RESUMO
OBJECTIVE: Dupuytren's disease is a genetic disorder related to the proliferation of myofibroblasts. The pluripotent property of stem cells present in adipose tissue inhibits myofibroblast proliferation. Our study sought to evaluate the effect of stem cell-rich fat grafts in patients that underwent limited fasciotomy. METHODS: We studied 45 patients, in a single-blind, prospective, randomized clinical trial. All patients underwent limited fasciotomy. In one group, fat graft was injected. RESULTS: The total passive extension deficit results did not exhibit a significant difference. Fat group exhibited worse functional score at 6 months and 1 year postoperatively, such as higher complication rates (43%), when compared with control group (8%), and more pain at 6 weeks follow-up. CONCLUSION: Fat grafting associated with limited fasciotomy promotes worse functional results compared to conventional limited fasciotomy in the short term. However, long-term results and recurrence rates should be further assessed. Level of Evidence II, Prospective comparative study.
OBJETIVO: A moléstia de Dupuytren (MD) está associada a um distúrbio genético relacionado à proliferação de miofibroblastos. Acredita-se que a propriedade totipotente das células-tronco, presentes no tecido adiposo, seria capaz de inibir a formação dos miofibroblastos. O objetivo deste estudo foi avaliar o efeito do enxerto de gordura, rico em células-tronco, nos pacientes com MD, submetidos à fasciectomia parcial. MÉTODOS: Estudamos 45 pacientes, em um ensaio clínico prospectivo, randomizado e cego. No grupo-controle, era realizada apenas a fasciectomia parcial. No grupo com gordura, era realizada a fasciectomia parcial e injetado o enxerto de gordura. Os desfechos foram avaliados pelo Déficit de Extensão Passiva Total (DEPT) e escore funcional Brief Michigan Hand Questionnaire (BMHQ). RESULTADOS: Os resultados do déficit de extensão passiva total não apresentaram diferença significativa. O grupo com gordura apresentou pior escore funcional após 6 meses e 1 ano, como maiores taxas de complicações (43%) em comparação ao grupo controle (8%) e mais dor com 6 semanas de seguimento. CONCLUSÃO: O uso de enxerto de gordura associado à fasciectomia parcial promove piores resultados funcionais em comparação com a fasciectomia parcial convencional, a curto prazo. No entanto, a recidiva e os resultados a longo prazo devem ser avaliados. Nível de Evidência II, Estudo prospectivo comparativo.
RESUMO
ABSTRACT Objective: Dupuytren's disease is a genetic disorder related to the proliferation of myofibroblasts. The pluripotent property of stem cells present in adipose tissue inhibits myofibroblast proliferation. Our study sought to evaluate the effect of stem cell-rich fat grafts in patients that underwent limited fasciectomy. Methods: We studied 45 patients, in a single-blind, prospective, randomized clinical trial. All patients underwent limited fasciectomy. In one group, fat graft was injected. Results: The total passive extension deficit results did not exhibit a significant difference. Fat group exhibited worse functional score at 6 months and 1 year postoperatively, such as higher complication rates (43%), when compared with control group (8%), and more pain at 6 weeks follow-up. Conclusion: Fat grafting associated with limited fasciectomy promotes worse functional results compared to conventional limited fasciectomy in the short term. However, long-term results and recurrence rates should be further assessed. Level of Evidence II, Prospective comparative study.
