Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.270
Filtrar
1.
J Surg Res ; 246: 550-559, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31668608

RESUMO

BACKGROUND: Intimal hyperplasia (IH) is the initial lesion of vein graft failure after coronary artery bypass grafting. The weak venous wall is likely one of the primary reasons for IH after exposure to the arterial environment. We investigate whether adventitial collagen cross-link by glutaraldehyde (GA) reinforces the venous wall and then reduces IH. MATERIALS AND METHODS: Adventitial collagen cross-link by 0.3% GA was performed on the rabbit jugular veins. The degree of cross-link was accessed by tensile test. The jugular vein with or without cross-link was implanted into the carotid artery of rabbit. Vein dilatation at the immediate anastomosis and pathological remodeling of vein graft after 4 wk was assessed. RESULTS: Tensile test indicated that the mechanical property of 3-min cross-linked veins more closely resembled that of the carotid artery. In rabbit arteriovenous graft models, 3-min adventitial collagen cross-link limited overdistension (diameter: 3.24 mm versus 4.65 mm, P < 0.01) at the immediate anastomosis and reduced IH (intima thickness: 78.83 µm versus 140.19 µm, P < 0.01) of vein grafts 4 wk after implantation in the cross-link group as compared with the graft group (without cross-link). Compared with the cross-link group, the expression of proliferating cell nuclear antigen and vascular cell adhesion molecule-1 increased significantly at both the mRNA and protein levels within the graft group (P < 0.01), but the expression of smooth muscle-22α decreased significantly (P < 0.01). CONCLUSIONS: Adventitial collagen cross-link by GA increased the vessel stiffness and remarkably reduced IH in a rabbit arteriovenous graft model.


Assuntos
Túnica Adventícia/efeitos dos fármacos , Colágeno/metabolismo , Reagentes para Ligações Cruzadas/administração & dosagem , Glutaral/administração & dosagem , Túnica Íntima/patologia , Túnica Adventícia/metabolismo , Animais , Artérias Carótidas/transplante , Ponte de Artéria Coronária/efeitos adversos , Modelos Animais de Doenças , Humanos , Hiperplasia/etiologia , Hiperplasia/prevenção & controle , Veias Jugulares/efeitos dos fármacos , Veias Jugulares/transplante , Masculino , Coelhos , Túnica Íntima/efeitos dos fármacos , Túnica Íntima/metabolismo , Rigidez Vascular/efeitos dos fármacos
2.
Eur J Vasc Endovasc Surg ; 59(2): 288-294, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31883684

RESUMO

OBJECTIVE: Arteriovenous grafts (AVGs) typically lose patency within two years of creation due to venous neointimal hyperplasia, which is initiated by disturbed haemodynamics after AVG surgery. Haemodialysis needle flow can further disturb haemodynamics and thus impact AVG longevity. In this computational study it was assessed how dialysis flow and venous needle positioning impacts flow at the graft-vein anastomosis. Furthermore, it was studied how negative effects of dialysis needle flow could be mitigated. METHODS: Non-physiological wall shear stress and disturbed blood flow were assessed in an AVG model with and without dialysis needle flow. Needle distance to the venous anastomosis was set to 6.5, 10.0, or 13.5 cm, whereas dialysis needle flow was set to 200, 300 or 400 mL/min. Intraluminal needle tip depth was varied between superficial, central, or deep. The detrimental effects of dialysis needle flow were summarised by a haemodynamic score (HS), ranging from 0 (minimal) to 5 (severe). RESULTS: Dialysis needle flow resulted in increased disturbed flow and/or non-physiological wall shear stress in the venous peri-anastomotic region. Increasing cannulation distance from 6.5 to 13.5 cm reduced the HS by a factor 4.0, whereas a central rather than a deep or superficial needle tip depth reduced the HS by a maximum factor of 1.9. Lowering dialysis flow from 400 to 200 mL/min reduced the HS by a factor 7.4. CONCLUSION: Haemodialysis needle flow, cannulation location, and needle tip depth considerably increase the amount of disturbed flow and non-physiological wall shear stress in the venous anastomotic region of AVGs. Negative effects of haemodialysis needle flow could be minimised by more upstream cannulation, by lower dialysis flow and by ensuring a central needle tip depth. Since disturbed haemodynamics are associated with neointimal hyperplasia development, optimising dialysis flow and needle positioning during haemodialysis could play an important role in maintaining AVG patency.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Oclusão de Enxerto Vascular/prevenção & controle , Modelos Cardiovasculares , Neointima/patologia , Diálise Renal/efeitos adversos , Derivação Arteriovenosa Cirúrgica/métodos , Implante de Prótese Vascular , Cânula/efeitos adversos , Simulação por Computador , Desenho Assistido por Computador , Oclusão de Enxerto Vascular/etiologia , Humanos , Hidrodinâmica , Hiperplasia/etiologia , Agulhas/efeitos adversos , Fluxo Sanguíneo Regional/fisiologia , Diálise Renal/instrumentação , Diálise Renal/métodos , Estresse Mecânico , Grau de Desobstrução Vascular/fisiologia
3.
Khirurgiia (Mosk) ; (10): 75-81, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626243

