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Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor

World Journal of Gastrointestinal Surgery 2023年第12期15卷 2739-2746页

作者： Francisco Javier Pérez Lara Rogelio Zubizarreta Jimenez Tatiana Prieto-Puga Arjona pilar gutierrez delgado Juan Manuel Hernández Carmona Jose Manuel Hernández Gonzalez Maria Pitarch Martinez Department of Surgery Hopital de AntequeraAntequera 29200Spain DOXA MicrofluidicsRincon de la Victoria 29730Spain Department of Surgery HRU Carlos HayaUnidad Cirugia Hepatobiliopancreat&TrasplantesMalaga 29200Spain

BACKGROUND Giant hernias present a significant challenge for digestive surgeons.The approach taken(laparoscopic vs thoracoscopic)depends largely on the preferences and skills of each surgeon,although in most cases today the laparoscopic approach is preferred.AIM To determine whether patients presenting inadequate laparoscopic access to the intrathoracic hernial sac obtain poorer postoperative results than those with no such problem,in order to assess the need for a thoracoscopic approach.METHODS For the retrospective series of patients treated in our hospital for hiatal hernia(n=112),we calculated the laparoscopic field of view and the working area accessible to surgical instruments,by means of preoperative imaging tests,to assess the likely outcome for cases inaccessible to laparoscopy.RESULTS Patients with giant hiatal hernias for whom a preoperative calculation suggested that the laparoscopic route would not access all areas of the intrathoracic sac presented higher rates of perioperative complications and recurrence during follow-up than those for whom laparoscopy was unimpeded.The difference was statistically significant.Moreover,the insertion of mesh did not improve results for the non-accessible group.CONCLUSION For patients with giant hiatal hernias,it is essential to conduct a preoperative evaluation of the angle of vision and the working area for surgery.When parts of the intrathoracic sac are inaccessible laparoscopically,the thoracoscopic approach should be considered.

关键词： Hiatal hernia Abdominal surgery Laparoscopy Thoracoscopy surgery

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Helicobacter pylori CagA protein polymorphisms and their lack of association with pathogenesis

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World Journal of Gastroenterology 2010年第31期16卷 3936-3943页

作者： Nicole Acosta Andrés Quiroga pilar delgado María Mercedes Bravo Carlos Jaramillo Molecular Diagnostics and Bioinformatics Laboratory Biological Sciences DepartmentLos Andes University Infectious Agents and Cancer Research Group National Cancer Institute(Colombia)

AIM: To investigate Helicobacter pylori (H. pylori) CagA diversity and to evaluate the association between protein polymorphisms and the occurrence of gastric pathologies. METHODS: One hundred and twenty-two clinical isolates of H. pylori cultured from gastric biopsies obtained from Colombian patients with dyspepsia were included as study material. DNA extracted from isolates was used to determine cagA status, amplifying the C-terminal cagA gene region by polymerase chain reaction. One hundred and six strains with a single amplicon were sequenced and results were used to characterize the 3' variable region of the cagA gene. To establish the number and type of tyrosine phosphorylation motifs Glutamine acid-Proline-Isoleucine-Tyrosine-Alanine (EPI-YA) bioinformatic analysis using Amino Acid Sequence Analyzer-Amino Acid Sequence Analyzer software was conducted. Analysis of the association between the number of EPIYA motifs and the gastric pathology was performed using χ2 test and analysis of the presence of EPIYA-C motifs in relation to the pathology was made by logistic regression odds ratios. Comparisons among EPIYA types found and those reported in GenBank were performed using a proportion test in Statistix Analytical Software version 8.0. RESULTS: After amplification of the 3' of the cagA gene, 106 from 122 isolates presented a single amplicon and 16 showed multiple amplicons. As expected, diversity in the size of the cagA unique fragments among isolates was observed. The 106 strains that presented a single amplicon after 3' cagA amplification came from patients with gastritis (19 patients), atrophic gastritis (21), intestinal metaplasia (26), duodenal ulcer (22) and gastric cancer. DNA sequence analysis showed that the differences in size of 3' cagA unique fragments was attributable to the number of EPIYA motifs: 1.9% had two EPIYA motifs, 62.3% had three, 33.0% had four and 2.8% had five motifs. The majority of tested clinical strains (62.3%) were found to harbor the ABC combination of EPIYA motifs and a signi

