ABSTRACT
The current global COVID-19 pandemic is caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, acquired tracheoesophageal fistulas are mainly iatrogenic lesions produced by prolonged tracheal intubation. We present a case of tracheoesophageal fistula with severe tracheal stenosis following tracheal intubation in a patient with SARS-CoV-2 infection.
Subject(s)
COVID-19/therapy , Intubation, Intratracheal/adverse effects , Otorhinolaryngologic Surgical Procedures/methods , Respiratory Distress Syndrome/therapy , Tracheal Stenosis/surgery , Tracheoesophageal Fistula/surgery , Adult , Anastomosis, Surgical/methods , Bronchoscopy/methods , COVID-19/complications , Humans , Male , Operating Rooms , Patient Isolators , Respiration, Artificial , Respiratory Distress Syndrome/etiology , SARS-CoV-2 , Tomography, X-Ray Computed , Tracheal Stenosis/etiology , Tracheoesophageal Fistula/etiologyABSTRACT
Paxillin is a focal adhesion-associated protein that functions as a multi-domain adapter protein, binding several structural and signaling molecules. alpha-Tubulin was identified as an interacting protein in a two-hybrid screen using the paxillin C-terminal LIM domain as a bait. In vitro binding assays with glutathione S-transferase-paxillin demonstrated an interaction of alpha-tubulin with the C terminus of paxillin. Another member of the tubulin family, gamma-tubulin, bound to both the N and the C terminus of paxillin. The interaction between paxillin and both alpha- and gamma-tubulin in vivo was confirmed by co-immunoprecipitation from human T lymphoblasts. Immunofluorescence studies revealed that, in adherent T cells, paxillin localized to sites of cell-matrix interaction as well as to a large perinuclear region. Confocal microscopy revealed that this region corresponds to the lymphocyte microtubule organizing center, where paxillin colocalizes with alpha- and gamma-tubulin. The localization of paxillin to this area was observed in cells in suspension as well as during adhesion to integrin ligands. These data constitute the first characterization of the interaction of paxillin with the microtubule cytoskeleton, and suggest that paxillin, in addition to its well established role at focal adhesions, could also be associated with the lymphocyte microtubule network.
Subject(s)
Cell Adhesion Molecules/metabolism , Centrosome/metabolism , Cytoskeletal Proteins/metabolism , Cytoskeleton/metabolism , Lymphocytes/metabolism , Phosphoproteins/metabolism , Cells, Cultured , Humans , Lymphocytes/cytology , Paxillin , Structure-Activity Relationship , Tubulin/metabolism , YeastsABSTRACT
The posterior preperitoneal approach for prosthetic hernioplasty is a safe and sound procedure for the repair of adult groin hernias. The authors' results, 0 mortality, 2.1% minor morbidity, and 2.1% overall recurrence rate (1.26% for mesh hernioplasty), compare favorably with results in contemporary literature. This operation can be performed as an outpatient procedure or 1-night stay surgery. Pain is significantly less than with the traditional anterior Cooper's ligament repair, and rapid return to ordinary daily activities is possible. The authors favor the use of mesh prostheses in most cases of adult Nyhus types 2, 3 (not necessary in crural hernias), and 4 hernias. The authors recognize the value of two new approaches to hernia repair, that is, the laparoscopic extraperitoneal method and the tension-free mesh-plug hernioplasty, which share many of the anatomophysiologic principles with the posterior preperitoneal mesh repair.
