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1.
Br J Surg ; 108(9): 1090-1096, 2021 09 27.
Artículo en Inglés | MEDLINE | ID: mdl-33975337

RESUMEN

BACKGROUND: Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life. METHODS: This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models. RESULTS: Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms. CONCLUSION: A long-term symptom burden is common after oesophageal cancer surgery.


Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Medición de Resultados Informados por el Paciente , Complicaciones Posoperatorias/epidemiología , Anciano , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Calidad de Vida , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
2.
Dis Esophagus ; 34(7)2021 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-32944747

RESUMEN

Esophagectomy causes postprandial symptoms associated with an exaggerated postprandial gut hormone response. This study aimed to compare the gastrointestinal transit time of patients 1 year after esophagectomy with unoperated controls, including its relation to satiety gut hormone release. In this cross-sectional study, consecutive, disease-free patients after esophagectomy with pyloroplasty were compared with unoperated control subjects to assess gastric emptying (GE) and cecal arrival time (CAT). Serial plasma samples were collected before, and for 300 minutes after, a mixed-meal challenge. Body composition was assessed, and symptom scores were calculated. Eleven patients 1 year post-esophagectomy (age: 62.6 ± 9.8, male: 82%) did not show a significantly different GE pattern compared with 10 control subjects (P = 0.245). Rather, patients could be categorized bimodally as exhibiting either rapid or slow GE relative to controls. Those with rapid GE trended toward a higher postprandial symptom burden (P = 0.084) without higher postprandial glucagon-like peptide-1 (GLP-1) secretion (P = 0.931). CAT was significantly shorter after esophagectomy (P = 0.043) but was not significantly associated with GE, GLP-1 secretion, or symptom burden. Neither early nutrient delivery to the proximal small intestine nor to the colon explains the exaggerated postprandial GLP-1 response after esophagectomy. GE varies significantly in these patients despite consistent pyloric management.


Asunto(s)
Esofagectomía , Vaciamiento Gástrico , Estudios Transversales , Péptido 1 Similar al Glucagón , Humanos , Masculino , Periodo Posprandial
3.
Br J Surg ; 107(13): 1708-1712, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33031569

RESUMEN

This study used a national administrative database to estimate perioperative SARS-CoV-2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, whereas laparoscopic surgery may be protective owing to reduced duration of hospital stay. Procedure-specific risk estimates are provided to facilitate surgical decision-making and informed consent. Estimated risks.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infección Hospitalaria/transmisión , Procedimientos Quirúrgicos Electivos/efectos adversos , Control de Infecciones/métodos , Tiempo de Internación/estadística & datos numéricos , Neumonía Viral/epidemiología , Infección de la Herida Quirúrgica/mortalidad , COVID-19 , Causas de Muerte , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Bases de Datos Factuales , Procedimientos Quirúrgicos Electivos/métodos , Urgencias Médicas , Femenino , Humanos , Incidencia , Masculino , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/prevención & control , Pronóstico , Medición de Riesgo , Infección de la Herida Quirúrgica/prevención & control , Análisis de Supervivencia
4.
Mol Ecol ; 28(6): 1439-1459, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30506831

RESUMEN

Chromosomal inversions have been implicated in facilitating adaptation in the face of high levels of gene flow, but whether chromosomal fusions also have similar potential remains poorly understood. Atlantic salmon are usually characterized by population structure at multiple spatial scales; however, this is not the case for tributaries of the Miramichi River in North America. To resolve genetic relationships between populations in this system and the potential for known chromosomal fusions to contribute to adaptation, we genotyped 728 juvenile salmon using a 50 K SNP array. Consistent with previous work, we report extremely weak overall population structuring (Global FST  = 0.004) and failed to support hierarchical structure between the river's two main branches. We provide the first genomic characterization of a previously described polymorphic fusion between chromosomes 8 and 29. Fusion genomic characteristics included high LD, reduced heterozygosity in the fused homokaryotes, and strong divergence between the fused and the unfused rearrangement. Population structure based on fusion karyotype was five times stronger than neutral variation (FST  = 0.019), and the frequency of the fusion was associated with summer precipitation supporting a hypothesis that this rearrangement may contribute local adaptation despite weak neutral differentiation. Additionally, both outlier variation among populations and a polygenic framework for characterizing adaptive variation in relation to climate identified a 250-Kb region of chromosome 9, including the gene six6 that has previously been linked to age-at-maturity and run-timing for this species. Overall, our results indicate that adaptive processes, independent of major river branching, are more important than neutral processes for structuring these populations.


