Since its first identification in Scotland, over 1000 cases of unexplained pediatric hepatitis in children have been reported worldwide, including 278 cases in the UK 1 . Here we report investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator subjects, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in liver, blood, plasma or stool from 27/28 cases. We found low levels of Adenovirus (HAdV) and Human Herpesvirus 6B (HHV-6B), in 23/31 and 16/23 respectively of the cases tested. In contrast, AAV2 was infrequently detected at low titre in blood or liver from control children with HAdV, even when profoundly immunosuppressed.AAV2, HAdV and HHV-6 phylogeny excluded emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T-cells and B-lineage cells.Proteomic comparison of liver tissue from cases and healthy controls, identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins.HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and in severe cases HHV-6B, may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children.
Background. Various tumor control genes and microRNAs (miRNa) play an important role in the development and progression of colorectal cancer (CRC). the expression of these genes can differ significantly in tumor and adjacent healthy tissues. there is no exact data at what distance from the tumor the adjacent healthy tissue is located in terms of gene expression.The aim of the investigation was to study the tumor control genes (E2F3, TGFB, NFKB, KLF-12, EGFR and MMP9), as well as the microRNA genes (microRNA-15, -16, -21 and -210) expression profiles in tumor and adjacent healthy tissues.Material and methods. the study included 19 patients diagnosed with colorectal cancer. the tumor control genes (E2F3, TGFB, NFKB, KLF-12, EGFR and MMP9), as well as the miRNA genes (miRNA-15, -16, -21 and -210) expression levels were investigated in tumor and adjacent normal tissue samples taken during colonoscopy.Results. a decrease in the level of expression of E2F3 (median 3,73, Q1-Q3 2,64 Reu vs. median 6.5, Q1-Q3 6,39 REU, p=0,01) and miRNA-16 (median 2,83, Q1-Q3 4,74 REU vs. median 4,29, Q1-Q3 3,73 REU, p=0,027) and an increase in the expression level of miRNA-21 (median 2,64, Q1-Q3 1,38 REU vs. median 1,41, Q1-Q3 1,21 REU, p<0,001) were found in tumor tissue compared to normal tissue of patients with CRC.Conclusion. significant differences in the E2F3, miRNA-16 and miRNA-21 gene expressions were revealed. an increased level of E2F3 and miRNA-16 expressions at a distance of 1–2 cm from the tumor may be a predictor of tumor recurrence and progression, and an increased miRNA-21 expression in tumor tissue as compared to adjacent tissue may be a negative prognostic factor. this information can be used in further clinical research.
The aim of the study was to evaluate the effectiveness of endoscopic submucosal dissection for early colorectal cancer. From 2014 to 2020 at the N.N. Petrov National Medical Research Centre of Oncology, 165 patients with stage cTis-T1N0M0 colorectal cancer were treated by endoscopic submucosal dissection, including 103 women and 62 men aged from 29 to 89 years (mean age 64 years). A single block resection was achieved in all cases, regardless of size and location. Intra- and early postoperative complications were observed in 14 (8.4%) patients, there was no postoperative mortality. In the presented study, endoscopic submucosal dissection showed technical success in 100% of cases, with a risk of postoperative complications of 4.2% and appeared curative in 80.7% of cases. Thus, this technique can be recommended for the treatment of early colorectal cancer due to its high efficiency and safety.
According to the literature review, the use of modern endoscopes with high resolution and a narrow-band imagine function with optical magnification, as well as autofluorescence, chromoscopy, endosonography, makes it possible to establish a diagnosis of early colorectal cancer with a high degree of accuracy. Nowadays, endoscopic submucosal dissection and endoscopic mucosal resection are the methods of choice in the treatment of early (Tis, T1sm1N0M0) colon cancer.
Introduction: Concept of sentinel lymph node biopsy has been discussed during several last decades, because this idea seems perspective in terms of modern minimally invasive and organ-preserving era. However, this method has several limitations including complicated anatomy of gastric lymph nodes distribution and presence of skip-metastases. Materials and methods: 66 Patients with early gastric cancer, intermediate risk of lymph node metastases and technical possibility of ESD were included into our investigation. Patients were assigned to either ESD with sentinel lymph node biopsy (54 patients), or underwent distal gastrectomy or total gastrectomy with D1+/D2 lymphadenectomy (12 patients) by chance. Results: 56 (84,6%) Patients had at least one sentinel lymph node. 11 (16,7%) Patients with T1a-T1b had metastases in regional lymph nodes, 9 of them in sentinel lymph nodes (2 false-negative result). So, we calculated sensitivity of 84,6%. In one case, the metastasis was located outside the sentinel lymphatic basin, and in the other case, metastasis was detected in a patient with unlit lymph nodes. Conclusion: Today sentinel lymph node biopsy thechnique is considered as a well investigated and widly used method. The concept itself is promising for organ-preserving gastric cancer surgery.
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