Electrochemotherapy as treatment option for hepatocellular carcinoma,a prospective pilot study

Background and objectives

Electrochemotherapy provides non-thermal ablation of cutaneous as well as deep seated tumors. Based on positive results of the treatment of colorectal liver metastases, we conducted a prospective pilot study on hepatocellular carcinomas with the aim of testing the feasibility, safety and effectiveness of electrochemotherapy.

Lymphography and computed tomography in staging nonseminomatous testicular cancer: Limited detection of early stage metastatic disease

The efficacy of lymphography and computed tomography (CT) in staging nonseminomatous testicular cancer was analyzed in 41 patients. Retroperitoneal lymphadenectomy in 30 patients with early tumor stage revealed 56% sensitivity, 90% specificity, and 80% overall accuracy for lymphography; CT was less accurate (44% sensitivity, 81% specificity, 70% overall accuracy). The presence of advanced disease in 11 patients was depicted equally by lymphography and CT, but CT better demonstrated the anatomic extent of the metastases. CT is valuable for discriminating between advanced and early tumor stages; the similar inaccuracy of lymphography in early disease militates against its routine and complementary use; retroperitoneal lymphadenectomy then remains the only accurate staging modality.     

Incidence of the 35delG/GJB2 mutation in low-risk newborns

Objective. To investigate, in a prospective study, the incidence of homozygotes and heterozygotes of the 35delG/GJB2 mutation for connexin 26 in the low-risk population of newborns undergoing two-stage universal neonatal hearing screening (UNHS).

Patients and methods. The study population consisted of 1048 neonates born at the Department of Obstetrics and Gynecology, Rijeka University Hospital, Croatia, in the period between March 1, 2005 and June 30, 2005. The neonates underwent a two-stage UNHS program that included evoked otoacoustic emission (E-OAE) in all infants and automated auditory brainstem response (A-ABR) in those who did not pass the E-OAE. The 35delG/GJB2 mutation was determined in the umbilical cord blood of all examinees.

Results. Fifteen out of 1048 infants (14.3 per 1000) did not pass the E-OAE, of whom three (2.86 per 1000) did not pass the A-ABR (two unilateral, one bilateral). The 35delG/GJB2 mutation was found in 13 out of 1033 infants who did pass the E-OAE and in one who did not pass the E-OAE. Thirteen out of 14 infants were heterozygotes (12.4 per 1000) and one infant was homozygote (0.95 per 1000) for the 35delG/GJB2 mutation. The homozygous infant had a bilateral pathological result on E-OAE and A-ABR, while 13 infants who were homozygotes passed the E-OAE.

Conclusion. In all neonates, regardless of hearing impairment, genetic testing for the 35delG/GJB2 mutation is desirable in southern Croatia. The incidence of affected homozygous and healthy heterozygous transmitters of the 35delG/GJB2 mutation was in concordance with findings in southern European countries.     

Association between genetic polymorphisms in cytokine genes and recurrent miscarriage – a meta-analysis

A meta-analysis of association studies was performed to assess whether the reported genetic polymorphisms in cytokine genes are risk factors for recurrent miscarriage (RM). The electronic PubMed database was searched for case–control studies on immunity-related genes in RM. Investigations of a single polymorphism/gene involvement in RM reported more than five times were selected. Aggregating data from seven case-control studies on ?308/tumour necrosis factor-α polymorphism, the odds ratio (OR) for RM was 1.1 (0.87–1.39) if the polymorphism was considered under a dominant genetic model. In six studies on ?1082/interleukin-10 (IL-10) polymorphism, the OR under a dominant model was 0.76 (0.58–0.99), and under a recessive model the OR was 0.90 (0.71–1.15). In five case–control studies on ?174/IL-6 polymorphism, the OR for RM under a recessive model was 1.29 (0.69–2.40). The results show a statistically significant association with RM for the ?1082/IL-10 genotype.     

An interactive surgical planning tool for acetabular fractures: initial results

Background  

Acetabular fractures still are among the most challenging fractures to treat because of complex anatomy, involved surgical access to fracture sites and the relatively low incidence of these lesions. Proper evaluation and surgical planning is necessary to achieve anatomic reduction of the articular surface and stable fixation of the pelvic ring. The goal of this study was to test the feasibility of preoperative surgical planning in acetabular fractures using a new prototype planning tool based on an interactive virtual reality-style environment.     

TIPS vs. Endoscopic Treatment for Prevention of Recurrent Variceal Bleeding: A Long-term Follow-up of 126 Patients

BackgroundRecurrent bleeding from gastroesophageal varices is the most common life-threatening complication of portal hypertension. According to guidelines, transjugular intrahepatic portosystemic shunt (TIPS) should not be used as a first-line treatment and should be limited to those bleedings which are refractory to pharmacologic and endoscopic treatment (ET). To our knowledge, long-term studies evaluating the role of elective TIPS in comparison to ET in patients with recurrent variceal bleeding episodes are rare.Patients and methodsThis study was designed as a retrospective single-institution analysis of 70 patients treated with TIPS and 56 with ET. Patients were followed-up from inclusion in the study until death, liver transplantation, the last follow-up observation or until the end of our study.ResultsRecurrent variceal bleeding was significantly more frequent in ET group compared to patients TIPS group (66.1% vs. 21.4%, p < 0.001; χ2-test). The incidence of death secondary to recurrent bleeding was higher in the ET group (28.6% vs. 10%). Cumulative survival after 1 year, 2 years and 5 years in TIPS group compared to ET group was 85% vs. 83%, 73% vs. 67% and 41% vs. 35%, respectively. The main cause of death in patients with cumulative survival more than 2 years was liver failure. Median observation time was 47 months (range; 2–194 months) in the TIPS group and 40 months (range; 1–168 months) in the ET group.ConclusionsIn present study TIPS was more effective in the prevention of recurrent variceal bleeding and had lower mortality due to recurrent variceal bleeding compared to ET.Key words: transjugular intrahepatic portosystemic shunt, endoscopic treatment, portal hypertension, esophageal and gastric varices, recurrent variceal bleeding, survival     

Peptide modulators of alpha‐glucosidase

Aims/Introduction

Acute glucose fluctuations during the postprandial period pose great risk for cardiovascular complications and thus represent an important therapeutic approach in type 2 diabetes. In the present study, screening of peptide libraries was used to select peptides with an affinity towards mammalian intestinal alpha-glucosidase as potential leads in antidiabetic agent development.

Materials and Methods

Three phage-displayed peptide libraries were used in independent selections with different elution strategies to isolate target-binding peptides. Selected peptides displayed on phage were tested to compete for an enzyme-binding site with known competitive inhibitors, acarbose and voglibose. The four best performing peptides were synthesized. Their binding to the mammalian alpha-glucosidase and their effect on enzyme activity were evaluated.

Results

Two linear and two cyclic heptapeptides with high affinity towards intestinal alpha-glucosidase were selected. Phage-displayed as well as synthetic peptides bind into or to the vicinity of the active site on the enzyme. Both cyclic peptides inhibited enzyme activity, whereas both linear peptides increased enzyme activity.

Conclusions

Although natural substrates of glycosidase are polysaccharides, in the present study we successfully isolated novel peptide modulators of alpha-glucosidase. Modulatory activity of selected peptides could be further optimized through peptidomimetic design. They represent promising leads for development of efficient alpha-glucosidase inhibitors.