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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 *** approach taken(laparoscopic vs thoracoscopic)depends largely on the preferences and skills of each surgeon,although in most cases today the laparoscopic approach is *** 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 *** 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 *** 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 *** difference was statistically ***,the insertion of mesh did not improve results for the non-accessible *** For patients with giant hiatal hernias,it is essential to conduct a preoperative evaluation of the angle of vision and the working area for *** 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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Effect of <i>Carica papaya</i>Leaf Extract on Serum Lipids and Liver Metabolic Parameters of Rats Fed a High Cholesterol Diet

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Health 2015年第9期7卷 1196-1205页

作者： Alma M. Zetina-Esquivel carlos A. Tovilla-Zárate Crystell Guzmán-Garcia Arturo Rodríguez-Hernández Andrés E. Castell-Rodríguez Jorge L. Ble-Castillo Angela Avila-Fernandez Isela E. Juárez-Rojop juan C. Díaz-Zagoya Centro de Investigación División Académica de Ciencias de la Salud Universidad Juárez Autónoma de Tabasco Villahermosa México División Académica Multidisciplinaria de Comalcalco Universidad Juárez Autónoma de Tabasco Comalcalco México Unidad de Medicina Familiar 10 Instituto Mexicano del Seguro Social Xalapa México División de Investigación Facultad de Medicina Universidad Nacional Autónoma de México México D. F. México

Hyperlipidemia plays an important role in the development of atherosclerosis, the main cause of death in the world. In this study, the lipid-lowering effect of Carica papaya leaf in rats fed with a high cholesterol diet was evaluated. Daily doses of C. papaya extract 0, 31, 62 or 125 mg/kg body weight were orally administered in 300 μl polyethylene glycol to hypercholesterolemic rats;it was also administered 62 mg/kg body weight of the extract to rats with normal diet. After a 20-day treatment, the animals were sacrificed;blood and liver were analyzed. Hypercholesterolemic rats showed an increased serum and liver cholesterol, triacylglycerols, and atherogenic index. The C. papaya extract produced a significant decrease of serum and liver cholesterol concentrations in hypercholesterolemic rats, but did not modify serum or liver triacylglycerols;however, the extract reduced the atherogenic index in a dose-dependent manner. C. papaya treatment decreased LDL-C and increased HDL-C in serum significantly. When the oxygen consumption was evaluated in phosphorylating and resting states, the respiratory control in hypercholesterolemic rats mitochondria was lower than in normal diet rats. However, a higher respiratory control in hypercholesterolemic rats mitochondria was observed after C papaya treatment. The liver morphological data are in accordance with serum and liver biochemical values. Our data support that C. papaya has a significant hypocholesterolemic action and HDL-C raising effect on rats fed with a cholesterol-rich diet, however, the precise metabolites responsible of this effect remain unknown.

关键词： Serum Lipids Carica papaya Cholesterol Mitochondria

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Mexican Guidelines for the Diagnosis and Treatment of Chronic Myeloid Leukaemia

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Journal of Cancer Therapy 2013年第3期4卷 747-764页

