Uptake of Staphylococcus aureus by keratinocytes is reduced by interferon–fibronectin pathway and filaggrin expression

Staphylococcus aureus (S. aureus) is frequently detected in the skin of patients with atopic dermatitis (AD). AD skin-derived strains of S. aureus (AD strain) are selectively internalized into keratinocytes (HaCaT cells) compared to standard strains. However, the mechanism of AD strain internalization by keratinocytes and effect of the skin environment on internalization remain unclear. HaCaT cells were exposed to heat-killed AD or standard strains of fluorescently labeled S. aureus, with or without interferon (IFN)-γ, interleukin (IL)-4, and IL-13 cytokines, for 24 h. Filaggrin and fibronectin expression in HaCaT cells was knocked down using small interfering RNA. The amount of internalized S. aureus was evaluated using a cell imaging system. The effects of INF-γ, IL-4, and S. aureus exposure on mRNA expression in HaCaT cells were analyzed using single-cell RNA sequencing. AD strains adhered to HaCaT cells in approximately 15 min and were increasingly internalized for up to 3 h (2361 ± 467 spots/100 cells, mean ± SD), whereas the standard strain was not (991 ± 71 spots/100 cells). In the presence of IFN-γ, both the number of internalized strains and fibronectin expression significantly decreased compared to in the control, whereas Th2 cytokines had no significant effects. The number of internalized AD strains was significantly higher in filaggrin knockdown and lower in fibronectin knockdown HaCaT cells compared to in the control. RNA sequencing revealed that IFN-γ decreased both fibronectin and filaggrin expression. Keratinocyte internalization of the AD strain may be predominantly mediated by the INF-γ-fibronectin pathway and partially regulated by filaggrin expression

Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery

AIM: To analyze the efficacy of routine intraoperative ultrasound (IOUS) as a guide for understanding biliary tract anatomy, to avoid bile duct injury (BDI) after laparoscopic cholecystectomy (LC), as well as any burden during the learning period

Role of Nurses in Early Ambulation of Living Donor Liver Transplant Recipients

［Introduction］ Liver transplant recipients suffer more complications than do patients undergoing other gastroenterological surgeries. Many factors inhibit ambulation in liver transplant patients, such as the level of restriction to bed rest and length of stay in the intensive care unit（ ICU）. Patients thus face ambulation difficulties. Support for ambulation is one of the major daily tasks of nurses. We reviewed the ambulation situations of patients who underwent living donor liver transplantation to investigate factors that contributed to ambulation and the nurse’s role therein. ［Patients］ Ten recipients underwent living donor liver transplantation in our hospital between April 2009 and December 2010. Records of the 8 patients who survived were evaluated for this study. ［Result］ According to the postoperative day of initiation of independent walking in the hospital ward, there were no significance difference among operation time, intraoperative bleeding, length of stay in ICU, bed rest level, complications, and rehabilitation intervention. However, the patients who received preoperative guidance were more highly motivated about ambulation than were patients who did not receive preoperative guidance. ［Discussion］ Although initiation of independent walking in the hospital ward differed depending on the patient's general status, it was found that volition is also a strong factor in patient ambulation. Preoperative orientation helps patients to understand perioperative management and clinical course. Moreover, it is necessary to share information with the rehabilitation team and to assist in the activities of daily living for early ambulation