RESUMEN
INTRODUCTION AND AIM: Anastomosis leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis. MATERIALS AND METHODS: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons. RESULTS: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m2 (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%. CONCLUSION: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.
Asunto(s)
Cirugía Colorrectal , Verde de Indocianina , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Angiografía con Fluoresceína , Humanos , México , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
INTRODUCTION AND AIM: Anastomotic leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis. MATERIALS AND METHODS: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons. RESULTS: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m2 (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%. CONCLUSION: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.
RESUMEN
The anti-biofouling and desalination properties of thin film composite reverse osmosis membranes (TFC-RO), modified by the incorporation of copper and iron nanoparticles, were compared. Nanoparticles of metallic copper (CuNPs) and an iron crystalline phase mix (Fe and Fe2O3, FeNPs) were obtained by oxide-reduction-precipitation and reduction reactions, respectively, and characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM) techniques. Modified membranes (PA+0.25Cu-PSL and PA+0.25Fe-PSL) were obtained by incorporating these nanoparticles during the interfacial polymerization process (PI). These membranes were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), atomic force microscopy (AFM), and contact angle measurements. Bactericidal tests by a Colony Forming Unit (CFU) were performed using Escherichia coli, and anti-adhesion properties were confirmed by fluorescence microscopy estimating the percentage of live/dead cells. The permeate flow and rejection of salts was evaluated using a crossflow cell. An increase of the membrane's roughness on the modified membrane was observed, influencing the desalination performance more strongly in the presence of the FeNPs with respect to the CuNPs. Moreover, a significant bactericidal and anti-adhesion effect was obtained in presence of both modifications with respect to the pristine membrane. An important decrease in CFU in the presence of modified membranes of around 98% in both modifications was observed. However, the anti-adhesion percentage and reduction of live/dead cells were higher in the presence of the copper-modified membrane in comparison to the iron-modified membrane. These facts were attributed to the differences in antimicrobial action mechanism of these types of nanoparticles. In conclusion, TFC-RO membranes modified by the incorporation of CuNPs during PI represent one alternative material to attend to the biofouling impact in the desalination process.
RESUMEN
Encephalitozoon cuniculi is an obligate macrophage parasite of vertebrates that commonly infects rodents, monkeys, dogs, birds, and humans. In the present study, we aimed to assess the phagocytosis and intracellular survival of E. cuniculi spores using untreated and lipopolysaccharide (LPS)-activated J774A.1 murine macrophages and assess the macrophage viability. The experimental groups comprised untreated spores, spores killed by heat treatment at 90 °C, and spores killed by treatment with 10% formalin. LPS-activated macrophages significantly increased the phagocytosis of spores and reduced their intracellular growth after 24 and 48 h (P < 0.01); however, after 72 h, we observed an increase in spore replication but no detectable microbicidal activity. These results indicate that LPS activation enhanced E. cuniculi phagocytosis between 24 and 48 h of treatment, but the effect was lost after 72 h, enabling parasitic growth. This study contributes to the understanding of the phagocytosis and survival of E. cuniculi in murine macrophages.
