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1.
Nature ; 595(7868): 526-531, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34290431

RESUMEN

Moiré quantum matter has emerged as a materials platform in which correlated and topological phases can be explored with unprecedented control. Among them, magic-angle systems constructed from two or three layers of graphene have shown robust superconducting phases with unconventional characteristics1-5. However, direct evidence of unconventional pairing remains to be experimentally demonstrated. Here we show that magic-angle twisted trilayer graphene exhibits superconductivity up to in-plane magnetic fields in excess of 10 T, which represents a large (2-3 times) violation of the Pauli limit for conventional spin-singlet superconductors6,7. This is an unexpected observation for a system that is not predicted to have strong spin-orbit coupling. The Pauli-limit violation is observed over the entire superconducting phase, which indicates that it is not related to a possible pseudogap phase with large superconducting amplitude pairing. Notably, we observe re-entrant superconductivity at large magnetic fields, which is present over a narrower range of carrier densities and displacement fields. These findings suggest that the superconductivity in magic-angle twisted trilayer graphene is likely to be driven by a mechanism that results in non-spin-singlet Cooper pairs, and that the external magnetic field can cause transitions between phases with potentially different order parameters. Our results demonstrate the richness of moiré superconductivity and could lead to the design of next-generation exotic quantum matter.

2.
Nature ; 592(7852): 43-48, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33790447

RESUMEN

Interaction-driven spontaneous symmetry breaking lies at the heart of many quantum phases of matter. In moiré systems, broken spin/valley 'flavour' symmetry in flat bands underlies the parent state from which correlated and topological ground states ultimately emerge1-10. However, the microscopic mechanism of such flavour symmetry breaking and its connection to the low-temperature phases are not yet understood. Here we investigate the broken-symmetry many-body ground state of magic-angle twisted bilayer graphene (MATBG) and its nontrivial topology using simultaneous thermodynamic and transport measurements. We directly observe flavour symmetry breaking as pinning of the chemical potential at all integer fillings of the moiré superlattice, demonstrating the importance of flavour Hund's coupling in the many-body ground state. The topological nature of the underlying flat bands is manifested upon breaking time-reversal symmetry, where we measure energy gaps corresponding to Chern insulator states with Chern numbers 3, 2, 1 at filling factors 1, 2, 3, respectively, consistent with flavour symmetry breaking in the Hofstadter butterfly spectrum of MATBG. Moreover, concurrent measurements of resistivity and chemical potential provide the temperature-dependent charge diffusivity of MATBG in the strange-metal regime11-a quantity previously explored only in ultracold atoms12. Our results bring us one step closer to a unified framework for understanding interactions in the topological bands of MATBG, with and without a magnetic field.

3.
Nature ; 590(7845): 249-255, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33526935

RESUMEN

Moiré superlattices1,2 have recently emerged as a platform upon which correlated physics and superconductivity can be studied with unprecedented tunability3-6. Although correlated effects have been observed in several other moiré systems7-17, magic-angle twisted bilayer graphene remains the only one in which robust superconductivity has been reproducibly measured4-6. Here we realize a moiré superconductor in magic-angle twisted trilayer graphene (MATTG)18, which has better tunability of its electronic structure and superconducting properties than magic-angle twisted bilayer graphene. Measurements of the Hall effect and quantum oscillations as a function of density and electric field enable us to determine the tunable phase boundaries of the system in the normal metallic state. Zero-magnetic-field resistivity measurements reveal that the existence of superconductivity is intimately connected to the broken-symmetry phase that emerges from two carriers per moiré unit cell. We find that the superconducting phase is suppressed and bounded at the Van Hove singularities that partially surround the broken-symmetry phase, which is difficult to reconcile with weak-coupling Bardeen-Cooper-Schrieffer theory. Moreover, the extensive in situ tunability of our system allows us to reach the ultrastrong-coupling regime, characterized by a Ginzburg-Landau coherence length that reaches the average inter-particle distance, and very large TBKT/TF values, in excess of 0.1 (where TBKT and TF are the Berezinskii-Kosterlitz-Thouless transition and Fermi temperatures, respectively). These observations suggest that MATTG can be electrically tuned close to the crossover to a two-dimensional Bose-Einstein condensate. Our results establish a family of tunable moiré superconductors that have the potential to revolutionize our fundamental understanding of and the applications for strongly coupled superconductivity.

4.
Nature ; 592(7853): 214-219, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33828314

RESUMEN

In the 1950s, Pomeranchuk1 predicted that, counterintuitively, liquid 3He may solidify on heating. This effect arises owing to high excess nuclear spin entropy in the solid phase, where the atoms are spatially localized. Here we find that an analogous effect occurs in magic-angle twisted bilayer graphene2-6. Using both local and global electronic entropy measurements, we show that near a filling of one electron per moiré unit cell, there is a marked increase in the electronic entropy to about 1kB per unit cell (kB is the Boltzmann constant). This large excess entropy is quenched by an in-plane magnetic field, pointing to its magnetic origin. A sharp drop in the compressibility as a function of the electron density, associated with a reset of the Fermi level back to the vicinity of the Dirac point, marks a clear boundary between two phases. We map this jump as a function of electron density, temperature and magnetic field. This reveals a phase diagram that is consistent with a Pomeranchuk-like temperature- and field-driven transition from a low-entropy electronic liquid to a high-entropy correlated state with nearly free magnetic moments. The correlated state features an unusual combination of seemingly contradictory properties, some associated with itinerant electrons-such as the absence of a thermodynamic gap, metallicity and a Dirac-like compressibility-and others associated with localized moments, such as a large entropy and its disappearance under a magnetic field. Moreover, the energy scales characterizing these two sets of properties are very different: whereas the compressibility jump has an onset at a temperature of about 30 kelvin, the bandwidth of magnetic excitations is about 3 kelvin or smaller. The hybrid nature of the present correlated state and the large separation of energy scales have implications for the thermodynamic and transport properties of the correlated states in twisted bilayer graphene.

