Heatstroke, a severe inflammatory response disease, is a medical emergency characterized by high body temperature. The protein C anticoagulant system inhibits inflammation resulting from various causes. Thrombomodulin (TM), a widely expressed glycoprotein originally identified in vascular endothelium, is an important cofactor in the protein C anticoagulant system. We tested the hypothesis that TM could prevent acute inflammation induced by heat stress in a rodent model. Male Wistar rats received a bolus of 1 mg x kg of body weight of TM or saline injected into the tail vein, followed by heat-stress treatment (exposure to 42°C for 30 min). Serum concentrations of cytokines (IL-1β, IL-6, and TNF-α), NO, and high-mobility group box 1 (HMGB1) protein were measured at various time points after treatment. We observed a decrease in the levels of cytokines and HMGB1 protein in sera of TM-treated animals over time. Inhibition of NO overproduction by recombinant TM was observed during heat stress-induced inflammation. Because of the decline in inflammatory marker levels, TM ameliorated injury to various organs in the rat model of heat stress-induced acute inflammation. As TM exhibited a strong anti-inflammatory effect in a rat model of acute inflammation induced by heat stress, TM represents a potential therapeutic for heatstroke prevention or management in patients.
A methodology for reversible molecular imprinting is presented. A molecularly imprinted polymer (MIP) is prepared by photo-cross-linking poly(methacrylic acid) (PMAA) with anthryl moieties as photo-cross-linking sites in the presence of an antimalarial drug cinchonidine as a template molecule, resulting in enhanced binding capacity to cinchonidine, compared with non-imprinted polymers. MIP is then ''initialized'' by exposure to shortwave UV that cleaves the anthracene-dimer-based crosslinks, resulting in the reduced binding capacity comparable to the non-imprinted polymers.Molecular imprinting is a methodology to produce a polymer with functional groups arranged for recognition of specific target molecules.1 Polymers obtained by molecular imprinting (molecularly imprinted polymers, MIPs) have often been compared to enzymes and antibodies, and utilized in various applications ranging from analysis 2 to catalysis. 3 In typical MIP syntheses, functional monomers, complexed with a template molecule, are polymerized (cross-linked) to preserve the arrangement of the monomers complementary to the template molecule. Even after removal of the template molecule from the resultant network polymer, it is believed that the complementarity can be still preserved in terms of both shape and functionality, allowing the polymer to specifically bind the template molecule. Cross-linking manners are greatly important for constructing binding sites, and have been the central theme for establishing the imprinting techniques. 4 Although radical polymerization has been the most commonly used in the MIP synthesis, the reaction is not quite appropriate for controlling and monitoring cross-linking degree. Furthermore, once the radical polymerization proceeds, the structure and property of resultant MIPs can not be changed due to inert cross-links. To date, however, few cross-linkers controllable by external stimuli have been reported. 5In this study, aiming at performing reversible molecular imprinting upon external stimuli, we examine [4 þ 4] photodimerization of anthryl groups as cross-linking step (Figure 1). It is known that anthracene and its derivatives form a dimer upon exposure to longwave UV and the dimer is restored to an original monomer by irradiation of shortwave UV.6 Various polymeric materials have been reported utilizing this reaction, 7,8 and our design of molecular imprinting is based on these studies demonstrating interesting reversible properties. Another point in our design is a use of a linear polymer with cross-linkable moieties (a pre-polymer); it is appropriate to use pre-polymers as MIP precursors rather than monomers for constructing network structure by dimerization-based cross-linking. We previously reported that poly(methacrylic acid) (PMAA) with styryl moieties can be used for preparing cinchonidine-selective MIPs, 9 in which carboxyl moieties of PMAA are supposedly immobilized as complementary to cinchonidine by cross-linking. 10 In this study, we designed a PMAA-based pre-polymer bearing anthryl moieties t...
Introduction:The prognosis of ureteral endometriosis is good if proper treatment is applied, but lack of subjective symptoms often lead to poor treatment. The disease comprises as low as 0.1% of all pelvic endometriosis and 10% of urinary tract endometriosis. Therefore, both patients and doctors are usually unaware of the seriousness of the disease, and in some cases, patients do not seek medical attention although problems are noted during examinations. Even when medical attention is sought, treatment is delayed because of the lack of a proper diagnosis. In this report, we describe three cases in which unilateral renal function was impaired due to ureteral endometriosis.Case 1: A 51-year-old woman was diagnosed with hydronephrosis at a checkup two years ago, but she had no symptoms and did not seek medical care. She visited her previous doctor for dysmenorrhea, irregular bleeding, and hematuria, and was referred to our hospital after CT and MRI scans revealed uterine fibroids, rectal endometriosis, and a left ureteral tumor. In addition to laparoscopic hysterectomy, bilateral adnexal resection, and low anterior resection, laparoscopic total left nephroureterectomy was performed.Case 2: A 52-year-old woman was diagnosed with adenomyosis at another hospital more than 10 years ago, but the condition was difficult to treat because of poorly controlled hypertension. Graves'disease was diagnosed three months before her first visit, and preoperative examination showed abnormal renal function. CT showed left hydronephrosis, right nonfunctioning kidney, and uterine adenomyosis. She underwent the robot-assisted total hysterectomy, bilateral adnexal resection, and left vesicoureteral neoanastomosis.Case 3: A 48-year-old woman visited her previous doctor because of abdominal pain and vomiting. MRI revealed multiple uterine fibroids and a left nonfunctioning kidney. Robot-assisted total hysterectomy, bilateral salpingooophorectomy, and left ureterolysis were performed. Conclusion:Even in advanced cases of ureteral endometriosis, about half of the patients have few symptoms.Asymptomatic hydronephrosis should lead to a suspicion of ureteral endometriosis. It is also important to consider ureteral endometriosis even if adnexal lesions are not suspected.
Objective: After the increasing number of recent reports of hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES), we have introduced a novel procedure called vaginally-assisted NOTES hysterectomy (VANH). The objective of this study was to describe the VANH technique step-by-step, assess the technical feasibility of the procedure, and evaluate its initial surgical outcomes. Methods:We retrospectively reviewed the perioperative outcomes in 20 patients with benign gynecologic disease who underwent VANH (n=10) or total laparoscopic hysterectomy (TLH; n=10) between February and November 2019 at our institution. Patient characteristics, operation time, blood loss, perioperative complications, and postoperative pain scores were compared between the two groups, as well as the amount of oral analgesia used in the first three postoperative days.Results: There was no significant between-group difference in operation time or length of postoperative hospital stay.Mean estimated blood loss was significantly greater (198 mL vs. 18 mL, p=0.02) and the mean postoperative pain score was significantly lower in the VANH group than in the TLH group. The mean number of oral analgesics used was significantly lower in the VANH group (1.9 vs 3.5, p=0.01). Conclusion:VANH could be safely introduced at our institution as an alternative approach for hysterectomy and have several benefits, including less postoperative pain and no visible scars. We anticipate that accumulation of more cases will allow us to improve our technique, consider expansion of the surgical indications for VANH, and introduce other vNOTES procedures.
SynopsisMixed reality is useful for assessing the location of uterine fibroids during laparoscopic myomectomy, potentially reducing recurrence of fibroid remnants and improving quality of life.
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