Polymers for cell/tissue anti-adhesion

Cancer constitutes a grave problem nowadays in view of the fact that it has become one of the main causes of death worldwide. Poor clinical prognosis is presumably due to cancer cells metabolism as tumor microenvironment is affected by oxidative stress. This event triggers adequate cellular response and thereby creates appropriate conditions for further cancer progression. Endoplasmic reticulum (ER) stress occurs when the balance between an ability of the ER to fold and transfer proteins and the degradation of the misfolded ones become distorted. Since ER is an organelle relatively sensitive to oxidative damage, aforementioned conditions swiftly cause the activation of the unfolded protein response (UPR) signaling pathway. The output of the UPR, depending on numerous factors, may vary and switch between the pro-survival and the pro-apoptotic branch, and hence it displays opposing effects in deciding the fate of the cancer cell. The role of UPR-related proteins in tumorigenesis, such as binding the immunoglobulin protein (BiP) and inositol-requiring enzyme-1α (IRE1α), activating transcription factor 6 (ATF6) or the protein kinase R (PKR)-like endoplasmic reticulum kinase (PERK), has already been specifically described so far. Nevertheless, due to the paradoxical outcomes of the UPR activation as well as gaps in current knowledge, it still needs to be further investigated. Herein we would like to elicit the actual link between neoplastic diseases and the UPR signaling pathway, considering its major branches and discussing its potential use in the development of a novel, anti-cancer, targeted therapy.

https://www.mdpi.com/1422-0067/20/18/4354/pdf

Dual role of Endoplasmic Reticulum Stress-Mediated Unfolded Protein Response Signaling Pathway in Carcinogenesis

Shifting paradigms in eligibility criteria for live kidney donation: a systematic review

BackgroundMinimally invasive live donor nephrectomy has become a fully implemented and accepted procedure. Donors have to be well educated about all risks and details during the informed consent process. For this to be successful, more information regarding short-term outcome is necessary.MethodsA l

Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy: A Systematic Review and Meta-Analysis

Purpose The purpose of this study was to systematically review the evidence on the outcomes of arthroscopic repair for anterior shoulder instability in first-time dislocators when compared with patients with recurrent instability. Methods We designed a systematic review with a specific methodology to investigate the outcomes of surgery for those with only a first-time dislocation versus those who underwent surgery after multiple instability events. We performed a literature search from January 1966 to December 2008 using Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials. Key words included the following: first time, primary shoulder, or recurrent shoulder instability, shoulder dislocation, Bankart repair, arthroscopic Bankart repair, and labral repair. The inclusion criteria were cohort studies (Level I to II) that evaluated the outcomes of patients undergoing arthroscopic stabilization after the first dislocation or multiple recurrent episodes. Studies that lacked a comparison group or were retrospective (Level III studies or higher) were excluded. Results There were 15 studies that met the inclusion criteria and were included in the final analysis: 5 in the first-time dislocation group and 10 in the recurrent instability group. Study design, patient demographics, mean number of dislocations, surgical technique, and rehabilitation protocol, as well as subjective and objective outcome measures, were recorded. Conclusions There were no differences in recurrence or complication rate among patients undergoing surgery after the primary dislocation when compared with those undergoing surgery after multiple recurrent episodes. Clinical outcome measures significantly improved within all independent studies from preoperatively to postoperatively. However, because of variation in the outcome measurement tools used, no direct comparison between the study groups could be performed. Additional randomized controlled studies are needed to compare the functional outcome, quality of life, and ability to return to preinjury activity level among patients undergoing early versus delayed repair for anterior shoulder instability. Level of Evidence Level II, systematic review of Level I and II studies.

Arthroscopic stabilization for first-time versus recurrent shoulder instability.

Background We investigated the safety and effectiveness of routine harvest of the left kidney for renal transplantation regardless of the presence of multiple renal arteries to obtain the longer renal vein. Patients and Methods Between February 2000 and July 2008, 325 patients underwent left hand-assisted laparoscopic living donor nephrectomy. The true renal arterial anatomy as evaluated intraoperatively was compared with the renal arterial anatomy by computed tomography (CT). We compared the results for the patients with a single renal artery (group I) with the patients with multiple renal arteries (group II) in terms of the donor and recipient outcomes. Results Multiple renal arteries in left kidney were identified in 86 patients (26.5%). Thirty-seven CTs (11.4%) were in discord with the renal arterial anatomy evaluated intraoperatively. There was no difference in age, gender, body mass index, estimated blood loss, complication rate, or length of hospital stay between the 2 groups in the donor. Although the warm ischemic time and the operation time were significantly longer in group II (P = .008 and .001), overall graft survival was similar between the groups. Conclusion Routine harvest of the left kidney can be performed safely and effectively for the donor and recipient, even in the presence of multiple renal arteries.

