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Pyloric Sympathectomy: A Novel Way to Get Pylorus Relaxation? Report of Two Bariatric Cases

Surgical Science 2024年第6期15卷 381-395页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Rui Ribeiro Paulo Reis Esselin de Melo fernando Fornari Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Lusadas Amadora Hospital Lisboa Portugal Paulo Reis Institute Goinia Brazil Alfredo Nasser University Center (UNIFAN) Goinia Brazil Faculdade de Medicina Universidade de Passo Fundo Passo Fundo Brazil Faculdade de Medicina Universidade Federal da Fronteira do Sul Chapec Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of pyloric sympathectomy on the pylorus motility, leading to its permanent relaxation, observed in two bariatric surgical cases, one primary and the other, revisional. Background: Pyloric sphincter is a physiological barrier to free gastric emptying. In sleeve gastrectomy and in Roux-en-Y gastric bypass revisions, that put the remnant stomach in transit, the pylorus can contribute to generate a high intragastric pressure, which could lead to acute gastric fistulas and/or chronic gastroesophageal reflux disease. The possibility of functionally relaxing the pylorus, promoting intragastric pressure reduction, could represent a protective maneuver against these complications. Methods: We describe herein a surgical maneuver applied in two cases of bariatric surgeries, with the intention of facilitating antrum-duodenal region exposure, in a sleeve gastrectomy and in a Roux-en-Y gastric bypass conversion to SADI-S. For this, a ligation of terminal peripyloric vessels was done, allowing a passage of a tape, which surrounded the pylorus, for its traction. In both cases, 30-day and 1-year endoscopic evaluations were done, to assess esophagitis signs, anastomosis healing and anatomical pouch aspect. A clinical evaluation was also done, to assess gastroesophageal symptoms (validated questionnaire). Results: In the postoperative endoscopic evaluations, no esophagitis were observed in any case and the gastric pouches had normal aspect, with the expected anatomical findings, compatible with the surgeries performed. The anastomosis healed without problems, in the revisional case. Interestingly, in both cases, it was observed a complete pyloric sphincter relaxation, which lasted until 1-year endoscopic evaluation. There were no fistulas, nor esophagitis in any of these cases. Clinically, there were no symptoms of gastroesophageal reflux disease (validated questionnaire). Conclusion: The observation of a

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Sympathectomy Bariatric Surgery

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Multi-omic study to unmask genes involved in prostate cancer development in amulti-case family

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Cancer Communications 2024年第3期44卷 443-447页

作者： Lucia Chica-Redecillas Sergio Cuenca-Lopez Eduardo Andres-Leon Laura Carmen Terron-Camero Blanca Cano-Gutierrez Jose Manuel Cozar Jose Antonio Lorente fernando Vazquez-Alonso Luis Javier Martinez-Gonzalez Maria Jesus Alvarez-Cubero GENYO Centre for Genomics and Oncological ResearchPfizerUniversity of GranadaAndalusian Regional GovernmentPTS GranadaGranadaGranadaSpain Department of Biochemistry Molecular Biology III and ImmunologyFaculty of MedicineUniversity of GranadaPTS GranadaGranadaGranadaSpain Bioinformatics Unit Institute of Parasitology and Biomedicine“López-Neyra”Spanish National Research CouncilGranadaGranadaSpain Nursery Service.University Hospital Clínico San Cecilio GranadaGranadaSpain Urology Department University Hospital Virgen de las NievesGranadaGranadaSpain Legal Medicine and Toxicology Department Faculty of MedicineUniversity of GranadaPTS GranadaGranadaGranadaSpain Ibs Biosanitary Research InstituteGranadaGranadaSpain

Dear Editor,Hereditary prostate cancer(PC)comprises 5%-10%of all PC *** increased risk of PC in menwith a family his-tory of the disease is well known and is commonly caused by germline mutations,leading to clinical guidelines men-tioning various genes for identifying high-risk ***,the complex inheritance patterns involvingmul-tiple single nucleotide polymorphisms(SNPs)make it a genetically heterogeneous disease,with genetic testing still in its early stages.

