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Patterns of local recurrence in rectal cancer after a multidisciplinary approach

World Journal of Gastroenterology 2011年第13期17卷 1674-1684页

作者： Jose M enríquez-navascués nerea Borda Aintzane Liz-erazu Carlos Placer Jose L Elosegui Juan P Ciria Adelaida Lacasta Luis Bujanda Colorectal Cancer Multidisciplinary Unit Donostia Hospital University of the Basque CountryCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas 20010 San Sebastian Spain

Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presa-cral) have become more common since the growth in the use of combined treatments. no differences have been reported in the current pattern of LRs as a function of the type of approach used, that is, neo-adjuvant therapies (short-term or long-course radiotherapy, orchemoradiotherapy versus extended lymphadenectomy, though there is a trend towards posterior or presacral LR in patients in the Western world and lateral LR in Asia. nevertheless, both may arise from the same mechanism. Moreover, as well as the mode of treatment, the type of LR is related to the height of the initial tumor. nowadays most LRs are related to the advanced nature of the disease. Involvement of the circumferential radial margin and spillage of residual tumor cells from lymphatic leakage in the pelvic side wall are two plausible mechanisms for the genesis of LR. The patterns of pelvic recurrence itself (pelvic subsites) also have important implications for prognosis and are related to the potential success of salvage curative approach. The re-operability for cure and prognosis are generally better for anastomotic and anterior types than for presacral and lateral recurrences. Overall survival after LR diagnosis is lower with radio or chemoradiotherapy plus optimal surgery approaches, compared to optimal surgery alone.

关键词：复发率直肠癌多学科联合治疗手术方法肿瘤细胞 LRS 辅助疗法

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novel TInF2 gene mutation in dyskeratosis congenita with extremely short telomeres:A case report

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World Journal of Clinical Cases 2022年第33期10卷 12440-12446页

作者： Verónica Judith Picos-Cárdenas Saúl Armando Beltrán-Ontiveros JoséAlfonso Cruz-Ramos JoséAlfredo Contreras-Gutiérrez Eliakym Arámbula-Meraz Carla Angulo-Rojo Alma Marlene Guadrón-Llanos Emir Adolfo Leal-León Dora María Cedano-Prieto Juan Pablo Meza-Espinoza Laboratorio de Genética Facultad de MedicinaUniversidad Autónoma de SinaloaCuliacán 80018SinaloaMexico centro de investigación y Docencia en ciencias de la Salud Hospital Civil de CuliacánUniversidad Autónoma de SinaloaCuliacán 80030SinaloaMexico departamento de Clínicas Médicas Centro Universitario de Ciencias de la SaludUniversidad de GuadalajaraGuadalajara 44340JaliscoMexico Facultad de Medicina Universidad Autónoma de SinaloaCuliacán 80018SinaloaMexico Laboratorio de Genética y Biología Molecular Facultad de Ciencias Químico-BiológicasUniversidad Autónoma de SinaloaCuliacán 80010SinaloaMexico Laboratorio de neurociencias Facultad de MedicinaUniversidad Autónoma de SinaloaCuliacán 80018SinaloaMexico Laboratorio de Diabetes y Comorbilidades Facultad de MedicinaUniversidad Autónoma de SinaloaCuliacán 80018SinaloaMexico Facultad de Medicina Universidad Autónoma de TamaulipasMatamoros 87349TamaulipasMexico

BACKGROUnD Dyskeratosis congenita is a rare disease characterized by bone marrow failure and a clinical triad of oral leukoplakia,nail dystrophy,and abnormal skin pigmentation.The genetics of dyskeratosis congenita include mutations in genes involved in telomere maintenance,including TInF2.CASE SUMMARy Here,we report a female patient who presented thrombocytopenia,anemia,reticulate hyperpigmentation,dystrophy in fingernails and toenails,and leukoplakia on the tongue.A histopathological study of the skin showed dyskeratocytes;however,a bone marrow biopsy revealed normal cell morphology.The patient was diagnosed with dyskeratosis congenita,but her family history did not reveal significant antecedents.Whole-exome sequencing showed a novel heterozygous punctual mutation in exon 6 from the TInF2 gene,namely,nM_001099274.1:-c.854delp.(Val285-Alafs*32).An analysis of telomere length showed short telomeres relative to the patient’s age.COnCLUSIOn The disease in this patient was caused by a germline novel mutation of TInF2 in one of her parents.