关键词： Helicobacter pylori CagA-protein polymorphisms Molecular characterization Bioinformatic analysis Pathogenesis Cancer

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Stable and efficient metal-biochar supported catalyst:degradation of model pollutants through sulfate radical-based advanced oxidation processes

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Biochar 2020年第3期2卷 319-328页

作者： Fermín delgado Victoria S.gutierrez Mariana Dennehy Mariana Alvarez INQUISUR Departamento de QuímicaUniversidad Nacional del SurAv.Alem 12538000 Bahía BlancaArgentina Planta Piloto de Ingeniería Química PLAPIQUI(CONICET-UNS)Camino La Carrindanga Km 78000 Bahía BlancaArgentina

This study focuses on the synthesis of metal-based biochar catalysts and their catalytic activation of peroxymonosulfate(PMS,HSO5−)for the degradation of three different wastewater model pollutants employing advanced oxidation processes(AOP).Iron,copper,and two different cobalt-based catalysts were prepared and evaluated.The catalysts were supported on a biochar obtained from the pyrolysis of woody pruning wastes.They were characterized by C,H,and N elemental analysis,X-Ray diffraction(XRD),Fourier-transform infrared spectroscopy(FTIR),and scanning electron microscope(SEM).The metal content in each catalyst was determined by means of atomic absorption spectroscopy(AAS).The degradation reac-tions of benzoic acid(BA),catechol(C),and cinnamic acid(CA)were carried out in a lab scale batch glass reactor and were followed by UV-Visible spectroscopy(UV-Vis).A colorimetric technique was employed to verify the presence of oxidant during the reaction progress.The catalyst/oxidant optimal ratio was determined for the cobalt catalysts.The mineralization degree of the pollutants after the degradations was verified by means of total organic carbon(TOC)content in the residual liquids.After 4 h of reaction,the maximum mineralization was reached when C was treated with a cobalt-based catalyst(>80%),and its stability was evaluated through successive cycles of use.

关键词： Biochar Organic pollutants Advanced oxidation processes Sulfate radicals Cobalt catalysts

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Phase Ⅱ trial of CDK4/6 inhibitor palbociclib in advanced sarcoma based on mRNA expression of CDK4/CDKN2A

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Signal Transduction and Targeted Therapy 2023年第11期8卷 5518-5527页

作者： Javier Martin-Broto Jeronimo Martinez-Garcia David SMoura Andres Redondo Antonio gutierrez Antonio Lopez-Pousa Javier Martinez-Trufero Isabel Sevilla Roberto Diaz-Beveridge Maria pilar Solis-Hernandez Amancio Carnero Marco Perez David Marcilla Jesus Garcia-Foncillas Pablo Romero Javier Fernandez-Jara Daniel Lopez-Lopez Ivan Arribas Nadia Hindi Health Research Institute-Fundación Jiménez Díaz University Hospital Universidad Autónoma de Madrid(IIS-FJDUAM)28040MadridSpain Medical Oncology Department Fundación Jimenez Diaz University Hospital28040MadridSpain General de Villalba University Hospital 28400MadridSpain Medical Oncology Department University Hospital Virgen de la Arrixaca30120MurciaSpain Department of Medical Oncology Hospital Universitario La Paz-IdiPAZP.Castellana26128046MadridSpain Hematology Department University Hospital Son Espases07120MallorcaSpain Medical Oncology Department Sant Pau Hospital08025BarcelonaSpain Medical Oncology Department University Hospital Miguel Servet50009ZaragozaSpain Investigación Clínica y Traslacional en Cáncer/Instituto de Investigaciones Biomédicas de Malaga(IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria de Malaga MalagaSpain Medical Oncology Department Hospital Universitari i Politècnic La Fe46026ValenciaSpain Medical Oncology Department Central University Hospital of Asturias33011OviedoSpain Instituto de Biomedicina de Sevilla(IBiS HUVRCSICUS)41013SevillaSpain Pathology Department Virgen del Rocio University Hospital41013SevillaSpain Radiology Department Fundación Jimenez Diaz University Hospital28040MadridSpain Computational Medicine Platform Fundación progreso y salud(FPS)Hospital Virgen del Rocío41013SevilleSpain Bioinformatics in Rare Diseases(BiER).Centro de Investigación Biomédica en Red de Enfermedades Raras(CIBERER) FPSHospital Virgen del RocioSevillaSpain Universitat de València-ERI-CES 46010ValenciaSpain

