Purpose: Laparoscopic right colectomy (LRC) with extracorporeal anastomosis (ECA) remains the most widely adopted technique despite mounting evidence that intracorporeal anastomosis (ICA) offers several advantages. This study aimed to compare the postoperative outcomes of ICA and ECA and to investigate the effect of ICA on postoperative ileus after LRC. Methods: This retrospective study included 45 patients who underwent ICA and 63 who underwent ECA in LRC for rightsided colonic diseases between January 2015 and December 2019. Results: There were no significant differences in total operation time, blood loss, total length of incisions, tolerance of diet, postoperative pain score on postoperative days 1 and 2, or length of hospital stays between the 2 groups. However, the ICA group had a significantly shorter time to first flatus passage (3.0 ± 0.9 days vs. 3.8 ± 1.9 days, P = 0.013). The rate of postoperative ileus was significantly higher in the ECA group (2.2% vs. 14.3%, P = 0.033); however, there was no significant difference in the overall morbidity within 30 days after surgery. Multivariate logistic regression analysis showed that the ECA technique (odds ratio [OR], 0.098; 95% confidence interval [CI]; 0.011–0.883, P = 0.038) and previous abdominal operation (OR, 5.269; 95% CI, 1.193–23.262; P = 0.028) were independent risk factors for postoperative ileus. Conclusion The postoperative outcomes of patients who underwent LRC with ICA or ECA were comparable, and ICA could reduce the incidence of postoperative ileus after LRC compared with ECA.

No abstract available.
Perfusion* ; Tomography, Emission-Computed, Single-Photon*

Epidermal keratinocyte differentiation is a tightly regulated stepwise process that requires protein kinase C (PKC) activation. Studies on cultured mouse keraitnocytes induced to differentiate with Ca2+ have indirectly implicated the involvement of PKC alpha isoform. When PKC alpha was overexpressed in undifferentiated keratinocytes using adenoviral system, expressions of differentiation markers such as loricrin, filaggrin, keratin 1 (MK1) and keratin 10 (MK10) were increased, and ERK1/2 phosphorylation was concurrently induced without change of other MAPK such as p38 MAPK and JNK1/2. Similarly, transfection of PKC alphakinase active mutant (PKC alpha- CAT) in the undifferentiated keratinocyte, but not PKC beta-CAT, also increased differentiation marker expressions. On the other hand, PKC alphadominant negative mutant (PKC beta-KR) reduced Ca2+ -mediated differentiation marker expressions, while PKC beta-KR did not, suggesting that PKC alphais responsible for keratinocyte differentiation. When downstream pathway of PKC alphain Ca2+ - mediated differentiation was examined, ERK1/2, p38 MAPK and JNK1/2 phosphorylations were increased by Ca2+ shift. Treatment of keratinocytes with PD98059, MEK inhibitor, and SB20358, p38 MAPK inhibitor, before Ca2+ shift induced morphological changes and reduced expressions of differentiation markers, but treatment with SP60012, JNK1/2 inhibitor, did not change at all. Dominant negative mutants of ERK1/2 and p38 MAPK also inhibited the expressions of differentiation marker expressions in Ca2+ shifted cells. The above results indicate that both ERK1/2 and p38 MAPK may be involved in Ca2+- mediated differentiation, and that only ERK1/2 pathway is specific for PKCa-mediated differentiation in mouse keratinocytes.
Animals ; Calcium/pharmacology/physiology ; Cell Differentiation/physiology ; Intermediate Filament Proteins/analysis/metabolism ; Keratinocytes/cytology/*enzymology ; Membrane Proteins/analysis/metabolism ; Mice ; Mitogen-Activated Protein Kinase 1/*metabolism ; Mitogen-Activated Protein Kinase 3/*metabolism ; Phosphorylation ; Protein Kinase C/genetics/*physiology ; Research Support, Non-U.S. Gov't ; p38 Mitogen-Activated Protein Kinases/metabolism