Asunto(s)
Encephalitozoon cuniculi/inmunología , Activación de Macrófagos/inmunología , Macrófagos/inmunología , Macrófagos/microbiología , Fagocitosis/inmunología , Esporas Fúngicas/inmunología , Animales , Encephalitozoon cuniculi/crecimiento & desarrollo , Humanos , Recuento de Leucocitos , Lipopolisacáridos/farmacología , Activación de Macrófagos/efectos de los fármacos , Ratones , Esporas Fúngicas/crecimiento & desarrolloRESUMEN
Friction is the natural response of all tribosystems. In a total knee replacement (TKR) prosthetic device, its measurement is hindered by the complex geometry of its integrating parts and that of the testing simulation rig operating under the ISO 14243-3:2014 standard. To develop prediction models of the coefficient of friction (COF) between AISI 316L steel and ultra-high molecular weight polyethylene (UHMWPE) lubricated with fetal bovine serum dilutions, the arthrokinematics and loading conditions prescribed by the ISO 142433: 2014 standard were translated to a simpler geometrical setup, via Hertz contact theory. Tribological testing proceeded by loading a stainless steel AISI 316L ball against the surface of a UHMWPE disk, with the test fluid at 37⯰C. The method has been applied to study the behavior of the COF during a whole walking cycle. On the other hand, the role of protein aggregation phenomena as a lubrication mechanism has been extensively studied in hip joint replacements but little explored for the operating conditions of a TKR. Lubricant testing fluids were prepared with fetal bovine serum (FBS) dilutions having protein mass concentrations of 5, 10, 20 and 36â¯g/L. The results were contrasted against deionized, sterilized water. The results indicate that even at protein concentration as low as 5â¯g/L, protein aggregation phenomena play an important role in the lubrication of the metal-on-polymer tribopair. The regression models of the COF developed herein are available for numerical simulations of the tribological behavior of the aforementioned tribosystem. In this case, surface stress rather than film thickness should be considered.
Asunto(s)
Fricción , Ensayo de Materiales/normas , Polietilenos , Acero , Lubrificación , Estándares de Referencia , Análisis de RegresiónRESUMEN
OBJECTIVE: To determine the incidence of serous tubal intraepithelial carcinoma (STIC) after risk reduction salpingo-oophorectomy(RRSO), and to describe oncological outcomes after RRSO. MATERIALS AND METHODS: BRCA pathogenic mutation carriers who had undergone an RRSO were evaluated in this retrospective multicenter observational study. Patients were only included when fallopian tubes were analyzed following the protocol for Sectioning and Extensively Examining the FIMbria (SEE-FIM). Surgeries were performed between June 2010 and April 2017 at eight Spanish hospitals. RESULTS: A total of 359 patients met the inclusion criteria. STIC was diagnosed in 3 (0.8%) patients; one of them underwent surgical staging due to positive peritoneal washing, with absence of disease at the final pathology report. None of the three patients received adjuvant chemotherapy and were free of disease at last follow-up. Fallopian tube and ovarian carcinoma were diagnosed in 5 (1.4%) and 1 (0.3%), respectively. At a median (range) follow-up time of 29 (3-92) months, five patients had a newly diagnosed breast cancer. Other types of cancer, which were diagnosed during the follow-up time, included: serous primary peritoneal carcinoma (n = 1), serous endometrial carcinoma (n = 1), colon (n = 1), pancreas (n = 1), jaw (n = 1), and lymphoma (n = 1). Seven patients died due to different types of cancer: breast (n = 4), pancreas (n = 1), jaw (n = 1), and colon (n = 1). CONCLUSION: The incidence of STIC after RRSO in BRCA mutation carriers is low (0.8%) and it presents an excellent oncological outcome. Patients after RRSO, however, run the risk to develop other types of cancer during follow-up and should be properly advised before the prophylactic surgery.
Asunto(s)
Carcinoma in Situ/epidemiología , Neoplasias de las Trompas Uterinas/epidemiología , Neoplasias Peritoneales/epidemiología , Adulto , Anciano , Proteína BRCA1/genética , Neoplasias de las Trompas Uterinas/genética , Neoplasias de las Trompas Uterinas/cirugía , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Neoplasias Peritoneales/genética , Salpingooforectomía , EspañaRESUMEN
We investigated the gene and protein expressions of V-type ATPase protein subunit C1 (ATP6V1C1) in cases of oral squamous cell carcinoma (OSCC) and contralateral normal mucosa in smokers, nonsmokers and former smokers. Subjects were separated into five groups of 15: group 1, smokers with OSCC; group 2, normal contralateral mucosa of OSCC patients; group 3, chronic smokers; group 4, former smokers who had stopped smoking 1 year earlier; group 5, individuals who had never smoked. Exfoliative cytology specimens from oral mucosa of smokers, former smokers and nonsmokers showed normal gene and protein expression. We found significantly greater gene expression in the OSCC group than in the nonsmoker groups. No difference in gene expression was observed between normal contralateral mucosa and nonsmoker groups, smoker and nonsmoker groups or former smoker and nonsmoker groups. We observed intense immunostaining for ATP6V1C1 protein in all cases of OSCC and weak or no staining in smoker, former smoker and nonsmoker groups. Significantly greater expression of ATP6V1C1 protein was observed in the OSCC group compared to the other groups, which supports the role of ATP6V1C1 in effecting changes associated with oral cancer. Analysis of the mucosae of chronic smokers, former smokers and the normal contralateral mucosa of patients with OSCC showed unaltered ATP6V1C1 gene and protein expression. Early stages of carcinogenesis, represented by altered epithelium of chronic smokers, had neither gene nor protein alterations as seen in OSCC. Therefore, we infer that the changes in ATP6V1C1 occur during later stages of carcinogenesis. Our preliminary study provides a basis for future studies of using ATP6V1C1 levels for detecting early stage OSCC.
