzheimer/induzido quimicamente , Humanos , Incidência , Estudos Longitudinais , Masculino , Risco , Medição de Risco , Fatores de Tempo
12.
Am J Alzheimers Dis Other Demen ; 32(1): 51-55, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28100075

RESUMO

OBJECTIVES: Urinary incontinence (UI) is more prevalent in the elderly populations with dementia than without dementia, and Alzheimer's disease (AD) is the most common cause of dementia. Urinary incontinence may complicate AD morbidity and mortality. Therefore, this study aimed to evaluate the prevalence and annual incidence and determine the risk possibility of UI, which is the main type of incontinence in patients with AD in Taiwan. METHODS: A total of 933 patients with AD were included in the study cohort, and a total of 2799 patients without AD by 1:3 proportion compared to the study cohort were used as a matched cohort. All participants were selected from the National Health Insurance Research Database in 2000 sample population. We utilize Cox proportional hazard regression to evaluate the risk of UI and cumulative incidence ratio curve to analyze the cumulative incidence function. Prevalence and annual incidence rate are calculated in individual medication including rivastigmine, donepezil, galantamine, and memantine only being initiated in patients with AD. RESULTS: The risk of UI is higher in AD cohort (hazard ratio: 1.54, 95% confidence interval: 1.13-2.09). The cumulative incidence ratio of UI event between AD cohort and matched cohort presents statistical significance ( P < .001). Annual incidence and prevalence of UI in patients with AD are 6.2% and 4.2%, respectively. CONCLUSION: The present results suggest that the risk of UI is higher in patients with AD than in the general population.


Assuntos
Doença de Alzheimer/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricos , Incontinência Urinária/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Incidência , Masculino , Prevalência , Risco , Taiwan/epidemiologia
13.
J Oral Sci ; 58(4): 515-521, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28025435

RESUMO

The orthodontic mini-implant (MI) is a widely used anchorage device in orthodontic treatment. This prospective study analyzed MI survival and factors associated with MI survival in 139 patients (114 females and 25 males; average age, 25.7 years; age range, 12-56 years) who had received orthodontic treatment with MIs. Survival analysis and Kaplan-Meier curves were used to identify clinical variables associated with MI survival. For the 254 MIs investigated, the overall success rate was 85.8%, and the 1-year cumulative survival rate was 81.6%. MI survival was significantly associated with patient age and MI size. Notably, MI survival was significantly longer in patients aged 20-30 years than in older patients. The Cox proportional-hazards model revealed a 5% increase in failure risk for every 1-year increase in age among participants older than 30 years. Additionally, MI failure risk was inversely associated with MI length. MIs are generally reliable anchorage devices for orthodontic treatment but should be used with caution in older patients, due to the higher rate of failure in that population. Another important factor in MI survival is implant size. Future studies should attempt to clarify associations between MI survival and clinical variables.(J Oral Sci 58, 515-521, 2016).


Assuntos
Implantes Dentários , Desenho de Aparelho Ortodôntico , Falha de Prótese , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
14.
Molecules ; 21(9)2016 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-27626400

RESUMO

Polysaccharopeptides (PSPs) are among the main bioactive constituents of Trametes versicolor (T. versicolor). The purpose of this research was to investigate the antioxidant activities of enzymatic hydrolysates obtained from T. versicolor polysaccharopeptides by 80 U/mL ß-1,3-glucanase (PSPs-EH80). The half-inhibitory concentration (IC50) of PSPs-EH80 in metal chelating assay, ABTS and DPPH radical scavenging test results were 0.83 mg/mL, 0.14 mg/mL and 0.52 mg/mL, respectively, which were lower than that of PSPs-EH 20 U/mL. The molecular weights of the PSPs-EH80 hydrolysates were 300, 190, 140 and 50 kDa, respectively, and the hydrolysis of polysaccharides by ß-1,3-glucanase did not change the original functional group. PSPs-EH80 reduced the reactive oxygen species (ROS) content at least twice that of treatment without PSPs-EH80. In addition, an oxidative damage test showed that PSPs-EH80 can improve HaCaT cell survival. According to our results, PSP demonstrates the potential of anti-oxidative damage; besides, enzyme hydrolysis can improve the ability of the PSP.


