Sulfur dioxide induces apoptosis via reactive oxygen species generation in rat cardiomyocytes

Abstract

Epidemiological evidence suggests that the incidence and mortality of cardiovascular diseases are closely related to sulfur dioxide (SO₂). In the present study, H9C2 cells were incubated with 100 μM NaHSO₃ with or without pretreatment of an antioxidant, N-acetyl-l-cysteine (NAC). The changes of apoptosis rate, mitochondrial membrane potential (MMP), ATP content, caspase-3 activity, and reactive oxygen species (ROS) were detected. Rats were inhaled 7 mg/m³ SO₂ and/or intraperitoneal injected with 50 mg/kg (bw) of NAC for 30 days. RT-PCR and Western blot were used to detect the mRNA and protein levels of apoptosis-related genes. We found that the apoptosis of H9C2 cells was induced by NaHSO₃, which decreased the content of MMP and ATP, and induced the expression of caspase-3. NAC can inhibit the apoptosis induced by NaHSO₃ treatment. SO₂ and NaHSO₃ decreased the expression of Bcl-2 and the ratio of Bcl-2/Bax, increased the expression of Bax and P53 accumulation and phosphorylation, and activated caspase-9 and caspase-3. Whereas NAC can reduce the changes of apoptosis-related proteins in rat heart. Our results suggest that SO₂ induces ROS-mediated P53 and caspase-dependent mitochondrial signaling pathways in H9C2 cells and rat hearts. Antioxidant therapy can reduce the adverse reactions of SO₂ and lead to a decline in the cardiovascular disease induced by SO₂.

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No Effect of Anodal Transcranial Direct Current Stimulation (tDCS) Over hMT+ on Motion Perception Learning.

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No Effect of Anodal Transcranial Direct Current Stimulation (tDCS) Over hMT+ on Motion Perception Learning.

Front Neurosci. 2018;12:1044

Authors: Larcombe SJ, Kennard C, O'Shea J, Bridge H

Abstract
Background: Human visual cortical area hMT+, like its homolog MT in the macaque monkey, has been shown to be particularly selective to visual motion. After damage to the primary visual cortex (V1), patients often exhibit preserved ability to detect moving stimuli, which is associated with neural activity in area hMT+. As an anatomical substrate that underlies residual function in the absence of V1, promoting functional plasticity within hMT+ could potentially boost visual performance despite primary visual cortical damage. Objective: To establish in healthy participants whether it is possible to use transcranial direct current stimulation (tDCS) over hMT+ to potentiate learning of visual motion direction discrimination. Methods: Twenty-one participants were trained daily for 5 days on a visual motion direction discrimination task. Task difficulty was increased as performance improved, by decreasing the proportion of coherently moving dots, such that participants were always performing at psychophysical threshold. tDCS, either anodal or sham, was applied daily during 20 min of training. Task performance was assessed at baseline and at the end of the training period. Performance was also compared with a third group of 10 participants from an earlier study who had undergone the same procedures but without tDCS. Results: All participants showed improved task performance both during and after training. Contrary to our hypothesis, anodal tDCS did not further improve performance compared to sham stimulation or no stimulation. Bayesian statistics indicated weak evidence in favor of the null hypothesis. Conclusion: This study found no evidence for a robust effect of anodal tDCS over hMT+ on visual motion direction discrimination learning in the young healthy visual system, although more subtle effects may have been missed in the relatively small sample size.

PMID: 30705617 [PubMed]

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Investigation of Event-Based Surfaces for High-Speed Detection, Unsupervised Feature Extraction, and Object Recognition.

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Investigation of Event-Based Surfaces for High-Speed Detection, Unsupervised Feature Extraction, and Object Recognition.