5.
Nature ; 600(7889): 439-443, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34912084

RESUMEN

Fractional Chern insulators (FCIs) are lattice analogues of fractional quantum Hall states that may provide a new avenue towards manipulating non-Abelian excitations. Early theoretical studies1-7 have predicted their existence in systems with flat Chern bands and highlighted the critical role of a particular quantum geometry. However, FCI states have been observed only in Bernal-stacked bilayer graphene (BLG) aligned with hexagonal boron nitride (hBN)8, in which a very large magnetic field is responsible for the existence of the Chern bands, precluding the realization of FCIs at zero field. By contrast, magic-angle twisted BLG9-12 supports flat Chern bands at zero magnetic field13-17, and therefore offers a promising route towards stabilizing zero-field FCIs. Here we report the observation of eight FCI states at low magnetic field in magic-angle twisted BLG enabled by high-resolution local compressibility measurements. The first of these states emerge at 5 T, and their appearance is accompanied by the simultaneous disappearance of nearby topologically trivial charge density wave states. We demonstrate that, unlike the case of the BLG/hBN platform, the principal role of the weak magnetic field is merely to redistribute the Berry curvature of the native Chern bands and thereby realize a quantum geometry favourable for the emergence of FCIs. Our findings strongly suggest that FCIs may be realized at zero magnetic field and pave the way for the exploration and manipulation of anyonic excitations in flat moiré Chern bands.

6.
Nature ; 583(7815): 215-220, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32499644

RESUMEN

The recent discovery of correlated insulator states and superconductivity in magic-angle twisted bilayer graphene1,2 has enabled the experimental investigation of electronic correlations in tunable flat-band systems realized in twisted van der Waals heterostructures3-6. This novel twist angle degree of freedom and control should be generalizable to other two-dimensional systems, which may exhibit similar correlated physics behaviour, and could enable techniques to tune and control the strength of electron-electron interactions. Here we report a highly tunable correlated system based on small-angle twisted bilayer-bilayer graphene (TBBG), consisting of two rotated sheets of Bernal-stacked bilayer graphene. We find that TBBG exhibits a rich phase diagram, with tunable correlated insulator states that are highly sensitive to both the twist angle and the application of an electric displacement field, the latter reflecting the inherent polarizability of Bernal-stacked bilayer graphene7,8. The correlated insulator states can be switched on and off by the displacement field at all integer electron fillings of the moiré unit cell. The response of these correlated states to magnetic fields suggests evidence of spin-polarized ground states, in stark contrast to magic-angle twisted bilayer graphene. Furthermore, in the regime of lower twist angles, TBBG shows multiple sets of flat bands near charge neutrality, resulting in numerous correlated states corresponding to half-filling of each of these flat bands, all of which are tunable by the displacement field as well. Our results could enable the exploration of twist-angle- and electric-field-controlled correlated phases of matter in multi-flat-band twisted superlattices.

7.
Nature ; 583(7816): E27, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32612239

RESUMEN

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

8.
Hepatology ; 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38652643

RESUMEN

BACKGROUND AND AIMS: Noninvasive tools assessing steatosis, such as ultrasonography-based 2D-attenuation imaging (ATI), are needed to tackle the worldwide burden of steatotic liver disease. This one-stage individual patient data (IPD) meta-analysis aimed to create an ATI-based steatosis grading system. APPROACH AND RESULTS: A systematic review (EMBASE + MEDLINE, 2018-2022) identified studies, including patients with histologically or magnetic resonance imaging proton-density fat fraction (MRI-PDFF)-verified ATI for grading steatosis (S0 to S3). One-stage IPD meta-analyses were conducted using generalized mixed models with a random study-specific intercept. Created ATI-based steatosis grading system (aS0 to aS3) was externally validated on a prospective cohort of patients with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (n=174, histologically and MRI-PDFF-verified steatosis). Eleven enrolled studies included 1374 patients, classified into S0, S1, S2, and S3 in 45.4%, 35.0%, 9.3%, and 10.3% of the cases. ATI was correlated with histological steatosis ( r = 0.60; 95% CI: 0.52, 0.67; p < 0.001) and MRI-PDFF ( r = 0.70; 95% CI: 0.66, 0.73; p < 0.001) but not with liver stiffness ( r = 0.03; 95% CI: -0.04, 0.11, p = 0.343). Steatosis grade was an independent factor associated with ATI (coefficient: 0.24; 95% CI: [0.22, 0.26]; p < 0.001). ATI marginal means within S0, S1, S2, and S3 subpopulations were 0.59 (95% CI: [0.58, 0.61]), 0.69 (95% CI [0.67, 0.71]), 0.78 (95% CI: [0.76, 0.81]), and 0.85 (95% CI: [0.83, 0.88]) dB/cm/MHz; all contrasts between grades were significant ( p < 0.0001). Three ATI thresholds were calibrated to create a new ATI-based steatosis grading system (aS0 to aS3, cutoffs: 0.66, 0.73, and 0.81 dB/cm/MHz). Its external validation showed Obuchowski measures of 0.84 ± 0.02 and 0.82 ± 0.02 with histologically based and MRI-PDFF-based references. CONCLUSIONS: ATI is a reliable, noninvasive marker of steatosis. This validated ATI-based steatosis grading system could be valuable in assessing patients with metabolic dysfunction-associated steatotic liver disease.

