BACKGROUND: Minimally invasive surgery may be further advanced with the novel biofragmentable magnetic anastomosis compression system. Two magnets may be swallowed, or placed by flexible endoscopy, in a side-to-side magnetic jejuno-ileostomy (MagJI) bipartition for weight and type 2 diabetes (T2D) reduction. MagJI markedly reduces the major complications of enterotomy, stapling/suturing, and retained foreign materials. METHODS: This was a prospective first-in-human investigation of feasibility, safety, and preliminary efficacy in adults with body mass index (BMI, kg/m2) ≥ 30.0- ≤ 40.0. After serial introduction via swallowing or endoscopy, linear magnets were laparoscopically guided to the distal ileum and proximal jejunum where they were aligned. Magnets fused over 7-21 days forming jejuno-ileostomy. PRIMARY ENDPOINTS: feasibility and severe adverse event (SAEs) incidence (Clavien-Dindo grade); secondary endpoints: weight, T2D reduction. RESULTS: Between 3-1 - 2024 and 6-30 - 2024, nine patients (mean BMI 37.3 ± 1.1) with T2D (all on T2D medications; mean HbA1C 7.1 ± 0.2%, glucose 144.8 ± 14.3 mg/dL) underwent MagJI. Mean procedure time: both magnets swallowed, 86.7 ± 6.3 min; one magnet swallowed with second delivered endoscopically, 113.3 ± 17.0 min. Ninety-day feasibility confirmed in 100.0%: 0.0% bleeding, leakage, infection, mortality. Most AEs grade I-II; no SAEs. At 6-month radiologic confirmation, all anastomoses were patent. Excess weight loss 17.5 ± 2.8 kg; mean BMI reduction 2.2 ± 0.3, HbA1C 6.1 ± 0.1% (p < 0.01), glucose 115.5 ± 6.5 mg/dL (p = 0.19); 83.0% dropped below 6.5% HbA1C and had markedly reduced anti-T2D medications. CONCLUSIONS: The swallowable, biofragmentable magnetic anastomosis system appeared to be feasible and safe in achieving incisionless, sutureless jejuno-ileostomy. The first-in-human MagJI procedure may offer minimally complicated anastomosis creation and moderate MBS weight loss and T2D reduction.
- MeSH
- anastomóza chirurgická metody MeSH
- diabetes mellitus 2. typu * chirurgie MeSH
- dospělí MeSH
- hmotnostní úbytek MeSH
- ileum * chirurgie MeSH
- index tělesné hmotnosti MeSH
- jejunostomie * metody přístrojové vybavení MeSH
- jejunum * chirurgie MeSH
- laparoskopie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetismus MeSH
- magnety * MeSH
- prospektivní studie MeSH
- studie proveditelnosti MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
We firstly identified 48 kDa molecular form of the unconventional myosin 1c (p48/Myo1C), and isolated it from blood serum of multiple sclerosis patients. The amount of p48/Myo1C in human blood serum correlated with some autoimmune, hemato-oncological and neurodegenerative diseases and thus may serve as a potential molecular biomarker. The biological functions of this protein in human blood remain unknown. Previously, we used the monodisperse magnetic poly (glycidyl methacrylate)(mag-PGMA-NH2 ) microspheres with immobilized 48/Myo1C and western-blot analysis, which allowed us to identify IgM and IgG immunoglobulins presenting an affinity to this protein. Here, we used mass spectrometry followed by the western blotting in order to identify other blood serum proteins with affinity to 48/Myo1C. The obtained data demonstrate that 48/Myo1C binds to component 3 of the complement and the antithrombin-III proteins. A combination of magnetic microparticle-based affinity chromatography with MALDI-TOF mass spectrometry and an in silico analysis provided an opportunity to identify the partners of interaction of 48/Myo1C with other proteins, in particular those participating in complement and coagulation cascades.
- MeSH
- chromatografie afinitní metody MeSH
- krevní proteiny analýza chemie metabolismus MeSH
- lidé MeSH
- magnety MeSH
- mikrosféry MeSH
- molekulární modely MeSH
- myosin typu I chemie metabolismus MeSH
- prognóza MeSH
- roztroušená skleróza krev MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice metody MeSH
- vazba proteinů MeSH
- western blotting MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Spolknutí cizího tělesa (CZT) je v pediatrické populaci častou diagnózou. V malém procentu případů jsou spolknutá cizí tělesa silnými magnety a spolknutí více magnetických těles může způsobit závažné komplikace v gastrointestinálním traktu. V článku předkládáme dvě kazuistiky, na kterých jsou v diskusi probrány komplikace, přístup v diagnostice a léčbě těchto pacientů dle současné medicíny založené na důkazech.
Among pediatric patients, the diagnosis of swallowing a foreign body is very common. In a minority of these cases, magnetic objects are swallowed. If more than one magnet is swallowed at a time, they can cause serious complications in the digestive tract. In this article, we present two case reports and discuss the possible complications, diagnostic approaches and treatment of these patients according to current evidence-based medicine.
