Predicting retinal pigment epithelium remodelling and its functional impact

Graefe's Archive for Clinical and Experimental Ophthalmology - To identify predictive factors for RPE tear remodelling and its correlation with functional and morphological outcomes....     

Endoscopic submucosal dissection for colorectal tumors—1,000 colorectal ESD cases: one specialized institute’s experiences

Purpose

Endoscopic submucosal dissection (ESD) is a very useful endoscopic technique, making it possible to perform en bloc resection regardless of lesion size. Since the introduction of ESD at our hospital, we have performed 1,000 colorectal ESDs during 56 months. The purpose of this study was to evaluate the clinical outcomes of our colorectal ESD experience and to access the efficacy and safety of colorectal ESD.

Methods

Between October 2006 and August 2011, we performed ESD on 1,000 consecutive colorectal tumors in 966 patients. We evaluated the clinical outcomes of all said cases.

Results

The mean resected tumor size was 24.1 ± 13.3 (3–145) mm. Our overall endoscopic en bloc resection rate was 97.5 % (975/1,000), and our R0 resection rate was 91.2 % (912/1,000) respectively. Our perforation rate was 5.3 % (53/1,000). Of these 53 perforations, 50 cases were treated through conservative management with/without endoscopic clipping, whereas the remaining 3 patients received laparoscopic operation. Pathological examination showed adenocarcinoma in 37.2 % of cases (372/1,000) and neuroendocrine tumors in 11.2 % (112/1,000). We recommended additional radical surgery to 82 patients who had a risk of lymph node metastasis. Follow-up colonoscopies were performed on 722 patients. During the median follow-up period of 13 (1–62) months, there were three recurrences (0.4 %).

Conclusions

ESD is technically difficult, with a substantial risk of perforation. However, ESD enabled en bloc resection and pathologically complete resection of large colorectal epithelial tumors and submucosal tumors. As experience with the technique increases, ESD may gradually replace piecemeal endoscopic mucosal resection and radical colon resection in the treatment of colorectal tumors.     

Topical application of the lectin Artin M accelerates wound healing in rat oral mucosa by enhancing TGF‐β and VEGF production

The lectin Artin M has been shown to accelerate the wound‐healing process. The aims of this study were to evaluate the effects of Artin M on wound healing in the palatal mucosa of rats and to investigate the effects of Artin M on transforming growth factor beta (TGF‐β) and vascular endothelial growth factor (VEGF) secretion by rat gingival fibroblasts. A surgical wound was created on the palatal mucosa of 72 rats divided into three groups according to treatment: C—Control (nontreated), A—Artin M gel, and V—Vehicle. Eight animals per group were sacrificed at 3, 5, and 7 days postsurgery for histology, immunohistochemistry and determination of the levels of cytokines, and growth factors. Gingival fibroblasts were incubated with 2.5 μg/mL of Artin M for 24, 48, and 72 hours. The expression of VEGF and TGF‐β was determined by enzyme‐linked immunosorbent assay. Histologically, at day 7, the Artin M group showed earlier reepithelialization, milder inflammatory infiltration, and increased collagen fiber formation, resulting in faster maturation of granular tissue than in the other groups (p < 0.05). Artin M–induced cell proliferation in vivo and promoted a greater expression of TGF‐β and VEGF in both experiments (p < 0.05). Artin M was effective in healing oral mucosa wounds in rats and was associated with increased TGF‐β and VEGF release, cell proliferation, reepithelialization, and collagen deposition and arrangement of fibers.     

The role of mutual in-feeding in maintaining problematic self-narratives: Exploring one path to therapeutic failure

Abstract

According to the author's narrative model of change, clients may maintain a problematic self-stability across therapy, leading to therapeutic failure, by a mutual in-feeding process, which involves a cyclical movement between two opposing parts of the self. During innovative moments (IMs) in the therapy dialogue, clients’ dominant self-narrative is interrupted by exceptions to that self-narrative, but subsequently the dominant self-narrative returns. The authors identified return-to-the-problem markers (RPMs), which are empirical indicators of the mutual in-feeding process, in passages containing IMs in 10 cases of narrative therapy (five good-outcome cases and five poor-outcome cases) with females who were victims of intimate violence. The poor-outcome group had a significantly higher percentage of IMs with RPMs than the good-outcome group. The results suggest that therapeutic failures may reflect a systematic return to a dominant self-narrative after the emergence of novelties (IMs).     

