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1.
Gan To Kagaku Ryoho ; 51(2): 208-210, 2024 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-38449415

RESUMO

Since the insurance coverage of colorectal stents for bowel obstruction due to colorectal cancer in 2012, the use of colorectal stenting for palliation has rapidly spread. We report a case of ascending colon cancer in which a colorectal stent was placed for palliation, but the stent was reimplanted due to obstruction, followed by radical resection. The patient was a 92- year-old woman who was brought to the emergency room at the age of 90 years with repeated vomiting and abdominal pain, and was diagnosed as colorectal cancer ileus caused by ascending colon cancer, and a colorectal stent was inserted. She received palliative care and had been asymptomatic for 1 year and 3 months, but due to in-stent stenosis, she had bowel obstruction and sent to emergency room, and another stent was installed. The patient had a good course, but 4 months after the second stenting, she was concerned about restenosis and referred to the department of surgery, then performed a radical resection. The indication for colorectal stents for palliative purposes should be considered on a case-by- case basis, including ADL, stage of the disease, and prognosis.


Assuntos
Neoplasias do Colo , Obstrução Intestinal , Feminino , Humanos , Idoso de 80 Anos ou mais , Colo Ascendente , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Reimplante , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Stents , Constrição Patológica
2.
Int J Mol Sci ; 24(4)2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36835361

RESUMO

Here we aimed to establish a simple detection method for detecting circulating tumor cells (CTCs) in the blood sample of colorectal cancer (CRC) patients using poly(2-methoxyethyl acrylate) (PMEA)-coated plates. Adhesion test and spike test using CRC cell lines assured efficacy of PMEA coating. A total of 41 patients with pathological stage II-IV CRC were enrolled between January 2018 and September 2022. Blood samples were concentrated by centrifugation by the OncoQuick tube, and then incubated overnight on PMEA-coated chamber slides. The next day, cell culture and immunocytochemistry with anti-EpCAM antibody were performed. Adhesion tests revealed good attachment of CRCs to PMEA-coated plates. Spike tests indicated that ~75% of CRCs from a 10-mL blood sample were recovered on the slides. By cytological examination, CTCs were identified in 18/41 CRC cases (43.9%). In cell cultures, spheroid-like structures or tumor-cell clusters were found in 18/33 tested cases (54.5%). Overall, CTCs and/or growing circulating tumor cells were found in 23/41 CRC cases (56.0%). History of chemotherapy or radiation was significantly negatively correlated with CTC detection (p = 0.02). In summary, we successfully captured CTCs from CRC patients using the unique biomaterial PMEA. Cultured tumor cells will provide important and timely information regarding the molecular basis of CTCs.


Assuntos
Neoplasias Colorretais , Células Neoplásicas Circulantes , Humanos , Acrilatos/química , Neoplasias Colorretais/patologia , Células Neoplásicas Circulantes/patologia , Polímeros/química , Células Tumorais Cultivadas , Técnicas de Cultura de Células
3.
Gan To Kagaku Ryoho ; 50(13): 1889-1891, 2023 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-38303242

RESUMO

An 84-year-old man with gastric cancer, cT2N0M0, cStage Ⅰ underwent laparoscopic distal gastrectomy, D1+dissection, and Roux-en-Y reconstruction. We started enteral nutrition on the second postoperative day, but milky drainage appeared from the drain on the fifth postoperative day. The triglyceride in the ascites was markedly elevated, and it was diagnosed as a lymphorrhea. Neither conservative treatment nor lymphangiography were successful. We decided to perform surgical intervention because the lymphorrhea did not improve for about 1 month after gastrectomy. At laparotomy, we detected the lymphatic ducts using enteral nutrition of fat formulas during surgery and successfully closed the lymphatic ducts by suturing and ligation on the 38th postoperative day. Prolonged lymphorrhea causes extreme deterioration of the patient's general condition. Prolonged total parenteral nutrition also increases the risk of infection. It is important to perform surgical treatment for intractable lymphorrhea that does not improve with conservative treatment without hesitation.