作者： Eduardo Cervera Federico Godínez Rosa Sosa Ramón Rivas carlos Best juan Hernández Adrián Morales Hugo Zurita Ivette Carrasco Jorge Cruz álvaro Aguayo José Espinoza juan Labardini Luis Valero Judith Cruz Diana Arcos Diego Limón Omar López-Navarro Daniela Gordillo-Bastidas Myrna Candelaria Francisco Torres juan Kassack Oscar de Jesús Pérez Ramírez Jorge Aquino Guillermo Díaz Mariela Cardiel Margarita Rodríguez Patricia Montoya juan Contreras María Chávez Sandra Chávez David Gómez Olga Cantú Jorge Duque Luis Pita Eduardo Lobato Julio López Antonio López Pedro González Jorge Cortés Haematology and Oncology Department National Institute of Medical and Nutrition Sciences “Dr. Salvador Zubirán” Mexico City Mexico Haematology Deparment from Hospital Juárez Mexico City Mexico Haematology Department Blood Bank and Unit of Aphaeresis General Hospital of Culiacán Health Ministry Culiacán Mexico Haematology Department Bone Marrow Transplant and Blood Bank from Hospital Regional de Alta Especialidad “Dr. Juan Graham Casassus” Villahermosa Mexico Haematology Department Cancerology National Institute (INCan) Mexico City Mexico Haematology Department Cancerology National Institute (INCan) Mexico City Mexico 2Internal Medicine Haematology Hospital ISSSTECALI Tijuana Mexico Haematology Department Centenario Hospital Miguel Hidalgo Health Ministry Aguascalientes Mexico Haematology Department General Hospital of Sonora State Sonora Mexico Haematology Department Hospital Universitario UANL Monterrey Mexico Haematology Haematology Service Hospital General Regional SSG León Mexico Haematology Head of Haematology Service School of Medicine Autonomous University of San Luis Potosí San Luis Potosí Mexico Haematology Hospital “Aranda de la Parra” León Mexico Haematology Hospital General de Especialidades Campeche Mexico Haematology Hospital General de México Mexico City Mexico Haematology Hospital General de Occidente SSA Guadalajara Mexico Haematology Hospital Regional de Alta Especialidad de Oaxaca Oaxaca Mexico Haematology Mérida Clinic Yucatán Mexico Haematology Oncology Unit SSEP Puebla Mexico Hospital Betania Puebla Mexico Hospital of the Poblano Child Puebla Mexico Internal Medicine Haematology Hospital ISSSTECALI Tijuana Mexico Leukaemias Clinic at ISSEMyM Toluca Mexico Leukemia Department MD Anderson Cancer Center Houston Mexico Los Mochis General Hospital Sinaloa Mexico Renaissance Clinic Morelia Mexico State Council for AIDS Prevention and Control Chihuahua Mexico Universidad Autónoma de Yucatán Mérida Mexico

Background: This document includes recommendations and guidelines issued by a group of Mexican researchers and specialists gathered in the First National Colloquium for the Diagnosis and Management of Chronic Myeloid Leukaemia (CML) by initiative of Instituto Nacional de Cancerología and with the support of the Leukaemia Department of the MD Anderson Cancer Center. Mexico lacks of updated information taken from its own reality on the diagnosis and treatment of CML and other haematological disorders;besides, there are no national guidelines. Aim: To publish a consensus document with guidelines for the management of CML adjusted to the national environment and overall characteristics. Method: The participants answered a DELPHI questionnaire about the overall aspects of the disease, aiming to target controversial topics, discuss them in the colloquium, and to agree on the best ones. After those meetings, a final document was drawn up. Results: The group presents recommendations for definition, diagnosis, prognosis, monitoring, and treatment of CML in Mexico. Conclusions: Having consensus guidelines for the clinical management of CML in our country will enable the consensual practice of Mexican specialists regarding the clinical approach to CML, as well as optimize the resources which allow the rational planning of the medical care strategies.

关键词： Chronic Myeloid Leukaemia Management Guidelines Diagnosis Treatment.

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Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment

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World Journal of Gastroenterology 2019年第38期25卷 5883-5896页

作者： Ana Isabel Gil-García Antonio Madejón Irene Francisco-Recuero Ana López-López Emiliana Villafranca Miriam Romero Araceli García Antonio Olveira Rocío Mena juan Ramón Larrubia Javier García-Samaniego Hepatology Unit Hospital Universitario La PazMadrid 28046Spain Centro de Investigación Biomédica en Red Instituto de Salud Carlos IIIMadrid 28029Spain Instituto de Investigación del Hospital Universitario la Paz Madrid 28046Spain Biochemistry Department Faculty of MedicineUniversidad Autónoma de MadridMadrid 28029Spain Instituto de Genética Médica y Molecular Hospital Universitario La PazMadrid 28046Spain Translational Hepatology Unit Hospital General Universitario de GuadalajaraGuadalajara 19002Castilla-La ManchaSpain

