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Objective: To systematically evaluate the safety and efficacy of laparoscopic versus open surgery for palliative resection of the primary tumor in stage IV colorectal cancer. Methods: The databases of CNKI, Wanfang, VIP, PubMed, EMBASE and Cochrane Library were searched to retrieve randomized controlled trials (RCT) or clinical controlled trials (CCT) comparing laparoscopic surgery with open surgery for palliative resection of the primary tumor in stage IV colorectal cancer published from January 1991 to May 2019. Chinese search terms included "colorectum/colon/rectum" , "cancer/malignant tumor" , "laparoscopy" , "metastasis" , " IV" ; English search terms included "laparoscop*" , "colo*" , "rect*" , "cancer/tumor/carcinoma/neoplasm" , " IV" , "metasta*" . Inclusion criteria: (1) RCT or CCT, with or without allocation concealment or blinding; (2) patients with stage IV colorectal cancer that was diagnosed preoperatively and would receive resection of the primary tumor; (3) the primary tumor that was palliatively resected by laparoscopic or open procedure. Exclusion criteria: (1) no valid data available in the literature; (2) single study sample size ≤20; (3) subjects with colorectal benign disease; (4) metastatic resection or lymph node dissection was performed intraoperatively in an attempt to perform radical surgery; (5) duplicate publication of the literature. Two researchers independently evaluated the quality of the included studies. In case of disagreement, the evaluation was performed by discussion or a third researcher was invited to participate. The data were extracted from the included studies, and the Cochrane Collaboration RevMan 5.1.0 version software was used for this meta-analysis. Results: Four CCTs with a total of 864 patients were included in this study, including 216 patients in the laparoscopic group and 648 patients in the open group. Compared with the open group, except for longer operation time (WMD=37.60, 95% CI: 26.11 to 49.08, P<0.05), laparoscopic group had less intraoperative blood loss (WMD=-74.89, 95% CI: -144.78 to -5.00, P<0.05), earlier first flatus and food intake after surgery (WMD=-1.00, 95% CI: -1.12 to -0.87, P<0.05; WMD=-1.61, 95%CI: -2.16 to -1.06, P<0.05), shorter hospital stay (WMD=-2.01, 95% CI: -2.21 to -1.80, P<0.05) and lower morbidity of postoperative complication (OR=0.52, 95% CI: 0.35 to 0.77, P<0.05). However, no significant differences were found in time to start postoperative chemotherapy, postoperative chemotherapy rate, and mortality (P > all 0.05). Conclusion: Laparoscopic surgery for palliative resection of the primary tumor is safe and feasible to enhance recovery after surgery by promoting postoperative bowel function recovery, shortening hospital stay and reducing postoperative complication in stage IV colorectal cancer.
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Neoplasias Colorrectales/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Cuidados Paliativos/métodos , Colectomía/métodos , Humanos , Laparoscopía , Laparotomía , Proctectomía/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
Retinoic acid-inducible gene-I (RIG-I) is a cytoplasmic viral RNA sensor that triggers the production of type I interferons (IFNs) and proinflammatory cytokines during viral infection. RIG-I gene has been identified previously in Japanese eel, Anguilla japonica. In the present study, we have characterized a novel isoform of RIG-I (designated as AjRIG-Ib) and its truncated variant (AjRIG-Ibv). The AjRIG-Ib encodes 940 amino acids (aa) consisting of two N-terminal caspase activation and recruitment domains (CARDs), a DEX(D/H) box RNA helicase domain, and a C-terminal regulatory domain (CTD). The AjRIG-Ibv encodes a protein of 843 aa, that shares similar structural organization with AjRIG-Ib, but lacking CTD. The gene expression analyses showed that AjRIG-Ib and AjRIG-Ibv were detectable in all tissues/organs examined, and AjRIG-Ib was the predominant form. The mRNA level of AjRIG-Ibv was upregulated rapidly at 8â¯h after the Poly I:C injection, and the significant increase of AjRIG-Ib was observed at 16 and 24â¯h post-injection (hpi). Laser confocal microscopy showed that AjRIG-Ib and AjRIG-Ibv were both located in cytoplasm. In addition, the overexpression of AjRIG-Ib or AjRIG-Ibv led to the increased activity of IFN promoter in transient transfection assay. Taken together, our results indicated that AjRIG-Ib and AjRIG-Ibv may play cooperative or somewhat complementary roles in coordinating the antiviral response in fish.
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Anguilla/genética , Anguilla/inmunología , Enfermedades de los Peces/inmunología , Proteínas de Peces/genética , Proteínas de Peces/inmunología , Regulación de la Expresión Génica/inmunología , Inmunidad Innata/genética , Secuencia de Aminoácidos , Animales , Proteínas de Peces/química , Perfilación de la Expresión Génica/veterinaria , Filogenia , Poli I-C/farmacología , Isoformas de Proteínas/química , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Alineación de Secuencia/veterinariaRESUMEN
OBJECTIVES: The purpose of this study was to explore the effectiveness of concurrent GRP78 overexpression combined with Cripto on hMSC proliferation and migration both in vitro and in vivo. Specifically, we explored whether the treatment enhances effectiveness of hMSC transplantation in ischaemic tissue. MATERIALS AND METHODS: Human MSCs obtained from human adipose tissue were cultured in α-minimum essential medium (Hyclone, Logan, UT, USA) supplemented with 10% (v/v) foetal bovine serum (Hyclone), 100 U mL-1 penicillin and 100 µg mL-1 streptomycin. Murine hindlimb ischaemic model was generated with 8-week-old male nude BALB/c mice (Biogenomics, Seoul, Korea) maintained under a 12-h light/dark cycle following the established protocol with minor modification. Cellular injection was performed no later than 3 hour after surgery. Lipofectamine transfection, single-cell cultivation assay, transwell assay, scratch wound-healing migration assay, immunohistochemistry and western blotting assays were performed. RESULTS: Overexpression of GRP78 along with Cripto enhanced hMSC proliferation, migration and invasion. It increased interaction of surface GRP78 receptor with Cripto via JAK2/STAT3 pathway. We confirmed our proposed mechanism by showing that treatment with GRP78 antibody blocks the enhancement in vitro. In vivo, we observed that Cripto induced by the hypoxic environment in hindlimb ischaemic model interacts with the overexpressed GRP78 and increases hMSC proliferation, migration and invasion potentials as well as angiogenesis around transplanted ischaemic site via cytokine secretions. CONCLUSIONS: These results demonstrate supporting evidences that GRP78-Cripto combination technique offers novel strategy to enhance MSC proliferation, migration and invasion potentials as well as angiogenesis around ischaemic site, ultimately facilitating MSC-based transplantation therapy in ischaemic conditions.
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Proteínas Ligadas a GPI/metabolismo , Proteínas de Choque Térmico/metabolismo , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Células Madre Mesenquimatosas/metabolismo , Proteínas de Neoplasias/metabolismo , Neovascularización Patológica/metabolismo , Células Madre/metabolismo , Animales , Hipoxia de la Célula/fisiología , Línea Celular , Movimiento Celular/fisiología , Proliferación Celular/fisiología , Supervivencia Celular/fisiología , Chaperón BiP del Retículo Endoplásmico , Humanos , Isquemia/metabolismo , Janus Quinasa 2/metabolismo , Masculino , Trasplante de Células Madre Mesenquimatosas/métodos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Factor de Transcripción STAT3/metabolismo , Transducción de Señal/fisiología , Cicatrización de Heridas/fisiologíaRESUMEN
Our aim was to identify the positional changes of the inferior alveolar neurovascular bundle and evaluate the relocation of the displaced mandibular canal after enucleation of a cyst. Seventy patients (72 sites) who had had cysts enucleated were divided into three groups based on the degree of encroachment of the cystic lesion into the mandibular canal and whether a bone graft had been inserted after the cyst had been enucleated. The mean (range) of patients' ages was 45 (18-75) years, and there were 29 male and 41 female patients. Group A comprised cysts with encroachment on the mandibular canal that were enucleated without a bone graft; Group B consisted of cysts with no encroachment of the mandibular canal, but were enucleated without a bone graft; and Group C comprised cysts with encroachment of the mandibular canal that were enucleated with a bone graft. The displacement of the mandibular canal was identified from analysis of computed tomographic (CT) images. Changes in the position of the mandibular canal were measured on panoramic radiographs. The mandibular canal was repositioned superiorly by a mean (SD) of 2.4 (1.65)mm after enucleation of the cyst, which was significant in Group A (p<0.001), but not in Groups B and C. These results indicate that the displaced inferior alveolar neurovascular bundles that were not surrounded by bony canal tended to relocate towards a supposedly normal position, and after enucleation of the cyst the mandibular canal was remodelled in this new location. This tendency to relocate was blocked by bone grafting. Bone grafts are therefore recommended in cases where enough bony height is required for future insertion of implants.