How Safe and Effective Is Routine Left Hand-Assisted Laparoscopic Donor Nephrectomy With Multiple Renal Arteries? A High-Volume, Single-Center Experience

There is limited clinical data on patellar maltracking in patients who have undergone total knee arthroplasty (TKA) without lateral release. We performed a retrospective review of 191 consecutive TKAs performed by one surgeon through the subvastus approach without lateral release from 2007 to 2008. Radiographic measurements were made using the preoperative and postoperative 2 years radiographs. Multivariate logistic regression analysis was performed to determine the risk factors for patellar maltracking after TKA performed without lateral release. TKA resulted in increases in the patellar tilt and displacement (P<0.05). The presence of preoperative patellar tilt and displacement were predictive of postoperative patellar tilt and displacement in patients who underwent TKA through the subvastus approach without lateral release (P<0.05).

Patellar tracking after total knee arthroplasty performed without lateral release

Purpose We investigated the relationships between biomarkers related to endoplasmic reticulum stress proteins (glucose-regulated protein of molecular mass 78 [GRP78] and Cripto-1 [teratocarcinoma-derived growth factor 1 protein]), pathologic response, and prognosis in locally advanced rectal cancer. Materials and methods All clinical stage II and III rectal cancer patients received 50.4 Gy over 5.5 weeks, plus 5-fluorouracil (400 mg/m(2)/day) and leucovorin (20 mg/m(2)/day) bolus on days 1 to 5 and 29 to 33, and surgery was performed at 7 to 10 weeks after completion of all therapies. Expression of GRP78 and Cripto-1 proteins was determined by immunohistochemistry and was assessed in 101 patients with rectal cancer treated with neoadjuvant chemoradiotherapy (CRT). Results High expression of GRP78 and Cripto-1 proteins was observed in 86 patients (85.1%) and 49 patients (48.5%), respectively. Low expression of GRP78 protein was associated with a significantly high rate of down staging (80.0% vs. 52.3%, respectively; p=0.046) and a significantly low rate of recurrence (0% vs. 33.7%, respectively; p=0.008) compared with high expression of GRP78 protein. Mean recurrence-free survival according to GRP78 expression could not be estimated because the low expression group did not develop recurrence events but showed a significant correlation with time to recurrence, based on the log rank method (p=0.007). GRP78 also showed correlation with overall survival, based on the log rank method (p=0.045). Conclusion GRP78 expression is a predictive and prognostic factor for down staging, recurrence, and survival in rectal cancer patients treated with 5-fluorouracil and leucovorin neoadjuvant CRT.

/pdf/grp78-protein-expression-as-prognostic-values-in-neoadjuvant-3nuxk0yn25.pdf

GRP78 Protein Expression as Prognostic Values in Neoadjuvant Chemoradiotherapy and Laparoscopic Surgery for Locally Advanced Rectal Cancer.

Kimura’s disease is a rare, benign lymphoproliferative disorder of unknown etiology. It occurs most often in Asian men, usually in the second or third decade of life. Most lesions occur in the head and neck followed by the axilla, groin, popliteal region, and arm. The lesions are commonly found in soft tissues. To the best of our knowledge, there has been only one case report of bone involvement in Kimura’s disease presented on plain radiography. We report a case of Kimura’s disease that involved the proximal meta-diaphysis of the humerus and adjacent soft tissue shown on radiography and MR imaging.

Kimura's disease involving a long bone.

A mixed solution of sodium hyaluronate and sodium carboxymethylcellulose (HA/CMC) has been shown to be effective for decreasing postoperative adhesions in various kinds of surgeries. We evaluated the clinical efficacy and safety of HA/CMC gel on the early postoperative range of motion and pain relief after total knee arthroplasty (TKA). Thirty one patients who underwent bilateral TKA as a single-stage procedure for primary osteoarthritis were included in the study. At the completion of surgery, among both knees, the HA/CMC gel was applied to one knee (the HA/CMC group) and HA/CMC gel was not applied to the other knee (the control group). The primary outcome measure was the early assessment of range of motion and the secondary outcome measures were the VAS pain scores and the number of complications in each group. Periarticular application of HA/CMC gel was safe without causing any wound problems or infection. However, local application of HA/CMC gel neither increased the range of motion nor reduced the pain during the early postoperative period of TKA.

Hyun-Min Cho

Papers

How Safe and Effective Is Routine Left Hand-Assisted Laparoscopic Donor Nephrectomy With Multiple Renal Arteries? A High-Volume, Single-Center Experience

Patellar tracking after total knee arthroplasty performed without lateral release

GRP78 Protein Expression as Prognostic Values in Neoadjuvant Chemoradiotherapy and Laparoscopic Surgery for Locally Advanced Rectal Cancer.

Kimura's disease involving a long bone.

The effects of applying adhesion prevention gel on the range of motion and pain after TKA.