BACKGROUND Antiviral treatment of patients with chronic hepatitis B(CHB)in the grey zone of treatment comands risk management in order to optimize the health *** this sense,the identification of HBV mutants related with an increased risk of hepatocellular carcinoma(HCC)could be useful to identify subpopulations with potential indication of antiviral *** To analyze the prevalence/persistence of hepatitis B virus(HBV)preS and basal core promoter(BCP)/precore/core variants associated to HCC development in CHB patients in the grey *** Work was designed as a longitudinal retrospective study,including 106 plasma samples from 31 patients with CHB in the grey zone of treatment:Hepatitis B e antigen negative,HBV-DNA levels between 12-20000 IU/mL,normal or discordant transaminase levels during follow up and mild/moderate necroinflammatory activity in liver biopsy or Fibroscan(up to 9.5 kPa).Serum HBVDNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen(HBsAg)coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCCrelated HBV *** High-risk HCC related mutants were detected in 24(77%)patients:19(61%)in the BCP/precore/core,and 7(23%)in the HBsAg coding region(2 preS1 and 5 preS2 deletions).The prevalence of preS deletions was genotype-dependent:3/5(60%)patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E *** HBV-E was the most prevalent in sub-Saharan patients,a correlation between preS deletions and ethnicity was also found:6/8(75%)sub-Saharan vs 1/19(5%)Caucasian patients had preS deletions(P=0.00016).Remarkably,this correlation was maintained in those patients infected with HBV-A,a minor genotype in sub-Saharan patients:2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS *** HCC related variants were the major strains and persisted over time(up to 48 mo).Pa

关键词： Hepatitis B virus Hepatocellular carcinoma PreS deletions Hepatitis B virus treatment Grey zone

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New real-time-PCR method to identify single point mutations in hepatitis C virus

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World Journal of Gastroenterology 2016年第43期22卷 9604-9612页

作者： Qian Chen Irene Belmonte Maria Buti Leonardo Nieto Damir Garcia-Cehic Josep Gregori Celia Perales Laura Ordeig Meritxell Llorens Maria Eugenia Soria Rafael Esteban juan Ignacio Esteban Francisco Rodriguez-Frias Josep Quer Liver Unit Internal Medicine Lab. Malalties Hepàtiques Vall d’Hebron Institut Recerca-Hospital Universitari Vall d’ Hebron08035 Barcelona Spain Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas Instituto de Salud Carlos Ⅲ28029 madrid Spain Liver Pathology Unit Departments of Biochemistry and Microbiology Hospital Universitari Vall d’Hebron Autonomous University of Barcelona 08035 Bareelona Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas del Instituto de Salud carlos Ⅲ 28029 Madrid Spain Universitat Autònoma de Barcelona 08193 Bareelona Spain

AIM To develop a fast, low-cost diagnostic strategy to identify single point mutations in highly variable genomes such as hepatitis C virus(HCV).METHODS In patients with HCV infection, resistance-associated amino acid substitutions within the viral quasispecies prior to therapy can confer decreased susceptibility to direct-acting antiviral agents and lead to treatment failure and virological relapse. One such naturally occurring mutation is the Q80 K substitution in the HCV-NS3 protease gene, which confers resistance to PI inhibitors, particularly simeprevir. Low-cost, highly sensitive techniques enabling routine detection of these single point mutations would be useful to identify patients at a risk of treatment failure. Light Cycler methods, based on real-time PCR with sequencespecific probe hybridization, have been implemented in most diagnostic laboratories. However, this technique cannot identify single point mutations in highly variable genetic environments, such as the HCV genome. To circumvent this problem, we developed a new method to homogenize all nucleotides present in a region except the point mutation of interest. RESULTS Using nucleotide-specific probes Q, K, and R substitutions at position 80 were clearly identified at a sensitivity of 10%(mutations present at a frequency of at least 10% were detected). The technique was successfully applied to identify the Q80 K substitution in 240 HCV G1 serum samples, with performance comparable to that of direct Sanger sequencing, the current standard procedure for this purpose. The new method was then validated in a Catalonian population of 202 HCV G1-infected individuals. Q80 K was detected in 14.6% of G1 a patients and 0% of G1 b in our setting. CONCLUSION A fast, low-cost diagnostic strategy based on real-time PCR and fluorescence resonance energy transfer probe melting curve analysis has been successfully developed to identify single point mutations in highly variable genomes such as hepatitis C virus. This

