Biomedical subjects

Ana Sanchez

Publications and source records attributed to Ana Sanchez.

5 recordsLinked to original sources

PubMed2005

Fistulotomy with primary sphincter reconstruction in the management of complex fistula-in-ano: prospective study of clinical and manometric results.

BACKGROUND: Complex fistula-in-ano is a frequent source of concern for both patients and surgeons, because of its high rate of recurrence and postoperative anal incontinence. The objective of this study was to assess the results of fistulotomy with sphincter reconstruction in terms of recurrence and anal function. STUDY DESIGN: We conducted a prospective study of 35 patients undergoing fistulotomy with sphincter reconstruction for complex fistula-in-ano. Preoperative and postoperative evaluation included physical examination, anal ultrasonography, and anal manometry, with a 32-month followup. Fecal continence was assessed using the Wexner Continence Grading Scale (0 to 20). RESULTS: Fistulas were classified as high trans-sphincteric in 30 patients (85.7%), suprasphincteric in 4 patients (11.4%), and extrasphincteric in 1 patient (2.9%). Eleven patients (31.4%) reported varying degrees of earlier fecal incontinence. Their mean continence scores decreased from 7.2 to 2.0 (p=0.008) after operation, and all patients improved except for 2, whose scores remained unchanged. On anal manometry, there were significant differences between continent and incontinent patients before operation (maximum resting pressure: 89.2 versus 65.5 mmHg, p=0.013; maximum squeeze pressure: 203.6 versus 148 mmHg, p=0.008) that disappeared after operation (maximum resting pressure: 81.9 versus 70.6 mmHg, p=0.21; maximum squeeze pressure: 199.1 versus 154.8 mmHg, p=0.052). There were neither clinical nor manometric differences between pre- and postoperative values in fully continent patients, although 3 patients (12.5%) reported minor alterations of continence (Wexner<4). Two female patients had recurrences (5.7%), 3 and 6 months after operation, respectively. CONCLUSIONS: Fistulotomy with sphincter reconstruction is an effective resource in the management of complex fistula-in-ano. It improves both anal continence and manometric values in incontinent patients without compromising them in fully continent ones.

Adult↗

PubMed2004

Immunohistochemistry and microsatellite instability testing for selecting MLH1, MSH2 and MSH6 mutation carriers in hereditary non-polyposis colorectal cancer.

Hereditary non-polyposis colorectal cancer (HNPCC) represents 1-3% of all colorectal cancers. HNPCC is caused by a constitutional defect in a mismatch repair (MMR) gene, most commonly affecting the genes MLH1, MSH2 and MSH6. The MMR defect results in an increased cancer risk, with the greatest lifetime risk for colorectal cancer and other cancers associated to HNPCC. The HNPCC-associated tumor phenotype is generally characterized by microsatellite instability (MSI) and immunohistochemical loss of expression of the affected MMR protein. The aim of this study was to determine the sensitivity of IHC for MLH1, MSH2 and MSH6, and MSI analysis in tumors from known MMR gene mutation carriers. Fifty-eight paired normal and tumor samples from HNPCC families enrolled in our high-risk colorectal cancer registry were studied for the presence of germline mutations in MLH1, MSH2 and MSH6 by DGGE and direct sequencing. MSI analysis and immunostaining for MLH1, MSH2 and MSH6 were evaluated. Of the 28 patients with a real pathogenic mutation, loss of immunohistochemical expression for at least 1 of these MMR proteins was found, and all except 1 have MSI-H. Sensitivity by MSI analysis was 96%. IHC analysis had a sensitivity of 100% in detecting MMR deficiency in carriers of a pathogenic MMR mutation, and can be used to predict which gene is expected to harbor the mutation for MLH1, MSH2 and MSH6. This study suggests that both analyses are useful for selecting high-risk patients because most MLH1, MSH2 and MSH6 gene carriers will be detected by this 2-step approach. This practical method should have immediate application in the clinical work of patients with inherited colorectal cancer syndromes.

