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Predicting early graft loss in pancreas transplantation using novel imaging techniques: are we there yet?

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 276-279页

作者： Samrat Ray trevor w.reichman Ajmera Transplant Centre Toronto General HospitalUniversity Health NetworkTorontoONCanada Department of Surgery University of TorontoTorontoONCanada

Since its inception in 1966 at the University of Minnesota,pancreas transplantation has witnessed major milestones in evolution of surgical techniques,immunosuppression regimen and more recently,machine perfusion for ... 详细信息

关键词： Hyperspectral imaging(HSI) pancreas transplantation duodenal leaks early graft loss

Using on-site liver 3-D reconstruction and volumetric calculations in split liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 587-592页

作者： trevor w reichman Brittany Fiorello Ian Carmody Humberto Bohorquez Ari Cohen John Seal David Bruce George E Loss Ochsner Multi-Organ Transplant Institute Ochsner Medical Center

BACKGROUND： Split liver transplantation increases the number of grafts available for transplantation. Pre-recovery assessment of liver graft volume is essential for selecting suitable recipients. The purpose of this study was to determine the ability and feasibility of constructing a 3-D model to aid in surgical planning and to predict graft weight prior to an in situ division of the donor liver. METHODS： Over 11 months, 3-D volumetric reconstruction of 4 deceased donors was performed using Pathfinder Scout liver volumetric software. Demographic, laboratory, operative, perioperative and survival data for these patients along with donor demographic data were collected prospectively and analyzed retrospectively. RESULTS： The average predicted weight of the grafts from the adult donors obtained from an in situ split procedure were 1130 g （930-1458 g） for the extended right lobe donors and 312 g （222-396 g） for left lateral segment grafts. Actual adult graft weight was 92% of the predicted weight for both the extended right grafts and the left lateral segment grafts. The predicted and actual graft weights for the pediatric donors were 176 g and 210 g for the left lateral segment grafts and 308 g and 280 g for the extended right lobe grafts,respectively. All grafts were transplanted except for the right lobe from the pediatric donors due to the small graft ***： On-site volumetric assessment of donors provides useful information for the planning of an in situ split and for selection of recipients. This information may expand the donor pool to recipients previously felt to be unsuitable due to donor and/or recipient weight.

关键词： split liver transplantation reduced-size liver transplantation 3-D reconstruction

“weighing the risk”: Obesity and outcomes following liver transplantation

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world Journal of Hepatology 2015年第11期7卷 1484-1493页

作者： trevor w reichman George Therapondos Maria-Stella Serrano John Seal Rachel Evers-Meltzer Humberto Bohorquez Ari Cohen Ian Carmody Emily Ahmed David Bruce George E Loss Multi-Organ Transplant Institute Ochsner Medical Center

Obesity is on the rise worldwide. As a result, unprecedented rates of patients are presenting with end stage liver disease in the setting of non-alcoholic fatty liver disease(NAFLD) and are requiring liver transplantation. There are significant concerns that the risk factors associated with obesity and the metabolic syndrome might have a detrimental effect on the long term outcomes following liver transplantation. In general, short term patient and graft outcomes for both obese and morbidly obese patients are comparable with that of non-obese patients, however, several studies report an increase in peri-operative morbidity and increased length of stay. Continued studies documenting the long-term outcomes from liver transplantation are needed to further examine the risk of recurrent disease(NAFLD) and also further define the role risk factors such cardiovascular disease might play long term. Effective weight reduction in the post liver transplant setting may mitigate the risks associated with the metabolic syndrome long-term.

关键词： End stage liver disease Obesity Morbidobesity Non-alcoholic steatohepatitis Non-alcoholicfatty liver disease Cirrhosis Liver transplantation

Liver transplantation and the management of progressive familial intrahepatic cholestasis in children

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world Journal of Transplantation 2016年第2期6卷 278-290页

作者： Ashley Mehl Humberto Bohorquez Maria-Stella Serrano Gretchen Galliano trevor w reichman University of Queensland-Ochsner Clinical School of Medicine Multi-Organ Transplant Institute Ochsner Medical Center Section of Pediatric Gastroenterology Hepatologyand NutritionDepartment of PediatricsOchsner Medical Center Department of Pathology Ochsner Medical Center

Progressive familial intrahepatic cholestasis(PFIC) is a constellation of inherited disorders that result in the impairment of bile flow through the liver that predominantly affects children. The accumulation of bile results in progressive liver damage, and if left untreated leads to end stage liver disease and death. Patients often present with worsening jaundice and pruritis within the first few years of life. Many of these patients will progress to end stage liver disease and require liver transplantation. The role and timing of liver transplantation still remains debated especially in the management of PFIC1. In those patients who are appropriately selected, liver transplantation offers an excellent survival benefit. Appropriate timing and selection of patients for liver transplantation will be discussed, and the short and long term management of patients post liver transplantation will also be described.