Assuntos
Antioxidantes , Glucana 1,3-beta-Glucosidase/química , Proteoglicanas , Espécies Reativas de Oxigênio/metabolismo , Trametes/química , Antioxidantes/química , Antioxidantes/farmacologia , Linhagem Celular , Humanos , Hidrólise , Proteoglicanas/química , Proteoglicanas/farmacologia
15.
Surg Endosc ; 30(4): 1585-91, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26162423

RESUMO

BACKGROUND: Partial nephrectomy has gained wider acceptance as a surgical technique in treating small renal tumors. Laparoscopic partial nephrectomy (LPN) still remains a technically demanding surgery to this day. We present our technique of laparoscopic partial nephrectomy, one that is performed without intracorporeal suturing. METHODS: We performed LPN on 31 patients with localized renal parenchymal tumor (stage T1). The procedures were done from September 2009 to March 2015 at the Kaohsiung Medical University Hospital and the Kaohsiung Municipal Ta-Tung Hospital. Our technique involves the covering of renal defect layer by layer with FloSeal, Tisseel and a fat pad after monopolar coagulation. RESULTS: Thirty-one patients were included in this study. Mean patient age was 53 years old (range 39-70). Mean tumor size was 2.9 cm (range 1.8-6.3). Mean RENAL nephrometry score was 5.3 (range 4-7). The average operation time was 188 min (range 120-290), and the average warm ischemic time was 19.0 min (range 9-26). Mean estimated blood loss was 171 ml (range 10-650), with no postoperative bleeding among the total 31 patients. No recurrent tumors were identified at a mean follow-up of 29 months postoperatively. The mean change in eGFR was 6.5 (ml/min/m2). CONCLUSION: Laparoscopic partial nephrectomy is a feasible surgical method for most patients with stage 1 tumor. Our technique has shown to reduce warm ischemic time significantly and provide patients with excellent functional outcomes without affecting oncological results. With this technique, surgeons can perform LPN with more efficiency and with fewer complications.


Assuntos
Neoplasias Renais/cirurgia , Laparoscopia/métodos , Nefrectomia/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica , Feminino , Esponja de Gelatina Absorvível/uso terapêutico , Hemostáticos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Quente
16.
Int J Med Mushrooms ; 17(2): 141-50, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25746619

RESUMO

Xylaria nigripes, a local rare medicinal fungus, has multi-antioxidant activities owing to its water extraction as shown by previous research. However, the main indicator causing the antioxidant effect was not clear, so this research focused on the antioxidant activities from different sources of X. nigripes such as fruiting body polysaccharides, mycelium intracellular polysaccharides, mycelium extracellular polysaccharides, and their deproteinization products. The mycelium intracellular polysaccharide (XnIPS-1) from X. nigripes showed the highest reducing power of antioxidant activity, since it revealed the lowest IC50 values in all the assayed methodologies. The IC50 values of chelating ferrous ion ability, ABTS radical scavenging activity, and DPPH free radical scavenging were 1412, 174.25, and 351.56 µg/mL, respectively. In addition to these results, this research also explored the mechanism between polysaccharides and antioxidants compared by FT-IR analysis. The spectrum shows that the X. nigripes polysaccharide structure changed after the proteins were removed.


Assuntos
Antioxidantes/farmacologia , Produtos Biológicos/farmacologia , Polissacarídeos Fúngicos/farmacologia , Micélio/química , Xylariales/química , Benzotiazóis/metabolismo , Compostos de Bifenilo/metabolismo , Medicamentos de Ervas Chinesas/farmacologia , Estruturas Fúngicas/química , Concentração Inibidora 50 , Estrutura Molecular , Picratos/metabolismo , Ácidos Sulfônicos/metabolismo
17.
Plast Reconstr Surg ; 134(6): 1213-23, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25255111

