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2.
Presse Med ; 48(7-8 Pt 2): e219-e231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31447333

RESUMO

Image-guided ablation is performed by percutaneously introducing ablation probes to deliver energy into a tumor to destroy it in a controlled and localized fashion. Ablation modalities can be broadly classified as thermal or non-thermal based on the mechanism of tumor destruction and are performed using different types of image guidance for planning, delivering and follow-up of the treatment. Ablation is performed in a minimally invasive fashion, providing greater residual organ preservation with minimal morbidity to the patient. Image-guided ablation is being used in the clinic for the treatment of primary and metastatic tumors, and this article reviews state of the art for the treatment of malignancies in the liver, lung, kidney and musculoskeletal tissue.


Assuntos
Ablação por Cateter/métodos , Neoplasias/cirurgia , Cirurgia Assistida por Computador/métodos , Ablação por Cateter/efeitos adversos , Tecido Conjuntivo/patologia , Tecido Conjuntivo/cirurgia , Humanos , Rim/patologia , Rim/cirurgia , Fígado/patologia , Fígado/cirurgia , Pulmão/patologia , Pulmão/cirurgia , Sistema Musculoesquelético/patologia , Sistema Musculoesquelético/cirurgia , Neoplasias/diagnóstico , Neoplasias/patologia , Especificidade de Órgãos , Complicações Pós-Operatórias/etiologia , Cirurgia Assistida por Computador/efeitos adversos , Resultado do Tratamento
3.
Cell Prolif ; 52(5): e12667, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31373101

RESUMO

OBJECTIVE: Interstitial fluid in extracellular matrices may not be totally fixed but partially flow through long-distance oriented fibrous connective tissues via physical mechanisms. We hypothesized there is a long-distance interstitial fluid transport network beyond vascular circulations. MATERIALS AND METHODS: We first used 20 volunteers to determine hypodermic entrant points to visualize long-distance extravascular pathway by MRI. We then investigated the extravascular pathways initiating from the point of thumb in cadavers by chest compressor. The distributions and structures of long-distance pathways from extremity ending to associated visceral structures were identified. RESULTS: Using fluorescent tracer, the pathways from right thumb to right atrium wall near chest were visualized in seven of 10 subjects. The cutaneous pathways were found in dermic, hypodermic and fascial tissues of hand and forearm. The perivascular pathways were along the veins of arm, axillary sheath, superior vena cava and into the superficial tissues on right atrium. Histological and micro-CT data showed these pathways were neither blood nor lymphatic vessels but long-distance oriented fibrous matrices, which contained the longitudinally assembled micro-scale fibres consistently from thumb to superficial tissues on right atrium. CONCLUSIONS: These data revealed the structural framework of the fibrous extracellular matrices in oriented fibrous connective tissues was of the long-distance assembled fibres throughout human body. Along fibres, interstitial fluid can systemically transport by certain driving-transfer mechanisms beyond vascular circulations.


Assuntos
Tecido Conjuntivo/metabolismo , Matriz Extracelular/metabolismo , Pontos de Acupuntura , Adulto , Cadáver , Tecido Conjuntivo/química , Tecido Conjuntivo/patologia , Meios de Contraste/química , Meios de Contraste/metabolismo , Feminino , Fluoresceína/química , Fluoresceína/metabolismo , Pé/diagnóstico por imagem , Mãos/diagnóstico por imagem , Humanos , Vasos Linfáticos/anatomia & histologia , Vasos Linfáticos/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Microscopia Confocal , Pontos Quânticos/química , Pontos Quânticos/metabolismo , Adulto Jovem
4.
Khirurgiia (Mosk) ; (8): 12-16, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31464268

RESUMO

OBJECTIVE: To define the indication for preventive mesh implantation in patients scheduled for laparotomy. MATERIAL AND METHODS: There were 108 patients divided into the control (52 patients without anterior abdominal wall hernia) and the main (56 patients with ventral hernia) groups. RESULTS: Predominance of collagen type III over type I was observed in patients older 60 years in the main group. The maximum ratio of collagen types I and III was 1.4 in the main group. The minimum number of inter-fiber spaces (n=5) was noted in patients aged 30-40 years. The maximum density of connective tissue was 250 pixels per inch. CONCLUSION: Analysis of connective tissue structures revealed some important age-related features and markers of connective tissue dysplasia in the main group. An indication for preventive mesh implantation in patients scheduled for laparotomy was determined.