9.
J Hepatol ; 81(3): 461-470, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38636849

RESUMEN

BACKGROUND & AIMS: Ultrasound (US) is recommended for HCC surveillance in high-risk patients but has limited performance in detecting early-stage HCC. We aimed to compare the diagnostic performance of biannual US and annual non-contrast abbreviated magnetic resonance imaging (NC-AMRI) as HCC surveillance modalities in high-risk patients. METHODS: This prospective, multicenter cohort study enrolled participants with an estimated annual risk of HCC greater than 5% between October 2015 and April 2017. Participants underwent six rounds of HCC surveillance at 6-month intervals, with both US and NC-AMRI at rounds 1, 3, and 5, and only US at rounds 2, 4, and 6. The sensitivity, diagnostic yield (DY), and false referral rate (FRR) for HCC detection by US and NC-AMRI were compared. RESULTS: In total, 208 participants underwent 980 US and 516 NC-AMRI examinations during 30 months of follow-up. Among them, 34 HCCs were diagnosed in 31 participants, with 20 (64.5%) classified as very early-stage and 11 (35.5%) as early-stage HCC. The sensitivity of annual NC-AMRI (71.0%, 22/31) was marginally higher than that of biannual US (45.2%, 14/31; p = 0.077). NC-AMRI showed a significantly higher DY than US (4.26% vs. 1.43%, p <0.001), with a similar FRR (2.91% vs. 3.06%, p = 0.885). A simulation of alternating US and NC-AMRI at 6-month intervals yielded a sensitivity of 83.9% (26/31), significantly exceeding that of biannual US (p = 0.006). CONCLUSIONS: Annual NC-AMRI showed a marginally higher sensitivity than biannual US for HCC detection in high-risk patients. The DY of annual NC-AMRI was significantly higher than that of biannual US, without increasing the FRR. Thus, alternating US and NC-AMRI at 6-month intervals could be an optimal surveillance strategy for high-risk patients. IMPACT AND IMPLICATIONS: Current guidelines permit the use of magnetic resonance imaging (MRI) as a surveillance tool for hepatocellular carcinoma in patients in whom ultrasonography (US) is inadequate. However, the specific indications, imaging sequences, and intervals for MRI surveillance remain unclear. In our study, we found that annual non-contrast abbreviated MRI exhibited marginally higher sensitivity and significantly better diagnostic yield than biannual US in patients at high risk of hepatocellular carcinoma. Alternating US and non-contrast abbreviated MRI at 6-month intervals led to significantly improved sensitivity compared to biannual US, making it a potentially optimal surveillance strategy for high-risk patients. GOV IDENTIFIER: NCT02551250.


Asunto(s)
Carcinoma Hepatocelular , Neoplasias Hepáticas , Imagen por Resonancia Magnética , Ultrasonografía , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/epidemiología , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/epidemiología , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/estadística & datos numéricos , Femenino , Masculino , Ultrasonografía/métodos , Ultrasonografía/estadística & datos numéricos , Estudios Prospectivos , Persona de Mediana Edad , Anciano , Detección Precoz del Cáncer/métodos , Sensibilidad y Especificidad
10.
Biochem Biophys Res Commun ; 702: 149567, 2024 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-38335701

RESUMEN

Glutaraldehyde (GA) is a protein crosslinker widely used in biochemical and pharmaceutical research because it can rapidly stabilize and immobilize substrates via amine group interactions. However, controlling GA crosslinking is challenging owing to its swift reactivity and the influence of various solution conditions, such as pH and concentrations of the substrate and crosslinker. Although extensive research has focused on GA cross-linking mechanisms, studies on quenching, which is critical for preventing non-specific aggregation during prolonged storage, remain sparse. This study examines the quenching efficiency of a combined amino acid mixture of glycine, histidine, and lysine, which are commonly used as individual quenchers. Our findings, confirmed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis, demonstrate that this amino acid blend offers superior quenching compared to single amino acids, enhancing quenching activity across a wide pH spectrum. These results provide a novel approach for mitigating the high reactivity of GA with implications for improving sample preservation and stabilization in a range of biochemical applications, including microscopy and cell fixation.


