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Transforming growth factor-β1 induces intestinal myofibroblast differentiation and modulates their migration

World Journal of Gastroenterology 2009年第12期15卷 1431-1442页

作者： Julia Brenmoehl Sandra Nicole Miller Claudia Hofmann Daniela Vogl Werner Falk Jrgen Schlmerich Gerhard Rogler Department of internal medicine Ⅰ University of Regensburg93055 Regensburg Germany Department of internal medicine Ⅱ University of Jena07747 Jena Germany clinic of Gastroenterology and Hepatology Department of Internal MedicineUniversity Hospital of Zurich8091 ZurichSwitzerland

AIM： To investigate the effects of transforming growth factor β1 （TGF-β1） on the differentiation of colonic lamina propria fibroblasts （CLPF） into myofibroblasts in vitro.METHODS： Primary CLPF cultures were incubated with TGF-β1 and analyzed for production of m-smooth muscle actin （α-SMA）, fibronectin （FN） and FN isoforms. Migration assays were performed in a modified 48-well Boyden chamber. Levels of total and phosphorylated focal adhesion kinase （FAK） in CLPF were analyzed after induction of *** not change α-SMA levels, while TGF-β1 treatment for 6 d significantly increased α-SIVlA production. Short term incubation （6 h） with TGF-β1 enhanced CLPF migration, while long term treatment （6 d） of CLPF with TGF-β1 reduced migration to 15%-37% compared to untreated cells. FN and FN isoform mRNA expression were increased after short term incubation with TGF-β1 （2 d） in contrast to long term incubation with TGF-β1 for 6 d. After induction of migration, TGF-β1-preincubated CLPF showed higher amounts of FN and its isoforms and lower levels of total and phosphorylated FAK than untreated cells.CONCLUSION： Long term incubation of CLPF with TGF-β1 induced differentiation into myofibroblasts with enhanced α-SMA, reduced migratory potential and FAK phosphorylation, and increased FN production. In contrast, short term contact （6 h） of fibroblasts with TGF-β1 induced a dose-dependent increase of cell migration and FAK phosphorylation without induction of α-SMA production.

关键词： Transforming growth factor β1 Colonicfibroblasts Myofibroblasts Migration Fibronectin

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Patient Feedback for Acupuncture Practice Improvement:A Survey from Mayo clinic

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Chinese Journal of Integrative medicine 2017年第11期23卷 816-821页

作者： Barbara S Thomley Saswati Mahapatra Brent A Bauer Molly J Mallory LI Guang-xi Alexander Do Tony Y Chon Division of Operations Mayo Clinic HospitalAZ(85054)United States Integrative medicine and Health Division of General Internal MedicineMayo ClinicMN(55902)United States

Objective： To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. Methods： Patients who were referred for an acupuncture consult to the Center for Integrative medicine at Mayo clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. Results： In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider（76 cases, 74%） and appointment length（74 cases, 68%） were ＂just right＂. Seventy cases（70%） of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients（62%） were willing to pay for additional costs not covered by insurance. Conclusions： We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.

关键词： care survey health integrative medicine acupuncture practice

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Diffuse large B-cell lymphoma successfully treated with amplified natural killer therapy alone: A case report

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World Journal of clinical Cases 2023年第30期11卷 7432-7439页

作者： Kenjiro Nagai Syo Nagai Yuji Okubo Keisuke Teshigawara Department of internal medicine Medical Corporation Ebino Centro ClinicEbino 889-4304Japan Department of internal medicine Higashinotoin ClinicKyoto 604-8175Japan

BACKGROUND The prognosis of patients with advanced diffuse large B-cell lymphoma(DLBCL)is poor,with a 5-year survival rate of approximately 50%.The mainstay of treatment is multidrug combination chemotherapy,which has been associated with serious side *** natural killer(ANK)cell therapy amplifies and activates natural killer(NK)cells to attack only malignant *** ANK cells attack programmed death ligand 1(PD-L1)-positive tumor cells,ANK therapy is considered effective against adult T-cell lymphoma and malignant *** SUMMARY Herein,we report a case of an older patient with advanced DLBCL who was successfully treated with ANK immunotherapy.A 91-year-old female visited our hospital with sudden swelling of the right axillary lymph node in April *** patient was diagnosed with stage II disease,given the absence of splenic involvement or contralateral *** therapy was *** rounds of lymphocyte sampling were performed on July 28,*** reduce the occurrence of side effects,the six samples were diluted by half to obtain 12 *** NK cells were administered twice *** treatment efficacy was evaluated by performing computed tomography and serological tests every 1 or 2 *** treatment suppressed lesion growth,and the antitumor effect persisted for several *** patient experienced mild side ***-L1 immunostaining was positive,indicating that the treatment was highly *** ANK therapy can be used as a first-line treatment for malignant lymphoma;the PD-L1 positivity rate can predict treatment efficacy.