Adaptor Proteins, Signal Transducing↗

PubMed2003

Radiation therapy depletes extrachromosomally amplified drug resistance genes and oncogenes from tumor cells via micronuclear capture of episomes and double minute chromosomes.

PURPOSE: To determine if clinically relevant doses of ionizing radiation are capable of inducing extrachromosomal DNA loss in transformed human cell lines. MATERIALS AND METHODS: The multidrug-resistant (MDR) human epidermoid KB-C1 cell line and the human neuroendocrine colon carcinoma line COLO320, which contain extrachromosomally amplified MDR1 drug resistance genes and MYCC oncogenes, were irradiated with 2 Gy fractions up to a total dose of 28 Gy. To track the fate of extrachromosomally amplified genes, cells surviving radiation therapy and unirradiated control cells were analyzed by fluorescent in situ hybridization of chromosomes using MDR1 and MYCC-specific cosmid DNA probes. In addition, total DNA and protein isolated from irradiated and control cells was subjected to Southern and Western blotting procedures, respectively, to determine amplified gene copy number and protein expression levels. Dose-response assays to follow loss of function of the MDR1 gene from KB-C1 cells were also performed. RESULTS: A significant reduction in extrachromosomal DNA, amplified gene copy number, and expression was detected in surviving cells after relatively low doses of radiation. Entrapment of extrachromosomal DNA into micronuclei was a consistent feature of irradiated cells. CONCLUSIONS: Clinically relevant doses of radiation can deplete extrachromosomal DNA in viable human malignant cells and alter their phenotype. Depletion of extrachromosomally amplified genes from tumor cells occurs via entrapment in radiation-induced micronuclei.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2003

A reverse genetics system for Borna disease virus.

Borna disease virus (BDV) is an enveloped virus. Its non-segmented, negative-stranded RNA genome has the coding capability for six main polypeptides and has an organization characteristic of members of the order Mononegavirales. However, based on its unique genetics and biological features, BDV is considered to be the prototypic member of a new virus family, Bornaviridae. Here, the establishment of a reverse genetics system for BDV is described. Intracellular synthesis of a BDV RNA analogue or minigenome (MG) from a plasmid was driven by RNA polymerase I. Co-transfection with plasmids expressing the BDV polymerase (L), nucleoprotein (N) and phosphoprotein (P) under the control of RNA polymerase II allowed for BDV MG replication and expression. This process depended on a delicate N:P ratio, whereas the L:P ratio was less critical. Two isoforms of N, Np40 and Np38, are present in BDV-infected cells but only Np40 was strictly required for virus polymerase activity. BDV p10 polypeptide encoded by the P gene exhibited a strong inhibitory effect on BDV MG expression.

Animals↗

PubMed2002

Quantitation of calcitonin gene-related peptide mRNA and neuronal cell death in facial motor nuclei following axotomy and 633 nm low power laser treatment.

BACKGROUND AND OBJECTIVES: A persistent increase in calcitonin gene-related peptide (CGRP) immunoreactivity in motoneurons may serve as an indicator for regeneration after peripheral nerve injury [Borke et al., J Neurocytol 1993;22:141-153]. STUDY DESIGN/MATERIALS AND METHODS: We examined the effects of low power laser treatment (633 nm) on axotomy-induced changes in alpha-CGRP mRNA and long-term neuronal survival in facial motoneurons. A quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) assay for alpha-CGRP mRNA was used to detect changes in the response to axotomy and laser irradiation. Cell counts of neurons in injured and non-injured facial motor nuclei of laser-treated and non-treated rats were done to estimate neuronal survival. RESULTS: A 10-fold increase (P < 0.0001) in mRNA for alpha-CGRP at 11 days post-transection and an almost threefold increase (P < 0.0001) in neuronal survival at 6-9 months post-transection were found in 633 nm light treated rats. DISCUSSION: These findings demonstrate that 633 nm laser light upregulates CGRP mRNA and support the theory that laser irradiation increases the rate of regeneration, target reinnervation, and neuronal survival of the axotomized neuron.

Animals↗