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1.
Nat Mater ; 18(7): 709-716, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31110345

RESUMO

Superconductivity in FeSe emerges from a nematic phase that breaks four-fold rotational symmetry in the iron plane. This phase may arise from orbital ordering, spin fluctuations or hidden magnetic quadrupolar order. Here we use inelastic neutron scattering on a mosaic of single crystals of FeSe, detwinned by mounting on a BaFe2As2 substrate to demonstrate that spin excitations are most intense at the antiferromagnetic wave vectors QAF = (±1, 0) at low energies E = 6-11 meV in the normal state. This two-fold (C2) anisotropy is reduced at lower energies, 3-5 meV, indicating a gapped four-fold (C4) mode. In the superconducting state, however, the strong nematic anisotropy is again reflected in the spin resonance (E = 3.6 meV) at QAF with incommensurate scattering around 5-6 meV. Our results highlight the extreme electronic anisotropy of the nematic phase of FeSe and are consistent with a highly anisotropic superconducting gap driven by spin fluctuations.

2.
Phys Rev Lett ; 118(10): 107203, 2017 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-28339266

RESUMO

Kitaev interactions underlying a quantum spin liquid have long been sought, but experimental data from which their strengths can be determined directly, are still lacking. Here, by carrying out inelastic neutron scattering measurements on high-quality single crystals of α-RuCl_{3}, we observe spin-wave spectra with a gap of ∼2 meV around the M point of the two-dimensional Brillouin zone. We derive an effective-spin model in the strong-coupling limit based on energy bands obtained from first-principles calculations, and find that the anisotropic Kitaev interaction K term and the isotropic antiferromagnetic off-diagonal exchange interaction Γ term are significantly larger than the Heisenberg exchange coupling J term. Our experimental data can be well fit using an effective-spin model with K=-6.8 meV and Γ=9.5 meV. These results demonstrate explicitly that Kitaev physics is realized in real materials.

3.
Phys Rev Lett ; 117(22): 227003, 2016 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-27925732

RESUMO

The origin of nematic order remains one of the major debates in iron-based superconductors. In theories based on spin nematicity, one major prediction is that the spin-spin correlation length at (0,π) should decrease with decreasing temperature below the structural transition temperature T_{s}. Here, we report inelastic neutron scattering studies on the low-energy spin fluctuations in BaFe_{1.935}Ni_{0.065}As_{2} under uniaxial pressure. Both intensity and spin-spin correlation start to show anisotropic behavior at high temperature, while the reduction of the spin-spin correlation length at (0,π) happens just below T_{s}, suggesting the strong effect of nematic order on low-energy spin fluctuations. Our results favor the idea that treats the spin degree of freedom as the driving force of the electronic nematic order.

4.
Phys Rev Lett ; 116(19): 197004, 2016 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-27232038

RESUMO

An essential step toward elucidating the mechanism of superconductivity is to determine the sign or phase of the superconducting order parameter, as it is closely related to the pairing interaction. In conventional superconductors, the electron-phonon interaction induces attraction between electrons near the Fermi energy and results in a sign-preserved s-wave pairing. For high-temperature superconductors, including cuprates and iron-based superconductors, prevalent weak coupling theories suggest that the electron pairing is mediated by spin fluctuations which lead to repulsive interactions, and therefore that a sign-reversed pairing with an s_{±} or d-wave symmetry is favored. Here, by using magnetic neutron scattering, a phase sensitive probe of the superconducting gap, we report the observation of a transition from the sign-reversed to sign-preserved Cooper-pairing symmetry with insignificant changes in T_{c} in the S-doped iron selenide superconductors K_{x}Fe_{2-y}(Se_{1-z}S_{z})_{2}. We show that a rather sharp magnetic resonant mode well below the superconducting gap (2Δ) in the undoped sample (z=0) is replaced by a broad hump structure above 2Δ under 50% S doping. These results cannot be readily explained by simple spin fluctuation-exchange pairing theories and, therefore, multiple pairing channels are required to describe superconductivity in this system. Our findings may also yield a simple explanation for the sometimes contradictory data on the sign of the superconducting order parameter in iron-based materials.

