Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysis-related complications during laparoscopic re-exploration after prior ventral hernia repair

Background  

The purpose of this study was to characterize the adhesion characteristics of absorbable- and nonabsorbable-barrier-coated meshes and to report adhesiolysis-related complications during laparoscopic re-exploration after prior ventral hernia repair.     

Interactions between bortezomib and romidepsin and belinostat in chronic lymphocytic leukemia cells.

PURPOSE: The goal of this study was to characterize interactions between the proteasome inhibitor bortezomib and the histone deacetylase (HDAC) inhibitors (HDACI) romidepsin or belinostat in chronic lymphocytic leukemia (CLL) cells. EXPERIMENTAL DESIGN: Primary and cultured (JVM-3 and MEC-2) CLL cells were exposed to agents alone or in combination, after which cell death was determined by 7-aminoactinomycin D staining/flow cytometry. Acetylation of target proteins, activation of caspase cascades, and expression of apoptosis-regulatory proteins were monitored by Western blot analysis. Nuclear factor-kappaB (NF-kappaB) activity was determined by luciferase reporter assay. Cells were transiently transfected with wild-type and acetylation site-mutated (inactive) RelA(p65) (e.g., K221R, K310R, or K281/221/310R) and assessed for HDACI sensitivity. RESULTS: Combined exposure to very low concentrations of romidepsin or belinostat (i.e., low nanomolar and submicromolar, respectively) in combination with low nanomolar concentrations of bortezomib synergistically induced cell death in primary and cultured CLL cells. These events were likely associated with prevention of HDACI-mediated RelA acetylation and NF-kappaB activation by bortezomib, down-regulation of antiapoptotic proteins (i.e., Bcl-xL, Mcl-1, and XIAP), as well as up-regulation of the proapoptotic protein Bim, resulting in activation of caspase cascade. Finally, CLL cells transfected with inactive RelA displayed a significant increase in HDACI lethality. CONCLUSIONS: Coadministration of the clinically relevant HDACIs romidepsin or belinostat with bortezomib synergistically induces cell death in CLL cells, likely through mechanisms involving, among other factors, NF-kappaB inactivation and perturbation in the expression of proapoptotic and antiapoptotic proteins. A strategy combining HDAC with proteasome inhibition warrants further attention in CLL.     

Gender- and race-specific comparison of tobacco-associated cancer incidence trends in Florida with SEER regional cancer incidence data

OBJECTIVE: Analysis of state and national tobacco-associated cancer trends is critical for the identification of high-risk regions of the country that require the attention of the public health community. This study compares Florida race- and gender-specific cancer trends with pooled data obtained from nine Surveillance, Epidemiology, and End Results (SEER-9) registries. METHODS: Age-adjusted, race- and gender-specific cancer incidence trends were evaluated using joinpoint regression analysis. Pooled, age-adjusted incidence rates and standardized incidence rate ratios were computed for each cancer for the years 1999-2003 to compare Florida to SEER-9. RESULTS: Relative to SEER-9 whites and irrespective of gender, lung cancer rates in white Floridians were elevated through the 1990s. However, lung cancer rates have recently declined at a steeper rate among white Floridians than among SEER-9 whites. For years 1999-2003, black Floridians had significantly lower rates of lung, bladder, pancreas, and kidney cancer relative to SEER-9 blacks. The opposite pattern was evident for white Floridians with significantly higher rates of lung and laryngeal cancer relative to SEER-9 whites. CONCLUSION: Progress in the reduction of tobacco-associated cancers among white Floridians lags behind the progress noted in SEER-9 registries suggesting that additional state-directed smoking prevention and smoking cessation measures are needed.     