RESUMO

Postoperative complications in vascular surgery may be partly provoked by suture material. Analysis of the mechanisms of these complications may be useful for their prevention. Mechanisms of suture-induced thrombosis and neointimal hyperplasia, possible strategies for prevention of postoperative complications including those allowing drug deliveries directly to the vascular anastomosis area are discussed in the article. According to the literature data, heparin is the most optimal drug for modifying suture material and prevention of thrombosis and neointimal hyperplasia. Heparin delivery to the vascular anastomosis site will reduce the risk of thrombosis by inhibiting the activity of thrombin. Complex of heparin and antithrombin III increases inhibitory effect of antithrombin against thrombin. In addition, heparin is able to reduce proliferation of vascular smooth muscle cells through inhibition of the synthesis of extracellular matrix proteases involved in migration and proliferation of cells. Thus, heparin delivery to the vascular injury site may be used to prevent thrombosis and myoproliferative response. Moreover, this strategy prevents complications associated with systemic administration of anticoagulants.


Assuntos
Suturas/efeitos adversos , Trombose/prevenção & controle , Doenças Vasculares/prevenção & controle , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Anticoagulantes/administração & dosagem , Heparina/administração & dosagem , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Hiperplasia/prevenção & controle , Neointima/patologia , Trombose/etiologia , Doenças Vasculares/etiologia
4.
Int J Pediatr Otorhinolaryngol ; 125: 107-112, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31280031

RESUMO

OBJECTIVE: To investigate the clinical, imaging and pathological features of congenital infiltrating lipomatosis of the face (CILF) and to discuss whether it is a subtype of hemifacial hyperplasia (HH). METHODS: Sixteen patients diagnosed with CILF were included in this study. All patients had undergone panoramic radiography and spiral CT examinations. Thirteen patients received biopsy, surgery treatment and pathological examination. The clinical documentation and imaging data were retrospectively reviewed. RESULTS: The cheeks (14/16), parotid glands (12/16), tongues (9/16), masticatory muscles (8/16) and the lips (7/16) were the most frequently affected soft tissue organs. The maxilla (14/16), zygoma (13/16), mandible (13/16) were involved among the maxillofacial bones. Dental malformations included macrodontia (8/16), poor formation of the roots (7/16), accelerated tooth germ development or premature eruption of permanent teeth (7/16) and missing of the permanent teeth (4/16). All malformations were restricted to one side of the face and did not trespass the middle line. Pathologically, CILF was featured by the diffuse infiltration of redundant mature adipose tissue into the tissue of the affected organ. CONCLUSION: CILF is a congenital developmental facial malformation characterized by infiltration of nonencapsulated, mature adipose tissue, resulting in facial soft and hard tissue hypertrophy and dental malformations in hemifacial structures. CILF could be considered as a subtype of HH.


Assuntos
Face/anormalidades , Face/cirurgia , Assimetria Facial/congênito , Hiperplasia/etiologia , Lipomatose/congênito , Lipomatose/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Face/diagnóstico por imagem , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Lipomatose/cirurgia , Masculino , Radiografia Panorâmica , Estudos Retrospectivos , Tomografia Computadorizada Espiral , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/etiologia , Adulto Jovem
5.
Mol Med Rep ; 20(2): 1436-1442, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173198

RESUMO

Neointimal hyperplasia could be one of the most important complications after balloon angioplasty. Since calcium signaling has several physiologic effects on the regulation of the proliferation and migration of vascular smooth muscle cells (VSMCs), it was hypothesized that transmembrane protein 66 (TMEM66), a store operated calcium entry (SOCE)­associated regulatory factor, possesses vascular protection against balloon injury. The rat balloon­induced carotid artery injury model was performed. Histological analysis was used to check neointimal hyperplasia. TMEM66 expression was measured by PCR and immunoblotting. The results revealed that TMEM66 was expressed in the medial and neointimal layers of the injured artery, and the expression of TMEM66 was markedly decreased. TMEM66 overexpression attenuated neointimal hyperplasia via VSMC proliferation/migration inhibition, and restored expression of VSMC phenotypic markers. Moreover, TMEM66 overexpression reduced the increased expression of Stim1 and Orai1 and PDGF­BB treatment­enhanced [Ca2+]i. In conclusion, TMEM66 protects against balloon injury­induced neointimal hyperplasia, and may be a pharmacological target for the treatment of restenosis.