5.
Nature ; 457(7229): 569-72, 2009 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-19177126

RESUMO

The distribution of valence electrons in metals usually follows the symmetry of the underlying ionic lattice. Modulations of this distribution often occur when those electrons are not stable with respect to a new electronic order, such as spin or charge density waves. Electron density waves have been observed in many families of superconductors, and are often considered to be essential for superconductivity to exist. Recent measurements seem to show that the properties of the iron pnictides are in good agreement with band structure calculations that do not include additional ordering, implying no relation between density waves and superconductivity in these materials. Here we report that the electronic structure of Ba(1-x)K(x)Fe(2)As(2) is in sharp disagreement with those band structure calculations, and instead reveals a reconstruction characterized by a (pi, pi) wavevector. This electronic order coexists with superconductivity and persists up to room temperature (300 K).

6.
Transfus Med ; 25(5): 333-6, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26197879

RESUMO

BACKGROUND: Cis-AB, a rare ABO variant, is the result of a mutated ABO gene that produces a glycosyltransferase enzyme with dual A and B glycosyltransferase activity. It may lead to ABO discrepancies and a delay in establishing the blood group. To date, there have been no reports of a de novo mutation leading to a cis-AB allele. OBJECTIVES AND METHODS: Sequencing of the ABO gene using blood and hair follicle cells from the proposita were performed along with blood from her parents. To establish maternity and paternity, short tandem repeat (STR) analysis was also performed. The A and B enzyme activities of the novel enzyme were measured in an in vitro expression study. RESULTS: A novel cis-AB allele arising from nucleotide substitution c.796A>G (p.M266V) in the B glycosyltransferase gene were discovered in the blood and hair follicle cells from the proposita, which was absent from her parents. In all 15 autosomal STR loci analysed, the probability of maternity and paternity were 0.999999 and 0.999989, respectively. The novel enzyme created 33.1% and 60.2% of A and B antigen compared to wild type A and B glycosyltransferases. CONCLUSION: A novel mechanism leading to a cis-AB allele was discovered.


Assuntos
Sistema ABO de Grupos Sanguíneos/genética , Glicosiltransferases/genética , Mutação , Adulto , Alelos , Feminino , Humanos
7.
J Eur Acad Dermatol Venereol ; 29(4): 713-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25174801

RESUMO

BACKGROUND: Following the recent elucidation of its pathogenic mechanisms involving reactive oxygen species, use of vitamins, folic acid and antioxidants as adjuvant therapy has been suggested. OBJECTIVE: To evaluate the long-term outcome of childhood facial vitiligo who were treated with nutritional education, vitamin E (α-tocopherol 100-400 IU/day), folic acid (1-2 mg/day) and multivitamin intake and antioxidant cosmetics as the mainstay of treatment as well as the conventional therapies including oral, topical and/or intralesional corticosteroid, topical macrolactam, Excimer laser and epidermal graft. METHODS: Medical data and photographs of 111 paediatric facial vitiligo patients who had been followed up for longer than 1 year from March 1, 2003 to June 30, 2013 were extracted from data warehouse of electric medical records. Photographic evaluation and final visual outcome assessment was performed. RESULT: By investigator's assessment, 9% of patients demonstrated no improvement regardless of treatment modality, whereas 91% showed improvement of lesions. Among the latter, 33.3% resulted in >75% improvement; 18% in 50%-75% improvement; 26.1% in 25%-50% improvement; and 13.5% in <25% improvement. In the final visual outcome assessment, 'Looking excellent' was seen in 42.3%; 'looking very good' in 30.6%; 'looking good' in 17.1%; 'looking fair' in 9.0%; and 'looking bad' in 0.9%. CONCLUSION: Although childhood facial vitiligo is quite refractory to treatment, the long-term outcome of this condition is not dismal with conventional vitiligo therapy along with basic nutritional therapeutic regimen.