Assuntos
Colágeno/análise , Doenças do Tecido Conjuntivo/complicações , Hérnia Ventral/prevenção & controle , Hérnia Incisional/prevenção & controle , Laparotomia/efeitos adversos , Telas Cirúrgicas , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Adulto , Tecido Conjuntivo/química , Tecido Conjuntivo/patologia , Doenças do Tecido Conjuntivo/patologia , Hérnia Ventral/etiologia , Hérnia Ventral/patologia , Herniorrafia/métodos , Humanos , Hérnia Incisional/etiologia , Hérnia Incisional/patologia , Pessoa de Meia-Idade
5.
Sud Med Ekspert ; 62(3): 9-11, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31198197

RESUMO

Diagnosis of sudden death in the young is based on the results of a set of research methods. Immunohistochemical, histochemical and histochemical methods are fundamental to the diagnosis of hidden forms of connective tissue pathology. These methods allow the sequence of initial and irreversible changes in connective tissue structures to be determined. The aim of this study was to determine the abnormalities of the vascular wall structure when using immunohistochemical and histological methods for the verification of congenital anomalies of various types of vessels, which expand the criteria for the diagnostic detection of individuals with connective tissue dysplasia. These investigation methods allow the diagnosis of hidden forms of congenital connective tissue pathology in the young. The main morphological signs of pathology of the aorta, carotid arteries, coronary and cerebral arteries are the disturbance of structural elements of the connective tissue.


Assuntos
Vasos Sanguíneos/patologia , Tecido Conjuntivo/patologia , Morte Súbita , Humanos
6.
Genes (Basel) ; 10(6)2019 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-31185693

RESUMO

FBN1 encodes fibrillin 1, a key structural component of the extracellular matrix, and its variants are associated with a wide range of hereditary connective tissues disorders, such as Marfan syndrome (MFS) and mitral valve-aorta-skeleton-skin (MASS) syndrome. Interpretations of the genomic data and possible genotype-phenotype correlations in FBN1 are complicated by the high rate of intronic variants of unknown significance. Here, we report two unrelated individuals with the FBN1 deep intronic variants c.6872-24T>A and c.7571-12T>A, clinically associated with MFS and MASS syndrome, respectively. The individual carrying the c.6872-24T>A variant is positive for aortic disease. Both individuals lacked ectopia lentis. In silico analysis and subsequent mRNA study by RT-PCR demonstrated the effect of the identified variant on the splicing process in both cases. The c.6872-24T>A and c.7571-12T>A variants generate the retention of intronic nucleotides and lead to the introduction of a premature stop codon. This study enlarges the mutation spectrum of FBN1 and points out the importance of intronic sequence analysis and the need for integrative functional studies in FBN1 diagnostics.


Assuntos
Fibrilina-1/genética , Predisposição Genética para Doença , Síndrome de Marfan/genética , Prolapso da Valva Mitral/genética , Miopia/genética , Dermatopatias/genética , Adulto , Processamento Alternativo/genética , Tecido Conjuntivo/metabolismo , Tecido Conjuntivo/patologia , Matriz Extracelular/genética , Feminino , Genótipo , Humanos , Íntrons/genética , Masculino , Síndrome de Marfan/fisiopatologia , Pessoa de Meia-Idade , Prolapso da Valva Mitral/fisiopatologia , Mutação/genética , Miopia/fisiopatologia , Dermatopatias/fisiopatologia
7.
Eur J Radiol ; 113: 24-31, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30927954

RESUMO

AIM: Radiographs (X-rays) are used for the preoperative assessment of hallux valgus (HV). Our purpose was to determine how well quantitative measurements of HV on radiographs and MRI correlate with the qualitative soft tissue and internal derangement findings on MRI. MATERIALS AND METHODS: After IRB approval, 56 consecutive patients with MRI and radiographs of the foot were retrospectively reviewed. Two trained readers independently evaluated radiographs, measuring hallux valgus angle (HVA) and intermetatarsal angle (IMA). Two separate readers assessed qualitative MRI data by evaluating 21 different soft tissue and bony features. Statistical analysis included inter-reader reliability (IRR) and correlation of quantitative and qualitative findings. RESULTS: Excellent IRR (ICC = 0.89-0.96) was observed for radiograph and MRI measurements of the hallux valgus severity. For qualitative assessments on MRI, IRR was good to excellent for all features (ICC = 0.63-0.9). No significant difference was found for HVA or IMA between normal and abnormal qualitative MRI features. No statistically significant correlation between the severity of hallux valgus and injury to hallux joints and supporting structures was found. CONCLUSION: Hallux valgus measurements are reliable on x-rays and MRI and qualitative findings of 1st MTP joint show good to excellent inter-reader agreement on MRI. No statistically significant correlations exist between the severity of hallux valgus and qualitative MRI findings.


