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Robotic-assisted retroperitoneal lymph node dissection for stage II testicular cancer

Asian Journal of Urology 2024年第1期11卷 121-127页

作者： George McClintock Ahmed S.Goolam Don Perera Ryan Downey Scott Leslie peter Grimison Henry Woo peter ferguson Nariman Ahmadi Department of Urology Chris O'Brien LifehouseSydneyNSWAustralia Department of Anaesthesia Chris O'Brien LifehouseSydneyNSWAustralia The University of Sydney SydneyNSW2006Australia Department of Medical Oncology Chris O'Brien LifehouseSydneyNSWAustralia

Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular cancer.Methods:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our institution.Data were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological outcomes.Descriptive statistics are presented.Results:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior chemotherapy.The median operative time was 300(interquartile range[IQR]240-315)min.Median blood loss was 100(IQR 50-175)mL.Median length of stay was 2(range 1-11)days.All robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day 3.The median lymph node yield was 40.5(IQR 38-51)nodes.All patients undergoing nerve-sparing procedures recovered antegrade ejaculatory function.One patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had recurrences.Conclusion:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low morbidity.Early oncological outcomes are promising.Larger cohorts and longer follow-ups are required to validate our institution's findings.

关键词： Retroperitoneal lymph node dissection Robotic surgery Testicular cancer Retroperitoneal node dissection

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Epidemiology of pelvic and acetabular fractures across 12-mo at a level-1 trauma centre

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World Journal of Orthopedics 2022年第8期13卷 744-752页

作者： Rory Cuthbert Samuel Walters David ferguson Edward Karam Jonathan Ward Homa Arshad Paul Culpan peter Bates Department of Trauma and Orthopaedic Surgery Royal London HospitalBarts HealthLondon E11BBUnited Kingdom

BACKGROUND Despite motor-vehicle safety advancements and increasingly rigorous workplace safety regulations,trauma/suicide remains the leading cause of death under the age of 45 in the United Kingdom.To promote centralisation of care and optimisation of major trauma outcomes,in 2012 the National Health Service introduced the Trauma Network System.To our knowledge,this is the first study to analyse the epidemiology of pelvic and acetabular trauma over a one-year period at a level-1 trauma centre in the United Kingdom,since nationwide introduction of the Trauma Network System.AIM To characterize the epidemiology of high-energy pelvic and acetabular fractures over a one-year period at a level-1 trauma centre,and explore both resources required to care for these patients and opportunities for future research and injury prevention initiatives.METHODS 227 consecutive patients at a level-1 trauma centre with pelvic and acetabular fractures were analysed between December 2017-December 2018.Paediatric patients(<18 years)and fragility fractures were excluded,leaving 175 patients for inclusion in the study.Statistical analysis was performed using Fisher’s exact test for categorical variables.RESULTS 72%of pelvic and acetabular fractures occurred in male patients at a median age of 45 years.15%were the result of a suicide attempt.48%of patients required pelvic or acetabular surgery,with 38%undergoing further surgery for additional orthopaedic injuries.43%of patients were admitted to intensive care.The median inpatient stay was 13 days,and the 30-day mortality was 5%.Pelvic ring trauma was more commonly associated with abdominal injury(P=0.01)and spine fractures(P<0.001)than acetabular fractures.Vertical shear pelvic ring fractures were associated with falls(P=0.03)while lateral compression fractures were associated with road traffic accidents(P=0.01).CONCLUSION High energy pelvic and acetabular fractures are associated with concomitant orthopaedic fractures(most commonly spine and lower limb),intensive care admission and pro

关键词： Pelvis Acetabulum Orthopedics Multiple trauma Trauma centers

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Mechanistic action of gibberellins in legume nodulation

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Journal of Integrative Plant Biology 2014年第10期56卷 971-978页

作者： Satomi Hayashi peter M.Gresshoff Brett J.ferguson Centre for Integrative Legume Research The University of Queensland

Legume plants are capable of entering into a symbiotic relationship with rhizobia bacteria.This results in the formation of novel organs on their roots,called nodules,in which the bacteria capture atmospheric nitrogen and provide it as ammonium to the host plant.Complex molecular and physiological changes are involved in the formation and establishment of such nodules.Several phytohormones are known to play key roles in this process.Gibberellins（gibberellic acids;GAs）,a class of phytohormones known to be involved in a wide range of biological processes（i.e.,cell elongation,germination）are reported to be involved in the formation and maturation of legume nodules,highlighted by recent transcriptional analyses of early soybean symbiotic steps.Here,we summarize what is currently known about GAs in legume nodulation and propose a model of GA action during nodule development.Results from a wide range of studies,including GA application,mutant phenotyping,and gene expression studies,indicate that GAs are required at different stages,with an optimum,tightly regulated level being key to achieve successful nodulation.Gibberellic acids appear to be required at two distinct stages of nodulation：（i）early stages of rhizobia infection and nodule primordium establishment;and（ii）later stages of nodule maturation.