Front Neurosci. 2018;12:1047

Authors: Afshar S, Hamilton TJ, Tapson J, van Schaik A, Cohen G

Abstract
In this work, we investigate event-based feature extraction through a rigorous framework of testing. We test a hardware efficient variant of Spike Timing Dependent Plasticity (STDP) on a range of spatio-temporal kernels with different surface decaying methods, decay functions, receptive field sizes, feature numbers, and back end classifiers. This detailed investigation can provide helpful insights and rules of thumb for performance vs. complexity trade-offs in more generalized networks, especially in the context of hardware implementation, where design choices can incur significant resource costs. The investigation is performed using a new dataset consisting of model airplanes being dropped free-hand close to the sensor. The target objects exhibit a wide range of relative orientations and velocities. This range of target velocities, analyzed in multiple configurations, allows a rigorous comparison of time-based decaying surfaces (time surfaces) vs. event index-based decaying surface (index surfaces), which are used to perform unsupervised feature extraction, followed by target detection and recognition. We examine each processing stage by comparison to the use of raw events, as well as a range of alternative layer structures, and the use of random features. By comparing results from a linear classifier and an ELM classifier, we evaluate how each element of the system affects accuracy. To generate time and index surfaces, the most commonly used kernels, namely event binning kernels, linearly, and exponentially decaying kernels, are investigated. Index surfaces were found to outperform time surfaces in recognition when invariance to target velocity was made a requirement. In the investigation of network structure, larger networks of neurons with large receptive field sizes were found to perform best. We find that a small number of event-based feature extractors can project the complex spatio-temporal event patterns of the dataset to an almost linearly separable representation in feature space, with best performing linear classifier achieving 98.75% recognition accuracy, using only 25 feature extracting neurons.

PMID: 30705618 [PubMed]

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Relationship Between Alzheimer's Disease and the Immune System: A Meta-Analysis of Differentially Expressed Genes.

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Relationship Between Alzheimer's Disease and the Immune System: A Meta-Analysis of Differentially Expressed Genes.

Front Neurosci. 2018;12:1026

Authors: Wang N, Zhang Y, Xu L, Jin S

Abstract
Alzheimer's disease (AD), a neurodegenerative diseases (neuro-diseases) which is prevalent in the elderly and seriously affects the lives of individuals. Many studies have discussed the relationship between immune system and AD pathogenesis. Here, the meta-analysis of differentially expressed (DE) genes based on microarray data was conducted to study the association between AD and immune system. 9519 target genes of hippocampus in 146 subjects (73 AD cases and 73 controls) from 4 microarray data sets were compiled and DE genes with p < 1.00E - 04 were selected to conduct the pathway-analysis. The results indicated that the DE genes were significantly enriched in the neuro-diseases as well as the immune system pathways.

PMID: 30705616 [PubMed]

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Selected Principles of Pankseppian Affective Neuroscience.

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Selected Principles of Pankseppian Affective Neuroscience.

Front Neurosci. 2018;12:1025

Authors: Davis KL, Montag C

Abstract
In the early nineties of the twentieth century Jaak Panksepp coined the term "Affective Neuroscience" (AN) today being accepted as a unique research area in cross-species brain science. By means of (i) electrical stimulation, (ii) pharmacological challenges, and (iii) brain lesions of vertebrate brains (mostly mammalian), Panksepp carved out seven primary emotional systems called SEEKING, CARE, PLAY, and LUST on the positive side, whereas FEAR, SADNESS, and ANGER belong to the negative affects. Abundant research into human clinical applications has supported the hypothesis that imbalances in these ancient primary emotional systems are strongly linked to psychiatric disorders such as depression. The present paper gives a concise overview of Panksepp's main ideas. It gives an historical overview of the development of Panksepp's AN thinking. It touches not only areas of neuroscience, but also shows how AN has been applied to other research fields such as personality psychology. Finally, the present work gives a brief overview of the main ideas of AN.

PMID: 30705615 [PubMed]

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Strong Ground and Excited State Charge Transfer in C3‐Symmetric Truxene Derived, Low‐Band Gap, Phenothiazine‐Tetracyanobutadine (TCBD) and Expanded TCBD Conjugates

