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Short-term outcomes of robotic liver resection: An initial singleinstitution experience

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World Journal of Hepatology 2022年第1期14卷 224-233页

作者： manuel durán Javier Briceño Ana Padial Ferdinando Massimiliano Anelli Juan manuel Sánchez-Hidalgo María Dolores Ayllón Rafael Calleja-Lozano Carmen García-Gaitan Unit of Hepatobiliary Surgery and Liver Transplantation General and Digestive Surgery DepartmentReina Sofia University HospitalCordoba 14004Spain GC18 Translational Research in Surgery of Solid Organ Transplantation Maimonides Biomedical Research InstituteCórdoba 14004Spain GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery Maimonides Biomedical Research InstituteCórdoba 14004Spain Department of Anesthesiology and Resuscitation Reina Sofia University HospitalCordoba 14004Spain

BACKGROUnD Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced *** robotic approach has gradually been introduced in liver surgery and has increased notably in recent ***,few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic *** To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary *** A total of forty consecutive patients underwent robotic liver resection(da Vinci Xi,***,United States)between June 2019 and January *** were prospectively followed and retrospectively *** characteristics and perioperative and short-term outcomes were *** are expressed as mean and standard *** study was approved by the Institutional Review *** The mean age of patients was 59.55 years,of which 18(45%)were *** mean body mass index was 29.41 kg/m^(2).nine patients(22.5%)were *** were divided by type of resection as follows:Ten segmentectomies,three wedge resections,ten left lateral sectionectomies,six bisegmentectomies(two VVI bisegmentectomies and four IVb-V bisegmentectomies),two right anterior sectionectomies,five left hepatectomies and two right *** lesions occurred in twenty-nine(72.5%)of the *** mean operative time was 258.11 min and two patients were transfused intraoperatively(5%).Inflow occlusion was used in thirty cases(75%)and the mean total clamping time was 32.62 *** was a single conversion due to uncontrollable *** postoperative complications(Clavien–Dindo>Ⅲb)occurred in three patients(7.5%)and mortality in one(2.5%).no patient required readmission to the *** mean hospital stay was 5.6 *** Althou

关键词： Robotics Hepatectomy Minimally invasive surgery Liver surgery Da vinci

Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant:What is the evidence?

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World Journal of Gastroenterology 2023年第20期29卷 3066-3083页

作者： manuel durán Rafael Calleja Angus Hann George Clarke Ruben Ciria Anisa nutu Rebeca Sanabria-Mateos María Dolores Ayllón Pedro López-Cillero Hynek Mergental Javier Briceño M Thamara P R Perera Department of Liver Transplantation Reina Sofía University HospitalCórdoba 14004Spain The Liver Unit Queen Elizabeth Hospital BirminghamBirmingham B152THUnited Kingdom Centre for Liver and Gastrointestinal Research Institute of Immunology and ImmunotherapyUniversity of BirminghamBirmingham B152THUnited Kingdom

The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft *** to the cholangiocytes during the liver donation,preservation,or early posttransplant period may result in stricturing of the biliary tree and inadequate biliary *** problem continues to trouble clinicians,and may have catastrophic consequences for the graft and *** injury,as a result of compromised hepatic artery flow,is a well-known cause of biliary strictures,sepsis,and graft ***,very similar lesions can appear with a patent hepatic artery and these are known as ischemic type biliary lesions(ITBL)that are attributed to microcirculatory dysfunction rather than main hepatic arterial *** the warm and cold ischemic period duration appear to influence the onset of *** of the commonly used MP techniques deliver oxygen to the graft cells,and therefore may minimize the cholangiocyte injury and subsequently reduce the incidence of *** clinical experience and published evidence grows for these modalities,the impact they have on ITBL rates is important to *** this review,the evidence for the three commonly used MP strategies(abdominal normothermic regional perfusion[A-nRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[nMP])for ITBL prevention has been critically *** with ITBL definitions used in trials,coupled with variations in techniques of MP,make interpretation ***,the evidence suggests that both HOPE and A-nRP prevent ITBL in donated after circulatory death grafts compared to cold *** evidence for ITBL prevention in donor after brain death grafts with any MP technique is weak.

