Surgical treatment for Parkinson's disease

Advances in stereotactic and functional neurosurgical techniques have brought about new developments in the surgical treatment for Parkinson's disease, including methods such as ablative therapy, chronic brain stimulation, stereotactic radiosurgery and transplantation. Significant benefits can be provided for patients who have become refractory to medical therapy or developed adverse side-effects after prolonged administration of levodopa.published_or_final_versio

Combined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomas

Background: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. Methods: A retrospective review was conducted on 12 consecutive patients. Surgical complications, visual and endocrinological functions, and tumour control were reviewed. Results: There were four men and eight women, with a mean age of 47.6 years. All but one patient had non-functioning PAs. The mean tumour height was 4.1 cm (range: 2.3-5.5). The predominant presenting symptoms were visual field loss in eight patients, headache in three patients and mental confusion in one patient. There was no operative mortality. Post-operative cerebrospinal fluid leakage occurred in one patient. Five of the eight patients who presented with visual field loss achieved full recovery, and three had partial improvement. Two patients developed permanent diabetes insipidus after surgery. Panhypopituitarism occurred in one patient. Gross total removal (GTR) was achieved in five, and subtotal removal (STR) in seven patients. Seven patients received post-operative external irradiation. All patients who had GTR remained tumour-free and all those with STR had stable diseases after a mean follow-up period of 53.1 months (range: 14.1-92.1). Conclusion: The simultaneous 'above and below' approach is a safe and effective surgical strategy for large-to-giant PAs, particularly when expertise in endoscopic transsphenoidal surgery is unavailable. Its use, however, should be limited to a carefully selected group of patients, and tailored to individual user's expertise and experience. © 2011 The Author(s).published_or_final_versio

MRI detection of peritoneal adhesion with dialysate enhancement

This study investigated the use of clinical peritoneal dialysis fluid (dialysate) as a peritoneal contrast agent to visualize peritoneal adhesions in rats at 7 Tesla. Intraperitoneal injection of dialysate (~0.1 mL/g) allowed the MR detection of peritoneal adhesions that were surgically induced in all rats studied (N = 6). MR measurements of adhesion surface areas correlated well with the postmortem estimations (R = 0.99). T1 and T2 values of undiluted dialysate were found to be 3017.5¡Ó35.3 ms and 108.4¡Ó2.0 ms, respectively. These findings demonstrated dialysate-enhanced MRI as a potentially valuable technique in clinical detection and evaluation of post-surgical peritoneal adhesion and to monitor therapeutic interventions (i.e., against peritoneal adhesion) in future preclinical research.published_or_final_versio

Non-viral Smad7 gene delivery and attenuation of postoperative peritoneal adhesion in an experimental model

Background: Postoperative intra-abdominal adhesion is associated with high morbidity and mortality. Smad7, a protein that occupies a strategic position in fibrogenesis, inhibits the transforming growth factor (TGF) β/Smad signalling pathway. In this study the therapeutic potential of exogenous Smad7 in preventing fibrogenesis in postoperative intra-abdominal adhesion was investigated. Methods: Intra-abdominal adhesion was induced in a rodent model by peritoneal abrasion. Smad7 was delivered into the peritoneal cavity by a non-viral ultrasound-microbubble-mediated naked gene transfection system. The effect of Smad7 transgene on adhesion formation was studied by measuring changes in TGF-β, fibrogenic factors, α-SMA and Smad2/3 activation in the anterior abdominal wall. Results: Four weeks after surgical abrasion, all rats developed significant peritoneal adhesion with enhanced TGF-β expression, increased levels of extracellular matrix components and activated myofibroblasts, accompanied by decreased Smad7 expression and increased Smad2/3 activation. In rats treated with the Smad7 transgene, the incidence and severity of peritoneal adhesion were significantly reduced, with biochemical downregulation of fibrogenic factors and inhibition of Smad2/3 activation. Serial quantitation using magnetic resonance imaging revealed a significant reduction in adhesion areas from day 14 onwards. Conclusion: Ultrasound-microbubble-mediated gene transfection provides timely targeted gene delivery for the treatment of postoperative peritoneal adhesions. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.postprin