Assuntos
Hallux Valgus/patologia , Adulto , Idoso , Tecido Conjuntivo/diagnóstico por imagem , Tecido Conjuntivo/patologia , Feminino , , Hallux Valgus/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Radiografia/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Raios X
8.
Chin J Traumatol ; 22(2): 93-98, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30928194

RESUMO

The clinical treatment of joint contracture due to immobilization remains difficult. The pathological changes of muscle tissue caused by immobilization-induced joint contracture include disuse skeletal muscle atrophy and skeletal muscle tissue fibrosis. The proteolytic pathways involved in disuse muscle atrophy include the ubiquitin-proteasome-dependent pathway, caspase system pathway, matrix metalloproteinase pathway, Ca2+-dependent pathway and autophagy-lysosomal pathway. The important biological processes involved in skeletal muscle fibrosis include intermuscular connective tissue thickening caused by transforming growth factor-ß1 and an anaerobic environment within the skeletal muscle leading to the induction of hypoxia-inducible factor-1α. This article reviews the progress made in understanding the pathological processes involved in immobilization-induced muscle contracture and the currently available treatments. Understanding the mechanisms involved in immobilization-induced contracture of muscle tissue should facilitate the development of more effective treatment measures for the different mechanisms in the future.


Assuntos
Contratura/etiologia , Imobilização/efeitos adversos , Articulações , Músculo Esquelético , Transdução de Sinais/fisiologia , Atrofia , Autofagia , Cálcio/metabolismo , Caspases/metabolismo , Tecido Conjuntivo/metabolismo , Tecido Conjuntivo/patologia , Contratura/metabolismo , Contratura/patologia , Contratura/terapia , Fibrose , Humanos , Lisossomos/metabolismo , Metaloproteinases da Matriz/metabolismo , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Complexo de Endopeptidases do Proteassoma/metabolismo , Proteólise , Fator de Crescimento Transformador beta1/metabolismo , Ubiquitina/metabolismo
9.
Bull Exp Biol Med ; 166(6): 722-725, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31020583

RESUMO

It was shown that the intensity of morphological changes in the dental system tissues (periodontium and pulp) of ISIAH rats depends on the mode of stress exposure. Acute stress was associated with a significant increase in the area of periodontal and pulp vessels, a decrease in the area of connective tissue of these components, and an increase in the thickness of the vascular endothelium. Chronic stress in these animals induced an increase in the thickness of the endothelial layer of the periodontal and pulp vessels, fibromatosis (increase in the number of fibroblasts), and a sharp decrease in the level of odontoblasts.


Assuntos
Polpa Dentária/patologia , Células Endoteliais/patologia , Fibroblastos/patologia , Hipertensão/patologia , Periodonto/patologia , Estresse Fisiológico , Animais , Contagem de Células , Tecido Conjuntivo/irrigação sanguínea , Tecido Conjuntivo/patologia , Polpa Dentária/irrigação sanguínea , Endotélio Vascular/patologia , Imobilização , Masculino , Odontoblastos/patologia , Periodonto/irrigação sanguínea , Ratos , Ratos Endogâmicos
10.
Analyst ; 144(8): 2635-2642, 2019 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-30839958

RESUMO

Infrared (IR) spectroscopic imaging, utilizing both the molecular and structural disease signatures, enables extensive profiling of tumors and their microenvironments. Here, we examine the relative merits of using either the fingerprint or the high frequency regions of the IR spectrum for tissue histopathology. We selected a complex model as a test case, evaluating both stromal and epithelial segmentation for various breast pathologies. IR spectral classification in each of these spectral windows is quantitatively assessed by estimating area under the curve (AUC) of the receiver operating characteristic curve (ROC) for pixel level accuracy and images for diagnostic ability. We found only small differences, though some that may be sufficiently important in diagnostic tasks to be clinically significant, between the two regions with the fingerprint region-based classifiers consistently emerging as more accurate. The work provides added evidence and comparison with fingerprint region, complex models, and previously untested tissue type (breast) - that the use of restricted spectral regions can provide high accuracy. Our study indicates that the fingerprint region is ideal for epithelial and stromal models to obtain high pixel level accuracies. Glass slides provide a limited spectral feature set but provides accurate information at the patient level.