Assuntos
Proteínas de Ligação ao Cálcio/metabolismo , Cálcio/metabolismo , Lesões das Artérias Carótidas/genética , Hiperplasia/genética , Proteínas Sensoras de Cálcio Intracelular/genética , Proteínas de Membrana/metabolismo , Neointima/genética , Angioplastia com Balão/efeitos adversos , Animais , Becaplermina/farmacologia , Sinalização do Cálcio , Proteínas de Ligação ao Cálcio/genética , Artérias Carótidas/metabolismo , Artérias Carótidas/patologia , Lesões das Artérias Carótidas/etiologia , Lesões das Artérias Carótidas/metabolismo , Lesões das Artérias Carótidas/patologia , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Regulação da Expressão Gênica , Hiperplasia/etiologia , Hiperplasia/metabolismo , Hiperplasia/patologia , Proteínas Sensoras de Cálcio Intracelular/metabolismo , Transporte de Íons , Masculino , Proteínas de Membrana/genética , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , Neointima/etiologia , Neointima/metabolismo , Neointima/patologia , Proteína ORAI1/genética , Proteína ORAI1/metabolismo , Cultura Primária de Células , Ratos , Ratos Sprague-Dawley , Molécula 1 de Interação Estromal/genética , Molécula 1 de Interação Estromal/metabolismo
6.
World J Gastroenterol ; 25(21): 2623-2635, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31210714

RESUMO

BACKGROUND: Laparoscopic resection of the pancreatic body and tail is the predominant methodology to remove lesions in these locations; its safety and surgical planning are relatively mature, but it remains a complex and high-precision surgical operation, requiring abundant experience and skills in laparoscopic surgery, with a 10% rate of complications. AIM: To verify the feasibility and safety, as well as to examine the complications of endoscopic pancreatectomy and healing mechanisms of pancreatic wounds after endoscopic resection. METHODS: Transgastric endoscopic resections of varying sizes of pancreases were performed in 15 healthy Bama miniature pigs. The technical success rate, the incidence of serious complications, and the survival of the animals were studied. The healing of the wounds was evaluated by sacrificing the animals at various time points. Finally, the expression of transforming growth factor-ß1 and Smad3/Smad7 in the surgical site was examined by immunohistochemistry to explore the role of these factors in wound healing of the pancreas. RESULTS: Partial and total resections were successfully performed in two groups of animals, respectively. The technical success rate and the survival rate of the pigs were both 100%. We obtained 12 pancreatic tissue samples by endoscopic resection. The pancreatic wounds were closed with metal clips in one group and the wounds healed well by forming scars. There was a small amount of pancreatic leakage in the other group, but it can be fully encapsulated. The level of transforming growth factor-ß1 (TGF-ß1) in the wounds increased during the inflammatory and fibrous hyperplasia phases, and decreased in the scar phase. The expression of Smad3 paralleled that of TGF-ß1, while the expression of Smad7 had an inverse relationship with the expression of TGF-ß1. CONCLUSION: Purely transgastric endoscopic resection of the pancreas is a safe, effective, and feasible procedure, but the incidence of pancreatic leakage in total pancreatic tail resection is high. The expression of TGF-ß1 and Smad3/Samd7 is related to the progression of pancreatic wound healing.


Assuntos
Endoscopia/métodos , Pâncreas/patologia , Pancreatectomia/métodos , Complicações Pós-Operatórias/epidemiologia , Cicatrização/fisiologia , Animais , Modelos Animais de Doenças , Endoscopia/efeitos adversos , Estudos de Viabilidade , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Incidência , Pâncreas/cirurgia , Pancreatectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Proteína Smad3/metabolismo , Proteína Smad7/metabolismo , Taxa de Sobrevida , Suínos , Porco Miniatura , Fator de Crescimento Transformador beta/metabolismo
7.
Pathol Int ; 69(5): 249-259, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31219232