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Quistes Maxilomandibulares/patología , Mandíbula/patología , Nervio Mandibular/patología , Adolescente , Adulto , Anciano , Trasplante Óseo/efectos adversos , Femenino , Humanos , Quistes Maxilomandibulares/diagnóstico por imagen , Quistes Maxilomandibulares/cirugía , Masculino , Mandíbula/irrigación sanguínea , Mandíbula/inervación , Mandíbula/cirugía , Persona de Mediana Edad , Radiografía Panorámica , Estudios Retrospectivos , Adulto JovenRESUMEN
The cellular prion protein (PrPC) is associated with metastasis, tumor progression and recurrence; however, the precise mechanisms underlying its action is not well understood. Our study found that PrPC degradation decreased tumor progression in colorectal cancer (CRC). In a CRC cell line and human CRC tissue exposed to hypoxia, induced heat-shock 70-kDa protein-1-like (HSPA1L) expression stabilized hypoxia-inducible factor-1α (HIF-1α) protein and promoted PrPC accumulation and tumorigenicity in vivo. PrPC was degraded via the proteasome pathway mediated by the ubiquitin-protein E3 ligase glycoprotein 78 (GP78), which interacts directly with PrPC. However, hypoxia-induced HSPA1L interacted with GP78 and inhibited its functions. HSPA1L knockdown facilitated the interaction of GP78 and PrPC, thereby increasing PrPC ubiquitination. Thus, GP78 was identified as the ubiquitinase for PrPC, thereby revealing an essential mechanism that controls PrPC levels in CRC. Our results suggest that the HSPA1L/HIF-1α/GP78 axis has a crucial role in PrPC accumulation during tumor progression.
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Carcinogénesis/metabolismo , Neoplasias Colorrectales/patología , Proteínas HSP70 de Choque Térmico/metabolismo , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Proteínas Priónicas/metabolismo , Receptores del Factor Autocrino de Motilidad/metabolismo , Técnicas de Cultivo de Célula , Neoplasias Colorrectales/tratamiento farmacológico , Progresión de la Enfermedad , Citometría de Flujo , Técnicas de Silenciamiento del Gen , Proteínas HSP70 de Choque Térmico/genética , Células HT29 , Humanos , Terapia Molecular Dirigida/métodos , Complejo de la Endopetidasa Proteasomal/metabolismo , Proteolisis , Interferencia de ARN , ARN Interferente Pequeño , Receptores del Factor Autocrino de Motilidad/genética , Transducción de Señal , UbiquitinaciónRESUMEN
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization. Although the complex postoperative course after LDLT can obscure the prompt diagnosis of an intrahepatic artery pseudoaneurysm and hemobilia, biliary stenting should be considered as a possible cause.
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Aneurisma Falso/etiología , Conductos Biliares/cirugía , Hemobilia/etiología , Arteria Hepática/patología , Trasplante de Hígado/efectos adversos , Stents/efectos adversos , Adulto , Anciano , Anastomosis Quirúrgica/efectos adversos , Fuga Anastomótica/etiología , Fuga Anastomótica/patología , Aneurisma Falso/patología , Procedimientos Quirúrgicos del Sistema Biliar/efectos adversos , Incompatibilidad de Grupos Sanguíneos , Femenino , Humanos , Trasplante de Hígado/instrumentación , Trasplante de Hígado/métodos , Donadores Vivos , Masculino , Persona de Mediana Edad , Plásticos , Factores de Riesgo , Resultado del TratamientoRESUMEN
OBJECTIVE: To campare the effect and tolerance beween intensified myeloablative conditioning regime (IMCR) without antithymocyte globulin (ATG) and myeloablative conditioning regime (MCR) for single-unit unrelated umbilical cord blood transplantation (sUCBT) in hematological malignancies. METHODS: The clinical data of 190 patients with hematological malignancies undergoing sUCBT between April 2000 and December 2013 at Department of Hematology, Anhui Provincial Hospital were retrospectively analyzed, of whom 156 received IMCR without ATG (IMCR group), including 79 patient receiving total body irradiation (TBI)/cytosine arabinoside (Ara-C)/cyclophosphamide (CY) regime, 47 receiving fludarabine (Flu)/busulfan (Bu)/CY regime, and 30 receiving Ara-C/Bu/CY regime, and all of the 156 received a combination of cyclosporine A (CsA) and mycophelonate mofetil (MMF) for the prophylaxis of graft-versus-host disease (GVHD); the remaining 34 patients received MCR (MCR group), 30 patients receiving Bu/CY regime, and 4 receiving TBI/CY regime, all using CsA/MMF±ATG or methotrexate (MTX) for the prophylaxis of GVHD. The two groups were compared in disease status at the time of transplantation, characteristics of graft, transplantation effect, and transplantation-related complications. RESULTS: There were no statistically significant differences between the two groups in gender, disease type, human leukocyte antigen match, ABO blood type match, and disease status at the time of transplantation (all P>0.05). The median age and body weight at transplantation in the IMCR group were significantly higher than those in the MCR group (13 years vs 9 years, P=0.003; 44 kg vs 26 kg, P=0.000). The median doses of infused total nucleated cells (×10(7)/kg) and CD34(+) cells (×10(5)/kg) in the IMCR group were significantly lower than in the MCR group (3.87 vs 4.99, P=0.002; 2.00 vs 3.17, P=0.000). The cumulative incidence of myeloid engraftment on the 42th day and platelet engraftment on the 120th day in the IMCR group were remarkably higher than in the MCR group [96.33%(95%CI: 96.27%-96.39%)vs 82.30%(95%CI: 80.67%-83.93%), P=0.000; 86.44%(95%CI: 86.28%-86.60%)vs 51.17%(95%CI: 49.02%-53.32%), P=0.002]. There were no statistically significant differences in the incidences of grade â ¡ to â £ acute GVHD, grade â ¢ to â £ acute GVHD, and 2-year chronic GVHD(P=0.482, 0.928, 0.579). The incidence of pre-engraftment syndrome in the IMCR group was higher than in the MCR group(82.70% vs 47.06%, P=0.000). And 180-day transplantation-related mortality (TRM) in the IMCR group was lower than that in the MCR group [20.50%(95%CI: 20.28%-20.71%)vs 42.20% (95%CI: 41.32%-45.09%), P=0.004]. Up to October 2015, with a median follow-up of 44.2(22.7-188.9)months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than those in the MCR group (62.90% vs 34.10%, P=0.000; 58.60% vs 34.10%, P=0.001). CONCLUSION: IMCR without ATG may improve the engraftment without increasing complications, reduce early transplantation-related mortality, and improve survival.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Busulfano/administración & dosificación , Trasplante de Células Madre de Sangre del Cordón Umbilical/métodos , Ciclofosfamida/administración & dosificación , Neoplasias Hematológicas/cirugía , Neoplasias Hematológicas/terapia , Acondicionamiento Pretrasplante/métodos , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Busulfano/uso terapéutico , China/epidemiología , Ciclofosfamida/uso terapéutico , Ciclofosfamida/toxicidad , Ciclosporina , Citarabina/administración & dosificación , Citarabina/uso terapéutico , Supervivencia sin Enfermedad , Femenino , Sangre Fetal/citología , Enfermedad Injerto contra Huésped/prevención & control , Antígenos HLA , Trasplante de Células Madre Hematopoyéticas , Humanos , Incidencia , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Vidarabina/análogos & derivados , Irradiación Corporal TotalRESUMEN
OBJECTIVE: To analyze the characteristics of distribution and drug resistance of bacterial infection in several different parts of hematology department inpatients of Anhui Provincial Hospital from January 2010 to December 2014, including patients who had received hematopoietic stem cell transplantation (HSCT). METHODS: Anti-microbial susceptibility test was done by Kirby-Bauer method and automated systems and the data were analysed by WHONET 5.6 software. RESULTS: A total of 3 312 copies of inspection samples were analyzed, including 2 716 (82%) blood samples and other 596 specimens (18%). 634 bacterial strains were isolated from 3 312 samples (19.14%) including 488 samples (76.97%) from blood culture. 427 (67.35%) bacterial strains were gram-negative, and the other 207 (32.65%) were gram-positive. Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were most common gram-negative bacterial and the resistant rates to imipenem were 0.8%, 11.8% and 3.3%, respectively. Detection rates of Extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae were 83.9% and 75.0%, respectively. At the same time, Coagulase negative Staphylococcus, Streptococcus and Enterococcus were most common kinds of gram-positive bacteria. Methicillin-resistant coagulase negative staphylococcus accounted for 65.9% antibiotic resistance. No vancomycin and/or linezolid and/or tigecycline resistant strains of Staphylococcus spp. and Enterococcus spp. were found in those patients. CONCLUSION: Patients with hematology diseases had a higher risk of bacterial infections, mainly caused by Gram-negative bacteria. There are different distributions of bacterial in different wards.
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Infecciones Bacterianas/epidemiología , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/efectos de los fármacos , Bacterias Grampositivas/aislamiento & purificación , Enfermedades Hematológicas/epidemiología , Enfermedades Hematológicas/microbiología , Hematología , Trasplante de Células Madre Hematopoyéticas , Departamentos de Hospitales , Humanos , Pruebas de Sensibilidad MicrobianaAsunto(s)
Enfermedades de los Peces/virología , Modelos Moleculares , Nodaviridae/efectos de los fármacos , Infecciones por Virus ARN/virología , ARN Polimerasa Dependiente del ARN/metabolismo , Ribavirina/farmacología , Replicación Viral/efectos de los fármacos , Secuencia de Aminoácidos , Animales , Lubina/virología , Línea Celular , Nodaviridae/enzimología , Nodaviridae/fisiología , Estructura Terciaria de Proteína , Alineación de SecuenciaRESUMEN
BACKGROUND: The association between intraoperative systemic hemodynamic status and preventing portal hyperperfusion, which induces shear stress on the sinusoidal endothelial cells of liver grafts, resulting in poor graft function in live-donor recipients, has not been identified. This study evaluates the effects of systemic hemodynamic parameters (SHPs) during the neohepatic phase on changes in hepatic hemodynamic parameters (HHPs) between the neohepatic phase and the 1st postoperative day. METHODS: Thirty-eight patients undergoing living donor liver transplantation (LDLT) were enrolled in this study. HHPs (flow velocities of portal vein and hepatic artery) were measured immediately after hepatic artery and bile duct reconstruction and on the first postoperative day. SHPs (mean arterial pressure, central venous pressure [CVP], cardiac index, stroke volume variation, stroke volume index, systemic vascular resistance index, and central venous oxygen saturation) were recorded and averaged for 5 minutes after the measurement of HHPs. The relationships between the SHPs and HHPs were assessed using linear or quadratic regression analysis. RESULTS: Peak portal vein flow velocity (PVV) decreased on the 1st postoperative day in 24 patients (63%). There was an inverted-U relationship between CVP and the percentage change in PVV (R(2) = 0.241, P = .008). According to the quadratic regression model, the PVV maximally decreased at a CVP of 7.8 mm Hg. No significant correlations were found between the other SHPs and HHPs. CONCLUSIONS: Maintaining CVP (approximately 8 mm Hg) during the neohepatic phase was clinically beneficial in decreasing PVV to prevent portal hyperperfusion in the early postoperative period of LDLT.
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Presión Venosa Central/fisiología , Arteria Hepática/fisiología , Trasplante de Hígado/métodos , Vena Porta/fisiología , Complicaciones Posoperatorias/prevención & control , Lesiones del Sistema Vascular/prevención & control , Adulto , Velocidad del Flujo Sanguíneo/fisiología , Estudios de Cohortes , Femenino , Hemodinámica , Hepatectomía , Humanos , Hígado/cirugía , Donadores Vivos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Circulación Esplácnica , Estrés MecánicoRESUMEN
Since various innovative strategies including local infusion therapy and rituximab have been introduced, the survivals and outcomes of recipients in ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) have remarkably improved. Thus, ABO-I LDLT can be a feasible therapeutic option for the patient with end-stage liver disease if an ABO-compatible donor is not available. Although most ABO-I protocols are based on rituximab, plasma exchange, and local infusion therapy, treatment strategies have been changing according to a center's preference or their results. Nonetheless, the consensus of the ABO-I LDLT protocol remains undetermined. Herein, we present our experience with new simple ABO-I LDLT protocol and the excellent results for 14 patients from January 2011 to May 2013. All patients were administrated a single dose of rituximab over 7 days before transplantation followed by plasma exchange to lower anti-ABO antibody titer ≤32. The basic immunosuppression protocol consisted of tacrolimus and steroids with mycophenolate mofetil starting 3 days before transplantation. Splenectomy was not performed routinely and local infusion therapy was not applied at the postoperative period. Instead, the patients received intravenous immunoglobulin (IVIG) after LDLT on days 1, 3, and 5. Neither antibody-mediated rejection nor biliary stricture were encountered in the patients, with a mean follow-up of 16.27 ± 9.4 months. This new simplified ABO-I LDLT protocol seems to prevent antibody-mediated rejection and could be considered as the safe and effective modality to overcome the ABO blood-type barrier in LDLT.
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Sistema del Grupo Sanguíneo ABO , Inmunoglobulinas Intravenosas/administración & dosificación , Trasplante de Hígado , Donadores Vivos , Adulto , Femenino , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Tasa de SupervivenciaRESUMEN
PURPOSE: To investigate the microorganisms in culture-proven endophthalmitis and their susceptibilities to antimicrobial agents commonly used in South Korea. METHODS: Medical records of consecutive patients with culture-proven endophthalmitis at eight institutions between 1 January 2004 and 31 July 31 2010 were reviewed. Four categories of endophthalmitis were studied: postoperative, posttraumatic, endogenous, and unspecified. Outcome measures were culture-proven infectious organisms, antimicrobial susceptibilities, and final visual acuity in the patients. RESULTS: A total of 93 microorganisms were identified from 103 patients during the study period. The positive culture rate was 59.2 % (103/174). The most common organisms identified were Enterococcus faecalis (in 20.8 % of patients, 20/96), Staphylococcus epidermidis (18.8 %, 18/96), other coagulase-negative staphylococci (10.4 %, 10/96), Pseudomonas aeruginosa (6.3 %, 6/96), and Klebsiella pneumoniae (6.3 %, 6/96). Two cases of Enterococcus faecium (2.1 %) were recognized. Overall, 70 of 96 (73.0 %) isolates were Gram-positive bacteria, 22 (23.0 %) were Gram-negative bacteria, and 4 (4.2 %) were fungi. The most common organisms resulting in reduced light perception were E. faecalis and K. pneumoniae. CONCLUSIONS: The emergence of E. faecalis in endophthalmitis is mainly caused by the high incidence of E. faecalis in postoperative endophthalmitis. This increase also impacts the final visual acuity of the patients.
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Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Endoftalmitis/epidemiología , Endoftalmitis/microbiología , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Antibacterianos/farmacología , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/clasificación , Bacterias Grampositivas/efectos de los fármacos , Humanos , Pruebas de Sensibilidad Microbiana , República de Corea/epidemiología , Estudios RetrospectivosRESUMEN
INTRODUCTION: Biliary reconstruction remains the "Achilles' heel" of living donor liver transplantation (LDLT). In the last decades, the technical aspects of biliary reconstruction have been debated for their impact on biliary complications in LDLT. A microsurgical technique in biliary reconstruction is more attractive. PATIENTS AND METHODS: From December 2010 to June 2011, 15 primary LDLTs underwent duct-to-duct biliary reconstruction using a microscopic technique. External stents were inserted in all patients. All procedures were performed under a microscope by a single transplant microsurgeon. RESULTS: The time consumed for bile duct reconstruction using the microscopic technique was 35 minutes. There were 8 grafts with a single bile duct orifice and seven with two orifices. The average duct size was 3 mm in patients with two orifices and 5 mm in those with a single orifice. There was no bile leak or biliary stricture associated with the biliary reconstruction over a median 5-month follow-up. There were two cases of bile leakage from the cut hepatic surface. CONCLUSION: The microscopic technique reduced early biliary complications. However, further technical advances are needed to decrease the time consumptions for the procedure.
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Conductos Biliares/cirugía , Procedimientos Quirúrgicos del Sistema Biliar , Trasplante de Hígado/métodos , Donadores Vivos , Microcirugia , Procedimientos de Cirugía Plástica , Adulto , Anastomosis Quirúrgica , Enfermedades de los Conductos Biliares/etiología , Procedimientos Quirúrgicos del Sistema Biliar/efectos adversos , Procedimientos Quirúrgicos del Sistema Biliar/instrumentación , Estudios de Factibilidad , Femenino , Humanos , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/instrumentación , Masculino , Microcirugia/efectos adversos , Microcirugia/instrumentación , Persona de Mediana Edad , Procedimientos de Cirugía Plástica/efectos adversos , Procedimientos de Cirugía Plástica/instrumentación , República de Corea , Stents , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To unravel the possible mechanism of acute posttraumatic insulin resistance in rats. METHODS: Resection of small intestine was performed to establish the surgical trauma model. The blood glucose and serum insulin level were detected and the HOMA index was calculated. The Hyperinsulinemic-euglycemic clamp was performed to investigate the glucose disposal rate by peripheral tissue. The content and phosphorylation state of IRS-1, p85 of PI3-K and PKB/Akt in skeletal muscle were measured respectively. Finally, the [3H] labeled glucose uptake experiment was carried out. RESULTS: The blood glucose elevated significantly after resection of small intestine in rats. The level of serum insulin decreased during the first 30 min after operation but elevated in the following time. The HOMA-IR in trauma group was significantly greater than control group; however the HOMA-ß in trauma group was less than control group. The glucose disposal rate was decreased 49% after operation. The p-IRS-1(Ser307) was significantly enhanced 95% after trauma while the p-IRS-1 (Tyr612) was attenuated by 38%. The phosphorylation of its downstream target, p-PKB/Akt(Ser473) was attenuated by 48%. Accordingly, the glucose uptaken by skeletal muscle was significantly decreased in trauma group. CONCLUSION: We demonstrated the posttraumatic insulin resistance occurred soon after surgical trauma in rats. The level of insulin was relatively insufficient because of the decreased sensitivity in peripheral tissue. Trauma induced Ser phosphorylation instead of Tyr phosphorylation eliminated the ability of IRS-1 to activate downstream effector molecules such as PKB/Akt and resulted in severe impairment of insulin signal transduction and glucose transport in skeletal muscle.
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Resistencia a la Insulina/fisiología , Complicaciones Posoperatorias/metabolismo , Heridas y Lesiones/metabolismo , Enfermedad Aguda , Animales , Glucemia/análisis , Glucemia/metabolismo , Modelos Animales de Enfermedad , Glucosa/farmacocinética , Técnica de Clampeo de la Glucosa , Insulina/sangre , Insulina/metabolismo , Masculino , Complicaciones Posoperatorias/patología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Heridas y Lesiones/complicaciones , Heridas y Lesiones/etiología , Heridas y Lesiones/patologíaRESUMEN
A new insect member of the signal transducer and activator of transcription (STAT) family of transcription factors, Hyphantria cunea STAT (HcSTAT), was cloned from the lepidopteran H. cunea. The domain involved in DNA interaction and the Src homology 2 (SH2) domain were well conserved. During all developmental stages, the gene was expressed at a low level in the haemocytes, fat body cells, midgut, epidermis and Malpighian tubules. The haemocytes and Malpighian tubules showed transcriptional activation of HcSTAT upon Gram-negative and Gram-positive bacterial challenges. These challenges increased the induction and nuclear translocation of the HcSTAT protein that recognizes a STAT target site in H. cunea haemocytes. In vivo treatment with sodium orthovanadate translocated HcSTAT to the haemocyte nucleus. This study shows the involvement of the haemocyte Janus kinase/STAT pathway after microbial infection in lepidopteran insects.
Asunto(s)
Hemocitos/metabolismo , Mariposas Nocturnas/genética , Factores de Transcripción STAT/metabolismo , Animales , Candida albicans/inmunología , Clonación Molecular , Escherichia coli/inmunología , Genes de Insecto , Hemocitos/microbiología , Larva/genética , Larva/inmunología , Larva/microbiología , Micrococcus luteus/inmunología , Mariposas Nocturnas/inmunología , Mariposas Nocturnas/microbiología , Pupa/genética , Pupa/inmunología , Pupa/microbiología , ARN Mensajero/metabolismo , Factores de Transcripción STAT/genética , Factores de Transcripción STAT/aislamiento & purificación , Análisis de Secuencia de ADNRESUMEN
Xanthomonas oryzae pv. oryzae (Xoo) produces a putative effector, XoAvrBs2. We expressed XoAvrBs2 homologously in Xoo with a TAP-tag at the C-terminus to enable quantitative analysis of protein expression and secretion. Addition of rice leaf extracts from both Xoo-sensitive and Xoo-resistant rice cultivars to the Xoo cells induced expression of the XoAvrBs2 gene at the transcriptional and translational levels, and also stimulated a remarkable amount of XoAvrBs2 secretion into the medium. In a T3SS-defective Xoo mutant strain, secretion of the TAPtagged XoAvrBs2 was blocked. Thus, we elucidated the transcriptional and translational expressions of the XoAvrBs2 gene in Xoo was induced in vitro by the interaction with rice and the induced secretion of XoAvrBs2 was T3SSdependent. It is the first report to measure the homologous expression and secretion of XoAvrBs2 in vitro by rice leaf extract. Our system for the quantitative analysis of effector protein expression and secretion could be generally used for the study of host-pathogen interactions.
Asunto(s)
Proteínas Bacterianas/metabolismo , Oryza/química , Extractos Vegetales/metabolismo , Activación Transcripcional/efectos de los fármacos , Xanthomonas/genética , Xanthomonas/metabolismo , Medios de Cultivo/química , Perfilación de la Expresión Génica , Biosíntesis de Proteínas , Transcripción Genética , Xanthomonas/efectos de los fármacosRESUMEN
In the absence of a reference genome, single-nucleotide polymorphisms (SNP) discovery in a group of abalone species was undertaken by random sequence assembly. A web-based interface was constructed, and 11 932 DNA sequences from the genus Haliotis were assembled, with 1321 contigs built. Of these, 118 contigs that consisted of at least ten annotation groups were selected. The 1577 putative SNPs were identified from the 118 contigs, with SNPs in several HSP70 gene contigs confirmed by PCR amplification of an 809-bp DNA fragment. SNPs in the HSP70 gene were compared across eight abalone species. A total of 129 polymorphic sites, including heterozygote sites within and among species, were observed. Phylogenetic analysis of the partial HSP70 gene region showed separation of the tested abalone into two groups, one reflecting the southern hemisphere species and the other the northern hemisphere species. Interestingly, Haliotis iris from New Zealand showed a closer relationship to species distributed in the northern Pacific region. Although HSP genes are known to be highly conserved among taxa, the validation of polymorphic SNPs from HSP70 in this mollusc demonstrates the applicability of cross-species SNP markers in abalone and the first step towards universal nuclear markers in Haliotis.
Asunto(s)
Bases de Datos Genéticas , Gastrópodos/genética , Proteínas HSP70 de Choque Térmico/genética , Polimorfismo de Nucleótido Simple , Animales , Secuencia de Bases , Mapeo Cromosómico , Etiquetas de Secuencia Expresada , Marcadores Genéticos , Genoma , Filogenia , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADNRESUMEN
OBJECTIVE: We examined the relationships between pre-pregnancy maternal body mass index (BMI), pregnancy outcomes and biochemical markers. DESIGN: This study was conducted as a cross-sectional analysis. SUBJECTS: Korean women in their second and third trimesters of pregnancy were recruited at two hospitals in the metropolitan Seoul area. Pre-pregnancy BMI was categorized in four groups according to the Asia-Pacific standard. MEASUREMENTS: Fasting blood samples were obtained and analyzed for serum levels of homocysteine, folate and high-sensitivity C-reactive protein (hs-CRP). Concentrations of fetal fibronectin were assessed in the cervix and vagina, and cervical length was measured. RESULTS: Obese subjects had a lower education level and a lower income level than subjects of normal weight. The level of maternal stress was positively associated with pre-pregnancy BMI. Normal weight subjects were more likely to eat breakfast and consume meals of appropriate size than the rest of our sample. In overweight and obese subjects, weight gain during pregnancy was significantly lower than in the underweight and normal subjects. High pre-pregnancy maternal BMI increased the risks of preterm delivery (odds ratio (OR)=2.85, confidence interval (CI)=1.20-6.74), low-birth-weight (LBW) infants (overweight subjects: OR=5.07, CI=1.76-14.63; obese subjects: OR=4.49, CI=1.54-13.13) and macrosomia. In obese subjects, the average serum folate level was significantly lower than in the underweight subjects. In obese subjects, the average serum hs-CRP level was significantly higher than in the rest of our sample. CONCLUSION: Pregnancy outcomes are influenced by pre-pregnancy BMI. These findings suggest that women can minimize their risks of preterm delivery, LBW and macrosomia by maintaining normal pre-pregnancy BMI.
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Proteína C-Reactiva/metabolismo , Ácido Fólico/metabolismo , Homocisteína/metabolismo , Obesidad/metabolismo , Aumento de Peso/fisiología , Adulto , Biomarcadores/metabolismo , Índice de Masa Corporal , Estudios Transversales , República Popular Democrática de Corea/epidemiología , Femenino , Humanos , Recién Nacido , Obesidad/epidemiología , Embarazo , Resultado del Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Factores de Riesgo , Factores SocioeconómicosRESUMEN
A manganese superoxide dismutase (MnSOD) gene was cloned from the fall webworm, Hyphantria cunea. MnSOD cDNAs encode precursor proteins of 215 amino acid residues. H. cunea MnSOD possesses the metal binding ligands of 3 histidines and 1 aspartic acid common to MnSODs. The deduced amino acid sequences of the H. cunea MnSOD cDNA showed 76% identity to Bombyx mori MnSOD and 56-62% identity to MnSOD sequences from other species. MnSOD and copper/zinc superoxide dismutase (Cu/ZnSOD) is expressed in all tissues of H. cunea. MnSOD expression changed at a trace-level in infected larvae, while Cu/ZnSOD expression strongly changed against Gram-positive and Gram-negative bacteria, and fungi. Environmental stresses such as different artificial photoperiods (24L:0D), ultraviolet irradiation (312 nm), and starvation condition increased Cu/ZnSOD expression, MnSOD expression, on the other hand, was increased by starvation. Moreover, MnSOD and Cu/ZnSOD expression showed no significant change in the 0L:24D condition. MnSOD and Cu/ZnSOD expression in H. cunea also significantly increased at high (37°C) and low (4°C) temperature. Oxidative stress induced by 10% H(2)O(2) reduced the expression levels of MnSOD and Cu/ZnSOD. However, paraquat-induced oxidative stress reduced MnSOD expression but increased Cu/ZnSOD expression. These results suggest that Cu/ZnSOD may play a larger role than MnSOD as a superoxide anion scavenger against oxidative stress in H. cunea.