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Sphincter-saving resection (SSR) for low rectal cancer remains challenging due to the high risk of positive resection margin (R1). Long-term outcomes and the dedicated oncological strategy are not well established in this situation. The aim of this study was to define the more appropriate strategy according to the patterns of recurrence.
Between 1994 and 2014, patients treated by SSR for low rectal cancer with preoperative chemoradiotherapy were included. Three types of recurrences were defined local (LR), distant (DR) and mixed (MR). Recurrences and survival after R0 and R1 resection were analysed by Kaplan-Meier and compared with the log-rang test.
Among 394 patients receiving SSR, 42 (10.6%) had R1 resection. Independent factors of R1 resection were EMVI (OR2.24,95%IC1.10-4.53,p=0.025) and no tumor downstaging (OR8.41,95%IC2.50-8.32,p=0.001). Both 5-year disease free and overall survival, and 5-year distant and local recurrence, were significantly worse after R1 resection. The overall recurrence after R1 resection was 57% (24/42), 7% had LR, 36% DR and 14% MR. Time to DR was shorter than time to LR (11.1 vs. 34.3) months. In all cases of MR, DR occurred before LR (12.1 vs. 34.3) months, meaning that after R1 resection, the first concern was DR.
R1 resection after SSR for low rectal cancer reflects a more aggressive and systemic disease. Prognosis depends on DR in about 90% of cases, suggesting that pelvic control should not be the priority in the oncological strategy after R1. Adjuvant systemic chemotherapy ought to be preferred to salvage abdominoperineal resection.
R1 resection after SSR for low rectal cancer reflects a more aggressive and systemic disease. Prognosis depends on DR in about 90% of cases, suggesting that pelvic control should not be the priority in the oncological strategy after R1. Adjuvant systemic chemotherapy ought to be preferred to salvage abdominoperineal resection.The Chemcatcher® (CC) passive sampler containing an Atlantic HLB-L Disk (AD) was calibrated in a laboratory-based flow-through tank over 21 days under stirring for 38 polar organic pesticides with log Kow ranging from -1.7 to 3.8. Defactinib inhibitor The resultant sampling rates Rs range from 0.025 to 0.068 L/d. In 2018, field trials were conducted in the German rivers Mulde and Havel, as well as in 7 agricultural streams in Lower Saxony and Saxony-Anhalt. For 36 detected pesticides, the overall low concentrations were 0.2 to 49.4 ng/L. The determined pesticide profiles reflect agricultural use and were dominated by triazine herbicides including transformation products, by neonicotinoid insecticides, and by the herbicide mecoprop. Additional single hot spots were provided by the herbicides metamitron, isoproturon, and MCPA (showing the overall largest value of 49.4 ng/L). Notably, the detected waterborne pesticides include banned herbicides and associated transformation products in concentration ratios suggesting also recent input. This concerns in particular atrazine and its transformation products 2-OH-atrazine, deethylatrazine and deisopropylatrazine. An extended target screening of AD-CC extracts from the river Havel revealed the additional presence of other organic micropollutants including biocides, surfactants and industrial chemicals, and demonstrated the AD-CC applicability up to log Kow of 4.5.
Our previous findings have identified vitronectin (VTN) as a potential biomarker for radiation pneumonitis (RP) through proteomics and molecular mechanism studies. In a recent study, we further explored associations of plasma level and single nucleotide polymorphisms of VTN with the risk of RP in patients with lung cancer receiving radiation therapy.
A total of 165 patients with lung cancer were prospectively enrolled with detection of VTN concentration before radiation therapy. VTN reference single nucleotide polymorphisms, rs704 and rs2227721, were genotyped by Taqman probe method. Cox proportional hazard models were performed to identify clinical variables and genotypes associated with the risk of RP on univariate and multivariate analyses, and t tests and analysis of variance were conducted to evaluate the expression level of VTN.
The baseline secretion level of VTN in patients with grade ≥3 RP was significantly higher than that in grade <3 RP patients (P < .0001), and elevated levels were obsved radiation therapy into low-, intermediate-, and high-risk RP groups. This study indicated that VTN may serve as a blood biomarker for susceptibility to RP in patients with lung cancer.
Among patients receiving radiation therapy, relatively high plasma levels of VTN before radiation therapy were associated with the higher incidence of RP, and VTN rs704 and rs2227721 each had a significant effect on predicting RP risk. Combining VTN concentration with MLD appeared to facilitate stratification of patients with lung cancer who received radiation therapy into low-, intermediate-, and high-risk RP groups. This study indicated that VTN may serve as a blood biomarker for susceptibility to RP in patients with lung cancer.
Bone marrow mesenchymal stem cells (BMSCs) are ideal seed cells for tissue engineering cartilage construction. However, the underlying mechanism of it has not been illuminate well. In this study, the effects of circATRNL1 (hsa_circ_0020093) on the differentiation of BMSCs into chondrocytes were investigated.
The degrees of chondrogenic differentiation of BMSCs on day 0, 14 and 21 mediums were detected by Alcian blue staining. Expressions of cartilage differentiation related factors SOX9, COL2 and Aggrecan, and circATRNL1 in BMSCs under differentiation were determined by western blot and quantitative real-time polymerase chain reaction (qRT-PCR) as needed. circATRNL1 knockdown or overexpression was performed in BMSCs. Then the viability of BMSCs and cartilage differentiation related factors were separately investigated through MTT assay, qRT-PCR, and western blot. Target gene of circATRNL1 and binding site were predicted using starbase and validated it by dual luciferase reporter. The effect of circATRNL1 and its target gene on chondrogenic differentiation of BMSCs was assessed using Alcian blue staining further.