Toll-like receptor 4 mediates tubular inflammation in diabetic nephropathy

published_or_final_versionThe 15th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 n. 1, suppl. 1, p. 39, abstract no. 6

Using bevacizumab in the fight against malignant glioma: First results in Asian patients

Objectives To investigate the efficacy and safety profile of bevacizumab in combination with irinotecan in Hong Kong Chinese patients with recurrent malignant glioma and to determine whether their response differed from that reported in other populations. Design Retrospective study. Setting Two private clinics and a public hospital in Hong Kong. Patients Fourteen individuals who presented with recurrent glioma presenting to the hospital between November 2005 and November 2009. Intervention Salvage therapy with bevacizumab (10 mg/kg) and irinotecan (125 mg/m 2 [340 mg/m 2 for those taking enzyme-inducing antiepileptic drugs]) on a 14-day schedule. Results A radiological response was observed in 12 (86%) of the patients, four (33%) of whom had a complete response. The median progression-free survival was 6 (range, 1-15) months; 71% remained progression-free at 6 months. The median overall survival was 18 (range, 9-61) months. The most common adverse events during the bevacizumab and irinotecan treatment period were haematological; five patients had grade 2/3 adverse events. Pulmonary embolism occurred in two patients, one of whom died. Intracranial haemorrhage was not detected in any of the 14 treated patients. Conclusions Bevacizumab plus irinotecan was at least as effective at treating Chinese patients with recurrent glioma as previously reported in clinical trials in different patient populations.published_or_final_versio

Simbolismos, Memórias e Narrativas: Redescobrindo a Rua da Lama da Década de 1980

Esta pesquisa teve por objetivo revelar aspectos simbólicos relacionados ao passado de um espaço na cidade de Vitória/ES, a Rua da Lama, a partir de pessoas que a frequentaram na década de 1980. Esta década foi escolhida por se tratar do início dessa região emblemática na cidade, que até hoje permanece sendo um ponto de encontro de lazer das pessoas. O que torna tal espaço contemporâneo e muito frequentado dentro da cidade. O estudo buscou relacionar os aspectos simbólicos de tal espaço, manifestados nas memórias presentes nas narrativas de seus antigos frequentadores. O objeto de pesquisa, composto por diferentes tipos de organizações, foi definido como espaço organizacional. Devido à complexidade do tema, buscou-se um aporte interdisciplinar dentro dos Estudos Organizacionais, abarcando as Ciências Sociais, História e o referencial de memória na Administração. Para o empreendimento, à luz de uma abordagem interdisciplinar nos Estudos Organizacionais, foi desenvolvida uma pesquisa de cunho qualitativo, utilizando a técnica de entrevistas narrativas para a coleta dos dados, gerando um conteúdo denso, que foram transcritas para posterior análise. Esse tipo de entrevista permitiu a pesquisadora entender de forma mais profunda o universo pesquisado. Após a coleta dos dados, o tratamento foi feito através da análise de conteúdo com as categorizações a posteriori. O período de coleta de dados se deu de maio a outubro de 2015, no qual foram realizadas oito entrevistas narrativas. Como resultado, foram encontradas três categorias seguindo um percurso temático, nomeadas por: O rock da Lama; As diferentes relações simbólicas com o espaço da Lama da década de 1980 e A Rua da Lama como um espaço de transgressão. A reflexão deu conta dos diferentes usos do passado para a reapropriação dos espaços simbólicos

The impact of aging on ciliary function and ultrastructive in human respiratory epithelium

Session - Respiratory & Critical Care Medicine: no. G-RC-8published_or_final_versio

Tissue kallikrein mediates pro-inflammatory pathways and activation of protease-activated receptor-4 in proximal tubular epithelial cells.

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Ciliary central microtubular orientation in stable bronchiectasis

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