Asunto(s)
Carcinoma de Células Escamosas/fisiopatología , Regulación Neoplásica de la Expresión Génica , Neoplasias de la Boca/fisiopatología , ATPasas de Translocación de Protón Vacuolares/genética , ATPasas de Translocación de Protón Vacuolares/metabolismo , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/genética , Perfilación de la Expresión Génica , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Neoplasias de la Boca/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Fumar/efectos adversosRESUMEN
Vacuolar ATPases (V-ATPases) are present in specialized proton secretory cells in which they pump protons across the membranes of various intracellular organelles and across the plasma membrane. The proton transport mechanism is electrogenic and establishes an acidic pH and a positive transmembrane potential in these intracellular and extracellular compartments. V-ATPases have been found to be practically identical in terms of the composition of their subunits in all eukaryotic cells. They have two distinct structures: a peripheral catalytic sector (V1) and a hydrophobic membrane sector (V0) responsible for driving protons. V-ATPase activity is regulated by three different mechanisms, which control pump density, association/dissociation of the V1 and V0 domains, and secretory activity. The C subunit is a 40-kDa protein located in the V1 domain of V-ATPase. The protein is encoded by the ATP6V1C gene and is located at position 22 of the long arm of chromosome 8 (8q22.3). The C subunit has very important functions in terms of controlling the regulation of the reversible dissociation of V-ATPases.
Asunto(s)
Subunidades de Proteína/fisiología , ATPasas de Translocación de Protón Vacuolares/fisiología , Membrana Celular/fisiología , Células Eucariotas/fisiología , Humanos , Relación Estructura-Actividad , ATPasas de Translocación de Protón Vacuolares/químicaRESUMEN
Vacuolar ATPases (V-ATPases) are present in specialized proton secretory cells in which they pump protons across the membranes of various intracellular organelles and across the plasma membrane. The proton transport mechanism is electrogenic and establishes an acidic pH and a positive transmembrane potential in these intracellular and extracellular compartments. V-ATPases have been found to be practically identical in terms of the composition of their subunits in all eukaryotic cells. They have two distinct structures: a peripheral catalytic sector (V1) and a hydrophobic membrane sector (V0) responsible for driving protons. V-ATPase activity is regulated by three different mechanisms, which control pump density, association/dissociation of the V1 and V0 domains, and secretory activity. The C subunit is a 40-kDa protein located in the V1 domain of V-ATPase. The protein is encoded by the ATP6V1C gene and is located at position 22 of the long arm of chromosome 8 (8q22.3). The C subunit has very important functions in terms of controlling the regulation of the reversible dissociation of V-ATPases.