RESUMO

CD109 is a glycosylphosphatidylinositol-anchored glycoprotein and a member of the α2 -macroglobulin/C3,C4,C5 family of thioester-containing proteins first identified as being expressed on blood cells, including activated T cells and platelets, and a subset of CD34 + bone marrow cells containing megakaryocyte progenitors. Although CD109 carries the biallelic platelet-specific alloantigen Gov, the physiological functions or roles of CD109 in human disease remain largely unknown. It was recently demonstrated that CD109 is expressed in many malignant tumors, including various squamous cell carcinomas and adenocarcinomas, and plays a role as a multifunctional coreceptor. CD109 reportedly associates with transforming growth factor (TGF)-ß receptors and negatively regulates TGF-ß signaling in keratinocytes. Additionally, CD109 is potentially related to signal transducer and activator of transcription-3 signaling and aberrant cell proliferation. In this review, we describe recent evidence of CD109-specific significance in malignant tumors shown in mouse models and human tissues. Furthermore, we discuss the physiological functions of CD109 in vitro and in vivo, including results of phenotype analyses of CD109-deficient mice exhibiting epidermal hyperplasia and osteopenia.


Assuntos
Antígenos CD/metabolismo , Carcinogênese/metabolismo , Proteínas Ligadas por GPI/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias , Adenocarcinoma/etiologia , Adenocarcinoma/metabolismo , Animais , Antígenos CD/genética , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/metabolismo , Carcinogênese/imunologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular , Proteínas Ligadas por GPI/genética , Homeostase , Humanos , Hiperplasia/etiologia , Hiperplasia/metabolismo , Camundongos , Proteínas de Neoplasias/genética , Neoplasias/etiologia , Neoplasias/imunologia , Neoplasias/metabolismo , Fator de Transcrição STAT3/metabolismo , Fatores de Crescimento Transformadores/metabolismo
8.
Cardiovasc Intervent Radiol ; 42(9): 1343-1351, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31087147

RESUMO

PURPOSE: To compare the degrees of stent-induced tissue hyperplasia of balloon-expandable, biodegradable stents (BEBSs) with those of self-expandable metallic stents (SEMSs) in a rat urethral model. MATERIALS AND METHODS: A total of 20 rats were randomized into two groups. The BEBS group (n = 10) received a poly-l-lactic acid (PLLA) biodegradable stent. The SEMS group (n = 10) received a nitinol bare stent. All rats were killed eight weeks after stent placement. The degree of stent-induced tissue hyperplasia was assessed by comparing the results of retrograde urethrography and histologic examination between the two groups. RESULTS: Stent placement was technically successful in all rats. Two rats in the BEBS group were excluded due to procedure-related death. The mean luminal diameter of stented urethra on urethrograms was not significantly different at 4 and 8 weeks between the two groups. On histologic analysis, the percentage of granulation tissue area (p < 0.001) and the thickness of papillary projection (p < 0.001) were significantly higher in the BEBS group compared with the SEMS group. The inflammatory cell infiltration showed a clear tendency to significance (p = 0.050). There were no statistical differences in the number of epithelial layers and the thickness of submucosal fibrosis between the two groups. CONCLUSION: Formation of stent-induced tissue hyperplasia was significantly evident in the rat urethra with similar degrees between the BEBS and the SEMS. The BEBS was associated with a thicker papillary projection and larger granulation tissue area resulting from higher inflammation compared with the SEMS.


Assuntos
Stents/efeitos adversos , Uretra/patologia , Doenças Uretrais/etiologia , Doenças Uretrais/patologia , Animais , Modelos Animais de Doenças , Hiperplasia/etiologia , Hiperplasia/patologia , Masculino , Radiografia , Ratos , Ratos Sprague-Dawley , Stents Metálicos Autoexpansíveis/efeitos adversos
9.
Life Sci ; 230: 111-120, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31129141