关键词： Liver transplant Ischemic type biliary lesions Hypothermic oxygenated machine perfusion normothermic machine perfusion Abdominal normothermic regional perfusion Donation after circulatory death

Promotion of structural plasticity in area V2 of visual cortex prevents against object recognition memory deficits in aging and Alzheimer's disease rodents

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neural Regeneration Research 2024年第8期19卷 1835-1841页

作者： Irene navarro-Lobato Mariam Masmudi-Martín manuel F.López-Aranda Juan F.López-Téllez Gloria Delgado Pablo Granados-durán Celia Gaona-Romero Marta Carretero-Rey Sinforiano Posadas María E.Quiros-Ortega Zafar U.Khan Laboratory of neurobiology Centro de Investigaciones Médico Sanitarias(CIMES)University of MalagaMalagaSpain Department of Medicine Faculty of MedicineUniversity of MalagaMalagaSpain Centro de Investigación Biomédica en Red de Enfermedades neurodegenerativas(CIBERnED) Institute of Health Carlos IIIMadridSpain the Donders Institute for Brain Cognition and Behaviour Radboud UniversityNijmegenThe Netherlands the Brain Metastasis Group National Cancer Research Centre(CNIO)MadridSpain the Department of neurobiology University of California-Los AngelesLos AngelesCAUSA

Memory deficit,which is often associated with aging and many psychiatric,neurological,and neurodegenerative diseases,has been a challenging issue for *** till now,all potential drug candidates have failed to produce satisfa ctory ***,in the search for a solution,we found that a treatment with the gene corresponding to the RGS14414protein in visual area V2,a brain area connected with brain circuits of the ventral stream and the medial temporal lobe,which is crucial for object recognition memory(ORM),can induce enhancement of *** this study,we demonstrated that the same treatment with RGS14414in visual area V2,which is relatively unaffected in neurodegenerative diseases such as Alzheimer s disease,produced longlasting enhancement of ORM in young animals and prevent ORM deficits in rodent models of aging and Alzheimer’s ***,we found that the prevention of memory deficits was mediated through the upregulation of neuronal arbo rization and spine density,as well as an increase in brain-derived neurotrophic factor(BDnF).A knockdown of BDnF gene in RGS14414-treated aging rats and Alzheimer s disease model mice caused complete loss in the upregulation of neuronal structural plasticity and in the prevention of ORM *** findings suggest that BDnF-mediated neuronal structural plasticity in area V2 is crucial in the prevention of memory deficits in RGS14414-treated rodent models of aging and Alzheimer’s ***,our findings of RGS14414gene-mediated activation of neuronal circuits in visual area V2 have therapeutic relevance in the treatment of memory deficits.

关键词： behavioral performance brain-derived neurotrophic factor cognitive dysfunction episodic memory memory circuit activation memory deficits memory enhancement object recognition memory prevention of memory loss regulator of G protein signaling

Effect of Carbohydrate Intolerance and Gestational Diabetes on Obstetric and Perinatal Outcomes

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Open Journal of Obstetrics and Gynecology 2014年第6期4卷 243-248页

作者： Leticia Lara-ávila José manuel Brambila-durán Diego Armando Camacho-Ramírez Felipe de Jesús Peraza-Garay Adrián Herrera-Salazar Fred Morgan-Ortiz Health Sciences Research and Teaching Center Autonomous University of Sinaloa Civil Hospital of Culiacan Culiacan Mexico

Objectives: To compare the frequency of obstetric and perinatal complications among patients with carbohydrate intolerance (CHI) and gestational diabetes (GD). Materials and Methods: In a prospective study at the Civil Hospital of Culiacán, we studied 182 pregnant patients between 16 and 30 weeks of gestation (WG) who received a glucose tolerance test following the oral administration of 100 g of glucose. The patients were classified as normal (n = 53), CHI (n = 61) and GD (n = 68) between January 15 to november 30, 2012. The analyzed variables included the frequency of polyhydramnios, preeclampsia-eclampsia, obstetric hemorrhage, fetal macrosomia, and admission to a neonatal intensive care unit (nICU). Results: no significant differences were found between women with CHI and women with GD with respect to obstetric hemorrhage (P = 0.774), preeclampsia-eclampsia (P = 0.590), and macrosomia (P = 0.119). However, polyhydramnios was more frequent in CHI group (OR = 3) compared to GD, whereas admission to the nICU was lower in the CHI group compared to GD group (OR = 0.38). Conclusion: Preeclampsia-eclampsia, obstetric hemorrhage, and macrosomia were similar among patients with CHI and GD. In contrast, polyhydramnios was more frequent in patients with CHI compared to patients with GD, but admission to the nICU was more frequent in patients with GD.