As Vacuolar ATPases (V-ATPases) estão presentes nas células especializadas em secreção de protões, nas quais eles são bombeados através das membranas de vários organelos intracelulares e da membrana plasmática. O mecanismo de transporte de protões é eletrogênico e estabelece um pH ácido e um potencial transmembrana positivo nestes compartimentos intracelulares e extracelulares. As V-ATPases foram encontradas em todas as células eucarióticas, praticamente idênticas em termos de composição das suas subunidades. Elas têm duas estruturas distintas: um setor periférico catalítico (V1) e uma membrana hidrofóbica (V0), responsável pela condução de protões. A atividade das V-ATPases é regulada por três mecanismos diferentes, os quais controlam a densidade de bomba, associação/dissociação de domínios V1 e V0, e a atividade secretora. A subunidade C é uma proteína de 40-kDa, localizada no domínio V1 da V-ATPase. Essa proteína é codificada pelo gene ATP6V1C e está localizada na posição 22 do braço longo do cromossomo 8 (8q22.3). A subunidade C tem funções muito importantes em termos de controle do regulamento da dissociação reversível da V-ATPase.
Asunto(s)
Humanos , Subunidades de Proteína/fisiología , ATPasas de Translocación de Protón Vacuolares/fisiología , Membrana Celular/fisiología , Células Eucariotas/fisiología , Relación Estructura-Actividad , ATPasas de Translocación de Protón Vacuolares/químicaRESUMEN
Vacuolar ATPases (V-ATPases) are present in specialized proton secretory cells in which they pump protons across the membranes of various intracellular organelles and across the plasma membrane. The proton transport mechanism is electrogenic and establishes an acidic pH and a positive transmembrane potential in these intracellular and extracellular compartments. V-ATPases have been found to be practically identical in terms of the composition of their subunits in all eukaryotic cells. They have two distinct structures: a peripheral catalytic sector (V1) and a hydrophobic membrane sector (V0) responsible for driving protons. V-ATPase activity is regulated by three different mechanisms, which control pump density, association/dissociation of the V1 and V0 domains, and secretory activity. The C subunit is a 40-kDa protein located in the V1 domain of V-ATPase. The protein is encoded by the ATP6V1C gene and is located at position 22 of the long arm of chromosome 8 (8q22.3). The C subunit has very important functions in terms of controlling the regulation of the reversible dissociation of V-ATPases.
As Vacuolar ATPases (V-ATPases) estão presentes nas células especializadas em secreção de protões, nas quais eles são bombeados através das membranas de vários organelos intracelulares e da membrana plasmática. O mecanismo de transporte de protões é eletrogênico e estabelece um pH ácido e um potencial transmembrana positivo nestes compartimentos intracelulares e extracelulares. As V-ATPases foram encontradas em todas as células eucarióticas, praticamente idênticas em termos de composição das suas subunidades. Elas têm duas estruturas distintas: um setor periférico catalítico (V1) e uma membrana hidrofóbica (V0), responsável pela condução de protões. A atividade das V-ATPases é regulada por três mecanismos diferentes, os quais controlam a densidade de bomba, associação/dissociação de domínios V1 e V0, e a atividade secretora. A subunidade C é uma proteína de 40-kDa, localizada no domínio V1 da V-ATPase. Essa proteína é codificada pelo gene ATP6V1C e está localizada na posição 22 do braço longo do cromossomo 8 (8q22.3). A subunidade C tem funções muito importantes em termos de controle do regulamento da dissociação reversível da V-ATPase.
RESUMEN
Our modifications to the Stamey, Guittes and Raz procedures are described and discussed. Our own experience of seven years and the experience reported by other authors in the world literature demonstrate the usefulness of the vagina in endoscopic percutaneous surgical treatment of female stress urinary incontinence. The complication rate is reduced, efficacy is enhanced and different alternatives are possible depending on the anatomic and functional characteristics of each case.
Asunto(s)
Colgajos Quirúrgicos/métodos , Técnicas de Sutura , Incontinencia Urinaria de Esfuerzo/cirugía , Vagina/cirugía , Femenino , HumanosRESUMEN
Ten patients with benign familial chronic pemphigus (BFCP) (Hailey-Hailey disease) were evaluated; semiologic and localization differences were described, and special attention was given to solitary or atypical forms. In all the cases, the diagnosis was confirmed by histopathology; some histopathologic differences and the results achieved by direct immunofluorescence of skin are discussed. Most of the patients responded to the treatment with corticosteroids and antibiotics.
