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1.
Acta méd. colomb ; 46(1): 27-33, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1278152

ABSTRACT

Resumen Propósito: determinar la efectividad de detección de lesiones orales potencialmente malignas de cuatro métodos por medio de revisión sistemática tipo paraguas. Fuente de los datos: la búsqueda fue realizada con bases de datos Pubmed y EBSCOhost. Restricción de los años 2013-2018. Estrategia de búsqueda: (early detection of cáncer) AND (mouth neoplasms), (early detection of cáncer) AND (diagnostic techniques and procedures), (mouth neoplasms) AND (diagnostic techniques and procedures). Selección de los estudios: fueron seleccionadas a través de lectura crítica y la lista de chequeo del formato PRISMA, aquellas revisiones sistemáticas cuyo objetivo sea evaluar la efectividad de al menos uno de los métodos de detección de lesiones orales potencialmente malignas, seis estudios cumplieron con los criterios de inclusión. Extracción de datos: mediante la realización de lectura crítica de las revisiones sistemáticas seleccionadas previamente. Resultado de síntesis de los datos: se determina la efectividad a través de la comparación de las medias de porcentajes de sensibilidad y especificidad. Las medias de sensibilidad y especificidad de Vizilite fueron de 81.31 y 25.4%, de Microlux DL de 82.63 y 69.52%, de azul de toluidina de 82.07 y 66.27% y de citología exfoliativa de 76.77 y 80.87%, respectivamente. Conclusiones: los métodos de detección de lesiones orales premalignas evaluados en el presente estudio requieren mayor respaldo de evidencia científica para validar su efectividad. El método con mayor eficacia es el Microlux/DL, debido a sus altos niveles de sensibilidad y especificidad.


Abstract Objective: to determine the effectiveness of four methods for detecting potentially malignant oral lesions through an umbrella systematic review. Source of data: the search was performed in the PubMed and EBSCOhost databases. Years of search limited to 2013-2018. Search strategy: (early detection of cancer) AND (mouth neoplasms), (early detection of cancer) AND (diagnostic techniques and procedures), (mouth neoplasms) AND (diagnostic techniques and procedures). Study selection: using critical reading and the PRISMA checklist, systematic reviews with the objective of evaluating the effectiveness of at least one of the detection methods for potentially malignant oral lesions were selected; six studies met the inclusion criteria. Data extraction: through critical reading of the previously selected systematic reviews. Results of data synthesis: effectiveness was determined by comparing the mean percentages of sensitivity and specificity. Vizilite's sensitivity and specificity means were 81.31 and 25.4%, Microlux DL's were 82.63 and 69.52%, toluidine blue's were 82.07 and 66.27%, and exfoliative cytology's were 76.77 and 80.87%, respectively. Conclusions: the detection methods for pre-malignant oral lesions evaluated in this study need greater scientific evidence to validate their effectiveness. The method with the greatest effectiveness is Microlux/DL, due to its high levels of sensitivity and specificity.


Subject(s)
Mouth Neoplasms , Early Detection of Cancer , Sensitivity and Specificity , Diagnostic Techniques and Procedures , Cell Biology
2.
Rev. bras. anal. clin ; 53(1): 9-14, 20210330.
Article in Portuguese | LILACS | ID: biblio-1290893

ABSTRACT

Cervical cancer is the second neoplasm that most affects women in Brazil. It is a slow-progressing disease with well-defined stages. When diagnosed early, it has a high probability of cure, and it is essential to study methods that help in its diagnosis. The main factor associated with this neoplasm is infection with HPV, a virus that infects approximately 75% of sexually active people. Currently in Brazil the most used prevention method is the Pap smear test. With further studies on molecular biology and HPV, screening methods for cervical carcinoma have emerged, based on the detection of HPV DNA. Among these new methods is the double staining p16 / Ki-67, a technique developed aiming at a high specificity for detecting high-grade lesions. This is a bibliographic review work with the objective of discussing how biomolecular methods can be important tools for the early diagnosis of cervical cancer. The most used methods to diagnose HPV are cytopathological, colposcopic and histopathological exams, however these methods can present high variations in the detection of neoplastic lesions. With this study, we concluded the importance of using double staining p16 / Ki-67 for an accurate diagnosis in cases of cervical cancer.


O câncer de colo de útero (CCU) é a segunda neoplasia que mais acomete mulheres no Brasil. É uma doença de progressão lenta com estágios bem definidos. Quando diagnosticado precocemente tem grande probabilidade de cura, sendo indispensável o estudo sobre métodos que auxiliem no seu diagnóstico. O principal fator associado a essa neoplasia é a infecção pelo HPV, vírus que infecta aproximadamente 75% das pessoas sexualmente ativas. Atualmente, no Brasil, o método de prevenção mais utilizado é o exame citológico de Papanicolaou. Com maiores estudos sobre biologia molecular e HPV surgiram métodos de triagem do carcinoma cervical, baseados na detecção de DNA-HPV. Entre esses novos métodos está a coloração dupla p16/Ki-67, técnica desenvolvida visando uma alta especificidade para detecção de lesões de alto grau. Este é um trabalho de revisão bibliográfica com o objetivo de discutir como métodos biomoleculares podem ser ferramentas importantes para o diagnóstico precoce do câncer de colo de útero. Os métodos mais utilizados para diagnosticar o HPV são os exames citopatológicos, colposcópicos e histopatológicos, porém esses métodos podem apresentar altas variações na detecção de lesões neoplásicas. Com este estudo, concluímos a importância do uso da coloração dupla p16/Ki-67 para um diagnóstico preciso em casos de CCU.


Subject(s)
Uterine Cervical Neoplasms , Papillomavirus Infections , Cell Biology , Squamous Intraepithelial Lesions
3.
Autops. Case Rep ; 11: e2021278, 2021. graf
Article in English | LILACS | ID: biblio-1249013

ABSTRACT

Peritoneal lymphomatosis (PL) is a rare presentation of extranodal precursor leukemia/lymphoma. The presentation is often non-specific, leading to delayed diagnosis and treatment. In this case, though the preliminary diagnosis was established on ascitic fluid cytology, the disease progressed rapidly, leading to demise before initiating chemotherapy. Immunophenotyping and molecular studies, performed later, established a diagnosis of de novo B-cell precursor leukemia/lymphoma with MYC, BCL2 rearrangements (Double-hit lymphoma). MYC, BCL2 rearrangements are rarely reported in precursor B-lymphoma/leukemia which carry dismal prognosis. In this report, we illustrate autopsy findings of PL in an elderly gentleman who presented with ascites for evaluation.


