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2.
Neurourol Urodyn ; 43(1): 236-245, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37767637

RESUMO

OBJECTIVES: A feasibility proof-of-concept study was conducted to assess the effects of acute tibial nerve stimulation (TNS) on the central nervous system in healthy volunteers using functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS: Fourteen healthy volunteers were included in a prospective, single-site study conducted on a clinical 3T MRI scanner. Four scans of functional MRI, each lasting 6 min, were acquired: two resting-state fMRI scans (prior and following the TNS intervention) and in-between two fMRI scans, both consisting of alternating rest periods and noninvasive acute transcutaneous TNS (TTNS). Whole brain seed-based functional connectivity (FC) correlation analysis was performed comparing TTNS stimulation with rest periods. Cluster-level familywise error (FWE) corrected p and a minimal cluster size of 200 voxels were used to explore FC patterns. RESULTS: Increased FC is reported between inferior frontal gyrus, posterior cingulate gyrus, and middle temporal gyrus with the precuneus as central receiving node. In addition, decreased FC in the cerebellum, hippocampus, and parahippocampal areas was observed. CONCLUSIONS: Altered FC is reported in areas which have been described to be also involved in lower urinary tract control. Although conducted with healthy controls, the assumption that the underlying therapeutic effect of TNS involves the central nervous system is supported and has to be further examined in patients with incomplete spinal cord injury.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Estudos Prospectivos , Mapeamento Encefálico/métodos , Nervo Tibial/diagnóstico por imagem
3.
Nature ; 555(7697): 497-501, 2018 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-29565365

RESUMO

Metal halide perovskites are of great interest for various high-performance optoelectronic applications. The ability to tune the perovskite bandgap continuously by modifying the chemical composition opens up applications for perovskites as coloured emitters, in building-integrated photovoltaics, and as components of tandem photovoltaics to increase the power conversion efficiency. Nevertheless, performance is limited by non-radiative losses, with luminescence yields in state-of-the-art perovskite solar cells still far from 100 per cent under standard solar illumination conditions. Furthermore, in mixed halide perovskite systems designed for continuous bandgap tunability (bandgaps of approximately 1.7 to 1.9 electronvolts), photoinduced ion segregation leads to bandgap instabilities. Here we demonstrate substantial mitigation of both non-radiative losses and photoinduced ion migration in perovskite films and interfaces by decorating the surfaces and grain boundaries with passivating potassium halide layers. We demonstrate external photoluminescence quantum yields of 66 per cent, which translate to internal yields that exceed 95 per cent. The high luminescence yields are achieved while maintaining high mobilities of more than 40 square centimetres per volt per second, providing the elusive combination of both high luminescence and excellent charge transport. When interfaced with electrodes in a solar cell device stack, the external luminescence yield-a quantity that must be maximized to obtain high efficiency-remains as high as 15 per cent, indicating very clean interfaces. We also demonstrate the inhibition of transient photoinduced ion-migration processes across a wide range of mixed halide perovskite bandgaps in materials that exhibit bandgap instabilities when unpassivated. We validate these results in fully operating solar cells. Our work represents an important advance in the construction of tunable metal halide perovskite films and interfaces that can approach the efficiency limits in tandem solar cells, coloured-light-emitting diodes and other optoelectronic applications.

4.
Laryngorhinootologie ; 102(12): 916-927, 2023 12.
Artigo em Alemão | MEDLINE | ID: mdl-37734389

RESUMO

Ultrasound-guided ablation techniques have been increasingly introduced into routine treatment of thyroid lesions as a complement to existing surgical therapies and radioiodine treatment. In cystic or predominantly cystic lesions instillation therapy (ethanol/polidocanol ablation) has yielded good results. Novel thermal ablation techniques, including radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA) and high intensity focused ultrasound (HIFU), induce irreversible cellular effects by locally applying temperatures ≥ 60 °C to the targeted thyroid region. Lesions causing local symptoms or focal hyperfunctionality can thus be selectively treated under continuous sonographic monitoring. While a considerable body of evidence supports the efficacy and safety of various local ablative techniques, future challenges lie in initiating comparative prospective trials and in standardizing clinical practice, training and continuous quality assessment on a regional and superregional level. In the future, it shall be indicated to include local ablative techniques - so far not known to all patients in Germany - into the informed decision-making process as a suitable alternative or supplement to existing therapies.