Assuntos
Dermatoses Faciais/terapia , Vitiligo/terapia , Adolescente , Corticosteroides/uso terapêutico , Antioxidantes/uso terapêutico , Criança , Pré-Escolar , Terapia Combinada , Dieta , Suplementos Nutricionais , Feminino , Ácido Fólico/uso terapêutico , Humanos , Lactente , Lactamas Macrocíclicas/uso terapêutico , Lasers de Excimer/uso terapêutico , Masculino , Necessidades Nutricionais , Educação de Pacientes como Assunto , Transplante de Pele , Fatores de Tempo , Resultado do Tratamento , Vitamina E/uso terapêutico
8.
Phys Rev Lett ; 113(14): 147206, 2014 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-25325658

RESUMO

We report a neutron scattering study of the magnetic order and dynamics of the bilayer perovskite Sr(3)Fe(2)O(7), which exhibits a temperature-driven metal-insulator transition at 340 K. We show that the Fe(4+) moments adopt incommensurate spiral order below T(N) = 115 K and provide a comprehensive description of the corresponding spin-wave excitations. The observed magnetic order and excitation spectra can be well understood in terms of an effective spin Hamiltonian with interactions ranging up to third-nearest-neighbor pairs. The results indicate that the helical magnetism in Sr(3)Fe(2)O(7) results from competition between ferromagnetic double-exchange and antiferromagnetic superexchange interactions whose strengths become comparable near the metal-insulator transition. They thus confirm a decades-old theoretical prediction and provide a firm experimental basis for models of magnetic correlations in strongly correlated metals.

9.
J Nutr Health Aging ; 27(11): 1018-1027, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37997724

RESUMO

OBJECTIVES: Dietary fiber intake is associated with a lower risk of diabetes, cardiovascular disease, and cancer. However, it is unknown whether dietary fiber has a beneficial effect on preventing the development of chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Using the UK Biobank prospective cohort, 110,412 participants who completed at least one dietary questionnaire and had an estimated glomerular filtration rate ≥60 mL/min/1.73 m2, urinary albumin-to-creatinine ratio <30 mg/g, and no history of CKD were included. The primary exposure was total dietary fiber density, calculated by dividing the absolute amount of daily total fiber intake by total energy intake (g/1,000 kcal). We separately examined soluble and insoluble fiber densities as additional predictors. The primary outcome was incident CKD based on diagnosis codes. RESULTS: A total of 3,507 (3.2%) participants developed incident CKD during a median follow-up of 9.9 years. In a multivariable cause-specific model, the adjusted hazard ratios (aHRs; 95% confidence intervals [CIs]) for incident CKD were 0.85 (0.77-0.94), 0.78 (0.70-0.86), and 0.76 (0.68-0.86), respectively, for the second, third, and highest quartiles of dietary fiber density (reference: lowest quartile). In a continuous model, the aHR for each +∆1.0g/1,000 kcal increase in dietary fiber density was 0.97 (95% CI, 0.95-0.99). This pattern of associations was similar for both soluble and insoluble fiber densities and did not differ across subgroups of sex, age, body mass index, hypertension, diabetes, smoking, and inflammation. CONCLUSION: Increased fiber intake was associated with a lower risk of CKD in this large well-characterized cohort.


Assuntos
Diabetes Mellitus , Insuficiência Renal Crônica , Humanos , Estudos Prospectivos , Bancos de Espécimes Biológicos , Fatores de Risco , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Taxa de Filtração Glomerular , Fibras na Dieta , Reino Unido/epidemiologia
10.
Diabetologia ; 55(4): 1205-17, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22311416

