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BACKGROUND: Arterial resection (AR) for pancreatic adenocarcinoma is increasingly considered at specialized centers. We aimed to examine the incidence, risk factors, and outcomes of hepatic artery (HA) occlusion after revascularization. METHODS: We included patients undergoing HA resection with interposition graft (IG) or primary end-to-end anastomoses (EE). Complete arterial occlusion (CAO) was defined as "early" (EO) or "late" (LO) before/after 90 days respectively. Kaplan-Meier and change-point analysis for CAO was performed. RESULTS: HA resection was performed in 108 patients, IG in 61% (66/108) and EE in 39% (42/108). An equal proportion (50%) underwent HA resection alone or in combination with celiac and/or superior mesenteric artery. CAO was identified in 18% of patients (19/108) with arterial IG least likely to occlude (p=0.019). Hepatic complications occurred in 42% (45/108) and correlated with CAO, symptomatic patients, venous resection, and postoperative portal venous patency. CAO-related operative mortality was 4.6% and significantly higher in EO vs LO (p = 0.046). Median CAO occlusion was 126 days. With change-point analysis, CAO was minimal beyond postoperative day 158. CONCLUSION: CAO can occur in up to 18% of patients and the first 5-month post-operative period is critical for surveillance. LO is associated with better outcomes compared to EO unless there is inadequate portal venous inflow.
Assuntos
Adenocarcinoma , Arteriopatias Oclusivas , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/patologia , Artéria Hepática/cirurgia , Artéria Hepática/patologia , Adenocarcinoma/cirurgia , Resultado do Tratamento , Pancreatectomia/efeitos adversos , Veia Porta/cirurgia , Estudos RetrospectivosRESUMO
Urban green spaces (UGS) improve living conditions in cities by mitigating the Urban Heat Island effect. While the cooling effect of UGS seems unequivocal, the relationship between the types of UGS and types of residential areas has not yet been well explored. In this study, we systematically analysed the cooling effect of 71 UGS in Prague, a central European city, on residential areas within 400 m of the UGS. The UGS are classified according to their spatial characteristics (size, shape, and tree density), and the residential areas according to three Local Climate Zones (LCZ 2, 5, 6) typical for European cities. The cooling effect is evaluated using a regression model of the Land Surface Temperature (LST) in residential zones according to the LCZ type and distance from the various UGS. The results show that compact UGS of 10-25 ha with dense trees have the most pronounced cooling effect. This type of UGS was associated with a mean decrease in LST within 400 m of 2.3 °C compared to the least effective UGS type (long with sparse trees) across LCZs. The results of the presented study can be applied in urban planning and urban design to improve microclimates in cities.
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Temperatura Alta , Parques Recreativos , Cidades , Clima , Temperatura , ÁrvoresRESUMO
Urbanization affects avian community composition in European cities, increasing biotic homogenization. Anthropic pollution (such as light at night and noise) is among the most important drivers shaping bird use in urban areas, where bird species are mainly attracted by urban greenery. In this study, we collected data on 127 breeding bird species at 1349 point counts distributed along a gradient of urbanization in fourteen different European cities. The main aim was to explore the effects of anthropic pollution and city characteristics, on shaping the avian communities, regarding species' diet composition. The green cover of urban areas increased the number of insectivorous and omnivorous bird species, while slightly decreasing the overall diet heterogeneity of the avian communities. The green heterogeneity-a measure of evenness considering the relative coverage of grass, shrubs and trees-was positively correlated with the richness of granivorous, insectivorous, and omnivorous species, increasing the level of diet heterogeneity in the assemblages. Additionally, the effects of light pollution on avian communities were associated with the species' diet. Overall, light pollution negatively affected insectivorous and omnivorous bird species while not affecting granivorous species. The noise pollution, in contrast, was not significantly associated with changes in species assemblages. Our results offer some tips to urban planners, managers, and ecologists, in the challenge of producing more eco-friendly cities for the future.
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Biodiversidade , Ruído , Animais , Cidades , Ruído/efeitos adversos , Melhoramento Vegetal , Aves , Urbanização , Dieta , EcossistemaRESUMO
Europe is an urbanized continent characterized by a long history of human-wildlife interactions. This study aimed to assess the effects of specific elements of urbanization and urban pollution on complementary avian diversity metrics, to provide new insights on the conservation of urban birds. Our study recorded 133 bird species at 1624 point counts uniformly distributed in seventeen different European cities. Our results thus covered a large spatial scale, confirming both effects of geographical and local attributes of the cities on avian diversity. However, we found contrasting effects for the different diversity components analyzed. Overall, taxonomic diversity (bird species richness), phylogenetic diversity and relatedness were significantly and negatively associated with latitude, while functional dispersion of communities showed no association whatsoever. At the local level (within the city), we found that urban greenery (grass, bush, and trees) is positively correlated with the number of breeding bird species, while the building cover showed a detrimental effect. Functional dispersion was the less affected diversity metric, while grass and trees and water (rivers or urban streams) positively affected the phylogenetic diversity of avian communities. Finally, the phylogenetic relatedness of species increased with all the main indicators of urbanization (building surface, floors, pedestrian's density and level of light pollution) and was only mitigated by the presence of bushes. We argue that maintaining adequate levels of avian diversity within the urban settlements can help to increase the potential resilience of urban ecosystems exposed to the stress provoked by rapid and continuous changes. We listed some characteristics of the cities providing positive and negative effects on each facet of urban avian diversity.
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Ecossistema , Urbanização , Animais , Biodiversidade , Aves , Cidades , Europa (Continente) , Humanos , Filogenia , Melhoramento VegetalRESUMO
Grassland is one of the most represented, while at the same time, ecologically endangered, land cover categories in the European Union. In view of the global climate change, detecting its change is growing in importance from both an environmental and a socio-economic point of view. A well-recognised tool for Land Use and Land Cover (LULC) Change Detection (CD), including grassland changes, is Remote Sensing (RS). An important aspect affecting the accuracy of change detection is finding the optimal indicators of LULC changes (i.e., variables). Inappropriately selected variables can produce inaccurate results burdened with a number of uncertainties. The aim of our study is to find the most suitable variables for the detection of grassland to cropland change, based on a pair of high resolution images acquired by the Landsat 8 satellite and from the vector database Land Parcel Identification System (LPIS). In total, 59 variables were used to create models using Generalised Linear Models (GLM), the quality of which was verified through multi-temporal object-based change detection. Satisfactory accuracy for the detection of grassland to cropland change was achieved using all of the statistically identified models. However, a three-variable model can be recommended for practical use, namely by combining the Normalised Difference Vegetation Index (NDVI), Wetness and Fifth components of Tasselled Cap. Increasing number of variables did not significantly improve the accuracy of detection, but rather complicated the interpretation of the results and was less accurate than detection based on the original Landsat 8 images. The results obtained using these three variables are applicable in landscape management, agriculture, subsidy policy, or in updating existing LULC databases. Further research implementing these variables in combination with spatial data obtained by other RS techniques is needed.
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Oligonucleotides homologous to 3'-telomere overhang (T-oligos) trigger inherent telomere-based DNA damage responses mediated by p53 and/or ATM and induce senescence or apoptosis in various cancerous cells. However, T-oligo has limited stability in vivo due to serum and intracellular nucleases. To develop T-oligo as an innovative, effective therapeutic drug and to understand its mechanism of action, we investigated the antitumor effects of T-oligo or T-oligo complexed with a novel cationic alpha helical peptide, PVBLG-8 (PVBLG), in a p53 null melanoma cell line both in vitro and in vivo. The uptake of T-oligo by MM-AN cells was confirmed by immunofluorescence, and fluorescence-activated cell sorting analysis indicated that the T-oligo-PVBLG nanocomplex increased uptake by 15-fold. In vitro results showed a 3-fold increase in MM-AN cell growth inhibition by the T-oligo-PVBLG nanocomplex compared with T-oligo alone. Treatment of preformed tumors in immunodeficient mice with the T-oligo-PVBLG nanocomplex resulted in a 3-fold reduction in tumor volume compared with T-oligo alone. This reduction in tumor volume was associated with decreased vascular endothelial growth factor expression and induction of thrombospondin-1 expression and apoptosis. Moreover, T-oligo treatment downregulated procaspase-3 and procaspase-7 and increased catalytic activity of caspase-3 by 4-fold in MM-AN cells. Furthermore, T-oligo induced a 10-fold increase of senescence and upregulated the melanoma tumor-associated antigens MART-1, tyrosinase, and thrombospondin-1 in MM-AN cells, which are currently being targeted for melanoma immunotherapy. Interestingly, siRNA-mediated knockdown of p73 (4-10-fold) abolished this upregulation of tumor-associated antigens. In summary, we suggest a key role of p73 in mediating the anticancer effects of T-oligo and introduce a novel nanoparticle, the T-oligo-PVBLG nanocomplex, as an effective anticancer therapeutic.