Subject(s)
Humans , Male , Aged , Peritoneal Neoplasms , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/pathology , Ascites , Autopsy , Genes, myc , Cell Biology
4.
Med. lab ; 25(3): 565-567, 2021.
Article in Spanish | LILACS | ID: biblio-1343143

ABSTRACT

Los nódulos tiroideos siempre han sido considerados problemas comunes en la práctica clínica, y con el fin de estudiarlos se han buscado diferentes técnicas de aproximación y diagnóstico a lo largo de los años [1,2]. Esto ha contribuido al aumento en su incidencia, ya que a mayor número de estudios de imágenes realizados, aumenta la probabilidad de encontrarlos, puesto que tan solo el 50% son detectados por palpación al examen físico [3]. Es importante mencionar que a pesar de que solo el 5% de los nódulos tiroideos finalmente presentan un diagnóstico maligno y requieren manejo quirúrgico, hace algunos años se llevaban a cabo exámenes médicos diagnósticos y manejos quirúrgicos invasivos y exhaustivos que no eran prácticos, necesarios ni costo efectivos [4]. Fue solo hasta hace aproximadamente 40 años que se empezó a difundir el uso de la técnica diagnóstica desarrollada en 1950 por Söderstrom, Einhorn, Franzèn y Zajicek en el Hospital Radiumhelmet, de Estocolmo, Suecia, y considerada actualmente como la prueba de elección para la evaluación de nódulos tiroideos: la aspiración con aguja fina (ACAF), la cual se describe segura, precisa y rentable


Subject(s)
Humans , Thyroid Nodule , Cell Biology , Molecular Diagnostic Techniques
5.
Rev. medica electron ; 42(6): 2609-2620, nov.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1150041

ABSTRACT

RESUMEN Introducción: el cáncer de tiroides representa un 1% del total de todos los tipos de cáncer. Su incidencia parece aumentar un 4% cada año, y en la actualidad es el octavo cáncer más frecuente en mujeres. Se utilizan medios diagnósticos para definir que paciente operar y la estrategia terapéutica a seguir. Objetivo: evaluar el resultado de los medios diagnósticos en los pacientes operados de cáncer de tiroides. Materiales y métodos: se realizó un estudio descriptivo, retrospectivo y observacional que incluye todos los pacientes operados de cáncer tiroides en el servicio de Cirugía General del Hospital Universitario "Comandante Faustino Pérez Hernández", en el período desde enero de 1993 a diciembre del 2018. Se confeccionó una planilla pararecopilar la información para el estudio de la base de datos y los resultados se presentaron en tablas de frecuencia, números y porciento. Resultados: el cáncer de tiroides fue más frecuente en el grupo etario de 31 a 50 años, predomino el sexo femenino, la variedad histológica papilar fue la más frecuente, el ultrasonido y la citología con aguja fina aportan resultados favorables para definir la estirpe biológica de los tumores del tiroides, no comportándose de igual forma la biopsia por congelación. Conclusiones: el cáncer de tiroides es más frecuente en pacientes relativamente jóvenes, del sexo femenino y de variedad papilar. El ultrasonido y la citología con aguja fina aportan criterios beneficiosos para definir conducta terapéutica (AU).


SUMMARY Introduction: thyroid cancer represents 1% of the total of all kinds of cancer. Its incidence seems to increase 4% every year, and at the present time it is the eighth more frequent cancer in women. Diagnostic means are used to determine what patient undergoes a surgery and the therapeutic strategy to follow. Objective: to evaluate the results of the diagnostic means used in patients who undergo a thyroid cancer surgery. Materials and methods: a retrospective, descriptive, observational study was carried out including all patients who underwent a surgery of thyroid cancer in the service of General Surgery of the University Hospital ¨Comandante Faustino Perez Hernandez¨ in the period from January 1993 to December 2018. A form was elaborated to collect the information for the study of the database; the results were presented in charts of frequency, numbers and percentages. Results: the thyroid cancer was more frequent in the age group of 31 to 50 years; the female sex prevailed; the most frequent variety was the histological papillary one; ultrasound and fine needle cytology yield favourable results to define the biological stock of the thyroid cancers unlike the behaviour of the biopsy by freezing. Conclusions: thyroid cancer of the papillary variety is more frequent in relatively young, female patients. Ultrasound and fine needle cytology yield beneficial criteria to define the therapeutic behaviour (AU).


Subject(s)
Humans , Male , Female , Thyroid Neoplasms/diagnostic imaging , Ultrasonography/methods , Patients , Cell Biology/instrumentation , Thyroid Cancer, Papillary/diagnosis
6.
Oncol. (Guayaquil) ; 30(3): 204-214, Diciembre 30, 2020.
Article in Spanish | LILACS | ID: biblio-1145722

ABSTRACT

Introducción: La citología de nódulos tiroideos es una técnica que, evita procedimientos quirúrgicos innecesarios por lo que se lo ha determinado como primera línea dentro del algoritmo de diagnóstico, el objetivo del estudio fue determinar la sensibilidad y la especificidad de la citología y biopsia por congelación frente al estudio histopatológico en el diagnóstico de nódulos tiroideos en pacientes atendidos en Solca desde el año 2009 -2017. Métodos: Es un estudio de tipo observacional, retrospectivo y de correlación diagnóstica; los datos fueron obtenidos de las historias clínicas de pacientes intervenidos quirúrgicamente por nódulos tiroideos con biopsia por congelación, a quienes se les realizó previamente un estudio citológico en el Departamento de patología de SOLCA de la ciudad de Cuenca, Ecuador. El cálculo del tamaño de la muestra fue de 324 casos. Resultados:324 casos fueron incluidos. El 8.3% correspondió a hombres y el 91.7% a mujeres. La media de la edad fue 51.8 años; la gran mayoría provenían de la provincia Azuay con el 64.8%. En los estudios citológicos el 34.6% (112 casos)corresponden a lesiones inflamatorias benignas; el 11.1% [36 casos]a patologías malignas y 14.2% (46 casos)fueron insatisfactorios. En la biopsia por congelación el mayor porcentaje estuvo concentrado en enfermedades benignas con un 62.6% y 35.5% a lesiones malignas. Hubo 6 casos con el 1.9% en donde fue diferido el criterio diagnóstico. En el histopatológico definitivo el 60.2% (195 casos)fueron patologías benignas y el 39.8% (129 casos)fueron lesiones malignas. La sensibilidad de la PAAF frente a histopatológico es alta con un 91.79%, pero la especificidad es baja con un 51.94%. La sensibilidad y la especificidad de la biopsia por congelación frente a histopatológico es alta con un 98.97% y 90.70% respectivamente lo que le confiere una metodología óptima. Conclusiones: La PAAF de tiroides demuestra ser una metodología útil en el diagnóstico de nódulos, siempre y cuando sea realizada y observada por personal capacitado. La biopsia por congelación constituye una técnica con alta sensibilidad y especificidad que nos permite discriminar lesiones benignas de las malignas. Palabras claves: Nódulo tiroideo, Biopsia con Aguja, Servicio de Patología en Hospital, Oncología Médica, Agencias Voluntarias de Salud, Biología Celular, Biopsia con Aguja Fina


