970 resultados para Articular instability
Resumo:
BACKGROUND: At least 2 apparently independent mechanisms, microsatellite instability (MSI) and chromosomal instability, are implicated in colorectal tumorigenesis. Their respective roles in predicting clinical outcomes of patients with T3N0 colorectal cancer remain unknown. METHODS: Eighty-eight patients with a sporadic T3N0 colon or rectal adenocarcinoma were followed up for a median of 67 months. For chromosomal instability analysis, Ki-ras mutations were determined by single-strand polymerase chain reaction, and p53 protein staining was studied by immunohistochemistry. For MSI analysis, DNA was amplified by polymerase chain reaction at 7 microsatellite targets (BAT25, BAT26, D17S250, D2S123, D5S346, transforming growth factor receptor II, and BAX). RESULTS: Overall 5-year survival rate was 72%. p53 protein nuclear staining was detected in 39 patients (44%), and MSI was detected in 21 patients (24%). MSI correlated with proximal location (P <.001) and mucinous content (P <.001). In a multivariate analysis, p53 protein expression carried a significant risk of death (relative risk = 4.0, 95% CI = 1.6 to 10.1, P =.004). By comparison, MSI was not a statistically significant prognostic factor for survival in this group (relative risk = 2.2, 95% CI = 0.6 to 7.3, P =.21). CONCLUSIONS: p53 protein overexpression provides better prognostic discrimination than MSI in predicting survival of patients with T3N0 colorectal cancer. Although MSI is associated with specific clinicopathologic parameters, it did not predict overall survival in this group. Assessment of p53 protein expression by immunocytochemistry provides a simple means to identify a subset of T3N0 patients with a 4-times increased risk for death.
Resumo:
Direct MR arthrography has a better diagnostic accuracy than MR imaging alone. However, contrast material is not always homogeneously distributed in the articular space. Lesions of cartilage surfaces or intra-articular soft tissues can thus be misdiagnosed. Concomitant application of axial traction during MR arthrography leads to articular distraction. This enables better distribution of contrast material in the joint and better delineation of intra-articular structures. Therefore, this technique improves detection of cartilage lesions. Moreover, the axial stress applied on articular structures may reveal lesions invisible on MR images without traction. Based on our clinical experience, we believe that this relatively unknown technique is promising and should be further developed.
Resumo:
Diplomityön tavoitteena oli tutkia miten ilman turbulenttisuus vaikuttaa tasaisesti liikkuvan rainan tilaan. Yhtenä sovelluskohteena teollisuudessa voidaan mainita esimerkiksi leiju-kuivain. Tiedetään, että konenopeuksien kasvu ja siitä johtuva ilmavirran nopeuden kasvu aiheuttaa voimavaikutuksia rainaan ja voi aiheuttaa lepatusta. Lepatus johtaa dynaamiseen epästabiilisuuteen, joka voidaan havaita, kun lineaarinen systeemi tulee epävakaaksi ja joh-taa epälineaariseen, rajoitettuun värähtelyyn. Lepatus huonontaa tuotteiden laatua ja voi johtaa ratakatkoihin. Työssä on esitetty tietoa ilman ja rainan vuorovaikutuksesta, jota hyödyntämällä voidaan kehittää yksinkertaistettu malli, jonka avulla liikkuvaa rainaa voidaan simuloida kuivaimes-sa. Kaasufaasin virtausyhtälöt on ratkaistu eri turbulenttimalleja käyttäen. Myös viskoelas-tisen rainan muodonmuutosta on tarkasteltu. Koska rainalle ei ole kirjallisuudesta saatavilla tarkkoja fysikaalisia ja mekaanisia arvoja, näitä ominaisuuksia testattiin eri arvoilla, jotta rainan käyttäytymistä jännityksen alaisena voidaan tarkastella. Näiden ominaisuuksien tun-teminen on ensiarvoisen tärkeää määritettäessä rainan aeroviskoelastista käyttäytymistä. Virtaussimulointi on kallista ja aikaa vievää. Tämä tarkoittaa uusien tutkimusmenetelmien omaksumista. Tässä työssä vaihtoehtoisena lähestymistapana on esitetty yksinkertaistettu malli, joka sisältää ilman ja rainan vuorovaikutusta kuvaavat ominaisuudet. Mallin avulla saadaan tietoa epälineaarisuuden ja turbulenssin vaikutuksesta sekä monimutkaisesta yh-teydestä stabiilisuuden ja ulkoisesti aikaansaadun värähtelyn sekä itse aiheutetun värähtelyn välillä. Työn lopussa on esitetty havainnollinen esimerkki, jolla voidaan kuvata olosuhteita, jossa rainan tasainen liike muuttuu epävakaaksi. Kun turbulenttisuudesta johtuva painevaih-telu ylittää tietyn rajan, rainan värähtely kasvaa muuttuen satunnaisesta järjestäytyneeksi. Saaduttulokset osoittavat, että turbulenttisuudella on suuri vaikutus eikä sitä voi jättää huomioimatta. Myös rainan viskoelastiset ominaisuudet tulee huomioida, jotta rainan käyt-täytymistä voidaan kuvata tarkasti.
Resumo:
BACKGROUND: Inflammatory bowel diseases (IBD) are systemic conditions that commonly display extraintestinal manifestations. Inflammatory articular disease (IAD: axial or peripheral) is the most common extraintestinal manifestation. The aim of this study was to evaluate the prevalence and the clinical characteristics associated with IAD in patients with IBD. METHODS: We analyzed patients enrolled in the Swiss IBD cohort study. IAD was defined as persistent or recurrent joint pain with an inflammatory pattern (night pain, progressive relief during the day, morning stiffness lasting at least 30 minutes) or the presence of arthritis as diagnosed by the physicians. A multivariate logistic regression was performed to analyze which disease characteristics were independently associated with the presence of IAD. RESULTS: A total of 2353 patients with IBD, 1359 with Crohn's disease, and 994 with ulcerative colitis (UC) were included. Forty-four percent of patients fulfilled the criteria for IAD, whereas 14.5% presented with other extraintestinal manifestations. IAD was associated with Crohn's disease, with female sex, with older age, and generally in patients with more active intestinal disease. Only in UC, IAD was further associated with tobacco smoking and with increasing body mass index. CONCLUSIONS: This population of patients with IBD displays a high prevalence of IAD. IAD was more strongly associated with Crohn's disease than UC. Other risk factors for IAD were female sex, advanced age, active digestive disease, and tobacco consumption in patients with UC, which is interesting given the established association between smoking and other inflammatory arthritides.
Resumo:
We show how certain N-dimensional dynamical systems are able to exploit the full instability capabilities of their fixed points to do Hopf bifurcations and how such a behavior produces complex time evolutions based on the nonlinear combination of the oscillation modes that emerged from these bifurcations. For really different oscillation frequencies, the evolutions describe robust wave form structures, usually periodic, in which selfsimilarity with respect to both the time scale and system dimension is clearly appreciated. For closer frequencies, the evolution signals usually appear irregular but are still based on the repetition of complex wave form structures. The study is developed by considering vector fields with a scalar-valued nonlinear function of a single variable that is a linear combination of the N dynamical variables. In this case, the linear stability analysis can be used to design N-dimensional systems in which the fixed points of a saddle-node pair experience up to N21 Hopf bifurcations with preselected oscillation frequencies. The secondary processes occurring in the phase region where the variety of limit cycles appear may be rather complex and difficult to characterize, but they produce the nonlinear mixing of oscillation modes with relatively generic features
Resumo:
OBJETIVO: Avaliar a eficácia da técnica extra-capsular para o tratamento de ruptura do ligamento cruzado anterior em cães. MÉTODOS: Foi realizada a reparação cirúrgica extra-articular, sem artrotomia do ligamento cruzado anterior, com a utilização da fáscia lata autógena para estabilização da articulação do joelho em seis animais que apresentaram claudicação grave e movimento de gaveta positivo. RESULTADOS: A técnica cirúrgica extra-articular foi eficaz com boa estabilização articular e evolução satisfatória. CONCLUSÃO: A via extra capsular com uso da fáscia lata para correção da ruptura do ligamento cruzado anterior mostrou-se útil haja vista tratar-se de um procedimento simples e de rápida execução, causando o mínimo dano tecidual e recuperação pós-operatória eficiente.