The degrees of chondrogenic differentiation of BMSCs were increased with time. Expressions of SOX9, COL2 and Aggrecan as well as circATRNL1 were enhanced during chondrogenic differentiation. Furthermore, overexpression of circATRNL1 enhanced BMSCs proliferation, SOX9, COL2 and Aggrecan expressions and the degree of chondrogenic differentiation of BMSCs. Further research showed that circATRNL1 targeted miR-338-3p. MiR-338-3p inhibited differentiation of BMSCs into cartilage but overexpression of circATRNL1 reversed it.
CircATRNL1 is beneficial to BMSCs differentiation into cartilage by regulating miR-338-3p, which may be a new mechanism of action in the treatment of cartilage repair.
CircATRNL1 is beneficial to BMSCs differentiation into cartilage by regulating miR-338-3p, which may be a new mechanism of action in the treatment of cartilage repair.
Radiocapitellar joint arthroplasty is a commonly performed procedure, which often leads to early failure or instability. Few studies assess the effect of radiocapitellar joint arthroplasty on the ulnohumeral joint. We hypothesized that static forces of contact (compressing cartilage, or cartilage relaxation contact force) would reveal the effect of varying radial head implant size and elbow position on the ulnohumeral joint.
A minimally-invasive method of measuring cartilage relaxation contact force was utilized in 10 fresh-frozen human cadaveric specimens that did not require significant dissection or intraarticular sensor placement. Specimens were rigidly fixed in various positions of elbow flexion and forearm pronosupination with increasing radial head implant lengths. Uniaxial distracting forces were applied and displacement was repeatedly measured with resultant best-fit polynomial curves to determine inflections corresponding to the force required to overcome static cartilage relaxation as in previos further supports attempts at anatomic reconstruction of the radiocapitellar joint to prevent pathologic ulnohumeral joint loading.The rapid spread of COVID-19 throughout the world, has led most of the affected countries to close their borders and implement some form of lockdown. Six months after the pandemic started, many countries made decisions tending to relax the lockdown, although without a vaccine or treatment capable of confronting SARS-CoV-2 infection, the situation could be reversed at any time. In this context, the aim of this work was to propose a decision algorithm that will allow to optimize asymptomatic case detections and strategically manage quarantine to prevent the spread of the virus and drive the transition to a managed new normal. This tentative proposal was developed for optimizing and ordering the number of tests for the detection of SARS-CoV-2, analyzing composite samples (group analysis) combining with those samples individually taken from asymptomatic members of cohorts of interest. Cohorts were defined according to their critical role in society and/or their vulnerability. The algorithm includes variables such as cohort priority, number of cohort members in the analysis groups, intra-and intergroup contact, vulnerability to contagion due to the activity performed, and time elapsed since last testing. The proposed tool was illustrated with defined hypothetical cohorts, in which, for the sake of simplification, only one analysis group was considered. The application of this tool allowed to establish in a rational way a priority order to test critical groups in society. Furthermore, this tool would help to optimize resources, reducing the impact on a region's health, society, and economy.
The objetive of these study is to know the characteristics of COVID-19 in patients with uveitis associated with Systemic Autoimmune Disease (SAD) through telematic survey.
Internal Medicine Society and Group of Systemic Autoimmune disease conducted a telematic survey of patients with SAD to learn about the characteristics of COVID-19 in this population.
A total of 2,789 patients answered the survey, of which 28 had a diagnosis of uveitis associated with SAE. The majority (82%) were female and caucasian (82%), with a mean age of 48 years. The most frequent SAEs were Behçet's disease followed by sarcoidosis and systemic lupus erythematosus. 46% of the patients were receiving corticosteroid treatment at a mean prednisone dose of 11mg/day. Regarding infection, 14 (50%) patients reported symptoms compatible with SARS-CoV-2 infection. RT-PCR was performed on the nasopharyngeal smear in two patients and in one of them (4%) it was positive.
Both asymptomatic and symptomatic COVID-19 patients with ASD-associated UNI had received similar immunosuppressive treatment.
Both asymptomatic and symptomatic COVID-19 patients with ASD-associated UNI had received similar immunosuppressive treatment.Two patients with panuveitis are presented in whom, after undergoing a vitrectomy, the optical coherence tomography (OCT) revealed some unusual pre-retinal hyper-reflective deposits with the shape of stalagmites, distributed in a multifocal and perivascular pattern. Case 1 51-year-old male with panuveitis in the right eye. After diagnostic-therapeutic vitrectomy, OCT showed pre-retinal stalagmite-like deposits. There was no clear aetiology, and the deposits persisted over the time. Case 2 76-year-old woman with panuveitis in the right eye. After a surgery for cataract-vitrectomy and epiretinal membrane peeling, OCT revealed pre-retinal stalagmite-like deposits. The analysis reported elevated Toxoplasma IgG titres. Clarithromycin and corticosteroid were prescribed, resulting in the disappearance of pre-retinal deposits. The stalagmite-like deposits are not a very common tomographic sign of a posterior uveitis process, but they seem to correlate with inflammatory activity. There does not seem to be a clear mechanism or a particular aetiology.
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