RESUMO

AIMS: In women, uterine alterations have been associated with sex steroid hormones. Sex hormones regulate the expression of thyroid hormone receptors (TRs) in the uterus, but an inverse link is unknown. We analyzed the impact of hypothyroidism on histological characteristics, vascular endothelial growth factor (VEGF-A), progesterone receptors (PR), estrogen receptors (ER), thyroid hormone receptors (TRs), perilipin (PLIN-A), and lipid content in the uterus of virgin rabbits. MAIN METHODS: Twelve Chinchilla-breed adult female rabbits were grouped into control (n = 6) and hypothyroid (n = 6; 0.02% of methimazole for 30 days). The thickness of endometrium and myometrium, number of uterine glands, and infiltration of immune cells were analyzed. The expression of VEGF-A, PR, ERα, and PLIN-A was determined by RT-PCR and western blot. The uterine content of triglycerides (TAG), total cholesterol (TC), and malondialdehyde (MDA) was quantified. KEY FINDINGS: Hypothyroidism promoted uterine hyperplasia and a high infiltration of immune cells into the endometrium, including macrophages CD163+. It also increased the expression of VEGF-A, TRA, and ERα-66 but reduced that of PR and ERα-46. The uterine content of PLIN-A, TAG, and TC was reduced, but that of MDA was augmented in hypothyroid rabbits. SIGNIFICANCE: Our results suggest that uterine hyperplasia and inflammation promoted by hypothyroidism should be related to changes in the VEGF-A, PR, ER, and TRs expression, as well as to modifications in the PLIN-A expression, lipid content, and oxidative status. These results suggest that hypothyroidism should affect the fertility of females.


Assuntos
Hormônios Esteroides Gonadais/metabolismo , Hiperplasia/etiologia , Hiperplasia/fisiopatologia , Hipotireoidismo/complicações , Animais , Endométrio/metabolismo , Feminino , Expressão Gênica/efeitos dos fármacos , Hormônios Esteroides Gonadais/análise , Hipotireoidismo/fisiopatologia , Inflamação , Lipídeos/análise , Miométrio/metabolismo , Perilipina-1/análise , Perilipina-1/metabolismo , Progesterona/farmacologia , Coelhos , Receptores Estrogênicos/análise , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/análise , Receptores de Progesterona/metabolismo , Receptores dos Hormônios Tireóideos/análise , Receptores dos Hormônios Tireóideos/metabolismo , Útero/metabolismo , Útero/fisiologia , Fator A de Crescimento do Endotélio Vascular/análise
10.
Gastroenterol Clin North Am ; 48(2): 199-220, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31046971

RESUMO

This article presents the most common gastrointestinal, hepatic, and pancreatic manifestations of the primary immunodeficiency diseases, including the appropriate laboratory testing, endoscopic evaluation, and recommendations for further management.


Assuntos
Gastroenteropatias/etiologia , /complicações , Doença Celíaca/etiologia , Disenteria/etiologia , Hepatite A/etiologia , Hepatite Autoimune/etiologia , Humanos , Hiperplasia/etiologia , Doenças Inflamatórias Intestinais/etiologia , Linfonodos/patologia , Transtornos Linfoproliferativos/etiologia , Desnutrição/etiologia
11.
Colloids Surf B Biointerfaces ; 180: 168-176, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31048242

RESUMO

Due to their relatively good biocompatibility and inactivity, titanium oxide films (Ti-O) are used in the coating of coronary stents, which reduces metal corrosion, slows metal ion release, and improves endothelial cell (EC) compatibility. Here, we report further functionalizing Ti-O with biological cues for selective endothelialization. Selenocystine with an l- or a d-enantiomer was first immobilized on the Ti-O film via polydopamine to generate nitric oxide (NO) endogenously, which inhibited smooth muscle cell (SMC) proliferation, followed by the grafting of a functional KREDVC peptide to induce EC adhesion. The synergistic effects of the immobilized KREDVC, surface chirality, and NO generation on selective endothelialization were investigated. The results showed that the surface chirality of the l-enantiomer and KREDVC grafting significantly enhanced the attachment and growth of ECs compared to SMCs. An in vivo study showed von Willebrand factor expression was increased and neointimal hyperplasia was significantly decreased in samples with l-selenocystine immobilization and KREDVC grafting. In summary, these findings provide new insights on the surface modification of cardiovascular implants with selective endothelialization.


Assuntos
Cistina/análogos & derivados , Hiperplasia/prevenção & controle , Indóis/química , Neointima/prevenção & controle , Oligopeptídeos/química , Compostos Organosselênicos/química , Polímeros/química , Titânio/química , Animais , Prótese Vascular/efeitos adversos , Implante de Prótese Vascular , Proliferação de Células/efeitos dos fármacos , Técnicas de Cocultura , Cistina/química , Expressão Gênica , Células Endoteliais da Veia Umbilical Humana/citologia , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Hiperplasia/etiologia , Hiperplasia/metabolismo , Hiperplasia/patologia , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Masculino , Miócitos de Músculo Liso/citologia , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Neointima/etiologia , Neointima/metabolismo , Neointima/patologia , Óxido Nítrico/biossíntese , Óxido Nítrico/farmacologia , Cultura Primária de Células , Ratos , Ratos Sprague-Dawley , Estereoisomerismo , Titânio/farmacologia , Fator de von Willebrand/genética , Fator de von Willebrand/metabolismo
12.
Medicine (Baltimore) ; 98(20): e15671, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096500

