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1.
J Neurosurg Sci ; 2023 Dec 21.
Article in English | MEDLINE | ID: mdl-38127302

ABSTRACT

BACKGROUND: Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up. METHODS: Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution. Of these, SE-FD insertion was performed in 40 patients with 41 aneurysms. At one-year follow-up, clinical and angiographic outcomes were retrospectively evaluated from electronic medical record and aneurysm database. RESULTS: There were 12 male and 28 female patients (mean age 59.1 years, 95% CI: 55.3-62.9). Fusiform aneurysm dissection was 46.3% (19/41). Mean maximum aneurysm diameter was 13.2 mm (SD 5.53), and 34.1% (14/41) of aneurysms were 15 mm or bigger. Among 41 aneurysms, complex aneurysm (recurred, thrombosed, or branch artery-incorporated) was accounted for 41.5% (17/41). All procedures were successfully conducted with 7.3% (3/41) of procedure-related complications. At one-year follow-up (N.=40), neurologic morbidity was noted in 2 cases (5.0%; both with modified Rankin Scale [mRS] 1) without any mortality. At one-year follow-up (N.=41), radiologic outcomes were adequate occlusion in 33 (80.5%) and complete occlusion in 29 (70.7%). There was no retreatment in our cohort. CONCLUSIONS: Surpass Evolve Flow Diverter seemed to be safe and effective for the treatment of dissecting/fusiform or complex aneurysms at one-year follow-up. However, further study is needed to evaluate long term results.

3.
Sci Total Environ ; 718: 137354, 2020 May 20.
Article in English | MEDLINE | ID: mdl-32325611

ABSTRACT

The hydrology of the Third Pole, Asia's freshwater tower, has shown considerable sensitivity to the impacts of climate change and human interventions, which affect the headwaters of many rivers that originate therein. For example, the Yangtze River has its basin (YRB) experiencing wetness of terrestrial water storage (TWS), whose rainfall seems to be the primary source as inferred from the previous studies. Consequently, it is crucial to understand the contributions of each TWS's sub-domain - i.e., groundwater (GWS); total water content (TWC) stored as soil moisture, ice/snow, and canopy; and the surface water (SWS) storages - on YRB's wetness. Hence, SWS, from altimetry and imagery satellites, and TWC, from Global Land Data Assimilation System, are inverted considering the same basis function as for TWS from the Gravity Recovery and Climate Experiment, which account for the differences in the resolutions inherent in each product. Furthermore, a "tie-in" signal approach is used to fit the temporal patterns of GWS, TWC, and SWS to TWS (i.e., the observations). Results show improvements in the reconstructed GWS series concerning standard deviation, correlation coefficient, and Nash-Sutcliffe efficiency of 22%, 27%, and 120%, respectively, regarding the use of the TWS-budget equation. The reconstructed time series of GWS, TWC, and SWS present an increase of 1.76, 2.69, and 0.14 mm per year (mm/yr) and that YRB loses water stored at its aquifers 55% of the time (regarding 2003-2016 period) based on the quantile function of storage (QFS). The QFS's slope shows that TWS has a fast and small storage potential w.r.t. GWS since inland waters and soil moisture reflect the dryness impacting TWS first. Despite the evidence of an increase of 19.05 mm/yr in annual precipitation, which seems to explain the bulk in TWS, further investigation to characterize controls on TWS memory within YRB is still necessary.

4.
J Am Coll Surg ; 230(4): 596-602, 2020 04.
Article in English | MEDLINE | ID: mdl-32220451

ABSTRACT

BACKGROUND: Recent reports suggest that component plasma products contain significant quantities of cellular contamination. We hypothesized that leukoreduction of whole blood before preparation of derived plasma is an effective method to prevent cellular contamination of stored plasma. STUDY DESIGN: Samples of never-frozen liquid plasma prepared by standard methods (n = 25) were obtained from 3 regional blood centers that supply 3 major trauma centers. Samples were analyzed for leukocyte and platelet contamination by flow cytometry. To determine if leukoreduction of whole blood before centrifugation and expression of plasma prevents cellular contamination of liquid plasma, 1 site generated 6 additional units of liquid plasma from leukoreduced whole blood, which were then compared with units of liquid plasma derived by standard processing. RESULTS: Across all centers, each unit of never-frozen liquid plasma contained a mean of 12.8 ± 3.0 million leukocytes and a mean of 4.6 ± 2 billion platelets. Introduction of whole blood leukoreduction (LR) before centrifugation and plasma extraction essentially eliminated all contaminating leukocytes (Non-LR: 12.3 ± 2.9 million vs LR: 0.05 ± 0.05 million leukocytes) and platelets (Non-LR: 4.2 ± 0.3 billion platelets vs LR: 0.00 ± 0.00 billion platelets). CONCLUSIONS: Despite widespread belief that stored plasma is functionally acellular, testing of liquid plasma from 3 regional blood banks revealed a significant amount of previously unrecognized cellular contamination. Introduction of a leukoreduction step before whole blood centrifugation essentially eliminated detectable leukocyte and platelet contaminants from plasma. Therefore, our study highlights a straightforward and cost-effective method to eliminate cellular contamination of stored plasma.