RESUMO

AIMS/HYPOTHESIS: Translationally controlled tumour protein (TCTP) is thought to be involved in cell growth by regulating mTOR complex 1 (mTORC1) signalling. As diabetes characteristically induces podocyte hypertrophy and mTORC1 has been implicated in this process, TCTP may have a role in the pathogenesis of diabetes-induced podocyte hypertrophy. METHODS: We investigated the effects and molecular mechanisms of TCTP in diabetic mice and in high glucose-stimulated cultured podocytes. To characterise the role of TCTP, we conducted lentivirus-mediated gene silencing of TCTP both in vivo and in vitro. RESULTS: Glomerular production of TCTP was significantly higher in streptozotocin induced-diabetic DBA/2J mice than in control animals. Double-immunofluorescence staining for TCTP and synaptopodin revealed that podocyte was the principal cell responsible for this increase. TCTP knockdown attenuated the activation of mTORC1 downstream effectors and the overproduction of cyclin-dependent kinase inhibitors (CKIs) in diabetic glomeruli, along with a reduction in proteinuria and a decrease in the sizes of podocytes as well as glomeruli. In addition, knockdown of TCTP in db/db mice prevented the development of diabetic nephropathy, as indicated by the amelioration of proteinuria, mesangial expansion, podocytopenia and glomerulosclerosis. In accordance with the in vivo data, TCTP inhibition abrogated high glucose-induced hypertrophy in cultured podocytes, which was accompanied by the downregulation of mTORC1 effectors and CKIs. CONCLUSIONS/INTERPRETATION: These findings suggest that TCTP might play an important role in the process of podocyte hypertrophy under diabetic conditions via the regulation of mTORC1 activity and the induction of cell-cycle arrest.


Assuntos
Biomarcadores Tumorais/metabolismo , Crescimento Celular , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Nefropatias Diabéticas/metabolismo , Podócitos/patologia , Animais , Quinases Ciclina-Dependentes/metabolismo , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 1/complicações , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/patologia , Inativação Gênica , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Masculino , Alvo Mecanístico do Complexo 1 de Rapamicina , Camundongos , Proteínas dos Microfilamentos/metabolismo , Complexos Multiproteicos , Podócitos/metabolismo , Proteínas/metabolismo , Serina-Treonina Quinases TOR , Proteína Tumoral 1 Controlada por Tradução
11.
Phys Rev Lett ; 107(17): 177005, 2011 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-22107568

RESUMO

We have studied the low-energy spin-excitation spectrum of the single-crystalline Rb(2)Fe(4)Se(5) superconductor (T(c)=32 K) by means of inelastic neutron scattering. In the superconducting state, we observe a magnetic resonant mode centered at an energy of ℏω(res)=14 meV and at the (0.5 0.25 0.5) wave vector (unfolded Fe-sublattice notation), which differs from the ones characterizing magnetic resonant modes in other iron-based superconductors. Our finding suggests that the 245-iron selenides are unconventional superconductors with a sign-changing order parameter, in which bulk superconductivity coexists with the √5×√5 magnetic superstructure. The estimated ratios of ℏω(res)/k(B)T(c)≈5.1±0.4 and ℏω(res)/2Δ≈0.7±0.1, where Δ is the superconducting gap, indicate moderate pairing strength in this compound, similar to that in optimally doped 1111 and 122 pnictides.

12.
Clin Nephrol ; 76(6): 447-54, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22105447

RESUMO

AIMS: In patients with immunoglobulin A (IgA) nephropathy, postnatal renal outcomes vary depending on kidney function and proteinuria. However, whether a decrease in proteinuria prior to conception improves postnatal maternal renal outcomes is unknown. METHODS: This was a single-center retrospective study. A total of 52 pregnant women with biopsy-proven IgA nephropathy were enrolled in the study between January 2004 and December 2009. We collected data on proteinuria, which had been measured 1 year prior to conception, at conception, during pregnancy, and postnatally. The study outcomes included changes in estimated glomerular filtration rate (eGFR) and proteinuria. RESULTS: The median serum creatinine, eGFR, and proteinuria levels at conception were 0.8 (0.5 - 2.6) mg/dl, 91.2 (24.1 - 157.0) ml/min, 0.7 (0.0 - 3.5) g/g, respectively. Compared with values measured at conception, serum creatinine (0.8 - 1.0 mg/dl, p < 0.01) and proteinuria (0.7 - 1.5 g/g, p < 0.01) increased significantly postnatally, while eGFR decreased (91.2 - 77.8 ml/min, p < 0.01). In a multiple linear regression analysis, proteinuria at conception were independently associated with a faster decline in postnatal maternal eGFR (ß = 4.50, p < 0.05). In addition, a less decline in maternal eGFR was observed in patients with a reduction in proteinuria (> 30%) prior to pregnancy, compared with those with a less reduction (≤ 30%). As for newborn outcomes, preterm delivery, caesarean section, low birth weight < 2,500 g, and need for neonatal intensive care were 15.4%, 46.2%, 25.0% and 7.7%, respectively. CONCLUSIONS: This study showed that in women with IgA nephropathy, proteinuria was significantly associated with the deterioration of postnatal maternal renal outcomes. Our study also suggests that a strategy for reducing proteinuria prior to pregnancy is required to preserve kidney function after delivery.