Introduction:Cytology of thyroid nodules is a technique that avoids unnecessary surgical procedures and has therefore been determined as the first line within the diagnostic algorithm.General Objective:To determine the sensitivity and specificity of cytology and freezing biopsy versus histopathological study in the diagnosis of thyroid nodules in patients treated in Solca since 2009 -2017. Methods:This is an observational, retrospective and diagnostic correlation study; the data were obtained from the clinical histories of patients surgically treated by thyroid nodules with freeze biopsy, who underwent a cytological study in the Department of pathology of the city of Cuenca, Ecuador. The calculation of the sample size was 324 cases. Results:8.3% corresponded to men and 91.7% to women. The mean age was 51.8 years; The vast majority came from the province of Azuay with 64.8%. In cytological studies, 34.6% [112 cases]correspond to benign inflammatory lesions; 11.1% [36 cases]to malignant pathologies and 14.2% [46 cases]were unsatisfactory. In the freeze biopsy the greater percentage was concentrated in benign diseases with 62.6% and 35.5% to malignant lesions. There were 6 cases with 1.9% where the diagnostic criterion was deferred. In the definitive histopathological, 60.2% [195 cases]were benign pathologies and 39.8% [129 cases]were malignant lesions. The sensitivity of FNAB to histopathological is high with 91.79%, but the specificity is low with 51.94%. The sensitivity and specificity of freezing versus histopathological biopsy is high with 98.97% and 90.70% respectively, which gives it an optimal methodology. Conclusions: Thyroid PAAF proves to be a useful methodology in the diagnosis of nodules, as long as it is performed and observed by trained personnel. Freezing biopsy is a technique with high sensitivity and specificity that allows us to discriminate benign from malignant lesions. Key words:Thyroid Nodule; Biopsy, Needle;Pathology Department, Hospital; Medical Oncology; Voluntary Health Agencies; Cell Biology; Biopsy, Fine-Needle


Subject(s)
Humans , Pathology Department, Hospital , Biopsy, Needle , Thyroid Nodule , Voluntary Health Agencies , Cell Biology , Biopsy, Fine-Needle , Medical Oncology
7.
Univ. salud ; 22(3): 231-237, set.-dic. 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1139844

ABSTRACT

Resumen Introducción: Actualmente, el cáncer de cérvix sigue siendo una enfermedad importante por su incidencia y mortalidad. Aunque se conoce su etiología generada por la infección del virus del Papiloma Humano (PVH) y sus métodos de tamizaje como la citología convencional y el test de ADN-PVH, aún es necesario reconocer diversas características que se relacionan con la aparición de este tipo de cáncer. Objetivo: Describir las características citológicas previas al diagnóstico de cáncer cervical en mujeres de una institución de salud de la ciudad de Medellín. Materiales y métodos: Estudio descriptivo. Se tomaron los registros clínicos correspondientes a mujeres con diagnóstico confirmado de cáncer de cérvix entre 2012 y 2017 y se revisaron los resultados de citología previos al diagnóstico. Se realizó análisis univariado para describir las variables de estudio. Resultados: La muestra de mujeres con cáncer fue de 714, la mediana de edad fue 51 años (rango intercuartílico: 42-60), la alteración citológica más frecuente fue lesión intraepitelial de alto grado (33,8%), el principal cáncer diagnosticado fue carcinoma escamocelular (70,6%). Conclusiones: Los resultados de citología alteradas son un indicador para riesgo de cáncer de cérvix, de ahí la importancia de continuar con el protocolo de tamizaje establecido.


Abstract Introduction: Currently, cervical cancer continues to be an important disease because of its high incidence and mortality. Even though its etiology (Human Papilloma Virus infection) and screening methods (conventional cytology and HPV-DNA test) are well known, understanding the various characteristics associated with the appearance of cervical cancer is fundamental. Objective: To describe the cytological characteristics that precede the diagnosis of cervical cancer in women diagnosed in a health care institution from the city of Medellín. Materials and methods: A descriptive study. The clinical records corresponding to women with a confirmed diagnosis of cervical cancer between 2012 and 2017 were used. Also, the citology results obtained before the diagnosis were reviewed. An univariate analysis was carried out in oder to describe the study variables. Results: The sample size of women with cervical cancer was 714, the age median was 51 years old (interquartile range: 42-60), the most frequent cytological alteration was high-grade intraepithelial lesion (33.8%), and the main diagnosed cancer type was squamous cell carcinoma (70.6%). Conclusions: Results showing an altered cytology are indicators of cervical cancer risk. Therefore, it is important to continue with the stablished screening protocol.