关键词： Dyskeratosis congenita TInF2 Germline mutation novel mutation Short telomeres Case report

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Exponential Continuous non-Parametric neural Identifier With Predefined Convergence Velocity

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IEEE/CAA Journal of Automatica Sinica 2022年第6期9卷 1049-1060页

作者： Mariana Ballesteros Rita Q.Fuentes-Aguilar Isaac Chairez Instituto Politécnico nacional Centro de Innovación y Desarrollo Tecnológico en Cómputo Unidad Profesional Interdisciplinaria de Biotecnología 07340Mexico CityMexico Tecnológico de Monterrey School of Engineering and SciencesZapopanJalisco 45138Mexico department of Bioprocesses UPIBIInstituto Politécnico Nacional07340Mexico City

This paper addresses the design of an exponential function-based learning law for artificial neural networks(Anns)with continuous dynamics.The Ann structure is used to obtain a non-parametric model of systems with uncertainties,which are described by a set of nonlinear ordinary differential equations.Two novel adaptive algorithms with predefined exponential convergence rate adjust the weights of the Ann.The first algorithm includes an adaptive gain depending on the identification error which accelerated the convergence of the weights and promotes a faster convergence between the states of the uncertain system and the trajectories of the neural identifier.The second approach uses a time-dependent sigmoidal gain that forces the convergence of the identification error to an invariant set characterized by an ellipsoid.The generalized volume of this ellipsoid depends on the upper bounds of uncertainties,perturbations and modeling errors.The application of the invariant ellipsoid method yields to obtain an algorithm to reduce the volume of the convergence region for the identification error.Both adaptive algorithms are derived from the application of a non-standard exponential dependent function and an associated controlled Lyapunov function.numerical examples demonstrate the improvements enforced by the algorithms introduced in this study by comparing the convergence settings concerning classical schemes with non-exponential continuous learning methods.The proposed identifiers overcome the results of the classical identifier achieving a faster convergence to an invariant set of smaller dimensions.

关键词： Exponential Lyapunov functions learning laws non-parametric identifier predefined convergence rate

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Mouse models of pancreatic cancer

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World Journal of Gastroenterology 2012年第12期18卷 1286-1294页

作者： Marta Herreros-Villanueva Elizabeth Hijona Angel Cosme Luis Bujanda Schulze Center for novel Therapeutics Division of Oncology ResearchDepartment of MedicineMayo ClinicRochesterMN 55905United States department of Gastroenterology Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)University of the Basque CountryDonostia HospitalSan Sebastian 20014Spain department of Gastroenterology Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)University of the Basque CountryDonostia Hospital

Pancreatic cancer is one of the most lethal of human malignancies ranking 4th among cancer-related death in the western world and in the United States,and potent therapeutic options are lacking.Although during the last few years there have been important advances in the understanding of the molecular events responsible for the development of pancreatic cancer,currently specific mechanisms of treatment resistance remain poorly understood and new effective systemic drugs need to be developed and probed.In vivo models to study pancreatic cancer and approach this issue remain limited and present different molecular features that must be considered in the studies depending on the purpose to fit special research themes.In the last few years,several genetically engineered mouse models of pancreatic exocrine neoplasia have been developed.These models mimic the disease as they reproduce genetic alterations implicated in the progression of pancreatic cancer.Genetic alterations such as activating mutations in KRas,or TGFb and/or inactivation of tumoral suppressors such as p53,InK4A/ARF BRCA2 and Smad4 are the most common drivers to pancreatic carcinogenesis and have been used to create transgenic mice.These mouse models have a spectrum of pathologic changes,from pancreatic intraepithelial neoplasia to lesions that progress histologically culminating in fully invasive and metastatic disease and represent the most useful preclinical model system.These models can characterize the cellular and molecular pathology of pancreatic neoplasia and cancer and constitute the best tool to investigate new therapeutic approaches,chemopreventive and/or anticancer treatments.Here,we review and update the current mouse models that reproduce different stages of human pancreatic ductal adenocarcinoma and will have clinical relevance in future pancreatic cancer developments.