关键词： Diffuse large B-cell lymphoma Natural killer cells Immunostaining Hodgkin's lymphoma Older adult Case report

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A case-based approach to integrative medicine for cardiovascular disease prevention

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Journal of Integrative medicine 2020年第2期18卷 159-162页

作者： Brody Slostad Tejinder Khalsa Kathleen Young Hildalicia Guerra Anjali Bhagra Department of internal medicine Mayo ClinicRochesterMinnesota 55904USA Department of Cardiovascular medicine Mayo ClinicRochesterMinnesota 55904USA Department of Neurology Mayo ClinicRochesterMinnesota 55904USA

Cardiovascular disease is commonly encountered in the adult population and has large impacts on morbidity and mortality. The ever-expanding evidence base for the use of integrative medicine in cardiology necessitates providers caring for patients with cardiovascular disease to be familiar with these ***, providers may find it difficult to adequately discuss these therapies in an average office *** a case-based, question-and-answer approach, the authors review some clinically relevant and helpful research that addresses the incorporation of integrative medicine in cardiovascular disease prevention.

关键词： Integrative medicine Coronary artery disease Atrial fibrillation Preventive medicine Cerebrovascular disease

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Echocardiography in centenarians： characteristics, utility and follow-up

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Journal of Geriatric Cardiology 2018年第5期15卷 328-333页

作者： Jorge A Brenes-Salazar Jaime de la Fuente Punnaiah Marella Hari Chaliki Christopher Scott Heidi M Connolly Roger L Click Department of Cardiovascular Diseases Mayo Clinic Rochester USA Department of internal medicine Mayo Clinic Rochester USA Department of Cardiovascular Diseases Mayo Clinic Arizona USA Division of Biostatistics Mayo Clinic Rochester USA

Background Echocardiography has been shown to be a valuable resource in the diagnosis of many cardiac conditions, and can be used in all age groups, from the fetus to the oldest old. In the context of an increasingly aging population, the impact and utility of echocar- diography in centenarians is largely unknown. This study is to determine whether echocardiography in centenarians aids in making clinical patient management decisions. Methods A retrospective review of echocardiograms from 1986 to 2014, at two affiliated tertiary centers, in individuals who were 100 years or older at the time of the examination. Patient and echocardiogram characteristics, management decisions based on echocardiography, and mortality were documented. Results 114 centenarians had echocardiograms, with ages ranging from 100 to 107 years （101 - 1.4 years）. In 82 of the centenarians evaluated （72%）, no changes in management occurred as a consequence of the echocardiogram. From all management changes directly related to the echocardiogram, 81% （n = 26） of these corresponded to medication adjustments; interventional or surgical procedures followed the echocardiogram only in 4% （n = 5） of the total number of centenarians. Echocardiogram-based changes in management were only significant in patients that were referred for congestive heart failure （P = 0.02）. After the echocardiogram was performed, 1-month and 1-year mortality were 15% and 47%, respectively. The median survival after the echocardiogram was obtained was 13 months （range 0.03 to 145 months）, with no difference if there was a change or no change in manage- ment （P = 0.21）. Conclusions Among centenarians undergoing echocardiography, despite additional diagnostic information, echocardio- grams in centenarians influence management in a minority of cases, most commonly in the form of medication changes for treatment of heart failure. A significant proportion of centenarians are deceased within a year of undergoing echocardiographic ass

关键词： Centenarian Echocardiography Geriatric

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Gastric cancer mortality related to direct radiographic and endoscopic screening:A retrospective study

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World Journal of Gastroenterology 2021年第33期27卷 5595-5609页

作者： Hiroaki Hagiwara Fumitaka Moki Yukiko Yamashita Kazuki Saji Keigo Iesaki Hiromitsu Suda Department of internal medicine Hagiwara ClinicMaebashi 379-2106GunmaJapan Maebashi Medical Association Maebashi 371-0035GunmaJapan Gunma Health Foundation Maebashi 371-0005GunmaJapan Department of internal medicine and Surgery Yamashita ClinicMaebashi 371-0016GunmaJapan Department of internal medicine Saji ClinicMaebashi 371-0133GunmaJapan Department of internal medicine Iesaki ClinicMaebashi 371-0805GunmaJapan Department of Pediatrics Suda Kids ClinicMaebashi 371-0813GunmaJapan