Asunto(s)
Adaptación Fisiológica/genética , Evolución Biológica , Genoma/genética , Salmo salar/genética , Animales , Cromosomas/genética , Clima , Flujo Génico/genética , Genética de Población , Genómica , Ríos , Salmo salar/fisiología
5.
Ann Surg Oncol ; 26(9): 2864-2873, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31183640

RESUMEN

BACKGROUND: The impact of cardiorespiratory comorbidity on operative outcomes after esophagectomy remains controversial. This study investigated the effect of cardiorespiratory comorbidity on postoperative complications for patients treated for esophageal or gastroesophageal junction cancer. PATIENTS AND METHODS: A European multicenter cohort study from five high-volume esophageal cancer centers including patients treated between 2010 and 2017 was conducted. The effect of cardiorespiratory comorbidity and respiratory function upon postoperative outcomes was assessed. RESULTS: In total 1590 patients from five centers were included; 274 (17.2%) had respiratory comorbidity, and 468 (29.4%) had cardiac comorbidity. Respiratory comorbidity was associated with increased risk of overall postoperative complications, anastomotic leak, pulmonary complications, pneumonia, increased Clavien-Dindo score, and critical care and hospital length of stay. After neoadjuvant chemoradiotherapy, respiratory comorbidity was associated with increased risk of anastomotic leak [odds ratio (OR) 1.83, 95% confidence interval (CI) 1.11-3.04], pneumonia (OR 1.65, 95% CI 1.10-2.47), and any pulmonary complication (OR 1.52, 95% CI 1.04-2.22), an effect which was not observed following neoadjuvant chemotherapy or surgery alone. Cardiac comorbidity was associated with increased risk of cardiovascular and pulmonary complications, respiratory failure, and Clavien-Dindo score ≥ IIIa. Among all patients, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio > 70% was associated with reduced risk of overall postoperative complications, cardiovascular complications, atrial fibrillation, pulmonary complications, and pneumonia. CONCLUSIONS: The results of this study suggest that cardiorespiratory comorbidity and impaired pulmonary function are associated with increased risk of postoperative complications after esophagectomy performed in high-volume European centers. Given the observed interaction with neoadjuvant approach, these data indicate a potentially modifiable index of perioperative risk.


Asunto(s)
Adenocarcinoma/cirugía , Enfermedades Cardiovasculares/epidemiología , Neoplasias Esofágicas/cirugía , Esofagectomía/efectos adversos , Complicaciones Posoperatorias , Trastornos Respiratorios/epidemiología , Adenocarcinoma/patología , Anciano , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/etiología , Estudios de Cohortes , Comorbilidad , Neoplasias Esofágicas/patología , Carcinoma de Células Escamosas de Esófago/patología , Carcinoma de Células Escamosas de Esófago/cirugía , Unión Esofagogástrica/patología , Unión Esofagogástrica/cirugía , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pronóstico , Trastornos Respiratorios/diagnóstico , Trastornos Respiratorios/etiología , Tasa de Supervivencia
6.
Br J Surg ; 106(6): 735-746, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30883706

RESUMEN

BACKGROUND: Oesophagectomy is associated with reduced appetite, weight loss and postprandial hypoglycaemia, the pathophysiological basis of which remains largely unexplored. This study aimed to investigate changes in enteroendocrine function after oesophagectomy. METHODS: In this prospective study, 12 consecutive patients undergoing oesophagectomy were studied before and 10 days, 6, 12 and 52 weeks after surgery. Serial plasma total fasting ghrelin, and glucagon-like peptide 1 (GLP-1), insulin and glucose release following a standard 400-kcal mixed-meal stimulus were determined. CT body composition and anthropometry were assessed, and symptom scores calculated using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires. RESULTS: At 1 year, two of the 12 patients exhibited postprandial hypoglycaemia, with reductions in bodyweight (mean(s.e.m.) 17·1(3·2) per cent, P < 0·001), fat mass (21.5(2.5) kg versus 25.5(2.4) kg before surgery; P = 0·014), lean body mass (51.5(2.2) versus 54.0(1.8) kg respectively; P = 0·003) and insulin resistance (HOMA-IR: 0.84(0.17) versus 1.16(0.20); P = 0·022). Mean(s.e.m.) fasting ghrelin levels decreased from postoperative day 10, but had recovered by 1 year (preoperative: 621·5(71·7) pg/ml; 10 days: 415·1(59·80) pg/ml; 6 weeks: 309·0(42·0) pg/ml; 12 weeks: 415·8(52·1) pg/ml; 52 weeks: 547·4(83·2) pg/ml; P < 0·001) and did not predict weight loss (P = 0·198). Postprandial insulin increased progressively at 10 days, 6, 12 and 52 weeks (mean(s.e.m.) insulin AUC0-30 min : fold change 1·7(0·4), 2·0(0·4), 3·5(0·7) and 4·0(0·8) respectively; P = 0·001). Postprandial GLP-1 concentration increased from day 10 after surgery (P < 0·001), with a 3·3(1·8)-fold increase at 1 year (P < 0·001). Peak GLP-1 level was inversely associated with the postprandial glucose nadir (P = 0·041) and symptomatic neuroglycopenia (Sigstad score, P = 0·017, R2 = 0·45). GLP-1 AUC predicted loss of weight (P = 0·008, R2 = 0·52) and fat mass (P = 0·010, R2 = 0·64) at 1 year. CONCLUSION: Altered enteroendocrine physiology is associated with early satiety, weight loss and postprandial hypoglycaemia after oesophagectomy.