Assuntos
Técnicas de Ablação , Ablação por Cateter , Humanos , Glândula Tireoide/diagnóstico por imagem , Radioisótopos do Iodo , Estudos Prospectivos , Técnicas de Ablação/métodos , Ultrassonografia de Intervenção , Ablação por Cateter/métodos , Resultado do Tratamento
5.
Acta Radiol ; 63(5): 632-641, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34056917

RESUMO

X-ray contrast media have been reported to have inhibitory effects on bacterial growth. Despite its potentially beneficial effect on patients, these features of contrast media have received relatively little attention in the medical literature in the past decades. The aim of this review is to evaluate the literature concerning the bactericidal and bacteriostatic effects of X-ray contrast media, specifically if there is a known difference concerning these effects between ionic and non-ionic contrast media. Systematic literature review was performed for the years of publication between 1911 and 2019. Since the publication of Grossich in 1911, the effect of iodine on the treatment of superficial infections in surgical procedures has been established clinical knowledge. Bacteriostatic and bactericidal effects of ionic X-ray contrast media are well established. However, non-ionic contrast agents have been the subject of little research in this respect. In past decades, the hypothesis emerged in the literature that mainly the concentration of free iodine might be responsible for any bacteriostatic or bactericidal effect of ionic X-ray contrast media. Nowadays, however, only non-ionic contrast media are used. The question regarding the mechanism and magnitude of bacteriostatic or bactericidal effects of these, non-ionic contrast media, could not be answered conclusively from this review. Non-ionic contrast media could be used intentionally when a local antibacterial effect is intended (e.g. in percutaneous abscess drainage), as well as to reduce the overall dose of antibiotics administered to a patient. Thus, this question remains relevant and might constitute the area of future research.


Assuntos
Meios de Contraste , Iodo , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Meios de Contraste/efeitos adversos , Humanos , Iodo/farmacologia , Raios X
6.
J Am Chem Soc ; 142(2): 777-782, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31851510

RESUMO

Metal-halide perovskites show excellent properties for photovoltaic and optoelectronic applications, with power conversion efficiencies of solar cell and LEDs exceeding 20%. Being solution processed, these polycrystalline materials likely contain a large density of defects compared to melt-grown semiconductors. Surprisingly, typical effects from defects (absorption below the bandgap, low fill factor and open circuit voltage in devices, strong nonradiative recombination) are not observed. In this work, we study thin films of metal-halide perovskites CH3NH3PbX3 (X = Br, I) with ultrafast multidimensional optical spectroscopy to resolve the dynamics of band and defect states. We observe a shared ground state between the band-edge transitions and a continuum of sub-bandgap states, which extends at least 350 meV below the band edge). We explain the comparatively large bleaching of the dark sub-bandgap states with oscillator strength borrowing from the band-edge transition. Our results show that upon valence to conduction band excitation, such subgap states are instantaneously bleached for large parts of the carrier lifetime and conversely that most dark sub-bandgap states can be populated by light excitation. This observation helps to unravel the photophysical origin of the unexpected optoelectronic properties of these materials.

7.
Phys Rev Lett ; 125(11): 117207, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32975976

RESUMO

We present numerical evidence for the crystallization of magnons below the saturation field at nonzero temperatures for the highly frustrated spin-half kagome Heisenberg antiferromagnet. This phenomenon can be traced back to the existence of independent localized magnons or, equivalently, flatband multimagnon states. We present a loop-gas description of these localized magnons and a phase diagram of this transition, thus providing information for which magnetic fields and temperatures magnon crystallization can be observed experimentally. The emergence of a finite-temperature continuous transition to a magnon crystal is expected to be generic for spin models in dimension D>1 where flatband multimagnon ground states break translational symmetry.