关键词： Gibberellic acid legume nodulation phytohormone plant development rhizobia symbiosis

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pHairyRed： A Novel Binary Vector Containing the DsRed2 Reporter Gene for Visual Selection of Transgenic Hairy Roots

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Molecular Plant 2011年第3期4卷 537-545页

作者： Meng-Han Lin peter M. Gresshoff Arief Indrasumunar Brett J. ferguson Australian Research Council Centre of Excellence for Integrative Legume Research The University of Queensland St Lucia Brisbane QLD 4072 Australia

We developed a new plant transformation vector, pHairyRed, for enabling high throughput, non-destructive selection of Agrobacterium rhizogenes-mediated ＇hairy-root＇ transformation, pHairyRed allows easy in planta visualiza- tion of transgenic tissue with minimal disturbance to the plant. The DsRed2 reporter gene, encoding a red fluorescent protein, was cloned to yield pHairyRed （harbouring a multiple cloning site）, which was used with the highly efficient K599 A. rhizogenes strain to infect soybean （Glycine max L. Merrill） plants. DsRed2 fluorescence was easily detected in planta for the duration of a 5-week study with negligible levels of background autofluorescence. This enabled visual selection of transformed roots and subsequent excission of non-transformed roots, pHairyRed-transformed roots nodu- lated normally when inoculated with Bradyrhizobiumjaponicum. Within the nodule, DsRed2 fluorescence was plant-spe- cific, being absent in the bacteroid-dominated nodule infected zone. To test the reliability of pHairyRed as a high-fidelity binary vector reporter system, the gene encoding the soybean Nod factor receptor, GmNFRloL, was cloned into the vector for use in a complementation study with a non-nodulating nfrloL mutant of soybean. Complementation was achieved and, without exception, DsRed2 fluorescence was detected in all hairy roots that successfully formed nodules （100%, n = 34）. We anticipate broad application of this reporter system for the further analysis of root-related events in soybean and related legumes.

关键词： Fluorescence imaging genetics molecular biology plant-microbe interactions soybean plant transformation.

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Molecular Analysis of Legume Nodule Development and Autoregulation

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Journal of Integrative Plant Biology 2010年第1期52卷 61-76页

作者： Brett J. ferguson Arief Indrasumunar Satomi Hayashi Yu-Hsiang Lin Dugald E. Reid peter M. Gresshoff ARC Centre of Excellence for Integrative Legume Research The University of Queensland

Legumes are highly important food, feed and biofuel crops. With few exceptions, they can enter into an intricate symbiotic relationship with specific soil bacteria called rhizobia. This interaction results in the formation of a new root organ called the nodule in which the rhizobia convert atmospheric nitrogen gas into forms of nitrogen that are useable by the plant. The plant tightly controls the number of nodules it forms, via a complex root-to-shoot-to-root signaling loop called autoregulation of nodulation （AON）. This regulatory process involves peptide hormones, receptor kinases and small metabolites. Using modern genetic and genomic techniques, many of the components required for nodule formation and AON have now been isolated. This review addresses these recent findings, presents detailed models of the nodulation and AON processes, and identifies gaps in our understanding of these process that have yet to be fully explained.

关键词： Molecular Analysis of Legume Nodule Development and Autoregulation

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Evidence-based approach to providing informed consent for hip fracture surgery during the COVID-19 era

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World Journal of Orthopedics 2021年第6期12卷 386-394页

作者： Rory Cuthbert David ferguson Babar Kayani Saeef Haque Aoun Ali Asif Parkar peter Bates Krishna Vemulapalli Department of Trauma&Orthopaedic Surgery Queen's Hospital-RomfordLondon RM70AGUnited Kingdom Department of Trauma&Orthopaedic Surgery Royal London HospitalLondon E11FRUnited Kingdom

