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Dealing with robot-assisted surgery for rectal cancer:current status and perspectives

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World Journal of Gastroenterology 2016年第2期22卷 546-556页

作者： Roberto Biffi Fabrizio Luca Paolo Pietro Bianchi Sabina Cenciarelli Wanda Petz Igor Monsellato manuela Valvo maria Laura Cossu Tiago Leal Ghezzi Kassem Shmaissany Department of Gastrointestinal Surgery European Institute of Oncology20141 MilanItaly

The laparoscopic approach for treatment of rectal cancer has been proven feasible and oncologically safe, and is able to offer better short-term outcomes than traditional open procedures, mainly in terms of reduced length of hospital stay and time to return to working activity. In spite of this, the laparoscopic technique is usually practised only in high-volume experienced centres, mainly because it requires a prolonged and demanding learning curve. It has been estimated that over 50 operations are required for an experienced colorectal surgeon to achieve proficiency with this technique. Robotic surgery enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, thus promising to overcome some of the technical difficulties associated with standard laparoscopy. It has high-definition threedimensional vision, it translates the surgeon's hand movements into precise movements of the instruments inside the patient, the camera is held and moved by the first surgeon, and a fourth robotic arm is available as a fixed retractor. The aim of this review is to summarise the current data on clinical and oncologic outcomes of robot-assisted surgery in rectal cancer, focusing on short- and long-term results, and providing original data from the authors' centre.

关键词： Rectal cancer Robotic total mesorectalexcision Robotic surgery Robotic resection Circumferentialresection margin Lymph node yield Distalresection margin positivity

Effect of Protein Adsorption onto the Dissolution of Silicon-Substituted Hydroxyapatite

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Journal of Encapsulation and Adsorption Sciences 2011年第4期1卷 72-79页

作者： Claudia manuela Botelho Roger Brooks Masanobu Kanitakahara Chikara Ohtsuki Serena Best maria Ascensao Lopers Neil Rushton William Bonfield JoséDomingos Santos Institute for Biotechnology and Bioengineering Centre of Biological EngineeringUniversidade do MinhoCampus de GualtarBragaPortugal Graduate School of Materials Science Nara Institute of Science and TechnologyTakayamaIkomaNaraJapan Orthopaedic Research Unit Addenbrooke’s HospitalCambridgeUK Department of Materials Science and Metallurgy University of CambridgeCambridgeUK Tohoku University Graduate School of Environmental StudiesAramakiAobaAoba-kuSendaiJapan Nagoya University Department of Crystalline Materials ScienceGraduate School of EngineeringFuro-choChikusa-kuNagoyaJapan CEMUC Faculty of EngineeringDepartment of Metallurgical and Materials EngineeringUniversity of PortoPortoPortugal

Several authors have shown the beneficial role to incorporate silicon into hydroxyapatite lattice, although, the mechanism behind the enhanced bioactivity of this Si-hydroxyapatite (Si-HA) is poorly understood. The incorporation of Si into the HA lattice alters the surface charge of HA, leading to more negative values. Due to the importance of the surface properties on the interaction between biomaterials, physiological fluids, and the host tissue, it is important to further characterize the surface of Si-HA by determining its surface energy and wettability. Our results showed that the incorporation of Si increased the hydrophilicity of HA, leading to a higher interfacial tension. Another important property for osteointegration is the formation of an apatite layer. The dissolution of Si-HA in the presence of serum-free simulated body fluid (SBF) started at early time points and using atomic force microscopy (AFM) it was possible to observe the dissolution at the grain boundaries and grains, therefore an apatite layer was formed in a short period of time. As the dissolution-precipitation process is much more complex in vivo, we tried to mimic the initial stages of the in vivo reaction by incubating the Si-HA in serum-SBF. It was shown that the dissolution kinetics in serum-SBF was slower when compared to the dissolution in serum free-SBF. At the same time point, no significant dissolution features were observed or apatite layer was visualized. The phase imaging AFM indicated the presence of a layer on top of these materials that could be a proteinaceous layer, as XPS analysis detected an increase on the concentration of nitrogen on the surface of the samples incubated in the presence of proteins.

