Alteration in transforming growth factor-beta (TGF-beta) signaling pathway is one of the main causes of esophageal squamous cell carcinoma (ESCC). The human runt-related transcription factor 3 (RUNX3), an important component of TGF-beta pathway which is located at 1p36, is commonly deleted in a variety of human cancers, including ESCC. Hypermethylation of RUNX3 promoter was frequently found in gastrointestinal cancers, including those of stomach, liver, colon and pancreas. However, RUNX3 promoter methylation status in ESCC has not been studied. The aim of this study was to determine whether promoter methylation of the RUNX3 gene correlates with ESCC tumor progression.Accordingly, we first determined RUNX3 mRNA expression and methylation status of its promoter region in 42 primary tumors with ESCC and Eca-109, an ESCC cell line. Loss of RUNX3 mRNA expression was detected by RT-PCR in 23 out of 42 (54.8%) ESCC specimens and Eca-109 cells. The Promoter hypermethylation was detected by Methylation Specific Polymerase Chain Reaction (MS-PCR) in 27 out of 42 (64.3%) ESCC specimen and Eca-109 cells. Importantly, we found positive correlations, not only between the promoter hypermethylation and tumor clinical pathologic stages (P = 0.003), but also between the loss of RUNX3 mRNA expression and the tumor progression (P = 0.016). Finally, we observed that the loss of RUNX3 mRNA expression is statistically correlated with the promoter hypermethylation in these tumors (P < 0.001). Our results suggest that epigenetic silencing of RUNX3 gene expression by promoter hypermethylation may play an important role in ESCC development.
The technical essentials of the procedure include femoral artery cannulation, selective antegrade cerebral perfusion for brain protection, total arch replacement with a 4-branched vascular graft, implantation of the special open stented graft into the descending aorta, moderate hypothermic balloon occluding descending aorta at 25℃. This technique allows arch reconstruction to be debranched first and upper part of the body is perfused via the 4-branched vascular graft, ensuring antegrade true lumen cerebral perfusion rapidly secured, the descending aorta is arrested by balloon occluding and early rewarming and reperfusion after distal anastomosis to minimize organs ischemia. K E Y W O R D S aortic aneurysm, aortic arch repair, aortic dissection, total arch replacement, vascular graft
The goal is to determine the best location for inserting a catheter into the aortic arch of patients with a certain type of aortic dissection (DeBakey type I) by analyzing images of the patient's aortic arch before surgery. This analysis will take into account the shape and structure of the patient's aortic arch to find the most optimal location for cannulation. MethodsA retrospective analysis was conducted on 100 patients with acute DeBakey type I aortic dissection diagnosed between January 2021 and February 2023, utilizing the Carestream medical imaging software Image Suite V4 (New York, USA). The study included 67 cases that underwent surgery and 33 cases that did not. The study aimed to evaluate the optimal intubation position on the patient's aortic arch by analyzing the true and false lumen classification, true and false lumen area, and hematoma thickness on the patient's aortic arch, as observed in the aortic computed tomography angiography (CTA) conducted upon admission. ResultsThe vascular axis analysis showed a significant difference in the true lumen area among the three regions that were examined (P < 0.001). Zone 1 had a larger true lumen area of 6.40 ± 2.71 cm 2 compared to zone 2 with 5.75 ± 2.13 cm 2 and zone 3 with 4.85 ± 1.70 cm 2 , as determined by statistical analysis.In addition, the statistical analysis of hematoma thickness in the three regions where cannulation can be performed revealed a significant difference among the three groups (P = 0.027). Further analysis showed that there was no significant difference between zone 1 and zone 2 (P = 1.000), a significant difference between zone 1 and zone 3 (P < 0.046), and no significant difference between zone 2 and zone 3 (P = 0.080). The difference between zone 1 false lumen thickness of 1.55 ± 0.51 cm and zone 3 false lumen thickness of 1.33 ± 0.55 cm was found to be small. ConclusionCannulation of the aortic arch is a common strategy used in cardiac surgery. Accurate cannulation is critical to the success of the procedure. The use of CTA provides valuable guidance for the cannulation procedure. A thorough examination of CTA and precise measurement of relevant parameters can help guide the surgeon to determine the optimal cannulation site. The study found that zone 1 of the aortic arch has the largest area and is the most suitable for cannulation, in accordance with the physiological characteristics and surgical practices of a surgeon. Furthermore, cannulation of the aortic arch has been found to be a safe and effective strategy for cannulation. Overall, careful examination of CTA and accurate measurement of relevant parameters can have a significant guiding effect on the cannulation of the aortic arch, which can lead to improved outcomes in cardiac surgery.
Background. To investigate safety and clinical efficacy of percutaneous closure of PFO under TEE guidance in patients with cryptogenic stroke (CS) and migraine, combined PFO and large right-to-left shunt(RLS). Methods. From January 2018 to June 2021 in our hospital, 128 patients were treated by percutaneous PFO occlusion under TEE guidance in CS and migraine. Effective occlusion rate, complications, cerebral ischemia events, migraine relief, and hospitalization costs were analyzed. Postoperative follow-up were conducted. Results. All the 128 patients were successful in percutaneous PFO occlusion. The average operation time was 20~32 (25.6±4.2) min, the average hospitalization time was 2~3(2.8±0.4) d. There were 122 patients without RLS and 6 patients with medium residual RLS, with the sealing efficiency of 95.31% by TTE and right heart contrast echocardiography. 30 patients with migraine underwent percutaneous PFO occlusion, 24 patients relief after operation, with a relief rate of 80.0%. Postoperative follow-up was conducted for 1-36(28.8±3.6)months, and no follow-up was lost. 98 cases of CS with PFO underwent percutaneous blockade were followed up without cerebral embolism recurrence, 26 of 30 patients with migraine received significant remission of migraine, with remission rate of 86.66%. There were no serious adverse events. Conclusions. For patients with CS and migraine, combined PFO and large RLS, percutaneous PFO occlusion under the guidance of TEE has fewer complications and is safe and effective. It can prevent the recurrence of CS and treat migraine.
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