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侵襲性齒頸部吸收 - 分布狀況、可能致病因子與臨床特徵

為了解決hypophosphatasia中文的問題，作者鄭博元 這樣論述：

Introduction: Invasive cervical resorption (ICR) is a relatively rare dental disease. It may cause irreversible destruction to the cervical area of the tooth. If left untreated, the tooth has to be extracted eventually. The demographic and tooth distribution of ICR had not been investigated in a

ny Asian populations. Its etiopathology and predisposing factors are also unclear. Furthermore, the clinical and radiographic features of ICR have not been investigated in a systematic way.Objective: To investigate the distribution, predisposing factors, and clinical characteristics of invasive cerv

ical resorption (ICR).Materials and methods: Cases with ICR from 2009 to 2019 were collected in National Taiwan University Hospital. Clinical records and radiographs were reviewed. Descriptive analysis was performed in combination with univariate analysis and Fisher’s exact test.Results: A total of

63 ICR teeth from 31 patients (14 males and 17 females) were found. The patients’ ages ranged from 18 to 81 years, with a mean age of 45.77. Most patients had a single ICR lesion. Among the 63 ICR teeth, maxillary anterior teeth (47.62%) were the most commonly affected, followed by maxillary premola

rs (20.63%). Maxillary teeth (76.19%) were more prone to ICR than mandibular teeth (23.81%). Most patients denied all major systemic diseases. The most common dental-related factors were dental/orofacial trauma (33.33%), periodontal treatment (26.98%), restoration/crown (17.46%), and orthodontic tre

atment (15.87%). Most teeth showed no percussion/palpation pain, probing depth > 3 mm, abscess formation, sinus tracts, or periapical lesions. The pulp status was mainly vital (73.02%). The presence of percussion pain and probing depth differed significantly among Heithersay ICR classification group

s.Conclusion: ICR showed no difference in sex or age group. Maxillary anterior teeth were the most affected in a Taiwanese population. Traumatic injury, periodontal treatment, and orthodontic treatment were the significant predisposing factors. The influence of endocrine imbalance may be related to

ICR. Furthermore, affected teeth typically lacked clinical signs and symptoms. Radiographic examination is critical for early diagnosis. In advanced cases, deep pockets and abscess formation were seen.Clinical significance: Up to our knowledge, this study is the first epidemiological study of ICR a

mong Asian populations. In different countries and races, the distribution of affected teeth may vary according to the type of predisposing factors. In agreement with previous studies, we support the hypothesis that traumatic injury and other dental treatments may be related to the development of IC

R. We have also highlighted the potential role of thyroid or parathyroid disorders in the etiopathogenesis of ICR. In addition, given that ICR-affected teeth are mainly asymptomatic and vital, clinicians should stay alerted to any possible anomalies in routine dental practice. Although most of our p

atients only presented one tooth affected by ICR during their observation period in National Taiwan University Hospital, few patients presented multiple teeth affected by ICR. Whether these single-ICR cases would suffer from ICR in other teeth in the future is still unknown. Literatures have shown t

hat ICR can appear successively in different teeth of the same patients. We recommend that clinicians should take routine radiographic check-ups for these patients, to diagnosis the problem earlier, to treat earlier and to increase the success rate.

造血相關蛋白GATA-binding protein 3於調控骨頭癒合過程扮演的角色研究

為了解決hypophosphatasia中文的問題，作者廖梅琇 這樣論述：

骨頭(bone)是支持、保護身體與造血功能的重要器官，當斷裂時會因程度及部位不同，使骨癒合(bone healing)的時間至少數月甚至長達一年，過程中因活動限制不僅引起生、心理上的問題並造成經濟上的負擔。而為了達到有效治療，準確的評估是重要的，但臨床上X光因受到影像解析度與拍攝角度受限的影響，常降低判讀的準確性，因此，本研究期望能藉由找到具代表性的生物標誌(biomarker)，提高評估的準確度，結合適時的治療，而達到縮短骨癒合的時間。從實驗室先前研究發現，造血相關蛋白GATA-3 (GATA-binding protein 3)會表現在骨母細胞(osteoblasts)，並且在低濃度一氧

化氮(nitric oxide, NO)的處理下，透過調控Bcl-XL基因表現，降低氧化壓力所造成的細胞凋亡(cell apoptosis)，此外，我們也在骨質疏鬆的老鼠血液中能夠偵測到GATA-3蛋白表現。因此，本研究欲利用小鼠建立骨缺陷(bone defect)模式，探討GATA-3在骨癒合扮演的角色及做為生物標誌的可能性。結果發現，GATA-3不僅會表現於骨母細胞當中，術後第一、三、五及七天，在骨缺陷處GATA-3及磷酸化GATA-3皆有明顯上升，且在細胞核中與調控骨母細胞分化的主要轉錄因子，Runx2 (runt-related transcription factor-2)結合，促使

bcl-xl基因表現量上升。此外，GATA-3與bcl-xl表現趨勢則與術後細胞凋亡的曲線相反。接著，本研究將骨母細胞長期處理低濃度一氧化氮後顯示，GATA-3表現量同樣會增加並且參與在骨母細胞分化及礦物化的過程。由以上結果得知GATA-3除了會抑制細胞凋亡外，還可能具有調控骨母細胞分化之角色。因此，我們更進一步從治療的評估觀點上，利用常見的植物性雌激素(phytoestrogen)，金雀異黃酮(Genistein)，先證實其會活化MAPK/NF-κB/AP-1訊息傳遞路徑，促進雌激素接受體(estrogen receptor, ER)-α及GATA-3的表現，並促使骨母細胞分化及礦物化。而當

小鼠給予genistein後，其同樣會促進骨頭的新生，同時，在骨缺陷處磷酸化GATA-3表現量則有增加的趨勢。綜合以上研究結果顯示，在骨頭癒合過程中會促使GATA-3表現增加，降低細胞凋亡，參與骨母細胞分化與骨頭生成，因此，GATA-3在未來臨床上可能具有做為一個評估骨頭損傷預後的生物標誌與治療上的參考指標，以配合有效治療方式，達到縮短骨癒合的時間。