RESUMO

BACKGROUND: Adipose-derived stem cells combined with transient immunosuppression prolonged vascularized composite tissue allotransplant survival and induced immune tolerance in a rodent hind-limb model. The authors investigated serum proteins in the adipose-derived stem cell tolerance group and control group using proteomic study. METHODS: An orthotopic hind-limb model from Brown-Norway to Lewis rats was used. The control group received no treatment. Rats in the tolerance group received combined treatments of short-term cyclosporine A, antilymphocyte serum, and multiple rounds of adipose-derived stem cells. Serum samples were analyzed. Spots of interest were subjected to in-gel trypsin digestion and matrix-assisted laser desorption ionization time-of-flight mass spectrometry to elucidate the peptide mass fingerprints. The mass spectrometric characteristics of the identified proteins were analyzed. Immunohistochemical analysis of transplanted tissue and enzyme-linked immunosorbent assay of serum were validated. RESULTS: Rats in the tolerance group had significantly higher amounts of ß2-glycoprotein, α1-macroglobulin, rat-albumin, and vitamin D-binding protein, and significantly lower levels of haptoglobin compared with controls. Immunohistochemical staining of the alloskin indicated similar effects, such as up-regulated vitamin D-binding protein and down-regulated haptoglobin in the tolerance group compared with rejection controls (p < 0.05). Enzyme-linked immunosorbent assay revealed that vitamin D-binding protein was statistically increased (p < 0.05) and haptoglobin expression was significantly decreased (p < 0.01) in the tolerance group compared with the controls. CONCLUSIONS: There were significant differences in the serum proteomics between the tolerance and control groups. Down-regulated haptoglobin and up-regulated vitamin D-binding protein are involved in adipose-derived stem cell-induced immune tolerance and allotransplant survival.


Assuntos
Rejeição de Enxerto/prevenção & controle , Membro Posterior/transplante , Imunossupressores/uso terapêutico , Transplante de Células-Tronco Mesenquimais , Proteoma/metabolismo , Tolerância ao Transplante , Alotransplante de Tecidos Compostos Vascularizados , Tecido Adiposo/citologia , Animais , Soro Antilinfocitário/farmacologia , Soro Antilinfocitário/uso terapêutico , Terapia Combinada , Ciclosporina/farmacologia , Ciclosporina/uso terapêutico , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Rejeição de Enxerto/sangue , Rejeição de Enxerto/imunologia , Imuno-Histoquímica , Imunossupressores/farmacologia , Masculino , Espectrometria de Massas , Proteômica/métodos , Ratos , Ratos Endogâmicos BN , Ratos Endogâmicos Lew , Tolerância ao Transplante/efeitos dos fármacos , Tolerância ao Transplante/fisiologia , Resultado do Tratamento
18.
Urolithiasis ; 42(2): 121-6, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24190698

RESUMO

The aim of this study was to compare the effects of one-step percutaneous nephrolithotomy (PCNL) by the urologist alone and two-step PCNL by cooperating with the radiologist. We included 168 patients who underwent surgery by the same surgeon, 83 who underwent two-step PCNL, in which percutaneous nephrostomy insertion was performed by the radiologists on the day before endo-surgery, and 85 who underwent one-step PCNL, which involved the creation of a nephrostomy tract and performing the PCNL at the same time in the operating room, by a urologist. We compared the perioperative and postoperative parameters between these two groups. The result revealed that there were no significant differences between one-step and two-step PCNL in the decreases in haemoglobin level and blood transfusion volume, and the hospital stay was shorter in the one-step PCNL group. In addition, the one-step PCNL group was associated with significantly lower visual analogue score (VAS), which were 2.3, 1.1, and 0.4 on the post-operative days 1, 2, and 3, respectively, compared with 3.2, 1.7, and 1.0 in the two-step PCNL group. The number of parenteral analgesic prescriptions was fewer in the one-step PCNL group (0.8 ± 1.1 amps/vials) than in the two-step PCNL group (4.1 ± 2.4 amps/vials). Furthermore, different stone locations barely affected VAS and analgesic administrations. The results indicate that the one-step PCNL by the urologist alone, compared to two-step PCNL with the radiologist, has better wound pain outcome and shorter hospital stay with comparable successful rate and complication grade.


