Br J Surg. 2021 Jul 6:znab234. doi: 10.1093/bjs/znab234. Online ahead of print.
NO ABSTRACT
PMID:34227652 | DOI:10.1093/bjs/znab234
Tag: nevin manimala
Hum Reprod. 2021 Jul 6:deab157. doi: 10.1093/humrep/deab157. Online ahead of print.
ABSTRACT
STUDY QUESTION: What are the knowledge and views of UK-based women towards egg donation (ED) and egg sharing (ES)?
SUMMARY ANSWER: Lacking knowledge of the practices of ED and ES could be an influential factor in donor egg shortages, rather than negative perceptions or lack of donor anonymity and financial incentives.
WHAT IS KNOWN ALREADY: The increasing age of women trying to conceive has led to donor egg shortages, with ED and ES failing to meet demand. Indeed, in recent years in the UK, ES numbers have fallen. This results in long waiting lists, forcing patients abroad for fertility treatment to take up cross border reproductive care. Previous research suggests a lack of knowledge of ED among members of the general public; however, no study has yet assessed knowledge or views of ES in the general public.
STUDY DESIGN, SIZE, DURATION: Six hundred and thirty-five UK-based women over 18 years were voluntarily recruited from social media community groups by convenience sampling. The recruitment period was from February to April 2020.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants completed a previously validated questionnaire regarding female fertility, ED and ES, including knowledge, perceptions and approval of the practices and relevant legislation. This included ranking key benefits and issues regarding egg sharing. The questionnaire was completed using the online Qualtrics survey software. Statistical analysis was conducted using SPSS.
MAIN RESULTS AND THE ROLE OF CHANCE: Regarding knowledge of ED and ES, 56.3% and 79.8%, respectively had little or no prior knowledge. Upon explanation, most approved of ED (85.8%) and ES (70.4%). A greater proportion of respondents would donate to a family member/friend (49.75%) than to an anonymous recipient (35.80%). Overall, ES was viewed less favourably than ED, with ethical and practical concerns highlighted. Women aged 18-30 years were significantly more likely to approve of egg donation practice compared to those aged >30 years (P < 0.0001). Those against ES found fears of financial coercion or negative psychological wellbeing the most concerning. About 35.8% and 49.7% would personally consider anonymous and known ED, respectively, whilst 56.7% would consider ES. Those answering in favour of egg sharing were significantly more likely to give higher benefit ratings compared to those against the practice (P < 0.001). Most agreed (55.8%) with and were not deterred to donate (60.1%) by the ‘Disclosure of Donor Identity’ legislation. Only 31.6% agreed with the compensatory cap; however, 52.7% would not be more motivated to donate by an increased cap.
LIMITATIONS, REASONS FOR CAUTION: There were several limitations of the study, including the use of convenience sampling and the voluntary nature of participation opening the study up to sampling and participation bias. Finally, closed questions were predominantly used to allow the generation of quantitative data and statistical analysis. However, this approach prevented opinion justification and qualitative analysis, limiting the depth of conclusions drawn.
WIDER IMPLICATIONS OF THE FINDINGS: To our knowledge, this is the first study to survey the general public’s knowledge and views of ED/ES using a previously validated questionnaire. The conclusion that lack of knowledge could be contributing to the current donor shortfall in the UK demonstrates that campaigns to inform women of the practices are necessary to alleviate donor oocyte shortages.
STUDY FUNDING/COMPETING INTEREST(S): No external funds were used for this study. The authors have no conflicts of interest.
TRIAL REGISTRATION NUMBER: NA.
PMID:34227667 | DOI:10.1093/humrep/deab157
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S186. doi: 10.14701/ahbps.LV-PP-2-5.
ABSTRACT
INTRODUCTION: Adult-to-adult living donor liver transplantation (LDLT) has been a dominant type of liver transplantation, especially in Asian countries where deceased donors are extremely scarce. Several centers have been attempted to use left liver graft because it could reduce the postoperative risk to the donor. This study retrospectively compared clinical outcomes between right and left liver grafts in adult-to-adult LDLT.
METHODS: All consecutive 116 patients who underwent adult-to-adult LDLT between 2010 and 2020 were enrolled in this study. The study cohort comprised of 94 patients in the right liver (RL) group and 22 in the left liver (LL) group. When both hemiliver grafts meet the selection criteria, LL graft was preferred. Prospectively collected clinicopathologic characteristics, perioperative outcomes, and survival were evaluated.