Assuntos
Laparoscopia , Doenças Linfáticas , Neoplasias Gástricas , Masculino , Humanos , Idoso de 80 Anos ou mais , Gastroenterostomia/efeitos adversos , Laparoscopia/efeitos adversos , Gastrectomia/efeitos adversos , Anastomose em-Y de Roux/efeitos adversos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/complicações
4.
Int J Mol Sci ; 24(1)2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36614115

RESUMO

Alzheimer's disease (AD) is a common dementia disease in the elderly. To get a better understanding of the pathophysiology, we performed a proteomic analysis of the urine exosomes (U-exo) in AD model mice (J20). The polymer precipitation method was used to isolate U-exo from the urine of 3-month-old J20 and wild-type (WT) mice. Neuron-derived exosome (N-exo) was isolated from U-exo by immunoprecipitation. iTRAQ-based MALDI TOF MS/MS was used for proteomic analysis. The results showed that compared to WT, the levels of 61 and 92 proteins were increased in the J20 U-exo and N-exo, respectively. Gene ontology enrichment analysis demonstrated that the sphingolipid catabolic process, ceramide catabolic process, membrane lipid catabolic process, Aß clearance, and Aß metabolic process were highly enriched in U-exo and N-exo. Among these, Asah1 was shown to be the key protein in lipid metabolism, and clusterin, ApoE, neprilysin, and ACE were related to Aß metabolism and clearance. Furthermore, protein-protein interaction analysis identified four protein complexes where clusterin and ApoE participated as partner proteins. Thus, J20 U-exo and N-exo contain proteins related to lipid- and Aß-metabolism in the early stages of AD, providing a new insight into the underlying pathological mechanism of early AD.


Assuntos
Doença de Alzheimer , Exossomos , Camundongos , Animais , Camundongos Transgênicos , Peptídeos beta-Amiloides/metabolismo , Clusterina/metabolismo , Exossomos/metabolismo , Espectrometria de Massas em Tandem , Proteômica , Doença de Alzheimer/metabolismo , Apolipoproteínas E/metabolismo , Modelos Animais de Doenças , Precursor de Proteína beta-Amiloide/metabolismo
5.
Gan To Kagaku Ryoho ; 49(13): 1805-1807, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36733005

RESUMO

A 71-year-old man with pathological Stage Ⅰ(pT1bN0M0)underwent laparoscopic sigmoid colon cancer resection. After 18 months postoperatively, follow-up computed tomography(CT)showed a 30 mm enhanced soft tissue tumor near the anastomotic site. Considering the magnetic resonance imaging(MRI)and positron emission tomography(PET)results, we diagnosed sigmoid colon cancer with local recurrence. Laparoscopic radical resection of the colon and intestine, including the tumor, was performed. Pathologically, the tumor comprised spindle-shaped cells with collagen fibers and was diagnosed as a desmoid tumor by immunostaining(ß-catenin+, c-kit-, CD34-, α-SMA-, and DOG-1-). We report a case of intra-abdominal desmoid tumor near the anastomotic site after laparoscopic sigmoid colon cancer resection.


Assuntos
Fibromatose Abdominal , Fibromatose Agressiva , Laparoscopia , Neoplasias do Colo Sigmoide , Humanos , Fibromatose Abdominal/diagnóstico , Fibromatose Agressiva/cirurgia , Fibromatose Agressiva/diagnóstico , Recidiva Local de Neoplasia/cirurgia , Neoplasias do Colo Sigmoide/cirurgia , Neoplasias do Colo Sigmoide/patologia , Masculino , Idoso
6.
Gan To Kagaku Ryoho ; 49(13): 1896-1998, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36733036

RESUMO

BACKGROUND: Advanced gastric cancer with peritoneal dissemination is difficult to treat, although prognosis has improved with chemotherapy and the introduction of molecular targeted drugs. CASE: A 65-year-old male was diagnosed as type 3 advanced gastric cancer on the posterior wall of antrum by esophagogastroduodenoscopy for anemia screening. When the patient underwent radical surgery, multiple disseminated nodules(P1c)were detected. After chemotherapy(SOX, PTX plus RAM)was administered, the tumor shrank, and staging laparoscopy was performed. Since disseminated nodules have disappeared, distal gastrectomy(R0)was performed as conversion surgery. As postoperative adjuvant chemotherapy, S-1 was administered for about 1 year and 6 months. During repair of incisional hernia at 1 year postoperatively, the patient was confirmed to have no disseminated recurrence. The patient is currently alive with no sign of recurrence for 4 years.


