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Regulatory T cells in patients with inflammatory bowel diseases treated with adacolumn granulocytapheresis

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World Journal of Gastroenterology 2008年第10期14卷 1521-1527页

作者： Emilio Cuadrado Marta Alonso Maria Dolores de juan Pilar Echaniz juan ignacio Arenas Immunology and Digestive units Hospital Donostia Donostia 20014 Spain

AIM: To investigate if the clinical efficacy of granulocytes and monocytes by adsorption (GMA) is associated with an increased frequency of peripheral regulatory T cells (Tregs), as these cells have proven to be successful in suppressing inflammatory bowel disease (IBD) in animal models. METHODS: We report four cases of corticosteroid- dependent ulcerative colitis (UC) and two Crohn’s disease (CD) cases with severe cutaneous lesions who received GMA therapy. The frequency of CD4+ CD25high (Tregs) in peripheral blood was analyzed by flow cytometry and the expression of FoxP3 and TGF beta in purified CD4+ T cells was determined by real time PCR prior to and one month after the last apheresis session, and at the time of endoscopic and clinical assessing. RESULTS: Increased expression of Fox P3 mRNA was found in all five patients who responded to cytapheresis with remission of clinical symptoms, mucosal inflammation and cutaneous lesions, and an increased frequency of circulating Tregs was found in four patients. These changes were not observed in the patient with UC who did no respond to GMA. Variations in TGF-β (mRNA) did not parallel that of FoxP3 mRNA. CONCLUSION: The clinical efficacy of GMA on IBD and related extra intestinal manifestations was associated with an expansion of circulating CD4+ CD25+ Tregs and higher expression of FoxP3 in CD4+ T cells. Accordingly, an elevated CD4+ CD25+ FoxP3 may be a valuable index of remission in patients with IBD and other chronic relapsing-remitting inflammatory conditions during treatment with GMA.

关键词： Adsorptive leukocytapheresis Regulatory T cells Inflammatory bowel diseases Adacolumn Granulocyte-monocyte adsortive apheresis

Splenic rupture following colonoscopy

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World Journal of Gastroenterology 2008年第41期14卷 6410-6412页

作者： juan Francisco Guerra ignacio San Francisco Fernando Pimentel Luis Ibanez Departamento de Cirugía Digestiva Pontificia Universidad Católica de Chile Marcoleta 367

Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insuffl ation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.

关键词： Colonoscopy Splenic injury Splenic rupture Splenectomy

Driving the sodium-oxygen battery chemistry towards the efficient formation of discharge products: The importance of sodium superoxide quantification

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Journal of Energy Chemistry 2022年第5期31卷 709-720页

作者： Marina Enterría Marine Reynaud juan ignacio Paredes Lidia Medinilla Reza Younesi Nagore Ortiz-Vitoriano Centre for Cooperative Research on Alternative Energies(CIC energiGUNE) Basque Research and Technology Alliance(BRTA)Vitoria-Gasteiz 01510Spain Instituto de Ciencia y Tecnología del Carbono INCAR-CSICC/Francisco Pintado Fe 26Oviedo 33011Spain Ångström Advanced Battery Centre(ÅABC) Department of Chemistry-Ångström LaboratoryUppsala UniversityUppsala SE-75121Sweden Ikerbasque Basque Foundation for ScienceBilbao 48013Spain

Sodium-oxygen batteries(SOBs) have the potential to provide energy densities higher than the state-ofthe-art Li-ion batteries. However, controlling the formation of sodium superoxide(NaO_(2)) as the sole discharge product on the cathode side is crucial to achieve durable and efficient SOBs. In this work, the discharge efficiency of two graphene-based cathodes was evaluated and compared with that of a commercial gas diffusion layer. The discharge products formed at the surface of these cathodes in a glyme-based electrolyte were carefully studied using a range of characterization techniques. NaO_(2) was detected as the main discharge product regardless of the specific cathode material while small amounts of Na_(2)O_(2).2H_(2)O and carbonate-like side-products were detected by X-ray diffraction as well as by Raman and infrared spectroscopies. This work leverages the use of X-ray diffraction to determine the actual yield of NaO_(2)which is usually overlooked in this type of batteries. Thus, the proper quantification of the superoxide formed on the cathode surface is widely underestimated;even though is crucial for determining the efficiency of the battery while eliminating the parasitic chemistry in SOBs. Here, we develop an ex-situ analysis method to determine the amount of NaO_(2) generated upon discharge in SOBs by transmission X-ray diffraction and quantitative Rietveld analysis. This work unveils that the yield of NaO_(2) depends on the depth of discharge where high capacities lead to very low discharge efficiency, regardless of the used cathode. We anticipate that the methodology developed herein will provide a convenient diagnosis tool in future efforts to optimize the performance of the different cell components in SOBs.