Asunto(s)
Esofagectomía , Hormonas Gastrointestinales/sangre , Hipoglucemia/etiología , Complicaciones Posoperatorias/etiología , Adulto , Anciano , Biomarcadores/sangre , Glucemia/metabolismo , Composición Corporal , Femenino , Estudios de Seguimiento , Ghrelina/sangre , Péptido 1 Similar al Glucagón/sangre , Humanos , Hipoglucemia/sangre , Hipoglucemia/diagnóstico , Hipoglucemia/fisiopatología , Insulina/sangre , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Periodo Posprandial , Estudios Prospectivos , Respuesta de Saciedad , Pérdida de Peso
7.
Br J Surg ; 106(10): 1341-1351, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31282584

RESUMEN

BACKGROUND: It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer. METHODS: Consecutive patients treated between 2010 and 2016 were included. Three-dimensional conformal radiation was standard, with a lung dose-volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41·4 Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) were assessed at baseline and 1 month after nCRT. Radiation-induced lung injury (grade 2 or greater), comprehensive complications index (CCI) and pulmonary complications were monitored prospectively. Health-related quality of life was assessed among disease-free patients in survivorship. RESULTS: Some 228 patients were studied. Comparing pulmonary physiology values before with those after nCRT, FEV1 decreased from mean(s.d.) 96·8(17·7) to 91·5(20·4) per cent (-3·6(10·6) per cent; P < 0·001), FVC from 104·9(15·6) to 98·1(19·8) per cent (-3·2(11·9) per cent; P = 0·005) and DLCO from 97·6(20·7) to 82·2(20·4) per cent (-14·8(14·0) per cent; P < 0·001). Five patients (2·2 per cent) developed radiation-induced lung injury precluding surgical resection. Smoking (P = 0·005) and increased age (P < 0·001) independently predicted percentage change in DLCO. Carboplatin and paclitaxel with 41·4 Gy resulted in a greater DLCO decline than cisplatin and 5-fluorouracil with 40 Gy (P = 0·001). On multivariable analysis, post-treatment DLCO predicted CCI (P = 0·006), respiratory failure (P = 0·020) and reduced physical function in survivorship (P = 0·047). CONCLUSION: These data indicate that modern nCRT alters pulmonary physiology, in particular diffusion capacity, which is linked to short- and longer-term clinical consequences, highlighting a potentially modifiable index of risk.


