Laparoscopic distal gastrectomy in a patient with gastric cancer complicated by eventration of the diaphragm: A case report

Abstract

Diaphragmatic eventration refers to an abnormal elevation of the diaphragm. Here, we report the case of a patient with gastric cancer who underwent successful laparoscopic distal gastrectomy despite the presence of diaphragmatic eventration. The patient was a 72‐year‐old man diagnosed with early gastric cancer in the antrum, as detected by upper gastrointestinal endoscopy. Preoperative imaging revealed an elevation of the left side of the diaphragm, which was diagnosed as diaphragmatic eventration. Laparoscopic surgery is beneficial for obtaining an optimal field of view. However, there are critical points that must be considered when laparoscopic distal gastrectomy is performed in patients with gastric cancer complicated by diaphragmatic eventration. There were difficulties that affected manipulation because the elevated diaphragm drew the intraperitoneal organs into the thoracic cavity, causing displacement of the normal anatomical position. We found it beneficial to secure the lesser curvature of the stomach given the possible effects of gastric deformation.

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Comparative Analysis of Carbapenem-Resistant Acinetobacter baumannii Sequence Types in Southern Brazil: From the First Outbreak (2007–2008) to the Endemic Period (2013–2014)

Microbial Drug Resistance, Ahead of Print.


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Lipid metabolism in adipose tissue and liver from diet-induced obese rats: a comparison between Wistar and Sprague-Dawley strains

Abstract

Some researchers have proposed important variations in adipose tissue among different strains of rats and mice in response to a high-caloric (hc) diet, but data concerning the mechanisms underlying these differences are scarce. The aim of the present research was to characterize different aspects of triacylglycerol (TG) metabolism and clock genes between Sprague-Dawley and Wistar rats. For this purpose, 16 male Sprague-Dawley and 16 male Wistar rats were divided into four experimental groups (n = 8) and fed either a normal-caloric (nc) diet or a hc diet for 6 weeks. After sacrifice, liver and epididymal, perirenal, mesenteric, and subcutaneous adipose tissue depots were dissected, weighed and immediately frozen. Liver TG content was quantified, RNA extracted for gene expression analysis and fatty acid synthase enzyme activity measured. Two-way ANOVA and Student's t test were used to perform the statistical analyses. Under hc feeding conditions, Wistar rats were more prone to fat accumulation in adipose tissue, especially in the epididymal fat depot, due to their increased lipogenesis and fatty acid uptake. By contrast, both strains of rats showed similarly fatty livers after hc feeding. Peripheral clock machinery seems to be a potential explanatory mechanism for Wistar and Sprague-Dawley strain differences. In conclusion, Wistar strain seems to be the best choice as animal model in dietary-induced obesity studies.

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Multi-material Three-Dimensional Food Printing with Simultaneous Infrared Cooking

3D Printing and Additive Manufacturing, Ahead of Print.


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All EMS providers deserve equal protection

Why it is time to do away with different rules for different providers under the Firefighter Bill of Rights

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Hemosuccus Pancreaticus and Hematochezia — An Unusual Presentation of a Rare Disease

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Dose De-escalation to Adalimumab 40 mg Every Three Weeks in Patients With Inflammatory Bowel Disease – a Multicenter, Retrospective, Observational Study

Data about the outcomes after adalimumab dose de-escalation in inflammatory bowel disease (IBD) are scarce.

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Selective Blocking Laminoplasty in Cervical Laminectomy and Fusion to Prevent Postoperative C5 Palsy

Cervical laminectomy and fusion (CLF) is a common surgical option for multi-level cord compression. Postoperative C5 palsy occurrence after CLF has been a vexing problem for spine physicians. The posterior shift of the cord following laminectomy has been implicated as a major factor for postoperative C5 palsy, but attempts by spine surgeons to mitigate excessive shift while providing sufficient decompression have not been well reported.

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Optimal Satellite Rod Constructs to Mitigate Rod Failure Following Pedicle Subtraction Osteotomy (PSO): A Finite Element Study

Pedicle subtraction osteotomy (PSO) is a challenging restoration technique for sagittal imbalance and is associated with significant complications. One of the major complications is rod fracture and there exists a need for a biomechanical assessment of this complication for various instrumentation configurations.

