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Introduction of new techniques and technologies in surgery: Where is transanal total mesorectal excision today?

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World Journal of Gastrointestinal Surgery 2020年第5期12卷 203-207页

作者： Antonio Caycedo-Marulanda Sunil Patel shaila merchant Carl Brown Department of surgery Queen’s University and Kingston General HospitalKingston K7L 2V7OntarioCanada Department of Surgery University of British Columbia and St.Paul HospitalVancouver V6Z 1Y6British ColumbiaCanada

The introduction of new surgical techniques and technologies has traditionally been *** many settings surgeons frequently adopt novel procedures without following a structured program of implementation or *** appearance of innovative technology played a pivotal role in the advancement of new surgical techniques during the industrial *** has been an essential component of surgical development,which led to contemporary surgical techniques such as minimally invasive *** initiatives have been developed to guide the safe introduction of new surgical techniques and other *** include comprehensive concepts such as the Idea,Development,Exploration,Assessment,Long-term study framework,which could be particularly relevant when reflecting on the novel transanal total mesorectal excision(taTME),introduced a decade *** relatively novel and complex procedure promised to overcome some of the major limitations of traditional surgical approaches for rectal *** to the Idea,Development,Exploration,Assessment,Long-term study framework,taTME is in the phase of exploration,where there is an existing and increasing number of reports being published as the experience *** current management of rectal cancer is in a state of radical evolution,with multiple options that were not previously *** TME is only one technique amongst many which could be part of a rectal cancer surgeon’s armamentarium;however,it requires further rigorous study and evaluation.

关键词： Rectal cancer New technology Safety Innovation Transanal surgery

Myeloid-derived suppressor cells in gastrointestinal cancers:A systemic review

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World Journal of Gastrointestinal Oncology 2021年第1期13卷 1-11页

作者： Maham Farshidpour Monjur Ahmed Shilpa Junna Juanita L merchant Inpatient Medicine Banner University of Medical CenterTucsonAZ 85724United States Division of Gastroenterology and Hepatology Department of Internal MedicineThomas Jefferson UniversityPhiladelphiaPA 19107United States Division of Gastroenterology and Hepatology Banner University of Medical CenterTucsonAZ 85724United States

Gastrointestinal(GI)cancers are one of the most common malignancies worldwide,with high rates of morbidity and ***-derived suppressor cells(MDSCs)are major components of the tumor microenvironment(TME).MDSCs facilitate the transformation of premalignant cells and play roles in tumor growth and ***,in patients with GI malignancies,MDSCs can lead to the suppression of T cells and natural killer ***,a better understanding of the role and mechanism of action of MDSCs in the TME will aid in the development of novel immune-targeted therapies.

关键词： Myeloid-derived suppressor cells Gastrointestinal cancers Immune checkpoint inhibitors Tumor progression

H pylori infection causes chronic pancreatitis in Mongolian gerbils

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World Journal of Gastroenterology 2007年第29期13卷 3939-3947页

作者： Gabriele Rieder Arno Karnholz Mechthild Stoeckelhuber Juanita L merchant Rainer Haas Max von Pettenkofer-Institute for Hygiene and Medical Microbiology Ludwig-Maximilians-University 80336 Munich Germany Institute of Anatomy Ludwig- Maximilians-University 80336 Munich Germany University of Michigan Departments of Internal Medicine and Molecular and Integrative Physiology Ann Arbor Michigan United States

AIM： To investigate whether chronic H pylori infection has the potential to induce pancreatitis in the Mongolian gerbil model, and whether it is dependent on an intact type Ⅳ secretion system. METHODS： Mongolian gerbils were infected with wild type （WT） H pylori type Ⅰ strain B128 or its isogenic mutant B128 △cag γ （defective type Ⅳ secretion）. After seven months of infection, H pylori was reisolated from antrum and corpus and Hpylori DNA was analyzed by seminested polymerase chain reaction （PCR）. Inflammation and histological changes were documented in the gastric antrum, corpus, and pancreas by immunohistochemistry. Cytokine mRNA, gastric pH, plasma gastrin, amylase, lipase, and glucose levels were determined. RESULTS： The H pylori infection rate was 95%. Eight infected animals, but none of the uninfected group, developed transmural inflammation and chronic pancreatitis. Extensive interstitial fibrosis and inflammation of the pancreatic lobe adjacent to the antrum was confirmed by trichrome stain, and immuno-histochemically. Pro-inflammatory cytokine mRNA was significantly increased in the antral mucosa of all infected gerbils. In the corpus, only cytokine levels of WT-infected animals andthose developing transmural inflammation and pancreatitis were significantly increased. Levels of lipase, but not glucose or amylase levels, were significantly reduced in the pancreatitis group. H pylori DNA was detected in infected antral and corpus tissue,but not in the pancreas CONCLUSION： H pylori infection is able to induce chronic pancreatitis in Mongolian gerbils independently of the type Ⅳ secretion system, probably by an indirect mechanism associated with a penetrating ulcer.