Homologous acellular matrix graft for vaginal repair in rats: a pilot study for a new reconstructive approach

The purpose of this paper is to investigate using an acellular matrix graft of vagina (VAMG) or bladder (BAMG) in vaginal reconstruction. In 18 rats, vaginal length was measured and a hysterectomy performed. In three control animals, the vaginal stump was closed. In eight rats, the vagina was augmented with a VAMG; in seven, a BAMG was used. After 2-12 weeks, the animals were sacrificed, the vaginal length was reevaluated, and the vaginas were prepared for histologic evaluation. In the controls, the vagina was markedly shorter postoperatively. In the grafted animals, vaginal length was not significantly less than preoperative values with either matrix. Epithelialization, vascularization, and alpha-actin expression in the grafts were consistently observed. Regeneration appeared to be slightly greater in the organ-specific vagina matrix. With either matrix, however, although the vaginal stump remained open, the grafts lost most of the lumen. Vaginal reconstruction with a vagina acellular matrix graft is technically feasible. If further experiments can address the problem of luminal collapse - with, for instance, tissue expanders in the matrix - this technique may offer an alternative to the complex therapeutic options currently available.     

The Harvest Smart PRePTM system versus the Friadent-Schütze platelet-rich plasma kit

An important reason to improve methods for isolating platelet-rich plasma (PRP) is the potential use of autogenous platelet growth factors. In addition to the Curasan PRP kit (Curasan, Kleinostheim, Germany) and the platelet concentrated collection system (PCCSTM) system, two new methods for the preparation of PRP by the surgeon are now available. This study compared the suitability of these new methods for the preparation of PRP. Whole blood was drawn from 54 healthy donors (33 men and 21 women) aged 23-79 years (38.0 +/- 17.7 years). PRP was prepared from each donor's blood using both the Smart PRePTM system (Harvest Technologies Corporation, Munich, Germany) and the Friadent-Schütze method (PRP kit; Friadent-Schütze, Vienna, Austria). The platelet count in donor whole blood was 276 810 +/- 59 440 /microl. Platelet counts differed significantly between the Smart PRP preparation (1227 890 +/- 312 440 platelets/microl) and the Friadent-Schütze PRP preparation (1440 500 +/- 501 700 platelets/microl) (sign test, P < 0.001). The Smart PRePTM system had a significantly higher collection efficiency (63.4 +/- 7.9%) than the Friadent-Schütze kit (49.6 +/- 13.6%) (sign test, P < 0.001). The leukocyte contents in the two platelet concentrates were similar (Smart PRePTM, 19 261 +/- 8082 platelets/microl; Friadent-Schütze, 21 691 +/- 16 430). Transforming growth factor (TGF)-beta1 and platelet-derived growth factor (PDGF)-AB were higher in the Friadent-Schütze PRP (TGF-beta1, 196.8 +/- 109.6 ng/ml; PDGF-AB, 251.6 +/- 115.4 ng/ml) than in the Smart PRePTM (TGF-beta1, 77.2 +/- 54.8 ng/ml; PDGF-AB, 208 +/- 85.2 ng/ml). The sign test indicated significant differences between the two methods in the concentrations of TGF-beta1 (P < 0.001) and PDGF-AB (P < 0.01). Insulin-like growth factor (IGF)-1 levels in the two PRP preparations were similar (Friadent-Schütze PRP, 72.8 +/- 22.3 ng/ml; Smart PRePTM, 91.4 +/- 21.3 ng/ml). The Smart PRePTM system was superior with respect to ease of handling and preparation time. It also had a significantly higher platelet collection efficiency than the Friadent-Schütze PRePTM kit. The Friadent-Schütze PRP kit offers a slight advantage in the resulting PRP platelet concentration. However, this is easily compensated for in the Smart PRePTM system by reducing the volume of the resulting PRP.     

Long-term survival of autotransplanted major pelvic ganglion in the corpus cavernosum of adult rats

