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INTRODUCTION: Complexities of robotic distal gastrectomy (RDG) give reason to assess physician's surgical skill. Varying levels in surgical skill affect patient outcomes. We aim to investigate how a novel artificial intelligence (AI) model can be used to evaluate surgical skill in RDG by recognizing surgical instruments. METHODS: Fifty-five consecutive robotic surgical videos of RDG for gastric cancer were analyzed. We used Deeplab, a multi-stage temporal convolutional network, and it trained on 1234 manually annotated images. The model was then tested on 149 annotated images for accuracy. Deep learning metrics such as Intersection over Union (IoU) and accuracy were assessed, and the comparison between experienced and non-experienced surgeons based on usage of instruments during infrapyloric lymph node dissection was performed. RESULTS: We annotated 540 Cadiere forceps, 898 fenestrated bipolars, 359 suction tubes, 307 Maryland bipolars, 688 harmonic scalpels, 400 staplers, and 59 large clips. The average IoU and accuracy were 0.82 ± 0.12% and 87.2 ± 11.9% respectively. Moreover, the percentage of each instrument's usage to overall infrapyloric lymphadenectomy duration predicted by AI were compared. The use of stapler and large clip were significantly shorter in the experienced group compared to the non-experienced group. CONCLUSIONS: This study is the first to report that surgical skill can be successfully and accurately determined by an AI model for RDG. Our AI gives us a way to recognize and automatically generate instance segmentation of the surgical instruments present in this procedure. Use of this technology allows unbiased, more accessible RDG surgical skill.
OBJECTIF: Les desmosomes sont les jonctions interkératinocytaires les plus proéminentes. Le fonctionnement appropriée des épithéliums stratifiés comme épiderme dépend de leur expression. La composition moléculaire et les propriétés physicochimiques des desmosomes évoluent au cours de la différenciation épidermique. La desquamation de cornéocytes la surface du stratum corneum depend de la dégradation ordonnée des desmosomes par les enzymes endogènes. Ce processus peut être régulé par les molécules glycosylées. Notre travail consistait en détection et caractérisation de l'un des acteurs potentiellement impliqués, portant des chaînes carbohydrate. METHODES: Les approches d'analyse biochimique s'appuyant sur un anticorps monoclonal original (immunotransfert monoet bidimensionnel, immunoprécipitationimmunodétection croisées, digestions enzymatiques, tests de déglycosylation et d'inhibition de synthèse) nous ont permis la caractérisation partielle d'un protéoglycanne sécrété dans les espaces interkératinocytaires. Cette molécule s'intègre aux desmosomes en quantités proportionnelles au stade de différenciation des kératinocytes, comme le démontrent les marquages ultrastructuraux à l'or colloïdal sur des cryocoupes et tissus enrobés en résines acryliques. RESULTATS: Cet antigène, que nous avons appelé desmosealine, est clairement distinct des éléments constitutifs de desmosomes décrits jusqu'alors. Contrairement aux protéoglycannes épidermiques connus, il porte exclusivement les chaînes glycosaminoglycannes de type chondroïtine/dermatane sulfate. La desmosealine est présente dans les parties extracellulaires de desmosomes, dans la portion supérieure de l'épiderme vivant et le début du stratum corneum. CONCLUSION: L'intégration massive d'un protéoglycanne dans des parties intercellulaires de desmosomes revêt vraisemblablement une importance fonctionnelle. De par son profile biochimique, sa distribution dans l'épiderme et son affinité pour les desmosomes, le desmosealine peut s'avérer être un élément clé dans la régulation de la cohésion interkératinocytaire et la formation de la barrière de perméabilité épidermique.
Assuntos
Proteoglicanas de Sulfatos de Condroitina , Condroitina , Desmossomos , Humanos , Condroitina/metabolismo , Proteoglicanas de Sulfatos de Condroitina/metabolismo , Desmossomos/metabolismoRESUMO
Selenocysteine insertion into selenoproteins involves the translational recoding of UGA stop codons. In mammals, selenoprotein expression further depends on selenium availability, which has been particularly described for glutathione peroxidase 1 and 4 (Gpx1 and Gpx4). The SECIS element located in the 3'UTR of the selenoprotein mRNAs is a modulator of UGA recoding efficiency in adequate selenium conditions. One of the current models for the UGA recoding mechanism proposes that the SECIS binds SECIS-binding protein 2 (SBP2), which then recruits a selenocysteine-specific elongation factor (EFsec) and tRNA (Sec) to the ribosome, where L30 acts as an anchor. The involvement of the SECIS in modulation of UGA recoding activity was investigated, together with SBP2 and EFsec, in Hek293 cells cultured with various selenium levels. Luciferase reporter constructs, in transiently or stably expressing cell lines, were used to analyze the differential expression of Gpx1 and Gpx4. We showed that, upon selenium fluctuation, the modulation of UGA recoding efficiency depends on the nature of the SECIS, with Gpx1 being more sensitive than Gpx4. Attenuation of SBP2 and EFsec levels by shRNAs confirmed that both factors are essential for efficient selenocysteine insertion. Strikingly, in a context of either EFsec or SBP2 attenuation, the decrease in UGA recoding efficiency is dependent on the nature of the SECIS, GPx1 being more sensitive. Finally, the profusion of selenium of the culture medium exacerbates the lack of factors involved in selenocysteine insertion.