Assuntos
Mama/anatomia & histologia , Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/patologia , Tecido Conjuntivo/anatomia & histologia , Tecido Conjuntivo/patologia , Epitélio/anatomia & histologia , Epitélio/patologia , Humanos , Hiperplasia/patologia , Modelos Biológicos , Curva ROC , Espectrofotometria Infravermelho/métodos
11.
Subcell Biochem ; 91: 281-310, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30888657

RESUMO

We begin this chapter by describing normal characteristics of several pertinent connective tissue components, and some of the basic changes they undergo with ageing. These alterations are not necessarily tied to any specific disease or disorders, but rather an essential part of the normal ageing process. The general features of age-induced changes, such as skin wrinkles, in selected organs with high content of connective or soft tissues are discussed in the next part of the chapter. This is followed by a section dealing with age-related changes in specific diseases that fall into at least two categories. The first category encompasses common diseases with high prevalence among mostly ageing populations where both genetic and environmental factors play roles. They include but may not be limited to atherosclerosis and coronary heart disease, type II diabetes, osteopenia and osteoporosis, osteoarthritis, tendon dysfunction and injury, age-related disorders of spine and joints. Disorders where genetics plays the primary role in pathogenesis and progression include certain types of progeria, such as Werner syndrome and Hutchinson-Gilford progeria belong to the second category discussed in this chapter. These disorders are characterized by accelerated signs and symptoms of ageing. Other hereditary diseases or syndromes that arise from mutations of genes encoding for components of connective tissue and are less common than diseases included in the first group will be discussed briefly as well, though they may not be directly associated with ageing, but their connective tissue undergoes some changes compatible with ageing. Marfan and Ehlers-Danlos syndromes are primary examples of such disorders. We will probe the role of specific components of connective tissue and extracellular matrix if not in each of the diseases, then at least in the main representatives of these disorders.


Assuntos
Envelhecimento/patologia , Doenças do Tecido Conjuntivo/patologia , Envelhecimento/genética , Tecido Conjuntivo/metabolismo , Tecido Conjuntivo/patologia , Doenças do Tecido Conjuntivo/genética , Humanos , Progéria/genética , Progéria/patologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-30794258

RESUMO

A graft's histologic composition depends on the harvesting technique used, and different connective tissue-harvesting procedures have been described in the literature. Some authors suggest the submucosal tissue not be incorporated into the graft because it may interfere with the graft revascularization. In those cases, the de-epithelialized gingival graft (DGG) is obtained with a superficial harvesting technique that leaves the deep portion of the submucosa and the periosteum excluded from the graft. The aim of this case series was to histologically and histomorphometrically evaluate the tissue obtained with this technique. The findings demonstrated that the DGG was mainly composed of connective tissue, and adipose tissue was in minimal proportions. However, epithelium was found in all of the samples.


Assuntos
Retalhos de Tecido Biológico/patologia , Gengiva/transplante , Tecido Adiposo/patologia , Adulto , Tecido Conjuntivo/patologia , Epitélio/cirurgia , Gengiva/patologia , Humanos , Coleta de Tecidos e Órgãos/métodos
13.
Artigo em Inglês | MEDLINE | ID: mdl-30794265

RESUMO

The objectives of this study were to clinically and histologically assess the capacity of bilaminar subepithelial connective tissue grafts (SCTGs) alone or in combination with gingivoplasty (Gv) to increase the keratinized gingiva width (KGW) in contralateral mandibular sites lacking KG (10 patients, 42 sites). The effects of Gv timing (1 vs 2 months) and technique (blade vs laser) were also evaluated. SCTGs alone resulted in mean KGW increase of 0.1 to 0.7 mm. Laser-Gv significantly increased KGW by an additional 1.9 mm at 4 months postabrasion as opposed to 0.9 mm achieved with blade-Gv. Histologically, laser-treated sites displayed parakeratinization with more pronounced rete pegs than observed in blade-abraded sites.