关键词： H pylori Mongolian gerbil Pancreatitis Gastritis Penetrating ulcer

Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 39-47页

作者： hee yeon kim chang wook kim chung-hwa park jong young choi kyungdo han anwar t merchant yong-moon park division of hepatology department of internal medicinecollege of medicinethe catholic university of korea222Banpo-daeroSeocho-guSeou1 06591Republic of Korea department of biostatistics college of medicinethe catholic university of korea222Banpo-daeroSeocho-guSeou1 06591Republic of Korea department of epidemiology and biostatistics arnold school of public healthuniversity of south carolinaColumbiaSC 29208USA epidemiology branch national institute of environmental health sciencesnational institutes of healthdepartment of health and human servicesResearch Triangle ParkNC 27709USA

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI）〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

关键词： Korea National Health and Nutrition Examination Survey non-alcoholic fatty liver disease sarcopenia skeletal muscle

Immunohistochemical analysis of the Wnt/β-catenin signaling pathway in pancreatic neuroendocrine neoplasms

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World Journal of Gastrointestinal Oncology 2016年第8期8卷 615-622页

作者： Vivian Weiss Julie Dueber Jesse P Wright Justin Cates Frank Revetta Alexander A Parikh Nipun B merchant Chanjuan Shi Department of Pathology Microbiology and Immunology Vanderbilt University Medical Center Department of Surgery Surgical Oncology Vanderbilt University Medical Center Department of Surgery Surgical Oncology University of Miami Hospital

AIM: To investigate the role of the Wnt/β-catenin pathway in pancreatic neuroendocrine neoplasms(PanN ENs). METHODS: Tissue microarrays containing 88 PanN ENs were immunohistochemically labeled with antibodies to β-catenin, E-cadherin, adenomatous polyposis coli(APC), chromogranin and synaptophysin. One case had only metastatic tumors resected, whereas others(n = 87) received pancreatectomy with or without partial hepatectomy. Pathology slides, demographic, clinicopathologic, and follow up data were reviewed. Patients' demographics, clinicopathologic features, and immunohistochemical results from 87 primary tumors were compared between patients with low stage(stage Ⅰ/Ⅱ) and high stage(stage Ⅲ/Ⅳ) tumors. In addition, correlation of immunohistochemical results from primary tumors with disease-specific survival(DSS) was evaluated. RESULTS: Strong membranous β-catenin staining in the primary tumor was observed in all 13 stage Ⅲ/Ⅳ Pan NENs as compared to 47%(35/74) of stage Ⅰ/Ⅱtumors(P < 0.01). However, the strong membranous β-catenin staining was unassociated with tumor grade or DSS. Decreased membranous β-catenin staining was associated with decreased membranous E-cadherin labeling. Nuclear β-catenin staining was seen in 15%(2/13) of stage Ⅲ/Ⅳ Pan NENs as compared to 0%(0/74) of stage Ⅰ/Ⅱ tumors(P = 0.02). The case with metastasectomy only also showed nuclear β-catenin staining. Two of the three cases with nuclear β-catenin staining were familial adenomatous polyposis(FAP) patients. Lack of APC expression was seen in 70%(57/81) of the cases, including the 3 cases with nuclear β-catenin staining. Expression of E-cadherin and APC in primary tumor was not correlated with tumor grade, tumor stage, or disease specific survival. CONCLUSION: The Wnt/β-catenin pathway was altered in some PanN ENs, but did not Impact DSS. PanN ENs in FAP patients demonstrated nuclear β-catenin accumulation and loss of APC.

关键词： β-catenin Familial adenomatous polyposis Pancreatic neuroendocrine neoplasm Adenomatous polyposis coli E-cadherin

Phenoloxidase and Melanization Innate Immune Activities in Green Darner Dragonfly Nymphs (Anax junius)

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Advances in Biological Chemistry 2022年第4期12卷 130-141页

作者： Mark merchant Matthew R. McClure Department of Chemistry McNeese State University Lake Charles USA Department of Biology Lamar State College Orange Orange USA

Insects in the Order Odonata are highly subject to infection by gregarine parasites. However, despite the important ecological roles that insects play in every ecosystem in which they exist, little research has been devoted to the description of insect immunity. Insects rely heavily on the rapid actions of innate immune mechanisms to prevent infection. We characterized the melanization response in the hemolymph of green darner dragonfly (Anax junius) nymphs. Incubation of chymotrypsin-activated hemolymph with L-DOPA resulted in volume- and time-dependent production of dopaquinone via the phenoloxidase (PO) enzyme, with biphasic accumulation of product. The PO activity was temperature-dependent, with a stepwise increase from 20℃ - 35℃ and maximum activity measured at 35℃ - 40℃. The formation of product was also inhibited in a concentration-dependent manner by diethylcarbonate, a specific inhibitor of PO activity, which indicated that the observed activity was due to the presence of PO enzyme. The rate of formation and quantity of melanin was dependent on exposure to different titers of bacteria. This is the first characterization of both PO activity and melanization response in green darner dragonflies.