Cyclin-dependent kinases 4 and 6(CDK4/6)inhibitors demonstrated activity in terms of progression-free survival(PFS)in advanced dedifferentiated liposarcoma(DD-LPS),a sarcoma with CDK4 amplification.CDK4 overexpression is by far more common than amplification in sarcomas and it might be a rational target for CDK inhibitors.Preclinical investigators of this study found that CDK4 overexpression,while not of CDKN2A,was the most consistent predictive factor for palbociclib efficacy in sarcomas.Advanced adult-type soft-tissue sarcoma,excluding DD-LPS,or bone sarcoma patients,progressing after at least one systemic line,whose tumors overexpressed CDK4,but not CDKN2A at baseline biopsy,were accrued in this single-arm phase II trial(EudraCT number:2016-004039-19).With the main endpoint of a 6-month PFS rate,40%was considered promising in this population.Palbociclib was administered orally at 125 mg/day for 21 days in 28-day cycles.A total of 214 patients with 236 CDK4/CDKN2A determinations were assessed for prescreening,archival material(141),and screening,baseline biopsy(95).There were 28(29%)with favorable mRNA profiles from 95 screened patients at baseline.From 23 enrolled patients,21 evaluable,the 6-month PFS rate was 29%(95%CI 9–48),and there were 6 patients out of 21 with a PFS longer than 6 months.The median PFS and overall survival were 4.2(95%CI 3.6–4.8)and 12(95%CI 8.7–15.4)months,respectively.Translational research showed a significant correlation between CDK4 mRNA and protein expression.Palbociclib was active in a variety of sarcoma subtypes,selected by CDK4/CDKN2A,and deserves further investigation in the sarcoma context.

关键词： CDKN2A sarcoma CDK4

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Acute postoperatory visual loss following bilateral lung transplantation surgery:a case series

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International Journal of Ophthalmology(English edition) 2017年第5期10卷 822-825页

作者： Rosa gutierrez-Bonet Jorge Ruiz-Medrano Maria Alarcon-Tomas Mónica Hijos pilar Cifuentes-Canorea Puerta de Hierro University Hospital Ophthalmology Department Madrid 28222 Spain Jules Gonin Eye Hospital Lausanne 1002 Switzerland Clinico San Carlos University Hospital Madrid 28040 Spain

Dear Editor,I am Rosa Gutiérrez Bonet,former ophthalmology resident at Puerta de Hierro University Hospital,Madrid,Spain.I write to present four cases of cortical blindness（CB）after bilateral lung transplant（LT）.