RESULTS: In terms of donor variables, median actual graft-to-recipient weight ratio was higher in the RL group than in the LL group (1.01 [0.66-1.66] vs. 0.85 [0.63-1.50], p = 0.030). Total bilirubin level and prothrombin time on postoperative day 5 were worse in the RL group, but it did not reach statistical significance. In terms of recipient variables, hepatic venous pressure gradient after reperfusion was comparable between the groups. The 90-day complication (above Clavien-Dindo grade IIIA) and 1-year graft survival rates were not different between the RL and LL groups (35.9% vs. 56.2%, p = 0.123; 91.3% vs. 93.8%, p = 0.744; respectively).
CONCLUSIONS: This study demonstrated comparable donor and recipient outcomes between the RL and LL groups. In an effort to minimize potential donor risk, LL graft is worth considering when both grafts meet the selection criteria.
PMID:34227546 | DOI:10.14701/ahbps.LV-PP-2-5
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S189. doi: 10.14701/ahbps.LV-PP-3-2.
ABSTRACT
INTRODUCTION: Caudate lobes are anatomically located between the hepatic hilum and inferior vena cava. Isolated caudate lobectomy is still a challenging procedure for hepatobiliary pancreas surgeons because it is quite complicated depending on the relationship between the surrounding major vascular structures and the biliary tract. In this study, we introduce a various surgical strategy for hepatocellular carcinoma located in the caudate lobe, and report the results.
METHODS: From January 2005 to December 2015, 35 patients who underwent caudate lobectomy due to hepatocellular carcinoma in Seoul National University Hospital were enrolled. We described several surgical strategies with hanging maneuver and compared the clinical outcomes between the radical resection group and the local resection group.
RESULTS: A total of 35 patients underwent hepatectomy including the caudate lobe. The median follow-up period was 86.7 months (3.8-183.6 months). There was 2 (5.7%) extended right hemihepatectomy, 2 (5.7%) extended left hemihepatectomy, 2 (5.7%) right posterior sectionectomy including caudate lobe, 12 (34.3%) cases of isolate caudate lobectomy, and 15 (42.9%) cases of local tumorectomy (non-anatomical). There was no statistically significant differences were observed in operative time, hospital stay, and complication rate (mean, 247.1 ± 104.7 minutes vs. 247.1 ± 104.7 minutes, p = 0.729; mean, 10.2 ± 6.68 days vs. 10.2 ± 6.14 days, p = 1.000). The rates of recurrence were significantly lower in the radical resection groups than in the local resection group (13/15, 86.7% vs. 10/20, 50.0%; p = 0.034).
CONCLUSIONS: Various surgical strategies are necessary to resect caudate tumors depending on the location and degree of invasion. These several methods would be helpful to reduce recurrence without complications.
PMID:34227549 | DOI:10.14701/ahbps.LV-PP-3-2
Genet Mol Biol. 2021 Jul 2;44(3):e20200349. doi: 10.1590/1678-4685-GMB-2020-0349. eCollection 2021.
ABSTRACT
This study aimed to elucidate the anti-inflammatory and antioxidant properties of resveratrol (RSV) in human gingival fibroblasts (HGFs) following stimulation by P. gingivalis lipopolysaccharide (LPS). The levels of the inflammatory cytokines IL-1β, IL-6, IL-8 and TNFα, the activity of the antioxidant enzymes SOD and GSH-Px, and the levels of MDA, were evaluated by ELISA. It was observed that the expression of IL-1β, IL-6, IL-8 and TNFα in LPS-induced HGFs was significantly downregulated by RSV in a dose-dependent manner. RSV also partly increased oxidative stress (OS)-related factors, including SOD and GSH-Px, which was accompanied by a decrease in MDA production, although the results were not statistically significant. Additionally, RSV-induced deactivation of the PI3K/AKT and Wnt/β-catenin pathways in LPS-induced HGFs was observed by western blot analysis. Subsequently, it was demonstrated treatment with PI3K/AKT pathway inhibitor (LY294002) or Wnt/β-catenin pathway inhibitor (Dickkopf-1, DKK-1) could further enhance the anti-inflammatory and antioxidant effects of RSV by downregulating the expression of IL-1β, IL-6, IL-8 and TNFα, and the production of MDA, and increasing the activity of SOD and GSH-Px in LPS-induced HGFs. These results suggested RSV attenuated the inflammation and OS injury of P. gingivalis LPS-treated HGFs by deactivating the PI3K/AKT and Wnt/β-catenin signaling pathways.