Assuntos
Neoplasias Peritoneais , Neoplasias Gástricas , Masculino , Humanos , Idoso , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Neoplasias Peritoneais/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Peritônio/patologia , Prognóstico , Gastrectomia
7.
Gan To Kagaku Ryoho ; 49(13): 1727-1729, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36732980

RESUMO

A 78-year-female underwent distal gastrectomy for gastric cancer. The final diagnosis was moderately differentiated tubular adenocarcinoma, T4a, N2, M0, Stage ⅢB. Four years later, S6 hepatic metastasis and S9 pulmonary metastasis were detected. After 10 courses of S-1 plus oxaliplatin therapy, she received partial hepatectomy(S6). One year after hepatectomy, she underwent partial pulmonary resection for lung metastasis in the left lung(S9). Histopathological findings revealed the lung tumor was a pulmonary metastasis from gastric cancer with a small primary lung adenocarcinoma. There has been no recurrence for 30 months since the last operation.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Hepáticas , Neoplasias Pulmonares , Neoplasias Gástricas , Humanos , Feminino , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Gastrectomia , Hepatectomia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/secundário , Adenocarcinoma de Pulmão/cirurgia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/secundário , Adenocarcinoma/cirurgia
8.
Lab Invest ; 101(6): 690-700, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33782532

RESUMO

The purpose of the study was to uncover the role of tenascin X in modulation of healing in mouse corneas subjected to epithelium debridement. Healing in corneas with an epithelial defect was evaluated at the levels of gene and protein expression. Wound healing-related mediators and inflammatory cell infiltration were detected by histology, immunohistochemistry and real-time RT-PCR. Tenascin X protein was upregulated in the wounded wild-type (WT) corneal epithelium. The lack of tenascin X impaired closure of an epithelial defect and accelerated infiltration of neutrophils into the wound periphery as compared to the response in WT tissue. Expression of wound healing-related proinflammatory and reparative components, i.e., interleukin-6, transforming growth factor ß, matrix metalloproteinases, were unaffected by the loss of tenascin X expression. Marked accumulation of malondialdehyde (a lipid peroxidation-derived product) was observed in KO healing epithelia as compared with its WT counterpart. Neutropenia induced by systemic administration of a specific antibody rescued the impairment of epithelial healing in KO corneas, with reduction of malondialdehyde levels in the epithelial cells. Finally, we showed that a chemical scavenging reactive oxygen species reversed the impairment of attenuation of epithelial repair with a reduction of tissue levels of malondialdehyde. In conclusion, loss of tenascin X prolonged corneal epithelial wound healing and increased neutrophilic inflammatory response to debridement in mice. Tenascin X contributes to the control of neutrophil infiltration needed to support the regenerative response to injury and prevent the oxidative stress mediators from rising to cytotoxic levels.


Assuntos
Córnea/imunologia , Infiltração de Neutrófilos , Espécies Reativas de Oxigênio/metabolismo , Tenascina/fisiologia , Cicatrização/imunologia , Animais , Córnea/metabolismo , Camundongos Knockout
9.
BMC Surg ; 20(1): 80, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316959