关键词： Pediatric liver transplant Progressive familial intrahepatic cholestasis Familial intrahepatic cholestasis protein 1 Cholestasis Multidrug resistance protein 3 Pediatric jaundice Bile salt excretion protein

Using proteomics to compare the molecular structures of sulfide and permeate-depilated sheepskins

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Collagen and Leather 2024年第1期6卷 70-84页

作者： Yi-Hsuan Tu trevor S.Loo Mark L.Patchett Gillian E.Norris School of Natural Sciences Massey UniversityPalmerston NorthNew Zealand

An environmentally friendly method using real or artificial bovine milk permeate to both depilate and preserve sheepskins has been reported which completely and cleanly removed the wool from the hair follicle and had no detrimental effects on the skin.A proteomic analysis,assessing the relative abundance of proteins in matched permeate-depilated and chemically depilated(sulfide)sheepskins,showed variations in the levels of specific collagen types in the skin's basement membrane and other proteins associated with the *** findings were corroborated by biochemical analyses of matched permeate depilated and raw skin samples,and provide clues to the mechanism of non-invasiveand complete *** also support the observation that permeate-depilated skins were smoother than their sulfide-depilated counterparts and resulted in leather with a superior surface.

关键词： Collagen Collagen crosslinks Glycosaminoglycan Proteomics Relative abundance

Electrobiocorrosion by microbes without outer-surface cytochromes

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mLife 2024年第1期3卷 110-118页

作者： Dawn E.Holmes trevor L.woodard Jessica A.Smith Florin Musat Derek R.Lovley Department of Microbiology University of Massachusetts AmherstAmherstMassachusettsUSA Department of Physical and Biological Science Western New England UniversitySpringfieldMassachusettsUSA Department of Biomolecular Sciences Central Connecticut State UniversityNew BritainConnecticutUSA Department of Biology Section for MicrobiologyAarhus UniversityAarhusDenmark Department of Molecular Biology and Biotechnology Facuity of Biology and GeologyBabes-Bolyai UniversityCluj-NapocaRomania

Anaerobic microbial corrosion of iron-containing metals causes extensive economic *** microbes are capable of direct metal-to-microbe electron transfer(electrobiocorrosion),but the prevalence of electrobiocorrosion among diverse methanogens and acetogens is poorly understood because of a lack of tools for their genetic *** studies have suggested that respiration with 316L stainless steel as the electron donor is indicative of electrobiocorrosion,because,unlike pure Fe^(0),316L stainless steel does not abiotically generate H_(2) as an intermediary electron ***,we report that all of the methanogens(Methanosarcina vacuolata,Methanothrix soehngenii,and Methanobacterium strain IM1)and acetogens(Sporomusa ovata and Clostridium ljungdahli)evaluated respired with pure Fe^(0)as the electron donor,but only ***,***,and *** were capable of stainless steel *** electrobiocorrosive methanogens re-quired acetate as an additional energy source in order to produce methane from stainless *** of *** and *** demonstrated how acetogens can provide acetate to methanogens during *** only was Meth-anobacterium strain IM1 not capable of electrobiocorrosion,but it also did not accept electrons from Geobacter metal-lireducens,an effective electron-donating partner for direct interspecies electron transfer to all methanogens that can directly accept electrons from Fe^(0).The finding that ***,***,and *** are capable of electrobiocorrosion,despite a lack of the outer-surface c-type cytochromes previously found to be important in other electrobiocorrosive microbes,demonstrates that there are multiple microbial strategies for making electrical contact with Fe^(0).

关键词： acetogen corrosion Fe^(0) methanogen stainless steel

Quasi-Static, Poiseuille Flow of Analgesics from an Elastomeric Pump: Theoretical Determination of Infusion Times and Toxicity Conditions

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Journal of Biosciences and Medicines 2024年第9期12卷 251-265页

作者： Clare B. Lipscombe trevor C. Lipscombe Don S. Lemons Division of General Surgery Vanderbilt University Medical Center Nashville TN USA Catholic University of America Press Washington DC USA Department of Physics Bethel College North Newton KS USA

Background: Elastomeric pumps (elastic balls into which analgesics or antibiotics can be inserted) push medicines through a catheter to a nerve or blood vessel. Since elastomeric pumps are small and need no power source, they fit easily into a pocket during infusion, allowing patient mobility. Elastomeric pumps are widely used and widely studied experimentally, but they have well-known problems, such as maintaining reliable flow rates and avoiding toxicity or other peak-and-trough effects. Objectives: Our research objective is to develop a realistic theoretical model of an elastomeric pump, analyze its flow rates, determine its toxicity conditions, and otherwise improve its operation. we believe this is the first such theoretical model of an elastomeric pump consisting of an elastic, medicine-filled ball attached to a horizontal catheter. Method: Our method is to model the system as a quasi-Poiseuille flow driven by the pressure drop generated by the elastic sphere. we construct an engineering model of the pressure exerted by an elastic sphere and match it to a solution of the one-dimensional radial Navier-Stokes equation that describes flow through a horizontal, cylindrical tube. Results: Our results are that the model accurately reproduces flow rates obtained in clinical studies. we also discover that the flow rate has an unavoidable maximum, which we call the “toxicity bump”, when the radius of the sphere approaches its terminal, unstretched value—an effect that has been observed experimentally. Conclusions: we conclude that by choosing the properties of an elastomeric pump, the toxicity bump can be restricted to less than 10% of the earlier, relatively constant flow rate. Our model also produces a relation between the length of time that the analgesic fluid infuses and the physical properties of the fluid, of the elastomeric sphere and the tube, and of the blood vessel into which the analgesic infuses. From these, we conclude that elastomeric pumps can be design

