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- Bypass of Quality Control in Protein Folding Pathways Induces Specific Misfolding of HIV Envelope V2 Loop: Implications for Iminosugars as Antivirals. [JOURNAL ARTICLE]
- AIDS Res Hum Retroviruses 2014 Oct; 30(S1):A49.
- The effect of perfusion pressure on the splanchnic circulation after CPB: a pilot study. [JOURNAL ARTICLE]
- Minerva Anestesiol 2014 Oct 30.
The impact of different blood pressure targets is unknown for post cardiac surgery patient in the intensive care unit. We, therefore, investigated the effects of a mean arterial pressure (MAP) target of 65 or 85 mmHg on splanchnic oxygenation, metabolic function, cytokine regulation and gastric tonometry after cardiopulmonary bypass.16 patients were randomized to the HLH group (high-low--high) where MAP of 85--65--85 mmHg was targeted or the LHL group where MAP 65-85-65 mmHg was targeted with norepinephrine infusion.MAP targets were achieved in all patients at all timepoints (64±3, 84±4; 65±5, LHL group; vs. 84±3; 66±2; 85±5 mmHg, HLH group). At corresponding timepoints, hepatic venous saturation was 41±15; 58±24; 56±21 % in the LHL group vs. 50±19; 43±20; 41±18 % in the HLH group (p<0.05). No changes were observed in cardiac output, global or trans-splanchnic lactate levels and cytokine levels or in gastric tonometry CO2.Achieving a MAP target of 85 mmHg by means of norepinephrine infusion after CPB appears safe for the splanchnic circulation.
- The Correlation of Matrix Metalloproteinase 9-to-Albumin Ratio in Wound Fluid with Postsurgical Complications after Body Contouring. [JOURNAL ARTICLE]
- Plast Reconstr Surg 2014 Oct; 134(4):530e-538e.
The authors' earlier retrospective report of surgical complications after abdominal contouring surgery provided evidence that post-bariatric surgery patients are at increased risk of developing wound complications compared with a normal population. This prospective pilot study was designed as a comparative analysis of both surgical and wound healing characteristics between massive weight loss and normal patients who present for abdominal contouring surgery.Excisional wounds were created and polytetrafluoroethylene tubing was inserted during the preoperative period for later harvesting in patients undergoing abdominal contouring following Roux-en-Y gastric bypass for weight loss (n = 16) or abdominoplasty (n = 17). Wound fluids were sequentially collected from drains and subjected to matrix metalloproteinase (MMP) analysis. Standard postsurgical complications were documented.Surgical complications were more common in weight loss patients (47 percent) than in control patients (25 percent). MMP analyses showed that MMP-9 levels remained significantly elevated at postoperative day 4 in patients who subsequently experienced complications in either the weight loss group (p = 0.02) or the control group (p = 0.03). Other parameters showed no significant differences between massive weight loss patients and controls.Although many markers were examined, the ratio of MMP-9 to albumin was the only predictor of postsurgical complications in any group. This lends further support to growing evidence that MMP-9 may be a useful biomarker of postsurgical complications. This pilot work showed no causal factors that explain the higher rates of postsurgical complications in the post-bariatric surgery patient population.Risk, II.
- Development of Excess Skin and Request for Body-Contouring Surgery in Postbariatric Adolescents. [JOURNAL ARTICLE]
- Plast Reconstr Surg 2014 Oct; 134(4):627-636.
Little is known about the development of excess skin and requests for body-contouring surgery after bariatric surgery in adolescents.Forty-seven of 86 adolescents that had undergone gastric bypass surgery answered two questionnaires regarding excess skin and requests for and performed body-contouring surgery. An objective assessment of the amount of excess skin was also performed. The results were compared to earlier results from postbariatric adults.The most common overall problem in adolescents was the feeling of having an unattractive body (91 percent). The most common locations for developing excess skin were the upper arms and thighs according to the measurements. Five of 47 adolescents had undergone body-contouring surgery, and 88 percent of the others desired one or more body-contouring operations. Correlations were found between the objectively measured excess skin and the subjectively experienced amount of excess skin. Correlations were also found between the measured excess skin and the experienced discomfort of excess skin for the abdomen, breast/chest, upper arms, and chin.The authors' results indicate that bariatric surgery in adolescents often leads to severe problems associated with excess skin in both sexes. Thus, the commonly held belief that young people do not develop excess skin to the same extent as adults is strongly questioned. Health care professionals must address the current imbalance between requests for and the performance of body-contouring surgery in adolescents.Therapeutic, IV.
- Preparation of sustained-release composite coating formed by dexamethasone and oxidated sodium alginate. [Journal Article]
- Int J Clin Exp Med 2014; 7(9):3053-61.
Inflammatory reaction and thrombosis are the unsolved main problems of non-coated biomaterials applied in cardiac surgery. In the present study, a series of sustained composite coating was prepared and characterized, such as in the chemical modification of polyvinyl chloride (PVC) for applications in cardiac surgery and the assessment of the biological property of modified PVC. The composite coatings were mainly formed by dexamethasone (DXM) and oxidated sodium alginate (OSA) through ionic and covalent bond methods. The biocompatibility and hemocompatibility of the coating surface were evaluated. Scanning electron microscopy analysis of the surface morphologies of the thrombus and platelets revealed that DXM-OSA coating improved the antithrombogenicity and biocompatibility of PVC circuits, which were essential for cardiac pulmonary bypass surgery. Evaluation of in vitro release revealed that the DXM on group PPC was gradually released in 8 h. Thus, DXM that covalently combined on the PVC surface showed sustained release. By contrast, DXM on groups PPI and PPD was quickly or shortly released, suggesting that groups PPI and PPD did not have sustained-release property. Overall, results indicated that the DXM-OSA composite coating may be a promising coating for the sustained delivery of DXM.
