Use of intra-abdominal drains.

The use of drains in colorectal surgery has been a subject of debate for several decades. Prophylactic drainage of the peritoneal cavity has become less popular in recent years. This change is due to several studies demonstrating that intraperitoneal drains do not adequately drain the peritoneal cavity and do not prevent or contain anastomotic leaks.

Preoperative optimization of crohn disease.

Crohn disease is a chronic disease that is treated with aminosalicylates, antibiotics, and immunosuppressant agents. Most patients ultimately require surgical intervention and many will require additional surgery for recurrent disease. Consequently, surgery is generally performed only when medical management fails; however, these patients are often malnourished and immunosuppressed.

Anatomic anterior cruciate ligament reconstruction with a flexible reamer system and 70° arthroscope.

Anterior cruciate ligament (ACL) reconstruction techniques continue to evolve as surgeons seek to improve surgical process and outcome measures. On the basis of published data showing improved biomechanics, many surgeons now attempt to better re-create native ACL anatomy in reconstruction. Use of flexible reamer technology and a 70° arthroscope allows for excellent visualization of the native ACL anatomy, as well as precise and independent drilling of the tibial and femoral reconstruction tunnels, while offering several surgical and technical advantages compared with other drilling techniques.

PTEN antagonises Tcl1/hnRNPK-mediated G6PD pre-mRNA splicing which contributes to hepatocarcinogenesis.

Background: Mounting epidemiological evidence supports a role for phosphatase and tensin homologue (PTEN)-T cell leukaemia 1 (Tcl1) signalling deregulation in hepatocarcinogenesis.

Objective: To determine the molecular and biochemical mechanisms by which the PTEN/Tcl1 axis regulates the pentose phosphate pathway (PPP) in hepatocellular carcinoma (HCC).

Methods: We compared levels of PTEN and glucose-6-phosphate dehydrogenase (G6PD) mRNA in human HCC and healthy liver tissue.

Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: a longitudinal study.

Studies show high rates of co-morbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) but there is no consensus on the causal direction of the relationship. Some theories suggest AUD develops as a coping mechanism to manage PTSD symptoms and others that AUD is a vulnerability factor for PTSD. A third hypothesis posits independent developmental pathways stemming from a shared etiology, such as the trauma exposure itself.

An epidemiologic analysis of clinical practice guidelines for non-arthroplasty treatment of osteoarthritis of the knee.

Purpose: To analyze the current practice patterns of non-arthroplasty treatment of knee osteoarthritis (OA) and to assess the impact of the American Academy of Orthopaedic Surgeons clinical practice guidelines on the management of OA of the knee, particularly as they relate to the use of arthroscopic treatment.

Methods: The United Healthcare Database (2004-2009, 11 million patients, 216 million records) was used for the study and was searched using Boolean language for International Classification of Diseases, Ninth Edition, Clinical Modification and Current Procedural Terminology, fourth revision codes. A reference group was defined as patients treated with knee arthroplasty in 2009 and diagnosed with knee OA in the same record.

A comparison of three types of therapies for three different ovulation disorders in establishing pregnancies and evaluation of laboratory parameters that could influence the outcome.

Purpose: To evaluate the empirical use of progesterone (P) in the luteal phase for unexplained infertility.

Methods: Clinical and live-delivered pregnancy rates in three treatment cycles were compared in women with unexplained infertility vs women taking follicle maturing drugs for women completely anovulatory or those who release the oocyte before the follicle is mature.

Results: There was insufficient power to show a significant difference in the 19.

Effect of poor motility on pregnancy outcome following intracytoplasmic sperm injection in couples whose male partners have subnormal hypo-osmotic swelling test scores.

Purpose: To determine the confounding effect, if any, of poor motility of sperm that are already compromised by an abnormal hypo-osmotic swelling (HOS) test on pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI).

Materials And Methods: Clinical and live-delivered pregnancy and implantation rates were retrospectively evaluated in first cycles of couples undergoing IVF-ET with ICSI where the HOS test was < 50% according to deciles of subnormal percentage motility (< 50%) and compared to those with normal motility > or = 50%.

Results: The combination of very poor motility and low HOS test scores did diminish pregnancy rates following IVF with ICSI.

Prevalence, predictors, and outcomes in treatment-resistant hypertension in patients with coronary disease.

Background: Increasingly, apparent treatment-resistant hypertension has been recognized. However, much of the prevalence, predictors, and outcomes are largely unknown, especially in patients with coronary artery disease.

Methods: We evaluated 10,001 patients with coronary artery disease who were enrolled in the Treating to New Targets trial.

The influence of dermatologist and primary care physician visits on melanoma outcomes among Medicare beneficiaries.

Background: Ambulatory visits to dermatologists and primary care physicians (PCPs) may improve melanoma outcomes through early detection. We sought to measure the effect of dermatologist and PCP visits on melanoma stage at diagnosis and mortality.

Methods: We used data from the database linking Surveillance Epidemiology and End Results (SEER) and Medicare data (1994 to 2005) to examine patterns of dermatologist and PCP ambulatory visits before diagnosis for 18,884 Medicare beneficiaries with invasive melanoma or unknown stage at diagnosis.

The biology of Nociceptin/Orphanin FQ (N/OFQ) related to obesity, stress, anxiety, mood, and drug dependence.