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Hemosuccus Pancreaticus and Hematochezia — An Unusual Presentation of a Rare Disease

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Dose De-escalation to Adalimumab 40 mg Every Three Weeks in Patients With Inflammatory Bowel Disease – a Multicenter, Retrospective, Observational Study

Data about the outcomes after adalimumab dose de-escalation in inflammatory bowel disease (IBD) are scarce.

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Novel Withdrawal Symptoms of a Neonate Prenatally Exposed to a Fentanyl Analog

Neonatal abstinence syndrome (NAS) is a withdrawal syndrome observed in neonates exposed to drugs in utero, typically opioids, which is associated with symptoms affecting the central and autonomic nervous systems and the gastrointestinal system. West Virginia, particularly the southeastern region of the state, has remarkably higher rates of NAS than similar communities. Our facility is increasingly faced with complex cases of NAS caused by in utero exposure to multiple substances. We present a case report of a neonate born to a 25-year-old mother enrolled in a medication-assisted treatment program for substance use disorder who was noncompliant in prenatal care, using multiple substances throughout the pregnancy, including gabapentin and fentanyl.

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Spotlight: Cradlepoint features a cloud-managed 4G LTE in-vehicle router, creating a secure and reliable network for first responders.

Cradlepoint is committed to making sure first responders can rely on them to keep them connected and protected.

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Impact of antagonistic muscle co-contraction on in vivo knee contact forces

The onset and progression of osteoarthritis, but also the wear and loosening of the components of an artificial joint, are commonly associated with mechanical overloading of the structures. Knowledge of the me...

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Time course of changes in motor-cognitive exergame performances during task-specific training in patients with dementia: identification and predictors of early training response

Some studies have already suggested that exergame interventions can be effective to improve physical, cognitive, motor-cognitive, and psychological outcomes in patients with dementia (PwD). However, little is ...

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Amputee perception of prosthetic ankle stiffness during locomotion

Prosthetic feet are spring-like, and their stiffness critically affects the wearer's stability, comfort, and energetic cost of walking. Despite the importance of stiffness in ambulation, the prescription proce...

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3 ways to improve your community paramedicine program

Brought to you by Medline Amidst rising costs and dramatic changes to healthcare reimbursements, the entire system has been tasked with discovering new and effective means to prevent and manage chronic health conditions. Throughout the country, Community Paramedicine programs have proven effective, providing follow-up care, education, and referrals when additional resources are needed. At home...

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Get an edge in EMS: Protect your staff, patients and business

Medline's presence at EMS World marked by unique insights for opioid crisis and budget issues. As thousands of emergency medical services professionals converge on Nashville, Tenn., Medline EMS will be at the 2018 EMS World Expo to help them keep up with the constant changes and demands of the industry. Along with solutions for revenue, patient care, and cost savings at the Medline EMS...

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Current and future perspectives of liquid biopsies in genomics-driven oncology

Current and future perspectives of liquid biopsies in genomics-driven oncology

Current and future perspectives of liquid biopsies in genomics-driven oncology, Published online: 08 November 2018; doi:10.1038/s41576-018-0071-5

Liquid biopsies enable non-invasive, longitudinal analysis of tumour components (including circulating tumour cells and circulating tumour DNA) in bodily fluids such as blood. However, their analytical and clinical validity must be rigorously demonstrated before they are adopted for precision oncology.

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New Pa. law provides reimbursement for non-transport calls

Act 103 of 2018 requires insurance companies and Medicaid to reimburse EMS agencies for calls where the EMS provider treated the patient without transport

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Firefighter-paramedic helps save life of man over the phone after taking 911 call

Norred, a 14-year veteran of the San Antonio Fire Department, helped Monica Pesek revive her unresponsive father after he suffered a stroke

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Why reducing patient anxiety makes the provider’s job easier

Prepare for awkward lifts with smart strategies and tools to boost patient confidence and avoid on-the-job injuries

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Ore. fire dept. launches PulsePoint app to enable 'citizen superheroes'

PulsePoint alerts users to cardiac arrests within a quarter mile of their location, so people can provide treatment before paramedics arrive

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How military medics can transition to civilian EMS

Licensing requirements and varying degrees of experience can make it difficult for returning servicemen to find jobs, but programs are emerging that can help

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Rapid Response: Active shooter response command decisions are made by first arriving ambulance crews, fire companies and police officers

What are the potential public policy, legislation, social service and healthcare actions fire/EMS providers should advocate to prevent mass shootings?