BACKGROUND Despite its decreased incidence in Japan,gastric cancer continues among the leading causes of cancer-related deaths in both men and ***,efforts are still required to lower the mortality rate of gastric cancer in *** City introduced endoscopic gastric cancer screening in 2004,and participants are able to choose between direct radiography and ***,we expected to see a decrease in mortality rate from gastric cancer after introducing endoscopic screening and a difference in mortality rate reduction between screening *** To evaluate the impact on gastric cancer mortality rate of two types of gastric cancer screening in Maebashi City,*** Participants aged 40 to 79 years of the Maebashi City gastric cancer screening program in 2006 who were screened by direct radiography(n=11155)or endoscopy(n=10747)were *** were followed until March 31,2012,by cross-referencing their data against the Gunma Prefecture cancer registry *** compared the detection rate of gastric ***,we compared the mortality rate between the two *** Cox proportional hazards model was used to estimate the hazard ratio(HR)of gastric cancer ***,the reduction in gastric cancer mortality rate associated with each screening method was *** Gastric cancer was detected in 22 participants undergoing direct radiography(detection rate,0.20%)and in 52 participants undergoing endoscopy(detection rate,0.48%).However,most gastric cancers detected by endoscopic screening were early cancers that may not have resulted in *** found no significant difference in gastric cancer mortality rate between participants receiving annual screening and those who do *** the number of gastric cancer deaths in the direct radiography group was set as 1 in the Cox proportional hazard analysis,the HR of gastric cancer death was 1.368(95%CI:0.7308-2.562)in the overall group of *** results showed no s

关键词： Gastric cancer Radiography Endoscopy Population-based cancer screening Mortality reduction

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Low testing rates and high BRCA prevalence: Poly (ADP-ribose) polymerase inhibitor use in Middle East BRCA/homologous recombination deficiency-positive cancer patients

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World Journal of clinical Oncology 2024年第7期15卷 848-858页

作者： Naveed Syed Ashish Vittalrao Chintakuntlawar Deepti Vilasini Aisha Mohamed Al Salami Riad Al Hasan Imrana Afrooz Kanishka Uttam Chandani Ashok Uttam Chandani Aref Chehal Department of Hematology and Oncology Sheikh Shakbout Medical CityAbu Dhabi 11001United Arab Emirates Department of Oncology Mayo ClinicRochesterNY 790339United States Department of Oncology Sheikh Shakbout Medical CityAbu Dhabi 11001United Arab Emirates clinical Research Sheikh Shakbout Medical CityAbu Dhabi 11001United Arab Emirates Department of internal medicine Landmark Medical CenterRhode IslandRI 02895United States

BACKGROUND Poly(ADP-ribose)polymerase inhibitors(PARPis)are approved as first-line therapies for breast cancer gene(BRCA)-positive,human epidermal growth factor receptor 2-negative locally advanced or metastatic breast *** are also effective for new and recurrent ovarian cancers that are BRCA-or homologous recombination deficiency(HRD)-***,data on these mutations and PARPi use in the Middle East are *** To assess BRCA/HRD prevalence and PARPi use in patients in the Middle East with breast/ovarian *** This was a single-center retrospective study of 57 of 472 breast cancer patients tested for BRCA mutations,and 25 of 65 ovarian cancer patients tested for *** adult patients participated in at least four visits to the oncology service at our center between August 2021 and May *** were summarized using descriptive statistics and compared using counts and *** to treatment was assessed using Response Evaluation Criteria in Solid Tumors *** Among the 472 breast cancer patients,12.1%underwent BRCA testing,and 38.5%of 65 ovarian cancer patients received HRD *** mutations were found in 25.6%of the tested patients:26.3%breast cancers had germline BRCA(gBRCA)mutations and 24.0%ovarian cancers showed ***,40.0%of gBRCA-positive breast cancers and 66.0%of HRD-positive ovarian cancers were Middle Eastern and Asian patients,*** treatment was used in 5(33.3%)gBRCA-positive breast cancer patients as first-line therapy(n=1;7-months progression-free),for maintenance(n=2;>15-months progression-free),or at later stages due to compliance issues(n=2).Four patients(66.6%)with HRD-positive ovarian cancer received PARPi and all remained *** Lower testing rates but higher BRCA mutations in breast cancer were *** reflected United Arab Emirates demographics,with breast cancer in Middle Eastern and ovarian cancer in Asian patients.