Asunto(s)
Histidina , Lisina , Glutaral/química , Glutaral/farmacología , Reactivos de Enlaces Cruzados/química , Glicina
11.
Am J Gastroenterol ; 119(6): 1117-1125, 2024 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-38634559

RESUMEN

INTRODUCTION: Visceral obesity is a risk factor for reflux esophagitis (RE). We investigated the risk of RE according to visceral adipose tissue (VAT) measured by deep neural network architecture using computed tomography (CT) and evaluated the longitudinal association between abdominal adipose tissue changes and the disease course of RE. METHODS: Individuals receiving health checkups who underwent esophagogastroduodenoscopy (EGD) and abdominal CT at Seoul National University Healthcare System Gangnam Center between 2015 and 2016 were included. Visceral and subcutaneous adipose tissue areas and volumes were measured using a deep neural network architecture and CT. The association between the abdominal adipose tissue area and volume and the risk of RE was evaluated. Participants who underwent follow-up EGD and abdominal CT were selected; the effects of changes in abdominal adipose tissue area and volume on RE endoscopic grade were investigated using Cox proportional hazards regression. RESULTS: We enrolled 6,570 patients who underwent EGD and abdominal CT on the same day. RE was associated with male sex, hypertension, diabetes, excessive alcohol intake, current smoking status, and levels of physical activity. The VAT area and volume increased the risk of RE dose-dependently. A decreasing VAT volume was significantly associated with improvement in RE endoscopic grade (hazard ratio: 3.22, 95% confidence interval: 1.82-5.71). Changes in subcutaneous adipose tissue volume and the disease course of RE were not significantly correlated. DISCUSSION: Visceral obesity is strongly associated with RE. VAT volume reduction was prospectively associated with improvement in RE endoscopic grade dose-dependently. Visceral obesity is a potential target for RE treatment.


Asunto(s)
Endoscopía del Sistema Digestivo , Esofagitis Péptica , Grasa Intraabdominal , Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Persona de Mediana Edad , Grasa Intraabdominal/diagnóstico por imagen , Grasa Intraabdominal/patología , Esofagitis Péptica/diagnóstico por imagen , Esofagitis Péptica/patología , Endoscopía del Sistema Digestivo/métodos , Factores de Riesgo , Adulto , Obesidad Abdominal/complicaciones , Obesidad Abdominal/diagnóstico por imagen , Redes Neurales de la Computación , Anciano , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
12.
Radiology ; 311(2): e232369, 2024 05.
Artículo en Inglés | MEDLINE | ID: mdl-38805727

RESUMEN

The American College of Radiology Liver Imaging Reporting and Data System (LI-RADS) standardizes the imaging technique, reporting lexicon, disease categorization, and management for patients with or at risk for hepatocellular carcinoma (HCC). LI-RADS encompasses HCC surveillance with US; HCC diagnosis with CT, MRI, or contrast-enhanced US (CEUS); and treatment response assessment (TRA) with CT or MRI. LI-RADS was recently expanded to include CEUS TRA after nonradiation locoregional therapy or surgical resection. This report provides an overview of LI-RADS CEUS Nonradiation TRA v2024, including a lexicon of imaging findings, techniques, and imaging criteria for posttreatment tumor viability assessment. LI-RADS CEUS Nonradiation TRA v2024 takes into consideration differences in the CEUS appearance of viable tumor and posttreatment changes within and in close proximity to a treated lesion. Due to the high sensitivity of CEUS to vascular flow, posttreatment reactive changes commonly manifest as areas of abnormal perilesional enhancement without washout, especially in the first 3 months after treatment. To improve the accuracy of CEUS for nonradiation TRA, different diagnostic criteria are used to evaluate tumor viability within and outside of the treated lesion margin. Broader criteria for intralesional enhancement increase sensitivity for tumor viability detection. Stricter criteria for perilesional enhancement limit miscategorization of posttreatment reactive changes as viable tumor. Finally, the TRA algorithm reconciles intralesional and perilesional tumor viability assessment and assigns a single LI-RADS treatment response (LR-TR) category: LR-TR nonviable, LR-TR equivocal, or LR-TR viable.


Asunto(s)
Carcinoma Hepatocelular , Medios de Contraste , Neoplasias Hepáticas , Ultrasonografía , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/radioterapia , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/radioterapia , Ultrasonografía/métodos , Sistemas de Información Radiológica , Hígado/diagnóstico por imagen , Resultado del Tratamiento
13.
Radiology ; 311(1): e233114, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38563667

