A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection

Paraskevas Gkolfakis,Marc-André Bureau,Marianna Arvanitakis,Jacques Devière,Daniel Blero 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1

A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions ofendoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initialstent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragmwas diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent wasplaced. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stentingduration, and persistence of low-grade inflammation could explain the patient’s symptoms and provide a mechanism for gradualmuscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management ofpost-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.

Management of Rhabdomyolysis in a Patient Treated with Clozapine: A Case Report and Clinical Recommendations

Laurent Bé,chard,Olivier Corbeil,Marc-André,Thivierge,Ibrahim Assaad,Camille Boulanger,Marie-Pierre Mailhot,Alexis Turgeon-Fournier,Marc-André, Roy,Marie-France Demers 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.1

Clozapine has a unique efficacy in treatment-resistant schizophrenia. Its use is, however, associated with potential adverse events. Among those, clozapine induced rhabdomyolysis can compromise clozapine treatment. Recommendations surrounding the management of this rare adverse event are limited. We present a case of clozapine-induced rhabdomyolysis. A 20-year-old Caucasian male diagnosed with resistant schizophrenia developed, after a 5-month total exposition and a significant response to treatment, a marked creatine kinase (CK) elevation and important myalgia in the weeks following an increment from 175 to 200 mg of the daily dose of clozapine. This event also coincided with weight training as reported by the patient. The patient was hospitalized, and the clozapine was stopped following the diagnosis of rhabdomyolysis (CK 45,564 U/L). The cause of rhabdomyolysis was thoroughly investigated, and clozapine was held accountable for most. Clozapine cessation led to a severe psychotic relapse. Clozapine rechallenge while strictly monitoring CK was then performed allowing a significant clinical response. Clozapine was pursued despite two other episodes of mild CK elevations observed following weight training. Rhabdomyolysis comes as a rare adverse event of clozapine and its mechanism is poorly understood. Evidence on clozapine rechallenge following this adverse event is lacking and the innocuity of such practice is unknown. The unique aspect of our case report is that a shared decision with the medical team, patient and family led to a proactive clozapine rechallenge. More research is needed to provide robust guidelines and evidenced based approaches for clinicians in such a clinical dilemma.

Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review

Eduarda Cristina Santos,Daniela Huller,Sabrina Brigola,Marceli Dias Ferreira,Márcia Thaís Pochapski,Fábio André dos Santos 대한치과마취과학회 2023 Journal of Dental Anesthesia and Pain Medicine Vol.23 No.5

Background: Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective: This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods: We included studies (period of 2000–2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results: A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions: Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.

Pollen/Fruit Syndrome: Clinical Relevance of the Cypress Pollen Allergenic Gibberellin-Regulated Protein

Hélène Sénéchal,Sanaz Keykhosravi,Rémy Couderc,Marie-Ange Selva,Youcef Shahali,Tomoyasu Aizawa,Jean-Marc Busnel,Rihane Arif,Inna Mercier,Nhan Pham-Thi,Denis-André Charpin,Pascal Poncet 대한천식알레르기학회 2019 Allergy, Asthma & Immunology Research Vol.11 No.1

A pollen/food-associated syndrome (PFAS) has been described between peach and cypress pollen. Cross-reactive allergens were characterized which belong to the Gibberellin-regulated protein (GRP) family, BP14 in cypress pollen and Pru p 7 in peach. GRP are small cationic protein with anti-microbial properties. A patient suffering from a peach/cypress syndrome was explored clinically and biologically using 2 types of immunoglobulin E (IgE) multiarray microchip, immunoblots and a basophil activation test to assess the clinical relevance of various extracts and purified allergens from fruits or cypress pollen. In addition to PR10 sensitization, the patient showed specific IgE to Pru p 7, BP14 and allergen from pomegranate. These last 3 allergens and allergenic sources are able to induce ex vivo basophil activation characterized by the monitoring of the expression of CD63 and CD203c, both cell surface markers correlated with a basophil mediator release. Up to 100% of cells expressed CD203c at 50 ng/mL of BP14 protein. In contrast, snakin-1, a GRP from potato sharing 82% sequence identity with Pru p 7 did not activate patient's basophils. These results strongly suggest that, like Pru p 7, BP14 is a clinically relevant allergenic GRP from pollen. Allergen members of this newly described protein family are good candidates for PFAS where no cross-reactive allergens have been characterized.

Comparative Study on the Optimization Methods for a Motor Drive of Artificial Hearts

Andre Pohlmann,Marc Leßmann,Kay Hameyer 대한전기학회 2012 Journal of Electrical Engineering & Technology Vol.7 No.2

Worldwide cardiovascular diseases are the major cause of death. Aside from heart transplants, which are limited due to the availability of human donor hearts, artificial hearts are the only therapy available for terminal heart diseases. For various reasons, a total implantable artificial heart is desirable. But the limited space in the human thorax sets rigorous restrictions on the weight and dimensions of the device. Nevertheless, the appropriate functionality of the artificial heart must be ensured and blood damage must be prevented. These requirements set further restrictions to the drive of this device. In the this paper, two optimization methods, namely, the manual parameter variation and Differential Evolution algorithm, are presented and applied to match the specifications of an artificial heart.