关键词： lung Acute postoperatory visual loss following bilateral lung transplantation surgery a case series case

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Effect of Nd3+doping on structure,microstructure,lattice distortion and electronic properties of TiO_2 nanoparticles

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Journal of Rare Earths 2017年第3期35卷 259-270页

作者： Balter Trujillo-Navarrete María del pilar Haro-Vázquez Rosa María Félix-Navarro Francisco Paraguay-delgado Henry Alvarez-Huerta Sergio Pérez-Sicairos Edgar Alonso Reynoso-Soto institute technology of tijuana(itt) blvd.alberto limón padillaP.O.B 1166.Tijuana B.C.Mexico university autonomous of baja california(uabc) roadway university14418P.O.B 22390Tijuana B.C.Mexico investigations center of advanced materials(cimav).miguel de cervantes 120.P.O.B31109ChihuahuaMexico

Doped and undoped TiCh nanoparticles were prepared by Stober method and thermally treated at 600 ℃.The effect of Nd^（3＋） ion on the structure and micro structure of anatase-phase TiCh nanocrystals was studied by Rietveld refinement method using X-ray powder diffraction data.Bond lengths,bond angles,and edges distances were analyzed.The phase formation was confirmed by high-resolution transmission electron microscopy.The adjustment of Ti-0 bond length induced by the addition of Nd^（3＋） ions,reduced the octahedral distortion and altered the octahedral array in the anatase-phase TiCh nanocrystal.The changes of structure and microstructure were mainly observed for TiCh nanoparticles doped with 0.1 at.%of Nd^（3＋） ions and attributed to the cationic substitution of Ti^（4＋） ions which promoted changes in the density of states and gap band of TiCh.The dopant insertion resulted in a better structural stability of the nanocrystals that enhanced their charge transference and photocatalytic efficiency.

关键词： neodymium TiO_2 nanoparticles microstructure lattice distortion photocatalytic activity optical properties Rietveld refinement rare earths

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Pulmonary arterial hypertension related to human immunodeficiency virus infection:A case series

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World Journal of Cardiology 2014年第6期6卷 495-501页

作者： Inês Araújo Cristina Enjuanes-Grau Carmen Jimenez Lopez-Guarch Dariusz Narankiewicz Maria J Ruiz-Cano Teresa Velazquez-Martin Juan delgado pilar Escribano 3~(rd) Medicine Department S?o Francisco Xavier HospitalCHLO1449-005 LisboaPortugal Cardiology Department University Hospital of Canarias38320 La LagunaTenerifeSpain Teresa Velazquez-Martin Juan DelgadoPilar EscribanoPulmonary Hypertension UnitUniversity Hospital of 12 de Octubre28041 MadridSpain Internal Medicine Department Carlos Haya Hospital29010 MálagaSpain Pulmonary Hypertension Unit University Hospital of 12 de Octubre28041 MadridSpain

AIM: To present 18 new cases of human immunodeficiency virus(HIV)-related pulmonary arterial hypertension(PAH) with presenting features,treatment options and follow-up data.METHODS: This is a single-centre,retrospective,observational study that used prospectively collected data,conducted during a 14-year period on HIV-related PAH patients who were referred to a pulmonary hy-pertension unit. All patients infected with HIV were consecutively admitted for an initial evaluation of PAH during the study period and included in our study. Right heart catheterisation was used for the diagnosis of PAH. Specific PAH treatment was started according to the physician's judgment and the recommendations for idiopathic PAH. The data collected included demographic characteristics,parameters related to both HIV infection and PAH and disease follow-up.RESULTS: Eighteen patients were included. Intravenous drug use was the major risk factor for HIV infection. Risk factors for PAH,other than HIV infection,were present in 55.5% patients. The elapsed time between HIV infection and PAH diagnoses was 12.2 ± 6.9 years. At PAH diagnosis,94.1% patients had a CD4 cell count > 200 cells/μL. Highly active antiretroviral therapy(present in 47.1% patients) was associated with an accelerated onset of PAH. Survival rates were 93.8%,92.9% and 85.7% at one,two and three years,respectively. Concerning specific therapy,33.3% of the patients were started on a prostacyclin analogue,and the rest were on oral drugs,mainly phosphodiesterase-5 inhibitors. During the follow-up period,specific therapy was de-escalated to oral drugs in all of the living patients.CONCLUSION: The survival rates of HIV-related PAH patients were higher,most likely due to new aggressive specific therapy. The majority of patients were on oral specific therapy and clinically stable. Moreover,sildenafil appears to be a safe therapy for less severe HIVrelated PAH.