RESUMO

BACKGROUND: The Fontan procedure has become the standard operation for patients with single ventricle physiology. Due to cardiac hypokinesis and high central venous pressure, laparoscopic approach, especially in hepatectomy, was considered as controversial after the Fontan procedure. We presented a case of hepatocellular carcinoma (HCC) that was successfully treated by pure laparoscopic hepatectomy with stable pneumoperitoneum after the Fontan procedure. CASE PRESENTATION: An 18-year-old man was referred to our hospital for examination of a hepatic tumor. The patient underwent the Fontan procedure for single ventricle physiology at 6 years of age. Abdominal contrast-enhanced computed tomography (CT) revealed a hypovascular mass in segment 2 and a hypervascular mass in segment 4 of the arterial phase, followed by a delayed washout. CT arteriography revealed that both masses showed hypervascular tumors, and CT during arterial portography showed that both were low-density masses. The patient's general condition was good, and cardiac and respiratory functions were well maintained. Pure laparoscopic hepatectomy was safely performed by keeping the pneumoteritoneum pressure under 6-8 mmHg and monitoring central venous pressure (11-21 mmHg) and end-tidal carbon dioxide. The Pringle maneuver was applied during hepatic resection. The non-anatomical resections were completed without intraoperative complications. The patient was discharged on the 9th postoperative day without postoperative complications. CONCLUSIONS: Our report suggests that treatment of HCC by pure laparoscopic hepatectomy after Fontan circulation can be safely performed in patients under sufficient circulatory management.


Assuntos
Carcinoma Hepatocelular/cirurgia , Técnica de Fontan/efeitos adversos , Neoplasias Hepáticas/cirurgia , Adolescente , Hepatectomia/métodos , Humanos , Laparoscopia/métodos , Masculino , Pneumoperitônio Artificial , Tomografia Computadorizada por Raios X
10.
Perfusion ; 35(7): 687-696, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32009532

RESUMO

INTRODUCTION: Whether hypothermic cardiopulmonary bypass could attenuate both blood coagulation and platelet activation compared to normothermic cardiopulmonary bypass remains elusive. METHODS: Biocompatibility of a polymer-coated cardiopulmonary bypass circuit was comparatively assessed by plasma proteomics between juvenile pigs undergoing hypothermic (23°C) cardiopulmonary bypass and those undergoing normothermic (37°C) cardiopulmonary bypass (n = 6, respectively). Plasma samples were taken three times: 5 minutes after initiation of cardiopulmonary bypass (T5, before cooling), just before declamping and rewarming (Tc), and just before termination of cardiopulmonary bypass (Trw, 120 minutes). Proteomic analysis was quantitively performed by isobaric tags for relative and absolute quantification labeling. Thrombin-antithrombin complexes (TAT III) were measured by enzyme immunoassay, and vitamin K-dependent protein C (PROC), ß-thromboglobulin (TG), and P-selectin were measured by enzyme-linked immunosorbent assay. Blood gas analyses evaluated oxygenator performance. RESULTS: Hypothermic cardiopulmonary bypass had a significantly higher PaO2 at Tc and lower PaCO2 at Trw than normothermic cardiopulmonary bypass. Two hundred twenty-four proteins were identified with statistical criteria of both protein confidence (>95%) and false discovery rate (<5%). Six of these proteins significantly decreased at Tc than at T5 in hypothermic cardiopulmonary bypass (p = 0.02-0.04), with three related to platelet degranulation. Protein C decreased at Trw compared with T5 in normothermic cardiopulmonary bypass (p = 0.04). Thrombin-antithrombin complex had a slightly larger increase with normothermic cardiopulmonary bypass at Trw than with hypothermic cardiopulmonary bypass. ß-thromboglobulin and P-selectin levels were significantly lower at Trw with hypothermic cardiopulmonary bypass than with normothermic cardiopulmonary bypass (p = 0.04). CONCLUSION: Hypothermic cardiopulmonary bypass attenuated platelet degranulation/blood coagulation and maintained better oxygenator performance compared to normothermic cardiopulmonary bypass in juvenile pigs.


Assuntos
Coagulação Sanguínea/fisiologia , Gasometria/métodos , Ponte Cardiopulmonar/métodos , Hipotermia Induzida/métodos , Oxigenadores de Membrana/normas , Animais , Humanos , Suínos
11.
J Stroke Cerebrovasc Dis ; 29(5): 104714, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32093992