Subject(s)
Blood Platelets , Leukocyte Reduction Procedures/methods , Leukocytes , Plasma/cytology , Humans , Male
5.
J Surg Res ; 245: 273-280, 2020 01.
Article in English | MEDLINE | ID: mdl-31421373

ABSTRACT

BACKGROUND: Transplantation of lungs procured after donation after circulatory death (DCD) is challenging because postmortem metabolic degradation may engender susceptibility to ischemia-reperfusion (IR) injury. Because oxidative mitochondrial DNA (mtDNA) damage has been linked to endothelial barrier disruption in other models of IR injury, here we used a fusion protein construct targeting the DNA repair 8-oxoguanine DNA glycosylase-1 (OGG1) to mitochondria (mtOGG1) to determine if enhanced repair of mtDNA damage attenuates endothelial barrier dysfunction after IR injury in a rat model of lung procurement after DCD. MATERIALS AND METHODS: Lungs excised from donor rats 1 h after cardiac death were cold stored for 2 h after which they were perfused ex vivo in the absence and presence of mt-OGG1 or an inactive mt-OGG1 mutant. Lung endothelial barrier function and mtDNA integrity were determined during and at the end of perfusion, respectively. RESULTS AND CONCLUSIONS: Mitochondria-targeted OGG1 attenuated indices of lung endothelial dysfunction incurred after a 1h post-mortem period. Oxidative lung tissue mtDNA damage as well as accumulation of proinflammatory mtDNA fragments in lung perfusate, but not nuclear DNA fragments, also were reduced by mitochondria-targeted OGG1. A repair-deficient mt-OGG1 mutant failed to protect lungs from the adverse effects of DCD procurement. CONCLUSIONS: These findings suggest that endothelial barrier dysfunction in lungs procured after DCD is driven by mtDNA damage and point to strategies to enhance mtDNA repair in concert with EVLP as a means of alleviating DCD-related lung IR injury.


Subject(s)
DNA Glycosylases/administration & dosage , Endothelium, Vascular/drug effects , Mitochondria/drug effects , Recombinant Fusion Proteins/administration & dosage , Reperfusion Injury/prevention & control , Allografts/blood supply , Allografts/cytology , Allografts/drug effects , Animals , DNA Glycosylases/genetics , DNA Repair/drug effects , DNA, Mitochondrial/drug effects , DNA, Mitochondrial/genetics , Disease Models, Animal , Endothelium, Vascular/cytology , Endothelium, Vascular/pathology , Humans , Lung/blood supply , Lung/cytology , Lung/drug effects , Lung Transplantation , Male , Mitochondria/genetics , Mitochondria/pathology , Oxidative Stress/drug effects , Oxidative Stress/genetics , Perfusion/methods , Rats , Recombinant Fusion Proteins/genetics , Reperfusion Injury/pathology , Tissue and Organ Harvesting/methods
6.
Nurs Res ; 68(6): 433-438, 2019.
Article in English | MEDLINE | ID: mdl-31693548