- Klíčová slova
- magnetická cizí tělesa,
- MeSH
- chirurgie trávicího traktu metody MeSH
- cizí tělesa * chirurgie diagnóza MeSH
- gastrointestinální trakt chirurgie patologie MeSH
- laparoskopie metody MeSH
- lidé MeSH
- magnety MeSH
- mladiství MeSH
- předškolní dítě MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
V pediatrické praxi přibývá případů polknutí magnetických cizích těles. Jde o magnetky ve tvaru kuliček, kostiček apod., které jsou součástí hraček. Tyto předměty jsou často drobné, a tím je usnadněno jejich náhodné polknutí. Přitom, pokud dojde k ingesci více než jednoho magnetického cizího tělesa, může dojít k závažným komplikacím, především ve smyslu perforace trávicího traktu.
The incidence of swalowing magnetic foreign bodies increases in children, often in the form of balls, cubes etc., which are part of toys. These magnets are often small, making it easy to accidentally swallow them. If more than one magnetic foreign body is ingested, serious complications can occur, especially perforation of the gastrointestinal tract.
- MeSH
- chirurgie trávicího traktu metody MeSH
- cizí tělesa * chirurgie MeSH
- dítě MeSH
- gastrointestinální endoskopie MeSH
- lidé MeSH
- magnety MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- úrazy v domácnosti MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
The cytopoxic effect of RL2 lactaptin (the recombinant analog of proteolytic fragment of human kappa-casein) toward tumor cells in vitro and in vivo presents it as a novel promising antitumor drug. The binding of any drug with serum proteins can affect their activity, distribution, rate of excretion and toxicity in the human body. Here, we studied the ability of RL2 to bind to various blood serum proteins. Using magnetic microparticles bearing by RL2 as an affinity matrix, in combination with mass spectrometry and western blot analysis, we found a number of blood serum proteins possessing affinity for RL2. Among them IgA, IgM and IgG subclasses of immunoglobulins, apolipoprotein A1 and various cortactin isoforms were identified. This data suggests that in the bloodstream RL2 lactaptin takes part in complicate protein-protein interactions, which can affect its activity.
- MeSH
- chromatografie afinitní metody MeSH
- kaseiny metabolismus MeSH
- krevní proteiny analýza izolace a purifikace metabolismus MeSH
- kyseliny polymethakrylové chemie MeSH
- lidé MeSH
- magnety chemie MeSH
- mikrosféry MeSH
- protinádorové látky metabolismus MeSH
- rekombinantní proteiny metabolismus MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
This review (with 129 refs) summarizes the progress in electrochemical immunoassays combined with magnetic particles that was made in the past 5 years. The specifity of antibodies linked to electrochemical transduction (by amperometry, voltammetry, impedimetry or electrochemiluminescence) gains further attractive features by introducing magnetic nanoparticles (MNPs). This enables fairly easy preconcentration of analytes, minimizes matrix effects, and introduces an appropriate label. Following an introduction into the fundamentals of electrochemical immunoassays and on nanomaterials for respective uses, a large chapter addresses method for magnetic capture and preconcentration of analytes. A next chapter discusses commonly used labels such as dots, enzymes, metal and metal oxide nanoparticles and combined clusters. The large field of hybrid nanomaterials for use in such immunoassays is discussed next, with a focus on MNPs composites with various kinds of graphene variants, polydopamine, noble metal nanoparticles or nanotubes. Typical applications address clinical markers (mainly blood and urine parameters), diagnosis of cancer (markers and cells), detection of pathogens (with subsections on viruses and bacteria), and environmental and food contaminants as toxic agents and pesticides. A concluding section summarizes the present status, current challenges, and highlights future trends. Graphical abstract Magnetic nanoparticles (MNP) with antibodies (Ab) capture and preconcentrate analyte from sample (a) and afterwards become magnetically (b) or immunospecifically (c) bound at an electrode. Signal either increases due to the presence of alabel (b) or decreases as the redox probe is blocked (c).
Monodisperse nonmagnetic macroporous poly(glycidyl methacrylate) (PGMA) microspheres were synthesized by multistep swelling polymerization of glycidyl methacrylate, ethylene dimethacrylate and 2-[(methoxycarbonyl)methoxy]ethyl methacrylate (MCMEMA). This was followed (a) by ammonolysis to modify the microspheres with amino groups, and (b) by incorporation of iron oxide (γ-Fe2O3) into the pores to render the particles magnetic. The resulting porous and magnetic microspheres were characterized by scanning and transmission electron microscopy (SEM and TEM), atomic absorption and Fourier transform infrared spectroscopy (AAS and FTIR), elemental analysis, vibrating magnetometry, mercury porosimetry and Brunauer-Emmett-Teller adsorption/desorption isotherms. The microspheres are meso- and macroporous, typically 5 μm in diameter, contain 0.9 mM · g-1 of amino groups and 14 wt.% of iron according to elemental analysis and AAS, respectively. The particles were conjugated to p46/Myo1C protein, a potential biomarker of autoimmune diseases, to isolate specific autoantibodies in the blood of patients suffering from multiple sclerosis (MS). The p46/Myo1C loaded microspheres are shown to enable the preconcentration of minute quantities of specific immunoglobulins prior to their quantification via SDS-PAGE. The immunoglobulin M (IgM) with affinity to Myo1C was detected in MS patients. Graphical abstract Monodisperse magnetic poly(glycidyl methacrylate) microspheres were synthesized, conjugated with 46 kDa form of unconventional Myo1C protein (p46/Myo1C) via carbodiimide (DIC) chemistry, and specific autoantibodies isolated from blood of multiple sclerosis (MS) patients; immunoglobulin M (IgM) level increased in MS patients.