Assuntos
Cálculos Renais/cirurgia , Nefrostomia Percutânea/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escala Visual Analógica
19.
Kaohsiung J Med Sci ; 29(4): 200-5, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23541265

RESUMO

Radical surgery (RS) with adjuvant chemotherapy (AC) or radiotherapy has been conventionally used for patients with advanced urothelial carcinoma (AUC). Recent research has indicated that systemic neoadjuvant chemotherapy (NC) with RS yields better outcomes than RS alone for patients with locally advanced bladder cancer. However, there are no reports indicating whether NC or AC would be beneficial for patients with AUC. The present study compared the survival rate for AUC patients receiving NC or AC. A retrospective analysis was conducted using data for 64 patients with AUC who underwent RS and systemic chemotherapy at our institution between March 2002 and March 2011. Of the 64 patients, 30 received NC before RS and 34 received RS followed by systemic AC. Pathologic stages (p=0.002), grades (p=0.018) and lymphovascular invasion (p=0.047) were significantly lower in the patients who received NC first than in those who received RC first. Furthermore, analysis of the surgical specimens revealed that 26.7% of patients who received NC before RS had complete remission. There were no significant differences in demographic data, surgical complications, and chemotoxicity between the two patient groups. The progression-free survival (PFS) and overall survival (OS) of patients who received initial NC were significantly better than those of patients who received initial RC (p=0.002 and 0.018, respectively). Our results indicate that NC administration before RS significantly improved the PFS and OS of AUC patients, without increasing surgical complications and chemotoxicity. Further prospectively controlled trials need to be conducted to confirm the effectiveness of NC for AUC patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células de Transição/tratamento farmacológico , Neoplasias da Bexiga Urinária/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/mortalidade , Carcinoma de Células de Transição/patologia , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia , Urotélio/patologia
20.
J Gen Virol ; 94(Pt 5): 1019-27, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23288420

RESUMO

Enterovirus 71 (EV71) infection has induced fatal encephalitis in thousands of young children in the Asia-Pacific region over the last decade. EV71 infection continues to cause serious problems in areas with outbreaks, because vaccines and antiviral therapies are not available. Lymphocytes are present in the brains of infected patients and mice, and they protect mice from infection by decreasing the viral burden. The chemokines responsible for recruiting lymphocytes to infected organs are yet to be identified. Among the lymphocyte chemokines detected, high levels of interferon-gamma-inducible protein-10 (IP-10) are found in the plasma and cerebral spinal fluid of patients with brainstem encephalitis as compared with the levels of a monokine induced by gamma interferon (Mig). Using a murine model to investigate the induction of IP-10 by EV71 infection, we observed that EV71 infection significantly enhanced IP-10 protein expression in the serum and brain, with kinetics similar to viral titres in the blood and brain. Brain neurons of infected mice expressed IP-10. Using wild-type mice and IP-10 gene knockout mice to investigate the role of IP-10 in EV71 infection, we found that IP-10 deficiency significantly reduced levels of Mig in serum, and levels of gamma interferon and the number of CD8 T cells in the mouse brain. Absence of IP-10 significantly increased the mortality of infected mice by 45%, with slow virus clearance in several vital tissues. Our observations are consistent with a model where EV71 infection boosts IP-10 expression to increase gamma interferon and Mig levels, infiltration of CD8 T cells, virus clearance in tissues and the survival of mice.


Assuntos
Quimiocina CXCL10/metabolismo , Encefalite Viral/virologia , Infecções por Enterovirus/virologia , Enterovirus/fisiologia , Interferon gama/metabolismo , Animais , Encéfalo/metabolismo , Encéfalo/virologia , Linfócitos T CD8-Positivos/imunologia , Linhagem Celular , Quimiocina CXCL10/sangue , Quimiocina CXCL10/imunologia , Modelos Animais de Doenças , Enterovirus/imunologia , Infecções por Enterovirus/imunologia , Feminino , Humanos , Interferon gama/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Baço/imunologia , Baço/patologia , Baço/virologia , Linfócitos T/imunologia , Carga Viral
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA