Effect of Birch Sap as Solvent and Source of Bioactive Compounds in Casein and Gelatine Films.

Birch sap consists of a natural water-based solution with valuable compounds such as minerals, sugars, organic acids and phenolic compounds that can be used advantageously in the preparation of edible films. In this study, gelatine- and casein-based films were prepared using birch sap as biopolymer solvent and source of bioactive compounds with the aim of developing new bioactive materials for food packaging. The physical, mechanical, barrier, antioxidant and iron-chelating properties of the obtained films were investigated. Birch sap enhanced the mechanical properties of the films by increasing puncture strength and flexibility, as well as their ultraviolet-visible light barrier properties. In addition, the presence of bioactive compounds endowed the birch sap films with an antioxidant capacity of almost 90% and an iron-chelating capacity of 40-50% with respect to the control films. Finally, to test these films as food packaging material, a photosensitive curcumin solution was packed and exposed to ultraviolet light. Tested films were able to protect curcumin against photodegradation, and the presence of bioactive compounds inside the birch-sap-enriched materials offered an additional 10% photoprotective effect compared to control films. Results showed the potential of birch sap as an environmentally friendly biopolymer solvent and plasticizer that can improve the mechanical and photoprotective properties of the prepared materials.

Transanal rectal mucosectomy and muscular plication: A new technique for rectal prolapse in patients with an anorectal malformation.

BACKGROUND: Rectal prolapse after repair of an anorectal malformation (ARM) occurs at a frequency of 3.8% to 60.0%. Different techniques have been described for repair, with a recurrence rate of up to 33%. We aimed to describe a new technique for rectal prolapse and present its results. METHODS: A retrospective review of our database identified 14 patients with rectal prolapse after posterior sagittal anorectoplasty (PSARP) for an ARM. The study was performed from January 2014 until March 2020. All patients underwent transanal rectal mucosectomy and muscular plication (TRMMP). RESULTS: All but one patient had PSARP, and the remaining patient had laparoscopic-assisted PSARP. The mean age at repair was 4 years and 8 months (range, 1-12 years). One patient had three previous repair attempts, and another five had only one attempt. The mean follow-up was 2 years and 5 months (range, 3 months to 5 years and 7 months). None of the patients experienced prolapse recurrence or postoperative complications. CONCLUSION: This preliminary report showed that TRMMP can be used for rectal prolapse, without the risk of recurrence or complications. Pediatric surgeons may consider this technique as another option for the treatment of rectal prolapse in patients with an ARM.

New surgical technique for creation of a continent appendicostomy: Invaginated appendicostomy.

INTRODUCTION: The main complications of appendicostomy are stenosis and stomal fecal leakage. Although many authors report that the appendix is naturally continent, it is recommended to perform a plication of the cecum with the appendix to prevent stomal fecal leakage. We present here the creation of a different continent mechanism. Our technique is advantageous when the anatomy, vascularity, or the length of the appendix does not allow for a standard plication procedure. DESCRIPTION OF OPERATIVE TECHNIQUE: During 2014-2016 we performed four appendicostomies in patients with anorectal malformations with fecal incontinence that requested an "Antegrade Continent Enema" procedure after a successful bowel management program in the Colorectal Center for Children of Mexico. The average age at surgery was 13years. All patients had anorectal malformations with a poor prognosis for proper control of defecation, with a sacral ratio lower than 0.4. In these patients, we invaginated a 1cm length of the appendix at its base, placing eight circumferential stitches with 5-0 silk. None of the patients experienced leakage when a saline solution was introduced with a catheter into the cecum during the surgical procedure. After an average of 15months of follow-up, none of the patients were experiencing stomal leakage. CONCLUSIONS: The "Invaginated Appendicostomy" is a reproducible and effective continent mechanism to prevent stomal fecal leakage. It appears to be an excellent alternative to cecal plication around the appendix.

Role of FAST Kinase Domains 3 (FASTKD3) in Post-transcriptional Regulation of Mitochondrial Gene Expression.