Assuntos
Regulação Enzimológica da Expressão Gênica , Glutationa Peroxidase/genética , Regiões 3' não Traduzidas , Animais , Sequência de Bases , Códon de Terminação/genética , Glutationa Peroxidase/metabolismo , Células HEK293 , Humanos , Sequências Repetidas Invertidas , Dados de Sequência Molecular , Conformação de Ácido Nucleico , Fatores de Alongamento de Peptídeos/genética , Fatores de Alongamento de Peptídeos/metabolismo , Fosfolipídeo Hidroperóxido Glutationa Peroxidase , Biossíntese de Proteínas , Proteínas de Ligação a RNA/genética , Proteínas de Ligação a RNA/metabolismo , Ratos , Selênio/fisiologia , Glutationa Peroxidase GPX1RESUMO
Selenoproteins are essential components of antioxidant defense, redox homeostasis, and cell signaling in mammals, where selenium is found in the form of a rare amino acid, selenocysteine. Selenium, which is often limited both in food intake and cell culture media, is a strong regulator of selenoprotein expression and selenoenzyme activity. Aging is a slow, complex, and multifactorial process, resulting in a gradual and irreversible decline of various functions of the body. Several cellular aspects of organismal aging are recapitulated in the replicative senescence of cultured human diploid fibroblasts, such as embryonic lung fibroblast WI-38 cells. We previously reported that the long-term growth of young WI-38 cells with high (supplemented), moderate (control), or low (depleted) concentrations of selenium in the culture medium impacts their replicative lifespan, due to rapid changes in replicative senescence-associated markers and signaling pathways. In order to gain insight into the molecular link between selenium levels and replicative senescence, in the present work, we have applied a quantitative proteomic approach based on 2-Dimensional Differential in-Gel Electrophoresis (2D-DIGE) to the study of young and presenescent cells grown in selenium-supplemented, control, or depleted media. Applying a restrictive cut-off (spot intensity ±50% and a p value < 0.05) to the 2D-DIGE analyses revealed 81 differentially expressed protein spots, from which 123 proteins of interest were identified by mass spectrometry. We compared the changes in protein abundance for three different conditions: (i) spots varying between young and presenescent cells, (ii) spots varying in response to selenium concentration in young cells, and (iii) spots varying in response to selenium concentration in presenescent cells. Interestingly, a 72% overlap between the impact of senescence and selenium was observed in our proteomic results, demonstrating a strong interplay between selenium, selenoproteins, and replicative senescence.
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Five sets of heterocyclic derivatives of various sizes and complexities coupled by an amidine function to putrescine, spermidine, or spermine were prepared. They were essentially tested to determine the influence of the polyamine chain on their cellular transport. To comment on affinity and on selective transport via the polyamine transport system (PTS), K(i) values for polyamine uptake were determined in L1210 cells, and the cytotoxicity and accumulation of the conjugates were determined in CHO and polyamine transport-deficient mutant CHO-MG cells, as well as in L1210 and alpha-difluoromethylornithine- (DFMO-) treated L1210 cells. Unlike spermine, putrescine and spermidine were clearly identified as selective motifs that enable cellular entry via the PTS. However, this property was clearly limited by the size of substituents: these polyamines were able to ferry a dihydroquinoline system via the PTS but did not impart any selectivity to bulkier substituents.
Assuntos
Amidinas/síntese química , Amidinas/farmacologia , Poliaminas/síntese química , Poliaminas/farmacologia , Amidinas/química , Amina Oxidase (contendo Cobre)/antagonistas & inibidores , Amina Oxidase (contendo Cobre)/sangue , Amina Oxidase (contendo Cobre)/química , Animais , Transporte Biológico/efeitos dos fármacos , Células CHO , Calmodulina/antagonistas & inibidores , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Cricetinae , Ciclização , Ensaios de Seleção de Medicamentos Antitumorais , Eflornitina/farmacologia , Guanidinas/farmacologia , Técnicas In Vitro , Camundongos , Estrutura Molecular , Poliaminas/química , Relação Estrutura-Atividade , Fatores de TempoRESUMO
Desmosomes are the most prominent and mechanically important epidermal intercellular junctions. Transmembrane proteins of desmosomes, desmogleins and desmocollins, are responsible for extracellular binding and, thus, are important for interkeratinocyte cohesion. We show here, using three different approaches, that the extracellular "cores" of epidermal desmosomes contain a highly glycosylated antigen, different from desmosomal cadherins. This protein, recognised by KM48 monoclonal antibody, is likely to be involved in the processes of keratinocyte differentiation, desmosome turnover and epidermal cohesion.
Assuntos
Anticorpos Monoclonais/imunologia , Autoantígenos/imunologia , Caderinas/imunologia , Desmossomos/imunologia , Animais , Reações Antígeno-Anticorpo , Moléculas de Adesão Celular/imunologia , Diferenciação Celular , Proteínas do Citoesqueleto/imunologia , Desmocolinas , Desmogleína 3 , Desmogleínas , Desmoplaquinas , Ensaio de Imunoadsorção Enzimática , Epiderme/imunologia , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Immunoblotting , Imunoglobulina M/imunologia , Queratinócitos/imunologia , Glicoproteínas de Membrana/imunologia , Camundongos , Microscopia de FluorescênciaRESUMO
The polyamine transport system (PTS) whose activity is up-regulated in cancer cells is an attractive target for drug design. Two heterocyclic (azepine and benzazepine) systems were conjugated to various polyamine moieties through an amidine bound to afford 18 compounds which were evaluated for their affinity for the PTS and their ability to use the PTS for cell delivery. Structure-activity relationship studies and lead optimization afforded two attractive PTS targeting compounds. The azepine-spermidine conjugate 14 is a very selective substrate of the PTS that may serve as a vector for radioelements used for diagnoses or therapeutics in nuclear medicine. The nitrobenzazepine-spermine conjugate 28 is a very powerful PTS inhibitor with very low intrinsic cytotoxicity, able to prevent the growth of polyamine depleted cells in presence of exogenous polyamines.