Assuntos
Glomerulonefrite por IGA/fisiopatologia , Rim/fisiopatologia , Complicações na Gravidez/fisiopatologia , Proteinúria/complicações , Adulto , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea , Feminino , Taxa de Filtração Glomerular , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos
13.
Phys Rev Lett ; 104(18): 187001, 2010 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-20482200

RESUMO

We report superconducting (SC) properties of stoichiometric LiFeAs (T(c)=17 K) studied by small-angle neutron scattering (SANS) and angle-resolved photoemission (ARPES). Although the vortex lattice exhibits no long-range order, well-defined SANS rocking curves indicate better ordering than in chemically doped 122 compounds. The London penetration depth lambda(ab)(0)=210+/-20 nm, determined from the magnetic field dependence of the form factor, is compared to that calculated from the ARPES band structure with no adjustable parameters. The temperature dependence of lambda(ab) is best described by a single isotropic SC gap Delta(0)=3.0+/-0.2 meV, which agrees with the ARPES value of Delta(0)(ARPES)=3.1+/-0.3 meV and corresponds to the ratio 2Delta/k(B)T(c)=4.1+/-0.3, approaching the weak-coupling limit predicted by the BCS theory. This classifies LiFeAs as a weakly coupled single-gap superconductor.

14.
Biotechnol Bioeng ; 105(2): 276-84, 2010 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-19731252

RESUMO

Process analytical technology (PAT) has been gaining momentum in the biotech community due to the potential for continuous real-time quality assurance resulting in improved operational control and compliance. In this two part series, we address PAT as it applies to processes that produce biotech therapeutic products. In the first part, we address evolution of the underlying concepts and applications in biopharmaceutical manufacturing. We also present a literature review of applications in the areas of upstream and downstream processing to illustrate how implementation of PAT can help realize advanced approaches to ensuring product quality in real time. In the second part, we will explore similar applications in the areas of drug product manufacturing, rapid microbiology, and chemometrics as well as evolution of PAT in biotech processing.


Assuntos
Biotecnologia/métodos , Biotecnologia/normas , Técnicas de Cultura de Células/métodos , Cromatografia/métodos , Meios de Cultura/química , Filtração/instrumentação , Filtração/métodos , Citometria de Fluxo/métodos , Polietilenoglicóis/química , Proteínas/química , Controle de Qualidade
15.
Biotechnol Bioeng ; 105(2): 285-95, 2010 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-19731253

RESUMO

Implementing real-time product quality control meets one or both of the key goals outlined in FDA's PAT guidance: "variability is managed by the process" and "product quality attributes can be accurately and reliably predicted over the design space established for materials used, process parameters, manufacturing, environmental, and other conditions." The first part of the paper presented an overview of PAT concepts and applications in the areas of upstream and downstream processing. In this second part, we present principles and case studies to illustrate implementation of PAT for drug product manufacturing, rapid microbiology, and chemometrics. We further present our thoughts on how PAT will be applied to biotech processes going forward. The role of PAT as an enabling component of the Quality by Design framework is highlighted. Integration of PAT with the principles stated in the ICH Q8, Q9, and Q10 guidance documents is also discussed.