RESUMO

BACKGROUND: When introducing a microguidewire into an occluded vessel during mechanical thrombectomy (MT), visual information on the vessel course distal to the occluded site could help to avoid perforation. We examined whether visualization of the middle cerebral artery (MCA) by coronal images of nonenhanced computed tomography (coronal CT) provides useful preoperative information on the vessel course in the setting of MT. METHODS AND RESULTS: We retrospectively studied 29 patients with ischemic stroke of the internal carotid artery and MCA occlusion who were admitted to our hospital within 4.5 hours from stroke onset and underwent MT. Coronal CT images were preoperatively created by a dedicated workstation and adjusted to visualize the M1 segment of the MCA (M1) and nearby areas. We referred to these images while performing MT. The shape and course of M1 on preoperative coronal CT images were compared with that in intraoperative angiography after recanalization. The median time from the start of imaging to arterial puncture was 40 minutes (interquartile range: 32.5-55.0 minutes). Successful recanalization of the thrombolysis in cerebral infarction 2b-3 was achieved in 89.7% of patients. The degree of matching was assessed as moderate to excellent, and was useful as preoperative information in 27 (93.1%) patients. CONCLUSIONS: Preoperative information on the vessel course by coronal CT well matched that in the intraoperative angiography. Only a little extra time and a small additional procedure are necessary for this technique. The addition of coronal CT images could contribute to a safe and successful MT.


Assuntos
Artéria Carótida Interna/diagnóstico por imagem , Estenose das Carótidas/terapia , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Infarto da Artéria Cerebral Média/terapia , Artéria Cerebral Média/diagnóstico por imagem , Trombectomia , Idoso , Idoso de 80 Anos ou mais , Artéria Carótida Interna/fisiopatologia , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/fisiopatologia , Circulação Cerebrovascular , Feminino , Humanos , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/fisiopatologia , Masculino , Artéria Cerebral Média/fisiopatologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Trombectomia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Fluxo de Trabalho
12.
Biochem Biophys Res Commun ; 512(4): 659-664, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-30922562

RESUMO

Tenascin-X (TNX), a glycoprotein of the extracellular matrix (ECM), is expressed in various tissues and plays an important role in ECM architecture. The TNXB gene encoding TNX is known as the gene responsible for classic-like Ehlers-Danlos syndrome (clEDS). To date, the role of TNX in dermal, muscular and obstetric features has been reported, but its role in bone homeostasis remains to be clarified. In this study, we found significant bone loss and upregulation of osteoclast marker gene expression in TNX-deficient mice. Further, TNX deficiency in the bone marrow promoted multinucleation of osteoclasts and resulted in increased bone resorption activity. These results indicate that multinucleated osteoclasts are the cause of bone loss in a TNX-deficient environment. Our findings provide new insight into the mechanism of osteoclast differentiation mediated by TNX and the pathology of clEDS.


Assuntos
Reabsorção Óssea/genética , Osteoclastos/patologia , Tenascina/genética , Animais , Reabsorção Óssea/patologia , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Regulação para Baixo , Deleção de Genes , Camundongos Endogâmicos C57BL , Osteoclastos/metabolismo , Regulação para Cima
13.
Exp Cell Res ; 363(1): 102-113, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29291401

RESUMO

Patients with tenascin-X (TNX)-deficient type Ehlers-Danlos syndrome (EDS) do not exhibit delayed wound healing, unlike classic type EDS patients, who exhibit mutations in collagen genes. Similarly, in TNX-knockout (KO) mice, wound closure of the skin is normal even though these mice exhibit a reduced breaking strength. Therefore, we speculated that the wound healing process may be affected in the absence of TNX. In this study, to investigate the effects of TNX absence on wound healing-related properties, we performed collagen gel contraction assays with wild-type (WT) and TNX-KO mouse embryonic fibroblasts (MEFs). Collagen gels with embedded TNX-KO MEFs showed significantly greater contraction than those containing WT MEFs. Subsequently, we assessed collagen gel contraction-related properties, such as the activities of matrix metalloproteinase (MMP)-2 and MMP-9 and the protein and mRNA expression levels of transforming growth factor ß1 (TGF-ß1) in the collagen gels. The activities of MMP-2 and MMP-9 and the expression level of TGF-ß1 were elevated in the absence of TNX. Furthermore, filopodia-like protrusion formation, cell proliferation, migration, and collagen expression in MEFs were promoted in the absence of TNX. These results indicate that these wound healing-related properties are affected in a TNX-deficient extracellular environment.