Assuntos
Gengiva/transplante , Gengivoplastia/métodos , Terapia a Laser/métodos , Adulto , Tecido Conjuntivo/patologia , Tecido Conjuntivo/cirurgia , Tecido Conjuntivo/transplante , Feminino , Gengiva/patologia , Gengiva/cirurgia , Retração Gengival/cirurgia , Gengivoplastia/instrumentação , Humanos , Queratinas , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
J Craniomaxillofac Surg ; 47(1): 120-126, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30528562

RESUMO

OBJECTIVE: To evaluate the effects of short-term teriparatide administration on healing of autologous bone graft in mandibular critical-size defects. SUBJECTS AND METHODS: A 5-mm mandibular bone defect was created and iliac bone graft was harvested in 135 rats. Rats were randomly divided into 3 groups of negative control (NC), control (C), and study (S). In groups S and C, iliac graft was placed in defect and 2 µg/kg/day teriparatide or saline, respectively, was administered for 20 days. In group NC, iliac graft was not transferred to the defect and saline was injected for 20 days. Twenty, 40, and 60 days after surgery, 15 rats in each group were euthanized and the healing process was histologically evaluated and scored using a grading system (1-6). RESULTS: In group NC, defects did not heal or were predominantly filled with fibrous tissue. At day 20, bone defects in both C and S groups contained a large area of graft particles, numerous collagen fibers and some areas of new trabeculae. At the day 40, defects in group S showed a larger bone graft area, more new bone formation, smaller connective tissue area, and a higher healing score compared to group C (P < 0.05). At day 60, most of the defect in group S was filled with graft particles and mature bone while in group C, new trabecular bone formation was still underway (P < 0.05). CONCLUSION: Teriparatide therapy improves healing of bone defects reconstructed with autograft by reducing bone graft resorption and enhancing new bone formation and maturation.


Assuntos
Transplante Ósseo , Mandíbula/cirurgia , Teriparatida/uso terapêutico , Transplante Autólogo , Cicatrização/efeitos dos fármacos , Análise de Variância , Animais , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/patologia , Doenças Ósseas/cirurgia , Regeneração Óssea/efeitos dos fármacos , Remodelação Óssea , Tecido Conjuntivo/patologia , Modelos Animais de Doenças , Consolidação da Fratura/efeitos dos fármacos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Osteogênese/efeitos dos fármacos , Ratos , Ratos Wistar , Solução Salina/uso terapêutico , Teriparatida/administração & dosagem
15.
Comput Methods Biomech Biomed Engin ; 22(1): 84-93, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30398374

RESUMO

The rotational cutting method has been used in needle biopsy technologies to sample tough tissues, such as calcifications in the breast. The rotational motion of the needle introduces shear forces to the cutting surface such that the cutting force in the axial direction is reduced. As a result, tissue samples with large volume and better quality can be obtained. In order to comprehensively understand the effect of the needle rotation to the axial cutting force under a wide range of the needle insertion speed, this paper demonstrates a computational approach that incorporates the surface-based cohesive behavior to simulate a rotating needle cutting soft tissue. The computational model is validated by comparing with a cutting test dataset reported in the literature. The validated model is then used to generate response surfaces of the axial cutting force and torque in a large parameter space of needle rotation and insertion speeds. The results provide guidelines for selecting optimal speed configurations under different design situations.


Assuntos
Simulação por Computador , Tecido Conjuntivo/patologia , Fenômenos Mecânicos , Rotação , Biópsia por Agulha , Análise de Elementos Finitos , Humanos , Torque
16.
Eye (Lond) ; 33(2): 200-205, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30385883

