Lymphatic drainage from the head and neck is variable with significant crossover, therefore sentinel lymph node (SLN) mapping can help ensure the appropriate lymph node(s) are sampled. To improve sensitivity, SLN mapping utilizing multiple modalities and a combination of preoperative computed tomography lymphography (CTL) and intraoperative near infrared fluorescence imaging (NIRF) with indocyanine green (ICG) +/− methylene blue (MB) dye has been suggested. The aim of this study was to describe a method for intraoperative ICG lymphography and determine agreement for SLN detection using preoperative CTL and intraoperative ICG NIRF + MB lymphography (IOL) in dogs with oral tumours. Fourteen client‐owned dogs were included. All dogs had preoperative CTL with iodinated contrast and intraoperative IOL with an exoscope. Lymph nodes with CTL contrast‐enhancement, blue staining or fluorescence were considered sentinel. The overall SLN identification rate was 100% when CTL and IOL were combined. A total of 57 SLNs were identified. Indocyanine green NIRF identified a greater proportion of SLNs (91%; 52/57) compared with MB (50.8%; 29/57) and CTL (42.1%; 24/57). Eighteen SLNs were identified by all three modalities with a fair level of agreement using Fleiss kappa. These findings suggest a combination of preoperative CTL with intraoperative SLN mapping techniques may greatly improve the ability to accurately detect the SLN in dogs with oral tumours.
Lactobacillus rhamnosus strain ASCC 1520 with high soy isoflavone transformation ability was used to ferment soymilk and added to the diet of mice. The impact of L. rhamnosus fermentation on soy isoflavone metabolites and intestinal bacterial community, in conjunction with fecal enzyme activity and short‐chain fatty acids (SCFA) excretion was evaluated. Antibiotics intervention resulted in a decrease in fecal enzyme activities and SCFA. Although long‐term intake of soymilk or L. rhamnosus‐fermented soymilk did not affect the fecal β‐glucuronidase and β‐galactosidase activities, it improved the β‐glucosidase activity when antibiotics were concomitantly administered. Soymilk or fermented soymilk administration increased the isoflavone metabolites (O‐DMA and equol) excreted in urine. Antibiotics decreased the daidzein excretion and its metabolites but showed little effect on glycitein and genistein excretion. Principal coordinates analysis (PCoA) of the 16s rRNA gene sequencing data found a remarkable shift in gut microbiota after soymilk administration and antibiotics treatment. Matastats test of the relative abundance of bacterial taxa revealed Odoribacter (Bacteroidales family), Lactobacillus (Lactobacillales order), and Alistipes (Rikenellaceae family) were enriched in soymilk while bacterial taxa from Bacteroides and Lactobacillus were enriched in L. rhamnosus‐fermented soymilk. Furthermore, there was less decrease in bacterial taxa with fermented soymilk group even when antibiotics were concomitantly administered. Overall, this study revealed that the gut microbiota of a healthy host is enough for the whole isoflavone metabolism under normal conditions. Feeding mice with L. rhamnosus‐fermented soymilk improved fecal enzyme activity and kept the balance of the gut mirobiota when antibiotics were used. Practical Application Feeding mice with L. rhamnosus‐fermented soymilk improved fecal enzyme activity and kept the balance of the gut mirobiota when antibiotics were used.
The account of acute inflammation is one of the classical clinical descriptions in medicine. However, those early physicians describing Rubor et tumor cum calor et dolore (Celsus in 50 BC) could hardly have imagined the complexity of the events that they were observing.In a healthy individual, the response to tissue injury and infection is rapid and efficient, with resolution occurring before involvement of the specific immune system. However, when the inflammatory stimulus is overwhelming, or if the patient is already malnourished or chronically ill, a series of inter-related events are set in motion. Among these are the interaction of immune cells, phagocytes and release of powerful cytokines that affect the utilization of nutritional substrates in the body. Moreover, antigen processed by macrophages is presented to lymphocytes, thus eliciting a specific immune response.The present paper summarizes our present understanding of the pathophysiology of inflammation and explores the objectives for nutritional support in the presence of immunodysfunction. The rationale for adjunctive nutritional support is explained, and modified regimens, tailored both to provide metabolic substrates and to enhance immunity to disease, are given. Pathophysiology of the inflammatory responseThe immune system is phylogenetically separated into innate or non-specific immunity and the adaptive or specific immune system. While understanding that both processes are often working together, events in each system will be considered individually at a cellular and molecular level.Non-specific immunity. Tissue injury leads to release of Hageman factor (XIIa-XII) and to the degranulation of tissue mast cells. Factor XI1 initiates the process, causing complement activation and bradykinin production locally. Micro-organisms and endotoxin may also trigger this pathway, directly activate complement, or cause mast cell degranulation ( Fig. 1) (Schlesinger, 1975). This mechanism ensures the presence of inflammatory mediators such as the complement factors C3a and C5a, bradykinin, and histamine. Damaged cell membranes release products of arachidonic acid (AA) metabolism, such as prostaglandins (PG) and leukotrienes (LT) (Goetzl, 1981), both of which are eicosanoids having important mediating functions in acute inflammation. The net effect is to increase vascular pernieability, which causes the accumulation of acute-phase at https://www.cambridge.org/core/terms. https://doi
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