Role of artificial nutrition in patients undergoing surgery for esophageal cancer

Malnourished cancer patients undergoing major surgical treatments are at a high risk of morbidity and mortality. As compared to patients affected by other tumors, the highest rate of malnutrition (78.9%) was found in those with esophageal cancer due to postoperative complications. The impact of perioperative nutritional support on outcome in esophageal cancer patients undergoing surgery is analyzed. Strategies that can be used to preserve or restore the nutritional condition in patients throughout treatment are illustrated. Oral supplementation, and enteral or parenteral nutrition are among several methods of support. Enteral option is to be preferred because the intestinal integrity is preserved, the risk of complications is reduced and costs are lower. Prevention or correction of nutrient depletion in severely malnourished esophageal cancer patients remarkably reduces or eliminates malnutrition-related morbidity and mortality. Therefore to identify and treat malnutrition is of the utmost importance.     

99mTc-tetrofosmin SPECT in solitary pulmonary nodule evaluation

A correct differential diagnosis between benign and malignant lesions is mandatory in patients with solitary pulmonary nodule (SPN). The aim of the present study was to investigate whether 99mTc-tetrofosmin SPECT may play a role in SPN evaluation. A consecutive series of 111 patients with an uncalcified 相似文献   

MEK inhibition exacerbates ischemic calcium imbalance and neuronal cell death in rat cortical cultures

Interruption in the brain's blood supply leads to an ischemic condition, which is characterised by a depletion of energy phosphates and related failure of ionic pumps, increased extracellular potassium, neuronal depolarisation and release of excitatory amino acids, e.g. glutamate. The subsequent activation of N-methyl-d-aspartate glutamate receptors triggers a wide range of intracellular signals, including the mitogen-activated protein kinase (MAPK) pathway. Activation and inhibition of the MAPK/extracellular regulated kinases (ERK) pathway are both reported to be neuroprotective in conditions associated with excitotoxic injury. The present study was designed to explore the involvement of this signalling pathway in cultured rat cortical neurons subjected to chemically-induced ischemia obtained by coupling the mitochondrial toxin 3-nitropropionic acid with glucose deprivation. Loss of neuronal viability, reduced neuronal energy state (ATP level and mitochondrial membrane potential) and increased cytoplasmic mitochondrial calcium were all observed. The NMDA antagonist MK-801 counteracted these effects, suggesting a glutamate-dependent ischemic cell death. Addition of U0126, a selective inhibitor of MAPK kinase, exacerbated this neuronal cell death. However, non-significant changes in activated cAMP response element-binding protein were seen. The rise in cytoplasmic calcium under ischemic conditions was associated with neuronal cell swelling. Both swelling and increase in cytoplasmic calcium were exacerbated and prevented by U0126 and MK-801, respectively. These data suggest that in this ischemic model the MAPK/ERK pathway might exert a regulatory effect on calcium entry independent from gene expression.     

Bv8, the amphibian homologue of the mammalian prokineticins, induces a proinflammatory phenotype of mouse macrophages

1.--The small protein Bv8, isolated from the amphibian skin, belongs to a novel family of secreted proteins linked to several biological effects. We describe the expression of Bv8/prokineticins and their receptors in mouse macrophages, and characterize their proinflammatory activities. 2.--The rodent analogue of Bv8, prokineticin-2, is expressed by macrophages, as well as its G-protein-coupled receptor prokineticin receptor (PKR-1 and PKR-2). PKR-1 is expressed more abundantly. 3.-- Bv8 induces potent chemotaxis of macrophages at concentrations as low as 10(-12) M. 4.-- It stimulates lipopolysaccharide-induced production of the proinflammatory cytokines IL-1 and IL-12, reducing that of the anti-inflammatory cytokine IL-10. The effects are observed starting at the very low concentration of 10(-11) M. 5.--Effects on chemotaxis and cytokine are not pertussis-toxin sensitive, but are completely prevented by addition of the phospholipase inhibitor U73122, suggesting a G(q) protein is involved in the Bv8-induced effects. 6.--Studies in PKR-1 knockout mice indicate that all the activities exerted by Bv8 on macrophages are mediated by the PKR-1 receptor. 7.--In conclusion, Bv8 appears to be able to induce the macrophage to migrate and to acquire a proinflammatory phenotype.     