ANTECEDENTES: El tema de si en el cáncer de esófago la quimiorradioterapia neoadyuvante (neoadjuvant chemoradiation, nCRT) repercute sobre la morbilidad postoperatoria, especialmente sobre la morbilidad pulmonar y la calidad de vida de los pacientes que sobreviven sigue siendo controvertido. Este estudio combina datos sobre resultados clínicos con una evaluación sistemática de la fisiología pulmonar para determinar el impacto de la nCRT sobre la fisiología pulmonar y los resultados clínicos en el cáncer de esófago localmente avanzado. MÉTODOS: Se incluyeron pacientes consecutivos tratados entre 2010-2016. La radioterapia conformal 3D fue la estándar, con un histograma dosis-volumen del pulmón V20 < 25% y radiación entre 40-41,4 Gy. Se evaluaron el volumen espiratorio forzado (forced expiratory volume, FEV1), la capacidad vital forzada (forced vital capacity, FVC) y la capacidad de difusión del monóxido de carbono (diffusion capacity for carbon monoxide, DLCO) al inicio y un mes tras la nCRT. La lesión pulmonar inducida por la radioterapia (EORTC grado ≥ 2), el índice de complicaciones integral (comprehensive complications index, CCI), grado de Clavien-Dindo, y complicaciones pulmonares fueron analizadas de manera prospectiva. Se evaluó la calidad de vida relacionada con la salud entre los pacientes supervivientes libres de enfermedad (EORTC QLQ-C30, OG25, OES18). RESULTADOS: Se estudiaron un total de 228 pacientes. Al comparar los valores de la fisiología pulmonar antes y después de la nCRT respectivamente, la FEV1 disminuyó de 96,8 ± 17,7% a 91,5 ± 20,4% (-3,6 ± 10,6%, P = 0,0002), la FVC de 104,9 ± 15,6 a 98,1 ± 19,8% (-3,2 ± 11,9%, P = 0,005) y la DLCO de 97,6 ± 20,7 a 82,2 ± 20,4% (-14,8 ± 14,0%, P < 0,0001). Cinco pacientes (2,2%) desarrollaron lesión pulmonar relacionada con la radioterapia impidiendo la resección quirúrgica. Los factores predictores independientes de %ΔDLCO fueron el hábito tabáquico (P = 0,005) y la edad avanzada (P < 0,001). El tratamiento con carboplatino/paclitaxel/41,4Gy determinó un mayor descenso de la DLCO en comparación con cisplatino/5-fluorouracilo/40Gy (P = 0,001). En el análisis multivariable, la DLCO tras el tratamiento fue una variable predictora de CCI (P = 0,006), fracaso respiratorio/intubación prolongada (P = 0,020) y reducción de la función física en los supervivientes (P = 0,047). CONCLUSIÓN: Estos datos indican que la moderna nCRT altera la fisiología pulmonar, especialmente la difusión pulmonar, con consecuencias clínicas a corto y largo plazo. La DLCO podría constituir un factor de riesgo potencialmente modificable.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioradioterapia Adyuvante/métodos , Neoplasias Esofágicas/terapia , Calidad de Vida , Trastornos Respiratorios/etiología , Monóxido de Carbono/análisis , Carboplatino/administración & dosificación , Esofagectomía/métodos , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Paclitaxel/administración & dosificación , Complicaciones Posoperatorias/etiología , Cuidados Preoperatorios/métodos , Capacidad Vital/fisiología
8.
BMC Cancer ; 19(1): 682, 2019 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-31299920

RESUMEN

BACKGROUND: Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy. METHODS: Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30. RESULTS: Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p < 0.001). Percentage time spent sedentary increased throughout recovery (p < 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p < 0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2. CONCLUSION: Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.


Asunto(s)
Neoplasias Esofágicas/epidemiología , Esofagectomía/efectos adversos , Ejercicio Físico , Estado de Salud , Adulto , Anciano , Supervivientes de Cáncer , Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Vigilancia en Salud Pública , Calidad de Vida , Factores de Riesgo
9.
Support Care Cancer ; 26(5): 1569-1576, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29197960

RESUMEN

PURPOSE: Preoperative chemo(radio)therapy for oesophageal cancer (OC) may have an attritional impact on body composition and functional status, impacting postoperative outcome. Physical decline with skeletal muscle loss has not been previously characterised in OC and may be amenable to physical rehabilitation. This study characterises skeletal muscle mass and physical performance from diagnosis to post-neoadjuvant therapy in patients undergoing preoperative chemo(radio)therapy for OC. METHODS: Measures of body composition (axial computerised tomography), muscle strength (handgrip), functional capacity (walking distance), anthropometry (weight, height and waist circumference), physical activity, quality-of-life and nutritional status were captured prospectively. Sarcopenia status was defined as pre-sarcopenic (low muscle mass only), sarcopenic (low muscle mass and low muscle strength or function) or severely sarcopenic (low muscle mass and low muscle strength and low muscle function). RESULTS: Twenty-eight participants were studied at both time points (mean age 62.86 ± 8.18 years, n = 23 male). Lean body mass reduced by 4.9 (95% confidence interval 3.2 to 6.7) kg and mean grip strength reduced by 4.3 (2.5 to 6.1) kg from pre- to post-neoadjuvant therapy. Quality-of-life scores capturing gastrointestinal symptoms improved. Measures of anthropometry, walking distance, physical activity and nutritional status did not change. There was an increase in sarcopenic status from diagnosis (pre-sarcopenic n = 2) to post-treatment (pre-sarcopenic n = 5, severely sarcopenic n = 1). CONCLUSIONS: Despite maintenance of body weight, functional capacity and activity habits, participants experience declines in muscle mass and strength. Interventions involving exercise and/or nutritional support to build muscle mass and strength during preoperative therapy, even in patients who are functioning normally, are warranted.


