Safety of peritoneal dialysis catheter surgery under dexmedetomidine and local anesthesia for elderly patients in Japan: a single-center prospective cohort study

Clinical and Experimental Nephrology - The number of patients aged ≥ 75 years and who need renal replacement therapy is steadily increasing. The study aimed to determine...     

三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中的运用

目的探讨三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中的优势。方法将2015年4月至10月同济大学附属东方医院肝胆外科行二维腹腔镜联合胆道镜胆囊取石术33例患者(二维组)与同期行三维腹腔镜联合胆道镜胆囊取石术30例患者(三维组)的临床资料进行对照研究,比较两组的手术时间、胆囊缝合时间、术中出血量等有无差异。结果两组手术均成功完成,63例患者中,二维组有3例、三维组有4例中转切胆术式(P0.05),均无中转开腹患者。手术时间、胆囊缝合时间、术中出血量,二维组分别为(31.7±4.8)min、(14.2±3.0)min、(9.1±3.8)ml,三维组分别为(29.4±4.7)min、(11.7±2.4)min、(8.5±3.2)ml;两组的胆囊缝合时间比较,差异有统计学意义(P0.05),手术时间、术中出血量比较,差异无统计学意义(P0.05)。两组患者术后均随访6个月,无结石复发,无再次住院。结论三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中安全、有效,在一定程度上可缩短胆囊缝合时间,提高胆囊缝合质量,降低手术难度,可作为腹腔镜联合胆道镜胆囊取石术的选择。     

Paraganglioma of the cauda equina: a tertiary centre experience and scoping review of the current literature

Neurosurgical Review - Cauda equina paragangliomas are rare benign extra-adrenal neuroendocrine tumours arising from the neural crest cells associated with autonomic ganglia. These tumours are...     

Continuous fever-range heat stress induces thermotolerance in odontoblast-leneage cells

Objective

Heat shock during restorative procedures can trigger damage to the pulpodentin complex. While severe heat shock has toxic effects, fever-range heat stress exerts beneficial effects on several cells and tissues. In this study, we examined whether continuous fever-range heat stress (CFHS) has beneficial effects on thermotolerance in the rat clonal dental pulp cell line with odontoblastic properties, KN-3.

Methods

KN-3 cells were cultured at 41 °C for various periods, and the expression level of several proteins was assessed by Western blot analysis. After pre-heat-treatment at 41 °C for various periods, KN-3 cells were exposed to lethal severe heat shock (LSHS) at 49 °C for 10 min, and cell viability was examined using the MTS assay. Additionally, the expression level of odontoblast differentiation makers in surviving cells was examined by Western blot analysis.

Results

CFHS increased the expression levels of several heat shock proteins (HSPs) in KN-3 cells, and induced transient cell cycle arrest. KN-3 cells, not pre-heated or exposed to CFHS for 1 or 3 h, died after exposure to LSHS. In contrast, KN-3 cells exposed to CFHS for 12 h were transiently lower on day 1, but increased on day 3 after LSHS. The surviving cells expressed odontoblast differentiation markers, dentine sialoprotein and dentine matrix protein-1. These results suggest that CFHS for 12 h improves tolerance to LSHS by inducing HSPs expression and cell cycle arrest in KN-3 cells.

Conclusions

The appropriate pretreatment with continuous fever-range heat stress can provide protection against lethal heat shock in KN-3 cells.     

Ketogenic Effects of Multiple Doses of a Medium Chain Triglycerides Enriched Ketogenic Formula in Healthy Men under the Ketogenic Diet: A Randomized,Double-Blinded,Placebo-Controlled Study

Ketogenic diets, which are carbohydrate-restricted high-fat diets, may have therapeutic effects on various diseases, including cancer. However, ketogenic diets are often not standardized and, therefore, results are difficult to interpret. We previously investigated the usefulness of ketogenic diets in cancer therapy, where ketogenic formulas (KF) were used as supplements to enhance blood ketone bodies; however, the amount of KF was determined empirically with reference to blood ketone bodies levels. Here, to determine a standardized optimal amount of KF, we investigated temporal changes in blood ketone bodies (acetoacetic acid (AcAc), β-hydroxybutyrate (BHB)) and safety in 20 healthy individuals when KF was taken repeatedly under the conditions of a ketogenic diet (UMIN000034216). The diurnal variation in total ketone bodies, and AcAc and BHB levels significantly increased after lunch and after dinner, on the 4th day of KF administration. There were no significant safety issues related to KF in the context of anthropometric, metabolic, nutritional, urological and gastrointestinal parameters. In addition, ketogenic diets lead to changes in gut microbiota. KF showed a decrease in phylum Firmicutes. Our study provides baseline data of the usefulness of KF in a ketogenic diet.