Comparative Study on the Optimization Methods for a Motor Drive of Artificial Hearts

Pohlmann, Andre,LeBmann, Marc,Hameyer, Kay The Korean Institute of Electrical Engineers 2012 Journal of Electrical Engineering & Technology Vol.7 No.2

Worldwide cardiovascular diseases are the major cause of death. Aside from heart transplants, which are limited due to the availability of human donor hearts, artificial hearts are the only therapy available for terminal heart diseases. For various reasons, a total implantable artificial heart is desirable. But the limited space in the human thorax sets rigorous restrictions on the weight and dimensions of the device. Nevertheless, the appropriate functionality of the artificial heart must be ensured and blood damage must be prevented. These requirements set further restrictions to the drive of this device. In the this paper, two optimization methods, namely, the manual parameter variation and Differential Evolution algorithm, are presented and applied to match the specifications of an artificial heart.

Crystal Structure of the Rad3/XPD Regulatory Domain of Ssl1/p44

Kim, Jin Seok,Saint-André,, Charlotte,Lim, Hye Seong,Hwang, Cheol-Sang,Egly, Jean Marc,Cho, Yunje American Society for Biochemistry and Molecular Bi 2015 The Journal of biological chemistry Vol.290 No.13

<P>The Ssl1/p44 subunit is a core component of the yeast/mammalian general transcription factor TFIIH, which is involved in transcription and DNA repair. Ssl1/p44 binds to and stimulates the Rad3/XPD helicase activity of TFIIH. To understand the helicase stimulatory mechanism of Ssl1/p44, we determined the crystal structure of the N-terminal regulatory domain of Ssl1 from <I>Saccharomyces cerevisiae</I>. Ssl1 forms a von Willebrand factor A fold in which a central six-stranded β-sheet is sandwiched between three α helices on both sides. Structural and biochemical analyses of Ssl1/p44 revealed that the β4-α5 loop, which is frequently found at the interface between von Willebrand factor A family proteins and cellular counterparts, is critical for the stimulation of Rad3/XPD. Yeast genetics analyses showed that double mutation of Leu-239 and Ser-240 in the β4-α5 loop of Ssl1 leads to lethality of a yeast strain, demonstrating the importance of the Rad3-Ssl1 interactions to cell viability. Here, we provide a structural model for the Rad3/XPD-Ssl1/p44 complex and insights into how the binding of Ssl1/p44 contributes to the helicase activity of Rad3/XPD and cell viability.</P>

Esthetic and Functional Reconstruction of the Posttumoral Interrupted Mandible With Double-Barrel Fibular Free Flap Graft: Rationale for a Microsurgical and Prosthodontic Approach

Paranque, Armand-Ré,gis,Steve, Marc,Vazquez, Lydia,Bolleyn, Alain,Roze-Pellat, Marie-André,e,Dohan Ehrenfest, David M. American Academy of Implant Dentistry 2011 The Journal of oral implantology Vol.37 No.5

<P>Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect. The challenge posed by these treatments is to achieve an end result that is both functional and esthetically pleasing-an endeavor that requires a defined prosthetic plan prior to complete microsurgical reconstruction. Using a detailed clinical case, this article discusses the importance of planning the mandible reconstruction with double-barrel fibular graft in view of an implant-supported fixed partial denture. Immediate implant loading was even possible in this case. This approach allows improvement of the final esthetic and functional result of such a complex rehabilitation. Maxillofacial reconstructive surgery should seek to establish a near-as-normal anatomic situation that will allow a permanent implant rehabilitation that is both esthetic and durable.</P>

Extraction of Lignans from Flaxseed and Evaluation of Their Biological Effects on Breast Cancer MCF-7 and MDA-MB-231 Cell Lines

Abdelali Lehraiki,Jacques Attoumbre,Christophe Bienaime,Fabrice Matifat,Lamine Bensaddek,Edmundo Nava-Saucedo,Marc-Andre´ Fliniaux,Halima Ouadid-Ahidouch,Sylvie Baltora-Rosset 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.4

Over the last decade, there has been an increasing interest in using flaxseed (Linum usitatissimum) in diet in order to improve nutritional and health status. Lignans are major components of flaxseed. Therefore an extraction procedure for lignans from flaxseed has been optimized. The influence of some parameters was investigated: first the preliminary extraction step with alcoholic solvent, and then the solvent polarity and pH of the extract. All these conditions affected the total lignan content, but the most critical variables were preliminary extraction and solvent polarity. The optimized procedure, consisting of a direct hydrolysis in hydrochloric acid (1 M) at 100°C for 1 hour followed by an extraction with a mixture of ethyl acetate/hexane (90:10vol/vol), was applied to 340g of defatted flaxseed and resulted in the isolation of secoisolariciresinol and anhydrosecoisolariciresinol with a purity of 97% and 98%, respectively, as determined by high-performance liquid chromatography. The ability of these two compounds and that of secoisolariciresinol diglucoside to modulate the growth of human breast cancer MCF-7 and MDA-MB-231 cell lines was assessed. Our results show that lignans modulate development of breast cancer cells. The most intense effect was observed for anhydrosecoisolariciresinol, which significantly decreased cell growth at 50 and 100μM.