- Retrograde approach to coronary chronic total occlusion via an occluded saphenous bypass graft: a case report. [Journal Article]
- Clin Case Rep 2013 Dec; 1(2):54-8.
Retrograde coronary intervention of chronic total coronary occlusion remains challenging. We describe a successful retrograde intervention of chronically occluded right coronary artery ostium via an occluded vein graft. An occluded saphenous vein graft can be a useful means to access the distal coronary bed, enabling delivery of retrograde percutaneous coronary intervention (PCI) equipment.
- Leptin deficiency is involved in the cognitive impairment of streptozocin-induced diabetic rats undergoing cardiopulmonary bypass. [Journal Article]
- Int J Clin Exp Med 2014; 7(9):2571-7.
Several lines of evidence have demonstrated that leptin is probably involved in the cognitive impairment which induced by a single injection of streptozocin (STZ). However, there is little literature reporting the relationship between cognitive impairment and cardiopulmonary bypass (CPB). This study aimed to investigate the role of leptin in the cognitive impairment of STZ-induced diabetic rats undergoing CPB. Wistar rats received 2 h of CPB exposure 1 month after a single intraperitoneal injection of 60 mg/kg of STZ or the vehicle. Behavioral results of rats in Morris water maze were recorded. After that, rat hippocampi were harvested for measuring leptin, tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). Besides, we observed intracerebroventricular injection of leptin on the cognitive impairment of diabetic-rats undergoing CPB and measured behavioral performance and hippocampal TNF-α and IL-1β levels. Rats undergoing CPB significantly aggravates STZ-induced an increase of the latency to the platform and a decrease of the proportion of time spent in the target quadrant of rats in Morris water maze test. Additionally, the expression of leptin significantly decreased, while TNF-α and IL-1β levels significantly increased. Moreover, intracerebroventricular injection of leptin has a therapeutic effect for cognitive impairment of diabetic rats undergoing CPB. Leptin deficiency in hippocampus is probably involved in the cognitive impairment of streptozocin-induced diabetic rats undergoing cardiopulmonary bypass.
- The Long-Term Effects of Bariatric Surgery for Type 2 Diabetes: Systematic Review and Meta-analysis of Randomized and Non-randomized Evidence. [JOURNAL ARTICLE]
- Obes Surg 2014 Oct 30.
This study aims to assess the long-term effects of bariatric surgery on type 2 diabetic patients. We searched Cochrane Library, PubMed, and EMbase up to Dec 2013. Randomized controlled trials (RCTs) and cohort studies of bariatric surgery for diabetes patients that reported data with more than 2 years of follow-up were included. We used rigorous methods to screen studies for eligibility and collected data using standardized forms. Where applicable, we pooled data by meta-analyses. Twenty-six studies, including 2 RCTs and 24 cohort studies that enrolled 7883 patients, proved eligible. Despite the differences in the design, those studies consistently showed that bariatric surgery offered better treatment outcomes than non-surgical options. Pooling of cohort studies showed that BMI decreased by 13.4 kg/m(2) (95 % confidence interval (CI), -17.7 to -9.1), fasting blood glucose by 59.7 mg/dl (95 % CI, -74.6 to -44.9), and glycated hemoglobin by 1.8 % (95 % CI, -2.4 to -1.3). Diabetes was improved or in remission in 89.2 % of patients, and 64.7 % of patients was in remission. Weight loss and diabetes remission were greatest in patients undergoing biliopancreatic diversion/duodenal switch, followed by gastric bypass, sleeve gastrectomy, and adjustable gastric banding. Bariatric surgery may achieve sustained weight loss, glucose control, and diabetes remission. Large randomized trials with long-term follow-up are warranted to demonstrate the effect on outcomes important to patients (e.g., cardiovascular events).
- Polymerase η suppresses telomere defects induced by DNA damaging agents. [JOURNAL ARTICLE]
- Nucleic Acids Res 2014 Oct 29.
Telomeres at chromosome ends are normally masked from proteins that signal and repair DNA double strand breaks (DSBs). Bulky DNA lesions can cause DSBs if they block DNA replication, unless they are bypassed by translesion (TLS) DNA polymerases. Here, we investigated roles for TLS polymerase η, (polη) in preserving telomeres following acute physical UVC exposure and chronic chemical Cr(VI) exposure, which both induce blocking lesions. We report that polη protects against cytotoxicity and replication stress caused by Cr(VI), similar to results with ultraviolet C light (UVC). Both exposures induce ataxia telangiectasia and Rad3-related (ATR) kinase and polη accumulation into nuclear foci and localization to individual telomeres, consistent with replication fork stalling at DNA lesions. Polη-deficient cells exhibited greater numbers of telomeres that co-localized with DSB response proteins after exposures. Furthermore, the genotoxic exposures induced telomere aberrations associated with failures in telomere replication that were suppressed by polη. We propose that polη's ability to bypass bulky DNA lesions at telomeres is critical for proper telomere replication following genotoxic exposures.