ABSTRACT
The relationship between the intra-abdominal pressure (IAP) and intracranial pressure (ICP) has been suspected for more than 100 years and was subsequently confirmed by numerous studies in both animals and humans which demonstrate the link and the positive correlation between IAP and ICP. There are mounting concerns that the pneumoperitoneum created during laparoscopic surgery to create space for instrument placement and to allow safe tissue dissection may result in an increase in the ICP secondary to the increase in the IAP which may result in serious consequences in patients with Ventriculoperitoneal (VP) shunts. There is uncertainty about the safety of laparoscopic surgery in VP shunt patients. The aim of this article is to review the literature to answer the question [Is laparoscopic surgery safe in VP shunt patients with and without intraoperative monitoring of ICP]? (AU)
Subject(s)
Humans , Ventriculoperitoneal Shunt/methods , Laparoscopy/methods , Patient SafetySubject(s)
Asian People/statistics & numerical data , Black People/statistics & numerical data , Coronavirus Infections/prevention & control , Ethnicity/statistics & numerical data , Health Personnel/statistics & numerical data , Minority Groups/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/ethnology , Coronavirus Infections/therapy , Female , Humans , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/ethnology , Pneumonia, Viral/therapy , Risk Assessment/statistics & numerical data , SARS-CoV-2 , United Kingdom/epidemiologyABSTRACT
OBJECTIVE: To investigate differential intestinal gene expression in patients with ulcerative colitis and in controls. DESIGN: Genome-wide expression study (41,058 expression sequence tags, 215 biopsies). SETTING: Western General Hospital, Edinburgh, UK, and Genentech, San Francisco, USA. PATIENTS: 67 patients with ulcerative colitis and 31 control subjects (23 normal subjects and 8 patients with inflamed non-inflammatory bowel disease biopsies). INTERVENTIONS: Paired endoscopic biopsies were taken from 5 specific anatomical locations for RNA extraction and histology. The Agilent microarray platform was used and confirmation of results was undertaken by real time polymerase chain reaction and immunohistochemistry. RESULTS: In healthy control biopsies, cluster analysis showed differences in gene expression between the right and left colon. (chi(2) = 25.1, p<0.0001). Developmental genes, homeobox protein A13 (HOXA13), (p = 2.3x10(-16)), HOXB13 (p<1x10(-45)), glioma-associated oncogene 1 (GLI1) (p = 4.0x10(-24)), and GLI3 (p = 2.1x10(-28)) primarily drove this separation. When all ulcerative colitis biopsies and control biopsies were compared, 143 sequences had a fold change of >1.5 in the ulcerative colitis biopsies (0.01>p>10(-45)) and 54 sequences had a fold change of <-1.5 (0.01>p>10(-20)). Differentially upregulated genes in ulcerative colitis included serum amyloid A1 (SAA1) (p<10(-45)) the alpha defensins 5 and 6 (DEFA5 and 6) (p = 0.00003 and p = 6.95x10(-7), respectively), matrix metalloproteinase 3 (MMP3) (p = 5.6x10(-10)) and MMP7 (p = 2.3x10(-7)). Increased DEFA5 and 6 expression was further characterised to Paneth cell metaplasia by immunohistochemistry and in situ hybridisation. Sub-analysis of the inflammatory bowel disease 2 (IBD2) and IBD5 loci, and the ATP-binding cassette (ABC) transporter genes revealed a number of differentially regulated genes in the ulcerative colitis biopsies. CONCLUSIONS: Key findings are the expression gradient in the healthy adult colon and the involvement of novel gene families, as well as established candidate genes in the pathogenesis of ulcerative colitis.
Subject(s)
Colitis, Ulcerative/genetics , Colon/metabolism , Adult , Case-Control Studies , Disease Susceptibility/metabolism , Female , Gene Expression , Gene Expression Profiling , Genome, Human/genetics , Germ-Line Mutation/genetics , Humans , Ileum/metabolism , Male , Polymerase Chain Reaction , RNA/metabolism , Up-RegulationABSTRACT
Immune cell-specific expression is one indication of the importance of a gene's role in the immune response. We have compiled a compendium of microarray expression data for virtually all human genes from six key immune cell types and their activated and differentiated states. Immune Response In Silico (IRIS) is a collection of genes that have been selected for specific expression in immune cells. The expression pattern of IRIS genes recapitulates the phylogeny of immune cells in terms of the lineages of their differentiation. Gene Ontology assignments for IRIS genes reveal significant involvement in inflammation and immunity. Genes encoding CD antigens, cytokines, integrins and many other gene families playing key roles in the immune response are highly represented. IRIS also includes proteins of unknown function and expressed sequence tags that may not represent genes. The predicted cellular localization of IRIS proteins is evenly distributed between cell surface and intracellular compartments, indicating that immune specificity is important at many points in the signaling pathways of the immune response. IRIS provides a resource for further investigation into the function of the immune system and immune diseases.