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Three-Dimensional Printed Braided Sleeves for Manufacturing McKibben Artificial Muscles

3D Printing and Additive Manufacturing, Ahead of Print.


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Support Optimization for Flat Features via Path Planning in Additive Manufacturing

3D Printing and Additive Manufacturing, Ahead of Print.


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Biological Background of Block Periodized Endurance Training: A Review

Abstract

Block periodized (BP) training is an innovative and prospective approach that is drawing increasing attention from coaching scientists and practitioners. However, its further dissemination and implementation demands serious scientific biological underpinnings. More specifically, the fundamental scientific concepts of homeostatic regulation, stress adaptation and the law of supercompensation determine the biological essence and content of appropriate block mesocycles, i.e., the accumulation, transmutation and realization cycles, respectively. Such a separation is intended to prevent conflicting physiological responses and provide a favorable interaction for training effects. Several studies have evaluated the metabolic effects of various training programs, and the superiority of the BP model has been confirmed in terms of significant gains of maximal oxygen uptake, maximal power output and positive trends in athletic performance. It was found that the endocrine status of athletes is strictly dependent on appropriate blocks such as voluminous extensive workloads combined with resistance training (accumulation), lower-volume intense training (transmutation), and event-specific precompetitive training (realization). Evidence from molecular biology indicates the major regulators that determine meaningful adaptive events within specific block mesocycles. Specifically, voluminous extensive accumulation blocks stimulate mitochondrial biogenesis and protein synthesis in slow-twitch muscle fibres, whereas lower-volume intense workloads of the transmutation blocks evoke adaptive modifications in fast-twitch glycolytic and oxidative-glycolytic muscle fibers. Furthermore, such a training program causes a remarkable elevation of myonuclear content in muscle fibers that enables athletes to regain previously acquired abilities. The precompetitive realization block produces accentuated expression of stress-related and myogenic genes that affect protein synthesis and increase muscle glycogen. In addition, such a program stimulates and increases the size, force and power of fast-twitch fibers.

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Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects

Abstract

The World Anti-Doping Agency is responsible for maintaining a Prohibited List that describes the use of substances and methods that are prohibited for athletes. The list currently contains 23 substance classes, and an important reason for the existence of this list is to prevent unfair competition due to pharmacologically enhanced performance. The aim of this review was to give an overview of the available evidence for performance enhancement of these substance classes. We searched the scientific literature through PubMed for studies and reviews evaluating the effects of substance classes on performance. Findings from double-blind, randomized controlled trials were considered as evidence for (the absence of) effects if they were performed in trained subjects measuring relevant performance outcomes. Only 5 of 23 substance classes show evidence of having the ability to enhance actual sports performance, i.e. anabolic agents, β2-agonists, stimulants, glucocorticoids and β-blockers. One additional class, growth hormone, has similar evidence but only in untrained subjects. The observed effects all relate to strength or sprint performance (and accuracy for β-blockers); there are no studies showing positive effects on reliable markers of endurance performance. For 11 classes, no well-designed studies are available, and, for the remaining six classes, there is evidence of an absence of a positive effect. In conclusion, for the majority of substance classes, no convincing evidence for performance enhancement is available, while, for the remaining classes, the evidence is based on a total of only 266 subjects from 11 studies.

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Awake fiberoptic nasotracheal intubation for patients with difficult airway.

Related Articles

Awake fiberoptic nasotracheal intubation for patients with difficult airway.

J Dent Anesth Pain Med. 2018 Oct;18(5):301-304

Authors: Tsukamoto M, Hitosugi T, Yokoyama T

Abstract
Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received 50 µg of fentanyl 2-3 times (total 2.2-2.3 µg/kg) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.

PMID: 30402550 [PubMed]

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Stakeholder Perspectives on Implementing Cognitive Behavioral Social Skills Training on Assertive Community Treatment Teams

Abstract

This study examined stakeholder perceptions of the "fit" between cognitive-behavioral social skills training (CBSST) and assertive community treatment (ACT) when implementing CBSST into existing community-based ACT teams. Focus group feedback was collected from a diverse set of stakeholders (i.e., clients, providers, supervisors, agency administrators, public sector representatives, and intervention developers). Results identified perceived client and provider benefits for integrating CBSST into ACT while highlighting the importance of purposeful adaptations, training, and implementation tools to facilitate structural and values fit between CBSST and ACT. Study findings will inform future endeavors to implement CBSST and other relevant EBPs into ACT. Trial Registry: ClinicalTrials.gov #NCT02254733.