C3‐symmetric, star shaped phenothiazene substituted truxene 1, synthesized by the Pd‐catalyzed Sonogashira cross‐coupling reaction, was reacted with electron acceptors tetracyanoethylene (TCNE) and 7,7,8,8‐tetracyanoquinodimethane (TCNQ) which undergo, cycloaddition‐retroelectrocyclization reaction to yield tetracyanobutadine (TCBD) and cyclohexa–2,5–diene–1,4–ylidene–expanded TCBD bearing conjugates 2 and 3. A combination of spectral, electrochemical, and photophysical investigations of 2 and 3 reveal that the functionalization of the triple bond by TCBD and expanded TCBD (abbreviated as DCNQ = dicyanoquinodimethane) has a pronounced effect on their ground and excited‐state interactions. Specifically, the existence of strong ground state interactions between phenothiazine and electron accepting TCBD or DCNQ resulting in PTZ+‐TCBD‐ or PTZ+‐DCNQ‐ charge transfer states, and subsequent ultrafast charge separation resulting in PTZ+‐TCBD‐ or PTZ+‐DCNQ‐ electron transfer products is unequalled not only in phenothiazine chemistry but also in TCBD and DCNQ‐derived donor‐acceptor conjugates. Additionally, for the first time, by manipulating spectroelectrochemical data, spectrum of the charge‐separated species is construed, and shown to be highly useful in interpreting the rather complex transient spectra.

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Slope‐dominated carbon anode with high specific capacity and superior rate capability for high safety Na‐ion batteries

The comprehensive performance of carbon anodes for Na‐ion batteries (NIBs) is largely restricted by their inferior rate capability and safety issue, resulted from the low‐potential plateau region. Herein, a slope‐dominated carbon is achieved at a low temperature of 800 oC, which delivers a high reversible capacity of 263 mA h g‐1 at 0.15C with an impressive initial Coulombic efficiency (ICE) of 80%. Extraordinarily, when paired with the NaNi1/3Fe1/3Mn1/3O2 cathode, the reversible capacity at 6C is still 75% of that at 0.15C, and 73% capacity retention can be obtained after 1000 cycles at 3C. It suggests that the enhanced Na storage performance could be attributed to the unique microstructure with randomly oriented short carbon layers and the relatively higher defect concentration. Given its robustness, such a low‐temperature carbonization strategy (contrast to commonly employed high temperatures) can also be applicable to other precursors and provide a new opportunity to design slope‐dominated carbon anode for high safety low‐cost NIBs with excellent ICE and superior rate capability.

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Long Noncoding RNA LINC00152 Facilitates the Leukemogenesis of Acute Myeloid Leukemia by Promoting CDK9 Through miR-193a.

Long Noncoding RNA LINC00152 Facilitates the Leukemogenesis of Acute Myeloid Leukemia by Promoting CDK9 Through miR-193a.

DNA Cell Biol. 2019 Feb 01;:

Authors: Zhang X, Tao W

Abstract
The vital role of long noncoding RNAs (lncRNAs) on the acute myeloid leukemia (AML) has been increasingly recognized. This study aims to explore the unknown function of lncRNA LINC00152 in the leukemogenesis of AML. LINC00152 is determined to be upregulated in the AML samples, and the overexpression of LINC00152 is also authenticated in the advanced French-American-British (FAB) AML patients and closely correlated with the poor outcome of AML patients. The functional experiments state that knockdown of LINC00152 suppresses the proliferation, accelerates the apoptosis, and induces the cycle arrest of AML cells. The mechanical experiments state that LINC00152 and CDK9 were both targeted by miR-193a with the complementary binding sites at 3'-UTR. Moreover, in the rescue experiments, the enhanced LINC00152 expression could regain the suppression of tumor behavior induced by LINC00152 knockdown. In conclusion, this research reveals the important role of lncRNA LINC00152 in the AML leukemogenesis through targeting miR-193a/CDK9 axis. This finding could indicate the important pathogenesis of ncRNA and the vital roles of epigenetic regulation.

PMID: 30707636 [PubMed - as supplied by publisher]

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Ribosomal Proteins Control Tumor Suppressor Pathways in Response to Nucleolar Stress.

Ribosomal Proteins Control Tumor Suppressor Pathways in Response to Nucleolar Stress.

