RESUMO
OBJECTIVE: To validate the 2016 ISGPS definition and grading scheme and investigate whether it segregates into distinct subclasses. METHODS: A total of 522 patients undergone pancreaticoduodenectomy in two pancreatic centers were reviewed. The 2016 ISGPS scheme was validated by comparing clinical and economic outcomes between different ISGPS grades. B-POPF were divided into 2 subgroups as B1(without invasive procedures) and B2(with invasive procedures) then outcomes were analyzed across the subgroups. RESULTS: Biochemical leak(BL) did not differ from the non-fistula condition in all outcomes except postoperative hospital stay and cost. Non-fistula/BL,B-POPF and C-POPF condition differed significantly in terms of all clinical and economic outcomes except 30-day readmission rate.B1 differ from B2 subgroup greatly in terms of most critical terms of outcomes such as hemorrhage(15.2% vs. 34.3%,P=0.045),biliary fistula(13.0% vs 34.3%,P=0.023),postoperative hospital stay(32.0 d vs. 39.0 d,P=0.011). CONCLUSION: The present study has confirmed the effectiveness of the 2016 ISGPS definition and grading scheme in identifying three conditions that differ in terms of clinical and economic outcomes. Subclassification of B-POPF according to whether invasive procedures has been used has potential implications for accurate reporting and performance evaluation.
RESUMO
The effect of visible light irradiation on the expression of pluripotent genes (Oct-4, Sox2, and Nanog) in amniotic fluid-derived stem cells (AFSCs) and on the osteogenic differentiation ability of AFSCs was investigated using light-emitting diodes (LEDs) at 0-2 mW/cm(2) in various wavelengths: [blue (470 nm), green (525 nm), yellow (600 nm), and red (630 nm)]. Pluripotent gene expression in AFSCs was up-regulated by visible light irradiation from a LED for more than 6 h. Green light irradiation of AFSCs up-regulated the expression of pluripotent genes more significantly than irradiation with other light. The osteogenic differentiation of AFSCs was facilitated by green and blue light irradiation. Facilitated differentiation into osteogenic cells by visible light irradiation was not mediated by reactive oxygen species (ROS); alkaline phosphatase activity (a marker of early osteogenic differentiation) and gene expression of osteopontin (a marker of late osteogenic differentiation) did not change significantly between AFSCs in differentiation medium with or without a ROS scavenger (vitamin C). The mitogen-activated protein kinase/extracellular signal-regulated protein kinase pathway, as well as other unknown signaling pathways, may be responsible for the activation of signaling pathways that facilitate the differentiation of AFSCs into osteogenic cells on light irradiation.
