Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience.

Background and aims  Rectal lesions traditionally represent the first lesions approached during endoscopic submucosal dissection (ESD) training in the West. We evaluated the safety and efficacy of rectal ESD in North America. Methods  This is a multicenter retrospective analysis of rectal ESD between January 2010 and September 2018 in 15 centers. End points included: rates of en bloc resection, R0 resection, adverse events, comparison of pre- and post-ESD histology, and factors associated with failed resection. Results  In total, 171 patients (median age 63 years; 56 % men) underwent rectal ESD (median size 43 mm). En bloc resection was achieved in 141 cases (82.5 %; 95 %CI 76.8-88.2), including 24 of 27 (88.9 %) with prior failed endoscopic mucosal resection (EMR). R0 resection rate was 74.9 % (95 %CI 68.4-81.4). Post-ESD bleeding and perforation occurred in 4 (2.3 %) and 7 (4.1 %), respectively. Covert submucosal invasive cancer (SMIC) was identified in 8.6 % of post-ESD specimens. There was one case (1/120; 0.8 %) of recurrence at a median follow-up of 31 weeks; IQR: 19-76 weeks). Older age and higher body mass index (BMI) were predictors of failed R0 resection, whereas submucosal fibrosis was associated with a higher likelihood of both failed en bloc and R0 resection. Conclusion  Rectal ESD in North America is safe and is associated with high en bloc and R0 resection rates. The presence of submucosal fibrosis was the main predictor of failed en bloc and R0 resection. ESD can be considered for select rectal lesions, and serves not only to establish a definitive tissue diagnosis but also to provide curative resection for lesions with covert advanced disease

Human annexin A6 interacts with influenza a virus protein M2 and negatively modulates infection

Copyright © 2012, American Society for Microbiology. All Rights ReservedThe influenza A virus M2 ion channel protein has the longest cytoplasmic tail (CT) among the three viral envelope proteins and is well conserved between different viral strains. It is accessible to the host cellular machinery after fusion with the endosomal membrane and during the trafficking, assembly, and budding processes. We hypothesized that identification of host cellular interactants of M2 CT could help us to better understand the molecular mechanisms regulating the M2-dependent stages of the virus life cycle. Using yeast two-hybrid screening with M2 CT as bait, a novel interaction with the human annexin A6 (AnxA6) protein was identified, and their physical interaction was confirmed by coimmunoprecipitation assay and a colocalization study of virus-infected human cells. We found that small interfering RNA (siRNA)-mediated knockdown of AnxA6 expression significantly increased virus production, while its overexpression could reduce the titer of virus progeny, suggesting a negative regulatory role for AnxA6 during influenza A virus infection. Further characterization revealed that AnxA6 depletion or overexpression had no effect on the early stages of the virus life cycle or on viral RNA replication but impaired the release of progeny virus, as suggested by delayed or defective budding events observed at the plasma membrane of virus-infected cells by transmission electron microscopy. Collectively, this work identifies AnxA6 as a novel cellular regulator that targets and impairs the virus budding and release stages of the influenza A virus life cycle.This work was supported by the Research Fund for the Control of Infectious Disease (project 09080892) of the Hong Kong Government, the Area of Excellence Scheme of the University Grants Committee (grant AoE/M-12/-06 of the Hong Kong Special Administrative Region, China), the French Ministry of Health, the RESPARI Pasteur Network

Direct sensing of nutrients via a lat1-like transporter in drosophila insulin-producing cells

Direct sensing of nutrients via a lat1-like transporter in drosophila insulin-producing cells. 16. european neurobiology of drosophila conferenc

Rehabilitation of children with ectodermal dysplasia. Part 1: An international delphi study

Purpose: An international Delphi study was undertaken to determine by consensus an agreed approach to the management of children with dental manifestations of ectodermal dysplasia, including the use of dental implants. This was done using a questionnaire developed by an interdisciplinary team. Materials and Methods: The Delphi study questionnaire was built around 19 areas of clinical relevance and included 90 items. Topic areas included dental disability; initial diagnosis; global disability; oral health aspects of dental treatment (orthodontics, hypodontia, anodontia, implants); and case studies of selected treatment options. Eleven teams from six countries contributed to three iterations of the questionnaire. An algorithm was designed to standardize analysis of the questionnaire answers, all of which were blinded to ensure anonymity. The second and third rounds of the questionnaire excluded previously agreed-upon items but included the responses to the questions from the earlier rounds. The nonconsensus items inquired about the use of radiographs at initial diagnosis; sedation of an uncooperative child; use of a pretreatment questionnaire; the age range for specific treatments (eg, dentures, orthodontics, implants); specific uses of implants (eg, partial prostheses, overdentures, cantilevered prostheses); and case study 2. The residual nonconsensus questions were subsequently discussed at a 2-day meeting. Results: Among the 90 questions and partial questions, there was progressive consensus, with agreements in rounds 1, 2, and 3 of 61%, 21%, and 8%, respectively. At the conclusion of round 3, there was 90% agreement and it was considered that the nonconsensus items required in-depth face-to-face discussion at a consensus meeting, which is described in part 2 of the study. Conclusion: The Delphi study provided an opportunity to engage specialist teams in recognized centers to integrate their clinical knowledge and draw on published data to develop a consensus of evidencebased responses. © 2013 by Quintessence Publishing Co Inc

Rehabilitation of children with ectodermal dysplasia. Part 2: An international consensus meeting

A consensus meeting was arranged to provide an opportunity to discuss the residual nonconsensus questions following three rounds of a Delphi study. It was hoped that the nonagreements could be resolved to define a comprehensive protocol for the management of ectodermal dysplasia, particularly with respect to the use of dental implants in growing patients. An international panel of expert clinicians in pediatric dentistry, prosthodontics, and orthodontics was invited to be part of the Delphi study to develop agreement on clinical questions through a consensus of ideas. Each expert had been invited to form a study group or team within his or her home institution. As required by the Delphi protocol, a 90-part questionnaire was considered by the collaborating teams and progressed through three iterations with increasing agreement. This process is discussed in part 1 of the study. The residual nonconsensus questions, which represented 10% of the questionnaire, required collaborative interaction for resolution. The consensus meeting was held in London, England, over a 2-day period with support from Nobel Biocare and the British Dental Association. © 2013 by Quintessence Publishing Co Inc

Mutations in the latent TGF-beta binding protein 3 (LTBP3) gene cause brachyolmia with amelogenesis imperfecta

Inherited dental malformations constitute a clinically and genetically heterogeneous group of disorders. Here, we report on four families, three of them consanguineous, with an identical phenotype, characterized by significant short stature with brachyolmia and hypoplastic amelogenesis imperfecta (AI) with almost absent enamel. This phenotype was first described in 1996 by Verloes et al. as an autosomal recessive form of brachyolmia associated with AI. Whole-exome sequencing resulted in the identification of recessive hypomorphic mutations including deletion, nonsense and splice mutations, in the LTBP3 gene, which is involved in the TGF-beta signaling pathway. We further investigated gene expression during mouse development and tooth formation. Differentiated ameloblasts synthesizing enamel matrix proteins and odontoblasts expressed the gene. Study of an available knockout mouse model showed that the mutant mice displayed very thin to absent enamel in both incisors and molars, hereby recapitulating the AI phenotype in the human disorder