Bjerregaardstephens1732
Being closely associated with a variety of physiological and pathological processes, matrix metalloproteinases (MMPs) are useful as potential targets for drug therapy and informative markers for disease diagnosis. On the basis of the electrochemically induced grafting of ferrocenyl polymers and the proteolytic cleavage of recognition peptide, a novel electrochemical sensor is presented in this work for the highly specific interrogation of MMP activities at ultralow levels. The recognition peptide, to be immobilized via the N-terminus, is free of carboxyl group. The presence of the target MMP would cleave the end-tethered recognition peptide, generating a free carboxyl group at the C-terminus of the rest fragment. To be used as the reversible addition-fragmentation chain-transfer (RAFT) agent, the dithiobenzoate, 4-cyano-4-(phenylcarbonothioylthio)pentanoic acid (CPAD), can therefore be tethered via the carboxylate-Zr(IV)-carboxylate chemistry. Subsequently, the grafting of ferrocenyl polymers through electrochemically induced RAFT (eRAFT) polymerization of ferrocenylmethyl methacrylate (FcMMA) would recruit a large quantity of Fc redox reporters on electrode surface. With benefits from the excellent specificity of the enzyme-substrate recognition, the presented cleavage-based sensor is highly selective. Under optimal conditions, the detection limit in the presence of MMP-2 as the model target can be as low as 0.27 pg mL-1, with a linear range from 1 pg mL-1 to 1 ng mL-1. Furthermore, its applicability in the interrogation of MMP activity in complex serum samples and the screening of MMP inhibitors is satisfactory. The presented cleavage-based electrochemical MMP sensor is easy to fabricate and low-cost, thus showing great promise in drug discovery and disease diagnosis.
Recent studies suggest that desmoid tumors can be managed more conservatively rather than undergoing wide surgical resection (SR). Ultrasound-guided vacuum-assisted biopsy (UGVAB) is a minimally invasive technique. This retrospective study aimed to compare the outcome in patients with breast desmoid tumor (BDT) who received UGVAB alone versus SR.
The pathology database was searched for patients diagnosed with BDT≤3cm from 2007 to 2019. All patients underwent breast ultrasound examination and were then performed UGVAB alone or local SR. The Kaplan-Meier method with a log-rank test was used as a univariate analysis to compare the relapse-free survival (RFS) rates between UGVAB and SR groups. Cox regression analysis was used for multivariate analysis.
A total of 39 patients were included. The median follow-up was 41mo (range, 5-110mo). The incidence of tumor recurrence was 23.1% (9/39). The 3-y cumulative RFS was 83.1% and 95.8% in the UGVAB and SR group, respectively, which was not significantly different between the two groups (P=0.131, log-rank test). Multivariate analysis also revealed that treatment strategy (UGVAB versus SR) was not associated with an increased risk of relapse events (P=0.274).
Small desmoid tumors (≤3cm) after UGVAB alone did not have a significantly compromised RFS compared with those who underwent SR. UGVAB may be an alternative and relatively conservative method for the diagnosis and local control of BDT with a smaller size. A prospective, randomized study with large sample size is needed to confirm this observation.
Small desmoid tumors (≤3 cm) after UGVAB alone did not have a significantly compromised RFS compared with those who underwent SR. UGVAB may be an alternative and relatively conservative method for the diagnosis and local control of BDT with a smaller size. A prospective, randomized study with large sample size is needed to confirm this observation.
Mobile smartphone thermal imaging (MTI) devices correlate with blood flow, which makes them appealing adjuncts during reconstructive surgery. MTI was assessed in the setting of deep inferior epigastric artery perforator (DIEAP) free flaps. We hypothesized that MTI can be a surrogate for blood flow to identify microvascular flow insufficiencies.
Nineteen patients underwent 30 DIEAP flaps for breast reconstruction. Images were obtained preoperatively, intraoperatively, and at instances of concern for flap viability. Three groups were evaluated normal DIEAP flaps (NDFs), flaps with arterial insufficiency (AI), and flaps with venous congestion (VC).
All flaps were successful. There were significant temperature increases from max ischemia (24.5±2.1°C) to 1min after anastomosis (27.2±1.6°C, P<0.001). Leupeptin clinical trial NDFs continued to warm until the final MTI was taken when leaving the operating room. There were no differences between MTI flap temperatures before transfer to the chest and after completion of microanastomosis. With questionable flap viability, VC and AI temperatures were found to be significantly colder than the NDF group (28.3±1.9°C versus 32.2±1.8°C, P=0.003) in the VC group and (27.2±0.7°C versus 32.2±1.8°C, P=0.001) in the AI group. After correction of the identified flow insufficiency, VC and AI rewarmed and temperatures were no different compared with NDF.
MTI recognizes microanastomotic failure and is a practical adjunct in the evaluation of free flap perfusion.
MTI recognizes microanastomotic failure and is a practical adjunct in the evaluation of free flap perfusion.
Trauma field triage matches injured patients to the appropriate level of care. Prior work suggests the Glasgow Coma Scale motor (GCSm) is as accurate as the total GCS (GCSt) and easier to use. However, older patients present with higher GCS for a given injury, and as such, it is unclear if this substitution is advisable. Our objective was to compare the GCS deficit patterns between geriatric and adult patients presenting with severe traumatic brain injury (TBI), as well as the diagnostic performance of the GCSm versus GCSt within the field triage criteria in these populations.
We conducted a retrospective, observational cohort study of patients ≥16y in the National Trauma Data Bank 2007-2015. GCS deficit patterns were compared between adults (16-65) and geriatric patients (>65). Measures of diagnostic performance of GCSt≤13 versus GCSm≤5 criteria to predict trauma center need (TCN) were compared.
In total, 4,480,185 patients were analyzed (28% geriatric). Geriatric patients more frequently presented with non-motor-only deficits than adults (16.