关键词：小鼠模型胰腺癌胰脏治疗方案肿瘤抑制基因恶性肿瘤分子特征遗传工程

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Refractory hepatic encephalopathy in a patient with hypothyroidism: Another element in ammonia metabolism

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World Journal of Gastroenterology 2017年第28期23卷 5246-5252页

作者： Fernando Díaz-Fontenla Marta Castillo-Pradillo Arantxa Díaz-Gómez Luis Ibanez-Samaniego Pilar Gancedo Juan Adan Guzmán-de-Villoria Pilar Fernández-García Rafael Banares-Canizares Rita García-Martínez Unidad de Hepatología Servicio de Aparato DigestivoHospital General Universitario Gregorio Maranón Instituto de investigación Sanitaria Hospital Gregorio Maranón Servicio de Aparato Digestivo Hospital Santa Bárbara Servicio de Radiodiagnóstico Hospital General Universitario Gregorio Maranón centro de investigación Biomédica en Red de Salud Mental centro de investigación Biomédica en Red de enfermedades Hepáticas y Digestivas Facultad de Medicina Universidad San Pablo CEU

Hepatic encephalopathy(HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE is an uncommon but serious condition that requires the search of hidden precipitating events(i.e.,portosystemic shunt) and alternative diagnosis. Hypothyroidism shares clinical manifestations with HE and is usually considered within the differential diagnosis of HE. Here,we describe a patient with refractory HE who presented a large portosystemic shunt and post-ablative hypothyroidism. Her cognitive impairment,hyperammonaemia,electroencephalograph alterations,impaired neuropsychological performance,and magnetic resonance imaging and spectroscopy disturbances were highly suggestive of HE,paralleled the course of hypothyroidism and normalized after thyroid hormone replacement. There was no need for intervention over the portosystemic shunt. The case findings support that hypothyroidism may precipitate HE in cirrhotic patients by inducing hyperammonaemia and/or enhancing ammonia brain toxicity. This case led us to consider hypothyroidism not only in the differential diagnosis but also as a precipitating factor of HE.

关键词：肝的 encephalopathy 甲状腺机能减退认知缺陷肝硬化 Portosystemic 分流磁性的回声光谱学

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Microphysiological systems for solid tumor immunotherapy:opportunities and challenges

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Microsystems & nanoengineering 2023年第6期9卷 77-106页

作者： Sara Abizanda-Campo María Virumbrales-Muñoz Mouhita Humayun Ines Marmol David J.Beebe Ignacio Ochoa Sara Oliván Jose M.Ayuso department of dermatology University of Wisconsin-MadisonMadisonWIUSA University of Wisconsin Carbone Cancer Center MadisonWIUSA department of Biomedical engineering University of WisconsinMadisonWIUSA Tissue Microenvironment Lab(TME lab) Aragón Institute of Engineering Research(I3A)University of ZaragozaZaragozaSpain Instituto de investigación Sanitaria Aragón(IISA) ZaragozaSpain centro investigación Biomédica en Red.Bioingeniería Biomateriales y Nanomedicina(CIBER-BBN)ZaragozaSpain department of Obstetrics and Gynecology University of Wisconsin-MadisonMadisonWIUSA department of Biological engineering Massachusetts Institute of Technology CambridgeCambridgeMAUSA department of Pathology&Laboratory Medicine University of WisconsinMadisonWIUSA

Immunotherapy remains more effective for hematologic tumors than for solid tumors.One of the main challenges to immunotherapy of solid tumors is the immunosuppressive microenvironment these tumors generate,which limits the cytotoxic capabilities of immune effector cells(e.g.,cytotoxic T and natural killer cells).This microenvironment is characterized by hypoxia,nutrient starvation,accumulated waste products,and acidic pH.Tumor-hijacked cells,such as fibroblasts,macrophages,and T regulatory cells,also contribute to this inhospitable microenvironment for immune cells by secreting immunosuppressive cytokines that suppress the antitumor immune response and lead to immune evasion.Thus,there is a strong interest in developing new drugs and cell formulations that modulate the tumor microenvironment and reduce tumor cell immune evasion.Microphysiological systems(MPSs)are versatile tools that may accelerate the development and evaluation of these therapies,although specific examples showcasing the potential of MPSs remain rare.Advances in microtechnologies have led to the development of sophisticated microfluidic devices used to recapitulate tumor complexity.The resulting models,also known as microphysiological systems(MPSs),are versatile tools with which to decipher the molecular mechanisms driving immune cell antitumor cytotoxicity,immune cell exhaustion,and immune cell exclusion and to evaluate new targeted immunotherapies.Here,we review existing microphysiological platforms to study immuno-oncological applications and discuss challenges and opportunities in the field.