关键词： Glucose Tolerance Test Carbohydrate Intolerance Gestational Diabetes Perinatal Outcome

Validation of a preclinical dry eye model in new Zealand white rabbits during and following topical instillation of 1% ophthalmic atropine sulfate

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Animal Models and Experimental Medicine 2022年第3期5卷 266-273页

作者： Alejandra Sánchez-Ríos Elba Yadira Correa-Gallegos José manuel Medina-Espinoza Andrea Anaid navarro-Sanchez Oscar Olvera-Montaño Leopoldo Baiza-durán Patricia Muñoz-Villegas Medical Affairs Department Laboratorios SophiaSA de CVZapopanJaliscoMexico

Background : The objective of this study was to validate an animal model for dry eye during and after the administration of 1% ophthalmic atropine sulfate(OAS) in new Zealand white(nZW) *** : OAS(1%) was applied three times per day to 30 eyes of 15 healthy nZW rabbits. Sacrifice, enucleation, and lacrimal gland removal took place on days 15, 21,and 30(OAS group). A second group(n = 5) was used as control. Clinical evaluations took place on days 3, 10, 15, 18, 21, 24 and 30. The primary endpoints were:Schirmer I test, tear break-up time(TBUT), and corneal fluorescein staining. As secondary endpoints, clinical changes including intraocular pressure, and histopathology were *** : While OAS was administered, the Schirmer I test showed a statistically significant reduction for OAS group versus control( p nd versus basal production( p nificant differences between groups(days 3 and 10;p = 0.001) and versus basal values(day 3;p n staining showed a statistically significant difference(day 3;p = 0.001). The most frequent clinical finding was conjunctival hyperemia(76.9% OAS vs. 20% control). For histopathology, all OAS subjects presented some degree of inflammation(86.7% minimal;13.3% mild) whereas the control presented only 30% minimal inflammation. Goblet cell density showed no *** : The effectiveness of the OAS dry eye model in nZW rabbits as reported in previous studies was confirmed, provided that the application of the drug is maintained throughout the intervention;it is not a viable model after OAS administration is suspended.

关键词： atropine sulfate dry eye rabbit model safety Schirmer I test TBUT

All About Maude - A High-Performance Logical Framework 2007

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Epigenetic mechanisms in non-alcoholic fatty liver disease:An emerging field

丛书名： Lecture notes in Computer Science

2007年

作者： manuel Clavel Francisco durán Steven Eker Patrick Lincoln narciso Martí-Oliet José Meseguer Carolyn Talcott

来源：畅想之星图书光盘版（南... 评论

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World Journal of Hepatology 2015年第24期7卷 2497-2502页

作者： Rocío Gallego-durán manuel Romero-Gómez Inter-Centre Unit of Digestive Diseases and CIBERehd Virgen Macarena-Virgen del Rocío University Hospitals Instituto de Biomedicina de Sevilla University of Sevilla

non-alcoholic fatty liver disease(nAFLD) is an emerging health concern in both developed and non-developed world, encompassing from simple steatosis to nonalcoholic steatohepatitis(nASH), cirrhosis and liver cancer. Incidence and prevalence of this disease are increasing due to the socioeconomic transition and change to harmful diet. Currently, gold standard method in nAFLD diagnosis is liver biopsy, despite complications and lack of accuracy due to sampling error. Further, pathogenesis of nAFLD is not fully understood, but is well-known that obesity, diabetes and metabolic derangements played a major role in disease development and progression. Besides, gut microbioma and host genetic and epigenetic background could explain considerable interindividual variability. Knowledge that epigenetics, heritable events not caused by changes in DnA sequence, contribute to development of diseases has been a revolution in the last few years. Recently, evidences are accumulating revealing the important role of epigenetics in nAFLD pathogenesis and in nASH genesis. Histone modifications, changes in DnA methylation and aberrant profiles or micro RnAs could boost development of nAFLD and transition into clinical relevant status. PnPLA3 genotype GG has been associated with a more progressive disease and epigenetics could modulate this effect. The impact of epigenetic on nAFLD progression could deserve further applications on therapeutic targets together with future non-invasive methods useful for the diagnosis and staging of nAFLD.

