Colocalization of connexin 36 and corticotropin-releasing hormone in the mouse brain

<p>Abstract</p> <p>Background</p> <p>Gap junction proteins, connexins, are expressed in most endocrine and exocrine glands in the body and are at least in some glands crucial for the hormonal secretion. To what extent connexins are expressed in neurons releasing hormones or neuropeptides from or within the central nervous system is, however, unknown. Previous studies provide indirect evidence for gap junction coupling between subsets of neuropeptide-containing neurons in the paraventricular nucleus (PVN) of the hypothalamus. Here we employ double labeling and retrograde tracing methods to investigate to what extent neuroendocrine and neuropeptide-containing neurons of the hypothalamus and brainstem express the neuronal gap junction protein connexin 36.</p> <p>Results</p> <p>Western blot analysis showed that connexin 36 is expressed in the PVN. In bacterial artificial chromosome transgenic mice, which specifically express the reporter gene Enhanced Green Fluorescent Protein (EGFP) under the control of the connexin 36 gene promoter, EGFP expression was detected in magnocellular (neuroendocrine) and in parvocellular neurons of the PVN. Although no EGFP/connexin36 expression was seen in neurons containing oxytocin or vasopressin, EGFP/connexin36 was found in subsets of PVN neurons containing corticotropin-releasing hormone (CRH), and in somatostatin neurons located along the third ventricle. Moreover, CRH neurons in brainstem areas, including the lateral parabrachial nucleus, also expressed EGFP/connexin 36.</p> <p>Conclusion</p> <p>Our data indicate that connexin 36 is expressed in subsets of neuroendocrine and CRH neurons in specific nuclei of the hypothalamus and brainstem.</p

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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Métastases hépatiques synchrones des cancers colorectaux (résultats chirurgicaux et oncologiques de la résection combinée)

La prise en charge chirurgicale des métastases hépatiques synchrones reste controversée. Le but de ce travail est de rapporter une série de patients ayant eu un traitement combiné des métastases hépatiques et du primitif. Quarante sept patients consécutifs présentant des métastases hépatiques synchrones d un cancer colorectal ont bénéficié une fois l exérèse colo-rectale réalisée du traitement combiné de leurs lésions hépatiques. Trois de ces patients présentaient des métastases bilobaires. Huit hépatectomies majeures (> 2 segments), sept bi-segmentectomies, une segmentectomie, trente et une métastasectomies et deux radiofréquences étaient réalisées. La mortalité post-opératoire était nulle. Quatre patients ont développé des complications mineures (8,5%), un patient a développé une complication majeure (2,1%). La morbidité post-opératoire n était pas supérieure pour les résections rectales associées à l hépatectomie. L examen histologique classait la tumeur primitive T1 dans 0 cas, T2 dans 4 cas, T3 dans 26 cas, T4 dans 16 cas, N0 chez 9 patients (19%). Chez un patient la tumeur primitive avait été stérilisée par la chimiothérapie néo- adjuvante. La résection hépatique était jugée R0 chez tous les patients. Huit patients sont décédés au cours du suivi. Les survies globales à 1, 3 et 5 ans sont respectivement de 90, 60 et 60% pour les patients opérés d un cancer du rectum et de 100, 90 et 90% pour les patients opérés d un cancer du colon. Les survies sans récidive à 1, 3 et 5 ans sont respectivement de 40, 30 et 20% chez les patients opérés d un cancer du rectum et de 85, 75 et 55% chez les patients opérés d un cancer du colon. Vingt- sept patients ont récidivé dans un délai moyen de 25,6 mois (1-50 mois). Parmi les neuf patients ayant présenté une récidive hépatique isolée, six ont bénéficié d une exérèse itérative sans complications. Un patient a présenté une métastase surrénalienne isolée traitée par exérèse chirurgicale. La résection combinée des métastases hépatiques synchrones des cancers colorectaux parait faisable avec une mortalité nulle, une morbidité faible, et des taux de survie comparables à ceux des résections différées.PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Quel rôle pour le glucagon-like peptide 1 produit par l’estomac ?

