Early diagnosis of Takayasu's Arteritis (TAK) and detection of disease activity may reduce the risk of vascular complications. The objective of this study was to determine the effectiveness of imaging modalities for the management of TAK.
Methods
MEDLINE and EMBASE were searched for studies of patients undergoing various imaging modalities for TAK diagnosis or to assess disease activity. We excluded case reports, reviews and case series with < 10 patients. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Random effects meta-analyses with inverse-variance weighting were performed.
Results
From the 1126 citations screened, 57 studies met our inclusion criteria. Many of the studies were of small sample size (average N = 27), cross-sectional design and low methodological quality. Ultrasound (US) had a lower pooled sensitivity (SN) of 81% (95% CI: 69–89%) than Magnetic Resonance Angiography (MRA) with SN = 92% (95% CI: 88–95%) for TAK diagnosis (by clinical criteria and/or X-Ray angiography). Both had high specificities (SP) of > 90% for TAK diagnosis. Fewer studies investigated computed tomography angiography (CTA), but SN and SP for TAK diagnosis was high (> 90%). The utility of vessel wall thickening and enhancement by MRA and CTA to predict disease activity varied across studies. The pooled SN and SP of 18F-fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) for disease activity was 81% (95% CI: 69–89%) and 74% (95% CI: 55–86%), respectively.
Conclusion
US, CTA and/or MRA are effective for the diagnosis of TAK. The utility of these imaging modalities for assessing disease activity remains unclear. 相似文献
The liver may be injured in situations where it is submitted to ischemia, such as partial hepatectomy and liver transplantation. In all cases, ischemia is followed by reperfusion and, although it is essential for the reestablishment of tissue function, reperfusion may cause greater damage than ischemia, an injury characterized as ischemia-reperfusion (I/R) damage. The aim of this work was to analyze the effect of ischemic preconditioning with the use of methylene blue (MB; 15 mg/kg) 5 or 15 minutes before I/R (IRMB5′ and IRMB15′, respectively) on the hepatic injury occurring after I/R.
Methods
Twenty-eight male Wistar rats were used, and liver samples submitted to partial ischemia (IR) or not (NI) were obtained from the same animal. The samples were divided into 7 groups. Data were analyzed statistically by means of the nonparametric Mann-Whitney test and Wilcoxon Matched test, with the level of significance set at 5% (P < .05).
Results
The rate of oxygen consumption by state 3 mitochondria was inhibited in all ischemic groups compared with the sham group (SH vs IR: P = .0052; SH vs IRMB5′: P = .0006; SH vs IRMB15′: P = .0048), which did not occur in the nonischemic contralateral portion of the same liver (SH vs NI: P = .7652; SH vs NIMB5′: P = .059; SH vs NIMB15′: P = .3153). The inhibition of the rate of oxygen consumption by state 3 mitochondria was maintained in the presence of MB (IR vs IRMB5′: P = .4563; IR vs IRMB15′: P = .9021). The respiratory control ratio was reduced in all ischemic groups compared with the sham group, owing to the inhibition of oxygen consumption in state 3 (SH vs IR: P = .0151; SH vs IRMB5′: P = .005; SH vs IRMB15′: P = .0007).
Conclusions
Methylene blue had no effect on the mitochondrial respiratory parameters studied, but was able to reduce lipid peroxidation, preventing the production of reactive oxygen species (SH vs IRMB15′: P = .0210). 相似文献
Few studies have investigated the volumetric polymerization shrinkage and film thickness of the different cementation techniques used to cement veneers.
Purpose
The purpose of this in vitro study was to evaluate the volumetric polymerization shrinkage (VS) and film thickness (FT) of various cementation techniques through 3-dimensional (3D) microcomputed tomography (μCT).
Material and methods
Forty-eight artificial plastic maxillary central incisors with standard preparations for veneers were provided by a mannequin manufacturer (P-Oclusal) and used as testing models with the manufacturer’s plastic veneers. They were divided into 8 groups (n=6): RelyX Veneer + Scotchbond Universal (RV+SBU); Variolink Esthetic LC+Adhese Universal (VE+ADU); Filtek Supreme Ultra Flowable + Scotchbond Universal (FF+SBU); IPS Empress Direct Flow + Adhese Universal (IEF+ADU); Filtek Supreme Ultra Universal + Scotchbond Universal (FS+SBU); IPS Empress Direct + Adhese Universal (IED+ADU); Preheated Filtek Supreme Ultra Universal + Scotchbond Universal (PHF+SBU); and Preheated IPS Empress Direct + Adhese Universal (PHI+ADU). Specimens were scanned before and after polymerization using a μCT apparatus (mCT 40; Scanco Medical AG), and the resulting files were imported and analyzed with 3D rendering software to calculate the VS and FT. Collected data from both the VS and FT were submitted to 1-way ANOVA (α=.05).
Results
VE+ADU had the lowest volumetric shrinkage (1.03%), which was not significantly different from RV+SBU, FF+SBU or IEF+ADU (P>.05). The highest volumetric shrinkage was observed for FS+SBU (2.44%), which was not significantly different from RV+SBU, IED+ADU, PHF+SBU, or PHI+ADU (P>.05). Group RV+SBU did not differ statistically from the remaining groups (P>.05). Film thickness evaluation revealed the lowest values for RV+SBU, VE+ADU, FF+SBU, and IEF+ADU, with an average between groups of 0.17 mm; these groups were significantly different from FS+SBU, IED+ADU, PHF+SBU, and PHI+ADU (P>.05), with an average of 0.31 mm.
Conclusions
Both the VS and the FT of direct restorative composite resins were higher than those of veneer cements and flowable composite resins, whether preheated or not preheated. 相似文献
ObjectiveTo explore the effect of acupuncture combined with Chinese medicine on expression of interstitial cells of Cajal (ICC), substance P (SP) and nerve nitric oxide synthase (nNOS) in diabetic gastroparesis mice.MethodsEighty Kunming male mice were randomly divided into normal group (group A, 15 mice), diabetic gastroparesis model mice group (group B, 12 mice), acupuncture combined with Chinese medicine group (group C, 12 mice), Chinese medicine group (group D, 13 mice) and western medicine group (group E, 13 mice). The mice were intraperitoneally injected with steptozotocin and fed with high-fat diet-induced irregular except the normal group mice, that made mouse model of diabetic gastroparesis. And then, the ACM group were treated by acupuncture at the acupoints of Housanli ( ST 36) and Zhōngwăn ( CV 12) combined with Chinese medicine, the CM group were only treated by Chinese medicine; the WM group were treated by domperidone and vitamin B 6. Numbers and expression of ICC, SP and nNOS were detected by immunohistochemical methods.ResultsAfter treatment, compared with normal group, ICC and SP indexes of model group were significantly reduced. Compared with model group, all indexes in ACM and CM groups were improved significantly (P<0.05, P<0.01), but only the positive area and average optical density value in c-Kit and SP in WM group increased obviously (P<0.05). Compared with ACM group, no significant difference in c-Kit and SP of CM group were observed (P>0.05), but expression of nNOS were increased markedly (P<0.01). Besides, c-Kit and SP expressions of WM group were significantly induced was increased remarkably (P<0.01).ConclusionAcupuncture combined with Chinese medicine have much better therapeutic effects for diabetic gastroparesis mice, which may be due to repairing ICC damage, upregulating the expression of SP and lowering the expression of nNOS. 相似文献