Assuntos
Colágeno/metabolismo , Fibroblastos/metabolismo , Tenascina/deficiência , Cicatrização/fisiologia , Animais , Células Cultivadas , Proteínas da Matriz Extracelular/metabolismo , Camundongos Endogâmicos C57BL , Modelos Teóricos , Proteínas do Tecido Nervoso/metabolismo , Pele/metabolismo , Tenascina/metabolismo , Fator de Crescimento Transformador beta1/metabolismo
14.
Biol Pharm Bull ; 42(9): 1596-1599, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474720

RESUMO

Joint hypermobility syndrome (JHS) (also termed hypermobility type Ehlers-Danlos syndrome, hEDS) is a heritable connective tissue disorder that is characterized by generalized joint hypermobility, chronic pain, fatigue, and minor skin changes. Initially, it was reported that there is a small subset of patients with JHS/hEDS who have haploinsufficiency of tenascin-X (TNX). However, the relationship between TNXB and JHS/hEDS has not been reported at all afterwards. EDS was reclassified into thirteen types in 2017, and the causative gene of JHS/hEDS remained to be identified. Therefore, in this study in order to determine whether JHS/hEDS can be diagnosed by the concentrations of serum form of TNX (sTNX), we measured the concentrations of sTNX in 17 JHS/hEDS patients. The sTNX concentrations in half of the JHS/hEDS patients were significantly lower than those in healthy individuals. No mutations, insertions or deletions were detected in the TNX exon sequence of the JHS/hEDS patients except for one in patient. That patient has a heterozygous mutation. A correlation between sTNX concentration and mutation of the TNXB genomic sequence was not found in the JHS/hEDS patients. These results indicate that the decrease in sTNX concentration could be used as a risk factor for JHS/hEDS.


Assuntos
Síndrome de Ehlers-Danlos/sangue , Instabilidade Articular/congênito , Tenascina/sangue , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Cromatografia Líquida , Síndrome de Ehlers-Danlos/genética , Feminino , Haploinsuficiência , Voluntários Saudáveis , Humanos , Instabilidade Articular/sangue , Instabilidade Articular/genética , Pessoa de Meia-Idade , Mutação , Sensibilidade e Especificidade , Espectrometria de Massas em Tandem , Tenascina/genética , Sequenciamento do Exoma , Adulto Jovem
15.
J Stroke Cerebrovasc Dis ; 28(10): 104301, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31375403

RESUMO

OBJECTIVE: The important factor for successful first-pass complete reperfusion (FPR) after combined techniques for mechanical thrombectomy (MT) is unclear. We consider that for successful FPR, the aspiration catheter (AC) should reach to and hold the thrombus before the device is pulled out. Therefore, we defined an ART (AC reached thrombus) sign characterized by the cessation of reverse blood flow in aspiration pump and deformation of stent retriever (SR) at the tip of AC. The purpose of this study was to identify the impact of the ART sign on the outcomes of the combined techniques. METHODS: A retrospective analysis was conducted between January 2015 and September 2018 on the data of consecutive patients who underwent MT for anterior circulation stroke using both SR and AC at the first-pass procedure. We divided the patients into 2 groups based on whether the first-pass procedure achieved the ART sign (ARTs group) or not (Non-ARTs group). The primary endpoint was FPR defined as modified thrombolysis in cerebral infarction (mTICI) score of 3. RESULTS: Sixty-six patients were included in our study (n = 38, ARTs group; n = 28, Non-ARTs group). There were no differences at mTICI 2b/3 (97.3% versus 89.2%, P = .30), but the FPR and mTICI3 were more common in the ARTs group (81.5% versus 14.2%, P < .001; and 89.4% versus 32.1%, P < .001, respectively). CONCLUSIONS: ART sign in combined technique was found to be an important factor for successful FPR.