RESUMEN

Background Noninvasive diagnostic guidelines for hepatocellular carcinoma (HCC) vary across different global geographic areas, especially regarding criteria about gadoxetic acid-enhanced MRI. Purpose To compare the diagnostic performance of four different international HCC diagnosis guidelines and readers' judgment in diagnosing HCC using gadoxetic acid-enhanced MRI in patients at high risk for HCC. Materials and Methods This retrospective study included patients who had not undergone treatment, were at risk for HCC, and who underwent gadoxetic acid-enhanced MRI from January 2015 to June 2018 from 11 tertiary hospitals in South Korea. Four radiologists independently reviewed focal liver lesions (FLLs) according to four guidelines: American Association for the Study of Liver Diseases (AASLD)/Liver Imaging Reporting and Data System (LI-RADS), Korean Liver Cancer Association-National Cancer Center (KLCA-NCC), European Association for the Study of the Liver (EASL), and Asian Pacific Association for the Study of the Liver (APASL). Reader judgment (HCC or not HCC) was also recorded. Malignant FLLs were confirmed at pathology, and histologic and clinical follow-up data were used for benign FLLs. The guidelines' diagnostic performance was compared using generalized estimating equations. Additionally, the diagnostic odds ratio was assessed. Results A total of 2445 FLLs (median size, 27.4 mm) were analyzed in 2237 patients (mean age, 59 years ± 11 [SD]; 1666 male patients); 69.3% (1694 of 2445) were HCCs. KLCA-NCC showed the highest accuracy (80.0%; 95% CI: 78.7, 81.2; P = .001), with high sensitivity in Eastern guidelines (APASL, 89.1% [95% CI: 87.8, 90.3]; KLCA-NCC, 78.2% [95% CI: 76.6, 79.7]) and high specificity in Western guidelines (AASLD/LI-RADS, 89.6% [95% CI: 87.8, 91.2]; EASL, 88.1% [95% CI: 86.2, 89.9]) (P = .001). The diagnostic odds ratios were 20.7 (95% CI: 17.0, 25.3) for AASLD/LI-RADS, 18.9 (95% CI: 15.8, 22.6) for KLCA-NCC, 16.8 (95% CI: 13.8, 20.4) for EASL, and 8.9 (95% CI: 7.4, 10.7) for APASL. The readers' judgment demonstrated higher accuracy than that of the guidelines (accuracy, 86.0%; 95% CI: 84.9, 86.9; P = .001). Conclusion Among four different international HCC diagnosis guidelines, Eastern guidelines demonstrated higher sensitivity, whereas Western guidelines displayed higher specificity. KLCA-NCC achieved the highest accuracy, and AASLD/LI-RADS exhibited the highest diagnostic odds ratio. © RSNA, 2024 Supplemental material is available for this article.


Asunto(s)
Carcinoma Hepatocelular , Gadolinio DTPA , Neoplasias Hepáticas , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Hepatocelular/diagnóstico por imagen , Estudios Retrospectivos , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética
14.
Ann Surg Oncol ; 31(10): 7111-7121, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39073661

RESUMEN

BACKGROUND: The selection of hyperthermic intraperitoneal chemotherapy (HIPEC) or early postoperative intraperitoneal chemotherapy (EPIC) for peritoneal metastases from colorectal cancer or appendiceal neoplasms following cytoreductive surgery (CRS) depends on the surgeon's discretion. This study was designed to compare postoperative and oncologic outcomes of HIPEC and EPIC using inverse probability of treatment weighting (IPTW). METHODS: This study included 175 patients who received HIPEC or EPIC following CRS at a single tertiary university hospital between December 1999 and December 2020. Inverse probability of treatment weighting analysis was performed to control for pretreatment characteristics between the two groups. Multivariate analysis was performed to determine factors associated with postoperative and survival outcomes. RESULTS: After IPTW, no significant differences in baseline demographics and tumor characteristics were observed between the two groups. The HIPEC group had a significantly longer operation time than the EPIC group. The EPIC group showed a significantly higher postoperative mortality rate than the HIPEC group. Operation time (odds ratio [OR] 1.01; 95% confidence interval [CI] 1.01-1.02; p < 0.001), bowel anastomosis (OR 7.25; 95% CI 1.16-45.2; p = 0.034), neoadjuvant chemotherapy (OR 7.62; 95% CI 1.85-31.4; p = 0.005), and EPIC (OR 8.76; 95% CI 2.16-35.5; p = 0.002) were independent risk factors for major surgical complications. No association was observed between intraperitoneal chemotherapy type and major hematologic toxicity, overall survival, progression-free survival, or peritoneal progression-free survival. CONCLUSIONS: EPIC was a risk factor for major surgical complications. Survival outcomes were similar between the two types of intraperitoneal chemotherapy.


Asunto(s)
Neoplasias del Apéndice , Neoplasias Colorrectales , Procedimientos Quirúrgicos de Citorreducción , Quimioterapia Intraperitoneal Hipertérmica , Neoplasias Peritoneales , Humanos , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/terapia , Neoplasias Peritoneales/mortalidad , Masculino , Femenino , Neoplasias del Apéndice/patología , Neoplasias del Apéndice/terapia , Neoplasias del Apéndice/mortalidad , Persona de Mediana Edad , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/terapia , Tasa de Supervivencia , Procedimientos Quirúrgicos de Citorreducción/mortalidad , Estudios de Seguimiento , Estudios Retrospectivos , Pronóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Anciano , Terapia Combinada , Quimioterapia Adyuvante , Quimioterapia del Cáncer por Perfusión Regional/mortalidad , Hipertermia Inducida/mortalidad , Adulto
15.
Ann Neurol ; 94(5): 836-847, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37532684