Role of partially hydrolyzed guar gum in the treatment of irritable bowel syndrome

Irritable bowel syndrome (IBS) is the world's most common gastrointestinal functional disorder and is associated with several social and economic costs. Health-related quality of life is often impaired in patients with IBS. The pathophysiologic mechanisms underlying IBS remain poorly defined. The therapeutic approach to patients with IBS is based on symptoms, and fibers may play an important role in treatment. Among the various types of fiber, water-soluble, non-gelling fibers seem to be a promising option for treatment of IBS. Partially hydrolyzed guar gum (PHGG) is a water-soluble, non-gelling fiber that has provided therapeutic benefits. In clinical trials, PHGG decreased symptoms in constipation-predominant and diarrhea-predominant forms of IBS and decreased abdominal pain. Further, an improvement in quality of life was observed in patients with IBS during and after treatment with PHGG. Moreover, PHGG seems to have prebiotic properties because it increases the colonic contents of short-chain fatty acids, Lactobacilli, and Bifidobacteria.     

Use of capillary electrophoresis and poly(ethylene oxide) as the coating agent for the determination of substances related to heroin addiction and treatment

The purpose of this study was to identify and quantify morphine, codeine, methadone, and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine using capillary electrophoresis in urine specimens. Adequate peak separation was achieved using nearly neutral pH phosphate buffer and poly(ethylene oxide) as the coating agent. This dynamic coating of the inner surface of the capillary was obtained by rinsing with a solution containing this compound. The electroosmotic flow and the interactions between analytes and the capillary wall surface were reduced, while resolution and reproducibility were thus improved. Detection limits were appropriate for usual analytical requirements in forensic laboratories.     

Contrasting performance of right- and left-hemisphere patients on short-term and long-term sequential visual memory

Fifty control subjects and 100 patients with damage restricted to one hemisphere were given two memory tests, one requiring immediate recognition of increasingly longer sequences of pictures and the second learning to criterion the order of presentation of eight pictures.On the short-term memory test, left- but not right-brain-damaged patients scored significantly lower than controls. Their inferiority disappeared when the means were corrected for Token Test scores. On the learning test, right-brain-damaged patients performed more poorly than controls and failed to reach criterion in a significantly higher proportion than left-brain-damaged patients. When the standardized scores on the two tests were compared, the left hemisphere group was found to perform more poorly on the short-term than on the long-term memory test, while the right-brain-damaged group showed the opposite pattern. It was concluded that the aid provided by the verbal code in sequential memory for pictures is limited to conditions requiring brief storage, while long-lasting acquisition of a pictorial sequence is mainly mediated by visual images.     

Bacterial derived proteoliposome as ideal delivery system and cellular adjuvant

We explored the potential of a proteoliposome (PL) from the outer membrane of N. meningitidis B, as an immunopotentiator and as a vector for antigen delivery to dendritic cells (DC). DC were incubated with PL resulting in up-regulation of MHC-II, CD40, CD80, and CD86 expression and production of TNFalpha and IL12(p70). Ovoalbumin (OVA) was incorporated within PL (PL-OVA). PL-OVA presented OVA-specific peptides to CD4+ and CD8+ OVA-specific T-cell hybridomas. PL exerts an immunomodulatory effect on DC and is a general system to deliver antigens for presentation to CD4+ and CD8+ T-cells possibly implicated in the induction CD8+ cytotoxic T lymphocytes (CTLs) responses.     

Modulators of pain: Bv8 and prokineticins

Bv8 is a small protein secreted by frog skin. Mammalian homologues of Bv8, the prokineticins PK1 and PK2, and their G-protein coupled receptors PKR1 and PKR2 have been identified and linked to several biological effects. Bv8 elicits a dose-dependent reduction in nociceptive threshold to thermal and mechanical stimuli applied to the skin of tail and paw of rats and mice and increases the sensitivity to nociceptive mediators as capsaicin and prostaglandins. The receptors for Bv8/PKs are present in a fraction of peptidergic population of C-fibre neurons, and in a fraction of A myelinated-fibre neurons. In mouse and rat dorsal root ganglia, PKR-expressing neurons also express TRPV1 and the activation of PKRs sensitises TPRV1 to the action of capsaicin. Mice lacking PKR1 gene exhibit impaired Bv8-induced hyperalgesia, develop deficient responses to noxious heat, capsaicin and protons and show reduced thermal and mechanical hypersensitivity to paw inflammation, indicating a requirement for PKR1 signalling associated with activation and sensitisation of primary afferent fibres. PKs are highly expressed by neutrophils and other inflammatory cells and must be considered as new pronociceptive mediators in inflammatory tissues. Bv8-like hyperalgesic activity was demonstrated in extracts of rat inflammatory granulocytes. Bv8 stimulate macrophage and T lymphocyte to differentiate between an inflammatory and Th1 profile indicating that Bv8/PK proteins play a role in immuno-inflammatory responses. Blockade of PKRs may represent a novel therapeutic strategy in acute and inflammatory pain conditions.