关键词： cancer clinical cases

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Extrahepatic cholestasis associated with paracoccidioidomycosis:Challenges in the differential diagnosis of biliopancreatic neoplasia

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2531-2540页

作者： Jose Sebastiao dos Santos Vitor de Moura Arrais William Jose Rosseto Ferreira Ricardo Ribeiro Correa Filho Mariangela Ottoboni Brunaldi Rafael Kemp Ajith Kumar Sankanrakutty Jorge Elias Junior fernando Bellissimo-Rodrigues Roberto Martinez Edson Zangiacomi Martinez Jose Celso Ardengh Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP) Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de PatologiaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Imagens MédicasHematologia e Oncologia ClínicaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Medicina SocialRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Clínica MédicaRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil and Hospital MoriahServico de Endoscopia DigestivaSao Paulo 04084-002Sao PauloBrazil

BACKGROUND Paracoccidioidomycosis(PCM)may involve the hepatic pedicle and peripan creatic lymph nodes,cause damage to the bile duct and manifest,exceptionally,in combination with extrahepatic cholestasis(EHC),making investigation and treatment *** To investigate the management of patients with visceral PCM admitted with *** All patients diagnosed with PCM treated in a public,tertiary teaching hospital between 1982 and 2020 were retrospectively *** also identified with EHC were allocated to two groups according to the treatment approach for the purpose of comparing clinical,laboratory,and imaging findings,resources used for etiological diagnosis,treatment results,and *** analyses were performed using the linear mixed-effects model(random and fixed effects),which was adjusted using the PROC MIXED procedure of the SAS®9.0 software,and Fisher’s exact *** Of 1645 patients diagnosed with PCM,40(2.4%)had *** these,20(50.0%)lived in the rural area and 29(72.5%)were men,with a mean age of 27.1 years(3-65 years).Jaundice as first symptom and weight loss of at least 10 kg were observed in 16 patients(40.0%),and a mass in the head of the pancreas was observed in 8(20.0%).The etiological diagnosis was made by tissue collection during surgery in 4 cases(10.0%)and by endoscopic methods in 3 cases(7.5%).Twenty-seven patients(67.5%)received drug treatment alone(Group 1),whereas 13(32.5%)underwent endoscopic and/or surgical procedures in combination with drug treatment(Group 2).EHC was significantly reduced in both groups(40.7% in Group 1,with a mean time of 3 months;and 38.4% in Group 2,with a mean time of 7.5 months),with no statistically significant difference between *** recurrence rates,associated mainly with treatment nonadherence,were similar in both groups:37% in Group 1 and 15.4% in Group *** mortality rate was 18.5% in Group 1 and 23% in Group 2,with survival estimates of 71.3% and 72.5%,respectively,with

关键词： Cholestasis Jaundice Obstructive Blastomycosis Paracoccidioides Diagnosis Treatment

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Impact of STAT-signaling pathway on cancer-associated fibroblasts in colorectal cancer and its role in immunosuppression

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1705-1724页

作者： Damián Sánchez-Ramírez Mónica G Mendoza-Rodríguez Omar R Alemán fernando A Candanedo-González Miriam Rodríguez-Sosa Juan JoséMontesinos-Montesinos Mauricio Salcedo Ismael Brito-Toledo Felipe Vaca-Paniagua Luis I Terrazas Unidad de Investigacion en Biomedicina Facultad de Estudios Superiores IztacalaUniversidad Nacional Autonoma de MexicoTlalnepantla 54090Estado de MexicoMexico Department of Biology Facultad de QuimicaUniversidad Nacional Autonoma de MexicoCiudad UniversitariaMexico City 04510Mexico Department of Pathology National Medical Center Century XXIInstituto Mexicano del Seguro SocialMexico City 06720Mexico Laboratorio de Células Troncales Mesenquimales Unidad de Investigación Médica en Enfermedades OncológicasHospital de Oncología Centro Medico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico City 06720Mexico Unidad de Investigacion en Biomedicina y Oncologia Genomica Instituto Mexciano del Seguro SocialMexico City 07300Mexico Servicio de Colon y Recto Hospital de Oncología Centro Medico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMexico City 06720Mexico Laboratorio Nacional en Salud Facultad de Estudios Superiores IztacalaUniversidad Nacional Autónoma de MéxicoTlalnepantla 54090Estado de MexicoMexico

Colorectal cancer(CRC)remains one of the most commonly diagnosed and deadliest types of cancer *** displays a desmoplastic reaction(DR)that has been inversely associated with poor prognosis;less DR is associated with a better *** reaction generates excessive connective tissue,in which cancer-associated fibroblasts(CAFs)are critical cells that form a part of the tumor *** are directly involved in tumorigenesis through different ***,their role in immunosuppression in CRC is not well understood,and the precise role of signal transducers and activators of transcription(STATs)in mediating CAF activity in CRC remains *** the myriad chemical and biological factors that affect CAFs,different cytokines mediate their function by activating STAT signaling ***,the harmful effects of CAFs in favoring tumor growth and invasion may be modulated using STAT ***,we analyze the impact of different STATs on CAF activity and their immunoregulatory role.