8.
J Am Soc Nephrol ; 30(8): 1439-1453, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31311828

RESUMO

BACKGROUND: New therapies blocking the IL-6 receptor (IL-6R) have recently become available and are successfully being used to treat inflammatory diseases like arthritis. Whether IL-6 blockers may help patients with kidney inflammation currently remains unknown. METHODS: To learn more about the complex role of CD4+ T cell-intrinsic IL-6R signaling, we induced nephrotoxic nephritis, a mouse model for crescentic GN, in mice lacking T cell-specific IL-6Ra. We used adoptive transfer experiments and studies in reporter mice to analyze immune responses and Treg subpopulations. RESULTS: Lack of IL-6Ra signaling in mouse CD4+ T cells impaired the generation of proinflammatory Th17 cells, but surprisingly did not ameliorate the course of GN. In contrast, renal damage was significantly reduced by restricting IL-6Ra deficiency to T effector cells and excluding Tregs. Detailed studies of Tregs revealed unaltered IL-10 production despite IL-6Ra deficiency. However, in vivo and in vitro, IL-6Ra classic signaling induced RORγt+Foxp3+ double-positive Tregs (biTregs), which carry the trafficking receptor CCR6 and have potent immunoregulatory properties. Indeed, lack of IL-6Ra significantly reduced Treg in vitro suppressive capacity. Finally, adoptive transfer of T cells containing IL-6Ra-/- Tregs resulted in severe aggravation of GN in mice. CONCLUSIONS: Our data refine the old paradigm, that IL-6 enhances Th17 responses and suppresses Tregs. We here provide evidence that T cell-intrinsic IL-6Ra classic signaling indeed induces the generation of Th17 cells but at the same time highly immunosuppressive RORγt+ biTregs. These results advocate caution and indicate that IL-6-directed therapies for GN need to be cell-type specific.


Assuntos
Fatores de Transcrição Forkhead/metabolismo , Subunidade alfa de Receptor de Interleucina-6/metabolismo , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/metabolismo , Receptores de Interleucina-6/metabolismo , Transdução de Sinais , Linfócitos T Reguladores/imunologia , Animais , Linhagem Celular , Cruzamentos Genéticos , Feminino , Glomerulonefrite/metabolismo , Glomerulonefrite/patologia , Imunossupressores/uso terapêutico , Inflamação , Subunidade alfa de Receptor de Interleucina-6/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Necrose , Receptores de Interleucina-6/genética , Células Th17/citologia
9.
J Am Soc Nephrol ; 29(7): 1825-1837, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29866800

RESUMO

Background Th17 cells are central pathogenic mediators of autoimmune disease, including many forms of GN. IL-10 receptor signaling (IL-10R) in regulatory T cells (Tregs) has been implicated in the downregulation of Th17 cells, but the underlying molecular mechanisms and functional relevance of this process remain unclear.Methods We generated mice with Treg-specific IL-10Ra deficiency and subjected these mice to nephrotoxic serum-induced nephritis as a model of crescentic GN. Immune responses and Treg phenotypes were extensively analyzed.Results Compared with controls, mice with IL-10Ra-/- Tregs showed a spontaneously overshooting Th17 immune response. This hyper-Th17 phenotype was further boosted during GN and associated with aggravated renal injury. Notably, abrogation of IL-10Ra signaling in Tregs increased dendritic cell activation and production of Th17-inducing cytokines. In contrast, Treg trafficking and expression of chemokine receptor CCR6 remained unaffected, indicating mechanisms of Th17 control, differing from those of previously identified CCR6+ Treg17 cells. Indeed, the capacity for direct in vitro suppression of Th17 responses by IL-10Ra-/- Tregs was significantly impaired. As underlying pathology, analyses conducted in vitro and in vivo using double-fluorescent reporter mice revealed strikingly decreased IL-10 production by IL-10Ra-/- Tregs. To assess, whether reduced IL-10 could explain the hyper Th17 phenotype, competitive cotransfer experiments were performed. Supporting our concept, IL-10Ra-/- T cells differentiated into Th17 cells at much higher frequencies than wild type T cells did during GN.Conclusions IL-10R engagement optimizes Treg-mediated suppression of Th17 immunity. We hypothesize a feed-forward loop, in which IL-10Ra signaling reinforces IL-10 secretion by Tregs which potently controls Th17 development via direct and indirect mechanisms. IL-10R thus may be a promising therapeutic target for the treatment of GN.