RESUMO

RATIONALE: Intravesical migrated intrauterine devices (IUDs) have been reported to cause bladder perforation, stone formation, or malignant transition. However, such extensive intravesical benign hyperplasia caused by an extravesical migrated IUD is firstly reported. PATIENT CONCERNS: A 38-year-old woman suffered from recurrent urinary urgency and dysuria and without macroscopic hematuria for about 1 month. DIAGNOSES: Urinary ultrasound and abdominal contrast-enhanced computed tomography (CT) revealed thickening of the bladder walls. Diagnostic transurethral resection and pathology initially misdiagnosed the intravesical lesions as non-invasive urothelial carcinoma. Further diagnostic and therapeutic transurethral resections and pathology confirmed the intravesical lesions to be extensive benign hyperplasia, which was extremely likely caused by the extravesical migrated IUD. INTERVENTIONS: The intravesical lesions received therapeutic transurethral resections. Then the migrated IUD was removed by open surgery. OUTCOMES: After above treatments, the patient's lower urinary tract symptoms gradually disappeared. No recurrent lesion was found in the bladder through CT 3 months later. LESSONS: Even an extravesical migrated IUD could silently cause extensive intravesical lesions. Whether symptomatic or not, any migrated IUD including extravesical and intravesical ones should be treated seriously, if possible, removed as soon as possible.


Assuntos
Hiperplasia/etiologia , Migração de Dispositivo Intrauterino/efeitos adversos , Doenças da Bexiga Urinária/etiologia , Adulto , Feminino , Humanos , Hiperplasia/cirurgia , Doenças da Bexiga Urinária/cirurgia
13.
World Neurosurg ; 122: e577-e583, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-31108073

RESUMO

BACKGROUND: Flow diverter stents have become a useful tool for treatment of complex intracranial aneurysms. A serious complication is incomplete wall apposition after flow diverter placement. The aim of this study was to present a comprehensive investigation of hemodynamic changes induced by incomplete expansion of a flow diverter. METHODS: A case of a patient treated for an internal carotid artery aneurysm by flow diversion with incomplete wall apposition was virtually investigated. The effect of incomplete flow diverter expansion was studied using image-based blood flow simulations under physiologically relevant flow conditions based on patient-specific clinical data. RESULTS: The numerical results revealed that incomplete expansion at the proximal end of the stent had minimal impact on the intra-aneurysmal blood flow alteration. A region of nonphysiologically high wall shear stress was observed near the contact area between the incompletely expanded proximal end of the flow diverter and the parent artery, which caused an intimal hyperplasia in this region. These simulation results were consistent with the real-life clinical course and outcome. CONCLUSIONS: The results of this study can be considered during treatment planning of complex cases where the risk of incomplete flow diverter expansion exists. Further studies are required before results can also be used to support the decision process about antiplatelet therapy and additional interventions to improve wall apposition.


Assuntos
Doenças das Artérias Carótidas/terapia , Embolização Terapêutica/efeitos adversos , Aneurisma Intracraniano/terapia , Túnica Íntima/patologia , Velocidade do Fluxo Sanguíneo/fisiologia , Prótese Vascular/efeitos adversos , Doenças das Artérias Carótidas/fisiopatologia , Artéria Carótida Interna , Embolização Terapêutica/instrumentação , Hemodinâmica/fisiologia , Humanos , Hiperplasia/etiologia , Hiperplasia/fisiopatologia , Aneurisma Intracraniano/fisiopatologia , Pessoa de Meia-Idade , Modelos Biológicos , Stents/efeitos adversos , Telas Cirúrgicas
14.
PLoS One ; 14(4): e0212235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30943188