关键词： Elastomeric Pump Infusion Therapy Bio-Fluids Medical Devices Antibiotic Delivery Analgesic Delivery

Anal cancer screening in women with a history of human papillomavirusrelated lower genital tract cancers:a pilot study

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 88-93页

作者： Isobel Mary Poynten Fengyi Jin Rhonda Farrell trevor Tejada-Berges Carmella Law Richard Hillman Jennifer Roberts Andrew Grulich The Kirby Institute University of New South WalesSydneyNew South WalesAustralia Chris O'Brien Lifehouse SydneyNew South WalesAustralia Prince of wales Private Hospital RandwickNew South WalesAustralia Dysplasia and Anal Cancer Services St Vincent's Hospital SydneyDarlinghurstNewSouthWalesAustralia Douglass Hanly Moir Pathology SydneyNew South WalesAustralia

Objectives women diagnosed with a history of lower genital tract cancer(LGTC)and precancer are at increased risk of anal *** for anal cancer in a manner analogous to cervical cancer may detect precursor anal high-grade squamous intraepithelial lesions(HSILs)and prevent progression to *** In a pilot study of anal cancer screening,women with previous LGTC and aged≥18 years in Sydney,Australia underwent a digital anorectal examination,anal swab for human papillomavirus(HPV)and p16/Ki67 testing and completeda *** with positive HPV and/or p16/Ki67 results were referred for a high-resolution anoscopy(HRA)and evaluation of their *** Of 52 participants,46 agreed to screening and 6 provided demographic information *** age was 46.5 years(IQR:36.059.0).Anal high-risk HPV(HRHPV)was detected in only seven(15.2%)participants(three HPV16).Eight(17.4%)had positive p16/Ki67 dual staining,with invalid results for 25(54.4%).0f 10 women referred for HRA,9 attended and 3 had HSILs,representing 6.5%of the screened *** were completed by 41 participants(89.1%).The majority reported that being screenedwas reassuring(97.5%)and was positive for their health(95.1%).Conclusion This pilot study demonstrated a lower-than-expected prevalence of anal *** with HRHPV and p16/Ki67 staining identified anal HSILs in 6.5%of ***,screeningwas viewed as beneficial by almost all *** utility of p16/Ki67dual staining was low,suggesting it may not be a suitable anal cancer screening methodology.

关键词： pilot Sydney screening

The epididymis, cytoplasmic droplets and male fertility

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Asian Journal of Andrology 2011年第1期13卷 130-138页

作者： trevor G Cooper Centre of Reproductive Medicine and Andrology University of MOnster MOnster D-48149 Germany

The potential of spermatozoa to become motile during post-testicular maturation, and the relationship between the cytoplasmic droplet and fertilizing capacity are reviewed. Post-testicular maturation of spermatozoa involves the autonomous induction of motility, which can occur in vivo in testes with occluded excurrent ducts and in vitro in testicular explants, and artefactual changes in morphology that appear to occur in the testis in vitro. Both modifications may reflect time-dependent oxidation of disulphide bonds of head and tail proteins. Regulatory volume decrease （RVD）, which counters sperm swelling at ejaculation, is discussed in relation to loss of cytoplasmic droplets and consequences for fertility. It is postulated that：（i） fertile males possess spermatozoa with sufficient osmolytes to drive RVD at ejaculation, permitting the droplet to round up and pinch off without membrane rupture; and （ii） infertile males possess spermatozoa with insufficient osmolytes so that RVD is inadequate, the droplet swells and the resulting flagellar angulation prevents droplet loss. Droplet retention at ejaculation is a harbinger of infertility caused by failure of the spermatozoon to negotiate the uterotubal junction or mucous and reach the egg. In this hypothesis, the epididymis regulates fertility indirectly by the extent of osmolyte provision to spermatozoa, which influences RVD and therefore droplet loss. Man is an exception, because ejaculated human spermatozoa retain their droplets. This may reflect their short midpiece, approximating head length, permitting a swollen droplet to extend along the entire midpiece; this not only obviates droplet migration and flagellar angulation but also hampers droplet loss.

关键词： epididymis fertility infertility sperm maturation