Nociceptin/Orphanin FQ (N/OFQ) is a 17 amino acid peptide that was deorphanized in 1995. The generation of specific agonists, antagonists and receptor deficient mice and rats has enabled progress in elucidating the biological functions of N/OFQ. Additionally, radio-imaging technologies have been advanced for investigation of this system in animals and humans.

Phylogenetic distinction of iNOS and IDO function in mesenchymal stem cell-mediated immunosuppression in mammalian species.

Mammalian mesenchymal stem cells (MSCs) have been shown to be strongly immunosuppressive in both animal disease models and human clinical trials. We have reported that the key molecule mediating immunosuppression by MSCs is species dependent: indoleamine 2,3-dioxygenase (IDO) in human and inducible nitric oxide synthase (iNOS) in mouse. In the present study, we isolated MSCs from several mammalian species, each of a different genus, and investigated the involvement of IDO and iNOS during MSC-mediated immunosuppression.

Exploration of alternate catalytic mechanisms and optimization strategies for retroaldolase design.

Designed retroaldolases have utilized a nucleophilic lysine to promote carbon-carbon bond cleavage of β-hydroxy-ketones via a covalent Schiff base intermediate. Previous computational designs have incorporated a water molecule to facilitate formation and breakdown of the carbinolamine intermediate to give the Schiff base and to function as a general acid/base. Here we investigate an alternative active-site design in which the catalytic water molecule was replaced by the side chain of a glutamic acid.

Erythema and ultraviolet indoor tanning: findings from a diary study.

The use of artificial ultraviolet (UV) indoor tanning (IT) beds increases the risk of skin cancer. The IT industry claims IT devices provide users with control over the amount of UV radiation exposure and thus reduces risks of sunburn (i.e.

P53 regulates the migration of mesenchymal stromal cells in response to the tumor microenvironment through both CXCL12-dependent and -independent mechanisms.

Mesenchymal stromal cells (MSCs) are multipotent fibroblast-like cells located in the bone marrow that localize to areas of tissue damage including wounds and solid tumors. Within the tumor microenvironment, MSCs adopt the phenotype of carcinoma-associated fibroblasts (CAFs) and stimulate tumor growth. Production of the chemokine CXCL12, also known as stromal cell-derived factor 1 (SDF-1), by MSCs is required for their in vitro migration in response to tumor cells and has also been implicated in stimulation of tumor growth.

p53 regulates mesenchymal stem cell-mediated tumor suppression in a tumor microenvironment through immune modulation.

p53 is one of the most studied genes in cancer biology, and mutations in this gene may be predictive for the development of many types of cancer in humans and in animals. However, whether p53 mutations in non-tumor stromal cells can affect tumor development has received very little attention. In this study, we show that B16F0 melanoma cells form much larger tumors in p53-deficient mice than in wild-type mice, indicating a potential role of p53 deficiency in non-tumor cells of the microenvironment.

RKIP and HMGA2 regulate breast tumor survival and metastasis through lysyl oxidase and syndecan-2.

Elucidating targets of physiological tumor metastasis suppressors can highlight key signaling pathways leading to invasion and metastasis. To identify downstream targets of the metastasis suppressor Raf-1 kinase inhibitory protein (RKIP/PEBP1), we utilized an integrated approach based upon statistical analysis of tumor gene expression data combined with experimental validation. Previous studies from our laboratory identified the architectural transcription factor and oncogene, high mobility group AT-hook 2 (HMGA2), as a target of inhibition by RKIP.

Gonadotropinoma presenting as a case of pseudo-ovarian failure changing to macroprolactinoma.

Purpose: To present the first gonadotropinoma presenting as pseudo-menopause in a teenager.

Methods: Human menopausal gonadotropins (hMG) were given to a 37-year-old woman whose hypergonadotropic amenorrhea with estrogen deficiency as a teenager was changed to hypogonadotropic amenorrhea by the growth and prolactin secretion of a macroprolactinoma.

Results: The patient responded multiple times, and every time to stimulation with hMG and each time produced several dominant follicles.

The use of sympathomimetic amines for the treatment of severe constipation refractory to conventional therapy--case report.

Purpose: Sympathetic nervous system hypofunction has been found to be associated with motility disorders of the bowel, including gastroparesis, pseudointestinal obstruction, and esophageal motility disorders. These disorders respond to sympathomimetic amine therapy. The purpose of this study was to see if this therapy could be effective in treating pathological constipation.

Sympathomimetic amines effectively control pain for interstitial cystitis that had not responded to other therapies.

Purpose: To further investigate the efficacy of treatment of interstitial cystitis that had been refractory to standard treatment with sympathomimetic amines.

Methods: Dextroamphetamine sulfate sustained release capsules up to 30 mg per day were prescribed in women with refractory painful bladder syndrome/interstitial cystitis in six new cases. The patients were carefully evaluated for relief of symptoms.

Peliosis hepatis in a child with myotubular myopathy: successful treatment using hepatic artery embolization.

Peliosis hepatis (PH) is a rare condition characterized by multiple blood-filled spaces within the hepatic parenchyma that can lead to fatal hemorrhage. There is no consensus on the best treatment algorithm for PH, and therapy is directed at removing the potential causative agent with operative intervention when necessary. Here we present the first known case of PH in a child with myotubular myopathy who was successfully treated with angiography and hepatic artery embolization as a first line therapy, without the need for operative intervention.