关键词： Aquatic Insects Arthropod Dragonfly Hemolymph Innate Immunity Insect

Enhancing medical-imaging artificial intelligence through holistic use of time-tested key imaging and clinical parameters:Future insights

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Artificial Intelligence in Medical Imaging 2022年第3期3卷 55-69页

作者： Prakash Nadkarni Suleman Adam merchant College of Nursing University of IowaIowa CityIA 52242United States Department of Radiology LTM Medical College&LTM General HospitalMumbai 400022MaharashtraIndia

Much of the published literature in Radiology-related Artificial Intelligence(AI)focuses on single tasks,such as identifying the presence or absence or severity of specific *** comparable to that achieved for general-purpose computer vision has been hampered by the unavailability of large and diverse radiology datasets containing different types of lesions with possibly multiple kinds of abnormalities in the same ***,since a diagnosis is rarely achieved through an image alone,radiology AI must be able to employ diverse strategies that consider all available evidence,not just imaging *** key imaging and clinical signs will help improve their accuracy and utility *** strategies that consider all available evidence will be a formidable task;we believe that the combination of human and computer intelligence will be superior to either one ***,unless an AI application is explainable,radiologists will not trust it to be either reliable or bias-free;we discuss some approaches aimed at providing better explanations,as well as regulatory concerns regarding explainability(“transparency”).Finally,we look at federated learning,which allows pooling data from multiple locales while maintaining data privacy to create more generalizable and reliable models,and quantum computing,still prototypical but potentially revolutionary in its computing impact.

关键词： Medical imaging Artificial intelligence Federated learning holistic approach Quantum computing Future insights

UAS-Based Plant Phenotyping for Research and Breeding Applications

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Plant Phenomics 2021年第1期3卷 242-262页

作者： Wei Guo Matthew E.Carroll Arti Singh Tyson L.Swetnam Nirav merchant Soumik Sarkar Asheesh K.Singh Baskar Ganapathysubramanian Graduate School of Agricultural and Life Sciences The University of TokyoJapan Department of Agronomy Iowa State UniversityAmesIowaUSA BIO5 Institute University of ArizonaTucsonUSA Data Science Institute University of ArizonaTucsonUSA Department of Mechanical Engineering Iowa State UniversityAmesIowaUSA

Unmanned aircraft system(UAS)is a particularly powerful tool for plant phenotyping,due to reasonable cost of procurement and deployment,ease and flexibility for control and operation,ability to reconfigure sensor payloads to diversify sensing,and the ability to seamlessly fit into a larger connected phenotyping *** advantages have expanded the use of UAS-based plant phenotyping approach in research and breeding *** paper reviews the state of the art in the deployment,collection,curation,storage,and analysis of data from UAS-based phenotyping *** discuss pressing technical challenges,identify future trends in UAS-based phenotyping that the plant research community should be aware of,and pinpoint key plant science and agronomic questions that can be resolved with the next generation of UAS-based imaging modalities and associated data analysis *** review provides a broad account of the state of the art in UAS-based phenotyping to reduce the barrier to entry to plant science practitioners interested in deploying this imaging modality for phenotyping in plant breeding and research areas.

关键词： breeding Plant payload

Characterization of Chitotriosidase Enzyme Activity in the Serum of the American Alligator (<i>Alligator mississippiensis</i>)

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Advances in Biological Chemistry 2018年第5期8卷 81-90页

作者： Kenneth Kidder Rodolfo Falconi Mark merchant Department of Chemistry McNeese State University Lake Charles USA

Chitotriosidase (ChT) is an endoglucosaminidase enzyme that cleaves chitinous substrates and has been strongly associated with innate immune activity and the ability to identify non-selftissues. This enzyme activity was detected and characterized the serum from the American alligator (Alligator mississippiensis) using a fluorometric probe. Alligator serum exhibited volume-dependent activity, with activity (2.1 ± 0.3 μmol/min) observed at dilutions as low as a 1:150, and maximum activity (5.2 ± 0.6 μmol/min) measured at a dilution of 1:30. Alligator serum ChT showed linear activity for approximately 20 min, at which time activity decreased exponentially, presumably due to the depletion of substrate. In addition, the ChT activity in alligator serum was temperature-dependent with low activity at 5°C, a sharp increase from 10°C - 30°C, and maximal activity from 30°C - 40°C. The activity was inhibited in the presence of water-soluble chitin, but not mannan, indicating the specificity of the enzyme. The presence of ChT in alligator serum is likely to be partially responsible for the potent innate immune system of these crocodylians, and particularly antifungal activities.

关键词： Antifungal Crocodilian Crocodylian Innate Immunity