Asunto(s)
Pénfigo/genética , Adulto , Betametasona/análogos & derivados , Betametasona/uso terapéutico , Enfermedad Crónica , Diagnóstico Diferencial , Quimioterapia Combinada , Femenino , Técnica del Anticuerpo Fluorescente , Gentamicinas/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Pénfigo/diagnóstico , Pénfigo/tratamiento farmacológico , Prednisona/uso terapéutico , Estaciones del Año , Piel/patologíaRESUMEN
Local sequelae of group A beta-hemolytic streptococci (GABHS) are common and can vary from otitis media, sinusitis, cervical adenitis associated with generalized adenopathy, peritonsillitis and persisting symptoms in spite of therapy, GABHS is one of the pathogens isolated in acute or chronic otitis media and in acute maxillary sinusitis. In cervical adenitis associated with generalized adenopathy GABHS is, along with S. aureus, the most commonly recovered bacteria. In peritonsillitis, GABHS can be recovered alone or in combination with anaerobes in 50% of the cases. These sequelae are usually associated with a slow clinical response to therapy and a high percentage of relapses, reinfections, and chronic infections in the presence of a penicillin-sensitive GABHS. One of the possible causes of these so-called failures is the interference that beta-lactamase producing bacteria can have on the activity of penicillin and similar compounds. When to select a beta-lactamase-resistant antibiotic for the treatment of an apparent penicillin-sensitive infection remains an important area for further research.
Asunto(s)
Infecciones del Sistema Respiratorio/complicaciones , Infecciones Estreptocócicas/complicaciones , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , MasculinoRESUMEN
Durante el periodo comprendido entre 1980 a 1985 se diagnosticaron 10 abscesos perinéfrico en siete mujeres y tres varones. La edad promedio fue de 43.1 años. La evolución promedio de 174.7 días. Los síntomas prominentes fueron dolor (costovertebral/abdominal), calosfríos repetidos y fiebre. A la exploración física se encontró una tumoración en nueve de los diez casos. La hemoglobina promedio fue de 9.94 con un recuento total de leucocitos de 16,360. Todos los pacientes tenían alteraciones en la urografía excretora sugestivas de absceso perinéfrico. Las enterobacterias gramnegativas sensibles predominaron (siete de 10) como los agentes etiogénicos. Esta entidad se debe sospechar en mujeres/varones mayores de 40 años, con diabetes sacarina no insulinodependiente, anémicos, con duración de signos y síntomas de más de una semana, a los que se les practicó una urografía excretora
Asunto(s)
Masculino , Femenino , Absceso/diagnóstico , Nefritis/diagnóstico , Leucocitos/diagnóstico , UrografíaRESUMEN
La mucinosis cutanea focal es una lesion generalmente unica, que asienta en cara, cuello, parte superior de tronco.Se caracteriza por tener una forma redondeada, lisa y de color amarillo translucido, ocasionalmente de crecimiento verrucoso, no mayor de 15 mm. Al microscospio observamos una zona no capsulada, con degeneracion de las fibras colagenas y aumento considerable de los mucopolisacaridos acidos y fibroblastos juveniles. Nuestro caso se refiere a un hombre de 40 anos de edad, con una lesion localizada en cuello. Estudios con Alcian Blue y Naranja de acridina muestran una actividad anormal de los fibroblastos
Asunto(s)
Adulto , Humanos , Masculino , Fibroblastos , Enfermedades de la Piel , CuelloRESUMEN
La mucinosis cutanea focal es una lesion generalmente unica, que asienta en cara, cuello, parte superior de tronco.Se caracteriza por tener una forma redondeada, lisa y de color amarillo translucido, ocasionalmente de crecimiento verrucoso, no mayor de 15 mm. Al microscospio observamos una zona no capsulada, con degeneracion de las fibras colagenas y aumento considerable de los mucopolisacaridos acidos y fibroblastos juveniles. Nuestro caso se refiere a un hombre de 40 anos de edad, con una lesion localizada en cuello. Estudios con Alcian Blue y Naranja de acridina muestran una actividad anormal de los fibroblastos