RESUMEN

OBJECTIVE: The effect of clonal hematopoiesis of indeterminate potential (CHIP) on the manifestation and clinical outcomes of acute ischemic stroke (AIS) has not been fully elucidated. METHODS: Patients with AIS were included from a prospective registry coupled with a DNA repository. Targeted next-generation sequencing on 25 genes that are frequently mutated in hematologic neoplasms was performed. The prevalence of CHIP was compared between patients with AIS and age-matched healthy individuals. A multivariate linear or logistic regression model was used to assess the association among CHIP and stroke severity, hemorrhagic transformation, and functional outcome at 90 days. RESULTS: In total, 380 patients with AIS (mean age = 67.2 ± 12.7 years; 41.3% women) and 446 age-matched controls (mean age = 67.2 ± 8.7 years; 31.4% women) were analyzed. The prevalence of CHIP was significantly higher in patients with AIS than in the healthy controls (29.0 vs 22.0%, with variant allele frequencies of 1.5%, p = 0.024). PPM1D was found to be most significantly associated with incident AIS (adjusted odds ratio [aOR] = 7.85, 95% confidence interval [CI] = 1.83-33.63, p = 0.006). The presence of CHIP was significantly associated with the initial National Institutes of Health Stroke Scale (NIHSS) score (ß = 1.67, p = 0.022). Furthermore, CHIP was independently associated with the occurrence of hemorrhagic transformation (65/110 clonal hematopoiesis positive [CH+] vs 56/270 CH negative [CH-], aOR = 5.63, 95% CI = 3.24-9.77, p < 0.001) and 90-day functional disability (72/110 [CH+] vs 99/270 [CH-], aOR = 2.15, 95% CI = 1.20-3.88, p = 0.011). INTERPRETATION: CH was significantly associated with incident AIS. Moreover, particularly, sequence variations in PPM1D, TET2, and DNMT3A represent a new prognostic factor for AIS. ANN NEUROL 2023;94:836-847.


Asunto(s)
Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Femenino , Persona de Mediana Edad , Anciano , Masculino , Hematopoyesis Clonal , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/genética
16.
Artículo en Inglés | MEDLINE | ID: mdl-39140846

RESUMEN

Two Gram-negative, obligately aerobic, rod-shaped bacteria, strains G1-22T and G1-23T, were isolated from the phycosphere of a marine brown alga. Both strains exhibited catalase- and oxidase-positive activities. Strain G1-22T displayed optimal growth at 25 °C, pH 8.0, and 2.0-3.0% (w/v) NaCl, while strain G1-23T exhibited optimal growth at 25 °C, pH 8.0, and 4.0% NaCl. Ubiquinone-8 was identified as the sole isoprenoid quinone in both strains. As major fatty acids (> 5%), strain G1-22T contained C16 : 0, summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c), summed feature 8 (C18 : 1 ω7c and/or C18 : 1 ω6c), C12 : 1 3-OH, and C10 : 0 3-OH, while strain G1-23T contained C16 : 0, summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c), and C14 : 0. Phosphatidylethanolamine, phosphatidylglycerol, and diphosphatidylglycerol were major polar lipids in both strains. Strains G1-22T and G1-23T had DNA G+C contents of 40.2 and 38.9 mol%, respectively. Phylogenetic analyses based on 16S rRNA and genome sequences revealed that strains G1-22T and G1-23T formed distinct phylogenetic lineages within the genera Psychrosphaera and Paraglaciecola, respectively. Strain G1-22T showed closest relatedness to Psychrosphaera ytuae MTZ26T with 97.8% 16S rRNA gene sequence similarity, 70.2% average nucleotide identity (ANI), and a 21.5% digital DNA-DNA hybridization (dDDH) value, while strain G1-23T was most closely related to Paraglaciecola aquimarina KCTC 32108T with 95.6% 16S rRNA gene sequence similarity, 74.6% ANI, and a 20.1% dDDH value. Based on phenotypic and molecular characteristics, strains G1-22T and G1-23T are proposed to represent two novel species, namely Psychrosphaera algicola sp. nov. (type strain G1-22T=KACC 22486T=JCM 34971T) and Paraglaciecola algarum sp. nov. (type strain G1-23T=KACC 22490T=JCM 34972T), respectively. Additionally, based on the comparison of whole genome sequences, it is proposed that Pseudoalteromonas elyakovii, Pseudoalteromonas flavipulchra, and Pseudoalteromonas profundi are reclassified as later heterotypic synonyms of Pseudoalteromonas distincta, Pseudoalteromonas maricaloris, and Pseudoalteromonas gelatinilytica, respectively.


Asunto(s)
Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano , Ácidos Grasos , Hibridación de Ácido Nucleico , Filogenia , Pseudoalteromonas , ARN Ribosómico 16S , Análisis de Secuencia de ADN , Ubiquinona , ARN Ribosómico 16S/genética , ADN Bacteriano/genética , Pseudoalteromonas/genética , Pseudoalteromonas/clasificación , Pseudoalteromonas/aislamiento & purificación , Phaeophyceae/microbiología
17.
Artículo en Inglés | MEDLINE | ID: mdl-38717925