The Fas-activated serine/threonine kinase (FASTK) family of proteins has recently emerged as a central regulator of mitochondrial gene expression through the function of an unusual RNA-binding domain named RAP (for RNA-binding domain abundant in Apicomplexans), shared by all six members of the family. Here we describe the role of one of the less characterized members, FASTKD3, in mitochondrial RNA metabolism. First, we show that, in contrast to FASTK, FASTKD2, and FASTKD5, FASTKD3 does not localize in mitochondrial RNA granules, which are sites of processing and maturation of mtRNAs and ribosome biogenesis. Second, we generated FASTKD3 homozygous knock-out cell lines by homologous recombination and observed that the absence of FASTKD3 resulted in increased steady-state levels and half-lives of a subset of mature mitochondrial mRNAs: ND2, ND3, CYTB, COX2, and ATP8/6. No aberrant processing of RNA precursors was observed. Rescue experiments demonstrated that RAP domain is required for FASTKD3 function in mRNA stability. Besides, we describe that FASTKD3 is required for efficient COX1 mRNA translation without altering mRNA levels, which results in a decrease in the steady-state levels of COX1 protein. This finding is associated with reduced mitochondrial complex IV assembly and activity. Our observations suggest that the function of this family of proteins goes beyond RNA processing and ribosome assembly and includes RNA stability and translation regulation within mitochondria.

Vaginal agenesis and rectovestibular fistula. Experience utilizing distal ileum for the vaginal replacement in these patients, preserving the natural fecal reservoir.

BACKGROUND: The association of rectovestibular fistula (RVF) and vaginal agenesis (VA) presents a diagnostic and management challenge. The vaginal replacement is usually performed with rectum or sigmoid, which are the natural fecal reservoirs; thus, the fecal control could be affected. We present our experience utilizing ileum to preserve the rectum and sigmoid. METHODS: We performed a retrospective study of eight patients with RVF and VA treated from May 2011 to June 2015 at two colorectal centers, at Pittsburgh and Mexico. We recorded the age at diagnosis of VA, treatment, presence of other associated malformations and outcome. RESULTS: Eight of forty-nine girls with RVF had an associated VA (16.3%). Three patients had a timely diagnosis and five a delayed diagnosis. Six patients were submitted to a vaginal replacement with ileum and achieved fecal control. Two are waiting for surgery. CONCLUSIONS: A high index of suspicion of vaginal agenesis helps in a timely diagnosis in girls with RVF. The use of ileum allows for preservation of the fecal reservoirs, thus optimizing the chance for fecal control in patients with anorectal malformations.

New cellular and molecular targets for the treatment of portal hypertension.

Portal hypertension (PH) is a common complication of chronic liver disease, and it determines most complications leading to death or liver transplantation in patients with liver cirrhosis. PH results from increased resistance to portal blood flow through the cirrhotic liver. This is caused by two mechanisms: (a) distortion of the liver vascular architecture and (b) hepatic microvascular dysfunction. Increment in hepatic resistance is latterly accompanied by splanchnic vasodilation, which further aggravates PH. Hepatic microvascular dysfunction occurs early in the course of chronic liver disease as a consequence of inflammation and oxidative stress and determines loss of the normal phenotype of liver sinusoidal endothelial cells (LSEC). The cross-talk between LSEC and hepatic stellate cells induces activation of the latter, which in turn proliferate, migrate and increase collagen deposition around the sinusoids, contributing to fibrogenesis, architectural disruption and angiogenesis. Therapy for PH aims at correcting these pathophysiological abnormalities: liver injury, fibrogenesis, increased hepatic vascular tone and splanchnic vasodilatation. Continuing liver injury may be counteracted specifically by etiological treatments, while architectural disruption and fibrosis can be ameliorated by a variety of anti-fibrogenic drugs and anti-angiogenic strategies. Sinusoidal endothelial dysfunction is ameliorated by statins and other drugs increasing NO availability. Splanchnic hyperemia can be counteracted by non-selective beta-blockers (NSBBs), vasopressin analogs and somatostatin analogs. Future treatment of portal hypertension will evolve to use etiological treatments together with anti-fibrotic agents and/or drugs improving microvascular function in initial stages of cirrhosis (pre-primary prophylaxis), while NSBBs will be added in advanced stages of the disease.