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Intestinal adaptations following bariatric surgery: towards the identification of new pharmacological targets for obesity-related metabolic diseases

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Effet de la chirurgie bariatrique sur la biodisponibilité des protéines chez le rat obèse

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Clinical characteristics and prognosis of bacteraemia during postoperative intra-abdominal infections

Abstract Background Bloodstream infections of abdominal origin are usually associated with poor prognosis. We assessed the clinical and microbiological characteristics of critically ill patients admitted to the intensive care unit (ICU) for postoperative intra-abdominal infection (PIAI) and analysed the influence of bacteraemia on their outcome. Methods All consecutive PIAI patients admitted to the ICU between 1999 and 2014 were prospectively analysed. Bacteraemic patients (at least one positive blood culture in the 24 h preceding/following surgery) were compared with non-bacteraemic patients. Demographic characteristics, underlying disease, severity scores at the time of reoperation, microbiological results, therapeutic management, outcome, and survival were recorded. Results are expressed as median (interquartile range (IQR)) or proportions. Results Overall, 343 patients (54% male, 62 (49–73) years old) with PIAI were analysed, including 64 (19%) bacteraemic patients. Immunosuppression and cancer were more frequent in bacteraemic patients (p < 0.001 in both cases). No difference between groups was observed for the characteristics of initial surgery. Time to reoperation, site, and cause of PIAI were similar in both groups. At the time of reoperation, Sequential Organ Failure Assessment (SOFA) score was higher in bacteraemic patients (8 (6–10) versus 7 (4–10); p < 0.05). A predominance of Gram-positive (34%) and Gram-negative (47%) bacteria were recovered from blood cultures (polymicrobial bacteraemia in 9 (14%) patients and bacteraemia involving multidrug-resistant organisms in 14 (22%) patients). In multivariate analysis, risk factors for bacteraemia were immunosuppression or cancer, high SOFA score, and E. coli in peritoneal samples. Bacteraemia did not impact the management (with similar results for the adequacy of antibiotic therapy, anti-infective agents used, de-escalation or duration of therapy in both groups). Neither hospital mortality nor morbidity criteria differed between groups. Risk factors for mortality in multivariate analysis were urgent initial surgery, high Simplified Acute Physiology Score (SAPS) II score and documented antifungal therapy, but not perioperative bacteraemia. Conclusions In this ICU population, bacteraemia did not change the overall management of patients with PIAI. Our data suggest that bacteraemic patients do not require a specific management

Shortening the Biliopancreatic Limb Length of One Anastomosis Gastric Bypass Maintains Glucose Homeostasis Improvement with Limited Weight Loss

One anastomosis gastric bypass (OAGB) is associated with similar metabolic improvements and weight loss as Roux-en-Y gastric bypass (RYGB). However, this bariatric procedure is still controversial as it is suspected to result in undernutrition. Reducing the size of the biliopancreatic limb of OAGB could be essential to maintain positive outcomes while preventing side effects. The objective of this study was to compare and contrast outcomes of OAGB with two different biliopancreatic limb lengths to RYGB and Sham surgery in obese and non-obese rats. Lean and diet-induced obese Wistar rats were operated on RYGB, OAGB with a short (15 cm OAGB-15) or a long (35 cm OAGB-35) biliopancreatic limb or Sham surgery. Body weight and food intake were monitored over 30 weeks, and rats underwent oral glucose and insulin tolerance tests with a pancreatic and gut hormone secretion assay. Macronutrient absorption was determined by fecal analyses. Statistical analyses used non-parametric one-way or two-way ANOVA tests. Compared to Sham rats, RYGB, OAGB-15 and OAGB-35 rats displayed a significant reduced weight. Weight loss was greater after OAGB-35 than after OAGB-15 or Sham surgery because of transient malabsorption. All OAGB- and RYGB-operated rats displayed an improved pancreatic and gut hormone secretion in response to a meal compared to Sham rats, these effects were independent of limb length, rat weight, and maintained overtime. In conclusion, glucose homeostasis was similarly improved in obese and non-obese OAGB-15 and OAGB-35 rats suggesting that shortening the biliopancreatic limb can improve the metabolic parameters without a major influence on weight

One-anastomosis Gastric Bypass (OAGB) in Rats

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