RESUMO

BACKGROUND/OBJECTIVES: Thyroid-associated ophthalmopathy (TAO), an autoimmune component of Graves' disease, remains a disfiguring and potentially blinding condition. Here, the author reviews the role of insulin-like growth factor-I receptor pathway in TAO and how it might be therapeutically targeted. METHODS: The recent literature is reviewed. RESULTS: TAO involves reactivity of orbital connective tissues and their remodeling. While many of the details concerning the pathogenesis of TAO remain to be determined, several insights have come to light recently. Among them is the apparent involvement of IGF-IR. This receptor protein, a membrane-spanning tyrosine kinase receptor can form both physical and functional complexes with the thyrotropin receptor (TSHR). This is notable because TSHR is the established primary autoantigen in Graves' disease. IGF-IR activity is critical to signaling downstream from both IGF-IR and TSHR. In addition, antibodies against IGF-IR have been detected in patients with Graves' disease and in rodent models of TAO. Evidence has been put forward that these antibodies may act directly on IGF-IR, perhaps in some manner activating the receptor. These experimental observations have led to the development of a novel therapy for active TAO, utilizing a monoclonal anti-IGF-IR inhibitory antibody which had been produced originally as treatment for cancer. The agent, teprotumumab was recently evaluated in a clinical trial and found to be highly effective and relatively well-tolerated. It is currently undergoing assessment in a follow-up trial. CONCLUSIONS: Should the current study yield similarly encouraging results, it is possible that teprotumumab will emerge as a paradigm-shifting medical therapy for TAO.


Assuntos
Autoantígenos/imunologia , Oftalmopatia de Graves/imunologia , Receptores de Somatomedina/imunologia , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Autoanticorpos/sangue , Congressos como Assunto , Tecido Conjuntivo/patologia , Oftalmopatia de Graves/tratamento farmacológico , Humanos , Órbita/patologia , Receptores de Somatomedina/antagonistas & inibidores , Receptores da Tireotropina/imunologia
17.
Int Ophthalmol ; 39(9): 2005-2014, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30315390

RESUMO

PURPOSE: To study the connective tissue (CT) structure of upper eyelid skin of primary open-angle glaucoma (POAG) patients. PATIENTS AND METHODS: Forty-seven patients aged 47-91 expecting blepharoplasty formed 3 groups: group 1 [16 subjects without POAG, median age 55 years (interquartile range 54-55.5)], group 2 [12 subjects without POAG, median age 73 (72-76.5)], and group 3 [(19 subjects with POAG, median age 74 (70-80.5)]. Age differences between groups 1 and 2 and groups 1 and 3 are significant (p < 0.05). Thermodynamic parameters of skin samples taken during blepharoplasty: Endothermic peak ([Formula: see text], °C) and denaturation enthalpy ([Formula: see text], J/g of dry weight) were determined using differential scanning calorimetry. RESULTS: [Formula: see text] and [Formula: see text] in groups 1-3 were, respectively, 8.41 (7.42-10.25) and 66.55 (59.9-66.7); 7.10 (5.76-10.17) and 67.35 (67.0-68.03); 11.40 (9.0-14.9) and 67.70 (67.05-68.45). [Formula: see text] differences between groups 1 and 2 are significant (p < 0.05), and Spearman's correlation between the age and [Formula: see text] is direct, medium (R = 0.638) and significant. [Formula: see text] in group 3 is significantly higher than in group 2. [Formula: see text] and [Formula: see text] in patients without POAG (groups 1 and 2) and those with POAG (group 3) are, respectively, 7.79 (6.9-10.17) and 66.6 (61.2-67,3); 11.40 (9.0-14.9); 67.7 (67.05-68.45); the respective differences are significant. CONCLUSION: Patients without POAG show a significant increase in [Formula: see text] with age, while [Formula: see text] slightly decreases. In POAG, [Formula: see text] is significantly higher and [Formula: see text] tends to grow, which may indicate structural changes in eyelid CT (collagen accumulation and cross-linking level rise). Since the upper lid is unaffected by increasing IOP directly, the changes may be viewed as manifestations of systemic CT pathology.


Assuntos
Tecido Conjuntivo/patologia , Pálpebras/patologia , Glaucoma de Ângulo Aberto/diagnóstico , Tomografia de Coerência Óptica/métodos , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Colorimetria , Tecido Conjuntivo/fisiopatologia , Pálpebras/fisiopatologia , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Termodinâmica , Campos Visuais/fisiologia
18.
J Robot Surg ; 13(3): 463-468, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30171485