RESUMO

Neointimal hyperplasia, stimulated by injury and certain vascular diseases, promotes artery obstruction and tissue ischemia. In vascular smooth muscle cell (VSMCs), multiple modulators of protein handling machinery regulate intimal hyperplasia. These include elements of the VSMC unfolded protein response to endoplasmic reticulum stress (UPRER), and transglutaminase 2 (TG2), which catalyzes post-translational protein modification. Previous results for deficiency of UPRER-specific mediator XBP1, and of TG2, have been significant, but in multiple instances contradictory, for effects on cultured VSMC function, and, using multiple models, for neointimal hyperplasia in vivo. Here, we engineered VSMC-specific deficiency of XBP1, and studied cultured VSMCs, and neointimal hyperplasia in response to carotid artery ligation in vivo. Intimal area almost doubled in Xbp1fl/fl SM22α-CRE+ mice 21 days post-ligation. Cultured murine Xbp1 deficient VSMCs migrated more in response to platelet derived growth factor (PDGF) than control VSMCs, and had an increased level of inositol-requiring enzyme 1α (Ire1α), a PDGF receptor-binding UPRER transmembrane endonuclease whose substrates include XBP1. Cultured XBP1-deficient VSMCs demonstrated decreased levels of TG2 protein, in association with increased TG2 polyubiquitination, but with increased TG transamidation catalytic activity. Moreover, IRE1α, and TG2-specific transamidation cross-links were increased in carotid artery neointima in Xbp1fl/fl SM22α-CRE+ mice. Cultured TG2-deficient VSMCs had decreased XBP1 associated with increased IRE1α, and increased migration in response to PDGF. Neointimal hyperplasia also was significantly increased in Tgm2fl/fl SM22α-CRE+ mice at 21 days after carotid ligation. In conclusion, a VSMC regulatory circuit between XBP1 and TG2 limits neointimal hyperplasia in response to carotid ligation.


Assuntos
Proteínas de Ligação ao GTP/metabolismo , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/patologia , Neointima/patologia , Transglutaminases/metabolismo , Proteína 1 de Ligação a X-Box/metabolismo , Animais , Artérias Carótidas/citologia , Artérias Carótidas/patologia , Artérias Carótidas/cirurgia , Movimento Celular , Proliferação de Células , Modelos Animais de Doenças , Endorribonucleases/metabolismo , Proteínas de Ligação ao GTP/genética , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Ligadura/efeitos adversos , Masculino , Camundongos , Camundongos Knockout , Músculo Liso Vascular/citologia , Processamento de Proteína Pós-Traducional , Proteínas Serina-Treonina Quinases/metabolismo , Transdução de Sinais , Transglutaminases/genética , Ubiquitinação , Resposta a Proteínas não Dobradas , Proteína 1 de Ligação a X-Box/genética
15.
J Pediatr Adolesc Gynecol ; 32(4): 446-449, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30981832

RESUMO

BACKGROUND: Beckwith-Wiedemann syndrome (BWS) is the most common pediatric overgrowth syndrome. BWS has a broad phenotypic presentation along with an increased propensity to develop various embryonal tumors. There are very few reported cases of gonadal hyperplasia in BWS patients in the existing literature. CASE: We describe a 13-year-old girl with BWS who presented with an episode of abdominal pain and was found to have torsion and necrosis of a markedly hyperplastic right ovary and fallopian tube. We present a brief literature review on ovarian hyperplasia in BWS patients for which we used an online search of the databases PubMed, Embase, Ovid Medline, and Cochrane. RESULTS AND CONCLUSION: Through an extensive literature search, we only found 3 previous reports of ovarian hyperplasia in BWS patients, all in postmortem specimens. Our case highlights a potentially important aspect of visceral organ hyperplasia in patients with BWS that could remain indolent until adolescence and might present as an abrupt-onset abdominopelvic catastrophe.


Assuntos
Síndrome de Beckwith-Wiedemann/complicações , Hiperplasia/etiologia , Doenças Ovarianas/etiologia , Anormalidade Torcional/etiologia , Adolescente , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Hiperplasia/cirurgia , Doenças Ovarianas/diagnóstico por imagem , Doenças Ovarianas/patologia , Doenças Ovarianas/cirurgia , Anormalidade Torcional/diagnóstico por imagem , Anormalidade Torcional/patologia , Anormalidade Torcional/cirurgia
16.
G Ital Nefrol ; 36(2)2019 Apr.
Artigo em Italiano | MEDLINE | ID: mdl-30983175