关键词： Na-O_(2)batteries Graphene Transmission X-Ray diffraction Rietveld refinement Na-O_(2)quantification Parasitic chemistry Cathode design

Overview of the anterolateral complex of the knee

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World Journal of Clinical Cases 2022年第24期10卷 8474-8481页

作者： ignacio Garcia-Mansilla juan Pablo Zicaro Ezequiel Fernando Martinez juan Astoul Carlos Yacuzzi MatiasCosta-Paz Knee Surgery Hospital Italiano de Buenos AiresBuenos Aires 1199Argentina

In the last few years,much more information on the anterolateral complex of the knee has become *** has now been demonstrated how it works in conjunction with the anterior cruciate ligament(ACL)controlling anterolateral rotatory *** studies have shown that the anterolateral complex(ALC)has a role as a secondary stabilizer to the ACL in opposing anterior tibial translation and internal tibial *** is of utmost importance that surgeons comprehend the intricate anatomy of the entire anterolateral aspect of the *** most studies have only focused on the anterolateral ligament(ALL),the ALC of the knee consists of a functional unit formed by the layers of the iliotibial band combined with the anterolateral joint *** interest has also been given to imaging evaluation using magnetic resonance and several studies have targeted the evaluation of the ALC in the setting of ACL *** are inconsistent with a lack of association between magnetic resonance imaging evidence of injury and clinical *** ACL reconstruction may not always reestablish knee rotatory stability in patients with associated ALC *** such cases,additional procedures,such as anterolateral reconstruction or lateral tenodesis,may be *** are several techniques available for ALL *** options include the iliotibial band,gracilis or semitendinosus tendon autograft,or allograft.

关键词： Anterolateral complex Knee instability Anterolateral ligament Anterior cruciate ligament reconstruction

Effect of snow on mountain river regimes： an example from the Pyrenees

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Frontiers of Earth Science 2017年第3期11卷 515-530页

作者： Alba SANMIGUEL-VALLELADO Enrique MORAN-TEJEDA Esteban ALONSO-gonzAlez juan ignacio LOPEZ-MORENO Pyrenean Institute of Ecology CSIC (Spanish Research Council) Zaragoza Spain Department of Geography University of the Balearic Islands Palma de Mallorca Spain

The purpose of this study was to characterize mountain river regimes in the Spanish Pyrenees and to assess the importance of snow accumulation and snowmelt on the timing of river flows. Daily streamflow data from 9 gauging stations in the Pyrenees were used to characterize river regimes. These data were analyzed by hydrological indices, with a focus on periods when snow accumulation and snowmelt occurred. These results were combined with data on Snow Water Equivalent （SWE）（from measure- ments of depth and density of snow in the main river basins and also simulated by a process-based hydrological model）, snowmelting （simulated by a process-based hydrological model）, precipitation （from observations）, and temperature （from observations）. Longitude. and elevation gradients in the Pyrenees explain the transition of river regimes from those that mostly had low nival signals （in the west and at low elevations） to those that mostly had high nival signals （low winter runoff and late spring peakflow, in the east and at high elevations）. Although trend analyses indicated no statistically signifi- cant changes, there was a trend of decreased nival signal over time in most of the analyzed rivers. Our results also demonstrated that snow processes cannot explain all of the interannual variability of river regimes, because the temporal distribution of liquid precipitation and tempera- ture play key roles in hydrography.