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Current and future perspectives of liquid biopsies in genomics-driven oncology

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Comparative evidence for the independent evolution of hair and sweat gland traits in primates

Publication date: December 2018

Source: Journal of Human Evolution, Volume 125

Author(s): Yana G. Kamberov, Samantha M. Guhan, Alessandra DeMarchis, Judy Jiang, Sara Sherwood Wright, Bruce A. Morgan, Pardis C. Sabeti, Clifford J. Tabin, Daniel E. Lieberman

Abstract

Humans differ in many respects from other primates, but perhaps no derived human feature is more striking than our naked skin. Long purported to be adaptive, humans' unique external appearance is characterized by changes in both the patterning of hair follicles and eccrine sweat glands, producing decreased hair cover and increased sweat gland density. Despite the conspicuousness of these features and their potential evolutionary importance, there is a lack of clarity regarding how they evolved within the primate lineage. We thus collected and quantified the density of hair follicles and eccrine sweat glands from five regions of the skin in three species of primates: macaque, chimpanzee and human. Although human hair cover is greatly attenuated relative to that of our close relatives, we find that humans have a chimpanzee-like hair density that is significantly lower than that of macaques. In contrast, eccrine gland density is on average 10-fold higher in humans compared to chimpanzees and macaques, whose density is strikingly similar. Our findings suggest that a decrease in hair density in the ancestors of humans and apes was followed by an increase in eccrine gland density and a reduction in fur cover in humans. This work answers long-standing questions about the traits that make human skin unique and substantiates a model in which the evolution of expanded eccrine gland density was exclusive to the human lineage.

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Cardiac basal autophagic activity and increased exercise capacity

Abstract

To investigate whether high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) have different impacts on exercise performance and cardiac function and to determine the influence of these exercise protocols on modulating basal autophagy in the cardiac muscle of rats. Rats were assigned to three groups: sedentary control (SC), CMT, and HIIT. Total exercise volume and mean intensity were matched between the two protocols. After a 10-week training program, rats were evaluated for exercise performance, including exercise tolerance and grip strength. Blood lactate levels were measured after an incremental exercise test. Cardiac function and morphology were assessed by echocardiography. Western blotting was used to evaluate the expression of autophagy and mitochondrial markers. Transmission electron microscopy was used to evaluate mitochondrial content. The results showed that time to exhaustion and grip strength increased significantly in the HIIT group compared with the SC and CMT groups. Both training interventions significantly increased time to exhaustion, reduced blood lactate level (after an incremental exercise test) and induced adaptive changes in cardiac morphology, but without altering cardiac systolic function. The greater improvements in exercise performance with the HIIT than with the CMT protocol were related to improvement in basal autophagic adaptation and mitochondria function in cardiac muscle. Mitochondria markers were positively correlated with autophagy makers. This study shows that HIIT is more effective for improving exercise performance than CMT and this improvement is related to mitochondrial function and basal autophagic adaptation in cardiac muscle.

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Effects of dried tofu supplementation during interval walking training on the methylation of the NFKB2 gene in the whole blood of older women

Abstract

Muscle atrophy with aging is closely associated with chronic systemic inflammation and lifestyle-related diseases. Here, we assessed whether dried tofu intake during 5-month interval walking training (IWT) enhanced increases in thigh muscle mass and strength and ameliorated susceptibility to inflammation in older women. Subjects (n = 32, ~ 65 years) who performed IWT for > 6 months participated in this study. They were randomly divided into 2 groups: IWT + placebo intake (PLG, n = 16; 108 kcal, 0.2 g protein, 5.5 g fat, and 14.4 g carbohydrate) and IWT + dried tofu intake (DTG, n = 16; 111 kcal, 9.6 g protein, 6.0 g fat, and 4.6 g carbohydrate). They were instructed to repeat ≥ 5 sets of fast and slow walking for 3 min each at ≥ 70 and 40% peak aerobic capacity for walking, respectively, per day for ≥ 4 days/week. Immediately after daily exercise, subjects were instructed to consume the supplements assigned to each group. In the DTG, after IWT, the methylation increased at 4/6 sites in the promoter region of the NFKB2 gene in the whole blood (all, P < 0.04), with an 18% increase in the average methylation of the 6 sites (P = 0.035). On the other hand, in the PLG, the increase occurred at only 2/6 sites, with no significant increase in the average methylation of the 6 sites. No significant differences were observed in increases in thigh muscle strength or cross-sectional area between the groups (all, P > 0.2). Altogether, dried tofu supplementation during IWT likely enhanced the methylation of the NFKB2 gene more than IWT alone, without detectably enhanced increases in thigh muscle strength or cross-sectional area.