Assuntos
Glomerulonefrite/imunologia , Subunidade alfa de Receptor de Interleucina-10/metabolismo , Interleucina-10/metabolismo , Nefrite/metabolismo , Transdução de Sinais , Linfócitos T Reguladores/metabolismo , Células Th17/imunologia , Animais , Diferenciação Celular , Citocinas/metabolismo , Células Dendríticas/fisiologia , Modelos Animais de Doenças , Regulação para Baixo , Subunidade alfa de Receptor de Interleucina-10/genética , Masculino , Camundongos , Camundongos Knockout , Nefrite/imunologia , Receptores CCR6/metabolismo , Células Th17/metabolismo
10.
J Am Chem Soc ; 140(43): 14097-14111, 2018 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-30293427

RESUMO

CdSe/CdTe core-crown type-II nanoplatelet heterostructures are two-dimensional semiconductors that have attracted interest for use in light-emitting technologies due to their ease of fabrication, outstanding emission yields, and tunable properties. Despite this, the exciton dynamics of these complex materials, and in particular how they are influenced by phonons, is not yet well understood. Here, we use a combination of femtosecond vibrational spectroscopy, temperature-resolved photoluminescence (PL), and temperature-dependent structural measurements to investigate CdSe/CdTe nanoplatelets with a thickness of four monolayers. We show that charge-transfer (CT) excitons across the CdSe/CdTe interface are formed on two distinct time scales: initially from an ultrafast (∼70 fs) electron transfer and then on longer time scales (∼5 ps) from the diffusion of domain excitons to the interface. We find that the CT excitons are influenced by an interfacial phonon mode at ∼120 cm-1, which localizes them to the interface. Using low-temperature PL spectroscopy we reveal that this same phonon mode is the dominant mechanism in broadening the CT PL. On cooling to 4 K, the total PL quantum yield reaches close to unity, with an ∼85% contribution from CT emission and the remainder from an emissive sub-band-gap state. At room temperature, incomplete diffusion of domain excitons to the interface and scattering between CT excitons and phonons limit the PL quantum yield to ∼50%. Our results provide a detailed picture of the nature of exciton-phonon interactions at the interfaces of 2D heterostructures and explain both the broad shape of the CT PL spectrum and the origin of PL quantum yield losses. Furthermore, they suggest that to maximize the PL quantum yield both improved engineering of the interfacial crystal structure and diffusion of domain excitons to the interface, e.g., by altering the relative core/crown size, are required.

11.
J Neurooncol ; 140(3): 659-667, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30196368

RESUMO

PURPOSE: Preoperative embolization of radiographically suspected meningiomas is often performed to facilitate tumor resection. Its effects on the subsequent disease course of meningioma patients have not been studied in detail and randomized trials are lacking. The purpose of this study was to explore associations of preoperative meningioma embolization with postoperative outcome. PATIENTS AND METHODS: Patients undergoing resection of an intracranial meningioma at the University Hospital Zurich 2000-2013 (N = 741) were reviewed for the inclusion of pre-operative embolization in the management strategy. Annotations included demographics, radiographic, surgical, histological and hematological parameters, cardiovascular risk factors, pre- and postoperative neurological function and gene methylation-based classification. Binary regression and Cox proportional hazards models were applied to determine factors associated with outcome. RESULTS: Pre-operative embolization was performed in 337 patients (42%). Cardiovascular events after surgery comprised mostly deep vein thrombosis (N = 39) and pulmonary embolisms (N = 64). On multivariate analyses of post-operative cardiovascular adverse events controlling for established risk factors, there were associations with embolization (OR 2.38, 95% CI 1.37-4.00), and with female gender (OR 2.18, 95% CI 1.17-4.08). Recurrence-free survival (RFS) of embolized patients was less favorable among patients with WHO grade II or grade III meningiomas (median RFS: 4.3 vs. 7.0 years, P = 0.029) or in patients with intermediate or malignant gene methylation subtype meningiomas (median RFS: 2.0 vs. 8.2 years, P = 0.005). CONCLUSION: Pre-operative meningioma embolization may cause adverse outcomes. Randomized trials to determine benefit-risk ratios are warranted to clarify the role of pre-operative embolization for the treatment of meningioma patients.