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Melanoma/tratamento farmacológico , Nanocápsulas/administração & dosagem , Nanocápsulas/química , Oligonucleotídeos/uso terapêutico , Peptídeos/administração & dosagem , Animais , Linhagem Celular Tumoral , Combinação de Medicamentos , Masculino , Melanoma/genética , Melanoma/patologia , Camundongos , Camundongos Nus , Nanocápsulas/ultraestrutura , Oligonucleotídeos/genética , Tamanho da Partícula , Peptídeos/química , Resultado do TratamentoRESUMO
Numerous tyrosine kinase inhibitors (TKIs) targeting c-Met are currently in clinical trials for several cancers. Their efficacy is limited due to the development of resistance. The present study aims to elucidate this mechanism of c-Met TKI resistance by investigating key mTOR and Wnt signaling proteins in melanoma cell lines resistant to SU11274, a c-Met TKI. Xenografts from RU melanoma cells treated with c-Met TKIs SU11274 and JNJ38877605 showed a 7- and 6-fold reduction in tumor size, respectively. Resistant cells displayed upregulation of phosphorylated c-Met, mTOR, p70S6Kinase, 4E-BP1, ERK, LRP6, and active ß-catenin. In addition, GATA-6, a Wnt signaling regulator, was upregulated, and Axin, a negative regulator of the Wnt pathway, was downregulated in resistant cells. Modulation of these mTOR and Wnt pathway proteins was also prevented by combination treatment with SU11274, everolimus, an mTOR inhibitor, and XAV939, a Wnt inhibitor. Treatment with everolimus, resulted in 56% growth inhibition, and a triple combination of SU11274, everolimus and XAV939, resulted in 95% growth inhibition in RU cells. The V600E BRAF mutation was found to be positive only in MU cells. Combination treatment with a c-Met TKI and a BRAF inhibitor displayed a synergistic effect in reducing MU cell viability. These studies indicate activation of mTOR and Wnt signaling pathways in c-Met TKI resistant melanoma cells and suggest that concurrent targeting of c-Met, mTOR, and Wnt pathways and BRAF may improve efficacy over traditional TKI monotherapy in melanoma patients.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Melanoma/tratamento farmacológico , Proteínas Proto-Oncogênicas c-met/antagonistas & inibidores , Neoplasias Cutâneas/tratamento farmacológico , Animais , Linhagem Celular Tumoral , Everolimo , Compostos Heterocíclicos com 3 Anéis/farmacologia , Xenoenxertos , Hormônio do Crescimento Humano/metabolismo , Humanos , Indóis/administração & dosagem , Masculino , Melanoma/metabolismo , Melanoma/patologia , Camundongos Endogâmicos BALB C , Camundongos Nus , Mutação , Fosforilação , Piperazinas/administração & dosagem , Estrutura Terciária de Proteína , Proteínas Proto-Oncogênicas c-met/metabolismo , Pirazóis/administração & dosagem , Piridazinas/administração & dosagem , Transdução de Sinais , Sirolimo/análogos & derivados , Sirolimo/farmacologia , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Sulfonamidas/administração & dosagem , Serina-Treonina Quinases TOR/metabolismo , Proteínas Wnt/metabolismoRESUMO
The use of tyrosine kinase inhibitors (TKIs) against EGFR/c-Met in non-small cell lung cancer (NSCLC) has been shown to be effective in increasing patient progression free survival (PFS), but their efficacy is limited due to the development of resistance and tumor recurrence. Therefore, understanding the molecular mechanisms underlying development of drug resistance in NSCLC is necessary for developing novel and effective therapeutic approaches to improve patient outcome. This study aims to understand the mechanism of EGFR/c-Met tyrosine kinase inhibitor (TKI) resistance in NSCLC. H2170 and H358 cell lines were made resistant to SU11274, a c-Met inhibitor, and erlotinib, an EGFR inhibitor, through step-wise increases in TKI exposure. The IC50 concentrations of resistant lines exhibited a 4-5 and 11-22-fold increase for SU11274 and erlotinib, respectively, when compared to parental lines. Furthermore, mTOR and Wnt signaling was studied in both cell lines to determine their roles in mediating TKI resistance. We observed a 2-4-fold upregulation of mTOR signaling proteins and a 2- to 8-fold upregulation of Wnt signaling proteins in H2170 erlotinib and SU11274 resistant cells. H2170 and H358 cells were further treated with the mTOR inhibitor everolimus and the Wnt inhibitor XAV939. H358 resistant cells were inhibited by 95% by a triple combination of everolimus, erlotinib and SU11274 in comparison to 34% by a double combination of these drugs. Parental H2170 cells displayed no sensitivity to XAV939, while resistant cells were significantly inhibited (39%) by XAV939 as a single agent, as well as in combination with SU11274 and erlotinib. Similar results were obtained with H358 resistant cells. This study suggests a novel molecular mechanism of drug resistance in lung cancer.