Bioessays. 2019 Feb 01;:e1800183

Authors: Lessard F, Brakier-Gingras L, Ferbeyre G

Abstract
Ribosome biogenesis includes the making and processing of ribosomal RNAs, the biosynthesis of ribosomal proteins from their mRNAs in the cytosol and their transport to the nucleolus to assemble pre-ribosomal particles. Several stresses including cellular senescence reduce nucleolar rRNA synthesis and maturation increasing the availability of ribosome-free ribosomal proteins. Several ribosomal proteins can activate the p53 tumor suppressor pathway but cells without p53 can still arrest their proliferation in response to an imbalance between ribosomal proteins and mature rRNA production. Recent results on senescence-associated ribogenesis defects (SARD) show that the ribosomal protein S14 (RPS14 or uS11) can act as a CDK4/6 inhibitor linking ribosome biogenesis defects to the main engine of cell cycle progression. This work offers new insights into the regulation of the cell cycle and suggests novel avenues to design anticancer drugs.

PMID: 30706966 [PubMed - as supplied by publisher]

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Antitumor effect of XCT790, an ERRα inverse agonist, on ERα-negative endometrial cancer cells.

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Antitumor effect of XCT790, an ERRα inverse agonist, on ERα-negative endometrial cancer cells.

Cell Oncol (Dordr). 2019 Jan 31;:

Authors: Kokabu T, Mori T, Matsushima H, Yoriki K, Kataoka H, Tarumi Y, Kitawaki J

Abstract
PURPOSE: The estrogen-related receptor (ERR) α is structurally similar to classical estrogen receptors (ERs), but is considered to be an orphan nuclear receptor. We previously found that ERRα regulates uterine endometrial cancer progression. Here, we investigated the efficacy of XCT790, a selective inverse agonist of ERRα, on endometrial cancer cells in vitro and in vivo.
METHODS: HEC-1A and KLE, ERα-negative endometrial cancer cells exhibiting high ERRα expression levels, and HEC-1A cell-derived xenograft model mice were treated with XCT790. Transcriptional activity and cell proliferation were examined using luciferase, WST-8 and colony formation assays, respectively. Cell cycle progression was evaluated using flow cytometry, immunofluorescence cytochemistry and Western blotting. Apoptosis was evaluated using a caspase-3/7 activity assay.
RESULTS: We found that XCT790 significantly inhibited ERRα-induced in vitro transcriptional activity, including that of the vascular endothelial growth factor (VEGF) gene, in a concentration-dependent manner (p < 0.05). We also found that XCT790 suppressed colony formation and cell proliferation in a concentration and time-dependent manner (p < 0.01) without cytotoxicity, and induced apoptosis (p < 0.01). XCT790 was found to cause cell cycle arrest at the mitotic phase. Akt and mTOR phosphorylation was found to be inhibited by XCT790, but PI3K levels were not found to be significantly affected. Combination therapy of XCT790 with paclitaxel elicited a synergistic inhibitory effect. Additionally, we found that XCT790 significantly inhibited in vivo tumor growth and angiogenesis, and induced apoptosis without a reduction in body weight, in xenograft models (p < 0.01).
CONCLUSIONS: From our data we conclude that XCT790 has an anti-tumor effect on endometrial cancer cells in vitro and in vivo. As such, it may serve as a novel therapeutic agent for endometrial cancer.

PMID: 30706380 [PubMed - as supplied by publisher]

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Muscadine grape skin extract inhibits prostate cancer cells by inducing cell-cycle arrest, and decreasing migration through heat shock protein 40.

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Muscadine grape skin extract inhibits prostate cancer cells by inducing cell-cycle arrest, and decreasing migration through heat shock protein 40.

Heliyon. 2019 Jan;5(1):e01128

Authors: Ignacio DN, Mason KD, Hackett-Morton EC, Albanese C, Ringer L, Wagner WD, Wang PC, Carducci MA, Kachhap SK, Paller CJ, Mendonca J, Li-Ying Chan L, Lin B, Hartle DK, Green JE, Brown CA, Hudson TS

Abstract
Previously we demonstrated that muscadine grape skin extract (MSKE), a natural product, significantly inhibited androgen-responsive prostate cancer cell growth by inducing apoptosis through the targeting of survival pathways. However, the therapeutic effect of MSKE on more aggressive androgen-independent prostate cancer remains unknown. This study examined the effects of MSKE treatment in metastatic prostate cancer using complementary PC-3 cells and xenograft model. MSKE significantly inhibited PC-3 human prostate cancer cell tumor growth in vitro and in vivo. The growth-inhibitory effect of MSKE appeared to be through the induction of cell-cycle arrest. This induction was accompanied by a reduction in the protein expression of Hsp40 and cell-cycle regulation proteins, cyclin D1 and NF-kBp65. In addition, MSKE induced p21 expression independent of wild-type p53 induced protein expression. Moreover, we demonstrate that MSKE significantly inhibited cell migration in PC-3 prostate cancer cells. Overall, these results demonstrate that MSKE inhibits prostate tumor growth and migration, and induces cell-cycle arrest by targeting Hsp40 and proteins involved in cell-cycle regulation and proliferation. This suggests that MSKE may also be explored either as a neo-adjuvant or therapeutic for castration resistant prostate cancer.