Subject(s)
Cervix Uteri , Cell Biology , Uterine Cervical Neoplasms , Colposcopy , Squamous Intraepithelial Lesions of the Cervix
8.
Rev. med. Risaralda ; 26(1): 28-37, ene.-jun. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1127001

ABSTRACT

Resumen Introducción: La infección genital por el Virus de Papiloma Humano (VPH) se ha asociado con el cáncer cérvicouterino (CCE) al provocar la aparición de lesiones precursoras de cáncer en la zona de transformación de la unión escamo-columnar del cuello uterino. Existen más de 100 tipos de VPH, clasificados en bajo riesgo oncogénico (VPH-BR) y alto riesgo oncogénico (VPH-AR). Estudios reportan la infección por genotipos de alto riesgo en el 100% de los CCE. En Venezuela, el 67,7% de los CCE, se relacionan con el genotipo de VPH-AR 16. Objetivo: Detectar la presencia de VPH en pacientes con cambios citológicos cervicouterino. Metodología: Se incluyeron 49 pacientes que presentaban cambios citológicos, se tomaron las muestras de la región endocervical y exocervical para la detección y genotipificación del virus mediante la técnica de Multiple PCR. Resultados: Las alteraciones citológicas presentes fueron Células Escamosas Atípicas (69,4%), Células Glandulares Atípicas (4,1%), Lesión Escamosa Intraepitelial de Bajo Grado (16,3%), y Lesión Escamosa Intraepitelial de Alto Grado (10,2%). La detección molecular demostró que 16,3% presentaba VPH, 62,5% correspondían a VPH-AR, 25% a VPH-BR, 12,5% al genotipo 16 y no se detectó el genotipo 18. Se reportó un solo caso de coinfección. Conclusiones: A diferencia de otros estudios, no se encontró una relación estadísticamente significativa entre la presencia del virus y la aparición de cambios citológicos cervicouterino en esta población. No obstante, se detectaron genotipos de alto riesgo oncogénico, lo que puede traducirse en una mayor incidencia de cáncer cervicouterino a futuro.


Abstract Introduction: Genital infection by the Human Papilloma Virus (HPV) has been associated with cervical cancer (CC) since it causes the appearance of precursor cancer lesions in the transformation area of ​​the squamous-columnar junction of the cervix. There are more than 100 types of HPV that are classified as low oncogenic risk (LR-HPV) and high oncogenic risk (HR-HPV). Studies report that the infection by high-risk genotypes is present in 100% of CC. In Venezuela, 67.7% of CC is related to the HPV-16 genotype. Objective: This study seeks to detect the presence of HPV in patients with cervical cytological cell changes. Methodology : Forty-nine patients with cytological changes were studied. The endocervical and ectocervical areas were sampled to detect and genotype the virus by using the Multiplex PCR technique. Results: The cytological alterations presented were: Atypical Squamous Cells (69.4%), Atypical Glandular Cells (4.1%), Low-grade Squamous Intraepithelial Lesion (16.3%) and High-grade Squamous Intraepithelial Lesion (10.2%). Besides, the general molecular detection showed that 16.3% had HPV, 62.5% of it corresponded to HR-HPV, 25% to LR-HPV, and 12.5% ​​to genotype 16. The genotype 18 was not detected, and only one co-infection case was reported. Conclusions: Unlike other studies, a statistically significant relationship was not found between the virus presence and the appearance of cervical cytological cell changes in this population. However, genotypes with high oncogenic risk were detected, which may lead to a higher incidence of cervical cancer in the future.


Subject(s)
Humans , Female , Papillomaviridae , Uterine Cervical Neoplasms , Cervix Uteri , Polymerase Chain Reaction , Cell Biology , Reproductive Tract Infections , Atypical Squamous Cells of the Cervix , Gynecology , Venezuela , Human papillomavirus 16 , Coinfection , Multiplex Polymerase Chain Reaction , Squamous Intraepithelial Lesions , Genitalia , Herpes Zoster
9.
Infectio ; 24(1): 20-26, ene.-mar. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1090539

ABSTRACT

Resumen Objetivos del trabajo: Se determinaron los porcentajes de las lesiones precancerosas de cuello uterino en un grupo de mujeres diagnosticadas positivas por la prueba ADN-VPH. Materiales y métodos: El presente estudio es un análisis exploratorio descriptivo transversal de una base de datos con resultados de las pruebas de ADN-VPH (genotipo y tipo de infección), citología y colposcopia, realizadas en 58 mujeres de 30 años o más, para el periodo de octubre del 2018 a febrero del 2019. Resultados: De las 58 mujeres positivas para la prueba ADN-VPH, el 57% (n=33) fueron positivas para la prueba citológica cervical. De este grupo de mujeres fueron diagnosticadas negativas para LEI el 21% (n=7); para LEI-BG el 33% (n=11); y para LEI-AG el 45% (n=15) mediante la prueba de colposcopia. El VPH-16 mostró la mayor frecuencia relativa de detección en las LEI-AG con un 46,7% (n=7). Igualmente, los genotipos que cubre la vacuna Gardasil_4 fueron identificados en mayor porcentaje en las LEI-AG en comparación con los otros tipos histopatológicos diagnosticados, siendo esta asociación estadísticamente significativa, valor de p = 0,033. Conclusiones: La implementación de la nueva guía de práctica clínica para la detección y manejo de lesiones precancerosas de cuello uterino muestra resultados satisfactorios, siendo concordante la detección de ADN-VPH, con la identificación de anormalidades citológicas e histopatológicas, permitiendo la identificación precoz de mujeres en riesgo de desarrollar cáncer cervical.


Abstract Objectives of the study: To determine the percentages of precancerous lesions in the cervix in a group of women with positive diagnostic to the DNA-HPV test. Materials and methods: The present study is a cross-sectional exploratory analysis of a database with information on the results of DNA-HPV tests (genotype and type of infection), cytology and colposcopy, carried out on 58 women aged 30 or older, for the period from October 2018 to February 2019. Results: Of the 58 women positive for the DNA-HPV test, 57% (n=33) were positive for the cervical cytology test. Of this group of women, 21% (n=7) were diagnosed LEI-negative; for LEI-BG 33% (n=11); and for LEI-AG, 45% (n=15) using the colposcopy test. HPV-16 has a higher detection frequency in the LEI-AG with 46.7% (n=7). Likewise, the genotypes that cover the Gardasil_4 vaccine were members in a greater percentage in the LEI-AG in comparison with other diagnosed histopathological types, this association being statistically significant, value of p = 0.033. Conclusions: The implementation of the new clinical practice guideline for the detection and management of precancerous lesions of the cervix shows satisfactory results, the DNA-HPV detection being consistent, with the identification of cytological and histopathological abnormalities, allowing the early identification of women at risk to develop cervical cancer.