ABSTRACT

BACKGROUND: The relationship between an increasing elderly population and wide-ranging neurological conditions has led to heightened rates of cognitive function impairment. Some researchers have found that health literacy risk may be associated with cognitive impairment in older adults. OBJECTIVES: The purpose of this study was to delineate the difference in health literacy risk between older adults with mild cognitive impairment and those with normal cognitive function. METHODS: We conducted a survey study to explore the health literacy risk in older adults with and without mild cognitive impairment. Data were collected from 412 subjects between 60 and 91 years of age (260 without and 152 with mild cognitive impairment) between June and December 2016 in China. Cognitive function was measured using the Mini-Mental Status Examination, Montreal Cognitive Assessment, Global Deterioration Scale, Activities of Daily Living, and Hamilton Depression Rating Scale. Health literacy was measured using the Chinese Citizen Health Literacy Questionnaire. RESULTS: The scores of total health literacy and its three dimensions (basic health knowledge and mind, basic skills, and health lifestyle and behavior) were lower in those with mild cognitive impairment. Older adults with normal cognitive function had adequate or marginal health literacy levels, whereas those with mild cognitive impairment had marginal or inadequate health literacy levels. Using multiple logistic regression analysis, we found that health literacy risk, education level, age, marital status, and body mass index were independent risk factors for mild cognitive impairment. DISCUSSION: These results suggest that low health literacy may be a predictor of mild cognitive impairment. Screening for lower health literacy risk should be included in multidimensional geriatric evaluation.


Subject(s)
Cognitive Dysfunction/psychology , Health Literacy , Age Factors , Aged , Aged, 80 and over , Body Mass Index , Case-Control Studies , China , Educational Status , Female , Humans , Logistic Models , Male , Marital Status , Middle Aged , Risk Factors
7.
J Am Coll Surg ; 229(3): 252-258, 2019 09.
Article in English | MEDLINE | ID: mdl-31029763

ABSTRACT

BACKGROUND: Stored plasma products are widely regarded as being functionally acellular, obviating the need for leukoreduction. We tested the hypothesis that donor plasma is contaminated by leukocytes and platelets, which, after frozen storage, would release cellular debris in quantities sufficient to elicit significant pro-inflammatory responses. STUDY DESIGN: Samples of never-frozen liquid plasma from 2 regional Level I trauma centers were analyzed for leukocyte and platelet contamination. To determine if the cellular contamination and associated debris found in liquid plasma were at levels sufficient to evoke an innate immune response, known quantities of leukocytes were subjected to a freeze-thaw cycle, added to whole blood, and the magnitude of the inflammatory response was determined by induction of interleukin-6. RESULTS: Units of never-frozen plasma from 2 regional Level I trauma centers located in Alabama and Louisiana contained significant amounts of leukocyte contamination (Louisiana, n = 22; 17.3 ± 4.5 million vs Alabama, n = 22; 11.3 ± 2.2 million) and platelet contamination (Louisiana, n = 21; 0.86 ± 0.20 billion vs Alabama, n = 22; 1.0 ± 0.3 billion). Cellular debris from as few as 1 million leukocytes induced significant increases in interleukin-6 levels (R2 = 0.74; p < 0.0001). CONCLUSIONS: Stored plasma units from trauma center blood banks were highly contaminated with leukocytes and platelets, at levels more than 15-fold higher than sufficient to elicit ex vivo inflammatory responses. In light of paradigm shifts toward the use of more empiric plasma for treatment of hypovolemia, this study suggests that new manufacturing and quality-control processes are needed to eliminate previously unrecognized cellular contamination present in stored plasma products.


Subject(s)
Blood Preservation/methods , Plasma/cytology , Alabama , Blood Component Transfusion , Blood Platelets/cytology , Humans , Leukocytes/cytology , Louisiana , Quality Control , Trauma Centers
8.
Head Neck ; 41(9): 2921-2928, 2019 09.
Article in English | MEDLINE | ID: mdl-30994951

ABSTRACT

BACKGROUND: The purpose of this study was to determine whether postauricular robotic and conventional hemithyroidectomy result in significantly different voice outcomes. METHODS: We prospectively compared the voice handicap index (VHI)-10 and acoustic parameters of a postauricular facelift robotic group and a conventional group preoperatively, 1 week, 1 month, and 6 months after surgery. RESULTS: Forty-two patients in the postauricular group and 68 patients in the conventional group completed the VHI-10 questionnaire and acoustic analysis. The postoperative VHI-10 scores were not significantly different between the two groups. In female patients, the highest frequency was higher and the frequency range was wider in the postauricular group compared to the conventional group postoperatively until 1 month after surgery. CONCLUSION: Postauricular facelift robotic thyroidectomy has advantages over conventional thyroidectomy in terms of postoperative voice pitch.