Assuntos
Infarto Encefálico/terapia , Trombose Intracraniana/terapia , Reperfusão/instrumentação , Trombectomia/instrumentação , Dispositivos de Acesso Vascular , Idoso , Idoso de 80 Anos ou mais , Infarto Encefálico/diagnóstico por imagem , Infarto Encefálico/fisiopatologia , Circulação Cerebrovascular , Feminino , Humanos , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/fisiopatologia , Masculino , Reperfusão/efeitos adversos , Estudos Retrospectivos , Stents , Trombectomia/efeitos adversos , Resultado do Tratamento
16.
J Cell Mol Med ; 22(2): 948-956, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29160014

RESUMO

To determine the contribution by tenascin X (Tnx) gene expression to corneal stromal angiogenesis, the effects were determined of its loss on this response in TNX knockout (KO) mice. In parallel, the effects of such a loss were evaluated on vascular endothelial growth factor (VEGF) and transforming growth factor ß1 (TGFß1) gene and protein expression in fibroblasts and macrophages in cell culture. Histological, immunohistochemical and quantitative RT-PCR changes determined if Tnx gene ablation on angiogenic gene expression, inflammatory cell infiltration and neovascularization induced by central corneal stromal cauterization. The role was determined of Tnx function in controlling VEGF-A or TGFß1 gene expression by comparing their expression levels in ocular fibroblasts and macrophages obtained from wild-type (WT) and body-wide Tnx KO mice. Tnx was up-regulated in cauterized cornea. In Tnx KO, macrophage invasion was attenuated, VEGF-A and its cognate receptor mRNA expression along with neovascularization were lessened in Tnx KOs relative to the changes occurring in their WT counterpart. Loss of Tnx instead up-regulated in vivo mRNA expression of anti-angiogenic VEGF-B but not VEGF-A. On the other hand, TGFß1 mRNA expression declined in Tnx KO cultured ocular fibroblasts. Loss of Tnx gene expression caused VEGF-A expression to decline in macrophages. Tnx gene expression contributes to promoting TGFß1 mRNA expression in ocular fibroblasts and VEGF-A in macrophages, macrophage invasion, up-regulation of VEGF-A expression and neovascularization in an injured corneal stroma. On the other hand, it suppresses anti-angiogenic VEGF-B mRNA expression in vivo.


Assuntos
Neovascularização da Córnea/genética , Substância Própria/irrigação sanguínea , Substância Própria/lesões , Tenascina/deficiência , Tenascina/genética , Animais , Cauterização , Neovascularização da Córnea/patologia , Citocinas/metabolismo , Regulação da Expressão Gênica , Inflamação/patologia , Macrófagos/metabolismo , Macrófagos/patologia , Camundongos Endogâmicos C57BL , Camundongos Knockout , Miofibroblastos/metabolismo , Miofibroblastos/patologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo
17.
J Cell Biochem ; 119(6): 4352-4360, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-28981158

RESUMO

Low-intensity pulsed ultrasound (LIPUS) has been used as an adjunct to fracture healing therapies, but the mechanisms underlying its action are not known. We reported that sonic hedgehog (SHH) signaling was activated in osteoblasts at the dynamic remodeling site of a bone fracture. Mechanical stimulation is a crucial factor in bone remodeling, and it is related to the primary cilia as a sensor of hedgehog signaling. Here we observed that LIPUS promoted callus formation in accord with Gli2-positive cells after 14 days at the mouse femur fractured site compared with a control group. An immunofluorescence analysis showed that the numbers of primary cilia and cilia/osterix double-positive osteoblasts were increased at the fracture site by LIPUS. LIPUS stimulated not only the number and the length of primary cilia, but also the levels of ciliated protein, Ift88 mRNA, and SHH, Gli1, and Gli2 in MC3T3-E1 cells. Further experiments revealed that LIPUS stimulated osteogenic differentiation in the presence of smoothened agonist (SAG) treatment. These results indicate that LIPUS stimulates osteogenic differentiation and the maturation of osteoblasts by a primary cilium-mediated activation of hedgehog signaling.