关键词： river regime precipitation snow indices,Spanish Pyrenees streamflow

Management of end-stage erectile dysfunction and stress urinary incontinence after radical prostatectomy by simultaneous dual implantation using a single trans-scrotal incision： surgical technique and outcomes

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Asian Journal of Andrology 2015年第5期17卷 792-796,I0008页

作者： juan I Martinez-Salamanca Estefania Linares Espinos ignacio Moncada Luis Del Portillo Joaquin Carballido Department of Urology Hospital Universitario Puerta de Hierro Majadahonda Autonomous University of Madrid Madrid 28222 Spain Hospital Universitario Infanta Sofia Madrid 28702 Spain Hospital La Zarzuela Madrid 28023 Spain

Stress urinary incontinence （SUI） and end-stage erectile dysfunction （ED） after radical prostatectomy （RP） can decrease a patient＇s quality of life （QoL）. We describe a surgical technique involving scrotal incision for simultaneous dual implantation of an artificial urinary sphincter （AUS） and an inflatable penile prosthesis （IPP）. Patients with moderate to severe SUI （〉3 pads per day） and end-stage ED following RP were selected for dual implantation. An upper transverse scrotal incision was made, followed by bulbar urethra dissection and AUS cuff placement. Through the same incision, the corpora cavernosa was exposed, and an IPP positioned. Followed by extraperitoneal reservoirs placement and pumps introduced in the scrotum. Short-term, intra- and post-operative complications; continence status and erectile function; and patient satisfaction and QoL were recorded. A total of 32 patients underwent dual implantation. Early AUS-related complications were： AUS reservoir migration and urethral erosion. One case of distal corporal extrusion occurred. No prosthetic infection was reported. Over 96% of patients were socially the continent （≤1 pad per day） and 〉95% had sufficient erections for intercourse. Limitations of the study were the small number of patients, the lack of the control group using a perineal approach for AUS placement and only a 12 months follow-up. IPP and AUS dual implantation using a single scrotal incision technique is a safe and effective option in patients with SUI and ED after RP. Further studies on larger numbers of patients are warranted.

关键词： artificial urinary sphincter erectile dysfunction penile prosthesis radical prostatectomy single scrotal incision urinary incontinence

Clinical outcomes of patterned laser trabeculoplasty as adjuvant therapy in open angle glaucoma and ocular hypertension

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International Journal of Ophthalmology(English edition) 2018年第4期11卷 635-640页

作者： Gustavo Espinoza Leonardo Castellanos ignacio Rodriguez-Una Paul Anthony Camacho juan Camilo Parra Fundacion Oftalmologica de Santander FOSCAL FloridablancaSantanderColombia Instituto Oftalmologico Fernandez-Vega University of OviedoOviedoAsturias 33012Spain Facultad de Salud Universidad Autonoma de BucaramangaBucaramangaSantanderColombia

AIM： To assess the efficacy and safety of patterned laser trabeculoplasty（PLT） as an adjunctive treatment in open angle glaucoma（OAG） or ocular hypertension（OHT） patients who were under antiglaucoma medical ***： This study was a retrospective review of primary or secondary OAG patients and OHT patients with medically uncontrolled（≥18 mm Hg） intraocular pressure（IOP） who underwent 360o PLT from June 2016 to August 2016. Follow-up visits at week 1, and 1, 3 and 6 mo were performed. IOP, best corrected visual acuity（BCVA）, complications and eye drop glaucoma medication were recorded at each follow-up visit. Success was defined as IOP reduction ≥20% from baseline. RESULTS： Forty-one eyes of 25 patients were included in this study. Pre-treatment mean IOP was 20.2±1.6 mm Hg. After PLT, IOP was 19.3±5.2, 16.1±2.7, 17.1±3.7 and 16.3±3.5 mm Hg,at 1 wk, 1, 3 and 6 mo, respectively. IOP reduction from baseline was statistically significant from the first month, remaining stable at 6 mo（P〈0.001）. PLT success at 6 mo of follow-up was 48.78%. The number of glaucoma medication per eye（P=0.10） and the mean BCVA both remained constant（P=0.37）. Complications included transient IOP spikes in 4 eyes（9.8%） and peripheral anterior synechiae in 7 eyes（17.1%）. CONCLUSION： PLT is an effective and safe method for the management of patients with OHT or OAG as an adjunctive therapy. Additional larger studies should be designed to verify the long-term stability of IOP reduction with this laser technology.