Subject(s)
Robotic Surgical Procedures , Thyroidectomy/methods , Voice Quality , Adult , Aged , Female , Humans , Male , Middle Aged , Postoperative Complications , Prospective Studies , Sex Factors , Surveys and Questionnaires
9.
Dermatol Ther ; 32(3): e12875, 2019 05.
Article in English | MEDLINE | ID: mdl-30884082

ABSTRACT

Nephrotoxicity is a major concern for patients with psoriasis using cyclosporine. Here, we evaluated the impact of intermittent cyclosporine treatment on nephrotoxicity risk among patients with psoriasis in real-world clinical practice. We retrospectively reviewed 611 patients with psoriasis treated with cyclosporine between January 2013 and January 2017, 398 of whom were considered eligible for analysis. Eighteen (4.5%) patients showed a greater than 25% increase in serum creatinine levels. Age over 60 years (relative risk [RR], 1.6; p = .015), diabetes (RR, 2.3; p < .001), and obesity (RR, 1.7; p = .011) were the significant risk factors of increased serum creatinine levels in patients with psoriasis. There was no significant association of the treatment duration or cumulative dose of cyclosporine with increased serum creatinine levels. In real clinical practice, intermittent cyclosporine use with regular serum creatinine tests can be used to treat psoriasis relatively safely. Age over 60 years, diabetes and obesity are significant risk factors for cyclosporine-induced nephrotoxicity.


Subject(s)
Creatinine/blood , Cyclosporine/administration & dosage , Immunosuppressive Agents/administration & dosage , Psoriasis/drug therapy , Adult , Age Factors , Aged , Cyclosporine/adverse effects , Diabetes Mellitus/epidemiology , Female , Humans , Immunosuppressive Agents/adverse effects , Kidney Diseases/chemically induced , Kidney Diseases/diagnosis , Male , Middle Aged , Obesity/complications , Retrospective Studies , Risk Factors
10.
Medicine (Baltimore) ; 97(31): e11721, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30075579

ABSTRACT

Colposcopy-directed punch biopsy (punch biopsy) and endocervical curettage (ECC) are accompanied by considerable pain. However, many physicians perform these procedures without adequate pain management. Therefore, identification of factors affecting pain experienced during the procedures may encourage physician effort in selective pain management. This study investigated factors affecting the severity of pain experienced during punch biopsy and ECC in an outpatient clinic of gynecologic oncology department.In this retrospective, exploratory study, a total of 101 Korean patients with abnormal cervical cytology underwent punch biopsy and ECC under a paracervical block performed for pain relief. Residents under training performed these procedures and recorded patient-reporting maximum Numeric Rating Scale (NRS) scores experienced during the procedures. Residents were classified into four outpatient clinic training groups (1st-4th); the group designators correspond to the resident's experience in performing these procedures. A linear mixed model adjusted for physician factors such as either residents or outpatient clinic training groups was used to analyze the association between each variable and maximum NRS score.Among the outpatient clinic training groups, maximum NRS scores significantly decreased in the 4th group, compared with those in the 1st group although those were not different among groups when adjusted for residents. Some of cervical cytology findings and discrepancies between the severity of cervical cytology results and those of punch biopsy or ECC showed significant associations with maximum NRS scores. However, when adjusted for either residents or outpatient clinic training groups, maximum NRS scores were not different by age, body mass index, presence of menopause, cervical cytology findings, discrepancies between the severity of cervical cytology results and those of punch biopsy or ECC, and tissue volume.There are no significant factors affecting the severity of pain experienced during punch biopsy and ECC.


Subject(s)
Biopsy, Needle/adverse effects , Cervix Uteri/pathology , Curettage/adverse effects , Pain/etiology , Adult , Age Factors , Aged , Ambulatory Care Facilities , Body Mass Index , Colposcopy , Female , Humans , Internship and Residency , Menopause , Middle Aged , Republic of Korea , Retrospective Studies , Severity of Illness Index , Young Adult
11.
Ann Am Thorac Soc ; 14(Supplement_3): S210-S215, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28945469

