Impact of monopolar radiofrequency coagulation on intraoperative blood loss during liver resection: a prospective randomised controlled trial

Purpose: To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection.

Materials and methods: A prospective randomised controlled trial was planned. Patients undergoing hepatectomy were randomised into two groups. In the control group (n?=?10), hemostasis was obtained with a combination of stitches, vessel-sealing bipolar RF systems, sutures or clips. In the monopolar radiofrequency coagulation (MRFC) group (n?=?18), hemostasis was mainly obtained using an internally cooled monopolar RF electrode.

Results: No differences in demographic or clinical characteristics were found between groups. Mean blood loss during liver resection in the control group was more than twice that of the MRFC group (556?±?471?ml vs. 225?±?313?ml, p?=?.02). The adjusted mean bleeding/transection area was also significantly higher in the control group (7.0?±?3.3?ml/cm² vs. 2.8?±?4.0?ml/cm², p?=?.006). No significant differences were observed in the rate of complications between the groups.

Conclusions: The findings suggest that the monopolar electrocoagulation created with an internally cooled RF electrode considerably reduces intraoperative blood loss during liver resection.     

Vitrified blastocysts from Preimplantation Genetic Diagnosis (PGD) as a source for human Embryonic Stem Cell (hESC) derivation

Embryos diagnosed as abnormal in Preimplantation Genetic Diagnosis (PGD) cycles are useful for the establishment of human Embryonic Stem Cells (hESC) lines with genetic disorders. These lines can be helpful for drug screening and for the development of new treatments. Vitrification has proved to be an efficient method to preserve human blastocysts. One hundred and three abnormal or undiagnosed vitrified blastocysts from the PGD programme at Institut Universitari Dexeus were donated for human embryonic stem cell derivation. The overall survival rate after warming was 70.6 %. Our results showed better survival rates when blastocysts have not started the hatching process (initial/expanded 87.8 %, hatching 68.3 % and hatched 27.3 %). Thirty-five blastocysts and 12 partially surviving embryos were seeded. One hESC line with the multiple exostoses type 2 paternal mutation was obtained.     

Intracisternal Gtf2i Gene Therapy Ameliorates Deficits in Cognition and Synaptic Plasticity of a Mouse Model of Williams–Beuren Syndrome

Williams–Beuren syndrome (WBS) is a neurodevelopmental disorder caused by a heterozygous deletion of 26–28 genes at chromosome band 7q11.23. Haploinsufficiency at GTF2I has been shown to play a major role in the neurobehavioral phenotype. By characterizing the neuronal architecture in four animal models with intragenic, partial, and complete deletions of the WBS critical interval (ΔGtf2i^+/–, ΔGtf2i^–/–, PD, and CD), we clarify the involvement of Gtf2i in neurocognitive features. All mutant mice showed hypersociability, impaired motor learning and coordination, and altered anxiety-like behavior. Dendritic length was decreased in the CA1 of ΔGtf2i^+/–, ΔGtf2i ^–/–, and CD mice. Spine density was reduced, and spines were shorter in ΔGtf2i ^–/–, PD, and CD mice. Overexpression of Pik3r1 and downregulation of Bdnf were observed in ΔGtf2i^+/–, PD, and CD mice. Intracisternal Gtf2i-gene therapy in CD mice using adeno-associated virus resulted in increased mGtf2i expression and normalization of Bdnf levels, along with beneficial effects in motor coordination, sociability, and anxiety, despite no significant changes in neuronal architecture. Our findings further indicate that Gtf2i haploinsufficiency plays an important role in the neurodevelopmental and cognitive abnormalities of WBS and that it is possible to rescue part of this neurocognitive phenotype by restoring Gtf2i expression levels in specific brain areas.     

Accuracy of the Narrow-Band Imaging International Colorectal Endoscopic Classification System in Identification of Deep Invasion in Colorectal Polyps

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Patterns of mortality in a cohort of workers followed during 28 years: the Manresa study

INTRODUCTION AND OBJECTIVES: To describe mortality patterns in a cohort of workers followed for 28 years, to estimate possible trends, and to compare the findings with those for the general population. SUBJECTS AND METHOD: The cohort included 1059 healthy male workers aged 30 to 59 years and followed for 28 years. Physical examinations and structured interviews were carried out every 5 years. Deaths were recorded from death certificates. The standardized mortality ratio (SMR) was calculated using sex- and age-specific mortality rates for the Catalan population as a reference for the same time period. RESULTS: The number of observed deaths in this cohort was 259 (24%). The main causes of death were cardiovascular diseases (n = 90, 35%) and cancer (n = 90, 35%). No excess mortality was observed in the cohort in comparison to the general population. All-cause mortality was lower, and cause-specific mortality was lower than or similar to rates in the general population. Overall, 382 deaths were expected, resulting in a significantly lower standardized mortality ratio of 67.7% (95% CI: 59.7%-76.5%). CONCLUSIONS: The patterns of mortality in this cohort of male workers were similar to those in the general population. Total mortality was lower than expected--evidence of the "healthy worker effect" which was particularly strong during the early part of the follow-up period.