BACKGROUND Hip fractures are the most common reason for inpatient orthopaedic trauma admission.Urgent surgical intervention for hip fractures has remained a clinical priority throughout the coronavirus disease 2019(COVID-19)pandemic.Despite this,there is a paucity of clinical guidance addressing the informed consent process for hip fracture surgery in COVID-19 positive patients.This is of paramount medicolegal importance in a high-risk patient population.AIM To quantify the additional perioperative risks for COVID-19 positive patients undergoing hip fracture surgery and provide clinicians with an evidence-based framework to establish an informed consent process.METHODS Two hundred and fifty nine consecutive patients undergoing surgical intervention for hip fractures in four hospitals in the United Kingdom were recruited.51 patients were confirmed positive for COVID-19.Predefined outcomes were analyzed over a 30-d postoperative period.COVID-19 positive and COVID-19 negative patients were compared after adjustment for confounding factors.RESULTS COVID-19 positive patients had more intensive care admissions(27%vs 5%,P<0.001),longer inpatient stays(median 23 d vs 9 d,P<0.001)and a higher 30-d mortality(29%vs 10%,P=0.001)than COVID-19 negative patients.Postoperative complications were evident in 74.5%of COVID-19 positive patients.35.3%of COVID-19 positive patients suffered postoperative lower respiratory tract infections with 13.7%developing acute respiratory distress syndrome(ARDS)and 9.8%experiencing symptomatic thromboembolic events.CONCLUSION The COVID-19 pandemic has created uncertainty in the medical community worldwide and poses unique challenges in providing informed consent for surgery.COVID-19 positive patients undergoing hip fracture surgery should be consented for the additional risk of postoperative complications(including lower respiratory tract infection,ARDS,deep vein thrombosis and pulmonary embolism),increased requirement for intensive care admission,longer inpatient stay and higher risk of mortality

关键词： COVID-19 Hip fractures Mortality Morbidity Outcome assessment Informed consent

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Identification of F1 Cassava (<i>Manihot esculenta</i>Crantz) Progeny Using Microsatellite Markers and Capillary Electrophoresis

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American Journal of Plant Sciences 2014年第1期5卷 119-125页

作者： Kyaligonza Vincent Kawuki Robert ferguson Morag Kaweesi Tadeo Baguma Yona Vuzi peter International Institute of Tropical Agriculture Nairobi Kenya Makerere University Kampala Uganda National Crops Resources Research Institute Kampala Uganda National Crops Resources Research Institute Kampala Uganda Makerere University Kampala Uganda

Generation of genetic diversity is necessary in improving on the potential of cassava when faced with various biotic and abiotic challenges. Presently, cassava breeders are breeding for a number of traits, such as drought tolerance, early root bulking, yield, starch, beta-carotene, protein, dry matter, pest and disease resistance, by relying on genetic diversity that exists in manihot esculenta germplasm. Controlled pollination is one of the main methods used to generate genetic diversity in cassava. However, the process of controlled pollination especially in an open field is prone to contamination by illegitimate pollen right from the time of pollination, seed collection, nursery bed establishment to planting of the trials. Therefore, authentication of the progeny obtained from cassava crosses is very important for genetic studies. Twelve informative microsatellite markers were used to verify the authenticity of 364 F1 progeny thought to come from four controlled parental crosses. The transmission of each allele at nine microsatellite loci was tracked from parents to progeny in each of the four Namikonga-derived F1 cassava families. Out of the 364 F1 progeny, 317 (87.1%) were true-to-type, 44 (12.1%) were a product of self-pollination and 3 (0.8%) were a product of open pollination. The consistency of the results obtained using microsatellite markers makes this technique a reliable tool for assessing the purity of progeny generated from cassava crosses.

关键词： Cassava Crosses Authenticity of F1 Progeny Molecular Markers

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大豆结瘤和固氮的现代遗传学与生物技术学

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自然杂志 2009年第6期31卷 320-326页

作者： peter M.Gresshoff Brett J.ferguson Arief Indrasumunar 江群益澳大利亚豆科综合研究中心昆士兰大学

大豆(Glycinemax)是一种重要的供给粮食和动物饲料的主要农作物。作为豆科植物的一员,大豆与一种被称之为根瘤菌的土壤细菌形成了复杂的共生关系,结果导致新的根器官——根瘤的形成。在这个吸引人的新器官中,被植物所囚禁的根瘤菌能把... 详细信息

大豆(Glycinemax)是一种重要的供给粮食和动物饲料的主要农作物。作为豆科植物的一员,大豆与一种被称之为根瘤菌的土壤细菌形成了复杂的共生关系,结果导致新的根器官——根瘤的形成。在这个吸引人的新器官中,被植物所囚禁的根瘤菌能把空气中的氮气转换为可利用的氮肥。在巴西,有助于增加种子收成的细菌菌株借助微生物学手段已经被分离出来。目前,现代遗传学、生物技术学、生理学、生物化学和基因组学使得分离根瘤形成过程中的关键基因成为现实。综合这些研究发现了诱导,并随后控制细胞分裂的一种新的分子机制。笔者所在的研究小组已经在大豆中克隆到了根瘤菌结瘤因子信号的关键受体,以及一些在复杂的根—茎—根信号传递途径中的分子组分,这些组分涉及到肽类激素,受体激酶和小的信号代谢产物。上述发现表明提高大豆产量和抗逆性的大豆改良进入一个新的阶段。

