9 research outputs found
Substernal reconstruction following esophagectomy: operation of last resort?
Background:
The posterior mediastinum is the preferred location for reconstruction following esophagectomy. Occasionally alternative routes are required. We examined patient outcomes of esophageal reconstruction in order to determine whether substernal reconstruction (SR) is an equivalent alternative to orthotopic placement.
Methods:
Following IRB approval, we performed a retrospective review of all patients who underwent an esophagectomy from 1988-2014. Only patients reconstructed with a gastric conduit and cervical anastomosis by either substernal or posterior mediastinal (PM) routes were included in the study. Endpoints assessed included anastomotic leak rate, post-operative complications, reoperation, hospital length of stay, and 30- and 90-day mortality.
Results:
Thirty-three patients underwent SR and 182 had a PM gastric conduit with cervical anastomosis. The SR pathology was predominantly benign while PM was mostly malignant. Sixteen SR patients had a delayed reconstruction after prior diversion. Mean hospital LOS was longer in the SR group (P<0.001). There was no significant difference in 30- and 90-day mortality. PM patients had significantly fewer respiratory complications (P<0.04), reoperations (P<0.04), and transfusions (P<0.0001) and a trend towards fewer anastomotic leaks (17.1% vs. 30.3%; P<0.09).
Conclusions:
This single institution experience demonstrated no significant difference in mortality between substernal and PM reconstruction following esophagectomy. However, SR was associated with significantly increased LOS and morbidity, including a trend toward increased anastomotic leaks. SR reconstruction should probably be considered an option of last resort
Purification and Characterization of α-Mannosidase from Moss Hyophilla nymaniana (Fleish.) Menzel
Schistosome infectivity in the snail, Biomphalaria glabrata, is partially dependent on the expression of Grctm6, a Guadeloupe Resistance Complex protein.
Production of therapeutic glycoproteins through the engineering of glycosylation pathway in yeast
Modulation of immune responses by targeting CD169/Siglec-1 with the glycan ligand
A fundamental role in the plant-bacterium interaction for
Gram-negative phytopathogenic bacteria is played by membrane
constituents, such as proteins, lipopoly- or lipooligosaccharides
(LPS, LOS) and Capsule Polysaccharides (CPS).
In the frame of the understanding the molecular basis of plant bacterium interaction, the Gram-negative bacterium Agrobacterium vitis was selected in this study. It is a phytopathogenic member of the Rhizobiaceae family and it induces the crown gall disease selectively on grapevines (Vitis vinifera).
A. vitis wild type strain F2/5, and its mutant in the quorum
sensing gene ΔaviR, were studied. The wild type produces biosurfactants; it is considered a model to study surface motility, and it causes necrosis on grapevine roots and HR (Hypersensitive
Response) on tobacco. Conversely, the mutant does not show any
surface motility and does not produce any surfactant material;
additionally, it induces neither necrosis on grape, nor HR on
tobacco. Therefore, the two strains were analyzed to shed some
light on the QS regulation of LOS structure and the consequent
variation, if any, on HR response. LOS from both strains were isolated and characterized: the two LOS structures maintained several common features and differed for few others.
With regards to the common patterns, firstly: the Lipid A region
was not phosphorylated at C4 of the non reducing glucosamine
but glycosylated by an uronic acid (GalA) unit, secondly: a third
Kdo and the rare Dha (3-deoxy-lyxo-2-heptulosaric acid) moiety
was present.
Importantly, the third Kdo and the Dha residues were substituted
by rhamnose in a not stoichiometric fashion, giving four different
oligosaccharide species.
The proportions among these four species, is the key difference
between the LOSs from both the two bacteria.
LOS from both strains and Lipid A from wild type A. vitis are
now examined for their HR potential in tobacco leaves and grapevine roots