关键词： Biomaterials Silicon Surface Properties Proteins Dissolution

Response Proliferative Capacity of Undifferentiated Stem Cells of Obtained Human Adult Dental Follicle

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Stem Cell Discovery 2014年第4期4卷 125-137页

作者： Larissa Kim Higashi de Carvalho Aline Vieira Pinheiro de Araujo manuela Garcia Laveli da Silva Rosa Andréa Nogueira Laiso Durvanei Augusto maria Faculty of Medicine University of Sao Paulo Sao Paulo Brazil Laboratory of Biochemistry and Biophysics Butantan Institute Sao Paulo Brazil

Objective: The aim of this study was correlation proliferative activity, markers express stem cells, and lipid peroxides of undifferentiated stem cells of human adult dental follicle (DF) following culture. Methods: For this study, we used 8 samples from DF of impacted third molars to maintain culture conditions and evaluated the growth curve, cell viability, production of lipid peroxidation, cell cycle phases, and proliferative index during 25 days of culture. Results: Cells after culture showed characteristics of fibroblast-like type following 25th day of culture. The results of lipid peroxidation showed that stem cells in culture produce 13 nmoles/ml malondialdehyde at the start of culture, increasing until the 12th day and then began a decline that lasted until the 25th day. We revealed that DFSCs presented a significantly higher percentage of cells in S + G2/M phases by the 15th day of culture compared with cells at the start of culture. Cell surface markers revealed that cell lines were negative for HLA-DR and positive for CD90, CD44, and CD105. The expression of p21 protein, involved in the regulation of the cell cycle, showed a significant increase from the 15th to 25th day of culture. Results of cell division rates show a significant increase between the 6th and 15th day of culture. Conclusions: We conclude that the culture remained stable during the 25 days of culture, presenting the markers of stem cells and markers of control, progression, and cell proliferation that there was an increased production of lipid peroxides between the 6th and 12th days;this increase is related to the increased numbers of cells that also occurs during this period. Then, there is a significantly decline in the production of lipid peroxides and the number of cells, which is accompanied by an increase in cell unviability.

关键词： Follicle Dental Stem Cells Lipid Peroxidation Cell Cycle Proliferation

Malnutrition Reduces Quality of Life and Performance in Hospitalized Elderly

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Open Journal of Endocrine and Metabolic Diseases 2014年第6期4卷 147-157页

作者： Patrizia D’Amelio Barbara Rosso Giorgia Fornelli Chiara Eandi maria T. Maniero Daniela Cobianchi Valerio Dimonte manuela Rebellato Giovanni C. Isaia Gerontology Section City of Health and Science Hospital Torino Italy Gerontology Section Department of Medical Science University of Torino Torino Italy University of Torino Torino Italy

Objectives: Severe protein energy malnutrition results in muscle wasting and loss of subcutaneous tissue and has serious implications for health, recovery from illness or surgery, and hospital costs;however this condition is often underestimated and considered as one of the aspects of aging. We measure the incidence of malnutrition and its consequences on general health, physical and mental performance in a cohort of elderly patients. Study Design: This is a cross-sectional study conducted in a geriatric inpatient unit. Three hundred patients admitted to the clinic who fulfilled the inclusion criteria were enrolled. Main Outcome Measures: Nutritional status was evaluated by Mini Nutritional Assessment (MNA) questionnaire, macro and micronutrients intake, anthropometric measures and biochemical parameters. Physical and mental performances were recorded by questionnaires. Muscular strength was measured by a hand dynamometer and clinical outcomes were recorded. Results: Patients with poor nutritional status have lower physical and mental performance as respect to well nourished patients. Undernourished patients have longer hospitalization and worst outcomes. We observe a high prevalence of severe hypovitaminosis D and the intake of various micronutrients was severely unbalanced. The incidence of malnutrition was 25% (75 patients);39% (119 patients) were at risk of malnutrition. MNA was inversely related with the length of hospital stay (R = -0.25, p = 0.012) and with Geriatric Depression Scale (GDS) (R = -0.56, p = 0.000), whereas directly related with cognitive performance measured through Mini Mental State Examination (MMSE) (R = 0.5, p = 0.000) and hand grip strength (R = 0.35, p = 0.000). Conclusions: Malnutrition significantly reduced quality of life, physical and mental performance and worsened patients’ prognosis.