RESUMEN

A Gram-stain-negative, facultative aerobic, catalase- and oxidase-positive, non-motile, non-flagellated, and coccus-shaped bacterium, strain J2-16T, isolated from a marine green alga, was characterized taxonomically. Strain J2-16T grew at 20-40 °C (optimum, 30 °C), pH 6.0-10.0 (optimum, pH 7.0), and 1.0-4.0 % (w/v) NaCl (optimum, 3.0 %). Menaquinone-7 was identified as the sole respiratory quinone, and major fatty acids (>5 %) were C18 : 1 ω9c, iso-C14 : 0, C14 : 0, anteiso-C15 : 0, C18 : 0, C16 : 0, and C17 : 1 ω8c. The polar lipids of strain J2-16T consisted of phosphatidylglycerol, phosphatidylethanolamine, two unidentified phospholipids, and three unidentified lipids. The genome size of strain J2-16T was 5384 kb with a G+C content of 52.0 mol%. Phylogenetic analyses based on 16S rRNA gene and 120 protein marker sequences revealed that strain J2-16T formed a distinct phyletic lineage within the genus Coraliomargarita, closely related to Coraliomargarita sinensis WN38T and Coraliomargarita akajimensis DSM 45221T with 16S rRNA gene sequence similarities of 95.7 and 94.4 %, respectively. Average nucleotide identity and digital DNA-DNA hybridization values between strain J2-16T and Coraliomargarita species were lower than 71.2 and 20.0 %, respectively. The phenotypic, chemotaxonomic, and molecular features support that strain J2-16T represents a novel species of the genus Coraliomargarita, for which the name Coraliomargarita algicola sp. nov. is proposed. The type strain is J2-16T (=KACC 22590T=JCM 35407T).


Asunto(s)
Técnicas de Tipificación Bacteriana , Composición de Base , Chlorophyta , ADN Bacteriano , Ácidos Grasos , Fosfolípidos , Filogenia , ARN Ribosómico 16S , Análisis de Secuencia de ADN , Vitamina K 2 , ARN Ribosómico 16S/genética , Ácidos Grasos/química , Vitamina K 2/análogos & derivados , Vitamina K 2/análisis , ADN Bacteriano/genética , Hibridación de Ácido Nucleico , Agua de Mar/microbiología
18.
Artículo en Inglés | MEDLINE | ID: mdl-38728177

RESUMEN

Two Gram-stain-negative, rod-shaped bacteria, designated as strains KJ10-1T and KJ40-1T, were isolated from marine brown algae. Both strains were catalase-positive, oxidase-positive, and facultative aerobic. Strain KJ10-1T exhibited optimal growth at 25 °C, pH 7.0, and 3 % NaCl, whereas strain KJ40-1T showed optimal growth at 25 °C, pH 7.0, and 2 % NaCl. The respiratory quinones of strain KJ10-1T were ubiquinone-8, ubiquinone-7, menaquinone-7, and methylated menaquinone-7, while the respiratory quinone of strain KJ40-1T was only ubiquinone-8. As major fatty acids, strain KJ10-1T contained C16 : 0, C17 : 1 ω8c, iso-C15 : 0, and summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c) and strain KJ40-1T contained C16 : 0 and summed features 3 and 8 (C18 : 1 ω7c and/or C18 : 1 ω6c). The major polar lipids in strain KJ10-1T were phosphatidylethanolamine, phosphatidylglycerol, and an unidentified aminolipid, whereas those in strain KJ40-1T were phosphatidylethanolamine, phosphatidylglycerol, and diphosphatidylglycerol. The DNA G+C contents of strains KJ10-1T and KJ40-1T were 42.1 and 40.8 mol%, respectively. Based on 16S rRNA gene sequences, strains KJ10-1T and KJ40-1T exhibited the closest relatedness to Shewanella saliphila MMS16-UL250T (98.6 %) and Vibrio rumoiensis S-1T (95.4 %), respectively. Phylogenetic analyses, based on both 16S rRNA and 92 housekeeping genes, showed that the strains formed distinct phylogenic lineages within the genera Shewanella and Vibrio. Digital DNA-DNA hybridization and orthologous average nucleotide identity values between strain KJ10-1T and other Shewanella species, as well as between strain KJ40-1T and other Vibrio species, were below the thresholds commonly accepted for prokaryotic species delineation. Based on the phenotypic, chemotaxonomic, and phylogenetic data, strains KJ10-1T and KJ40-1T represent novel species of the genera Shewanella and Vibrio, respectively, for which the names Shewanella phaeophyticola sp. nov. and Vibrio algarum sp. nov. are proposed, respectively. The type strains of S. phaeophyticola and V. algarum are KJ10-1T (=KACC 22589T=JCM 35409T) and KJ40-1T (=KACC 22588T=JCM 35410T), respectively.


Asunto(s)
Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano , Ácidos Grasos , Phaeophyceae , Filogenia , ARN Ribosómico 16S , Análisis de Secuencia de ADN , Shewanella , Ubiquinona , Vibrio , Vitamina K 2 , ARN Ribosómico 16S/genética , ADN Bacteriano/genética , Vibrio/genética , Vibrio/clasificación , Vibrio/aislamiento & purificación , Ubiquinona/análogos & derivados , Shewanella/genética , Shewanella/aislamiento & purificación , Shewanella/clasificación , Phaeophyceae/microbiología , Vitamina K 2/análogos & derivados , Fosfolípidos , Hibridación de Ácido Nucleico , Agua de Mar/microbiología
19.
Artículo en Inglés | MEDLINE | ID: mdl-38700924