Assuntos
Doenças Cardiovasculares/etiologia , Embolização Terapêutica/efeitos adversos , Neoplasias Meníngeas/terapia , Meningioma/terapia , Recidiva Local de Neoplasia/epidemiologia , Cuidados Pré-Operatórios/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/epidemiologia , Meningioma/complicações , Meningioma/epidemiologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto Jovem
12.
J Am Chem Soc ; 139(34): 12050-12059, 2017 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-28753299

RESUMO

We have prepared a series of MII4L6 tetrahedral cages containing one or the other of two distinct BODIPY moieties, as well as mixed cages that contain both BODIPY chromophores. The photophysical properties of these cages and their fullerene-encapsulated adducts were studied in depth. Upon cage formation, the charge-transfer character exhibited by the bis(aminophenyl)-BODIPY subcomponents disappeared. Strong excitonic interactions were instead observed between at least two BODIPY chromophores along the edges of the cages, arising from the electronic delocalization through the metal centers. This excited-state delocalization contrasts with previously reported cages. All cages exhibited the same progression from an initial bright singlet state (species I) to a delocalized dark state (species II), driven by interactions between the transition dipoles of the ligands, and subsequently into geometrically relaxed species III. In the case of cages loaded with C60 or C70 fullerenes, ultrafast host-to-guest electron transfer was observed to compete with the excitonic interactions, short-circuiting the I → II → III sequence.

13.
J Am Chem Soc ; 139(50): 18376-18385, 2017 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-29164879

RESUMO

Singlet fission offers the potential to overcome thermodynamic limits in solar cells by converting the energy of a single absorbed photon into two distinct triplet excitons. However, progress is limited by the small family of suitable materials, and new chromophore design principles are needed. Here, we experimentally vindicate the design concept of diradical stabilization in a tunable family of functionalized zethrenes. All molecules in the series exhibit rapid formation of a bound, spin-entangled triplet-pair state TT. It can be dissociated by thermally activated triplet hopping and exhibits surprisingly strong emission for an optically "dark" state, further enhanced with increasing diradical character. We find that the TT excited-state absorption spectral shape correlates with the binding energy between constituent triplets, providing a new tool to understand this unusual state. Our results reveal a versatile new family of tunable materials with excellent optical and photochemical properties for exploitation in singlet fission devices.

14.
J Am Chem Soc ; 139(51): 18632-18639, 2017 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-29155583

RESUMO

We investigate the origin of the broadband visible emission in layered hybrid lead-halide perovskites and its connection with structural and photophysical properties. We study ⟨001⟩ oriented thin films of hexylammonium (HA) lead iodide, (C6H16N)2PbI4, and dodecylammonium (DA) lead iodide, (C12H28N)2PbI4, by combining first-principles simulations with time-resolved photoluminescence, steady-state absorption and X-ray diffraction measurements on cooling from 300 to 4 K. Ultrafast transient absorption and photoluminescence measurements are used to track the formation and recombination of emissive states. In addition to the excitonic photoluminescence near the absorption edge, we find a red-shifted, broadband (full-width at half-maximum of about 0.4 eV), emission band below 200 K, similar to emission from ⟨110⟩ oriented bromide 2D perovskites at room temperature. The lifetime of this sub-band-gap emission exceeds that of the excitonic transition by orders of magnitude. We use X-ray diffraction measurements to study the changes in crystal lattice with temperature. We report changes in the octahedral tilt and lattice spacing in both materials, together with a phase change around 200 K in DA2PbI4. DFT simulations of the HA2PbI4 crystal structure indicate that the low-energy emission is due to interstitial iodide and related Frenkel defects. Our results demonstrate that white-light emission is not limited to ⟨110⟩ oriented bromide 2D perovskites but a general property of this class of system, and highlight the importance of defect control for the formation of low-energy emissive sites, which can provide a pathway to design tailored white-light emitters.