关键词： Malnutrition Quality of Life Muscular Strength Aging

Simultaneous Neurocysticercosis and Cerebral Toxoplasmosis in a Patient Living with HIV—Case Report

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Advances in Infectious Diseases 2023年第3期13卷 521-526页

作者： Ema Leal João Caria Vasco Almeida Claudina Cruz Ana Raquel Garrote manuela Mafra Freddy Ramirez Diana Póvoas maria José Manata Fernando Maltez Infectious Diseases Department Hospital de Curry Cabral Lisbon Portugal Anatomic Pathology Department Hospital de S&#227o José Lisbon Portugal

Background: Simultaneous central nervous system infection by more than one pathogen is very uncommon, even in individuals with acquired immunodeficiency syndrome. Purpose and methods: We report a clinical case of an HIV positive patient with simultaneous biopsy-confirmed neurotoxoplasmosis and neurocysticercosis. Results and conclusion: In this report, we present a rare occurrence of two simultaneous parasitic infections of the central nervous system in a patient with advanced immunosuppression due to HIV-1 infection. Despite the limited data available regarding the prevalence of such co-infections, this case underscores the importance of maintaining a high index of suspicion and promptly identifying concurrent neurologic diseases to enable accurate diagnosis and appropriate treatment in these patients.

关键词： HIV Concomitant CNS Infections Neurotoxoplasmosis Neurocysticercosis

Group Analysis＂ Other Sights of the Conscious and the Unconscious

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Psychology Research 2015年第1期5卷 10-22页

作者： Abreu-Afonso Jose Dinis Cesar Ferreira Guilherme Sara maria Caseiro Ferro Marques Paulo Motta Melo Joao Carlos Neto Isaura Porto manuela Rodrigues Teresa Bastos Valente Aucindio Portuguese Group Analytic Society and Group Analytic Psychotherapy (SPG PAG) Lisbon Portugal

Polymorphism in cardiovascular diseases(CVD)susceptibility loci in the azores islands(Portugal)

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Open Journal of Genetics 2011年第3期1卷 48-53页

作者： Mafalda Raposo Paul Sousa Stefan Nemeth Ana Rita Couto Margarida Rodrigues Santos Joao Paulo Pinheiro maria Joao Peixoto Christian Oberkanins Nadiya Kazachkova Teresa Cymbron manuela Lima Jacome Bruges-Armas Center of Research in Natural Resources(CIRN)and Department of Biology University of the AzoresPonta DelgadaPortugal Specialized Service of Epidemiology and Molecular Biology(SEEBMO) Hospital of Santo EspiritoAngra do HeroismoPortugal Institute for Molecular and Cell Biology(IBMC) University of PortoPortoPortugal ViennaLab Diagnostics GmbH ViennaAustria