Subject(s)
Hernia, Inguinal/surgery , Surgical Mesh , Surgical Procedures, Operative/methods , Adult , Aged , Aged, 80 and over , Ambulatory Surgical Procedures/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrence , Surgical Procedures, Operative/adverse effects , Surgical Procedures, Operative/trends , Treatment OutcomeABSTRACT
Characterization of novel cell-surface protein molecules, initially identified by cDNA cloning techniques, usually requires the generation of specific antibodies to further analyze their biochemical and/or functional properties. Here we report a simple method, using recombinant vaccinia virus, for the generation of monoclonal antibodies (mAb) to the cell-surface antigen endoglin. A recombinant vaccinia virus carrying a cDNA encoding human endoglin was inserted into the thymidine kinase locus under the control of the 7.5k vaccinia virus promoter. Infection of Balb/c mice with this recombinant virus led to the generation of specific polyclonal antibodies, as demonstrated by the antisera reactivity against human endoglin transfectants. The spleen cells of these infected animals were fused to myeloma cells, allowing efficient generation of several hybridomas which secrete mAbs to human endoglin, as evidenced by their reactivity with purified endoglin as well as with endoglin transfectants. Some of the mAbs selected seem to be specific for regions of endoglin conserved among different species as evidenced by their cross-reactivity with chicken endoglin. These results underline the utility of recombinant vaccinia virus to generate antibodies with novel properties to new cell surface proteins such as endoglin.
Subject(s)
Antibodies, Monoclonal , Recombinant Fusion Proteins/immunology , Vaccinia virus/immunology , Vaccinia/immunology , Vascular Cell Adhesion Molecule-1/immunology , Animals , Antibody Specificity , Antigens, CD , Endoglin , Humans , Hybridomas , Mice , Mice, Inbred BALB C , Receptors, Cell Surface , Thymidine Kinase/genetics , Vaccinia virus/geneticsABSTRACT
La trombosis venosa profunda del miembro superior (enfermedad de Paget-Schroetter), ha aumentado su frecuencia debido al uso de cateteres centrales empleados para medicion de presiones venosas y pulmonares, metodos de diagnostico especializado, administración prolongada de líquidos y como medio de tratamiento de algunas enfermedades vasculares. En nuestra institucion hemos estudiado y tratado 12 casos en los ultimos 5 años, algunos de ellos asociados a trombosis venosa en los miembros inferiores, trombosis superficial de las venas del seno (Enfermedad de Mondor) y, en 1 caso, a tromboflebitis de los miembros inferiores en otras personas de la misma familia. El tratamiento es esencialmente de tipo medico e incluye anticoagulacion inicial con heparina, seguida de warfarina a largo plazo. Queda abierta la posibilidad terapeutica con estreptoquinasa.
Subject(s)
Venous ThrombosisABSTRACT
Se analiza la serie inicial de 50 operaciones en 42 adultos, 34 hombres y 8 mujeres (edad promedio 60 años), con hernias de la region inguinal operados por los autores en forma consecutiva utilizando la tecnica preperitoneal preconizada por Nyhus ("Operacion de Nyhus") entre el 13 de febrero de 1990 y el 13 de febrero de 1992. La herniografia ha probado ser un estudio de utilidad en la valoración preoperatoria del paciente con hernias complejas o recurrentes. Creemos que la hernioplastia preperitoneal que consiste en la reparación del anillo inguinal interno combinada con la implantacion de malla de prolene para corregir el defecto en la pared posterior, es el procedimiento de elección en todas las hernias del hombre adulto. El acceso preperitoneal permite una excelente visualizacion de las estructuras anatomicas afectadas, la fácil reparación del anillo inguinal interno y la colocacion de una protesis que refuerza y realmente reconstruye la pared posterior en forma segura y durable. En los casos de hernias recurrentes provee un territorio "virgen" que evita la tediosa y dificil diseccion de tejidos cicatriciales defectuosos y distorsionados por operaciones previas. En los casos de incarceración, permite un excelente y rápido acceso a las estructuras atrapadas y un potencial acceso directo al peritoneo si hay necrosis intestinal, así como la reseccion del exceso de epiplon mayor cuando la adiposidad intraabdominal sea un factor potencial de recurrencia. La tecnica de acceso preperitoneal es sencilla, provee excelente visualizacion de las estructuras anatomicas afectadas, es poco traumatica, se asocia con menor dolor e incapacidad posoperatorios y se acompaña de minima morbilidad. La reparación por via laparoscopica es factible, pero debe ser considerada todavia como un procedimiento experimental.