Traumatic Middle Cerebral Artery Aneurysm Secondary to a Gunshot Wound

Traumatic intracranial aneurysms are rare lesions, accounting for less than 1% of all intracranial aneurysms. Formation of these lesions after a penetrating missile wound is very unusual, and diagnosis can be difficult due to the presence of associated lesions. In this article, we report a case of a woman who developed a middle cerebral artery aneurysm after a gunshot wound, and discuss potential pitfalls found during diagnostic work‐up.     

Hydroelectrolytic balance of Brazilian jiu-jitsu athletes during a simulated competition

Purpose

To analyze the hydroelectrolytic balance of Brazilian jiu-jitsu athletes during a simulated competition.

Methods

Eight athletes were analyzed in simulated competition (four matches of 10 min). Blood lactate and rating of perceived exertion (6–20 scale) were used to infer the intensity of the matches. Blood samples were taken to determine the serum levels of osmolality, total protein and some electrolytes (chlorides, sodium, potassium, calcium, magnesium, phosphorus and iron).

Results

The lactate concentration changed during the simulated competition (F _7.49 = 35.5; P < 0.001; η ² = 0.85), with an increase post-match compared to the pre-match in matches 1, 2 and 4, but not for match 3. For rating of perceived exertion, no changes were found during the competition (F _3.21 = 9.4; P = 0.440; η ² = 0.12). The matches did not change the osmolality, chlorides, sodium, potassium, magnesium and iron values. For total protein, a difference was observed between the time-points (F _{2.8; 19.6} = 4.6; P = 0.015; η ² = 0.40), with lower concentrations in pre-match 2 than pre-match 1, post-matches 2 and 3. The calcium concentration was also affected by the simulated competition (F _7.49 = 4.0; P = 0.002; η ² = 0.37), with values lower in pre-match 2 than post-matches 1 and 2. The phosphorus serum was changed by matches (F _{3.1; 21.7} = 18.6; P < 0.001; η ² = 0.73), with post-match 1 values higher than the pre-matches 1, 2, 3 and 4 and post-match 3. The pre-match 4 values were lower than post-matches 2 and 4.

Conclusion

Although there were some changes during simulated competition, important alterations in the hydroelectrolytic balance did not occur.

     

Synthesis of dental matrix proteins and viability of odontoblast-like cells irradiated with blue LED

To evaluate the effect of irradiation with light-emitting diode (LED; 455 nm) on the viability and synthesis of dentin matrix proteins by odontoblast-like cells, MDPC-23 cells were cultivated (10⁴ cells/cm²) in 24-well culture plates. After 12 h incubation in Dulbecco’s modified Eagle’s medium (DMEM), the cells were submitted to nutritional restriction by means of reducing the concentration of fetal bovine serum (FBS) for an additional 12 h. Cells were irradiated one single time with one of the following energy densities (EDs): 0.5, 2, 4, 10, or 15 J/cm² and irradiance fixed at 20 mW/cm². Non-irradiated cells served as control. After 72 h, cells were evaluated with regard to viability (methylthiazol tetrazolium technique (MTT)), mineralization nodule (MN) formation, total protein (TP) production, alkaline phosphatase activity (ALP), and collagen synthesis (Sircol), n?=?8. The data were submitted to Kruskal–Wallis and Mann–Whitney tests (p?>?0.05). There was no statistical difference between the viability of cells irradiated or not (control), for all the EDs. However, an increase in TP was observed for all the EDs when compared with the control group. A reduced ALP activity was seen in all irradiated groups, except for the ED of 0.5 J/cm², which did not differ from the control. There was no difference between the irradiated groups and control regarding collagen synthesis, with the exception of the ED of 10 J/cm², which inhibited this cell function. Significant reduction in MN occurred only for the EDs of 0.5 and 2 J/cm². The single irradiation with blue LED (455 nm), irradiance of 20 mW/cm², and energy densities ranging from 0.5 to 15 J/cm² exerted no effective biostimulatory capacity on odontoblast-like cells.