RESUMO Objetivo: A moléstia de Dupuytren (MD) está associada a um distúrbio genético relacionado à proliferação de miofibroblastos. Acredita-se que a propriedade totipotente das células-tronco, presentes no tecido adiposo, seria capaz de inibir a formação dos miofibroblastos. O objetivo deste estudo foi avaliar o efeito do enxerto de gordura, rico em células-tronco, nos pacientes com MD, submetidos à fasciectomia parcial. Métodos: Estudamos 45 pacientes, em um ensaio clínico prospectivo, randomizado e cego. No grupo-controle, era realizada apenas a fasciectomia parcial. No grupo com gordura, era realizada a fasciectomia parcial e injetado o enxerto de gordura. Os desfechos foram avaliados pelo Déficit de Extensão Passiva Total (DEPT) e escore funcional Brief Michigan Hand Questionnaire (BMHQ). Resultados: Os resultados do déficit de extensão passiva total não apresentaram diferença significativa. O grupo com gordura apresentou pior escore funcional após 6 meses e 1 ano, como maiores taxas de complicações (43%) em comparação ao grupo controle (8%) e mais dor com 6 semanas de seguimento. Conclusão: O uso de enxerto de gordura associado à fasciectomia parcial promove piores resultados funcionais em comparação com a fasciectomia parcial convencional, a curto prazo. No entanto, a recidiva e os resultados a longo prazo devem ser avaliados. Nível de Evidência II, Estudo prospectivo comparativo.
RESUMO
Italian law on occupational exposure to noise identify 87 dBA as ceiling exposure level and 80 dBA as action level; the respect of ceiling level can be achieved by using devices, as ear plugs, whose efficacy must be verified. We studied 8119 audiometric of workers exposed to noise between 80 and 87 dBA. The hearing level of those who use ear plugs is significantly better than who don't use. Different devices show different efficacy, but for all, in the exposure setting studied, the level of protection that is provided is enough safe for othological protection. The workers must be informed about the efficacy of the protection and sensibilized to the use of the ear plugs within the periodical clinical surveillance.
Assuntos
Ruído Ocupacional/efeitos adversos , Ruído Ocupacional/legislação & jurisprudência , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , Adolescente , Adulto , Idoso , Humanos , Itália , Pessoa de Meia-Idade , Medição de RiscoRESUMO
Hepatocyte growth factor induces proliferation, motility and differentiation of epithelial cells through the tyrosine kinase receptor encoded by the MET protooncogene. The cytoplasmic portion of Met (referred to as cyto-Met) is activated but only weakly transforming. In order to determine the effect of activated Met on hepatocytes, we have targeted truncated Met expression to the liver by incorporating the cDNA into a vector carrying the entire human alpha-1-antitrypsin transcriptional unit. Transgenic expression in the liver of truncated human Met, containing the regulatory and the catalytic cytoplasmic domains, renders hepatocytes constitutively resistant to apoptosis and reproducibly permits immortalization. The emerging stable cell lines are not transformed and maintain a highly differentiated phenotype judged by the retention of epithelial cell polarity and the expression of hepatocyte-enriched transcription factors as well as hepatic products.
Assuntos
Apoptose/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Fígado/metabolismo , Proto-Oncogenes/genética , Receptores Proteína Tirosina Quinases/genética , Transgenes/genética , Animais , Anticorpos Monoclonais/imunologia , Anticorpos Monoclonais/metabolismo , Anticorpos Monoclonais/farmacologia , Apoptose/fisiologia , Northern Blotting , Southern Blotting , Western Blotting , Diferenciação Celular/genética , Células Cultivadas , Fator de Crescimento de Hepatócito/metabolismo , Histocitoquímica , Humanos , Imuno-Histoquímica , Camundongos , Camundongos Transgênicos , Microscopia Eletrônica , alfa 1-Antitripsina/genéticaRESUMO
We inserted the sequence coding for the cytoplasmic portion of the human MET receptor into an 18-kb genomic fragment containing the entire human A1AT gene (encoding alpha-1-antitrypsin). Stringent control of gene expression, at the transcriptional, post-transcriptional and translational levels, was ensured by insertion of the MET open reading frame into A1AT, thus maintaining: (i) all the elements that confer tissue-specific transcription initiation, (ii) all the sequences involved in transcript processing and (iii) all the sequences which influence messenger stability and translational efficiency. The expression pattern of this vector in transgenic mice was identical to that of the human A1AT transgene, as well as to that of A1AT in humans with regard to both temporal and tissue-specific regulation.