关键词： non-alcoholic steatohepatitis Epigenetics Diagnosi

Evaluation of novel 3D Architectures Based on Knitting Technologies for Engineering Biological Tissues

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Journal of Donghua University(English Edition) 2013年第5期30卷 421-426页

作者： RIBEIRO Viviana Pinto RIBEIRO Ana Soares SILVA Carla Joana durES nelson Feio BOnIFCIO Graa CORRELO Vitor manuel MARQUES Alexandra Pinto SOUSA Rui Amandi OLIVEIRA Ana Leite REIS Rui Luís 3B's Research G roup-Biomaterials Biodegradables and BiomimeticsUniversity of MinhoHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine ICVS /3B's-PT G overnment Associated Laboratory University of Minho CenTI Centre for Nanotechnology and Smart MaterialsV. N. CITEVE Technological Centre for Textile and Clothing IndustryV. N. CBQF-School of Biotechnology Portuguese Catholic University

Textile-based technologies are considered as potential routes for the production of 3D porous architectures for tissue engineering( TE) applications. We describe the use of two polymers,namely polybutylene succinate( PBS) and silk fibroin(SF) to produce fiber-based finely tuned porous architectures by weft and warp knittings. The obtained knitted constructs are described in terms of their morphology, mechanical properties,swelling ability,degradation behaviour,and cytotoxicity. Each type of polymer fibers allows for the processing of a very reproducible intra-architectural scaffold geometry,with distinct characteristics in terms of the surface physicochemistry,mechanical performance,and degradation capability,which has an impact on the resulting cell behaviour at the surface of the respective biotextiles. Preliminary cytotoxicity screening shows that both materials can support cell adhesion and proliferation. Furthermore, different surface modifications were performed( acid /alkaline treatment, UV radiation,and plasma) for modulating cell behavior. An increase of cell-material interactions were observed,indicating the important role of materials surface in the first hours of culturing. Human adipose-derived stem cells( hASCs) became an emerging possibility for regenerative medicine and tissue replacement therapies. The potential of the recently developed silk-based biotextile structures to promote hASCs adhesion,proliferation,and differentiation is also evaluated. The obtained results validate the developed constructs as viable matrices for TE applications. Given the processing efficacy and versatility of the knitting technology, and the interesting structural and surface properties of the proposed polymer fibers,it is foreseen that our developed systems can be attractive for the functional engineering of tissues such as bone,skin,ligaments or cartilage and also for develop more complex systems for further industrialization of TE products.

关键词： textile-based technologies silk polybutylene succinate(PBS) surface modifications human adipose-derived stem cells(hASCs) tissue engineering(TE)

Comparison of the Incidence of Complications among the Different Techniques of Laparoscopic Approach: Experience in a General Surgery Service in a Private Hospital

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Surgical Science 2018年第7期9卷 227-232页

作者： Mauricio Valdez-durón Jorge Fernández-álvarez Alberto manuel González-Chávez Francisco ángel Vega-Romero Ketzalcoatl Tecomahua-Román Antonio García-Ruiz Hospital Españ ol de México Mexico City Mexico Hospital General Xoco Mexico City Mexico Hospital Central Militar Mexico City Mexico

Introduction: At least four techniques or approaches to minimize the risk of injury have been introduced. The correlation between techniques and the complication rate is controversial. The objective of the study is to report the incidence of laparoscopic entry associated injury, in relation to the used technique. Material and Methods: A retrospective study was conducted at the Hospital Espa? ol, in a 12-month period (2013). The medical records of all patients who underwent laparoscopic surgery were reviewed. Demographic and surgical variables were analyzed, comparing the results statistically through an analysis of variance (AnOVA). Results: A total of 792 cases were analyzed. The surgeries performed were: cholecystectomies (42%), appendectomies (26%), diagnostic laparoscopies (20%), ventral or inguinal hernioplasty (9%) and fundoplications (3%). The preferred approach was Hasson’s (79%) and Veres’s needle technique (14%), followed by classic closed (14%) and Palmer technique (2%). We documented six cases of laparoscopic entry associated injury (0.76%), four associated with the Hasson technique, one with Veress’s needle technique and one with direct approach technique were reported. The statistical analysis was performed considering the different techniques and their relation with the injuries. Analysis of variance did not reach statistical significance (p = 0.31). Conclusions: Among our data, the number of laparoscopic entry associated injuries, was less than 1%, and has a similar frequency to the reported literature. We did not find significant differences between the four laparoscopic entry techniques. There remains no clear evidence as to the optimal form of laparoscopic entry in the low-risk patient.

关键词： Laparoscopic Surgery Pneumoperitoneum Complications