关键词：人的免疫不全病毒感染肺的动脉的高血压处理

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YKL40 expression in CD14^+ liver cells in acute and chronic injury

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World Journal of Gastroenterology 2011年第33期17卷 3830-3835页

作者： Oscar Pizano-Martínez Irinea Yaez-Sánchez pilar Alatorre-Carranza Alejandra Miranda-Díaz Pablo C Ortiz-Lazareno Trinidad García-Iglesias Adrian Daneri-Navarro Mónica Vázquez-Del Mercado Mary Fafutis-Morris Vidal delgado-Rizo Department of Physiology CUCSUniversity of GuadalajaraGuadalajaraJalisco 44340México Division of Immunology Centro de Investigación Biomédica de OccidenteIMSS.GuadalajaraJalisco 44340México

AIM:To demonstrate that CD14 + cells are an important source of the growth factor YKL40 in acute and chronic liver damage.METHODS:Rats were inoculated with one dose of CCl4 to induce acute damage.Liver biopsies were obtained at 0,6,12,24,48 and 72 h.For chronic damage,CCl4 was administered three days per week for 6 or 8 wk.Tissue samples were collected,and cellular populations were isolated by liver digestion and purified by cell sorting.YKL40 mRNA and protein expression were evaluated by realtime polymerase chain reaction and western blot.RESULTS:Acute liver damage induced a rapid increase of YKL40 mRNA beginning at 12 h.Expression peaked at 24 h,with a 26fold increase over basal levels.By 72 h however,YKL40 expression levels had nearly returned to control levels.On the other hand,chronic damage induced a sustained increase in YKL40 expression,with 7and 9fold higher levels at 6 and 8 wk,respectively.The pattern of YKL40 expression in different subpopulations showed that CD14+cells,which include Kupffer cells,are a source of YKL40 after acute damage at 72 h[0.09 relative expression units(REU)]as well as after chronic injury at 6 wk(0.11 REU).Hepatocytes,in turn,accounted for 0.06 and 0.01 REU after 72 h(acute)or 6 wk(chronic),respectively.The rest of the CD14cells(including T lymphocytes,B lymphocytes,natural killer and natural killer T cells) yielded 0.07 and 0.15 REU at 72 h and 6 wk,respectively.YKL40 protein expression in liver was detected at 72 h as well as 6 and 8 wk,with the highest expression relative to controls(11fold;P≤0.05)seen at 6 wk.Macrophages were stimulated by lipopolysaccharide.We demonstrate that under these conditions,these cells showed maximum expression of YKL40 at 12 h,with P<0.05 compared with controls.CONCLUSION:Hepatic CD14 + cells are an YKL40 mRNA and protein source in acute and chronic liver injury,with expression patterns similar to growth factors implicated in inflammationfibrogenesis.

关键词：急性肝损伤 CD14 肝细胞慢性细胞生长因子聚合酶链反应四氯化碳蛋白表达

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Short and long term fate of human AMSC subcutaneously injected in mice

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World Journal of Stem Cells 2011年第6期3卷 53-62页

作者： pilar López-Iglesias Alejandro Blázquez-Martínez Jorge Fernández-delgado Javier Regadera Manuel Nistal Maria P De Miguel Cell Engineering Laboratory IdiPazLa Paz Hospital Research Institute Department of Plastic Surgery and Center for Comprehensive Breast Treatment Santa Cristina Hospital Department of Histology and Neuroscience Autonomous University of Madrid 28046Spain Department of Pathology La Paz Hospital

