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1.
Langenbecks Arch Surg ; 405(4): 469-477, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32504206

RESUMEN

PURPOSE: Progressive loss (sarcopenia) and fatty infiltration of muscle mass (myosteatosis) are well-established risk factors for an adverse clinical outcome in obese patients. Data concerning non-obese sarcopenic patients in oncologic surgery are scarce and heterogeneous. The aim of this study was to determine the impact of sarcopenia and myosteatosis in non-obese patients with cancer of the right colon on clinical outcome. METHODS: This study comprised 85 patients with a BMI < 30 kg/m2, who underwent surgery for right colon cancer in a single center. Skeletal muscle area (SMA), visceral fat area (VFA), and myosteatosis were retrospectively assessed using preoperative abdominal CT images. Univariate und multivariate analysis was performed to evaluate the association between body composition, complications, and oncologic follow-up. RESULTS: Traditional risk factors such as visceral fat (p = 0.8653), BMI (p = 0.8033), myosteatosis (p = 0.7705), and sarcopenia (p = 0.3359) failed to show any impact on postoperative complications or early recurrence. In our cohort, the skeletal muscle index (SMI) was the only significant predictor for early cancer recurrence (p = 0.0467). CONCLUSION: SMI is a significant prognostic factor for early cancer recurrence in non-obese colon cancer patients. Our study shows that conventional thresholds for sarcopenia and BMI do not seem to be reliable across various cohorts. Target prehabilitation programs could be useful to improve outcome after colorectal surgery. TRIAL REGISTRATION: DRKS00014655, www.apps.who.int/trialsearch.


Asunto(s)
Colectomía/efectos adversos , Neoplasias del Colon/cirugía , Recurrencia Local de Neoplasia/epidemiología , Complicaciones Posoperatorias/epidemiología , Sarcopenia/complicaciones , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Femenino , Humanos , Masculino , Músculo Esquelético , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Resultado del Tratamiento
2.
Abdom Radiol (NY) ; 45(10): 3301-3306, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-31278460

RESUMEN

PURPOSE: The objective of this study was to determine the incidence of needle track seeding after ultrasound-guided percutaneous biopsy of indeterminate liver lesions with a coaxial biopsy system without any other additional intervention or ablation therapy. METHODS: We identified 172 patients in a retrospective cohort study who underwent ultrasound-guided biopsy due to a liver mass in our institution between 2007 and 2016. The same coaxial biopsy system was used in all patients, no consecutive ablation was performed. RESULTS: None of the finally included 131 patients developed neoplastic seeding. There was one major complication (0.76%), the rest of the complications were minor (3.8%) and did not require further intervention. CONCLUSION: Needle track seeding is a rare delayed complication after percutaneous liver biopsy. Coaxial liver biopsy is a safe method to obtain multiple samples with a single punch in patients with primary or metastatic liver lesions.


Asunto(s)
Biopsia Guiada por Imagen , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía Intervencional
3.
J Cell Biol ; 210(7): 1153-64, 2015 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-26416965

RESUMEN

Neutrophils use chemotaxis to locate invading bacteria. Adenosine triphosphate (ATP) release and autocrine purinergic signaling via P2Y2 receptors at the front and A2a receptors at the back of cells regulate chemotaxis. Here, we examined the intracellular mechanisms that control these opposing signaling mechanisms. We found that mitochondria deliver ATP that stimulates P2Y2 receptors in response to chemotactic cues, and that P2Y2 receptors promote mTOR signaling, which augments mitochondrial activity near the front of cells. Blocking mTOR signaling with rapamycin or PP242 or mitochondrial ATP production (e.g., with CCCP) reduced mitochondrial Ca(2+) uptake and membrane potential, and impaired cellular ATP release and neutrophil chemotaxis. Autocrine stimulation of A2a receptors causes cyclic adenosine monophosphate accumulation at the back of cells, which inhibits mTOR signaling and mitochondrial activity, resulting in uropod retraction. We conclude that mitochondrial, purinergic, and mTOR signaling regulates neutrophil chemotaxis and may be a pharmacological target in inflammatory diseases.


Asunto(s)
Quimiotaxis/fisiología , Mitocondrias/metabolismo , Neutrófilos/metabolismo , Transducción de Señal/fisiología , Serina-Treonina Quinasas TOR/metabolismo , Adenosina Trifosfato/genética , Adenosina Trifosfato/metabolismo , Animales , Quimiotaxis/efectos de los fármacos , Células HL-60 , Humanos , Indoles/farmacología , Potencial de la Membrana Mitocondrial/efectos de los fármacos , Potencial de la Membrana Mitocondrial/fisiología , Ratones , Mitocondrias/genética , Activación Neutrófila/efectos de los fármacos , Activación Neutrófila/fisiología , Neutrófilos/citología , Purinas/farmacología , Receptores Purinérgicos P2Y2/genética , Receptores Purinérgicos P2Y2/metabolismo , Transducción de Señal/efectos de los fármacos , Sirolimus/farmacología , Serina-Treonina Quinasas TOR/antagonistas & inhibidores , Serina-Treonina Quinasas TOR/genética
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