PMID: 30705983 [PubMed]

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Protosappanin B promotes apoptosis and causes G1 cell cycle arrest in human bladder cancer cells.

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Protosappanin B promotes apoptosis and causes G1 cell cycle arrest in human bladder cancer cells.

Sci Rep. 2019 Jan 31;9(1):1048

Authors: Yang X, Zhao L, Zhang T, Xi J, Liu S, Ren L, Zheng Y, Zhang H

Abstract
The aim of the study was to investigate the effects of protosappanin B on the proliferation and apoptosis of bladder cancer cells. The effects of protosappanin B (12.5, 25, 50, 100, or 200 μg/mL, 48 h) on proliferation of SV-HUC-1, T24 and 5637 cells was assessed using the MTT assay. The effects of protosappanin B (100, 150, 200, 250, or 300 μg/mL, 48 h) on cell apoptosis and cell cycle were analyzed using flow cytometry. T24 and 5637 cells treated with 200 µg/mL protosappanin B showed morphological changes (shrinkage, rounding, membrane abnormalities, and reduced adhesion), but protosappanin B had no proliferation arrest effect on SV-HUC-1 cells. Protosappanin B caused concentration-dependent inhibition of cell growth, with IC50 of 82.78 µg/mL in T24 cells and 113.79 µg/mL in 5637 cells. Protosappanin B caused concentration-dependent increases in T24 and 5637 cell apoptosis (100-300 µg/mL). The effects of protosappanin B on the cell cycle in both cell types was G1 arrest with reductions in the proportion of S-phase cells and proliferation index. A proteomics analysis showed that protosappanin B modulated a number of genes involved in the cell cycle. In conclusion, protosappanin B inhibits the proliferation and promotes the apoptosis of T24 and 5637 human bladder cancer cells in a concentration-dependent manner, possibly via interference with cell cycle regulation, preventing G1-to-S transition.

PMID: 30705351 [PubMed - in process]

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CYT997(Lexibulin) induces apoptosis and autophagy through the activation of mutually reinforced ER stress and ROS in osteosarcoma.

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CYT997(Lexibulin) induces apoptosis and autophagy through the activation of mutually reinforced ER stress and ROS in osteosarcoma.

J Exp Clin Cancer Res. 2019 Jan 31;38(1):44

Authors: Wang Z, Yin F, Xu J, Zhang T, Wang G, Mao M, Wang Z, Sun W, Han J, Yang M, Jiang Y, Hua Y, Cai Z

Abstract
BACKGROUND: Osteosarcoma (OS) is a common malignant cancer in children and adolescents and has a cure rate that has not improved in the last two decades. CYT997 (lexibulin) is a novel potent microtubule-targeting agent with various anticancer activities, such as proliferation inhibition, vascular disruption, and cell cycle arrest and apoptosis induction, in multiple cancers. However, the direct cytotoxic mechanisms of CYT997 have not yet been fully characterized.
METHODS: We evaluated apoptosis and autophagy in human osteosarcomas after treatment with CYT997 and investigated the underlying mechanisms. To explore relationships, we used the reactive oxygen species (ROS) scavenger N-acetyl cysteine (NAC), PERK inhibitor GSK2606414, ERO1 inhibitor EN460 and mitochondrial targeted protection peptide elamipretide. BALB/c-nu mice were inoculated with 143B tumor cells to investigate the in vivo effect of CYT997.
RESULTS: We explored the efficacy and mechanism of CYT997 in osteosarcoma (OS) in vitro and in vivo and demonstrated that CYT997 potently suppresses cell viability and induces apoptosis and autophagy. CYT997 triggered production of ROS and exerted lethal effects via endoplasmic reticulum (ER) stress in OS cells. NAC attenuated these effects. The PERK inhibitor GSK2606414, which can block the ER stress pathway, reduced ROS production and enhanced cell viability. Moreover, activation of ERO1 in the ER stress pathway was responsible for inducing ROS production. ROS produced by the mitochondrial pathway also aggravate ER stress. Protection of mitochondria can reduce apoptosis and autophagy. Finally, CYT997 prominently reduced tumor growth in vivo.
CONCLUSIONS: This study suggests that CYT997 induces apoptosis and autophagy in OS cells by triggering mutually enhanced ER stress and ROS and may thus be a promising agent against OS.

