RESUMEN
BACKGROUND: The aim of the study was to evaluate the safety and feasibility of ultrasound guidance gastric access for percutaneous retrograde transabdominal gastrostomy (G)-tube placement. METHODS: Twenty-eight patients undergoing 31 percutaneous retrograde transabdominal G-tube placements utilizing ultrasound-guided gastric accesses were retrospectively identified. RESULTS: All patients had successful placement of G tubes with ultrasound-guided gastric access. There were no cases of aspiration or peritonitis. Average fluoroscopy time was 2.7 ± 1.4 min and average radiation dose was 220 ± 202 µGym2. CONCLUSIONS: Ultrasound-guided access for gastrostomy placement is safe and feasible and can be performed with minimal fluoroscopy times resulting in low patient and operator radiation dose.
RESUMEN
Cystic artery pseudoaneurysm is a rare entity most closely associated with trauma to the biliary vasculature (usually iatrogenic) or inflammation from adjacent cholecystitis. Most cases are treated intraoperatively during cholecystectomy. We describe 3 cases of cystic artery pseudoaneurysms secondary to acute cholecystitis, 2 with active hemobilia, treated with transcatheter embolization at our institution.
Asunto(s)
Aneurisma Falso/terapia , Arterias , Colecistitis Aguda/complicaciones , Embolización Terapéutica , Vesícula Biliar/irrigación sanguínea , Anciano de 80 o más Años , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Angiografía de Substracción Digital , Arterias/diagnóstico por imagen , Colecistectomía Laparoscópica , Colecistitis Aguda/diagnóstico por imagen , Colecistitis Aguda/cirugía , Angiografía por Tomografía Computarizada , Femenino , Hemobilia/etiología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Networks of transcription factors (TFs) are thought to determine and maintain the identity of cells. Here we systematically repressed each of 100 TFs with shRNA and carried out global gene expression profiling in mouse embryonic stem (ES) cells. Unexpectedly, only the repression of a handful of TFs significantly affected transcriptomes, which changed in two directions/trajectories: one trajectory by the repression of either Pou5f1 or Sox2; the other trajectory by the repression of either Esrrb, Sall4, Nanog, or Tcfap4. The data suggest that the trajectories of gene expression change are already preconfigured by the gene regulatory network and roughly correspond to extraembryonic and embryonic fates of cell differentiation, respectively. These data also indicate the robustness of the pluripotency gene network, as the transient repression of most TFs did not alter the transcriptomes.
Asunto(s)
Células Madre Embrionarias/metabolismo , Regulación del Desarrollo de la Expresión Génica , Factores de Transcripción/genética , Animales , Análisis por Conglomerados , Perfilación de la Expresión Génica , Silenciador del Gen , Ratones , Modelos Biológicos , Interferencia de ARN , Factores de Transcripción/metabolismo , TranscriptomaRESUMEN
To examine transcription factor (TF) network(s), we created mouse ESC lines, in each of which 1 of 50 TFs tagged with a FLAG moiety is inserted into a ubiquitously controllable tetracycline-repressible locus. Of the 50 TFs, Cdx2 provoked the most extensive transcriptome perturbation in ESCs, followed by Esx1, Sox9, Tcf3, Klf4, and Gata3. ChIP-Seq revealed that CDX2 binds to promoters of upregulated target genes. By contrast, genes downregulated by CDX2 did not show CDX2 binding but were enriched with binding sites for POU5F1, SOX2, and NANOG. Genes with binding sites for these core TFs were also downregulated by the induction of at least 15 other TFs, suggesting a common initial step for ESC differentiation mediated by interference with the binding of core TFs to their target genes. These ESC lines provide a fundamental resource to study biological networks in ESCs and mice.