关键词： Hepatitis C virus Resistance-associated amino acid substitutions Low-cost test Single-point mutations Q80K

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Endosonography-guided cholangiopancreatography as a salvage drainage procedure for obstructed biliary and pancreatic ducts

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World Journal of Gastrointestinal Endoscopy 2010年第6期2卷 212-222页

作者： Manuel Perez-Miranda carlos de la Serna Pilar Diez-Redondo juan J Vila Endoscopy Unit.Hospital Universitario Rio Hortega Endoscopy Unit Gastroenterology DepartmentHospital de Navarra

Endoscopic ultrasound allows transmural access to the bile or pancreatic ducts and subsequent contrast injection to provide ductal drainage under fluoroscopy using endoscopic retrograde cholangiopancreatography (ERCP)-based *** patient specifics and operator techniques result in six possible variant approaches to this procedure,known as endosonography-guided cholangiopancreatography(ESCP). ESCP has been in clinical use for a decade now,with over 300 cases *** has become established as a salvage procedure after failed ERCP in the palliation of malignant biliary *** role in the management of clinically severe chronic/relapsing pancreatitis remains under *** review aims to clarify the concepts underlying the use of ESCP and to provide technical tips and a detailed step-by-step procedural description.

关键词： Endosonography Drainage Endoscopy Digestive system Therapeutics Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography

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咖啡——哥斯达黎加的“黄金谷物”

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中外食品 2008年第6期 5-5页

作者： juan carlos Martinez 哥斯达黎加外贸协会驻华代表处

作为哥斯达黎加商务参赞，及哥斯达黎加对外贸易协会驻华的负责人，多年来我一直致力于对外推广哥斯达黎加的产品，现在我非常荣幸与新朋友们分享我们祖国的的成果，尤其是在哥斯达黎加处于最核心地位的产品——咖啡。

关键词：哥斯达黎加咖啡谷物黄金贸易协会负责人产品

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Telomere function in colorectal cancer

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World Journal of Gastrointestinal Oncology 2009年第1期1卷 3-11页

作者： Cristina Frías Alberto Morán Carmen de juan Paloma Ortega Tamara Fernández-Marcelo Andrés Sánchez-Pernaute Antonio José Torres Eduardo Díaz-Rubio Manuel Benito Pilar Iniesta Department of Biochemistry and Molecular Biology Faculty of PharmacyComplutense University Surgery Service San Carlos Hospital Oncology Service San Carlos Hospital

Colorectal cancer is the third most common form of cancer and the second leading cause of cancer-related death in the western *** cells acquire the hallmarks of cancer during the carcinogenic selection *** immortality is one of the principal features acquired during this process which involves the stabilization of telomere *** is achieved mainly,by telomerase ***,the discovery of telomeres and telomerase allowed an understanding of the mechanisms by which cells can become *** studies have shown that tumour cells have shorter telomeres than nontumour cells and have detected telomerase activity in the majority of *** studies have determined that telomere maintenance and telomerase activity are associated with poor *** into account all the results achieved by different groups,quantification and evaluation of telomerase activity and measurement of telomere length may be useful methods for additional biologic and prognostic staging of colorectal carcinoma.

