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Abstract Introduction All patients with a new head and neck squamous cell carcinoma (HNSCC) undergo diagnostic panendoscopy as part of the screening for synchronous second primary tumors. It includes a pharyngolaryngoscopy (PLS), a tracheobronchoscopy and esophagoscopy, and a stomatoscopy. Rigid techniques are risky, with long learning curves. Objective We propose a precise description of the panendoscopy protocol. We include an optimization of the PLS technique that completes the flexible esophagoscopy when rigid esophagoscopy isn't performed. Methods The present retrospective observational study includes 122 consecutive patients with a new primary HNSCC who underwent traditional panendoscopy and the new PLS technique between January 2014 and December 2016. A two-step procedure using a Macintosh laryngoscope and a 30° telescope first exposes panoramically the larynx, the upper trachea, and the oropharynx; then, in a second step, the hypopharynx is exposed down to the upper esophageal sphincter. Broncho-esophagoscopy is performed with a rigid and flexible scope. Results In total, 6 (5%) patients presented synchronous tumors (3 in the esophagus, 2 in the oral cavity, and 1 in the larynx 1). Rigid endoscopy was complicated by 2 (1,6%) dental lesions, and had to be completed with a flexible scope in 38 (33%) cases for exposition reasons. The two-step PLS offered a wide-angle view of the larynx, upper trachea, and oroand hypopharynx down to the sphincter of the upper esophagus. The procedure was easy, reliable, safe, repeatable, and effectively completed the flexible endoscopies. Conclusion Rigid esophagoscopy remains a difficult procedure. Two-step PLS combined with flexible broncho-esophagoscopy offers good optical control.
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Introduction All patients with a new head and neck squamous cell carcinoma (HNSCC) undergo diagnostic panendoscopy as part of the screening for synchronous second primary tumors. It includes a pharyngolaryngoscopy (PLS), a tracheobronchoscopy and esophagoscopy, and a stomatoscopy. Rigid techniques are risky, with long learning curves. Objective We propose a precise description of the panendoscopy protocol. We include an optimization of the PLS technique that completes the flexible esophagoscopy when rigid esophagoscopy isn't performed. Methods The present retrospective observational study includes 122 consecutive patients with a new primary HNSCC who underwent traditional panendoscopy and the new PLS technique between January 2014 and December 2016. A two-step procedure using a Macintosh laryngoscope and a 30° telescope first exposes panoramically the larynx, the upper trachea, and the oropharynx; then, in a second step, the hypopharynx is exposed down to the upper esophageal sphincter. Broncho-esophagoscopy is performed with a rigid and flexible scope. Results In total, 6 (5%) patients presented synchronous tumors (3 in the esophagus, 2 in the oral cavity, and 1 in the larynx 1). Rigid endoscopy was complicated by 2 (1,6%) dental lesions, and had to be completed with a flexible scope in 38 (33%) cases for exposition reasons. The two-step PLS offered a wide-angle view of the larynx, upper trachea, and oro- and hypopharynx down to the sphincter of the upper esophagus. The procedure was easy, reliable, safe, repeatable, and effectively completed the flexible endoscopies. Conclusion Rigid esophagoscopy remains a difficult procedure. Two-step PLS combined with flexible broncho-esophagoscopy offers good optical control.
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Although human B cells have been extensively studied, most reports have used peripheral blood as a source. Here, we used a unique tissue resource derived from healthy organ donors to deeply characterize human B-cell compartments across multiple tissues and donors. These datasets revealed that B cells in the blood are not in homeostasis with compartments in other tissues. We found striking donor-to-donor variability in the frequencies and isotype of CD27+ memory B cells (MBCs). A comprehensive antibody-based screen revealed markers of MBC and allowed identification of novel MBC subsets with distinct functions defined according to surface expression of CD69 and CD45RB. We defined a tissue-resident MBC phenotype that was predominant in the gut but absent in blood. RNA-sequencing of MBC subsets from multiple tissues revealed a tissue-resident MBC gene signature as well as gut- and spleen-specific signatures. Overall, these studies provide novel insights into the nature and function of human B-cell compartments across multiple tissues.