ABSTRACT

Lung ischemia-reperfusion (IR) injury contributes to post-transplant complications, including primary graft dysfunction. Decades of reports show that reactive oxygen species generated during lung IR contribute to pulmonary vascular endothelial barrier disruption and edema formation, but the specific target molecule(s) that "sense" injury-inducing oxidant stress to activate signaling pathways culminating in pathophysiologic changes have not been established. This review discusses evidence that mitochondrial DNA (mtDNA) may serve as a molecular sentinel wherein oxidative mtDNA damage functions as an upstream trigger for lung IR injury. First, the mitochondrial genome is considerably more sensitive than nuclear DNA to oxidant stress. Multiple studies suggest that oxidative mtDNA damage could be transduced to physiologic dysfunction by pathways that are either a direct consequence of mtDNA damage per se or involve formation of proinflammatory mtDNA damage-associated molecular patterns. Second, transgenic animals or cells overexpressing components of the base excision DNA repair pathway in mitochondria are resistant to oxidant stress-mediated pathophysiologic effects. Finally, published and preliminary studies show that pharmacologic enhancement of mtDNA repair or mtDNA damage-associated molecular pattern degradation suppresses reactive oxygen species-induced or IR injury in multiple organs, including preclinical models of lung procurement for transplant. Collectively, these findings point to the interesting prospect that pharmacologic enhancement of DNA repair during procurement or ex vivo lung perfusion may increase the availability of lungs for transplant and reduce the IR injury contributing to primary graft dysfunction.


Subject(s)
DNA, Mitochondrial/drug effects , Lung/blood supply , Reperfusion Injury/genetics , Reperfusion Injury/prevention & control , Animals , DNA Damage , DNA Repair , Humans , Lung Transplantation , Primary Graft Dysfunction , Reactive Oxygen Species
12.
N Engl J Med ; 375(9): 850-60, 2016 Sep 01.
Article in English | MEDLINE | ID: mdl-27579635

ABSTRACT

BACKGROUND: Concerns remain about the safety of adding long-acting ß2-agonists to inhaled glucocorticoids for the treatment of asthma. In a postmarketing safety study mandated by the Food and Drug Administration, we evaluated whether the addition of formoterol to budesonide maintenance therapy increased the risk of serious asthma-related events in patients with asthma. METHODS: In this multicenter, double-blind, 26-week study, we randomly assigned patients, 12 years of age or older, who had persistent asthma, were receiving daily asthma medication, and had had one to four asthma exacerbations in the previous year to receive budesonide-formoterol or budesonide alone. Patients with a history of life-threatening asthma were excluded. The primary end point was the first serious asthma-related event (a composite of adjudicated death, intubation, and hospitalization), as assessed in a time-to-event analysis. The noninferiority of budesonide-formoterol to budesonide was defined as an upper limit of the 95% confidence interval for the risk of the primary safety end point of less than 2.0. The primary efficacy end point was the first asthma exacerbation, as assessed in a time-to-event analysis. RESULTS: A total of 11,693 patients underwent randomization, of whom 5846 were assigned to receive budesonide-formoterol and 5847 to receive budesonide. A serious asthma-related event occurred in 43 patients who were receiving budesonide-formoterol and in 40 patients who were receiving budesonide (hazard ratio, 1.07; 95% confidence interval [CI], 0.70 to 1.65]); budesonide-formoterol was shown to be noninferior to budesonide alone. There were two asthma-related deaths, both in the budesonide-formoterol group; one of these patients had undergone an asthma-related intubation. The risk of an asthma exacerbation was 16.5% lower with budesonide-formoterol than with budesonide (hazard ratio, 0.84; 95% CI, 0.74 to 0.94; P=0.002). CONCLUSIONS: Among adolescents and adults with predominantly moderate-to-severe asthma, treatment with budesonide-formoterol was associated with a lower risk of asthma exacerbations than budesonide and a similar risk of serious asthma-related events. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01444430 .).


Subject(s)
Adrenergic beta-2 Receptor Agonists/administration & dosage , Asthma/drug therapy , Budesonide/administration & dosage , Formoterol Fumarate/administration & dosage , Glucocorticoids/administration & dosage , Administration, Inhalation , Adolescent , Adrenergic beta-2 Receptor Agonists/adverse effects , Adult , Aged , Asthma/prevention & control , Bronchodilator Agents/administration & dosage , Bronchodilator Agents/adverse effects , Budesonide/adverse effects , Child , Delayed-Action Preparations , Double-Blind Method , Drug Therapy, Combination , Female , Formoterol Fumarate/adverse effects , Glucocorticoids/adverse effects , Humans , Male , Middle Aged , Prospective Studies , Young Adult
13.
Genet Mol Res ; 13(4): 10852-62, 2014 Dec 19.
Article in English | MEDLINE | ID: mdl-25526205