- MeSH
- autoimunitní nemoci imunologie MeSH
- autoprotilátky krev chemie imunologie izolace a purifikace MeSH
- kyseliny polymethakrylové chemie MeSH
- lidé MeSH
- magnety chemie MeSH
- mikrosféry * MeSH
- molekulová hmotnost MeSH
- myosin typu I chemie imunologie MeSH
- roztroušená skleróza imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
In this paper, we demonstrate the effectiveness of a new 3D printed magnet holder that enables capture of magnetic microparticles in commercially available capillary electrophoresis equipment with a liquid or air based coolant system. The design as well as the method to capture magnetic microparticles inside the capillary are discussed. This setup was tested at temperature and pH values suitable for performing enzymatic reactions. To demonstrate its applicability in CE- immobilized microenzyme reactors (IMER) development, human flavin-containing monooxygenase 3 and bovine serum albumin were immobilized on amino functionalized magnetic microparticles using glutaraldehyde. These microparticles were subsequently used to perform in-line capillary electrophoresis with clozapine as a model substrate. This setup could be used further to establish CE-IMERs of other drug metabolic enzymes in a commercially available liquid based capillary coolant system. The CE-IMER setup was successful, although a subsequent decrease in enzyme activity was observed on repeated runs.
- MeSH
- aminy chemie MeSH
- design vybavení přístrojové vybavení MeSH
- elektroforéza kapilární přístrojové vybavení MeSH
- enzymy imobilizované chemie MeSH
- glutaraldehyd chemie MeSH
- klozapin chemie MeSH
- lidé MeSH
- magnetické pole MeSH
- magnety chemie MeSH
- mikrosféry * MeSH
- NADP chemie MeSH
- oxid křemičitý chemie MeSH
- oxygenasy chemie MeSH
- povrchové vlastnosti MeSH
- sérový albumin hovězí chemie MeSH
- stabilita enzymů MeSH
- teplota MeSH
- velikost částic MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND AND AIMS: Most patients with type 2 diabetes mellitus have obesity. Studies show that bariatric surgery is superior to medical treatment for remission of type 2 diabetes mellitus. Nevertheless, very few patients undergo surgery, and a less-invasive endoscopic alternative is desirable. METHODS: This was a single-arm first-in-human pilot study designed to evaluate the technical feasibility, safety, and clinical performance of the incisionless magnetic anastomosis system (IMAS) to create a partial jejunal diversion (PJD). Ten patients with obesity and type 2 diabetes mellitus, prediabetes, or no diabetes were enrolled. A PJD to the ileum was attempted in all patients under general anesthesia. The IMAS was delivered through the working channel of a colonoscope, with laparoscopic supervision. The patients were not required to participate in an intensive lifestyle/diet management program. Endoscopic visualization of the anastomosis was obtained at 2, 6, and 12 months. Patient weight, glycemic profile, and metabolic panels were acquired at 0.5, 1, 2, 3, 6, 9, and 12 months. RESULTS: A PJD was created in all patients with no device-related serious adverse events. The anastomosis remained widely patent in all patients at 1 year. Average total weight loss was 14.6% (40.2% excess weight loss at 12 months). A significant reduction in glycated hemoglobin level was observed in all diabetic (1.9%) and prediabetic (1.0%) patients, while reducing or eliminating the use of diabetes medications. CONCLUSIONS: Permanent anastomosis for PJD was created in all patients with the IMAS. This resulted in improvement in measures of hyperglycemia and progressive weight loss. (Clinical trial registration number: NCT02839512.).
- MeSH
- anastomóza chirurgická přístrojové vybavení metody MeSH
- bariatrická chirurgie metody MeSH
- diabetes mellitus 2. typu komplikace farmakoterapie metabolismus MeSH
- dospělí MeSH
- gastrointestinální endoskopie metody MeSH
- glykovaný hemoglobin metabolismus MeSH
- hypoglykemika terapeutické užití MeSH
- jejunum chirurgie MeSH
- krevní glukóza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnety * MeSH
- obezita komplikace metabolismus chirurgie MeSH
- pilotní projekty MeSH
- prediabetes komplikace metabolismus MeSH
- prospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
