Anastomotic leakage and chronic presacral sinus after transanal total mesorectal excision (taTME) for rectal cancer: A comparative study to laparoscopic TME

BACKGROUND

Several studies have shown that there are no significant differences in anastomotic leakage associated with Transanal total mesorectal excision (taTME) versus laparoscopic TME (lapTME) for rectal cancer; however, little is known about late anastomotic leakage, such as that primarily found in the chronic presacral sinus. We aimed to compare the occurrence of anastomotic leakage and chronic presacral sinus in rectal cancer for taTME and lapTME.

METHODS

In this retrospective cohort study, data were collected for patients with rectal cancer who underwent surgery between January 2009 and September 2019. Of the 220 patients included in this study, 182 were in the lapTME group and 38 in the taTME group. We compared factors associated with anastomotic leakage and chronic presacral sinus formation between the two groups. A binary-logistic model was used to determine the risk factors for chronic presacral sinus.

RESULTS

Anastomotic leakage occurred in six patients (15.8%) in the taTME group and 36 patients (19.7%) in the lapTME group. Chronic presacral sinus occurred in three patients (7.9%) in the taTME group and 15 patients (8.2%) in the lapTME group. There was no significant difference in anastomotic leakage or chronic presacral sinus between groups (P = 0.569 and P = 1.000, respectively). Pathologic stage III or higher was significantly associated with chronic presacral sinus formation (P = 0.006).

CONCLUSION

There were no significant differences between taTME and lapTME regarding the incidence of anastomotic leakage or chronic presacral sinus. Almost one-third of anastomotic leakages developed into chronic presacral sinus.

Combined untargeted and targeted metabolomic profiling reveals urinary biomarkers for discriminating obese from normal-weight adolescents

BACKGROUND

Childhood and adolescent obesity may lead to obesity and related complications in adulthood. Biomarkers of obesity can be useful for screening for obesity complications and promoting early intervention during school age. Thus, the metabolomic differences in obese children and adolescents should be investigated for identification of potential biomarkers.

OBJECTIVES

We investigated urinary biomarkers to distinguish metabolomic characteristics between obesity and normal weight in adolescents.

METHODS

Adolescent subjects were divided into non-obese (n = 91) and obese (n = 93) groups according to body mass index. Untargeted and targeted metabolomic profiling of urine was performed using high-performance liquid chromatography (LC)-quadrupole time-of-flight mass spectrometry (MS), LC-MS/MS and flow injection analysis-MS/MS systems, respectively.

RESULTS

Multivariate statistical analysis showed clear discrimination between the untargeted metabolomes of non-obese and obese groups. Seven endogenous metabolites were distinguished in the obese group, and inflammation-related metabolite markers showed strong predictive power for group classification. From targeted metabolomics, 45 metabolites mostly related to inflammation were significantly different in the obese group.

CONCLUSIONS

Significantly different metabolome signatures were identified between normal-weight and obese adolescents. Combined untargeted and targeted metabolomics demonstrated that inflammation-driven insulin resistance, ammonia toxicity and oxidative stress may represent crucial metabolomic signatures in obese adolescents.

Clinical effects of pre-transplant serum 25-hydroxyvitamin D level on post-transplant immunologic and non-immunologic outcomes in kidney transplant recipients

BACKGROUND

The aim of this study was to investigate the effects of pre-transplant serum 25-hydroxyvitamin D (25(OH)D) level on non-immunologic and immunologic aspects of post-transplant clinical outcomes in kidney transplant recipients (KTRs).

METHODS

We investigated 174 KTRs with low immunologic risk at baseline. We divided the patients into three groups according to baseline serum 25(OH)D level and compared the post-transplant clinical outcomes of acute rejection, infectious complications, and osteoporosis among the groups.

RESULT

Thirty cases of biopsy-proven acute rejection (BPAR) were detected during the first year after KT. In the highest tertile, the rate of acute rejection (8.6%) was significantly lower than that in the lowest tertile (25.4%) (p=0.016), and a high 25(OH)D level was independently associated with a low incidence of BPAR in multivariate analysis. In contrast, serum 25(OH)D level did not show a significant association with overall or any specific type of infectious complication. Lipid profile, intact parathyroid hormone (PTH) level, and hemoglobin level were similar among the three tertile groups. The incidence of osteoporosis and bone mineral density (BMD) score were also similar across all three groups.

CONCLUSIONS

Pre-transplant serum 25(OH)D level is a significant predictor of acute rejection, but it does not predict infection or metabolic complications.

Interactions between ADIPOQ gene variants and dietary monounsaturated: saturated fatty acid ratio on serum lipid levels in Korean children

BACKGROUND AND AIMS

Adiponectin plays important roles in the regulation of insulin action and metabolism of glucose and lipids. We investigated whether ADIPOQ genetic variants are associated with serum lipid levels in Korean children and whether those influences might be modulated by dietary factors such as dietary monounsaturated fatty acid to saturated fatty acid ratio (MUFA:SFA).

METHOD AND RESULTS

The study included a population-based sample of 687 children aged 7-11 years in Gwacheon city, Kyunggi Province, Korea. Anthropometric and biochemical measurements and ADIPOQ genotype (-11377 C/G, +45 T/G, and +276 G/T) were determined. Dietary intake was estimated with a self reported 3-day food diary. The -11377 G allele carriers had significantly higher serum total cholesterol and LDL cholesterol compared to non-carriers. When dietary MUFA:SFA ratio was dichotomized (MUFA:SFA ≥ 1 or <1), the aggravating effects of the minor allele on serum total and LDL cholesterol were only present when the MUFA:SFA ratio was <1. Additionally, we observed that the ADIPOQ haplotype influenced serum total and LDL cholesterol levels. G-T-G haplotype carriers had higher total and LDL cholesterol levels than non-G-T-G carriers. The deleterious effect of ADIPOQ G-T-G haplotype to increase serum total and LDL cholesterol could be seen only when the MUFA:SFA ratio was <1.

CONCLUSION

In this present study, we found interaction effects between ADIPOQ genetic variants and dietary MUFA:SFA ratio on serum lipid levels in Korean children. These results suggest that individual genetic information and dietary fatty acid intake information should be assessed together to achieve an effective outcome for reducing the atherogenic lipid profile.

Detection of antigenic proteins expressed by lymphocystis virus as vaccine candidates in olive flounder, Paralichthys olivaceus (Temminck & Schlegel)

Although the major capsid proteins (MCPs) of lymphocystis disease virus (LCDV) have been characterized, little is known about the host-derived immune response to MCPs and other LCDV antigenic proteins. To identify antigenic proteins of LCDV that could be used as vaccine candidates in olive flounder, Paralichthys olivaceus, we analysed the viral proteins responsible for its virulence by applying immuno-proteomics. LCDV proteins were separated by one-dimensional gel electrophoresis, transferred to polyvinylidene difluoride membrane, and probed with homogeneous P. olivaceus antisera elicited by LCDV natural infection and vaccination with formalin-killed LCDV. Four immune-reactive proteins were obtained at 68-, 51-, 41- and 21 kDa using antisera collected from natural infection while two proteins at 51- and 21 kDa exhibited response to antisera from vaccinated fish, indicating that the latter two proteins have vaccine potential. Using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and nanoelectrospray MS/MS, the 51 and 21 kDa proteins were identified as MCP and an unknown protein, respectively.