关键词： immunotherapy versatile solid

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Human umbilical artery smooth muscle exhibits a 2-APBsensitive capacitative contractile response evoked by vasoactive substances and expresses mRnAs for STIM, Orai and TRPC channels

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BIOCELL 2012年第2期36卷 73-81页

作者： AnA ROCÍO ROLDÁn PALOMO PEDRO MARTIn ALEJAnDRO REBOLLEDO nICOLÁS enRIQUE LUIS E.FLORES VERÓnICA MILESI GInFIV–Grupo de investigación en Fisiología Vascular Facultad de Ciencias ExactasUniversidad Nacional de La Plata.Argentina CenEXA–centro de endocrinología Experimental y aplicada (UNLP-CONICET La PlataCentro Colaborador OPS/OMS)Facultad de Ciencias MédicasUniversidad Nacional de La Plata.Argentina

After depletion of intracellular Ca^(2+)stores the capacitative response triggers an extracellular Ca^(2+)influx through store-operated channels(SOCs)which refills these stores.Our objective was to explore if human umbilical artery smooth muscle presented this response and if it was involved in the mechanism of serotonin-and histamine-induced contractions.Intracellular Ca^(2+)depletion by a Ca^(2+)-free extracellular solution followed by Ca^(2+)readdition produced a contraction in artery rings which was inhibited by the blocker of Orai and TRPC channels 2-aminoethoxydiphenyl borate(2-APB),suggesting a capacitative response.In presence of 2-APB the magnitude of a second paired contraction by serotonin or histamine was significantly less than a first one,likely because 2-APB inhibited store refilling by capacitative Ca^(2+)entry.2-APB inhibition of sarcoplasmic reticulum Ca^(2+)release was excluded because this blocker did not affect serotonin force development in a Ca^(2+)-free solution.The PCR technique showed the presence of mRnAs for STIM proteins(1 and 2),for Orai proteins(1,2 and 3)and for TRPC channels(subtypes 1,3,4 and 6)in the smooth muscle of the human umbilical artery.Hence,this artery presents a capacitative contractile response triggered by stimulation with physiological vasoconstrictors and expresses mRnAs for proteins and channels previously identified as SOCs.

关键词： human umbilical artery capacitative response TRPC channels serotonin histamine

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Risk Factors and Gender Differences for depression in Chilean Older Adults:A Cross-Sectional Analysis from the national Health Survey 2016–2017

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International Journal of Mental Health Promotion 2022年第5期24卷 679-697页

作者： Gabriela nazar Carlos-María Alcover yeny Concha-Cisternas Igor Cigarroa Ximena Díaz-Martínez Mariela Gatica-Saavedra Fabián Lanuza Ana María Leiva-Ordónez María Adela Martínez-Sanguinetti Miquel Martorell Fanny Petermann-Rocha Claudia Troncoso-Pantoja Carlos Celis-Morales departamento de Psicología Facultad de Ciencias SocialesUniversidad de ConcepciónConcepciónChile centro de Vida Saludable Universidad de ConcepciónConcepciónChile departamento de Psicología Facultad de Ciencias de la SaludUniversidad Rey Juan CarlosMadridEspaña Pedagogía en Educación Física Facultad de EducaciónUniversidad AutónomaTalcaChile Escuela de Kinesiología Facultad de SaludUniversidad Santo TomásLosÁngelesChile Grupo de investigación Calidad de Vida Departamento de Ciencias de la EducaciónUniversidad del BiobíoChillánChile depto de Psiquiatría y Salud Mental Facultad de MedicinaUniversidad de ConcepciónConcepciónChile centro de Epidemiología Cardiovascular y nutricional(EPICyn) Facultad de MedicinaUniversidad de La FronteraTemucoChile Biomarkers and nutrimetabolomics Laboratory Department of NutritionFood Sciences and GastronomyFood Technology Reference Net(XIA)Nutrition and Food Safety Research Institute(INSA)Faculty of Pharmacy and Food SciencesUniversity of BarcelonaBarcelona08028Spain Instituto de Anatomía Histología y PatologíaFacultad de MedicinaUniversidad Austral de ChileValdiviaChile Instituto de Farmacia Facultad de CienciasUniversidad Austral de ChileValdiviaChile departamento de nutrición y Dietética Facultad de Farmacia.Universidad de ConcepciónConcepciónChile Facultad de Medicina Universidad Diego PortalesSantiagoChile BHF Glasgow Cardiovascular Research Centre Institute of Cardiovascular and Medical SciencesUniversity of GlasgowGlasgowUK centro de investigación en Educación y desarrollo(CIEde-UCSC).departamento de Salud Pública Facultad de MedicinaUniversidad Católica de la Santísima ConcepciónConcepciónChile Laboratorio de Rendimiento Humano Grupo de Estudio en EducaciónActividad Física y Salud(GEEAFyS)Universidad Católica del MauleTalcaChile