Subject(s)
Humans , Female , Adult , Precancerous Conditions , Uterine Cervical Neoplasms , Practice Guideline , Cervix Uteri , Colombia , Colposcopy , Cell Biology
10.
Int. j. morphol ; 38(1): 26-29, Feb. 2020. graf
Article in English | LILACS | ID: biblio-1090663

ABSTRACT

Mitochondria (m) are responsible for the energy availability of cells, and their analysis is indicated for example, in studies related to metabolism and oxidative stress. The direct measurement of mitochondria (morphometry) is biased because of the section obliquity and position relative to the mitochondria length (non-equatorial cut). Therefore, stereology is an appropriate technique to evaluate mitochondria. However, before beginning the study, it is necessary to consider the premises to obtain random and uniform samples to be analyzed stereology. Mitochondria must have the chance to appear in all the possibilities of cut and orientation in the micrographs. The number of micrographs to be analyzed will depend on the distribution and occupation of mitochondria in the cell. After this is resolved, a proposal is the estimation of the following stereological data: volume density (Vv), surface density (Sv), and mean cross-sectional area (A). Overlapping a known test area at each micrograph, the density by area of mitochondria is estimated (NAT). Vv [m] can easily be estimated by point-counting (Vv = Pp/PT; Pp are the points hitting the structure, PT are the number of points of the test system). Sv is estimated overlaying a test-line (LT) on the micrographs and counting the intersections of the lines (I) with the outer membrane (om), inner membrane (im), and crests (c), thus, Sv [om], Sv [im], Sv [c] (Sv = 2I / LT). A [m] is obtained as the ratio: A = Vv / 2NAT.


Las mitocondrias (m) son responsables de la disponibilidad de energía de las células, y su análisis está indicado, por ejemplo, en estudios relacionados con el metabolismo y el estrés oxidativo. La medición directa de las mitocondrias (morfometría) está sesgada debido a la oblicuidad de la sección y la posición relativa a la longitud de las mitocondrias (corte no ecuatorial). Por lo tanto, la estereología es una técnica apropiada para evaluar las mitocondrias. Sin embargo, antes de comenzar el estudio, es necesario considerar las premisas para obtener muestras aleatorias y uniformes para analizar estereológicamente. Es esencial que las mitocondrias tengan la posibilidad de aparecer en todas las posibilidades de corte y orientación en las micrografías. El número de micrografías que se analizarán dependerá de la distribución y ocupación de las mitocondrias en la célula. Una vez resuelto esto, una propuesta es la estimación de los siguientes datos estereológicos: densidad de volumen (Vv), densidad de superficie (Sv) y área de sección transversal media (A). Superponiendo un área de prueba conocida en cada micrografía, se estima la densidad por área de mitocondrias (NAT). Vv [m] se puede estimar fácilmente contando puntos (Vv = Pp / PT; Pp son los puntos que llegan a la estructura, PT son el número de puntos del sistema de prueba). Sv se estima superponiendo una línea de prueba (LT) en las micrografías y contando las intersecciones de las líneas (I) con la membrana externa (om), la membrana interna (im) y las crestas (c), por lo tanto, Sv [om], Sv [im], Sv [c] (Sv = 2I / LT). A [m] se obtiene como la relación: A = Vv / 2NAT.


Subject(s)
Microscopy, Electron, Transmission , Mitochondria/ultrastructure , Cell Biology
11.
Rev. salud bosque ; 10(1): 1-11, 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1104443

ABSTRACT

El fluido lagrimal se caracteriza por ser una mezcla de moléculas que incluye proteínas, lípidos, metabolitos, entre otros; estas moléculas juegan un papel importante en la fisiopatología de distintas enfermedades, por lo cual las lágrimas han sido de gran interés para la comunidad científica en la búsqueda de biomarcadores y en el desarrollo de estrategias terapéuticas para enfermedades sistémicas y oculares. La poca invasividad y el bajo riesgo al obtener la lágrima la convierten en una interesante muestra en comparación con algunos fluidos corporales que pueden ser mucho más costosos y molestos para su obtención. Lo anterior ha sido demostrado en diversos estudios que sugieren estrategias para obtener la muestra e indican un posterior análisis mediante avanzadas técnicas de biología molecular y celular, entre ellas los análisis ómicos, que han logrado una mejor caracterización lagrimal.Los análisis ómicos han contribuido en la identificación diferencial de distintas moléculas que pueden desempeñar un papel importante en el diagnóstico, seguimiento y/o tratamiento de enfermedades oculares y sistémicas. Por tanto, el propósito del presente artículo fue describir las diferentes características del fluido lagrimal, así como los posibles candidatos de biomarcadores de patologías oculares y sistémicas reportados.


The lacrimal fluid is characterized by a mixture of molecules from proteins, lipids, metabolites among others, which play an important role in the pathophysiology of different diseases, for which it has been of great interest in the scientific community for the search of biomarkers and development of therapeutic strategies in systemic and eye diseases. The lower invasiveness and risk when obtaining the tear, makes it an interesting sample compared to some bodily fluids that can be much more expensive and annoying to obtain. The above has been demonstrated through various studies in which they suggest different strategies to obtain the sample and its subsequent analysis using techniques of molecular and cellular biology among them advanced molecular technology such as those such as omic analyses, which have achieved a better lacrimal characterization. These analyses have contributed to the differential identification of different molecules that may play an important role in the diagnosis, monitoring and/or treatment of eye and systemic diseases. The purpose of this article is to describe the different characteristics of the tear fluid as well as the possible candidates for biomarkers of mainly reported eye and systemic pathologies.


O líquido lacrimal é caracterizado por ser uma mistura de moléculas que inclui proteínas, lipídios, metabólitos, entre outros; Essas moléculas desempenham um papel importante na fisiopatologia de diferentes doenças, motivo pelo qual as lágrimas têm sido de grande interesse para a comunidade científica na busca de biomarcadores e no desenvolvimento de estratégias terapêuticas para doenças sistêmicas e oculares. A baixa invasividade e o baixo risco de obter a lágrima fazem dela uma amostra interessante em comparação com alguns fluidos corporais que podem ser muito mais caros e problemáticos de obter. Isso foi demonstrado em vários estudos que sugerem estratégias para obter a amostra e indicam uma análise subsequente usando técnicas avançadas de biologia molecular e celular, incluindo análise ômica, que alcançaram melhor caracterização das lágrimas.A análise ômica contribuiu para a identificação diferencial de diferentes moléculas que podem desempenhar um papel importante no diagnóstico, monitoramento e / ou tratamento de doenças oculares e sistêmicas. Portanto, o objetivo deste artigo foi descrever as diferentes características do líquido lacrimal, bem como os possíveis candidatos a biomarcadores de patologias oculares e sistêmicas relatadas.