Assuntos
Biotecnologia/métodos , Biotecnologia/normas , Técnicas de Cultura de Células/métodos , Técnicas de Cultura de Células/normas , Indústria Farmacêutica/normas , Liofilização/métodos , Liofilização/normas , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas , Controle de Qualidade , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Análise Espectral Raman/métodos , Estados Unidos , United States Food and Drug Administration
16.
Surg Radiol Anat ; 32(8): 753-6, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20512646

RESUMO

PURPOSE: The aim of this study was to clarify the morphology and topography of the deep layer of levator labii superioris alaeque nasi muscle (LLSAN) and the transverse part of the nasalis. Anatomical variations in the topographic relationships were also described to understand the function of the LLSAN and the transverse part of the nasalis. METHODS: Anatomical dissections were performed on 40 specimens of embalmed Korean adult cadavers. RESULTS: The LLSAN was divided into two layers, which were superficial and deep in the levator labii superioris muscle (LLS), respectively. The superficial layer of LLSAN descended on the LLS, and the deep layer was located deep in the LLS. The deep layer of LLSAN originated from the superficial layer of LLSAN and the frontal process of the maxilla. It inserted between the levator anguli oris and the orbicularis oris muscles. This transverse part of the nasalis received some muscle fibers from the superficial layer of LLSAN in 90% (36/40) of specimens. The transverse part of the nasalis originated from the maxilla and ascended, passing posterior to the superficial layer of LLSAN in 65% (26/40) of specimens. However, it originated as two muscle bellies from the maxilla and the upper half of the alar facial crease, respectively, in 35% (14/40) of specimens. CONCLUSIONS: These findings will be crucial data to understand the structure and function of the LLSAN and the transverse part of the nasalis.


Assuntos
Músculos Faciais/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/anatomia & histologia
17.
Nat Commun ; 11(1): 5728, 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33184278

RESUMO

A small in-plane external uniaxial pressure has been widely used as an effective method to acquire single domain iron pnictide BaFe2As2, which exhibits twin-domains without uniaxial strain below the tetragonal-to-orthorhombic structural (nematic) transition temperature Ts. Although it is generally assumed that such a pressure will not affect the intrinsic electronic/magnetic properties of the system, it is known to enhance the antiferromagnetic (AF) ordering temperature TN ( < Ts) and create in-plane resistivity anisotropy above Ts. Here we use neutron polarization analysis to show that such a strain on BaFe2As2 also induces a static or quasi-static out-of-plane (c-axis) AF order and its associated critical spin fluctuations near TN/Ts. Therefore, uniaxial pressure necessary to detwin single crystals of BaFe2As2 actually rotates the easy axis of the collinear AF order near TN/Ts, and such effects due to spin-orbit coupling must be taken into account to unveil the intrinsic electronic/magnetic properties of the system.

18.
Am J Transplant ; 9(10): 2424-8, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19624563

RESUMO

Domino kidney paired donation (KPD) is a method by which an altruistic living nondirected donor (LND) is allocated to a pool of incompatible donor-recipient pairs (DRP) and a series of KPDs is initiated. To evaluate the feasibility and clinical outcomes of multicenter domino KPD, we retrospectively analyzed a cohort of DRPs who underwent domino KPD between February 2001 and July 2007 at one of 16 transplant centers. One hundred seventy-nine kidney transplants were performed, with 70 domino chains initiated by altruistic LND. There were 45 two-pair chains, 15 three-pair chains, 7 four-pair chains, 2 five-pair chains and 1 six-pair chain. A majority of donors were spouses (47.5%) or altruistic LNDs (39.1%). DRPs with a blood type O recipient or an AB donor comprised 45.9% of transplanted DRPs. HLA mismatch improved in transplanted donors compared to intended donors in pairs enrolled to improve HLA mismatch (3.4 +/- 0.7 vs. 4.8 +/- 1.0, p < 0.001). One-year and 5-year graft survival rates were 98.3% and 87.7%, respectively, with a median follow-up of 46 months. One-year and 5-year patient survival rates were 97.2% and 90.8%, respectively. In conclusion, multicenter domino KPD could multiply the benefits of donation from LNDs, with patients and graft survival rates comparable to those seen with conventional KPD.