PMID: 30704503 [PubMed - in process]

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Quantitative profiling of CD13 on single acute myeloid leukemia cells by super-resolution imaging and its implication in targeted drug susceptibility assessment.

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Quantitative profiling of CD13 on single acute myeloid leukemia cells by super-resolution imaging and its implication in targeted drug susceptibility assessment.

Nanoscale. 2019 Jan 23;11(4):1737-1744

Authors: Xi Y, Wang D, Wang T, Huang L, Zhang XE

Abstract
Quantitative profiling of membrane proteins on the cell surface is of great interest in tumor targeted therapy and single cell biology. However, the existing technologies are either of insufficient resolution, or unable to provide precise information on the localization of individual proteins. Here, we report a new method that combines the use of quantum dot labeling, super-resolution microscopy (structured illumination microscopy, SIM) and software modeling. In this proof-of-principle study, we assessed the biological effects of Bestatin on individual cells from different AML cell lines expressing CD13 proteins, a potential target for tumor targeted therapy. Using the proposed method, we found that the different AML cell lines exhibit different CD13 expression densities, ranging from 0.1 to 1.3 molecules per μm2 cell surface, respectively. Importantly, Bestatin treatment assays shows that its effects on cell growth inhibition, apoptosis and cell cycle change are directly proportional to the density of CD13 on the cell surface of these cell lines. The results suggest that the proposed method advances the quantitative analysis of single cell surface proteins, and that the quantitative profiling information of the target protein on single cells has potential value in targeted drug susceptibility assessment.

PMID: 30623954 [PubMed - indexed for MEDLINE]

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Low-fidelity Paediatric Surgical Simulation: Description of Models in Low-Resource Settings.

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Low-fidelity Paediatric Surgical Simulation: Description of Models in Low-Resource Settings.

World J Surg. 2019 Jan 31;:

Authors: McClelland TJ, Ford K, Dagash H, Lander A, Lakhoo K

Abstract
BACKGROUND: Surgical simulation is an important aspect of competency-based training. Recent trends in paediatric surgical simulations have migrated towards high-fidelity simulation with advanced technology resulting in models which are expensive and largely inaccessible in low- and middle-income countries.
METHODS: This article describes four wet simulation models of common surgical procedures in paediatric population created with animal tissue from local abattoir. The models are designed to provide a framework for others to make the models and benefit from the training opportunity they provide especially in low-middle-income countries.
RESULTS: The models created in the wet laboratory are neonatal bowel anastomosis, duodenoduodenostomy for discrepancy anastomosis, gastrostomy and pyeloplasty. These models are easily reproducible in resource-challenged healthcare setting as they are low cost, utilise locally available resources and require only a basic set of surgical instruments with which to perform the procedures.
CONCLUSION: These models provide locally accessible material for sustainable training programmes which are fundamental in developing safe and affordable surgical care worldwide.

PMID: 30706107 [PubMed - as supplied by publisher]

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Comparison of Preoperative and Postoperative MRI After Fistula-in-Ano Surgery: Lessons Learnt from An Audit of 1323 MRI At a Single Centre.

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Comparison of Preoperative and Postoperative MRI After Fistula-in-Ano Surgery: Lessons Learnt from An Audit of 1323 MRI At a Single Centre.