15.
J Am Chem Soc ; 138(9): 2941-4, 2016 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-26901659

RESUMO

Metal halide perovskite crystal structures have emerged as a class of optoelectronic materials, which combine the ease of solution processability with excellent optical absorption and emission qualities. Restricting the physical dimensions of the perovskite crystallites to a few nanometers can also unlock spatial confinement effects, which allow large spectral tunability and high luminescence quantum yields at low excitation densities. However, the most promising perovskite structures rely on lead as a cationic species, thereby hindering commercial application. The replacement of lead with nontoxic alternatives such as tin has been demonstrated in bulk films, but not in spatially confined nanocrystals. Here, we synthesize CsSnX3 (X = Cl, Cl0.5Br0.5, Br, Br0.5I0.5, I) perovskite nanocrystals and provide evidence of their spectral tunability through both quantum confinement effects and control of the anionic composition. We show that luminescence from Sn-based perovskite nanocrystals occurs on pico- to nanosecond time scales via two spectrally distinct radiative decay processes, which we assign to band-to-band emission and radiative recombination at shallow intrinsic defect sites.

16.
Chemistry ; 22(42): 14846-14850, 2016 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-27481541

RESUMO

The design and synthesis of model compounds that do not exist naturally is one of the important targets in modern coordination chemistry. Herein, an eighteen-membered honeycomb structure with equal numbers of MnII (s=5/2) and GdIII (s=7/2) metal centers has been prepared, for the first time, by using a hydrophobic force-directed self-assembling process. Due to the weakly coupled GdIII pairs, the magnetic properties are mainly determined by eight-membered chains in the experimentally considered temperature range. These [Mn4 Gd4 ] "finite-size" chains, albeit with large Hilbert space, can be fully resolved by the high-temperature series expansion and the powerful finite-temperature Lanczos method, which reveal that the exchange-couplings between the metal centers are antiferromagnetic and consistent with the magnetization measurement. Interestingly, from the surface-engineering point of view, the [Mn4 Gd4 ] chains are "precisely" assembled into a 2D honeycomb pattern, which is potentially desirable in the design of weakly coupled qubits.

17.
Wien Klin Wochenschr ; 136(7-8): 236-238, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38305909

RESUMO

Techniques of artificial intelligence (AI) are increasingly used in the treatment of patients, such as providing a diagnosis in radiological imaging, improving workflow by triaging patients or providing an expert opinion based on clinical symptoms; however, such AI techniques also hold intrinsic risks as AI algorithms may point in the wrong direction and constitute a black box without explaining the reason for the decision-making process.This article outlines a case where an erroneous ChatGPT diagnosis, relied upon by the patient to evaluate symptoms, led to a significant treatment delay and a potentially life-threatening situation. With this case, we would like to point out the typical risks posed by the widespread application of AI tools not intended for medical decision-making.


Assuntos
Ataque Isquêmico Transitório , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/etiologia , Inteligência Artificial , Diagnóstico Tardio , Algoritmos , Tomada de Decisão Clínica
18.
Invest Radiol ; 58(2): 131-138, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35926077

RESUMO

OBJECTIVES: In spinal cord injury (SCI), the primary mechanical injury is followed by secondary sequelae that develop over the subsequent months and manifests in biochemical, functional, and microstructural alterations, at the site of direct injury but also in the spinal cord tissue above and below the actual lesion site. Noninvasive magnetic resonance spectroscopy (MRS) can be used to assess biochemical modulation occurring in the secondary injury phase, in addition to and supporting conventional MRI, and might help predict and improve patient outcome. In this article, we aimed to examine the metabolic levels in the pons of subacute SCI by means of in vivo proton MRS at 3 T and explore the association to clinical scores. MATERIALS AND METHODS: In this prospective study, between November 2015 and February 2018, single-voxel short-echo MRS data were acquired in healthy controls and in SCI subjects in the pons once during rehabilitation. Besides the single-point MRS examination, in addition, in participants with SCI, the clinical status (ie, motor, light touch, and pinprick scores) was assessed twice: (1) around the MRS session (approximately 10 weeks postinjury) and (2) before discharge (at approximately 9 months postinjury). The group differences were assessed with Kruskal-Wallis test, the post hoc comparison was assessed with Wilcoxon rank sum test, and the clinical correlations were conducted with Spearman rank correlation test. Bayes factor calculations completed the statistical part providing relevant evidence values. RESULTS: Twenty healthy controls (median age, 50 years; interquartile range, 41-55 years; 18 men) and 18 subjects with traumatic SCI (median age, 50 years; interquartile range, 32-58 years; 16 men) are included. Group comparison showed an increase of total N -acetylaspartate and combined glutamate and glutamine levels in complete SCI and a reduction of total creatine in incomplete paraplegic SCI. The proton MRS-based glutathione levels at baseline correlate to the motor score improvement during rehabilitation in incomplete subacute SCI. CONCLUSIONS: This exploratory study showed an association of the metabolite concentration of glutathione in the pons assessed at approximately 10 weeks after injury with the improvements of the motor score during the rehabilitation. Pontine glutathione levels in subjects with traumatic subacute incomplete SCI acquired remote from the injury site correlate to clinical score and might therefore be beneficial in the rehabilitation assessments.