RESUMEN

Two Gram-stain-negative, facultatively aerobic, and motile rod bacteria, designated as strains KJ51-3T and 15G1-11T, were isolated from marine algae collected in the Republic of Korea. Both strains exhibited catalase- and oxidase-positive activities. Optimum growth conditions for strain KJ51-3T were observed at 30 °C and pH 6.0-8.0, with 1.0-7.0 % (w/v) NaCl, whereas strain 15G1-11T exhibited optimal growth at 30 °C, pH 7.0, and 1.0-5.0 % NaCl. Major fatty acids detected in both strains included C16 : 0, C10 : 0 3-OH and summed features 3 (C16 : 1 ω7c and/or C16 : 1 ω6c) and 8 (C18 : 1 ω7c and/or C18 : 1 ω6c). As for polar lipids, strain KJ51-3T contained phosphatidylethanolamine (PE), phosphatidylglycerol (PG), diphosphatidylglycerol, and two unidentified phospholipids, whereas strain 15G1-11T had PE, PG, and an unidentified aminolipid. Ubiquinone-8 was the predominant respiratory quinone in both strains, with minor detection of ubiquinone-9 in strain KJ51-3T. The genomic DNA G+C contents were 44.0 mol% for strain KJ51-3T and 40.5 mol% for strain 15G1-11T. Phylogenetic analyses based on both 16S rRNA gene and genome sequences placed strains KJ51-3T and 15G1-11T into distinct lineages within the genus Marinomonas, most closely related to Marinomonas arctica 328T (98.6 %) and Marinomonas algicola SM1966T (98.3 %), respectively. Strains KJ51-3T and 15G1-11T exhibited a 94.6 % 16S rRNA gene sequence similarity and a 70.7 % average nucleotide identity (ANI), with ANI values of 91.9 and 79.3 % between them and M. arctica 328T and M. algicola SM1966T, respectively, indicating that they represent novel species. In summary, based on their phenotypic, chemotaxonomic, and phylogenetic properties, strains KJ51-3T and 15G1-11T are proposed to represent novel species within the genus Marinomonas, for which the names Marinomonas rhodophyticola sp. nov. (KJ51-3T=KACC 22756T=JCM 35591T) and Marinomonas phaeophyticola sp. nov. (15G1-11T=KACC 22593T=JCM 35412T) are respectively proposed.


Asunto(s)
Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano , Ácidos Grasos , Marinomonas , Fosfolípidos , Filogenia , ARN Ribosómico 16S , Análisis de Secuencia de ADN , Ubiquinona , ARN Ribosómico 16S/genética , Ácidos Grasos/química , ADN Bacteriano/genética , Marinomonas/genética , Marinomonas/aislamiento & purificación , Marinomonas/clasificación , República de Corea , Agua de Mar/microbiología
20.
Artículo en Inglés | MEDLINE | ID: mdl-39264709

RESUMEN

A Gram-stain-negative, yellow-pigmented, and strictly aerobic bacterium, designated as strain MSW5T, was isolated from seawater of the Yellow Sea in South Korea. The cells were non-motile rods exhibiting oxidase- and catalase-positive activities. Growth was observed at 15-25 °C (optimum, 25 °C) and pH 5.0-9.0 (optimum, pH 7.0-8.0) and in the presence of 1.0-5.0% (w/v) NaCl (optimum, 2.0%). Menaquinone-6 was the sole respiratory quinone, and iso-C15 : 0, summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c), iso-C15 : 0 3-OH, and C15 : 1 ω6c were the major cellular fatty acids. Major polar lipids included phosphatidylethanolamine, two unidentified aminolipids, and three unidentified lipids. Phylogenetic analyses based on 16S rRNA gene sequences and 92 concatenated core protein sequences revealed that strain MSW5T formed a distinct lineage within the genus Polaribacter. The genome of strain MSW5T was 3582 kb in size with a 29.1 mol% G+C content. Strain MSW5T exhibited the highest similarity to Polaribacter atrinae WP25T, with a 97.9% 16S rRNA gene sequence similarity. However, the average nucleotide identity and digital DNA-DNA hybridization values were 79.4 and 23.3%, respectively, indicating that strain MSW5T represents a novel species. Based on its phenotypic, chemotaxonomic, and phylogenetic characteristics, strain MSW5T is proposed to represent a novel species, with the name Polaribacter ponticola sp. nov. The type strain is MSW5T (=KACC 22340T=NBRC 116025T). In addition, whole genome sequence comparisons and phenotypic features suggested that Polaribacter sejongensis and Polaribacter undariae belong to the same species, with P. undariae proposed as a later heterotypic synonym of P. sejongensis. An emended description of Polaribacter sejongensis is also proposed.


Asunto(s)
Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano , Ácidos Grasos , Filogenia , ARN Ribosómico 16S , Agua de Mar , Análisis de Secuencia de ADN , Vitamina K 2 , ARN Ribosómico 16S/genética , Ácidos Grasos/análisis , Agua de Mar/microbiología , República de Corea , ADN Bacteriano/genética , Vitamina K 2/análogos & derivados , Vitamina K 2/análisis , Fosfatidiletanolaminas , Hibridación de Ácido Nucleico , Bacteroidetes/genética , Bacteroidetes/clasificación , Bacteroidetes/aislamiento & purificación , Fosfolípidos/análisis , Fosfolípidos/química
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