PMID:34227646 | DOI:10.1590/1678-4685-GMB-2020-0349
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S181. doi: 10.14701/ahbps.LV-PP-1-6.
ABSTRACT
INTRODUCTION: Depending on the recipient’s condition and lack of donors, even liver grafts with poor conditions may need to be transplanted. This study was conducted to analyze the outcomes after receiving a liver graft that abandoned transplantation due to poor graft conditions at the preceding centers.
METHODS: From January 2010 to September 2020, deceased-donor liver transplantation (DDLT) was performed in 161 patients in our center. Among them, 127 patients (allocated group) were preferentially allocated to our center by KONOS and the remaining 34 patients (abandoned group) received liver grafts that were abandoned by other transplant centers due to poor organ conditions. Various perioperative factors and postoperative outcomes were compared.
RESULTS: There was no difference in recipient factors before transplantation, and the donor had a longer stay in the ICU in the abandoned group. The operation time was less in the abandoned group, but there was no statistical difference (p = 0.06), and there was no difference in ischemic time or transfusion between the two groups. Postoperative ICU hospital stay was longer in the abandoned group (p = 0.04), but postoperative in-hospital mortality was not different between the two groups. There was no difference between the two groups in long term survival after transplantation.
CONCLUSIONS: Even if the graft that was abandoned due to poor condition, good results can be obtained if the transplant is carried out according to the recipient state. And as a result, it is expected that the discarded graft can be reduced.
PMID:34227541 | DOI:10.14701/ahbps.LV-PP-1-6
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S182. doi: 10.14701/ahbps.LV-PP-2-1.
ABSTRACT
INTRODUCTION: For the APRI and FIB-4 index, which are one of the non-invasive methods of examining the degree of liver fibrosis, our paper aims to examine the implications for predicting the prognosis in hepatocellular carcinoma patients undergoing hepatectomy.
METHODS: Between 2006 and 2013, total 973 patients were underwent hepatic resection due to hepatocellular carcinoma and 871 patients were enrolled in our study after adjusting exclusion criteria. Statistics were performed by calculating the optimal cut off values for the recurrence free survival and overall survival of each group which are categorized by etiology and multivariate analysis were performed for evaluating the performance of index.
RESULTS: Among the causes of HCC patients, HBV (n = 629, 72%) was the most common, and men were dominant in all groups. In each group divided by etiology, the area under the receiver operating characteristics of APRI and FIB-4 for recurrence free survival and overall survival were relatively higher in HCV patients than in other groups. After setting the cut-off value through the Youden index, univariate analysis and multivariate analysis for RFS and OS of all groups were performed, and the results of APRI values for RFS in each group were statistically significant (HBV : OR = 1.849, p = 0.001; HCV : OR = 6,548, p = 0.010; Alcohol : OR = 3.393, p = 0.004).
CONCLUSIONS: The significance of this study is that these simple laboratory findings are meaningful in revealing the prognosis of HCC patients, which can be predicted accurately only after the pathologic staging after surgery.
PMID:34227542 | DOI:10.14701/ahbps.LV-PP-2-1
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S175. doi: 10.14701/ahbps.BP-PP-4-7.
ABSTRACT
INTRODUCTION: It is known that gallbladder cancer (GBC) in the neck or cystic duct (NC-GBC) has a better prognosis than GBC in the fundus or body (FB-GBC), but systematic studies on this are insufficient. We performed this study to investigate the impact of longitudinal tumor location on postoperative outcomes in patients undergoing resection for GBC.
METHODS: A retrospective study was conducted for patients who underwent a radical resection for GBC from February 2008 to November 2017 at the Dankook University Hospital. A total of 98 patients underwent surgery for GBC, of which 77 patients who underwent curative intent surgery were included in the study. They were classified into FB-GBC and NC-GBC groups according to longitudinal tumor location, and the postoperative outcomes were compared and analyzed.