Subject(s)
Tears , Technology , Therapeutics , Methods , Cell Biology , Eye , Molecular Biology
12.
Rev. bras. ciênc. saúde ; 24(1): 17-28, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1087470

ABSTRACT

Objetivo: Conhecer a tendência temporal de realização da citologia oncótica e identificar fatores associados à realização do exame em algum momento da vida e nos últimos três anos. Metodologia: Trata-se de um estudo epidemiológico, utilizando dados autorreferidos por mulheres, de 25 a 64 anos, oriundos do estudo transversal Vigitel. Para análise da tendência, dados de 2007 a 2015 da Capital João Pessoa, PB, foram analisados por meio de regressão linear simples e, para identificação dos fatores associados, razões de prevalências foram estimadas utilizando-se regressão de Poisson com dados de 2015. Resultados: A realização da citologia oncótica permaneceu, praticamente, estável no período de 2007 a 2015. Dentre as variáveis analisadas, a faixa etária manteve-se associada a uma maior prevalência de realização do exame nos dois desfechos e o estado civil casado/união estável manteve-se associado à maior prevalência de realização do exame em algum momento da vida; a escolaridade de 9 a 11 anos de estudo apresentou uma associação negativa com a realização do exame nos últimos três anos. Conclusão: A cobertura da citologia oncótica não foi satisfatória entre as mulheres de João Pessoa, Paraíba. A faixa etária mais avançada e as mulheres casadas ou em união estável apresentaram maior prevalência de realização do exame.(AU)


Objective: Know the time trend of performing cytology smears and identifying factors associated with performing the examination at some point in life and in the last three years. Methodology: It is an epidemiological study using self-reported data by women from 25 to 64 years old, from the cross-sectional Vigitel study. For the trend analysis, data from 2007 to 2015 in the city of João Pessoa, Paraiba, were analyzed by means of simple linear regression, and to identify associated factors, prevalence ratios were estimated using Poisson Regression, with data from 2015. Results: Oncotic cytology was practically stable from 2007 to 2015. Among the analyzed variables, age remained associated with a higher prevalence of performing the examination in both outcomes and the marital status married/in a stable union remained associated with a higher prevalence of performing the examination at any lifetime; education from 9 to 11 years of schooling showed a negative association with the completion of the exam in the last three years. Conclusion: The coverage of the Pap smear exam was not satisfactory among women in Joao Pessoa. The advanced age and married/in a stable union woman had higher prevalence of performing the examination. (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms , Cell Biology , Papanicolaou Test , Neoplasms
13.
Orient Journal of Medicine ; 32(1-2): 28-38, 2020. tab
Article in English | AIM | ID: biblio-1268294

ABSTRACT

Background:A majority of breast lesionisbenignin nature; benignbreast disease is four times more commonin Nigerian women. The percentage of unsatisfactory smears in breast cytology appears to behigher in benign conditions compared to malignant ones.The aim of this study is to determine the effectiveness of cytopathology in the diagnosis of benign breast disease in our institution.Methodology: This is a prospective study of 96 patients with benign breast disease seen during the study period. The patients were subjected to clinical assessment, fine needle aspiration cytology (FNAC) and open biopsy histopathology (as standardreference test).Results:One hundred andseventy-fourpatients with both FNACand histopathology reports were initially evaluated, 96 (55.2%) had benign while the rest (78, 44.8%) harbored malignant lumps. On analysis of the benign lumps, FNAC achieved high sensitivity (98.8%), specificity (96.9%) and overall diagnostic accuracy (98.0%) compared to clinical assessment with values of 83.3% (sensitivity), 82.1% (specificity) and 82.2% (overall diagnostic accuracy). The false positive rate (FPR, 2.3%) and false negative rate(FNR, 1.6%) reported for FNAC were equally better than figures of 14.9% (FPR) and 20.0% (FNR) documented for clinical assessment.Cytopathology was utilized insubclassifying 76 (79.2%) out of the 96 biopsy confirmed benign lumps; 49 slides were correctly typed giving a concordant rate of 64.5%.Conclusion:Fine needle aspiration cytology in our index study showed appreciable concordance with open biopsy histologyin the diagnosis and sub-classification of benign breast disease


Subject(s)
Biopsy , Cell Biology , Needles , Nigeria
14.
Article in English | WPRIM | ID: wpr-828960

ABSTRACT

Once pulp necrosis or apical periodontitis occurs on immature teeth, the weak root and open root apex are challenging to clinicians. Berberine (BBR) is a potential medicine for bone disorders, therefore, we proposed to apply BBR in root canals to enhance root repair in immature teeth. An in vivo model of immature teeth with apical periodontitis was established in rats, and root canals were filled with BBR, calcium hydroxide or sterilized saline for 3 weeks. The shape of the roots was analyzed by micro-computed tomography and histological staining. In vitro, BBR was introduced into stem cells from apical papilla (SCAPs). Osteogenic differentiation of stem cells from apical papilla was investigated by alkaline phosphatase activity, mineralization ability, and gene expression of osteogenic makers. The signaling pathway, which regulated the osteogenesis of SCAPs was evaluated by quantitative real time PCR, Western blot analysis, and immunofluorescence. In rats treated with BBR, more tissue was formed, with longer roots, thicker root walls, and smaller apex diameters. In addition, we found that BBR promoted SCAPs osteogenesis in a time-dependent and concentration-dependent manner. BBR induced the expression of β-catenin and enhanced β-catenin entering into the nucleus, to up-regulate more runt-related nuclear factor 2 downstream. BBR enhanced root repair in immature teeth with apical periodontitis by activating the canonical Wnt/β-catenin pathway in SCAPs.