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Post-myocardial infarction exercise training beneficially regulates thyroid hormone receptor isoforms

Abstract

Thyroid hormone receptors (TRs) play a critical role in the expression of genes that are major determinants of myocardial contractility, including α-myosin heavy chain (α-MHC) and β-MHC. After myocardial infarction (MI), changes in myocardial TRs consistently correlate with changes in thyroid hormone (TH) target gene transcription, and this is thought to play a key role in the progression to end-stage heart failure. Interestingly, post-MI exercise training has been shown to beneficially alter TH-target gene transcription and preserve cardiac function without changing serum TH. Therefore, in this study, we investigated whether mild exercise training alters expression of α1 and β1 TR isoforms in post-MI rats. Seven-week-old male Sprague–Dawley rats underwent coronary ligation or sham operation, and were assigned to 3 groups (n = 10): sham, sedentary MI (MI-Sed), and exercise MI (MI-Ex). Treadmill training was initiated 1 week post-MI, and gradually increased up to 16 m/min, 5° incline, 50 min/day, 5 days/week, and lasted for a total of 8 weeks. Real-time polymerase chain reaction and gel electrophoresis were performed to quantify changes in TR isoforms. Our results illustrated that mRNA expression of TR-α1 and TR-β1 was higher in both MIs; however, protein electrophoresis data showed that TR-α1 was 1.91-fold higher (P < 0.05) and TR-β1 was 1.62-fold higher (P < 0.05) in the MI-Ex group than in the MI-Sed group. After MI, TR-α1 and TR-β1 protein levels are significantly decreased in the surviving non-infarcted myocardium. Moderate-intensity exercise training significantly increases TR-α1 and TR-β1 protein expression, which in turn may upregulate α-MHC and improve myocardial contractile function and prognosis.

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Effects of load on the acute response of muscles proximal and distal to blood flow restriction

Abstract

To determine the effects of load and blood flow restriction (BFR) on muscular responses, we asked 12 participants to perform chest presses under four different conditions [30/0, 30/40, 50/0, and 50/40, presented as percentage one-repetition maximum (1RM)/percentage arterial occlusion pressure (AOP)]. Muscle thickness increased pre- to post-exercise [chest: mean 0.29, 95% confidence interval (CI) 0.21, 0.37 cm; triceps: mean 0.44, 95% CI 0.34, 0.54 cm], remaining elevated for 15 min post-exercise. Electromyography amplitude was greater with 50% 1RM and increased over time for the first three repetitions of each set of chest presses. The last three repetitions differed across time only. AOP increased from pre- to post-exercise, augmented by BFR [30/0: mean 31, 95% CI 18, 44 mmHg; 30/40: mean 39, 95% CI 28, 50 mmHg; 50/0: mean 32, 95% CI 23, 41 mmHg; 50/40: mean 46, 95% CI 32, 59 mmHg). Tranquility decreased and physical exhaustion increased from the pre- to post-condition, with both parameters returning to the baseline 15 min post-exercise level. In conclusion, load and BFR do not elicit meaningful differences in the acute response of chest press exercise taken to failure.

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Population-based study of outcomes following an initial acute diverticular abscess

British Journal of Surgery

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Predictors of nonalcoholic steatohepatitis and significant fibrosis in non-obese nonalcoholic fatty liver disease

Liver International

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Estimating prevalence of hepatitis C virus infection in the United States, 2013-2016

Hepatology

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Association of smoking with liver fibrosis and mortality in primary biliary cholangitis

European Journal of Gastroenterology & Hepatology

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Analysis of survival and prognostic factors in treatment of hepatocellular carcinoma in Spanish patients with drug-eluting bead transarterial chemoembolization

European Journal of Gastroenterology & Hepatology

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Randomized controlled trial of polyethylene glycol vs lactulose for the treatment of overt hepatic encephalopathy

European Journal of Gastroenterology & Hepatology

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Periodontitis is associated with incident chronic liver disease—A population-based cohort study

Liver International

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Human beta-defensin-1 is a highly predictive marker of mortality in patients with acute-on-chronic liver failure