Asunto(s)
Neoplasias Esofágicas/complicaciones , Fuerza Muscular/fisiología , Terapia Neoadyuvante/efectos adversos , Rendimiento Físico Funcional , Sarcopenia/etiología , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Sarcopenia/patología
10.
J Anim Breed Genet ; 135(2): 132-137, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29516550

RESUMEN

An assumption in aquaculture of Atlantic salmon is that male and female growth within families is perfectly genetically correlated. That is, families would rank identically if based on male growth only or female growth only. Also, growth in freshwater and sea water is assumed to be highly correlated between males and females within families. However, structural analysis of the DNA of Atlantic salmon has found that the linkage maps of females differ significantly from that of males. Genetic variability for any trait measured on females could be greater or lesser than on males. Thus, male and female growth might be considered as separate traits giving rise to families ranking differently depending on gender. A multiple trait family model for weight and length at 3 years of age in Atlantic salmon according to gender was applied to data on North American Atlantic salmon obtained from the Oak Bay Hatchery in New Brunswick, Canada. Genetic correlations between male and female growth in both freshwater and sea water were estimated by Bayesian methods. The estimates support the possible existence of gender dimorphism in North American Atlantic salmon for growth traits.


Asunto(s)
Sitios de Carácter Cuantitativo , Salmo salar/crecimiento & desarrollo , Salmo salar/genética , Animales , Femenino , Masculino , Caracteres Sexuales
11.
J Chem Phys ; 147(21): 214904, 2017 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-29221394

RESUMEN

The morphology and transport properties of thin films of the ionomer Nafion, with thicknesses on the order of the bulk cluster size, have been investigated as a model system to explain the anomalous behaviour of catalyst/electrode-polymer interfaces in membrane electrode assemblies. We have employed dissipative particle dynamics (DPD) to investigate the interaction of water and fluorocarbon chains, with carbon and quartz as confining materials, for a wide range of operational water contents and film thicknesses. We found confinement-induced clustering of water perpendicular to the thin film. Hydrophobic carbon forms a water depletion zone near the film interface, whereas hydrophilic quartz results in a zone with excess water. There are, on average, oscillating water-rich and fluorocarbon-rich regions, in agreement with experimental results from neutron reflectometry. Water diffusivity shows increasing directional anisotropy of up to 30% with decreasing film thickness, depending on the hydrophilicity of the confining material. A percolation analysis revealed significant differences in water clustering and connectivity with the confining material. These findings indicate the fundamentally different nature of ionomer thin films, compared to membranes, and suggest explanations for increased ionic resistances observed in the catalyst layer.

13.
Phys Chem Chem Phys ; 17(8): 5574-85, 2015 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-25372858

RESUMEN

Using Gibbs' adsorption equation and a literature isotherm, a new general model to predict the contact angle of surfactant solutions on (smooth or rough) chemically heterogeneous surfaces is constructed based on the Cassie equation. The model allows for adsorption at the liquid-vapor, solid-liquid, and solid-vapor interfaces. Solid-vapor adsorption is allowed in order to model the autophobic effect on hydrophilic surfaces. Using representative values for the coefficients which describe adsorption at each interface, model predictions for contact angles as a function of f parameters (area fractions) and surfactant concentration are made for heterogeneous surfaces made up of different materials. On smooth surfaces, the f parameters serve as weighting factors determining how to combine the effects of surfactant adsorption on each material to predict the behavior on the heterogeneous surface. Due to the non-linear nature of the model, the inclusion of a small amount of hydrophobic material has a greater effect on a predominantly hydrophilic material than vice versa, explaining the result seen in literature that a small amount of hydrophobic contamination (such as oil) significantly increases contact angle on a hydrophilic surface. The fact that even a small amount of heterogeneity can greatly change experimental results could lead to incorrect experimental conclusions about surfactant adsorption if a surface were wrongly assumed to be homogeneous. Model predictions rapidly become more complex as the number of differently wettable materials present on the surface increases. Also, an approximately equal weighting of different materials generally leads to more complex behaviors compared to heterogeneous surfaces composed largely of a single material. Rough heterogeneous surfaces follow previous results for surfactant wetting of rough homogeneous surfaces, leading to an amplification/attenuation of surfactant effects for penetrated/unpenetrated wetting, and further increasing the complexity of predictions. These potential complexities point to the importance of characterizing the heterogeneities of any surface under consideration. With proper characterization, the model described in this paper will allow for prediction of contact angles on all types of heterogeneous surfaces, and design of surfaces for specific interactions with surfactant solutions.