Subject(s)
Animals , Berberine , Pharmacology , Cell Differentiation , Dental Papilla , Male , Osteogenesis , Periapical Periodontitis , Therapeutics , Rats , Stem Cells , Cell Biology , Metabolism , Wnt Signaling Pathway , Wnt3A Protein , Genetics , Metabolism , X-Ray Microtomography
15.
Article in English | WPRIM | ID: wpr-828956

ABSTRACT

A splicing mutation in VPS4B can cause dentin dysplasia type I (DD-I), a hereditary autosomal-dominant disorder characterized by rootless teeth, the etiology of which is genetically heterogeneous. In our study, dental follicle cells (DFCs) were isolated and cultured from a patient with DD-I and compared with those from an age-matched, healthy control. In a previous study, this DD-I patient was confirmed to have a loss-of-function splicing mutation in VPS4B (IVS7 + 46C > G). The results from this study showed that the isolated DFCs were vimentin-positive and CK14-negative, indicating that the isolated cells were derived from the mesenchyme. DFCs harboring the VPS4B mutation had a significantly higher proliferation rate from day 3 to day 8 than control DFCs, indicating that VPS4B is involved in cell proliferation. The cells were then replenished with osteogenic medium to investigate how the VPS4B mutation affected osteogenic differentiation. Induction of osteogenesis, detected by alizarin red and alkaline phosphatase staining in vitro, was decreased in the DFCs from the DD-I patient compared to the control DFCs. Furthermore, we also found that the VPS4B mutation in the DD-I patient downregulated the expression of osteoblast-related genes, such as ALP, BSP, OCN, RUNX2, and their encoded proteins. These outcomes confirmed that the DD-I-associated VPS4B mutation could decrease the capacity of DFCs to differentiate during the mineralization process and may also impair physiological root formation and bone remodeling. This might provide valuable insights and implications for exploring the pathological mechanisms underlying DD-I root development.


Subject(s)
ATPases Associated with Diverse Cellular Activities , Genetics , Case-Control Studies , Cell Differentiation , Genetics , Cells, Cultured , Dental Sac , Cell Biology , Dentin Dysplasia , Genetics , Pathology , Endosomal Sorting Complexes Required for Transport , Genetics , Humans , Mutation , Genetics , Osteogenesis , Genetics , RNA Splicing , Genetics
16.
Protein & Cell ; (12): 740-770, 2020.
Article in English | WPRIM | ID: wpr-828746

ABSTRACT

Age-associated changes in immune cells have been linked to an increased risk for infection. However, a global and detailed characterization of the changes that human circulating immune cells undergo with age is lacking. Here, we combined scRNA-seq, mass cytometry and scATAC-seq to compare immune cell types in peripheral blood collected from young and old subjects and patients with COVID-19. We found that the immune cell landscape was reprogrammed with age and was characterized by T cell polarization from naive and memory cells to effector, cytotoxic, exhausted and regulatory cells, along with increased late natural killer cells, age-associated B cells, inflammatory monocytes and age-associated dendritic cells. In addition, the expression of genes, which were implicated in coronavirus susceptibility, was upregulated in a cell subtype-specific manner with age. Notably, COVID-19 promoted age-induced immune cell polarization and gene expression related to inflammation and cellular senescence. Therefore, these findings suggest that a dysregulated immune system and increased gene expression associated with SARS-CoV-2 susceptibility may at least partially account for COVID-19 vulnerability in the elderly.


Subject(s)
Adult , Aged , Aged, 80 and over , Aging , Genetics , Allergy and Immunology , Betacoronavirus , CD4-Positive T-Lymphocytes , Metabolism , Cell Lineage , Chromatin Assembly and Disassembly , Coronavirus Infections , Allergy and Immunology , Cytokine Release Syndrome , Allergy and Immunology , Cytokines , Genetics , Disease Susceptibility , Flow Cytometry , Methods , Gene Expression Profiling , Gene Expression Regulation, Developmental , Gene Rearrangement , Humans , Immune System , Cell Biology , Allergy and Immunology , Immunocompetence , Genetics , Inflammation , Genetics , Allergy and Immunology , Mass Spectrometry , Methods , Middle Aged , Pandemics , Pneumonia, Viral , Allergy and Immunology , Sequence Analysis, RNA , Single-Cell Analysis , Transcriptome , Young Adult
17.
Protein & Cell ; (12): 740-770, 2020.
Article in English | WPRIM | ID: wpr-828582

ABSTRACT

Age-associated changes in immune cells have been linked to an increased risk for infection. However, a global and detailed characterization of the changes that human circulating immune cells undergo with age is lacking. Here, we combined scRNA-seq, mass cytometry and scATAC-seq to compare immune cell types in peripheral blood collected from young and old subjects and patients with COVID-19. We found that the immune cell landscape was reprogrammed with age and was characterized by T cell polarization from naive and memory cells to effector, cytotoxic, exhausted and regulatory cells, along with increased late natural killer cells, age-associated B cells, inflammatory monocytes and age-associated dendritic cells. In addition, the expression of genes, which were implicated in coronavirus susceptibility, was upregulated in a cell subtype-specific manner with age. Notably, COVID-19 promoted age-induced immune cell polarization and gene expression related to inflammation and cellular senescence. Therefore, these findings suggest that a dysregulated immune system and increased gene expression associated with SARS-CoV-2 susceptibility may at least partially account for COVID-19 vulnerability in the elderly.


Subject(s)
Adult , Aged , Aged, 80 and over , Aging , Genetics , Allergy and Immunology , Betacoronavirus , CD4-Positive T-Lymphocytes , Metabolism , Cell Lineage , Chromatin Assembly and Disassembly , Coronavirus Infections , Allergy and Immunology , Cytokine Release Syndrome , Allergy and Immunology , Cytokines , Genetics , Disease Susceptibility , Flow Cytometry , Methods , Gene Expression Profiling , Gene Expression Regulation, Developmental , Gene Rearrangement , Humans , Immune System , Cell Biology , Allergy and Immunology , Immunocompetence , Genetics , Inflammation , Genetics , Allergy and Immunology , Mass Spectrometry , Methods , Middle Aged , Pandemics , Pneumonia, Viral , Allergy and Immunology , Sequence Analysis, RNA , Single-Cell Analysis , Transcriptome , Young Adult
18.
Article in Chinese | WPRIM | ID: wpr-828531

ABSTRACT

Neurons are the structural and functional unit of the nervous system. Precisely regulated dendrite morphogenesis is the basis of neural circuit assembly. Numerous studies have been conducted to explore the regulatory mechanisms of dendritic morphogenesis. According to their action regions, we divide them into two categories: the intrinsic and extrinsic regulators of neuronal dendritic morphogenesis. Intrinsic factors are cell type-specific transcription factors, actin polymerization or depolymerization regulators and regulators of the secretion or endocytic pathways. These intrinsic factors are produced by neuron itself and play an important role in regulating the development of dendrites. The extrinsic regulators are either secreted proteins or transmembrane domain containing cell adhesion molecules. They often form receptor-ligand pairs to mediate attractive or repulsive dendritic guidance. In this review, we summarize recent findings on the intrinsic and external molecular mechanisms of dendrite morphogenesis from multiple model organisms, including , and mice. These studies will provide a better understanding on how defective dendrite development and maintenance are associated with neurological diseases.