关键词： Homologous recombination repair BRCA1 BRCA2 Homologous recombination deficiency Ovarian cancer Breast cancer Poly(ADP-ribose)polymerase inhibitors Olaparib DNA double-strand breaks

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Fractional excretion of sodium in hepatorenal syndrome:clinical and pathological correlation

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World Journal of Hepatology 2016年第34期8卷 1497-1501页

作者： Ali A Alsaad Hani M Wadei Department of internal medicine Mayo Clinic Department of Transplant Mayo Clinic

AIMTo determine the accuracy of fractional excretion of sodium (FeNa) in the diagnosis of hepatorenal syndrome (HRS). METHODSEighty-eight liver transplantation candidates with renal dysfunction and/or proteinuria were included in the study sample. The baseline characteristics of the patients were obtained. All the 88 patients underwent iothalamate glomerular filtration rate testing, 24-h urine collection for urinary sodium and protein excretions, random urine for sodium and creatinine testing, and percutaneous kidney biopsy. FeNa was calculated using the equation [(urine sodium × serum creatinine)/(serum sodium × urine creatinine)] × 100%. Diuretic use was recorded among the participants. Patients on renal replacement therapy were not included in the original sample. RESULTSSeventy-seven (87%) of the 88 patients had FeNa P = 0.4). FeNa P = 0.47). Calculated positive predictive value and negative predictive value for FeNa P = 0.41). CONCLUSIONFeNa 1%.

关键词： Fractional excretion of sodium Hepatorenal syndrome Renal dysfunction Liver transplantation Urinary sodium excretion Accuracy

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An uncommon source of upper gastrointestinal bleeding:epiphrenic esophageal diverticulum

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Gastroenterology Report 2017年第4期5卷 313-315,I0003页

作者： Chung Sang Tse Neil D.Parikh Department of internal medicine Mayo ClinicRochesterMNUSA Division of Gastroenterology Department of Internal MedicineYale School of MedicineNew HavenCTUSA

Esophageal diverticula are rare findings that have an estimated incidence of 1 per 500000 people per year,even though acute upper gastrointestinal bleeding is a relatively common medical emergency with an incidence of up to 150 per 100000 people per year and a mortality rate of 7-14%.An 83-year-old man presented with hematemesis and *** upper endoscopy revealed an esophageal diverticulum,within which was an adherent *** of the clot identified a bleeding vessel within the diverticulum;this was successfully clipped and hemostasis was *** the best of our knowledge,this is the first case report of a bleeding epiphrenic esophageal diverticulum that was successfully managed endoscopically with hemostatic clips *** rare,our case serves as a reminder that bleeding epiphrenic esophageal diverticula can present as massive upper gastrointestinal bleeding and urgent endoscopic therapy can be life-saving.

关键词： upper gastrointestinal bleed epiphrenic esophageal diverticulum esophago-gastroduodenoscopy

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Nationwide trends of hospital admissions for acute cholecystitis in the United States

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Gastroenterology Report 2017年第1期5卷 36-42,I0002页

作者： Vaibhav Wadhwa Yash Jobanputra Sushil K Garg Soumil Patwardhan Dhruv Mehta Madhusudhan R.Sanaka Department of internal medicine Fairview HospitalCleveland ClinicOHUSA Department of Gastroenterology and Hepatology Digestive Disease InstituteCleveland ClinicClevelandOHUSA Department of internal medicine University of MinnesotaMinneapolisMNUSA Department of internal medicine University of MassachusettsWorcesterMAUSA Department of internal medicine Westchester Medical CenterValhallaNYUSA

Background and aims:Acute cholecystitis is a fairly common inpatient diagnosis among the gastrointestinal *** aim of this study was to use a national database of US hospitals to evaluate the incidence and costs of hospital admissions associated with acute ***:We analyzed the National Inpatient Sample Database(NIS)for all patients in which acute cholecystitis(ICD-9 codes:574.00,574.01,574.30,574.31,574.60,574.61 or 575.0)was the principal discharge diagnosis from 1997 to *** NIS is the largest all-payer inpatient database in the United States and contains data from approximately 8 million hospital stays each *** statistical significance of the difference in the number of hospital discharges,lengths of stay and associated hospital costs over the study period was determined by using the Chi-square test for ***:In 1997,there were 149661 hospital admissions with a principal discharge diagnosis of acute cholecystitis,which increased to 215995 in 2012(P<0.001).The mean length of stay for acute cholecystitis decreased by 17% between 1997 and 2012(*** 4.7 days to 3.9 days);(P<0.05).During the same time period,however,mean hospital charges have increased by 195.4% from US$14608 per patient in 1997 to US$43152 per patient in 2012(P<0.001).Conclusion:The number of inpatient discharges related to acute cholecystitis has increased significantly in the United States over the last 16 years,along with a great increase in the associated hospital ***,there has been a gradual decline in the mean length of *** costs associated with acute cholecystitis contribute significantly to the total healthcare *** research on cost-effective evaluation and management of acute cholecystitis is required.

关键词： inpatient admission rates acute cholecystitis epidemiology trends

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