关键词： Cancer-associated fibroblasts Signal transducer and activator of transcription signaling Colorectal cancer Immunity Immunosuppression

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Planetary Gear Profile Modification Design Based on Load Sharing Modelling

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Chinese Journal of Mechanical Engineering 2015年第4期28卷 810-820页

作者： IGLESIAS Miguel FERNáNDEZ DEL RINCóN alfonso DE-JUAN Ana Magdalena GARCIA Pablo DIEZ Alberto VIADERO fernando Mechanical Engineering Research Group University of Cantabria

In order to satisfy the increasing demand on high performance planetary transmissions, an important line of research is focused on the understanding of some of the underlying phenomena involved in this mechanical system. Through the development of models capable of reproduce the system behavior, research in this area contributes to improve gear transmission insight, helping developing better maintenance practices and more efficient design processes. A planetary gear model used for the design of profile modifications ratio based on the levelling of the load sharing ratio is presented. The gear profile geometry definition, following a vectorial approach that mimics the real cutting process of gears, is thoroughly described. Teeth undercutting and hypotrochoid definition are implicitly considered, and a procedure for the incorporation of a rounding arc at the tooth tip in order to deal with corner contacts is described. A procedure for the modeling of profile deviations is presented, which can be used for the introduction of both manufacturing errors and designed profile modifications. An easy and flexible implementation of the profile deviation within the planetary model is accomplished based on the geometric overlapping. The contact force calculation and dynamic implementation used in the model are also introduced, and parameters from a real transmission for agricultural applications are presented for the application example. A set of reliefs is designed based on the levelling of the load sharing ratio for the example transmission, and finally some other important dynamic factors of the transmission are analyzed to assess the changes in the dynamic behavior with respect to the non-modified case. Thus, the main innovative aspect of the proposed planetary transmission model is the capacity of providing a simulated load sharing ratio which serves as design variable for the calculation of the tooth profile modifications.

关键词： transmission planetary gear load sharing relief profile modification

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Geogenic Pollution of Groundwater Quality in Gampaha District, Sri Lanka: A Case Study of Groundwater Acidification from Rathupaswala

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International Journal of Geosciences 2024年第8期15卷 590-604页

作者： Ishara Pathirage Anushka Upamali Rajapaksha S. P. Sucharitha Bandara G. W. A. Rohan fernando Postgraduate Institute of Science University of Peradeniya Peradeniya Sri Lanka Instrument Centre Faculty of Applied Sciences University of Sri Jayewardenepura Colombo Sri Lanka Ecosphere Resilience Research Centre Faculty of Applied Sciences University of Sri Jayewardenepura Colombo Sri Lanka Central Environmental Authority Battaramulla Sri Lanka Department of Physics The Open University of Sri Lanka Colombo Sri Lanka

Over recent decades, Gampaha district, Sri Lanka, has experienced significant urbanisation and industrial growth, increasing groundwater demand due to limited and polluted surface water resources. In 2013, a community uprising in Rathupaswala, a village in Gampaha district, accused a latex glove manufacturing factory of causing groundwater acidity (pH < 4). This study evaluates the spatial and temporal changes in geochemical parameters across three transects in the southern part of Gampaha district to 1) assess the impact of geological formations on groundwater;2) compare temporal variations in groundwater;and 3) explain acidification via a geochemical model. Seventy-two sample locations were tested for pH, electrical conductivity (EC), and anion concentrations (sulphate, nitrate, chloride and fluoride). Depth to the water table and distance from the sea were measured to study variations across sandy, peaty, lateritic, and crystalline aquifers. Results showed pH readings around 7 for sandy and crystalline aquifers, below 7 for peaty aquifers, and below 5 for lateritic aquifers, with significant water table fluctuations near Rathupaswala area. Principal component analysis revealed three principal components (PCs) explaining 86.0% of the variance. PC1 (40.6%) correlated with pH, EC, and sulphate (saltwater intrusion), while PC2 (32.0%) correlated with nitrates and depth to the water table (anthropogenic nutrient pollution). A geochemical transport model indicated a cone of depression recharged by acidic groundwater from peat-soil aquifers, leading to acidic groundwater in Rathupaswala area. Previous attributions of acidic pH to the over-exploitation of groundwater by the latex factory have been reevaluated;the results suggest natural acidification from prolonged water-rock interactions with iron-rich lateritic aquifers. Groundwater pH is influenced by local climate, geology, topography, and drainage systems. It is recommended that similar water-rock interaction condit