Assuntos
Diferenciação Celular , Proteínas Hedgehog/metabolismo , Osteoblastos/metabolismo , Transdução de Sinais , Ondas Ultrassônicas , Animais , Masculino , Camundongos , Osteoblastos/citologia , Proteína GLI1 em Dedos de Zinco/metabolismo , Proteína Gli2 com Dedos de Zinco/metabolismo
18.
Odontology ; 106(4): 360-368, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29417376

RESUMO

The purpose of this study was to retrospectively evaluate and examine the incidence of complications using poly-L-lactic acid and polyglycolic acid (PLLA/PGA) copolymer plate system in maxillofacial osteosynthesis. The retrospective study included 87 patients (50 men, 37 women), who needed maxillofacial surgery. We examined the proportion of complications and their factors from clinical data. A comparison was also made for plate decomposition using the molecular weight of the plate without plate exposure and complications. Osteosynthesis sites healed in all patients. Ten cases (11.5%) showed plate exposure-related complications, with all occurring at intraoral surgical sites. There was no significant difference in molecular weight changes of plates in resorbable process. Statistical analysis of study variables between patients with and without exposed plates showed that the plate thickness was significantly associated with the risk of exposed plates (p < 0.05). The commercially available PLLA/PGA device could be a useful rapid resorbable material for maxillofacial osteosynthesis. When thick plates are used on the intraoral site, it may be necessary to pay attention to the complication of plate exposure. Even if exposure-related complications have occurred, resorption and degradation of this material proceeds, suggesting the ease of appropriate risk management.


Assuntos
Implantes Absorvíveis , Materiais Biocompatíveis/química , Placas Ósseas , Craniotomia/instrumentação , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Peso Molecular , Estudos Retrospectivos , Resultado do Tratamento
19.
Artigo em Inglês | MEDLINE | ID: mdl-30093825

RESUMO

Recent climate modeling studies have concluded that cumulative carbon emissions determine temperature increase, regardless of emission pathways. Accordingly, the optimal emission pathway can be determined from a socioeconomic standpoint. To access the path dependence of socioeconomic impacts for cumulative carbon emissions, we used a computable general equilibrium model to analyze impacts on major socioeconomic indicators on a global scale for 30-50 pathways with different emission reduction starting years, different subsequent emission pathways, and three different cumulative 2100 emission scenarios (emissions that meet the 2 °C target, the 2 °C target emissions plus 10 %, and emissions producing radiative forcing of 4.5 W/m2). The results show that even with identical cumulative emission figures, the resulting socioeconomic impacts vary by the pathway realized. For the United Nations 2 °C target, for example, (a) the 95 % confidence interval of cumulative global gross domestic product (GDP) is 1355-1363 trillion US dollars (2010-2100, discount rate = 5 %), (b) the cumulative GDP of pathways with later emission reduction starting years grows weaker (5 % significance level), and (c) emissions in 2100 have a moderate negative correlation with cumulative GDP. These results suggest that GDP loss is minimized with pathways with earlier emission reduction followed by more moderate reduction rates to achieve lower emission levels. Consequently, we suggest an early emission peak to meet the stringent target. In our model setting, it is desirable for emissions to peak by 2020 to reduce mitigation cost and by 2030 at the latest to meet the 2 °C target.

20.
Biosci Biotechnol Biochem ; 81(3): 587-594, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28052719

RESUMO

Polyamines have beneficial properties to prevent aging-associated diseases. Raw soybean has relatively high polyamine contents; and the fermented soybean natto is a good source of polyamines. However, detailed information of diversity of polyamine content in raw soybean is lacking. The objectives of this study were to evaluate differences of polyamines among raw soybeans and select the high polyamine-containing cultivar for natto production. Polyamine contents were measured chromatographically in 16 samples of soybean, which showed high variation among soybeans as follows: 93-861 nmol/g putrescine, 1055-2306 nmol/g spermidine, and 177-578 nmol/g spermine. We then confirmed the high correlations of polyamine contents between raw soybean and natto (r = 0.96, 0.95, and 0.94 for putrescine, spermidine, and spermine, respectively). Furthermore, comparison of the polyamine contents among 9 Japanese cultivars showed that 'Nakasen-nari' has the highest polyamine contents, suggesting its suitability for enhancement of polyamine contents of natto.


Assuntos
Glycine max/química , Glycine max/genética , Poliaminas/análise , Alimentos de Soja/análise , Bacillus subtilis/fisiologia , Análise de Alimentos , Japão , Alimentos de Soja/microbiologia
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