ABSTRACT

The early response to the dehydration 15 (ERD15) gene is widely involved in the processes of signal transduction, programmed cell death, gene transcription, and stress tolerance in plants. In a previous study, the ERD15 gene was shown to be an important regulator of the abscisic acid response and salicylic acid-dependent defense pathway, acting as an important negative regulator of abscisic acid. The complete IbERD15 gene (accession No. KF723428) was isolated by reverse transcription-polymerase chain reaction. The IbERD15 gene contains an open reading frame of 504 bp, encodes a peptide of 167 amino acids, and has a molecular mass of 18.725 kDa. The transcript levels of the IbERD15 gene in a variety of tissues were examined by digital gene expression profiling. The roots of the sweet potato were treated by 3 degrees of polyethylene glycol, and the results indicate that the IbERD15 gene might play an important role in the defense response to drought stress. Moreover, the IbERD15 gene was successfully transformed into yeast cells for analysis of drought tolerance in transgenic yeast.


Subject(s)
Cloning, Molecular/methods , Ipomoea batatas/genetics , Plant Proteins/genetics , Stress, Physiological , Gene Expression Profiling , Gene Expression Regulation, Plant/drug effects , Ipomoea batatas/physiology , Phylogeny , Polyethylene Glycols/pharmacology , Saccharomyces cerevisiae/genetics , Saccharomyces cerevisiae/growth & development , Sequence Alignment , Sequence Analysis, DNA
14.
Environ Sci Technol ; 48(1): 255-62, 2014.
Article in English | MEDLINE | ID: mdl-24328102

ABSTRACT

Glyoxal is an important precursor to secondary organic aerosol (SOA) formed through aqueous chemistry in clouds, fogs, and wet aerosols, yet the gas-particle partitioning of the resulting mixture is not well understood. This work characterizes the volatility behavior of the glyoxal precursor/product mix formed after aqueous hydroxyl radical oxidation and droplet evaporation under cloud-relevant conditions for 10 min, thus aiding the prediction of SOA via this pathway (SOACld). This work uses kinetic modeling for droplet composition, droplet evaporation experiments and temperature-programmed desorption aerosol-chemical ionization mass spectrometer analysis of gas-particle partitioning. An effective vapor pressure (p'L,eff) of ∼10(-7) atm and an enthalpy of vaporization (ΔHvap,eff) of ∼70 kJ/mol were estimated for this mixture. These estimates are similar to those of oxalic acid, which is a major product. Addition of ammonium until the pH reached 7 (with ammonium hydroxide) reduced the p'L,eff to <10(-9) atm and increased the ΔHvap,eff to >80 kJ/mol, at least in part via the formation of ammonium oxalate. pH 7 samples behaved like ammonium oxalate, which has a vapor pressure of ∼10(-11) atm. We conclude that ammonium addition has a large effect on the gas-particle partitioning of the mixture, substantially enhancing the yield of SOACld from glyoxal.


Subject(s)
Aerosols/chemistry , Ammonium Compounds/chemistry , Glyoxal/chemistry , Aerosols/analysis , Hydroxyl Radical/chemistry , Kinetics , Oxidation-Reduction , Volatilization , Water/chemistry
15.
Laryngoscope ; 124(4): 1042-7, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24338236

ABSTRACT

OBJECTIVES/HYPOTHESIS: The aim of this study was to investigate the surgical completeness of robotic total thyroidectomy compared with conventional open thyroidectomy. STUDY DESIGN: Retrospective, case-control study. METHODS: We studied 245 patients with papillary thyroid carcinoma who underwent total thyroidectomy and postoperative radioactive iodine (RAI) ablation. Of these, 62 patients underwent robotic thyroidectomy by a gasless unilateral axillo-breast (GUAB) or axillary (GUA) approach, and 183 underwent conventional open thyroidectomy. We analyzed serum TSH-stimulated thyroglobulin (Tg) and RAI uptake at the time of RAI remnant ablation to compare surgical completeness in the two groups. RESULTS: Tumor characteristics and complications did not differ between the two groups except TNM stage. The mean TSH-stimulated Tg at the first RAI ablation was significantly higher in the robotic group (10.20 ± 9.98 ng/ml) than in the open group (3.85 ± 6.79 ng/ml) (P <0.001). In subgroup analysis of the robotic group by the period in which operations took place, TSH-stimulated Tg was significantly higher than in the open group in the first (13.28 ± 11.91 ng/ml) and second (10.45 ± 9.30 ng/ml) periods, but there was no significant difference in the third period (6.00 ± 6.26 ng/ml, P = 0.141). The RAI uptake rate at the first RAI ablation did not differ between the two groups, and TSH-stimulated Tg after RAI ablation was similar. CONCLUSION: The surgical completeness of robotic total thyroidectomy by a GUAB/GUB approach is comparable to that of open thyroidectomy, if performed by experienced robotic thyroid surgeons in properly selected patients. LEVEL OF EVIDENCE: 3b. Laryngoscope, 124:1042-1047, 2014.


Subject(s)
Carcinoma/surgery , Endoscopy/methods , Robotics/methods , Thyroglobulin/blood , Thyroid Neoplasms/surgery , Thyroidectomy/methods , Adult , Axilla , Biomarkers, Tumor/blood , Carcinoma/blood , Carcinoma, Papillary , Female , Follow-Up Studies , Humans , Male , Middle Aged , Propensity Score , Retrospective Studies , Thyroid Cancer, Papillary , Thyroid Neoplasms/blood , Treatment Outcome
16.
Toxins (Basel) ; 5(7): 1261-81, 2013 Jul 17.
Article in English | MEDLINE | ID: mdl-23867763

ABSTRACT

Three feed additives were tested to improve the growth and health of pigs chronically challenged with aflatoxin (AF) and deoxynivalenol (DON). Gilts (n = 225, 8.8 ± 0.4 kg) were allotted to five treatments: CON (uncontaminated control); MT (contaminated with 150 µg/kg AF and 1100 µg/kg DON); A (MT + a clay additive); B (MT + a clay and dried yeast additive); and C (MT + a clay and yeast culture additive). Average daily gain (ADG) and feed intake (ADFI) were recorded for 42 days, blood collected for immune analysis and tissue samples to measure damage. Feeding mycotoxins tended to decrease ADG and altered the immune system through a tendency to increase monocytes and immunoglobulins. Mycotoxins caused tissue damage in the form of liver bile ductule hyperplasia and karyomegaly. The additives in diets A and B reduced mycotoxin effects on the immune system and the liver and showed some ability to improve growth. The diet C additive played a role in reducing liver damage. Collectively, we conclude that AF and DON can be harmful to the growth and health of pigs consuming mycotoxins chronically. The selected feed additives improved pig health and may play a role in pig growth.


Subject(s)
Aflatoxins/toxicity , Animal Feed/analysis , Food Additives/chemistry , Swine/growth & development , Trichothecenes/toxicity , Animals , Edetic Acid/blood , Food Contamination/analysis , Food Microbiology , Immune System/drug effects , Liver/drug effects , Liver/growth & development , Organ Size/drug effects , Swine/immunology
17.
Eur J Surg Oncol ; 38(12): 1171-7, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22809860

ABSTRACT

AIM: Limb-salvage surgery has become the standard of care for extremity osteosarcoma. In this study, we investigated the survival and functional outcomes of patients with osteosarcoma around the knee who were treated with limb-salvage surgery. METHODS: We retrospectively reviewed the clinical data for 120 patients with osteosarcoma around the knee who were treated with limb-salvage surgery between 1998 and 2008. The sample included 75 males and 45 females. The mean age of the patients was 18.9 years. Osteosarcoma was diagnosed in the distal femur in 78 patients and in the proximal tibia in 42 patients. Statistical analyses were conducted to process and record the patient data and analyse the surgery's efficacy, prognosis and survival rates. RESULTS: All patients were followed for 6-144 months (mean of 56.8 months). The overall 5-year survival rate was 61.8%. Lung metastasis developed in 31 patients. Local recurrence developed in 9 patients. The average Musculoskeletal Tumor Society Score (MSTS) was 25.5 points on a 30-point scale. Sixteen patients underwent prosthesis revision and twelve patients underwent amputation. The overall survivorship of the prosthesis based on Kaplan-Meier estimates was 77% at five years and 71% at ten years. There was a higher incidence of extensor lag for the patients with osteosarcoma in the proximal tibia than for those with osteosarcoma in the distal femur (P < 0.01). CONCLUSIONS: Treating osteosarcoma around the knee with limb-salvage surgery can preserve most of the knee's functionality. Attention must be paid to prevent the relatively high incidence of postoperative complications.


Subject(s)
Bone Neoplasms/surgery , Femur , Limb Salvage/methods , Osteosarcoma/surgery , Tibia , Adolescent , Bone Neoplasms/mortality , China/epidemiology , Female , Follow-Up Studies , Humans , Knee Joint , Male , Osteosarcoma/mortality , Retrospective Studies , Survival Rate/trends , Time Factors , Treatment Outcome
18.
Ann Neurol ; 71(6): 850-4, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22718549

ABSTRACT

Somatic mutations in mitochondrial DNA (mtDNA) are hypothesized to play a role in Parkinson disease (PD), but large increases in mtDNA mutations have not previously been found in PD, potentially because neurons with high mutation levels degenerate and thus are absent in late stage tissue. To address this issue, we studied early stage PD cases and cases of incidental Lewy body disease (ILBD), which is thought to represent presymptomatic PD. We show for the first time that mtDNA mutation levels in substantia nigra neurons are significantly elevated in this group of early PD and ILBD cases.


Subject(s)
DNA, Mitochondrial/genetics , Lewy Body Disease/genetics , Mutation/genetics , Parkinson Disease/genetics , Aged , Aged, 80 and over , Brain/metabolism , DNA Mutational Analysis , Female , Humans , Laser Capture Microdissection , Lewy Body Disease/pathology , Male , Middle Aged , Neuroglia/pathology , Neurons/pathology , Parkinson Disease/pathology
19.
Proteomics ; 11(24): 4688-701, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22002957

ABSTRACT

Many morphological and physiological changes have been widely reported during ontogeny in higher plants. In order for the better understanding of the proteomic differences between ontogenetic phases, protein compositions between leaves of juvenile, adult vegetative and reproductive phases were compared in an apple (Malus domestica Borkh., Jonathan × Golden Delicious) seedling. Totally, 122 differentially expressed or modified protein spots were separated by DIGE. Of the 122 protein spots, 44, 17 and 29 were abundant in the leaf samples from the juvenile, adult vegetative and reproductive phases, respectively, two spots showed a lower level in the adult vegetative tissue, while the amount of protein increased in 21 spots during ontogeny and declined in nine spots. One hundred and fifteen spots were successfully picked and 95 spots were identified by MALDI-TOF-TOF high-resolution tandem mass spectrometry. Twenty-three juvenile phase abundant or down-regulated spots were photosynthesis-associated proteins, implying a juvenile phase-related photosynthesis enhancement. The expression of 10 enzymes and coenzymes involved in protein synthesis and catabolism was elevated in the adult reproductive phase or up-regulated during ontogeny, contributing a phase change-related activation in protein metabolism. Six proteins generated 30 differential gel spots via post-translational modifications. The differential expression of NADP-dependent D-sorbitol-6-phosphate dehydrogenase was confirmed by Western blotting in six seedlings derived from two hybrid populations. The results of semi-quantitative PCR indicate that some but not all of these proteomic changes were transcriptionally regulated.


Subject(s)
Gene Expression Regulation, Plant , Malus/enzymology , Plant Proteins/analysis , Plant Proteins/metabolism , Amino Acid Sequence , Malus/embryology , Malus/growth & development , Plant Leaves/genetics , Plant Leaves/metabolism , Proteome/analysis , Proteome/metabolism , Proteomics/methods , Seedlings/genetics , Seedlings/metabolism , Sequence Analysis, Protein , Sugar Alcohol Dehydrogenases/metabolism
20.
J Nanosci Nanotechnol ; 11(3): 2640-3, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21449444

ABSTRACT

The substrate effects on surface morphologies, crystal structures, and magnetic properties of the sputter-deposited FePt thin films on Corning 1737, normal glass, and Si wafer substrates, respectively, were investigated. High in-plane coercivities of 10 kOe were obtained for the air-annealed films on Corning 1737 and Si wafer, where both films similarly have granular-like morphologies. Besides, increasing grain size and surface roughness of all the FePt films with the post-anneal temperature were observed. Moreover, partially separated grains were seen in the film on Si wafer, where the formation of Fe silicides during post-anneal is suspected, in which has enhanced the magnetic ordering.


Subject(s)
Iron/chemistry , Magnetics , Membranes, Artificial , Nanostructures/chemistry , Nanostructures/ultrastructure , Platinum/chemistry , Crystallization/methods , Macromolecular Substances/chemistry , Materials Testing , Molecular Conformation , Nanotechnology/methods , Particle Size , Surface Properties
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