RESULTS: There were no significant differences in the clinicopathological characteristics, TNM stage, postoperative complications, and in-hospital mortality between two groups. However, NC-GBC significantly showed more sclerotic gross type, poorer differentiation, and more lymphatic and perineural microinvasion. The radical resection rate was statistically higher in FB-GBC group (93.1% vs. 73.7%; p = 0.036) and adjuvant 5-FU based CCRT was more carried out in NC-GBC group (19.0% vs. 57.9%; p < 0.001). The recurrence rates after surgery was statistically higher in NC-GBC group (25.9% vs. 52.6%, p = 0.047), but there were no differences in disease-free survival (DFS) and overall survival (OS).
CONCLUSIONS: Although NC-GBC showed more aggressive microscopic pathological findings and higher recurrence rate than FB-GBC, there were no differences in DFS and OS according to longitudinal tumor location of GBC.
PMID:34227535 | DOI:10.14701/ahbps.BP-PP-4-7
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S177. doi: 10.14701/ahbps.LV-PP-1-2.
ABSTRACT
INTRODUCTION: Inadequate liver volume and weight is a major source of morbidity and mortality after adult living donor liver transplantation (LDLT). The purpose of our study was to investigate HCC recurrence, graft failure, and patient survival according to change in right liver graft weight after histidine-tryptophan-ketoglutarate (HTK) solution perfusion in LDLT.
METHODS: Two hundred twenty-eight patients underwent LDLT between 2013 and 2017. We calculated the change in graft weight by subtracting pre-perfusion graft weight from post-perfusion graft weight. Patients with increased graft weight were defined as the positive group, and patients with decreased graft weight were defined as the negative group.
RESULTS: After excluding patients who did not meet study criteria, 148 patients underwent right or extended right hepatectomy. The negative group included 89 patients (60.1%), and the positive group included 59 patients (39.9%). Median graft weight change was -28 g (range, -132-0 g) in the negative group and 21 g (range, 1-63 g) in the positive group (p < 0.001). Median hospitalization time was longer for the positive group than the negative group (27 days vs. 23 days; p = 0.048). There were no statistical differences in tumor characteristics, postoperative complications, early allograft dysfunction, or acute rejection between the two groups. Disease-free survival, death-censored graft survival, and patient survival were lower in the positive group than the negative group. Additionally, the positive group showed strong association with HCC recurrence, death-censored graft survival, and patient survival in multivariate analysis.
CONCLUSIONS: This study suggests that positive graft weight change during HTK solution perfusion indicates poor prognosis in LDLT.
PMID:34227537 | DOI:10.14701/ahbps.LV-PP-1-2
Ann Hepatobiliary Pancreat Surg. 2021 Jun 30;25(Suppl 1):S162. doi: 10.14701/ahbps.BP-PP-3-1.
ABSTRACT
INTRODUCTION: Optimal timing of percutaneous transhepatic gallbladder drainage (PTGBD) and subsequent laparoscopic cholecystectomy (LC) according to the severity of acute cholecystitis (AC) is not established.
METHODS: Total 739 patients with AC without common bile duct stone who underwent PTGBD and subsequent LC from January 2010 to December 2019 were retrospectively reviewed. We defined difficult surgery (DS; open conversion, subtotal cholecystectomy, adjacent organ injury, transfusion, operative time ≥ 90 minutes, or estimated blood loss ≥ 100 milliliters) and poor postoperative outcomes (PPO; postoperative hospital stays ≥ 7 days, or postoperative complication ≥ grade II). The receiver operating characteristic analyses were performed for evaluating appropriate duration from onset of symptom to PTGBD (duration A) and from PTGBD to LC (duration B).
RESULTS: Of the 739 patients, 458 were for grade I AC, and 281 were for grade II/III AC. In grade I AC, the cut-off value for the relationship between duration A and PIO was 4.5 days. The cut-off value for the relationship between duration B and PPO was 7.5 days. In multivariate analysis, duration A ≥ 5 days and duration B ≥ 8 days were statistically significant predictors for DS and PPO, respectively. In grade II/III AC, the cut-off value for the relationship between duration A and PPO was 2.5 days. In multivariate analysis, duration A ≤ 2 days was statistically significant predictor for PPO.
CONCLUSIONS: Optimal timing of PTGBD and LC is for duration from onset of symptom to PTGBD ≤ 4 days with duration from PTGBD to LC ≤ 7 days in grade I AC, and for duration from onset of symptom to PTGBD > 2 days.
PMID:34227522 | DOI:10.14701/ahbps.BP-PP-3-1