Resumo:
OBJETIVO: Analisar os efeitos da injeção repetida de betametasona na concentração de proteoglicanos da cartilagem articular do joelhos normais de coelhos californianos de ambos os sexos. MÉTODOS: Os animais foram randomizados em oito grupos de dez animais cada. Três grupos controle (injeção ou não de solução salina isotônica) e cinco grupos de estudo - doses terapêuticas, repetidas ou não, de betametasona injetadas no joelho direito de cada coelho, com intervalos semanais. Após oito dias da última injeção prevista, cortes histológicos da cartilagem das áreas de apoio dos platôs tibiais foram corados com hematoxilina e eosina para análise por microscopia óptica, e com safranina O para a pesquisa da quantidade de proteoglicanos. A intensidade da coloração da safranina O foi quantificada em aparelho de histomorfometria, composto por microscópio Olympus BX 50 e microcomputador com software Image Pro-plus 4.5Ò. RESULTADOS: Não houve diferenças nos animais que tiveram seus joelhos injetados com betametasona uma, duas e quatro vezes quando comparados com os grupos controle. Nos animais que receberam seis e oito aplicações a intensidade da coloração com safranina O reduziu-se significativamente (p < 0,05) quando comparada tanto com grupos controle quanto com os outros de estudo. CONCLUSÃO: Foi possível demonstrar redução da concentração de proteoglicanos na matriz cartilaginosa articular dependente do efeito deletério cumulativo das repetidas injeções intra-articulares de betametasona.
Resumo:
An early experiment found that a square rubber sheet under symmetric biaxial loading may not remain square. This curious result has been one of the most instructive examples in finite elasticity. Here thermodynamic considerations are used to analyze this instability.
Resumo:
Several human genetic syndromes have long been recognized to be defective in DNA repair mechanisms. This was first discovered by Cleaver (1968), who showed that cells from patients with xeroderma pigmentosum (XP) were defective for the ability to remove ultraviolet (UV)-induced lesions from their genome. Since then, new discoveries have promoted DNA repair studies to one of the most exciting areas of molecular biology. The present work intends to give a brief summary of the main known human genetic diseases related to DNA repair and how they may be linked to acquired diseases such as cancer
Resumo:
We evaluated the mechanical behavior of the repaired surfaces of defective articular cartilage in the intercondylar region of the rat femur after a hydrogel graft implant. The results were compared to those for the adjacent normal articular cartilage and for control surfaces where the defects remained empty. Hydrogel synthesized by blending poly(2-hydroxyethyl methacrylate) and poly(methyl methacrylate-co-acrylic acid) was implanted in male Wistar rats. The animals were divided into five groups with postoperative follow-up periods of 3, 5, 8, 12 and 16 weeks. Indentation tests were performed on the neoformed surfaces in the knee joint (with or without a hydrogel implant) and on adjacent articular cartilage in order to assess the mechanical properties of the newly formed surface. Kruskal-Wallis analysis indicated that the mechanical behavior of the neoformed surfaces was significantly different from that of normal cartilage. Histological analysis of the repaired defects showed that the hydrogel implant filled the defect with no signs of inflammation as it was well anchored to the surrounding tissues, resulting in a newly formed articular surface. In the case of empty control defects, osseous tissue grew inside the defects and fibrous tissue formed on the articular surface of the defects. The repaired surface of the hydrogel implant was more compliant than normal articular cartilage throughout the 16 weeks following the operation, whereas the fibrous tissue that formed postoperatively over the empty defect was stiffer than normal articular cartilage after 5 weeks. This stiffness started to decrease 16 weeks after the operation, probably due to tissue degeneration. Thus, from the biomechanical and histological point of view, the hydrogel implant improved the articular surface repair.
Resumo:
Microsatellites are short tandem repeat sequences dispersed throughout the genome. Their instability at multiple genetic loci may result from mismatch repair errors and it occurs in hereditary nonpolyposis colorectal cancer. This instability is also found in many sporadic cancers. In order to evaluate the importance of this process in myeloid leukemias, we studied five loci in different chromosomes of 43 patients, 22 with chronic myelocytic leukemia (CML) in the chronic phase, 7 with CML in blast crisis, and 14 with acute myeloid leukemia (AML), by comparing leukemic DNA extracted from bone marrow and constitutional DNA obtained from buccal epithelial cells. Only one of the 43 patients (2.1%), with relapsed AML, showed an alteration in the allele length at a single locus. Cytogenetic analysis was performed in order to improve the characterization of leukemic subtypes and to determine if specific chromosome aberrations were associated with the presence of microsatellite instability. Several chromosome aberrations were observed, most of them detected at diagnosis and during follow-up of the patients, according to current literature. These findings suggest that microsatellite instability is an infrequent genetic event in myeloid leukemias, adding support to the current view that the mechanisms of genomic instability in solid tumors differ from those observed in leukemias, where specific chromosome aberrations seem to play a major role.