World J Surg. 2019 Jan 31;:

Authors: Garg P

Abstract
AIM: Several studies have evaluated the efficacy of preoperative MRI in fistula-in-ano. However, the evaluation of MRI after fistula-in-ano surgery has never been done. The aim was to evaluate the utility of MRI in postoperative period after fistula-in-ano surgery.
METHODS: Preoperative MRI was done in all the patients presenting with fistula-in-ano. Postoperative MRI was done to check radiological healing in clinically healed fistulas or when postoperative complication/healing problem was seen. The postoperative MRI was compared with preoperative MRI and correlated with the clinical picture.
RESULTS: A total of 1323 MRI were done in 1003 fistula-in-ano patients, out of which 702 patients underwent surgery. In 702 patients, there were 361 recurrent fistulas, 153 had associated abscess, 388 had multiple tracts, 146 had horseshoe tract, and 76 had supralevator fistula. In total, 320 postoperative MRI scans were done in 180/702 patients. The requirement of postoperative MRI was significantly higher in complex (grades III-V) than simple fistulas (grades I-II) [43.5% (136/313) vs. 11.3% (44/389), respectively, P < 0.0001]. In early postoperative period (8 weeks), healing (granulation) tissue was difficult to differentiate from active fistula tract/pus. The complete radiological healing took at least 10-12 weeks. So getting MRI scan for the assessment of healing was more accurate after 12 weeks. MRI was very accurate to identify postoperative complications like abscess, missed tract or non-healing of a tract. MRI detected such complications even in apparently clinically healed tracts. Closure/healing of internal opening and intersphincteric tract was assessed accurately by MRI and correlated well with the fistula healing.
CONCLUSIONS: MRI is highly useful to assess healing and detect complications after fistula surgery.

PMID: 30706106 [PubMed - as supplied by publisher]

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Short- and Long-term Outcomes after Robotic and Laparoscopic Liver Resection for Malignancies: A Propensity Score-Matched Study.

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Short- and Long-term Outcomes after Robotic and Laparoscopic Liver Resection for Malignancies: A Propensity Score-Matched Study.

World J Surg. 2019 Jan 31;:

Authors: Lim C, Salloum C, Tudisco A, Ricci C, Osseis M, Napoli N, Lahat E, Boggi U, Azoulay D

Abstract
OBJECTIVES: A laparoscopic approach improves short-term outcomes and maintains long-term outcomes compared to an open approach. In turn, the recent development of robotic surgery raises the question whether it performs as well as laparoscopic surgery. The aim of this study was to compare the short- and long-term outcomes of laparoscopic liver resection (LLR) and robotic liver resection (RLR) for malignancies.
METHOD: From 2011 to 2017, the study population included 111 patients in the LLR group and 61 in the RLR group. Short- and long-term outcomes were compared before and after propensity score matching (PSM).
RESULTS: Operative mortality rate was nil. The intraoperative blood transfusion rate was higher during RLR (15% vs. 2%, p = 0.0009). Major morbidity and hospital stay were not different between the two groups. The resection margin width (LLR 7 mm vs. RLR 10 mm, p = 0.13) and R1 resection rates (resection margin width < 1 mm; LLR 15% vs. RLR 11%, p = 0.49) were similar. After PSM (55 patients in each group), the blood transfusion, major morbidity, hospital stay and R1 resection were similar between the two groups. When considering the largest subset of patients with hepatocellular carcinoma including 114 patients (66%), the 3-year overall survival rate was 80% in the LLR group and 97% in the RLR group (p = 0.10) and remained similar after PSM (p = 0.27). The 3-year recurrence-free survival rate was 50% in the LLR group and 64% in the RLR group (p = 0.30) and remained similar after PSM (p = 0.26).
CONCLUSIONS: No differences were found in blood transfusion, incidence of positive resection margins and long-term outcomes between the two techniques. RLR does not compromise short-term and oncologic outcomes in patients with liver cancers.

PMID: 30706105 [PubMed - as supplied by publisher]

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Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery.

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Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery.