Assuntos
Prótons , Traumatismos da Medula Espinal , Masculino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Teorema de Bayes , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/patologia , Ponte/diagnóstico por imagem , Ponte/patologia
19.
Sci Rep ; 13(1): 7245, 2023 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-37142669

RESUMO

The aim of this exploratory study was the assessment of the metabolic profiles of persons with complete spinal cord injury (SCI) in three region-of-interests (pons, cerebellar vermis, and cerebellar hemisphere), with magnetic resonance spectroscopy, and their correlations to clinical scores. Group differences and association between metabolic and clinical scores were examined. Fifteen people with chronic SCI (cSCI), five people with subacute SCI (sSCI) and fourteen healthy controls were included. Group comparison between cSCI and HC showed lower total N-acetyl-aspartate (tNAA) in the pons (p = 0.04) and higher glutathione (GSH) in the cerebellar vermis (p = 0.02). Choline levels in the cerebellar hemisphere were different between cSCI and HC (p = 0.02) and sSCI and HC (p = 0.02). A correlation was reported for choline containing compounds (tCho) to clinical scores in the pons (rho = - 0.55, p = 0.01). tNAA to total creatine (tNAA/tCr ratio) correlated to clinical scores in the cerebellar vermis (rho = 0.61, p = 0.004) and GSH correlated to the independence score in the cerebellar hemisphere (rho = 0.56, p = 0.01). The correlation of tNAA, tCr, tCho and GSH to clinical scores might be indicators on how well the CNS copes with the post-traumatic remodeling and might be further examined as outcome markers.


Assuntos
Cerebelo , Traumatismos da Medula Espinal , Humanos , Espectroscopia de Prótons por Ressonância Magnética , Cerebelo/metabolismo , Traumatismos da Medula Espinal/metabolismo , Ponte/diagnóstico por imagem , Ponte/metabolismo , Creatina/metabolismo , Metaboloma , Colina/metabolismo , Receptores de Antígenos de Linfócitos T/metabolismo , Ácido Aspártico/metabolismo
20.
Phys Rev E ; 106(1-1): 014107, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35974518

RESUMO

The rich ground-state phase diagram of the mixed spin-(1,1/2) Heisenberg octahedral chain was previously elaborated from effective mixed-spin Heisenberg chains, which were derived by employing a local conservation of a total spin on square plaquettes of an octahedral chain. Here we present a comprehensive analysis of the thermodynamic properties of this model. In the highly frustrated parameter region the lowest-energy eigenstates of the mixed-spin Heisenberg octahedral chain belong to flat bands, which allow a precise description of low-temperature magnetic properties within the localized-magnon approach exploiting a classical lattice-gas model of hard-core monomers. The present article provides a more comprehensive version of the localized-magnon approach, which extends the range of its validity down to a less frustrated parameter region involving the Haldane and cluster-based Haldane ground states. A comparison between results of the developed localized-magnon theory and accurate numerical methods such as full exact diagonalization and finite-temperature Lanczos technique convincingly evidence that the low-temperature magnetic properties above the Haldane and the cluster-based Haldane ground states can be extracted from a classical lattice-gas model of hard-core monomers and dimers, which is additionally supplemented by a hard-core particle spanned over the whole lattice representing the gapped Haldane phase.

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