14.
Br J Surg ; 101(13): 1702-11, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25351460

RESUMEN

BACKGROUND: The role of CT-PET after neoadjuvant chemoradiation (nCRT) for prediction of pathological response and oncological outcome in oesophageal and junctional adenocarcinoma (OAC) is unclear. The relationship between complete metabolic response (cMR), pathological complete response (pCR) and nodal status has not been clarified. METHODS: Patients with locally advanced OAC selected to receive nCRT and surgery with curative intent, on the basis of staging that included CT-PET positivity, were included. Repeat scanning (PET2) with an identical protocol was performed 2-4 weeks after completion of nCRT (cisplatin and 5-fluorouracil plus 44 Gy radiation). Changes in [(18) F]fluorodeoxyglucose uptake, considered as either a maximum standardized uptake value (SUVmax) or a relative reduction (%ΔSUVmax), and PET-predicted nodal status following nCRT were compared with histopathological response, histological node positivity and survival. RESULTS: One hundred consecutive patients with PET-positive OAC were studied. Following nCRT, PET2 identified M1 disease in 2·0 per cent of patients. There were no significant associations between PET2 SUVmax or %ΔSUVmax with respect to primary tumour stage (ypT) (P = 0.216 and P = 0·975 respectively), tumour regression grade (P = 0·109 and P = 0·232), pCR (P = 0·633 and P = 0·870) or complete resection (R0) (P = 0·440 and P = 0·235). The sensitivity of PET2 for ypN was 10 per cent. %ΔSUVmax was not associated with disease-free or overall survival (P = 0·162 and P = 0·154 respectively). Of 46 patients with a cMR on PET2, 37 (80 per cent) had histological evidence of residual tumour in the resected specimen, and cMR was not associated with overall survival benefit (P = 0·478). CONCLUSION: CT-PET following nCRT for OAC has poor prognostic and discriminatory value for clinical application.


Asunto(s)
Adenocarcinoma/patología , Neoplasias Esofágicas/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/terapia , Quimioradioterapia/métodos , Quimioradioterapia/mortalidad , Supervivencia sin Enfermedad , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/terapia , Femenino , Fluorodesoxiglucosa F18 , Humanos , Metástasis Linfática , Masculino , Terapia Neoadyuvante/métodos , Terapia Neoadyuvante/mortalidad , Estadificación de Neoplasias , Tomografía de Emisión de Positrones/métodos , Tomografía de Emisión de Positrones/mortalidad , Estudios Prospectivos , Radiofármacos , Inducción de Remisión , Retratamiento , Resultado del Tratamiento
15.
Horm Behav ; 65(3): 301-7, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24440383

RESUMEN

Light regulates a variety of behavioral and physiological processes, including activity rhythms and hormone secretory patterns. Seasonal changes in the proportion of light in a day (photoperiod) further modulate those functions. Recently, short (SP) versus long days (LP) were found to markedly increase light sensitivity for phase shifting in Syrian hamsters. To our knowledge, photoperiod effects on light sensitivity have not been studied in other rodents, nor is it known if they generalize to other circadian responses. We tested whether photic phase shifting and melatonin suppression vary in Siberian hamsters maintained under LP or SP. Select irradiances of light were administered, and shifts in activity were determined. Photic sensitivity for melatonin suppression was examined in a separate group of animals via pulses of light across a 4 log-unit photon density range, with post-pulse plasma melatonin levels determined via RIA. Phase shifting and melatonin suppression were greater at higher irradiances for both LP and SP. The lower irradiance condition was below threshold for phase shifts in LP but not SP. Melatonin suppression did not vary by photoperiod, and the half saturation constant for fitted sigmoid curves was similar under LP and SP. Thus, the photoperiodic modulation of light sensitivity for phase shifting is conserved across two hamster genera. The dissociation of photoperiod effects on photic phase shifting and melatonin suppression suggests that the modulation of sensitivity occurs downstream of the common retinal input pathway. Understanding the mechanistic basis for this plasticity may yield therapeutic targets for optimizing light therapy practices.