RESUMO

Robotic surgeries in the extreme Trendelenburg position can lead to changes in the airway dimensions. We conducted a prospective, observational trial to explore the use of ultrasound to quantify these changes in the airway dimensions and identify the factors associated with it. Fifty-two American society of Anaesthesiologists physical status I-II patients between 18 and 70 years of age of either sex scheduled to undergo robot assisted urological procedures in steep Trendelenburg position were enrolled. Anterior soft tissue thickness at the level of hyoid bone and vocal cords, tongue thickness, Malampatti grading and neck circumference were measured at predefined postoperative intervals in the immediate postoperative period, at 2-, 6- and 12-h period postoperatively. Linear stepwise regression analysis was done to explore the factors associated with change in anterior tissue thickness immediately after surgery. The mean difference (95%; CI) in the anterior soft tissue thickness in the immediate postoperative period at the level of hyoid was 0.023 (0.029-0.016) cm, p < 0.001 and at level of vocal cords was - 0.012 (- 0.017 to - 0.008) cm, p < 0.001 from the baseline. There was a significant increase in tongue thickness (0.002), Mallampati score (p = 0.002) and neck circumference (p < 0.001) in immediate postoperative period. The change in anterior tissue thickness at the level of hyoid was affected by total intraoperative fluids used (r = 0.602, p < 0.001), airway trauma (r = 0.275, p = 0.002) and duration of surgery (r = 0.243, p = 0.025). Significant changes in airway dimensions after robotic surgeries in Trendelenburg position persist till 2 h in the postoperative period which warrant vigilant monitoring for any airway compromise during this period.


Assuntos
Tecido Conjuntivo/patologia , Decúbito Inclinado com Rebaixamento da Cabeça/efeitos adversos , Osso Hioide/patologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Língua/patologia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Prega Vocal/patologia , Adolescente , Adulto , Idoso , Tecido Conjuntivo/diagnóstico por imagem , Feminino , Humanos , Osso Hioide/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Fatores de Tempo , Língua/diagnóstico por imagem , Ultrassonografia , Prega Vocal/diagnóstico por imagem , Adulto Jovem
19.
J Am Acad Orthop Surg ; 27(5): e199-e206, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30431504

RESUMO

Necrotizing soft-tissue infections are caused by a variety of bacterial pathogens that may affect patients at any age or health status. This orthopaedic emergency initially presents with nonspecific signs such as erythema and edema. As the disease progresses, classic signs such as bullae, cutaneous anesthesia, ecchymosis, tense edema, and gas can be seen. A high level of suspicion is needed to properly identify and treat in a timely manner. Pain out of proportion to presentation and rapid progression even with appropriate antibiotic treatment should heighten suspicion of a necrotizing soft-tissue infection. The mainstay of management is extensive débridement and decompression of all necrotic tissue and broad-spectrum antibiotics. Débridements are repeated to ensure that disease progression has been halted. Early surgical débridements should take precedent over transfer because of the high rate of limb loss and mortality as a result of surgical delay.


Assuntos
Antibacterianos/uso terapêutico , Tecido Conjuntivo/patologia , Desbridamento , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/terapia , Desbridamento/métodos , Descompressão Cirúrgica/métodos , Progressão da Doença , Emergências , Humanos , Necrose , Ortopedia , Fatores de Risco , Infecções dos Tecidos Moles/patologia
20.
Cranio ; 37(4): 223-230, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29318946

RESUMO

OBJECTIVE: The purpose of this study was to analyze facial soft tissue thickness and cranial skeletal transverse widths in adolescent subjects with different body mass index (BMI) percentiles. METHODS: The 80 subjects were divided into three groups according to BMI percentile: normal-weight, overweight, and obese adolescent subjects. Facial soft tissue linear and cranial skeletal transversal width measurements were performed on lateral and postero-anterior cephalometric radiographs. RESULTS: Glabella, nasion, pogonion, and gnathion soft tissue thicknesses were significantly different among normal-weight, overweight, and obese subjects (p < 0.05). However, other facial soft tissue thickness parameters were not statistically significantly different among the groups (p > 0.05). Moreover, there were no significant differences in cranial skeletal transversal widths among groups (p > 0.05). CONCLUSION: Nasion soft tissue thickness was thicker in overweight subjects; whereas, glabella, pogonion and gnathion soft tissue thickness was thicker in obese subjects. All measured cranial skeletal widths were similar in normal-weight, overweight, and obese subjects.


Assuntos
Índice de Massa Corporal , Tecido Conjuntivo/anatomia & histologia , Face/anatomia & histologia , Crânio/anatomia & histologia , Adolescente , Cefalometria , Tecido Conjuntivo/diagnóstico por imagem , Tecido Conjuntivo/patologia , Face/patologia , Feminino , Humanos , Masculino , Obesidade/patologia , Sobrepeso/patologia , Radiografia , Valores de Referência , Crânio/patologia
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