Liver International

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Risk of mortality and level of serum alanine aminotransferase among community-dwelling elderly in Israel

European Journal of Gastroenterology & Hepatology

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Model for end-stage liver disease score and hemodynamic instability as a predictor of poor outcome in early transjugular intrahepatic portosystemic shunt treatment for acute variceal hemorrhage

European Journal of Gastroenterology & Hepatology

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Adverse outcomes of long-term use of proton pump inhibitors: A systematic review and meta-analysis

European Journal of Gastroenterology & Hepatology

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Transcranial Direct Current Stimulation in Pediatric Motor Disorders: A Systematic Review and Meta-analysis

Publication date: Available online 7 November 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Ghazala T. Saleem, Jewel E. Crasta, Beth Slomine, Gabriela Lucila Cantarero, Stacy J. Suskauer

Abstract

Objective

To systematically examine the safety and effectiveness of transcranial direct current stimulation (tDCS) interventions in pediatric motor disorders.

Data Sources

PubMed, EMBASE, Cochrane, CINAHL, Web of Science, and ProQuest databases were searched from inception to August 2018.

Study Selection

tDCS randomized controlled trials (RCTs), observational studies, conference proceedings and dissertations in pediatric motor disorders were included. Two authors independently screened articles based on predefined inclusion criteria.

Data Extraction

Data related to participant demographics, intervention, and outcomes were extracted by two authors. Quality assessment was independently performed by two authors.

Data Synthesis

Twenty-three studies involving a total of 391 participants were included. There was no difference in drop-out rates between active (1/144) and sham (1/144) tDCS groups, risk difference 0.0, 95% CI [-.05, .04]. Across studies, the most common adverse effects in the active group were tingling (17.2%), discomfort (8.02%), itching (6.79%), and skin redness (4%). Across 3 studies in children with cerebral palsy, tDCS significantly improved gait velocity (MD = .23; 95% CI [0.13, 0.34], p < .0005), stride length (MD = 0.10; 95% CI [0.05, 0.15], p< .0005), and cadence (MD = 15.7; 95% CI [9.72, 21.68], p< .0005). Mixed effects were found on balance, upper-extremity function, and overflow movements in dystonia.

Conclusion

Based on the studies reviewed, tDCS is a safe technique in pediatric motor disorders and may improve some gait measures and involuntary movements. Research to date in pediatric motor disorders shows limited effectiveness in improving balance and upper-extremity function. tDCS may serve as a potential adjunct to pediatric rehabilitation; to better understand if tDCS is beneficial for pediatric motor disorders, more well-designed RCTs are needed.

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Diagnostic efficacy of dual-focus endoscopy with narrow-band imaging using simplified dyad criteria for superficial esophageal squamous cell carcinoma

Abstract

Background

Our previous studies have shown the diagnostic utility of a newly developed dual-focus endoscope with narrow-band imaging (DF-NBI) and simplified dyad criteria for detection of superficial esophageal squamous cell carcinoma (SESCC). This clinical trial aimed to study the diagnostic efficacy of DF-NBI with dyad criteria for detecting SESCC compared to white light imaging (WLI).

Methods

This was a single-arm prospective comparative trial. We enrolled 170 consecutive high-risk patients for esophageal squamous cell carcinoma. Patients were initially examined with WLI by one independent endoscopist and then the other performed DF-NBI blinded to the WLI diagnosis to avoid a carry-over effect. Lesions showing proliferation and/or various shapes of intrapapillary capillary loops (IPCL) under DF-NBI (i.e., dyad criteria) were endoscopically diagnosed as SESCC including high-grade intraepithelial neoplasia. The primary endpoint was sensitivity of WLI and DF-NBI for detecting SESCC. The secondary endpoints were the diagnostic performance (i.e., specificity and accuracy) and inter/intra-observer concordance of DF-NBI with dyad criteria.

Results

A total 77 SESCCs were detected. The sensitivity of DF-NBI for SESCC was significantly higher than that of WLI (91% vs. 51%, P < 0.001). The specificity and accuracy of WLI and DF-NBI using dyad criteria were 100% vs. 84%, and 86% vs. 86%, respectively. Various shapes and proliferation of IPCL showed the highest value in inter-observer and intra-observer agreements (κ = 0.77 and 0.82, respectively).