Asunto(s)
Conducta Animal/fisiología , Ritmo Circadiano/fisiología , Melatonina/metabolismo , Phodopus/fisiología , Fotoperiodo , Animales , Conducta Animal/efectos de la radiación , Ritmo Circadiano/efectos de la radiación , Luz , Masculino , Melatonina/sangre , Melatonina/efectos de la radiación , Phodopus/metabolismo , Distribución Aleatoria
16.
Cryobiology ; 68(1): 50-6, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24269869

RESUMEN

Vitrification of articular cartilage (AC) could enhance tissue availability but requires high concentrations of cyroprotective agents (CPAs). This study investigated relative injuries caused by commonly used CPAs. We hypothesized that the in situ chondrocyte dose-injury relationships of five commonly used CPAs are nonlinear and that relative injuries could be determined by comparing cell death after exposure at increasing concentrations. Human AC samples were used from four patients undergoing total knee arthroplasty surgery. Seventy µm slices were exposed in a stepwise protocol to increasing concentrations of 5 CPAs (max = 8 M); dimethyl sulfoxide (Me(2)SO), glycerol (Gly), propylene glycol (PG), ethylene glycol (EG), and formamide (FM). Chondrocyte viability was determined by membrane integrity stains. Statistical analysis included t-tests and nonlinear least squares estimation methods. The dose-injury to chondrocytes relationships for all CPAs were found to be nonlinear (sigmoidal best fit). For the particular loading protocol in this study, the data identified the following CPA concentrations at which chondrocyte recoveries statistically deviated significantly from the control recovery; 1 M for Gly, 4 M for FM and PG, 6 M for Me(2)SO, and 7 M for EG. Comparison of individual means demonstrated that Gly exposure resulted in the lowest recovery, followed by PG, and then Me(2)SO, FM and EG in no specific order. The information from this study provides an order of damage to human chondrocytes in situ of commonly used CPAs for vitrification of AC and identifies threshold CPA concentrations for a stepwise loading protocol at which chondrocyte recovery is significantly decreased. In general, Gly and PG were the most damaging while DMSO and EG were among the least damaging.


Asunto(s)
Condrocitos/efectos de los fármacos , Crioprotectores/farmacología , Cartílago Articular/citología , Cartílago Articular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Condrocitos/citología , Criopreservación , Dimetilsulfóxido/farmacología , Glicol de Etileno/farmacología , Formamidas/farmacología , Glicerol/farmacología , Humanos , Cultivo Primario de Células , Propilenglicol/farmacología , Vitrificación
17.
Osteoarthritis Cartilage ; 20(9): 1004-10, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22579917

RESUMEN

UNLABELLED: Cartilage cryopreservation requires optimal loading of protective solutes, most commonly dimethyl sulfoxide (DMSO), to maximize chondrocyte survival. Previously, diffusion models have been used to predict the distribution of solutes in tissue samples, but the accuracy of spatiotemporal predictions of these models have not been validated with empirical studies and remains unknown. OBJECTIVE: In this study, magnetic resonance spectroscopic imaging was used to measure the spatial and temporal changes in DMSO and water concentrations in porcine articular cartilage plugs, throughout 1 h of solute loading. DESIGN: A custom NMR spectroscopic imaging pulse sequence provided water and DMSO concentration images with an in-plane spatial resolution of 135 µm and a temporal resolution of 150 s, repeated for 60 min throughout DMSO loading. Delayed gadolinium-enhanced magnetic resonance of cartilage (d-GEMRIC) imaging provided fixed charge density and spin-density imaging provided water density images prior to DMSO loading. RESULTS: The measured spatial and temporal distribution of DMSO in three different samples was compared to independent predictions of Fick's law and the modified triphasic biomechanical model by Abazari et al. (2011) with the empirical data more closely agreeing with the triphasic model. CONCLUSION: Dynamic NMR spectroscopic imaging can measure spatial and temporal changes in water and cryoprotectant concentrations in articular cartilage. The modified triphasic model predictions for the interstitial distribution of DMSO were confirmed and its advantage over the predictions by Fick's law model, which is commonly used in the literature of cryobiology, was demonstrated.