Assuntos
Transplante de Rim , Doadores de Tecidos , Altruísmo , Humanos , Resultado do Tratamento
19.
Ann Oncol ; 19(2): 321-6, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17962205

RESUMO

BACKGROUND: To determine the clinical and pathologic prognostic factors in surgically treated patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix (SCNEC). PATIENTS AND METHODS: We retrospectively reviewed a total of 68 patients with FIGO stage IB-IIA SCNEC surgically treated from January 1997 to December 2003 in Korea. RESULTS: Of the 68 patients, 43 had FIGO stage IB1 SCNEC, 15 had stage IB2, and 10 had stage IIA. Seven were treated with radical surgery alone; 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery; 24 with radical surgery followed by adjuvant chemotherapy; and 26 with radical surgery followed by adjuvant radiation or chemoradiation. After a median follow-up of 44 months (range, 6-113 months), the 2-year and 5-year survival rates for all patients were 64.6% and 46.6%, respectively. Univariate and multivariate analysis showed that FIGO stage was predictive of poor prognosis. Patients who received NACT showed poorer prognosis than those who did not receive NACT. Adjuvant chemoradiation did not improve survival compared with adjuvant chemotherapy alone. CONCLUSIONS: FIGO stage may act as a surrogate for factors prognostic of survival. Primary radical surgery followed by adjuvant chemotherapy is the preferred treatment modality for patients with early stage SCNEC.


Assuntos
Carcinoma Neuroendócrino/mortalidade , Carcinoma Neuroendócrino/cirurgia , Carcinoma de Células Pequenas/mortalidade , Carcinoma de Células Pequenas/cirurgia , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Biópsia por Agulha , Carcinoma Neuroendócrino/patologia , Carcinoma de Células Pequenas/patologia , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , Histerectomia/métodos , Imuno-Histoquímica , Coreia (Geográfico) , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Análise Multivariada , Estadiamento de Neoplasias , Probabilidade , Prognóstico , Modelos de Riscos Proporcionais , Radioterapia Adjuvante , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida , Resultado do Tratamento , Neoplasias do Colo do Útero/patologia
20.
QJM ; 111(6): 389-397, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29554373

RESUMO

BACKGROUND: Although asymptomatic microscopic hematuria (MH) is a common finding in clinical practice, its long-term outcome remains unknown. AIM: This study evaluated the clinical implication of MH in the general population using a large-scale long-term longitudinal cohort database. METHODS: This study included 8719 participants from the Korean Genome and Epidemiology Study between 2001 and 2014. MH was defined as ≥5 red blood cells per high-power field in random urinalysis without evidence of pyuria. The primary study outcome measure was incident chronic kidney disease (CKD), defined as estimated glomerular filtration rate <60 ml min-1⋅1.73⋅m-2. RESULTS: During a median follow-up of 11.7 years, CKD occurred in 677 (7.8%) subjects. In Cox regression after adjustment for multiple confounders, subjects with MH had a significantly higher risk of incident CKD than those without [hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.12-1.87; P = 0.005]. Isolated MH without proteinuria was also a risk factor of incident CKD (HR 1.37, 95% CI 1.04-1.79; P = 0.023) and the risk was further increased in MH with concomitant proteinuria (HR 5.41, 95% CI 2.54-11.49; P < 0.001). In propensity score matching analysis after excluding subjects with proteinuria, multi-variable stratified Cox regression analysis revealed that subjects with isolated MH had a significantly higher risk of incident CKD than those without (HR 1.83, 95% CI 1.14-2.94; P = 0.012). CONCLUSION: The presence of MH is associated with an increased risk of incident CKD in the general population. Therefore, attentive follow-up is warranted in persons with MH for early detection of CKD.


Assuntos
Hematúria/complicações , Hematúria/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , Progressão da Doença , Feminino , Taxa de Filtração Glomerular , Humanos , Incidência , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Prospectivos , Proteinúria/complicações , Fatores de Risco , Urinálise
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