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Antígenos CD/imunologia , Subpopulações de Linfócitos B/imunologia , Memória Imunológica , Mucosa Intestinal/imunologia , HumanosRESUMO
Highly photoresponsive semiconductor photocatalysis for energy and environmental applications require judicious choice and optimization of semiconductor interfaces for wide spectral capabilities. This work aims at rational designing of highly active SrTiO3/g-C3N4 junctions bridged with Ag/Fe3O4 nanoparticles for utilizing Z-scheme transfer and surface plasmon resonance effect of Ag augmented by iron oxide. The SrTiO3/(Ag/Fe3O4)/g-C3N4 (SFC) catalyst was employed for photocatalytic hydrogen production and photodegradation of levofloxacin (LFC; 20 mg/L) under UV, visible, near infra-red, and natural solar light exhibiting high performance. Under visible light (<780 nm), SFC-3 sample (30 wt % g-C3N4 and 3% Ag/Fe3O4) shows a H2 evolution of 2008 µmol g-1 h-1 which is â¼14 times that of bare g-C3N4. In addition, 99.3% removal of LFC was degraded in 90 min under visible light with retention of activity under sun. The inherent topological properties, complete, higher charge separation, and reduced recombination allowed this catalyst for a high photocatalytic response which was proved by UV-diffuse reflectance spectroscopy, photoluminescence, electrochemical impedance spectroscopy, and photocurrent response measurements. Scavenging experiments and electron spin resonance analysis reveal that the mechanism shifts from a dual charge transfer in case of binary junction to essential Z-scheme with incorporation of Ag/Fe3O4. Both â¢O2- and â¢OH are main active radicals in visible light, whereas â¢O2- majorly participate under UV. The synergistic effect of SrTiO3, g-C3N4, and plasmon resonance of Ag/Fe3O4 not only improves light response and reduce recombination but also enhances the redox-ability of charge carriers. A H2 production mechanism and LFC degradation pathway (degradation, defluorination, and hydrolysis) has been predicted. This work paves a way for development of photocatalysts working in practical conditions for pollution and energy issues.
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Compostos Férricos/química , Hidrogênio/química , Levofloxacino/química , Luz , Nanopartículas/química , Óxidos/química , Prata/química , Estrôncio/química , Titânio/química , Carbono/análise , Catálise , Eletroquímica , Grafite/química , Concentração de Íons de Hidrogênio , Compostos de Nitrogênio/química , Compostos Orgânicos/análise , Espectroscopia Fotoeletrônica , Fatores de Tempo , Difração de Raios XRESUMO
The aim of this study is to identify genetic variants that harbour signatures of recent positive selection and may facilitate physiological adaptations to hypobaric hypoxia. To achieve this, we conducted whole genome sequencing and lung function tests in 19 Argentinean highlanders (>3500 m) comparing them to 16 Native American lowlanders. We developed a new statistical procedure using a combination of population branch statistics (PBS) and number of segregating sites by length (nSL) to detect beneficial alleles that arose since the settlement of the Andes and are currently present in 15-50% of the population. We identified two missense variants as significant targets of selection. One of these variants, located within the GPR126 gene, has been previously associated with the forced expiratory volume/forced vital capacity ratio. The other novel missense variant mapped to the EPAS1 gene encoding the hypoxia inducible factor 2α. EPAS1 is known to be the major selection candidate gene in Tibetans. The derived allele of GPR126 is associated with lung function in our sample of highlanders (p < 0.05). These variants may contribute to the physiological adaptations to hypobaric hypoxia, possibly by altering lung function. The new statistical approach might be a useful tool to detect selected variants in population studies.
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Altitude , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Receptores Acoplados a Proteínas G/genética , Seleção Genética , Alelos , Argentina , Frequência do Gene/genética , HumanosRESUMO
Breast cancer is a burden for western societies, and an increasing one in emerging economies, because of its high incidence and enormous psychological, social, sanitary and economic costs. However, breast cancer is a preventable disease in a significant proportion. Recent developments in the armamentarium of effective drugs for breast cancer prevention (namely exemestane and anastrozole), the new recommendation from the National Institute for Health and Care Excellence to use preventative drugs in women at high risk as well as updated Guidelines from the US Preventive Services Task Force and the American Society of Clinical Oncology should give renewed momentum to the pharmacological prevention of breast cancer. In this article we review recent major developments in the field and examine their ongoing repercussion for breast cancer prevention. As a practical example, the potential impact of preventive measures in Spain is evaluated and a course of practical actions is delineated.