关键词： Groundwater Acidification Acid Sulphate Soils (AAS) Ion Chromatography Groundwater Quality

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Neuroscience Bulletin 2015年第3期31卷 317-330页

作者： fernando Marmolejo-Ramos Kim Hellemans Amy Comeau Adam Heenan Andrew Faulkner alfonso Abizaid Amedeo D'Angiulli Department of Psychology Stockholm University Department of Neuroscience Carleton University Department of Psychology Queens UniversityKingston Institute of Interdisciplinary Studies Carleton University

Although food and affective pictures share similar emotional and motivational characteristics, the relationship between the neuronal responses to these stimuli is unclear. Particularly, it is not known whether perceiving and imagining food and affective stimuli elicit similar event-related potential （ERP） patterns. In this study, two ERP correlates, the early posterior negativity （EPN） and the late positive potential （LPP） for perceived and imagined emotional and food photographs were investigated. Thirteen healthy volunteers were exposed to a set of food photos, as well as unpleasant, pleasant, and neutral photos from the International Affective Picture System. In each trial, participants were first asked to view a photo （perception condition）, and then to create a visual mental image of it and to rate its vividness （imagery condition）. The results showed that during perception, brain regions corresponding to sensorimotor and parietal motivational （defensive and appetitive） systems were activated to different extents, producing a graded pattern of EPN and LPP responses specific to the photo content - more prominent for unpleasant than pleasant and food content. Also, an EPN signature occurred in both conditions for unpleasant content, suggesting that, compared to food or pleasant content, unpleasant content may be attended to more intensely during perception and may be represented more distinctly during imagery. Finally, compared to LLP activation during perception, as well as imagery and perception of all other content, LPP activation was significantly reduced during imagery of unpleasant photos, suggesting inhibition of unwanted memories. Results are framed within a neurocognitive working model of embodied emotions.

关键词： food emotion perception mentaimagery ERP EPN LPP vividness InternationaAffective Picture System embodiment

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Persistent Abdominal Pain Associated with Splenic Lymphangioma in An Adult Patient: A Case Presentation

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Journal of Biosciences and Medicines 2024年第9期12卷 82-88页

作者： David fernando Ortiz Pérez Janne Jorgeth Fabregas Ramirez Mario Enrique Montoya Jaramillo Juan José Iles Bravo John Sebastián Osorio Muñoz Manuel fernando Chavarro Muñoz Daniel de Jesús González Villarreal Manuel Esteban Ortiz Pérez Department of Internal Medicine Cartagena del Mar Clinical Center Cartagena Colombia

Splenic lymphangioma is a rare benign lesion, predominantly seen in the pediatric population and exceptionally in adults. It is usually associated with lymphatic system malformations caused by secondary lymphangiectasia due to abnormal communication between lymphatic ducts. It often coexists with complex clinical syndromes, such as Klippel-Trenaunay syndrome, congenital epithelial cysts, or, in less frequent conditions, infectious or post-traumatic triggering events. It typically presents in the neck or axillae, with intra-abdominal cases accounting for less than 5% of all cases. We present the clinical case of a 44-year-old male patient who presented with a clinical course of approximately one month, characterized by progressive abdominal pain associated with nausea, multiple episodes of emesis, anorexia, and involuntary weight loss. A diagnostic laparoscopy was performed, revealing a poorly differentiated lesion in the splenic topography, for which a biopsy was performed, leading to the definitive diagnosis. In this scenario, splenic lymphangioma should be considered among the differential diagnoses of persistent abdominal pain, and definitive interventions should be determined based on clinical characteristics.

