作者: Morelli, Luca ; Palmeri, Matteo ; Bianchini, Matteo ; Gianardi, Desirée ; Masi, Gianluca ; Furbetta, Niccolò ; Guadagni, Simone ; Di Franco, Gregorio ; Dauccia, Chiara ; Pucci, Valentina ; Di Candio, Giulio ; Comandatore, Annalisa ; Farè, Camilla ; Pagani, Anna ; Cremolini, Chiara ; Borelli, Beatrice ; Pollina, Luca Emanuele ; Pietrabissa, Andrea ; Gallo, Virginia ; Peri, Andrea

AbstractBackgroundConventional Right Colectomy with D2 lymphadenectomy (RC-D2) currently represent the most common surgical treatment of right-sided colon cancer (RCC). However, whether it should be still considered a standard of care, or replaced by a routine more extended D3 lymphadenectomy remains unclear. In the present study, we aim to critically review the patterns of relapse and the survival outcomes obtained from our 11-year experience of RC-D2.MethodsClinical data of 489 patients who underwent RC-D2 for RCC at two centres, from January 2009 to January 2020, were retrospectively reviewed. Patients with synchronous distant metastases and/or widespread nodal involvement at diagnosis were excluded. Post-operative clinical–pathological characteristics and survival outcomes were evaluated including the pattern of disease relapse.ResultsWe enrolled a total of 400 patients with information follow-up. Postoperative morbidity was 14%. The median follow-up was 62 months. Cancer recurrence was observed in 55 patients (13.8%). Among them, 40 patients (72.7%) developed systemic metastases, and lymph-node involvement was found in 7 cases (12.8%). None developed isolated central lymph-node metastasis (CLM), in the D3 site. The estimated 3- and 5-year relapse-free survival were 86.1% and 84.4%, respectively. The estimated 3- and 5-year cancer-specific OS were 94.5% and 92.2%, respectively.ConclusionsThe absence of isolated CLM, as well as the cancer-specific OS reported in our series, support the routine use of RC-D2 for RCC. However, D3 lymphadenectomy may be recommended in selected patients, such as those with pre-operatively known CLM, or with lymph-node metastases close to the origin of the ileocolic vessels.

2022-03-01·Gut1区 · 医学

Several faces of refractory coeliac disease type 2

1区 · 医学

Article

作者: Murray, Joseph A

Enteropathy-associated t-cell lymphoma (EATL) is a rightly feared complication of coeliac disease (CeD) often presenting as the first manifestation of CeD or a complication of preexisting refractory coeliac disease type 2 (RCD2).1 Cording et al in Gut have provided in exquisite detail the molecular landscape of RCD2 and the resultant EATL.2 It provides not so much of a road map to guide us, but rather a sketch of what has gone wrong in this severe complication of CeD. The sequence of CeD leading to RCD2 and finally to EATL provides a rare opportunity for so much confusion. Is RCD2 a chronic inflammatory disease? Most certainly yes. Is it a lymphoma? Perhaps not yet? Thanks to this paper and another recent paper we have a clearer picture of the genotoxic somatic aberrations that occur in and cause expansion and spread of these rare lineage cells.3 Short of the often-lethal lymphoma, RCD2 itself produces substantial morbidity and even mortality.4 Intraepithelial lymphocytes (IELS) can be quite cytotoxic causing significant damage to the epithelium that has persisted despite a gluten-free diet. These aberrant IELS drive the destructive nature of the disease and its cytotoxicity. The face of RCD2 for the gastroenterologist: gastroenterologists looking after these patients are often faced with an ill patient who has very advanced malnutrition as well as a propensity to infection.5 This face of CeD requires the clinician to confirm preexisting CeD, then detect and treat concurrent conditions such as small intestinal bacterial overgrowth, exocrine pancreatic insufficiency, microscopic colitis, motility changes, lactose or other maldigestive problems. Vigorous management of nutritional deficiencies including protection of bone health is crucial.5 Often, gastroenterologists will institute an anti-inflammatory approach to the disease on the basis that it has produced chronic inflammation. In the author’s experience, the early and …

2002-05-01·Journal of Bioscience and Bioengineering3区 · 工程技术

Properties of cellulose-degrading enzymes from Aspergillus oryzae and their contribution to material utilization and alcohol yield in sake mash fermentation

3区 · 工程技术

Article

作者: Ryu-Ichi Shimizu ; Akira Hiyoshi ; Hisashi Fukuda ; Shinya Izuwa ; Yu-Ichi Yamane ; Kaoru Fukuchi ; Shigeaki Mikami ; Yasuzo Kizaki ; Saburo Wakabayashi ; J. I. N. Fujita

Four cellulose-degrading enzymes were identified in a solid-state culture of Aspergillus oryzae. The three major enzymes were purified and named Cel-1, Cel-2, and Cel-3, respectively. The molecular weights were determined to be 62, 120, and 34 kDa, respectively. The optimum temperature of Cel-3 activity was higher than that of the other enzymes. An acidic pH was found to be more suitable for Cel-1 activity than for the other enzymes, and Cel-3 was more stable under acidic conditions than the other two. These properties and the results of a protein homology search for N-terminal amino acid sequences suggest that Cel-1 and Cel-3 correspond to the previously isolated endo-1,4-beta-glucanase CelB and CelA, respectively. The analysis of substrate specificity suggested that Cel-2 is likely to be beta-glucosidase. The effect of Cel-1, Cel-2, and Cel-3 on the sake mash fermentation was determined and it was found that Cel-2 markedly improved material utilization and alcohol yield in sake mash fermentation.

100 项与 RCD-2 相关的药物交易

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