depressive disorders are recognized as one of the most common mental health conditions across different age groups.However,the risk factors associated with depression among older people from low-and middle-income countries remains unclear.This study aims to identify socio-demographic,health and psychosocial-related factors associated with depression in Chilean older adults.A cross-sectional study was carried out in a representative sample of 1,765 adults aged≥60 years participants from the Chilean national Health Survey 2016–2017.depres-sion was assessed with the Composite International Diagnostic Interview(CIDI-SF).Associations between the exposure variables and depression were investigated using Poisson regression analyses.The mainﬁndings indi-cated that women showed higher likelihood of depression than men(Prevalence Ratio(PR)=2.6[95%CI:1.40;4.89]).An increased likelihood of depression was found in older adults with chronic pain,multimorbidity(≥2 diseases),previous diagnose of depression,high perception of stress,ﬁnancial stress,and difﬁculties for social par-ticipation.In women,higher likelihood of depression was found for those with the frailty phenotype(PR:8.53[95%CI:1.68;43.32]),rheumatoid arthritis(PR:2.41[95%CI:1.34;4.34]),insomnia(PR:2.99[95%CI:1.74;5.12])and low self-rated well-being(PR:4.94[95%CI:2.26;10.79]).Men who were divorced(PR:7.10[95%CI:1.44;34.90])or widowed(PR:10.83[95%CI:3.71;31.58]),obese(PR:5.08[95%CI:1.48;17.42])and who had asthma(PR:7.60[95%CI:2.31;24.99])were associated with higher odds of depression.The currentﬁndings may have clinical implications for the early identiﬁcation of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.

关键词： depression older adults aging late-life depression risk factors

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endoscopic shielding technique, a new method in therapeutic endoscopy

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World Journal of Gastroenterology 2017年第21期23卷 3761-3764页

作者： Ignacio Bon Ramon Bartolí Vicente Lorenzo-Zúniga Institut investigació en Ciències de la Salut Germans Trias i Pujol centro de investigación Biomédica en Red de enfermedades Hepáticas y Digestivas endoscopy Unit Department of GastroenterologyHospital Universitari Germans Trias i Pujol

Prevention of late complications after large endoscopic resection is inefficient with current methods.endoscopic shielding,as a simple and safe technique,has been proposed to improve the incidence of these events.Different methods,sheets or hydrogels,have showed proven efficacy in the prevention of late bleeding and perforation,as well as the improvement of tissue repair,in experimental models and in clinical practice.

关键词：内视镜的防护技术迟了的复杂并发症治疗学的内视镜检查法

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Current role and future perspectives of artificial intelligence in echocardiography

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World Journal of Cardiology 2023年第6期15卷 284-292页

作者： Rafael Vidal-Perez Julia Grapsa Alberto Bouzas-Mosquera Ricardo Fontes-Carvalho Jose Manuel Vazquez-Rodriguez Servicio de Cardiología Unidad de Imagen y Función CardíacaComplexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red-Instituto de Salud Carlos ⅢA Coruña 15006Spain department of Cardiology Guys and St Thomas NHS TrustLondon SE17EHUnited Kingdom Cardiology department Centro Hospitalar de Vila Nova de Gaia/EspinhoVilanova de Gaia 4434-502Portugal Cardiovascular R&D Centre-UnIC@RISE Department of Surgery and PhysiologyFaculty of Medicine of the University of PortoPorto 4200-319Portugal Servicio de Cardiología Complexo Hospitalario Universitario A CoruñaA Coruña 15006Spain

Echocardiography is an essential tool in diagnostic cardiology and is fundamental to clinical care.Artificial intelligence(AI)can help health care providers serving as a valuable diagnostic tool for physicians in the field of echocardiography specially on the automation of measurements and interpretation of results.In addition,it can help expand the capabilities of research and discover alternative pathways in medical management specially on prognostication.In this review article,we describe the current role and future perspectives of AI in echocardiography.

关键词： Echocardiography Artificial intelligence Machine learning deep learning Prognosis

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