RESUMO

Native arteriovenous fistula is the preferred vascular access because of it does not usually cause infections and seems to be closely related with prolonged patient survival, compared to prosthetic grafts and central venous catheters; it also is cost effective. Venous stenosis is one of the main causes of AVF failure. It is caused by a number of upstream and downstream events. The former group comprises hemodynamic and surgical stressors, inflammatory stimuli and uraemia, while downstream events involve the proliferation of smooth muscle cells and myofibroblasts and the development of neo-intimal hyperplasia. Percutaneous transluminal angioplasty is the gold standard for arteriovenous fistula stenosis. It allows the visualization of the whole vascular circuit and the immediate use of the vascular access for the next dialysis session. Ultrasound-guided percutaneous endovascular angioplasty is a feasible and safe alternative to conventional fluoroscopic technique: it is equally effective in treating arteriovenous fistula stenosis, but it presents the advantage of not using contrast media or ionizing radiation. The aim of this review is to report the latest evidence on cellular and molecular mechanisms that contribute to the development of neo-intimal hyperplasia, as well as the current and future therapeutic perspectives, especially concerning the use of anti-proliferative drugs, and the efficacy of the ultrasound-guided angioplasty in restoring and maintaining the vascular access patency over time.


Assuntos
Angioplastia/métodos , Fístula Arteriovenosa/terapia , Ultrassonografia de Intervenção , Angioplastia com Balão/métodos , Constrição Patológica/terapia , Stents Farmacológicos , Humanos , Hiperplasia/etiologia , Miócitos de Músculo Liso/patologia , Complicações Pós-Operatórias/terapia , Diálise Renal/efeitos adversos , Stents , Túnica Íntima/patologia
17.
J Craniofac Surg ; 30(3): e235-e238, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30730516

RESUMO

OBJECTIVES: The aim of this paper is to investigate electronic cigarettes (e-cigarettes) from the otorhinolaryngologic point of view. METHODS: The authors searched Central Database of Kirikkale University Library, Google, PubMed, and Proquest and Google Scholar. RESULTS: An electronic cigarette or e-cigarette is a battery-powered device that vaporizes a liquid, generally including nicotine. Nowadays, e-cigarettes are used for smoking cessation or to reduce the consumption of conventional tobacco cigarettes. First generation e-cigarette devices were similar to conventional tobacco cigarettes in terms of shape and size and expressed as "cigalikes." Differently from traditional cigarettes in which tobacco is burned to generate smoke, electronic cigarettes contain a tank filled with liquid. It was found that e-cigarette liquids contained different types of chemical compounds which were either previously known carcinogens or probably prove to be carcinogenic to humans in the near future. It seems that the use of electronic cigarette does not harm the oral cells. However, the use of e-cigarette for 4 weeks led to metaplasia and hyperplasia of the laryngeal mucosa in rats. Furthermore, e-ciagarettes produce some adverse effects on the nasal mucosa, supressing the immune system. CONCLUSION: It should not be considered that e-cigarettes are safer unless their effects on the mucosa of the ear, nose, and throat are more precisely clarified.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Mucosa Laríngea/patologia , Mucosa Bucal , Mucosa Nasal/imunologia , Animais , Humanos , Hiperplasia/etiologia , Metaplasia/etiologia , Abandono do Hábito de Fumar
20.
Artif Organs ; 43(6): 577-583, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30488514

RESUMO

Although the efficacy of external stents for vein grafts in coronary artery bypass grafting has been recognized, the ideal diameter and material of the stent remain controversial. We created a new external stent made of soft polyester mesh and performed an animal experiment using canines. Bilateral saphenous vein grafts were interposed in the bilateral common carotid artery of 10 beagles. The grafts in the left carotid artery were designated as the control group, and those in the right rolled by a soft polyester mesh external stent were designated as mesh group. Two of the 10 animals were sacrificed due to severe wound infection. The other eight were observed by echography for 6 months, and then grafts were extracted and thickness of the neointima of the grafts was measured. The control group showed 146% ± 26% postoperative enlargement of the internal diameter of the vein grafts after 6 months, whereas the mesh group showed only 115% ± 15% after the same duration (P = 0.0003). The median thickness of the neointima in the mesh group (170 µm [range: 150-190]) was significantly thinner than that in the control group (260 µm [range: 220-310], P < 0.0001). Some degree of correlation between the thickness of neointima and proportion of enlargement was noted (r = 0.518, P = 0.0024). A soft polyester mesh external stent for vein grafts successfully suppressed the enlargement of the vein grafts and thickness of the neointima after 6 months.


Assuntos
Materiais Biocompatíveis/química , Hiperplasia/prevenção & controle , Neointima/prevenção & controle , Poliésteres/química , Veia Safena/patologia , Stents , Animais , Cães , Feminino , Hiperplasia/etiologia , Hiperplasia/patologia , Neointima/etiologia , Neointima/patologia , Stents/efeitos adversos , Túnica Íntima/patologia , Enxerto Vascular/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA