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1.
Microsurgery ; 44(5): e31209, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38970406

RESUMO

BACKGROUND: Instep flaps are commonly used for the reconstruction of weight-bearing areas of the foot. However, in cases of large defects or damage to the instep area, non-instep flaps such as reverse sural flaps (RSF) or free anterolateral thigh flaps (ALTF) can be employed. Previous studies have primarily focused on heel reconstruction when comparing different flaps, without considering the forefoot. This study aims to verify the clinical outcomes of these flaps and determine the appropriate donor site for weight-bearing areas of the foot including forefoot reconstruction. METHODS: In a retrospective study, 39 patients who had undergone flap reconstruction of weight-bearing area defects in the foot with a follow-up period of ≥1 year were included. The patients were categorized into two groups: Group A (n = 19) using instep flaps, and Group B (n = 20) using non-instep flap including RSFs and ALTFs. Surgical outcomes were assessed based on the success of the flap, the presence of partial necrosis, the number of additional surgeries, and complications related to the donor site. Clinical evaluation included visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score, and the occurrence of ulcers. RESULTS: All flaps were successful, while partial necrosis occurred in one case in Group B. There were three reclosures after flap border debridement in both groups and one donor site debridement in Group A. The VAS scores during weight-bearing were 2.0 ± 1.1 and 2.2 ± 1.5 for Groups A and B, respectively (p = .716). The AOFAS scores were 52.8 ± 6.8 and 50.2 ± 12.7 for Groups A and B, respectively (p = .435). The occurrence of ulcers was 0.4 ± 0.9 times for Group A and 0.3 ± 0.7 times for Group B, with no significant difference between the two groups (p = .453). CONCLUSION: There was no difference in clinical outcomes between the types of flaps after reconstruction of the forefoot and hindfoot. Therefore, it is recommended to choose the appropriate flap based on factors such as the size of the defect, its location, and vascular status rather than the type of flap.


Assuntos
Traumatismos do Pé , Antepé Humano , Calcanhar , Procedimentos de Cirurgia Plástica , Suporte de Carga , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Calcanhar/cirurgia , Calcanhar/lesões , Adulto , Traumatismos do Pé/cirurgia , Antepé Humano/cirurgia , Retalhos Cirúrgicos/transplante , Lesões dos Tecidos Moles/cirurgia , Idoso , Retalhos de Tecido Biológico/transplante , Resultado do Tratamento , Adulto Jovem
2.
Front Neurosci ; 18: 1373837, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38784087

RESUMO

Determining the laterality of the seizure onset zone is challenging in frontal lobe epilepsy (FLE) due to the rapid propagation of epileptic discharges to the contralateral hemisphere. There is hemispheric lateralization of autonomic control, and heart rate is modulated by interactions between the sympathetic and parasympathetic nervous systems. Based on this notion, the laterality of seizure foci in FLE might be determined using heart rate variability (HRV) parameters. We explored preictal markers for differentiating the laterality of seizure foci in FLE using HRV parameters. Twelve patients with FLE (6 right FLE and 6 left FLE) were included in the analyzes. A total of 551 (460 left FLE and 91 right FLE) 1-min epoch electrocardiography data were used for HRV analysis. We found that most HRV parameters differed between the left and right FLE groups. Among the machine learning algorithms applied in this study, the light gradient boosting machine was the most accurate, with an AUC value of 0.983 and a classification accuracy of 0.961. Our findings suggest that HRV parameter-based laterality determination models can be convenient and effective tools in clinical settings. Considering that heart rate can be easily measured in real time with a wearable device, our proposed method can be applied to a closed-loop device as a real-time monitoring tool for determining the side of stimulation.

3.
Anim Biosci ; 37(5): 826-831, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38419540

RESUMO

OBJECTIVE: The major histocompatibility complex in chicken demonstrates a great range of variations within varities, breeds, populations and that can eventually influence their immuneresponses. The preset study was conducted to understand the major histocompatibility complex-B (MHC-B) variability in five major populations of Bangladesh native chicken: Aseel, Hilly, Junglefowl, Non-descript Deshi, and Naked Neck. METHODS: These five major populations of Bangladesh native chicken were analyzed with a subset of 89 single nucleotide polymorphisms (SNPs) in the high-density MHC-B SNP panel and Kompetitive Allele-Specific polymerase chain reaction genotyping was applied. To explore haplotype diversity within these populations, the results were analyzed both manually and computationally using PHASE 2.1 program. The phylogenetic investigations were also performed using MrBayes program. RESULTS: A total of 136 unique haplotypes were identified within these five Bangladesh chicken populations, and only one was shared (between Hilly and Naked Neck). Phylogenetic analysis showed no distinct haplotype clustering among the five populations, although they were shared in distinct clades; notably, the first clade lacked Naked Neck haplotypes. CONCLUSION: The present study discovered a set of unique MHC-B haplotypes in Bangladesh chickens that could possibly cause varied immune reponses. However, further investigations are required to evaluate their relationships with global chicken populations.

4.
Nano Lett ; 24(7): 2421-2427, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38319957

RESUMO

We demonstrate excitatory and inhibitory properties in a single heterostructure consisting of two quantum dots/graphene synaptic elements using linearly polarized monochromatic light. Perovskite quantum dots and PbS quantum dots were used to increase and decrease photocurrent weights, respectively. The polarization-dependent photocurrent was realized by adding a polarizer in the middle of the PbS quantum dots/graphene and perovskite quantum dots/graphene elements. When linearly polarized light passed through the polarizer, both the lower excitatory and upper inhibitory devices were activated, with the lower device with the stronger response dominating to increase the current weight. In contrast, the polarized light was blocked by the polarizer, and the above device was only operated, reducing the current weight. Furthermore, two orthogonal polarizations of light were used to perform the sequential processes of potentiation and habituation. By adjustment of the polarization angle of light, not only the direction of the current weight but also its level was altered.

5.
Orthop Traumatol Surg Res ; : 103816, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38246491

RESUMO

BACKGROUND: This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament (MPFL) reconstruction (MPFLR) between anatomic femoral tunnel positions: proximal (near adductor tubercle [AT]) and distal (near medial epicondyle [ME]). HYPOTHESIS: MPFLR with the proximal femoral tunnel position has worse clinical and radiological outcomes than those with the distal femoral tunnel position. PATIENTS AND METHODS: Fifty-five patients who underwent isolated MPFLR with proximal or distal femoral tunnels with at least 2 years of follow-up were retrospectively analyzed. Based on postoperative CT images, 28 patients were classified as group AT and the remaining 27 patients were classified as group ME. The International Knee Documentation Committee, Lysholm, Tegner, Kujala scores, and complications were evaluated. Radiologically, the Caton-Deschamps Index (CDI), patellar tilt angle, patellofemoral osteoarthritis (PFOA), patellofemoral cartilage status by the International Cartilage Repair Society (ICRS) grade, bone contusion, and MPFL graft signal intensity were evaluated. RESULTS: All clinical scores significantly improved in both groups (p<0.01). No statistically significant difference was noted between the two groups in regards to their preoperative demographic data, postoperative clinical scores, complications, or radiological findings (CDI, patellar tilt angle, PFOA, bone contusion, and graft signal intensity). The group AT had worse cartilage status on the medial facet of the patella (p=0.02). The ICRS grade for the medial facet of the patella statistically progressed in group AT compared to group ME (p=0.04) as well. DISCUSSION: Both groups showed significantly improved clinical outcomes. However, for the medial facet of the patella, MPFLR with the proximal femoral tunnel position had worse cartilage status and ICRS grade progression than those with the distal femoral tunnel position. LEVEL OF EVIDENCE: III; retrospective comparative study.

6.
Knee Surg Sports Traumatol Arthrosc ; 31(6): 2208-2215, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36562810

RESUMO

PURPOSE: This study sought to confirm whether traditional open Broström-Gould repair and arthroscopic Broström-Gould repair for chronic ankle instability (CAI) would produce comparable radiological and clinical outcomes in high-demand patients. METHODS: This retrospective case-cohort study included high-demand patients, as determined by a pre-injury Tegner Activity Level ≥ 6, who underwent Broström-Gould repair and were followed up for ≥ 2 years. Patients were divided into the arthroscopic Broström-Gould repair group (AS Group) and the open Broström-Gould repair group (Open Group). Perioperative radiological assessments were performed. The Tegner Activity Levels, Foot and Ankle Outcome Scores (FAOSs), Karlsson and Peterson (K-P) scores, and American Orthopaedic Foot and Ankle Society ankle-hindfoot (AOFAS) scores were evaluated clinically. RESULTS: A total of 65 patients (31 from the AS Group and 34 from the Open Group) were included in the study. There were no differences in age, sex, body mass index, preoperative anterior talar translation, talar tilt, signal-to-noise ratio, FAOS, K-P score, or AOFAS score between the two groups (n.s.). The preinjury median Tegner Activity Level was 7 and unchanged at the final follow-up in both groups. Postoperative stress radiographs showed improvement; however, the groups did not differ significantly. The FAOS, K-P scores, and AOFAS scores improved in each group (P < 0.001). However, the clinical scores did not differ between the groups (all n.s.). CONCLUSIONS: Traditional open and arthroscopic Broström-Gould repair for CAI in high-demand patients had comparable radiological and clinical outcomes. Clinically, arthroscopic Broström-Gould repair may represent a viable surgical alternative to open Broström-Gould repair in high-demand patients. LEVEL OF EVIDENCE: Level III.


Assuntos
Instabilidade Articular , Ligamentos Laterais do Tornozelo , Humanos , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Ligamentos Laterais do Tornozelo/cirurgia , Estudos de Coortes , Estudos Retrospectivos , Artroscopia , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia
7.
Int J Mol Sci ; 23(18)2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-36142401

RESUMO

Polyamine oxidase (PAOX) (N1-acetylpolyamine oxidase) is a major enzyme in the polyamine catabolism pathway that generates hydrogen peroxide. Hydrogen peroxide plays a crucial role in skin aging via extracellular matrix (ECM) degradation by increasing the matrix metalloproteinase-1 (MMP-1) levels. We analyzed the integrity of the ECM in foreskin fibroblasts using PAOX expression. PAOX increased the MMP-1 secretion and type Ι collagen degradation in 2D and 3D cultures of fibroblasts, respectively. Similarly, PAOX overexpression increased the messenger ribonucleic acid (mRNA) level of MMP-1. PAOX expression induced polyamine catabolism, decreased the spermine levels, and increased the putrescine levels. However, the exogenous polyamine treatment did not change the MMP-1 and type I collagen levels as much as PAOX expression. PAOX expression increased the reactive oxygen species (ROS) production in fibroblasts, and exogenous hydrogen peroxide increased both the ROS production and MMP-1 secretion. Furthermore, N-acetylcysteine, an antioxidant, reversed the PAOX-induced ROS production and MMP-1 secretion. PAOX induced the signaling pathways that activate activator protein-1 (AP-1) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), which are important transcription factors for MMP-1 transactivation. We concluded that PAOX increased the ROS levels in fibroblasts, leading to an increase in MMP-1 expression. Therefore, we propose that PAOX is a potential target molecule in protecting the ECM integrity.


Assuntos
Metaloproteinase 1 da Matriz , Fator de Transcrição AP-1 , Acetilcisteína/farmacologia , Antioxidantes/metabolismo , Colágeno Tipo I/metabolismo , Matriz Extracelular/metabolismo , Fibroblastos/metabolismo , Peróxido de Hidrogênio/metabolismo , Peróxido de Hidrogênio/farmacologia , Metaloproteinase 1 da Matriz/genética , Metaloproteinase 1 da Matriz/metabolismo , NF-kappa B/metabolismo , Oxirredutases atuantes sobre Doadores de Grupo CH-NH , Poliaminas/metabolismo , Putrescina/metabolismo , RNA/metabolismo , RNA Mensageiro/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Espermina/metabolismo , Fator de Transcrição AP-1/metabolismo , Poliamina Oxidase
8.
Int J Mol Sci ; 23(14)2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35886868

RESUMO

Polyamine levels decrease with menopause; however, little is known about the mechanisms regulated by menopause. In this study, we found that among the genes involved in the polyamine pathway, polyamine oxidase (PAOX) mRNA levels were the most significantly reduced by treatment with 17ß-estradiol in estrogen receptor (ESR)-positive MCF-7 breast cancer cells. Treatment with 17ß-estradiol also reduced the PAOX protein levels. Treatment with selective ESR antagonists and knockdown of ESR members revealed that estrogen receptor 2 (ESR2; also known as ERß) was responsible for the repression of PAOX by 17ß-estradiol. A luciferase reporter assay showed that 17ß-estradiol downregulates PAOX promoter activity and that 17ß-estradiol-dependent PAOX repression disappeared after deletions (-3126/-2730 and -1271/-1099 regions) or mutations of activator protein 1 (AP-1) binding sites in the PAOX promoter. Chromatin immunoprecipitation analysis showed that ESR2 interacts with AP-1 bound to each of the two AP-1 binding sites. These results demonstrate that 17ß-estradiol represses PAOX transcription by the interaction of ESR2 with AP-1 bound to the PAOX promoter. This suggests that estrogen deficiency may upregulate PAOX expression and decrease polyamine levels.


Assuntos
Neoplasias da Mama , Receptor beta de Estrogênio , Oxirredutases atuantes sobre Doadores de Grupo CH-NH , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Estradiol/metabolismo , Estradiol/farmacologia , Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Feminino , Humanos , Células MCF-7/metabolismo , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/genética , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/metabolismo , Poliaminas , Fator de Transcrição AP-1/genética , Poliamina Oxidase
9.
Antioxidants (Basel) ; 11(5)2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35624792

RESUMO

The superoxide dismutase (SOD) family functions as a reactive oxygen species (ROS)-scavenging system by converting superoxide anions into hydrogen peroxide in the cytosol (SOD1), mitochondria (SOD2), and extracellular matrix (SOD3). In this study, we examined the potential roles of SOD family members in skin aging. We found that SOD3 expression levels were significantly more reduced in the skin tissues of old mice and humans than in young counterparts, but SOD1 and SOD2 expression levels remained unchanged with aging. Accordingly, we analyzed the effects of SOD3 on intracellular ROS levels and the integrity of the extracellular matrix in fibroblasts. The treatment of foreskin fibroblasts with recombinant SOD3 reduced the intracellular ROS levels and secretion of MMP-1 while increasing the secretion of type I collagen. The effects of SOD3 were greater in fibroblasts treated with the TNF-α. SOD3 treatment also decreased the mRNA levels and promoter activity of MMP-1 while increasing the mRNA levels and promoter activities of COL1A1 and COL1A2. SOD3 treatment reduced the phosphorylation of NF-κB, p38 MAPK, ERK, and JNK, which are essential for MMP-1 transactivation. In a three-dimensional culture of fibroblasts, SOD3 decreased the amount of type I collagen fragments produced by MMP-1 and increased the amount of nascent type I procollagen. These results demonstrate that SOD3 reduces intracellular ROS levels, suppresses MMP-1 expression, and induces type I collagen expression in fibroblasts. Therefore, SOD3 may play a role in delaying or preventing skin aging.

10.
Life (Basel) ; 11(4)2021 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-33919658

RESUMO

PURPOSE: To investigate clinical outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) using HepaSpheres 20-40 µm in diameter and subsequent cisplatin-based lipiodol TACE (Cis-TACE) in patients with hepatocellular carcinoma (HCC) > 5 cm. MATERIALS AND METHODS: This study included 39 consecutive patients (34 men, 5 women; mean age, 63.5 years; range, 39-80 years) who underwent DEB-TACE using HepaSpheres 20-40 µm as first-line treatment for HCC > 5 cm (mean diameter, 8.2 cm; range, 5.1-13 cm) between September 2018 and August 2019. Patients with new tumors, residual tumors, or tumor growth after initial DEB-TACE underwent subsequent Cis-TACE. RESULTS: All 39 patients underwent initial DEB-TACE successfully, with 35 (89.7%) and three (7.7%) patients experiencing minor and major complications, respectively. After initial DEB-TACE, one patient (2.6%) achieved complete response (CR), 35 (89.7%) achieved partial response (PR), and three (7.7%) experienced progressive disease (PD). During a median follow-up period of 14.4 months (range, 0.6-23 months), 23 patients underwent Cis-TACE, with 11, three, and nine achieving CR, PR, and PD, respectively. The median overall survival time was 20.9 months (95% confidence interval (CI), 18.6-23.2 months), the median time to progression was 8.8 months (95% CI, 6.5-11.1 months), and the median time to local tumor recurrence was 16 months (95% CI, 7.4-24.6 months). CONCLUSIONS: DEB-TACE using HepaSpheres 20-40 µm in diameter can be a safe and effective initial treatment method in patients with HCC > 5 cm. Subsequent Cis-TACE constitutes a good adjuvant method to enhance tumor response after initial DEB-TACE.

11.
Ophthalmologica ; 244(1): 18-26, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31968350

RESUMO

PURPOSE: To evaluate the relationship between coronary artery calcification and subfoveal thicknesses of individual chorioretinal layers in subjects with subclinical atherosclerosis by using enhanced-depth imaging optical coherence tomography. METHODS: In this retrospective, noninterventional, cross-sectional study, we included 193 eyes from 193 subjects and divided them into three cardiovascular (CV) risk groups based on coronary artery calcification (CAC) scores calculated from cardiac-gated computed tomography: low (CAC = 0; n = 77), intermediate (CAC = 1-300; n = 83), and high (CAC >300; n = 33). Central macula individual retinal layer thicknesses and subfoveal choroidal thickness were measured and compared among groups. Multivariate linear regression was used to evaluate associations of subfoveal choroidal thickness or central retinal thickness with CAC scores. RESULTS: Average subfoveal choroidal thickness differed significantly among low, intermediate, and high CV risk groups (all p < 0.05). There were no statistically significant changes in segmented retinal layer thickness of the central macula. Multivariate regression analyses showed that higher CAC scores were significantly negatively associated with subfoveal choroidal thickness (ß = -2.169, p < 0.001). CONCLUSIONS: Higher CAC scores were significantly associated with subfoveal choroidal thinning in subjects with subclinical atherosclerosis. Prominent reductions in the subfoveal choroidal layer could provide a useful biomarker for predicting CV risk in patients of advanced age with subclinical atherosclerosis.


Assuntos
Aterosclerose , Vasos Coronários , Aterosclerose/complicações , Aterosclerose/diagnóstico , Corioide , Vasos Coronários/diagnóstico por imagem , Estudos Transversais , Humanos , Estudos Retrospectivos , Tomografia de Coerência Óptica
12.
RSC Adv ; 11(11): 6201-6211, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35423145

RESUMO

MXenes, a new class of 2D materials, have recently attracted increasing attention as promising adsorbents for environmental remediation. It has been previously demonstrated that MXenes can successfully capture selected organic dyes from aqueous media; however, to date, the adsorption performance of MXenes for a wide variety of dyes in simulated real-life aquatic environments other than clean laboratory deionized (DI) water has not been systematically investigated. In this study, we systematically investigated the adsorption performance of delaminated Ti3C2-MXenes for six different organic dyes in aquatic media at different pH levels and ionic strengths. Our results strongly suggest the importance of the electrostatic interactions between the ionizable functional groups of MXenes and dyes for removal efficiency. The electrostatic repulsions between negatively charged MXenes and certain anionic dyes reduced the removal efficiencies of MXenes for these dyes in DI water; however, the presence of divalent cations significantly improved the removal efficiencies, possibly owing to the charge screening effects and like-charge attractions mediated by cation binding to the functionalities of dyes and MXenes. These results provide a rational strategy for optimizing the conditions for efficient removal of different types of organic dyes using MXenes.

13.
RSC Adv ; 10(43): 25966-25978, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-35518610

RESUMO

MXenes, an emerging class of two-dimensional materials, are recently gaining significant attention for numerous environmental applications owing to their superior hydrophilicity and unique surface functionalities, which are suitable for adsorptive removal of various aqueous contaminants. However, it has recently been shown that MXenes have poor colloidal stability in both synthetic or natural waters containing small amounts of salt ions, which will limit the potential uses of MXenes in remediation of subsurface environments that might sometimes contain considerable amounts of salt ions, and other relevant environmental applications. Herein, we develop Ti3C2-MXenes grafted with highly salt-resistant polyelectrolytes (PEs), MXene-g-PEs, which are colloidally stable in extreme salinity aquatic environments and have low adsorption to soil mineral substrates. The MXenes grafted with zwitterionic PEs are found to have superior mobility properties to those with anionic PEs, which are attributed to the anti-PE behavior of the grafted polymer brushes. The MXene-g-(zwitterionic) PEs show long-term colloidal stability over 6 months in American Petroleum Institute (API) brine with extreme salinity (ionic strength of 2 M with 182.2 mM Ca2+), and little adsorption (0.5 mg m-2) against α-alumina surfaces (2.3 m2 g-1). Furthermore, the MXene-g-PEs retained the excellent adsorption capacity for methylene blue as a model aqueous organic pollutant. The results suggest the great potential of the MXene-g-PEs as an aqueous pollutant scavenger for various environmental applications including the combined ex situ/in situ remediation, and other relevant subsurface applications.

14.
Sci Rep ; 9(1): 14000, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31570740

RESUMO

The incidence of myopia is increasing worldwide, and the investigation on pathophysiology of myopia is becoming more important. This retrospective study aimed to compare the thicknesses of individual retinal layers between high-myopic and control eyes, and to evaluate the effects of age and sex on each retinal layer thickness. We assessed 164 subjects and divided them into two groups based on axial length (AL) (i.e., high-myopic group (AL ≥ 26 mm) and control group (AL < 26 mm)). Individual retinal layer thicknesses of five subfields in the macula were measured using automated retinal segmentation software packaged with the spectral-domain optical coherence tomography and were compared. In high-myopia group, the thicknesses of total retina and all individual retinal layers in central and entire perifoveal subfields were significantly thicker than the corresponding layers in control group after adjustment for ocular magnification (all P < 0.05). There were no significant effects of sex on individual retinal thicknesses, and age had less negative effects on the thicknesses of retina layers in high-myopic eyes than normal eyes. Axially elongated, non-pathologic highly myopic eyes had different structural features than control eyes, with significantly greater individual macular layer thicknesses independent of sex or age.


Assuntos
Miopia/patologia , Retina/patologia , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Humanos , Macula Lutea/anatomia & histologia , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Retina/anatomia & histologia , Fatores Sexuais , Tomografia de Coerência Óptica
15.
Korean J Ophthalmol ; 32(3): 190-195, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29770642

RESUMO

PURPOSE: This study aimed to investigate the diagnosis and severity of patients who were referred to tertiary medical centers according to the type and function of the referral hospitals. METHODS: First-visit patients referred from July 2015 to June 2016 were retrospectively reviewed with regard to referral hospital, final diagnosis, treatment necessity, and medical fees for the six months after their first hospital visit. Based on these data, differences in type and function of medical institution were examined. RESULTS: In a comparison of hospitals according to their number of beds, clinics, hospitals and, tertiary hospitals had no differences in the ratio of patients who needed treatment (p = 0.075) and their medical fees over six months (p = 0.372). When hospitals were classified by functional capability in terms of doctors' medical specialty, increasing ratios of patients requiring medical treatment (p < 0.001) and medical fees for six months (p < 0.001) were found in the order of non-eye specialists, eye specialists, and eye specialists in trainee hospital. CONCLUSIONS: Efficient healthcare delivery systems should classify medical institutions by functionality capability based on medical specialties rather than hospital size according to the number of beds.


Assuntos
Continuidade da Assistência ao Paciente/estatística & dados numéricos , Atenção à Saúde/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Retina ; 38(11): 2190-2196, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28902096

RESUMO

PURPOSE: To evaluate clinical correlations between the thicknesses of individual retinal layers in the foveal area of diabetic patients and the presence of diabetic peripheral neuropathy (DPN). METHODS: This retrospective, observational, cross-sectional study enrolled a total of 120 eyes from 120 patients. The eyes were divided into 3 groups: normal controls (n = 42 eyes), patients with diabetes mellitus (n = 42 eyes) but no DPN, and patients with diabetes mellitus and DPN (n = 36 eyes). The primary outcome measures were the thickness of all retinal layers in the central 1-mm zone measured using the segmentation analysis of spectral-domain optical coherence tomography. Correlations between the thicknesses of the individual retinal layers and the presence of DPN were also analyzed. Logistic regression analyses were used to determine which change in layer thickness had the most significant association with the presence of DPN. RESULTS: The mean thicknesses and the ratios of retinal nerve fiber layers to total retina thicknesses in the DPN group were 10.77 ± 1.79 µm and 4.10 ± 0.55%, which was significantly lower than those in normal controls and the diabetes mellitus with no DPN group (P = 0.014 and P = 0.001, respectively). Logistic regression analyses also showed that the decrease in thicknesses of the retinal nerve fiber layers and the inner nuclear layer are significant factors for predicting a higher risk for DPN development (odds ratio = 7.407 and 1.757; P < 0.001 and P = 0.001, respectively). CONCLUSION: A decrease in the retinal nerve fiber layer and the inner nuclear layer thickness was significantly associated with the presence of DPN.


Assuntos
Neuropatias Diabéticas/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Idoso , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Retrospectivos
17.
Korean J Radiol ; 18(2): 355-360, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28246515

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. MATERIALS AND METHODS: A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE. RESULTS: All women received successful bilateral prophylactic UAE followed by D&C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester. CONCLUSION: Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility.


Assuntos
Embolização da Artéria Uterina , Hemorragia Uterina/prevenção & controle , Adulto , Angiografia , Dilatação e Curetagem , Feminino , Humanos , Trabalho de Parto , Pessoa de Meia-Idade , Gravidez , Gravidez Ectópica/cirurgia , Estudos Retrospectivos , Adulto Jovem
18.
Optom Vis Sci ; 92(10): e363-7, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26367340

RESUMO

PURPOSE: To report a case of visual loss associated with traumatic choroidal rupture after blunt ocular trauma that was successfully treated with an early intravitreal bevacizumab injection despite the absence of choroidal neovascularization (CNV). CASE REPORT: A 14-year-old boy presented with visual disturbance in his left eye after sustaining an ocular contusion 4 weeks earlier. The best-corrected visual acuity (BCVA) in the left eye was 20/50. Funduscopic examination revealed macular choroidal rupture accompanied by subretinal hemorrhage. Optical coherence tomography (OCT) showed accumulation of subretinal fluid around a disrupted retinal pigment epithelium/Bruch membrane complex extending into the juxtafoveolar area, but there was no active leakage suggestive of CNV on fluorescein angiography. Intravitreal bevacizumab (1.25 mg) injection was performed to treat persistent serous retinal detachment at macula causing visual loss. There was a reduction of subretinal fluid and concomitant improvement of BCVA to 20/30 within 1 week after intravitreal bevacizumab injection. The BCVA recovered to 20/25 in the left eye after 4 weeks, and only a minimal amount of residual fluid remained according to OCT. Complete resolution of subretinal fluid was observed by OCT at the 6-week follow-up examination, and BCVA improved to 20/20. Good visual acuity (20/20) and stable macula were maintained in the left eye at 1 year of follow-up without recurrence of subretinal fluid accumulation or hemorrhage and CNV. There were no ocular or systemic complications associated with intravitreal bevacizumab injection. CONCLUSIONS: Early intravitreal bevacizumab injection could be an effective treatment option for patients with vision loss associated with traumatic choroidal rupture and subretinal fluid within the posterior pole before development of CNV.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Corioide/lesões , Traumatismos Oculares/tratamento farmacológico , Ferimentos não Penetrantes/tratamento farmacológico , Adolescente , Traumatismos Oculares/etiologia , Traumatismos Oculares/fisiopatologia , Angiofluoresceinografia , Humanos , Injeções Intravítreas , Masculino , Descolamento Retiniano/tratamento farmacológico , Descolamento Retiniano/etiologia , Descolamento Retiniano/fisiopatologia , Hemorragia Retiniana/tratamento farmacológico , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/fisiopatologia , Ruptura , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Ferimentos não Penetrantes/etiologia , Ferimentos não Penetrantes/fisiopatologia
19.
IEEE Trans Pattern Anal Mach Intell ; 37(9): 1792-805, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26353127

RESUMO

Improving the quality of degraded images is a key problem in image processing, but the breadth of the problem leads to domain-specific approaches for tasks such as super-resolution and compression artifact removal. Recent approaches have shown that a general approach is possible by learning application-specific models from examples; however, learning models sophisticated enough to generate high-quality images is computationally expensive, and so specific per-application or per-dataset models are impractical. To solve this problem, we present an efficient semi-local approximation scheme to large-scale Gaussian processes. This allows efficient learning of task-specific image enhancements from example images without reducing quality. As such, our algorithm can be easily customized to specific applications and datasets, and we show the efficiency and effectiveness of our approach across five domains: single-image super-resolution for scene, human face, and text images, and artifact removal in JPEG- and JPEG 2000-encoded images.

20.
Nanotechnology ; 26(16): 165302, 2015 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-25824622

RESUMO

Superhydrophobic surfaces are normally fixed on the chosen materials. Here, we report transferrable superhydrophobicity which was enabled by fabricating TiO2 nanorods on a reduced graphene oxide (rGO) film. Superhydrophobic TiO2 nanorods were first synthesized from a nanoporous template of block copolymers (BCPs). The controllability over the dimension and shape of nanopores of the BCP template allowed for the adjustment of TiO2 nanostructures for superhydrophobicity. Since the rGO film provided effective transferring, TiO2 nanorods were conveyed onto a flexible polymer film and a metal substrate. Thus, the surface of the designated substrate was successfully changed to a superhydrophobic surface without alteration of its inherent characteristics.

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