关键词： glaucoma intraocular pressure laser ocular hypertension trabeculoplasty

Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

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World Journal of Gastroenterology 2017年第4期23卷 703-711页

作者： Marisol Luján-Sanchis Enrique Pérez-Cuadrado-Robles Javier Garcia-Lledo José-Francisco juanmartinena Fernandez Luca Elli Victoria-Alejandra Jiménez-García juan Egea-Valenzuela Julio Valle-munoz Cristina Carretero-Ribón ignacio Fernández-Urién-Sainz Antonio López-Higueras Noelia Alonso-Lazaro Mileidis Sanjuan-Acosta Francisco Sanchez-Ceballos Bruno Rosa Santiago gonzález-Vázquez Federica Branchi Lucía Ruano-Díaz César Prieto-de-Frías Vicente Pons-Beltrán Pilar Borque-Barrera Begona gonzález-Suárez Sofía Xavier Federico Argüelles-Arias juan-Manuel Herrerías-Gutiérrez Enrique Pérez-Cuadrado-Martínez Javier Sempere-García-Argüelles Digestive Diseases Unit General University Hospital of Valencia Small Bowel Unit Hospital Morales Meseguer Digestive Diseases Unit General University Gregorio Maranón Unit of Gastroenterology and Endoscopy Complejo Hospitalario de Navarra Center for prevention and Diagnosis of Celiac Disease Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Unit of Gastroenterology and Endoscopy University Hospital Virgen Macarena Gastroenterology department Hospital Virgen de la Arrixaca Department of Gastroenterology Complejo Hospitalario de Toledo Department of Gastroenterology University of Navarra Clinic1 Endoscopy Digestive Unit Digestive Diseases AreaUniversitari i Politècnic La Fe Hospital1 Digestive Diseases Unit University Hospital Nuestra Senora de Candelaria1 Digestive Diseases Unit Clinical Hospital San Carlos1 Digestive Diseases Unit Hospital da Senhora da Oliveira-Guimaraes1 Endoscopy Digestive Unit Hospital Clinic de Barcelona

AIMTo analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE).METHODSThis is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were *** overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated *** has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.

关键词： Capsule endoscopy Celiac disease Anti-transglutaminase antibodies Gluten-free diet Non-celiac gluten sensitivity

MicroRNAs dysregulation in hepatocellular carcinoma: Insights in genomic medicine

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World Journal of Hepatology 2015年第11期7卷 1530-1540页

作者： Iván Lyra-gonzález Laura E Flores-Fong ignacio gonzález-García David Medina-Preciado juan Armendáriz-Borunda Departamento de Biología Molecular y Genómica CUCS Universidad de Guadalajara Instituto de Biología Molecular en Medicina y Terapia Génica O.P.D. Hospital Civil de Guadalajara "Fray Antonio Alcalde" O.P.D. Hospital Civil de Guadalajara "juan I. Menchaca" Departamento de Biología Molecular y Genómica CUCS Universidad de Guadalajara

Hepatocellular carcinoma(HCC) is the leading primary liver cancer and its clinical outcome is still poor. MicroRNAs(mi RNAs) have demonstrated an interesting potential to regulate gene expression at post-transcriptional level. Current findings suggest that mi RNAs deregulation in cancer is caused by genetic and/or epigenetic, transcriptional and post-transcriptional modifications resulting in abnormal expression and hallmarks of malignant transformation: aberrant cell growth, cell death, differentiation, angiogenesis, invasion and metástasis. The important role of mi RNAs in the development and progression of HCC has increased the efforts to understand and develop mechanisms of control overt this single-stranded RNAs. Several studies have analyzed tumoral response to the regulation and control of deregulated mi RNAs with good results in vitro and in vivo, proving that targeting aberrant expression of mi RNAs is a powerful anticancer therapeutic. Identification of up and/or down regulated mi RNAs related to HCC has led to the discovery of new potential application for detection of their presence in the affected organism. Mi RNAs represent a relevant new target for diagnosis, prognosis and treatment in a wide variety of pathologic entities, including HCC. This manuscript intends to summarize current knowledge regarding mi RNAs and their role in HCC development.

关键词： Hepatocellular carcinoma MicroRNAs Regulation Therapeutic targets