关键词： Lymphangioma Neoplasms Splenic Neoplasms Laparoscopy Adulthood

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霉菌毒素的危害及其防治

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猪业科学 2024年第1期41卷 18-20页

作者：张振玲 fernando Bittencourt Luciano 徐州生物工程职业技术学院动物工程学院江苏徐州221006 不详

霉菌毒素是某些种类的真菌所产生的有毒化合物,若谷物和动物饲料受到污染则会对动物的生长以及人类的健康构成重大威胁。一定要重视并采取有效措施来避免霉菌毒素污染谷物。谷物霉菌毒素污染率可高达60%~80%,霉菌毒素含量超标的谷物约... 详细信息

霉菌毒素是某些种类的真菌所产生的有毒化合物,若谷物和动物饲料受到污染则会对动物的生长以及人类的健康构成重大威胁。一定要重视并采取有效措施来避免霉菌毒素污染谷物。谷物霉菌毒素污染率可高达60%~80%,霉菌毒素含量超标的谷物约占全部谷物的1/4左右(高于欧盟和美国食品法典的标准)。

关键词：食品法典霉菌毒素污染动物饲料谷物有毒化合物采取有效措施含量超标

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Association between Helicobacter pylori infection,mismatch repair,HER2 and tumor-infiltrating lymphocytes in gastric cancer

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2487-2503页

作者： Carlos A Castaneda Miluska Castillo Luis A Bernabe Joselyn Sanchez Matteo Fassan Katherine Tello Ignacio Ivan Wistuba Ivan Chavez Passiuri Eloy Ruiz Juvenal Sanchez fernando Barreda Daniel Valdivia Yaqueline Bazan Milagros Abad-Licham Claudio Mengoa Hugo Fuentes Paola Montenegro Ebert Poquioma Raul Alatrista Claudio J Flores Luis Taxa Faculty of Health Sciences Universidad Cientifica del SurLima 15038Peru GECO PERU Grupo de Estudios Clinicos Oncologicos del PeruLima 15038Peru Department of Research Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Faculty of Human Medicine Universidad Ricardo PalmaLima 15039Peru Department of Medicine Surgical Pathology&Cytopathology UnitUniversity of PaduaPadua 35121Italy Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Abdominal Surgery Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Pathology Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Medical Specialties Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Pathology Instituto Regional de Enfermedades Neoplasicas del NorteTrujillo 13001Peru Faculty of Human Medicine Universidad Privada Antenor OrregoTrujillo 13008Peru Department of Surgery Instituto Regional de Enfermedades Neoplasicas del SurArequipa 04002Peru Department of Medical Oncology Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Epidemiology Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Unidad de Investigación Básica y Traslacional Oncosalud-AUNALima 15038Peru Faculty of Medicine Universidad San Martin de PorresLima 15008Peru

BACKGROUND The influence of Helicobacter-pylori(***)infection and the characteristics of gastric cancer(GC)on tumor-infiltrating lymphocyte(TIL)levels has not been extensively *** of infiltrating-immune-cell subtypes as well as survival is necessary to obtain comprehensive *** To determine the rates of deficient mismatch-repair(dMMR),HER2-status and *** infection and their association with TIL levels in *** Samples from 503 resected GC tumors were included and TIL levels were evaluated following the international-TILs-working-group recommendations with assessment of the intratumoral(IT),stromal(ST)and invasive-border(IB)*** density of CD3,CD8 and CD163 immune cells,and dMMR and HER2-status were determined by immunohistochemistry(IHC).*** infection was evaluated by routine histology and quantitative PCR(qPCR)in a subset of *** dMMR was found in 34.4%,HER2+in 5%and ***-positive in 55.7%of *** IT-TIL was associated with grade-3(P=0.038),while ST-TIL with grade-1(P<0.001),intestinal-histology(P<0.001)and no-recurrence(P=0.003).dMMR was associated with high TIL levels in the ST(P=0.019)and IB(P=0.01)compartments,and STCD3(P=0.049)and ST-CD8(P=0.05)***2-was associated with high IT-CD8(P=0.009).*** was associated with high IT-TIL levels(P=0.009)when assessed by routine-histology,and with high TIL levels in the 3 compartments(P=0.002-0.047)and CD8 density in the IT and ST compartments(P=0.001)when assessed by qPCR.A longer overall survival was associated with low IT-CD163(P=0.003)and CD8/CD3(P=0.001 in IT and P=0.002 in ST)and high IT-CD3(P=0.021),ST-CD3(P=0.003)and CD3/CD163(P=0.002).CONCLUSION TIL levels were related to dMMR and *** CD8/CD3 and high CD163/CD3 were associated with lower recurrence and longer survival.

关键词： Lymphocytes Macrophages Gastric cancer Helicobacter pylori HER2 Mismatch repair

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