Conclusion

DF-NBI combined with dyad criteria may be a promising technique with a high sensitivity for diagnosis of SESCC and high inter/intra-observer agreement.

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Post-transcriptional pseudouridylation in mRNA as well as in some major types of noncoding RNAs

Publication date: Available online 8 November 2018

Source: Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms

Author(s): Hironori Adachi, Meemanage D. De Zoysa, Yi-Tao Yu

Abstract

Pseudouridylation is a post-transcriptional isomerization reaction that converts a uridine to a pseudouridine (Ψ) within an RNA chain. Ψ has chemical properties that are distinct from that of uridine and any other known nucleotides. Experimental data accumulated thus far have indicated that Ψ is present in many different types of RNAs, including coding and noncoding RNAs. Ψ is particularly concentrated in rRNA and spliceosomal snRNAs, and plays an important role in protein translation and pre-mRNA splicing, respectively. Ψ has also been found in mRNA, but its function there remains essentially unknown. In this review, we discuss the mechanisms and functions of RNA pseudouridylation, focusing on rRNA, snRNA and mRNA. We also discuss the methods, which have been developed to detect Ψs in RNAs. This article is part of a Special Issue entitled: mRNA modifications in gene expression control edited by Dr. Soller Matthias and Dr. Fray Rupert.

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EP300-HDAC1-SWI/SNF functional unit defines transcription of some DNA repair enzymes during differentiation of human macrophages

Publication date: Available online 8 November 2018

Source: Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms

Author(s): Julita Pietrzak, Tomasz Płoszaj, Łukasz Pułaski, Agnieszka Robaszkiewicz

Abstract

Differentiation of human macrophages predisposes these cells to numerous tasks, i.e. killing invading pathogens, and this entails the need for enhanced intracellular defences against stress, including conditions that may increase DNA damage. Our study shows that expression of DNA repair enzymes, such as PARP1, BRCA1 and XRCC1, are activated during macrophage development by the SWI/SNF chromatin remodelling complex, which serves as a histone acetylation sensor. It recognises and displaces epigenetically marked nucleosomes, thereby enabling transcription. Acetylation is controlled both in monocytes and macrophages by the co-operation of EP300 and HDAC1 activities. Differentiation modulates the activities of individual components of EP300-HDAC1-SWI/SNF functional unit and entails recruitment of PBAF to gene promoters. In monocytes, histone-deacetylated promoters of repressed PARP1, BRCA1 and XRCC1 respond only to HDAC inhibition, with an opening of the chromatin structure by BRM, whereas in macrophages both EP300 and HDAC1 contribute to the fine-tuning of nucleosomal acetylation, with HDAC1 remaining active and the balance of EP300 and HDAC1 activities controlling nucleosome eviction by BRG1-containing SWI/SNF. Since EP300-HDAC1-SWI/SNF operates at the level of gene promoters characterized simultaneously by the presence of E2F binding site(s) and CpG island(s), this allows cells to adjust PARP1, BRCA1 and XRCC1 transcription to the differentiation mode and to restart cell cycle progression. Thus, mutual interdependence between acetylase and deacetylase activities defines the acetylation-dependent code for regulation of histone density and gene transcription by SWI/SNF, notably on gene promoters of DNA repair enzymes.

Graphical abstract

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Detection of ribonucleoside modifications by liquid chromatography coupled with mass spectrometry

Publication date: Available online 7 November 2018

Source: Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms

Author(s): Manasses Jora, Peter A. Lobue, Robert L. Ross, Brittney Williams, Balasubrahmanyam Addepalli

Abstract

A small set of ribonucleoside modifications have been found in different regions of mRNA including the open reading frame. Accurate detection of these specific modifications is critical to understanding their modulatory roles in facilitating mRNA maturation, translation and degradation. While transcriptome-wide next-generation sequencing (NGS) techniques could provide exhaustive information about the sites of one specific or class of modifications at a time, recent investigations strongly indicate cautionary interpretation due to the appearance of false positives. Therefore, it is suggested that NGS-based modification data can only be treated as predicted sites and their existence need to be validated by orthogonal methods. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is an analytical technique that can yield accurate and reproducible information about the qualitative and quantitative characteristics of ribonucleoside modifications. Here, we review the recent advancements in LC-MS/MS technology that could help in securing accurate, gold-standard quality information about the resident post-transcriptional modifications of mRNA.

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Dietary Fiber and Gastrointestinal Disease: an Evolving Story

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