Asunto(s)
Cartílago Articular/química , Crioprotectores/análisis , Dimetilsulfóxido/análisis , Agua/análisis , Algoritmos , Animales , Criopreservación/métodos , Gadolinio , Miembro Posterior/química , Espectroscopía de Resonancia Magnética/métodos , Modelos Teóricos , Porcinos
18.
Cryobiology ; 64(3): 185-91, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22274740

RESUMEN

BACKGROUND: Vitrification is a method of cryopreservation by which cells and tissues can be preserved at low temperatures using cryoprotective agents (CPAs) at high concentrations (typically ≥6.0 M) to limit the harmful effects of ice crystals that can form during cooling processes. However, at these concentrations CPAs are significantly cytotoxic and an understanding of their toxicity characteristics and interactions is important. Therefore, single-CPA and multiple-CPA solutions were evaluated for their direct and indirect toxicities on chondrocytes. METHODS: Chondrocytes were isolated from human articular cartilage samples and exposed to various single-CPA and multiple-CPA solutions of five common CPAs (dimethyl sulfoxide (DMSO), ethylene glycol (EG), propylene glycol (PG), glycerol (Gy) and formamide (Fm)) at both 6.0 and 8.1 M concentrations at 0 °C for 30 min. Chondrocyte survival was determined using a fluorescent cell membrane integrity assay. The data obtained was statistically analyzed and regression coefficients were used to represent the indirect toxicity effect which a specific combination of CPAs exerted on the final solution's toxicity. RESULTS: Multiple-CPA solutions were significantly less toxic than single-CPA solutions (P<0.01). The indirect toxicity effects between CPAs were quantifiable using regression analysis. Cell survival rates of approximately 40% were obtained with the four-CPA combination solution DMSO-EG-Gy-Fm. In the multiple-CPA combinations, PG demonstrated the greatest degree of toxicity and its presence within a combination solution negated any benefits of using multiple lower concentration CPAs. CONCLUSIONS: Multiple-CPA solutions are less cytotoxic than single-CPA solutions of the same total concentration. PG was the most toxic CPA when used in combinations. The highest chondrocyte survival rates were obtained with the 6.0 M DMSO-EG-Gy-Fm combination solution.


Asunto(s)
Cartílago Articular/efectos de los fármacos , Condrocitos/efectos de los fármacos , Criopreservación/métodos , Crioprotectores/toxicidad , Cartílago Articular/citología , Membrana Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Condrocitos/citología , Frío , Dimetilsulfóxido/toxicidad , Interacciones Farmacológicas , Glicol de Etileno/toxicidad , Colorantes Fluorescentes , Formamidas/toxicidad , Glicerol/toxicidad , Humanos , Propilenglicol/toxicidad , Análisis de Regresión , Vitrificación
19.
Phys Rev Lett ; 107(16): 168301, 2011 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-22107432

RESUMEN

We derive an expression for the nonequilibrium segregation coefficient of colloidal particles near a moving solid-liquid interface. The resulting kinetic phase diagram has applications for the rapid solidification of clay soils, gels, and related colloidal systems. We use it to explain the formation of bandlike defects in rapidly solidified alumina suspensions.

20.
Phys Chem Chem Phys ; 13(36): 16208-19, 2011 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-21822523

RESUMEN

Despite the practical need, no models exist to predict contact angles or wetting mode of surfactant solutions on rough hydrophobic or superhydrophobic surfaces. Using Gibbs' adsorption equation and a literature isotherm, a new model is constructed based on the Wenzel and Cassie equations. Experimental data for aqueous solutions of sodium dodecyl sulfate (SDS) contact angles on smooth Teflon surfaces are fit to estimate values for the adsorption coefficients in the model. Using these coefficients, model predictions for contact angles as a function of topological f (Cassie) and r (Wenzel) factors and SDS concentration are made for different intrinsic contact angles. The model is also used to design/tune surface responses. It is found that: (1) predictions compare favorably to data for SDS solutions on five superhydrophobic surfaces. Further, the model predictions can determine which wetting mode (Wenzel or Cassie) occurred in each experiment. The unpenetrated or partially penetrated Cassie mode was the most common, suggesting that surfactants inhibit the penetration of liquids into rough hydrophobic surfaces. (2) The Wenzel roughness factor, r, amplifies the effect of surfactant adsorption, leading to larger changes in contact angles and promoting total wetting. (3) The Cassie solid area fraction, f, attenuates the lowering of contact angles on rough surfaces. (4) The amplification/attenuation is understood to be due to increased/decreased solid-liquid contact-area.

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