World J Surg. 2019 Jan 31;:

Authors: Manzano-Nunez R, Zogg CK, Bhulani N, McCarty JC, Herrera-Escobar JP, Lu K, Andriotti T, Uribe-Leitz T, de Jager E, Jarman MP, Haider AH, Ortega G

Abstract
BACKGROUND: Medicaid expansion has reduced obstacles faced in receiving care. Emergency general surgery (EGS) is a clinical event where delays in appropriate care impact outcomes. Therefore, we assessed the association between non-Medicaid expansion policy and multiple outcomes in homeless patients requiring EGS.
METHODS: We used 2014 State Inpatient Database to identify homeless individuals admitted with a primary EGS diagnosis who underwent an EGS procedure. States were divided into those that did and did not implement Medicaid expansion. Multivariable quantile regression was used to examine associations between non-Medicaid expansion states and (1) length of stay and (2) total index hospital charges within the homeless population. Multivariable logistic regression was used to assess the associations between non-Medicaid expansion and (1) mortality, (2) surgical complications, (3) discharge against medical advice, and (4) home healthcare.
RESULTS: A total of 6930 homeless patients were identified. Of these, 435 (6.2%) were in non-expansion states. Non-Medicaid expansion was associated with higher charges (coef: $46,264, 95% CI 40,388-52,139). There were non-significant differences in mortality (OR 1.4, 95% CI 0.79-2.62; p = 0.2) or surgical complications (OR 1.16, 95% CI 0.7-1.8; p = 0.4). However, homeless individuals living in non-expansion states did have higher odds of being discharged against medical advice (OR 2.1, 95% CI 1.08-4.05; p = 0.02), and lower odds of receiving home healthcare (OR 0.6, 95% CI 0.4-0.8; p = 0.01).
CONCLUSION: Homeless patients living in Medicaid expansion states had lower odds of being discharged against medical advice, higher likelihood of receiving home healthcare and overall lower total index hospital charges.

PMID: 30706104 [PubMed - as supplied by publisher]

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Letter to the Editor: Definitive Chemoradiotherapy Versus Trimodality Therapy for Resectable Oesophageal Carcinoma: Meta-analyses and Systematic Review of Literature.

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Letter to the Editor: Definitive Chemoradiotherapy Versus Trimodality Therapy for Resectable Oesophageal Carcinoma: Meta-analyses and Systematic Review of Literature.

World J Surg. 2019 Jan 31;:

Authors: Deng HY

Abstract

PMID: 30706103 [PubMed - as supplied by publisher]

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Differentiated Operative Strategy in Minimally invasive, Video-assisted Thyroid Surgery Results in 196 Patients.

Differentiated Operative Strategy in Minimally invasive, Video-assisted Thyroid Surgery Results in 196 Patients.

World J Surg. 2004 October 29;:

Authors: Schabram J, Vorländer C, Wahl RA

Abstract
To date, experience in minimally invasive thyroid surgery has been limited to unilateral lobectomy and total thyroidectomy. There are no reports regarding selective operative strategy, guided by morphology and function, which is widely accepted in endemic goiter regions. To analyze the efficiency and outcome of tissue-preserving thyroid surgery using a minimally invasive video-assisted technique (MIVA-T), a total of 196 patients were operated on for thyroid nodules between February 1999 and October 2003. Concurrent primary hyperthyroidism was treated in 22 (11%) cases. Indications for operation were solitary, multiple unilateral, or bilateral nodules with a maximum diameter of 30 mm and a maximum lobe volume of 15 ml. Contraindications for minimally invasive operation were thyroid malignancy diagnosed by fine-needle aspiration (FNA), recurrent goiter, and Hashimoto's thyroiditis. Nodule excision was performed in 6% of these cases; subtotal lobectomy, in 6%; selective resection, in 48%; and total lobectomy, in 39%. Histological examination revealed follicular adenoma in 82%, colloid and cystic lesions in 11%, thyroiditis in 1%, and differentiated thyroid carcinoma in 6%. Conversion to open surgery was necessary in 7.7% of the patients (secondary to malignancy demonstrated on frozen section in 3% and to technical difficulties in 4.7%). Transient and permanent laryngeal nerve palsy occurred in 2.0% and 0.5% of patients, respectively. Temporary hypoparathyroidism occurred in 5.6% of patients exclusively after conversion to open total thyroidectomy or in those patients ( n = 22) with additional primary hyperparathyroidism. Given a correct indication, MIVA-T technique can be performed with low conversion and complication rates. Selective operative strategy, guided by morphology and thyroid function, with a variety of operative procedures fitting the individual situation may be performed by this minimally invasive technique.

PMID: 15517475 [PubMed - as supplied by publisher]

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