Background: Atherosclerosis and thrombosis are the major manifestations underlying cardiovascular diseases (CVD), which are the leading cause of mortality and morbidity worldwide. Both result from an interaction between genetic and environmental risk factors. The goal of our study was to evaluate several polymorphisms identified as predisposing factors to atherosclerosis and thrombosis. Material and Methods: A series of 155 healthy unrelated individuals of Azorean origin were analyzed using the CVD StripAssay (ViennaLab Diagnostics, Austria) for the most established polymorphisms involved in blood coagulation (F2, F5, F13A1, FGB), fibrinolitic system (SERPINE1), platelet adhesion (ITGB3), homocysteine metabolism (MTHFR), reninangio-tensin system (ACE) and lipid metabolism (APOE). Results: No significant differences were observed in allelic frequencies when comparing our data to mainland Portugal. Group stratification according to the number of “increased” risk alleles, demonstrated that 116/155 (75%) individuals belong to the moderate risk group (5 - 10 risk alleles). Conclusions: Although acknowledging the fact that the allelic states at the analysed loci lack predictive value, the fact that a high frequency of individuals presents at least 5 risk alleles (124/155;80%) is important for the establishment of the appropriate preventive measures in the Azorean population.

关键词： Atherosclerosis Thrombosis Cardiovascular Diseases Susceptibility Genes Genetic Risk Poly-morphism

Validation of a new scoring system: Rapid assessment faecal incontinence score

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World Journal of Gastrointestinal Surgery 2015年第9期7卷 203-207页

作者： Fernando de la Portilla Arantxa Calero-Lillo Rosa M Jiménez-Rodríguez maria L Reyes manuela Segovia-González María Victoria Maestre Ana M García-Cabrera Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD o Ciberehd) Instituto de Salud Carlos Ⅲ Department of General and Digestive Surgery Colorrectal Surgery Unit"Virgen del Rocío" University Hospital/IBi S/CSIC/University of Seville Department of Economics Quanti- tative MethodsUniversity Pablo Olavide of Seville

AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and ***: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% ***: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between "state" and "leaks" was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r " for the different subscales of the questionnaire were: "lifestyle" r =-0.87, "c

关键词： Faecal incontinence Measure Score Test Faecal inco

2-aminoethyl Dihydrogen Phosphate as a Modulator of Proliferative and Apoptotic Effects in Breast Cancer Cell Lines

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Journal of Pharmacy and Pharmacology 2021年第3期9卷 83-97页

作者： manuela Garcia Laveli da Silva Laertty Garcia de Sousa Cabral Monique Gonçalves Alves Thais deOliveira Conceição Henrique Hesse Rosa Andrea Nogueira Laiso Daniel da Conceição Rabelo Durvanei Augusto maria Development and Innovation Laboratory Butantan InstituteSao PauloSP 05503-900Brazil Faculty of Medicine University of São PauloSao PauloSP 01246-000Brazil

Background: Breast cancer is a type of cancer that affects more women throughout the world, in developing anddeveloped countries. 2-AEH2P is a phospholipid analog of cellular membrane, which makes it different from existing molecules fortheir absorption, stability and display anti-inflammatory, anti-proliferative and pro-apoptotic properties. Methods: MCF-7 humanbreast adenocarcinoma cells were treated with 2-AEH2P. The viability and adhesion cells were evaluated by MTT assay. Cell cyclephases, apoptosis, markers and mitochondrial potential were assessed by flow cytometry. Morphological ultrastructural analyzeswere performed by laser confocal microscopy. Results: MCF-7 Tumor cells acquired round shapes, lost cytoplasmic expansions,formed clusters in suspension and decreased significantly viability. There were changes in the morphology, membrane fragmentationand loss of cytoplasmic projection. The obtained concentrations for IC50% were 37.2;25.8;1.8 mM for periods of 24, 48 and 72 h,respectively. Changes in the distribution of cell population phases of the cell cycle showed an increase in fragmented DNA and anincrease in the G2/M phase. The expression β-gal showed proliferative reduction induced by 2-AEH2P. Laser confocal microscopyshowed changes in the mitochondrial membrane and alteration in distribution. Proliferative index of MCF-7 tumor cells treated with2-AEH2P decreased significantly when compared to fibroblast normal cells. The compound 2-AEH2P is a phospholipid withantiproliferative potential and apoptosis modulator.

关键词： Human Breast Adenocarcinoma MCF-7 2-AEH2P Antitumor Apoptosis Cell cycle Senescence