关键词： Colorectal cancer Telomeres Immortality

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重建的塞维利亚PaCatar餐厅

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中国建筑装饰装修 2012年第8期 256-259页

作者： juan Pedro Donaire carlos Iglesias Ignacio Núez Bootello Jesús Núez Bootello Delia Pacheco Donaire Pablo Baruc García Gómez Fernando Alda

这是一个室内改造项目,位于塞维利亚市中心,改造后成为一家葡萄酒主题餐厅。项目的主要目的是创造一个将酒的传统文化与现代美食相结合的空间。装修中使用的材料包括木材,金属,玻璃,吸音板和混凝土地面,所有这些共同制造出特殊的照明对... 详细信息

这是一个室内改造项目,位于塞维利亚市中心,改造后成为一家葡萄酒主题餐厅。项目的主要目的是创造一个将酒的传统文化与现代美食相结合的空间。装修中使用的材料包括木材,金属,玻璃,吸音板和混凝土地面,所有这些共同制造出特殊的照明对比效果,为餐厅里不同种类的容器创造一个独特的环境。我们将源于酒文化的元素运用到了照明元素中。同时,狭小空间中的细部设计也是非常重要

关键词：塞维利亚西班牙 PaCatar 餐厅

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Precision medicine in pantothenate kinase-associated neurodegeneration

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Neural Regeneration Research 2019年第7期14卷 1177-1185页

作者： Mónica álvarez-Córdoba Marina Villanueva-Paz Irene Villalón-García Suleva Povea-Cabello juan M.Suárez-Rivero Marta Talaverón-Rey Javier Abril-Jaramillo Ana Belén Vintimilla-Tosi José A.Sánchez-Alcázar Centro Andaluz de Biología del Desarrollo(CABD-CSIC-Universidad Pablo de Olavide) and Centro de Investigación Biomédica en Red:Enfermedades RarasInstituto de Salud Carlos Ⅲ Centro de Neurología Avanzada Centro Civet

Neurodegeneration with brain iron accumulation is a broad term that describes a heterogeneous group of progressive and invalidating neurologic disorders in which iron deposits in certain brain areas,mainly the basal *** predominant clinical symptoms include spasticity,progressive dystonia,Parkinson's disease-like symptoms,neuropsychiatric alterations,and retinal *** the neurodegeneration with brain iron accumulation disorders,the most frequent subtype is pantothenate kinase-associated neurodegeneration(PKAN) caused by defects in the gene encoding the enzyme pantothenate kinase 2(PANK2)which catalyzed the first reaction of the coenzyme A biosynthesis *** there is no effective treatment to prevent the inexorable course of these *** aim of this review is to open up a discussion on the utility of using cellular models derived from patients as a valuable tool for the development of precision medicine in ***,we have described that dermal fibroblasts obtained from PKAN patients can manifest the main pathological changes of the disease such as intracellular iron accumulation accompanied by large amounts of lipofuscin granules,mitochondrial dysfunction and a pronounced increase of markers of oxidative *** addition,PKAN fibroblasts showed a morphological senescence-like ***,pantothenate supplementation,the substrate of the PANK2 enzyme,corrected all pathophysiological alterations in responder PKAN fibroblasts with low/residual PANK2 enzyme ***,pantothenate treatment had no favourable effect on PKAN fibroblasts harbouring mutations associated with the expression of a truncated/incomplete *** correction of pathological alterations by pantothenate in individual mutations was also verified in induced neurons obtained by direct reprograming of PKAN *** observations indicate that pantothenate supplementation can increase/stabilize the expression levels of PANK2 in s

关键词： neurodegeneration with brain iron accumulation pantothenate kinase-associated neurodegeneration pantothenate kinase 2 pantothenate induced neurons precision medicine induced neuron fibroblast

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