关键词：共生关系干细胞氮肥生物燃料蛋白供给可持续发展

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Engineering osteoarthritic cartilage model through differentiating senescent human mesenchymal stem cells for testing disease-modifying drugs

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Science China(Life Sciences) 2022年第2期65卷 309-327页

作者： Ning Wang Yuchen He Silvia Liu Meagan J.Makarcyzk Guanghua Lei Alexander Chang peter G Alexander Tingjun Hao Anne-Marie Padget Nuria de Pedro Tsapekos Menelaos Hang Lin Department of Orthopaedic Surgery University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Orthopedic Surgery Xiangya HospitalCentral South UniversityChangsha 410008China Department of Pathology University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Bioengineering University of Pittsburgh Swanson School of EngineeringPittsburgh PA 15219USA Department of Bioinformatics University of Pittsburgh School of MedicinePittsburgh PA 15219USA McGowan Institute for Regenerative Medicine University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Biology University of Pittsburgh Dietrich School of Arts and SciencePittsburgh PA 15219USA Department of Research B2B Life Length SLMadrid 28010Spain Xiangya Third Hospital Central South UniversityChangsha 410013China

Significant cellular senescence has been observed in cartilage harvested from patients with osteoarthritis(OA).In this study,we aim to develop a senescence-relevant OA-like cartilage model for developing disease-modifying OA drugs(DMOADs).Spe-cifically,human bone marrow-derived mesenchymal stromal cells(MSCs)were expanded in vitro up to passage 10(P10-MSCs).Following their senescent phenotype formation,P10-MSCs were subjected to pellet culture in chondrogenic medium.Results from qRT-PCR,histology,and immunostaining indicated that cartilage generated from P10-MSCs displayed both senescent and OA-like phenotypes without using other OA-inducing agents,when compared to that from normal passage 4(P4)-MSCs.Interestingly,the same gene expression differences observed between P4-MSCs and P10-MSC-derived cartilage tissues were also observed between the preserved and damaged OA cartilage regions taken from human samples,as demonstrated by RNA sequencing data and other analysis methods.Lastly,the utility of this senescence-initiated OA-like cartilage model in drug development was assessed by testing several potential DMOADs and senolytics.The results suggest that pre-existing cellular senescence can induce the generation of OA-like changes in cartilage.The P4-and P10-MSCs derived cartilage models also represent a novel platform for predicting the efficacy and toxicity of potential DMOADs on both preserved and damaged cartilage in humans.

关键词： osteoarthritis MSC senescence cartilage tissue engineering disease-modifying OA drug senolytic

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Open Journal of Anesthesiology 2014年第4期4卷 88-98页

作者： Kris ferguson Jason Young peter Panagopoulos Philip Khoury George M. McKelvey Samir F. Fuleihan Walid A. Osta Department of Anesthesiology Wayne State University/Detroit Medical Center Detroit USA

The analysis of closed claims and litigations can provide an invaluable tool to improve patient safety by minimizing adverse anesthesia-related outcomes. Analysis of collective data describing such claims is integral to develop new guidelines aimed to reduce adverse anesthesia-related events. In this study, we give a descriptive analysis of anesthesia-related claims at the Detroit Medical Center, Detroit, MI, USA. The study analyzed different components in anesthesia-related closed claims and litigations such as medical, demographic and socio-economic factors. From 67,000 procedures in anesthesiology care provider, related cases claims were made in 0.057% (38/67,000) of all cases. The majority of claims involved procedures involving Caucasian females aged 51-55 years. The highest risk periods involved early shift times during Monday and Tuesday, particularly of procedures performed during August. About 33% of all cases in which death occurred involved patients who received an Obstetrics/Gynecology or an Orthopedic procedure under general anesthesia. The majority of closed claims and litigations cases were distributed between procedures treating nerves injuries and anoxic encephalopathy. The OR and PACU at urban hospitals had the highest claim rates. MD anesthesiologists constituted the lowest proportion of all anesthesia providers involved in closed claims incidents. The average compensation paid was predominately in the range of $200,000-$250,000. In addition to reporting anesthesia related factors involved in closed claims and litigations this study also includes a series of recommendations which may work as a framework for improving anesthesia practices.

关键词： Anesthesia Closed Claims Complications Litigations Malpractice Negligence

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