Notes

Chemical substance change assignments in the fibronectin Three like domains 7-8 involving type VII bovine collagen.
Patients with persistently elevated NLR did worse than those with decreasing NLR trends between baseline and postoperative time points (3-year OS 43.4% versus 71.3%, p  less then  0.0001, 3-year DFS 29.7% versus 61.9%, p  less then  0.0001). High baseline and postoperative NLR were associated with significantly worse OS and DFS. Patients with complete pathological response had lower mean baseline NLR. CONCLUSION Dynamic changes in NLR during treatment are associated with survival and may be more informative than static baseline values.OBJECTIVES Subsolid lung adenocarcinoma with cystic airspaces (LACA) is a unique manifestation of lung cancer. This study was conducted to establish a radiologic disease progression model of LACA and to explore its association with the clinical course and clinicopathologic features of LACA. MATERIALS AND METHODS Sixty patients with LACA who underwent surgery at our center between 2004 and 2017 were retrospectively reviewed. The morphological changes of LACA over time on 98 serial computed tomography scans from 27 of 60 patients were tracked to establish a radiologic disease progression model. Associations between this model and the clinicopathologic characteristics of LACA were investigated. RESULTS The following stepwise progression model of LACA was developed in phase I, cystic airspaces (CAs) appear in the middle of non-solid nodules; in phase II, the CAs grow; in phase III, a solid component appears on the border of the CAs; and in phase IV, the solid component gradually surrounds the CAs and becomes thicker, and the CAs shrink. In total, 10 (17%), 33 (55%), and 17 (28%) LACA patients were classified as belonging to phases II, III, and IV at the time of surgery, respectively. More advanced phases were associated with higher pathologic T and N staging, lymphovascular invasion, visceral pleural invasion, spread through air spaces, and solid/micropapillary subtype. In the multivariate analysis, our model demonstrated a good discrimination capability for cancer recurrence risk. CONCLUSIONS The stepwise disease progression model of LACA based on radiologic findings developed in this study represented its natural clinical course and clinicopathologic features well.BACKGROUND Hilar cholangiocarcinoma is the most common malignant neoplasm of the biliary tract. Surgical resection is the only curative modality of treatment. The aim of this video is to present a robotic left hepatectomy extended to caudate lobe, combined with bile duct resection, lymphadenectomy, and Roux-en-Y biliary reconstruction. METHODS A 76-year-old female presented with progressive jaundice due to hilar cholangiocarcinoma. She underwent chemoradiation and after 5 months of treatment was referred for second opinion; imaging reevaluation showed objective response and no arterial invasion. Multidisciplinary team decided for radical treatment, which consisted in robotic left hepatectomy, caudate lobe resection, resection of bile duct, lymphadenectomy, and hepaticojejunostomy. RESULTS Operative time was 8 h. Estimated blood loss was 740 mL (received 2 U). The patient's recovery was complicated by drainage clogging resulting in fever and perihepatic fluid collection, successfully treated by change of drainage. Pathology confirmed cholangiocarcinoma with free surgical margins (T1aN0). The patient is well, with no signs of disease 5 months after the procedure. CONCLUSIONS Robotic resection of hilar cholangiocarcinoma is feasible and safe. The robotic approach has some technical advantages over laparoscopic approach. This video may help oncological surgeons to perform this complex procedure.BACKGROUND The differences between perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC) regarding recurrence and the factors that affect recurrence after surgery are unclear. This study aims to investigate the differences in recurrence patterns between patients with PHCC and those with DCC after surgical resection with curative intent. It also investigates the risk factors associated with recurrence and survival thereafter. PATIENTS AND METHODS The postoperative courses of 366 patients with extrahepatic cholangiocarcinomas (EHCCs), including 236 with PHCC and 130 with DCC, who underwent surgical resections were investigated retrospectively. RESULTS During follow-up, tumors recurred in 143 (60.6%) patients with PHCC and in 72 (55.4%) patients with DCC. Overall survival (OS) after surgery, recurrence-free survival (RFS), and OS after recurrence were similar for the patients with PHCC and those with DCC. The cumulative probability of recurrence declined 3 years after surgery in the patients with PHCC and those with DCC. A multivariable analysis determined that, among the patients with PHCC and those with DCC, regional lymph node metastasis was a significant risk factor associated with RFS. Ten patients with PHCC and eight patients with DCC with two or fewer sites of recurrence in a single organ underwent resections. A multivariable analysis determined that recurrent tumor resection was an independent prognostic factor associated with OS after recurrence in the patients with PHCC and those with DCC. CONCLUSIONS Postoperative survival did not differ between the patients with PHCC and those with DCC. Frequent surveillances for recurrence are needed for 3 years after surgical resection of EHCCs. In selected patients, surgery for recurrent EHCCs might be associated with improved outcomes.BACKGROUND In the current study, we have investigated the effect of each of curcumin (CUR) and sulfamethoxazole (SMX) either separate or mixed together (CUR + SMX) on biochemical, hematological and histological alternations associated with carbon tetrachloride (CCl4)-induced liver fibrosis in mice. RESULTS CCl4, caused changes of several biomarkers, proving its hepatotoxic effects, such as an increase in aminotransferases liver enzymes alanine and aspartate transaminases (ALT, AST), malondialdehyde (MDA), and nitric oxide (NO) formation, with a decrease in superoxide dismutase (SOD), glutathione reductase (GSSG), total antioxidant capacity (TAO), glutathione (GSH), total protein, and albumin, compared to a negative control mice group. Compared to the CCl4 group of mice, the CUR and SMX separate and/or together (CUR + SMX) treatments showed significance in (p less then 0.001), ameliorated liver injury (characterized by an elevation of (ALT, AST) and a decrease (p less then 0.001) in serum albumin and total protein), antioxidant (characterized by a decrease in (p less then 0.001) MDA, NO; an increase (p less then 0.001) SOD, GSSG, TAO; and reducing GSH), hematological changes (characterized by a decrease (p less then 0.001) in white blood cells count and an increase (p less then 0.001) in platelets count, hematocrit levels, hemoglobin concentration, and (p less then 0.05) red blood cells count), SDS-PAGE electrophoresis with a decrease in protein synthesis and changes in histological examinations. CONCLUSIONS CUR and SMX either separate or together (SUR + SMX) may be considered promising candidates in the prevention and treatment of liver fibrosis.Because of COVID-19 outbreak, regular clinical services for Parkinson's disease (PD) patients have been suddenly suspended, causing worries, confusion and unexpected needs in such frail population. Here, we reviewed the messages spontaneously sent by patients to an Italian PD clinic during the first two weeks of COVID-19 lockdown (9-21 March 2020), in order to highlight their main needs and then outline appropriate strategies of care for this critical period. One hundred sixty-two messages were analysed. Forty-six percent queried about clinical services; 28% communicated an acute clinical worsening for which a therapeutic change was done in 52% of cases; 17% (those patients with younger age and milder disease) asked about the relationship between PD and COVID-19; 8% informed about an intercurrent event. Our analysis suggests that PD patients' needs during COVID-19 emergency include appropriate and complete information, a timely update on changes in clinical services, and the continuity of care, even in a remote mode. By addressing these issues, acute clinical worsening, complications and subsequent therapeutic changes could be prevented. In this perspective, telecommunication systems and virtual medicine should be implemented.Enterobacter cloacae strain HNR was found to grow well and denitrify aerobically at high NO3--N concentrations. When the concentrations of NO3--N were 200, 300 and 500 mg/L, the removal efficiencies of NO3--N were 83%, 74.5% and 75%, respectively. More importantly, the intermediates accumulation of NO2--N and NH4+-N was not obvious during the aerobic denitrification processes, resulting in a high TN removal of 82%, 74% and 70%, respectively. Meanwhile, strain HNR also presented the ability of heterotrophic nitrification. With initial NH4+-N concentrations of 20 and 80 mg/L, the NH4+-N removal efficiency reached 78% and 76%, respectively. Selleck CTx-648 The key nitrate reductase enzyme gene relating to denitrification was successfully amplified by polymerase chain reaction (PCR) from strain HNR, and identified it as napA, which encodings the large catalytic subunit A of periplasmic nitrate reductase (NAPA). The sequence analysis of napA indicates that NAPA is a hydrophilic, non-transmembrane protein. The existence of napA might be crucial for strain HNR to denitrify nitrate under aerobic conditions. This study showed prospect to develop novel technology for nitrogen removal by application of E. cloacae strain HNR.PURPOSE Endoscopic sphenopalatine artery ligation (ESPAL) is known as an effective treatment for posterior epistaxis. Anatomical variations of the intranasal branching may result in long operative time and possible inadequate cauterization. A modification of ESPAL by cauterization at the sphenopalatine foramen (SPF), has been performed by our group. Our study assessed the clinical benefit of endoscopic sphenopalatine foramen cauterization (ESFC) and compared it to ESPAL. METHOD A retrospective study was conducted. Patients who received ESFC for posterior epistaxis from 2016 to 2018 at a tertiary hospital were recruited. Middle meatal antrostomy was done. After ethmoidal crest was identified and nipped, pterygopalatine fossa was entered through the SPF. Sphenopalatine artery (SPA) and its branches within the SPF were cauterized without identification of any SPA distal branches in the nasal cavity. Patients receiving conventional ESPAL by the same surgeon were recruited and compared as control. Patients were followed-up for 3 months. Success rate, operative time, and complication were assessed. RESULTS Thirty-four patients were identified. Recurrent epistaxis was absent in 90.0% and 100% of patients receiving ESPAL (9/10 patients) and ESFC (24/24 patients) respectively, p = 0.294. Median operative time was 115 and 60 min, respectively, p  less then  0.001. Ipsilateral hard palatal or anterior palatal numbness were found in one and three patients, respectively. All resolved spontaneously within 2 weeks. CONCLUSION ESFC is effective in treating posterior epistaxis. It requires significantly less amount of time while the success rate was comparable to conventional ESPAL.
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