Subject(s)
Animals , Caenorhabditis elegans , Cell Biology , Dendrites , Mice , Morphogenesis , Nervous System Diseases , Neurons , Cell Biology , Transcription Factors , Metabolism
19.
Article in Chinese | WPRIM | ID: wpr-828518

ABSTRACT

OBJECTIVE@#To explore the effects of taurolithocholic acid (tLCA) and chenodeoxycholic acid (CDCA) on the expression of aorexigenic neuropeptide in mouse hypothalamus GT1-7 cells.@*METHODS@#Mouse hypothalamic GT1-7 cells were treated with culture medium containing 10% FBS (control group, =3) or with 10 nmol/L, 100 nmol/L, 1 μmol/L and 10 μmol/L tLCA (tLCA group, =3) or CDCA (CDCA group, =3) for 12, 24 or 48 h. Real-time PCR was performed to determine the expression levels of proopiomelanocortin (POMC) mRNA in the cells, and the production levels of α-melanocyte-stimulating hormone (α-MSH) were assessed using an ELISA kit. Signal transduction and activator of transcription 3 phosphorylation (p-STAT3), threonine kinase phosphorylation (p-AKT), suppressor of cytokine signaling 3 (SOCS3), G protein-coupled bile acid receptor-1 (TGR5) and farnesoid X receptor (FXR) protein were detected by Western blotting.@*RESULTS@#Western blotting results showed that mouse hypothalamic GT1-7 cells expressed two bile acid receptors, TGR5 and FXR, whose expressions were regulated by bile acids. Real-time PCR showed that the expression of POMC mRNA was significantly increased in the cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. POMC-derived anorexigenic peptide α-MSH increased significantly in GT1-7 cells after treatment with 10 μmol/L tLCA or CDCA for 24 h. Treatment of the cells with tLCA or CDCA significantly increased the expressions of intracellular signaling proteins including p-STAT3, p-AKT and SOCS3.@*CONCLUSIONS@#Mouse hypothalamic GT1-7 cells express bile acid receptors TGR5 and FXR. Bile acids tLCA or CDCA can promote the expression of POMC mRNA and increase the production of the anorexigenic peptide α-MSH. The intracellular signaling proteins p-AKT, p-STAT3 and SOCS3 are likely involved in bile acid-induced anorexigenic peptide production.


Subject(s)
Animals , Cell Line , Chenodeoxycholic Acid , Pharmacology , Gene Expression Regulation , Hypothalamus , Cell Biology , Mice , Neuropeptides , Genetics , Metabolism , Pro-Opiomelanocortin , Genetics , RNA, Messenger , Genetics , STAT3 Transcription Factor , Metabolism , Signal Transduction , Suppressor of Cytokine Signaling 3 Protein , Metabolism , Taurolithocholic Acid , Pharmacology , alpha-MSH , Genetics
20.
Article in Chinese | WPRIM | ID: wpr-828513

ABSTRACT

OBJECTIVE@#To investigate the effect of periostin on hypoxia-induced oxidative stress and apoptosis in human periodontal ligament fibroblasts and the molecular mechanism involved.@*METHODS@# cultured human periodontal ligament fibroblasts were placed in an anaerobic gas-producing bag for hypoxia treatment for 48 h followed by treatment with periostin at low (25 ng/mL), moderate (50 ng/mL) or high (100 ng/mL) doses. MTT assay was used to measure the cell viability, and the cell apoptosis rate was determined using flow cytometry. The contents of IL-1β, IL-6 and TNF-α in the cells were determined with ELISA, and ROS levels were measured using a fluorescent plate reader. The intracellular SOD activity was detected using ELISA. The expressions of HIF-1α, P21, cyclin D1, Bax, cleaved caspase-3, Bcl-2, P38MAPK and p-p38 MAPK proteins in the cells were detected with Western blotting.@*RESULTS@#Hypoxia treatment significantly reduced the cell viability ( < 0.05), increased P21, Bax, and cleaved caspase-3 protein levels ( < 0.05), promoted cell apoptosis ( < 0.05), and decreased cyclin D1 and Bcl-2 protein levels ( < 0.05) in the cells. Compared with the hypoxic group, the cells treated with periostin at different concentrations showed significantly increased cell viability ( < 0.05) with significantly lowered apoptotic rates ( < 0.05) and decreased expression levels of Bax and cleaved caspase-3 ( < 0.05) but significantly increased expression levels of cyclin D1 and Bcl-2 ( < 0.05). Hypoxic exposure of the cells resulted in significantly increased expression levels of HIF-1α and p-p38 MAPK ( < 0.05) and increased levels of IL-1β, IL-6, TNF-α and ROS ( < 0.05) but decreased SOD activity ( < 0.05). Periostin treatment at different concentrations significantly lowered the expression levels of HIF-1α and p-p38 MAPK ( < 0.05) and the levels of IL-1β, IL-6, TNF-α and ROS ( < 0.05) and significantly increased SOD activity in the hypoxic cells ( < 0.05).@*CONCLUSIONS@#Periostin promotes the proliferation, inhibits apoptosis, enhances cellular antioxidant capacity, and reduces inflammatory damage in human periodontal ligament fibroblasts exposed to hypoxia possibly by inhibiting the activation of the p38 MAPK signaling pathway.


Subject(s)
Apoptosis , Cell Adhesion Molecules , Cell Hypoxia , Fibroblasts , Humans , Oxidative Stress , Periodontal Ligament , Cell Biology , Signal Transduction , p38 Mitogen-Activated Protein Kinases
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