AIM:To study the ability of human adipose-derived mesenchymal stem cells(AMSCs)to survive over the short and long term,their biodistribution and their biosafety in vivo in tumor-prone environments.METHODS:We subcutaneously injected human AMSCs from different human donors into immunodeficient SCID mice over both short-(2 and 4 mo)and long-(17 mo)term in young,and aged tumor-prone mice.Presence of human cells was studied by immunohistochemistry and polymerase chain reaction analysis in all organs of injected mice.RESULTS:Subcutaneously injected AMSCs did not form teratomas at any time point.They did not migrate but remained at the site of injection regardless of animal age,and did not fuse with host cells in any organ examined.AMSCs survived in vivo for at least 17 mo after injection,and differentiated into fibroblasts of the subdermic connective tissue and into mature adipocytes of fat tissue,exclusively at the site of injection.CONCLUSION:Our results support the assertion that AMSC may be safe candidates for therapy when injected subcutaneously because of their long term inability to form teratomas.

关键词： Adipose-derived stem cells Cell transplant SCID mice Teratoma Mesenchymal stem cells Cell therapy Biosafety

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CagA EPIYA polymorphisms in Colombian Helicobacter pylori strains and their influence on disease-associated cellular responses

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World Journal of Gastrointestinal Oncology 2013年第3期5卷 50-59页

作者： Carlos Alberto Fajardo Andrés Javier Quiroga Andrea Coronado Karen Labrador Nicole Acosta pilar delgado Carlos Jaramillo María Mercedes Bravo Cancer and Infectious Agents Research Group National Cancer Institute Molecular Diagnostics and Bioinformatics Laboratory Biological Sciences Department Los Andes University

AIM: To investigate the influence of the CagA diversity in Helicobacter pylori (H. pylori ) strains from Colombia on the host cell biology. METHODS: Eighty-four H. pylori-cagA positive strains with different Glu-Pro-Ile-Tyr-Ala (EPIYA) motifs patterns, isolated from patients with gastritis (n=17), atrophic gastritis (n=17), duodenal ulcer (n=16), intestinal metaplasia (n=16) and gastric cancer (n=18), were included. To determine the integrity of the cag pathogenicity island (cag PAI) we evaluated the presence of cagA, cagT, cagE, and cag10 genes by polymerase chain reaction. AGS gastric epithelial cellswere infected with each strain and assayed for translo-cation and tyrosine phosphorylation of CagA by western blot, secretion of interleukin-8 (IL-8) by enzyme-linked immuno sorbent assay after taking supernatants from cocultures and cell elongation induction. For cell elongation quantification, coculture photographs were taken and the proportion of "hummingbird" cells (>15 μm) was determined. RESULTS: Overall 72% (60/84) of the strains were found to harbor a functional cag PAI. Levels of phos-phorylated CagA were significantly higher for isolates from duodenal ulcer than the ones in strains from gas-tritis, atrophic gastritis, intestinal metaplasia and gastric cancer (49.1% ± 23.1% vs 21.1% ± 19.5%, P < 0.02; 49.1% ± 23.1% vs 26.2%±14.8%, P<0.045; 49.1% ± 23.1% vs 21.5% ± 19.5%, P<0.043 and 49.1% ± 23.1% vs 29.5% ± 27.1%, P < 0.047 respectively). We observed variable IL-8 expression levels ranging from 0 to 810 pg/mL and from 8.8 to 1442 pg/mL at 6 h and 30 h post-infection, respectively. cagPAI-defective strains did not induce detectable levels of IL-8 at 6 h post-infection. At 30 h post-infection all strains induced IL-8 expression in AGS cells, although cagPAI-defective strains induced significantly lower levels of IL-8 than strains with a functional cagPAI (57.1 ± 56.6 pg/mL vs 513.6 ± 338.6 pg/mL,P < 0.0001). We did not observe differences in the extent of cell elongation induction between strains with a func

关键词： Helicobacter pylori cagA 3’region CagA protein Interleukin 8 Cell elongation Glu-Pro-Ile-Tyr-Ala

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