PURPOSE: Neurogenic impotence is a common complication after radical pelvic surgery, irradiation or perineal trauma. Neuronal transplantation is a new frontier for treating neurological disorders. We investigated whether the major pelvic ganglion can survive and become functional after being implanted into the corpus cavernosum in adult rats. MATERIALS AND METHODS: Adult male rats (13) were divided into 3 groups and sacrificed at 3 time points, namely 30 (4), 60 (5) and 90 (4) days. All rats underwent excision of the right major pelvic ganglion and left cavernous nerve. The right ganglion was implanted into the right crus of the penis. Electrostimulation was applied to the left major pelvic ganglion and cavernous nerve (1.5 mA.) and right crus (10 mA.) at sacrifice. The crural region and left ganglion were then excised for immunostaining of neuronal nitric oxide synthase (nNOS), protein gene product 9.5 and growth associated protein 43. Image analysis was used to calculate the area stained in pixels. Electron microscopy of the implanted area was performed to assess neuronal survival. RESULTS: Although the degree varied, all neuronal implants survived after transplantation. The response to electrostimulation was insufficient to produce erection. No difference was noted among the areas of nNOS staining when specimens from the 3 time points were compared. The area of expression of nNOS, protein gene product 9.5 and growth associated protein 43 was larger in the implanted area than in the surrounding cavernous tissue. Under electron microscopy most surviving implants showed normal ultrastructure, although areas of fibrotic replacement were seen in several implants. CONCLUSIONS: Our results show that the autotransplanted major pelvic ganglion expresses nNOS, protein gene product 9.5 and growth associated protein 43, and survived up to 90 days after implantation into the corpus cavernosum. Further studies with fetal neuronal tissue seem warranted.     

Cancer trends among Hispanic men in South Florida, 1981-1998

BACKGROUND: Hispanics now represent a majority of residents in Miami-Dade County, Florida. In this report, the authors present new cancer incidence and mortality data for South Florida's Hispanic men for the period 1990-1998 and compare them with data from a previous report from the 1980s. Periodic updating of cancer incidence data, reflecting current population distribution, lifestyle, and environmental risk factors, is necessary to inform cancer prevention and control activities optimally. METHODS: The study population consisted of all incidents of cancer (1981-1998) occurring in males from Miami-Dade County, as determined from the Florida Cancer Data System data base; patients were divided into two 9-year periods for analysis. Age-standardized incidence and mortality rates were computed for 14 common cancer sites, and rates for Hispanic men were compared with the rates for non-Hispanic white men as standardized rate ratios (SRRs) with 95% confidence intervals (95% CIs). Incidence and mortality trends were determined using linear regression analysis. RESULTS: Nearly 70,000 incident cancer cases were analyzed. For 1990-1998, the top five incident cancers for both race/ethnic groups were the same. The overall decreased cancer risk for Hispanic men (SRR, 0.80; 95% CI, 0.79-0.82), compared with non-Hispanic white men, remained essentially constant over the two study periods. Cancer incidence increased similarly for the two race-ethnic groups; cancer mortality decreased, with a sharper decrease for non-Hispanic white men, resulting in apparent convergence of mortality trends recently. CONCLUSIONS: Differences in cancer risk for South Florida's Hispanic men have not attenuated over the past 20 years. With cancer incidence significantly less for Hispanic men, their mortality rate approaches that of non-Hispanic white men, and cancer prevention and control strategies targeted for this ethnic group become increasingly important.     

alpha v-Integrin antagonist EMD 121974 induces apoptosis in brain tumor cells growing on vitronectin and tenascin

Orthotopic brain tumor growth is inhibited in athymic mice by the daily systemic administration of the alpha v-integrin antagonist EMD 121974. This compound, a cyclic RGD-penta-peptide, is a potent inhibitor of angiogenesis, which induces apoptosis of growing endothelial cells through inhibition of their alpha v-integrin interaction with the matrix proteins vitronectin and tenascin. Here we show that EMD 121974 also induces apoptosis in the alpha v-integrin-expressing tumor cell lines U87 MG and DAOY by detaching them from vitronectin and tenascin, matrix proteins known to be essential for brain tumor growth and invasion. These matrix proteins are shown to be produced by the brain tumor cells in vitro and in vivo. Furthermore, only tumor cells expressing alpha v-integrins responded to the treatment with EMD 121974, after xenotransplantation into the forebrain of nude mice, supporting the importance of tumor cell-matrix interactions in tumor cell survival in the brain. Thus, the alpha v-antagonist EMD 121974 suppresses brain tumor growth through induction of apoptosis in both brain capillary and brain tumor cells by preventing their interaction with the matrix proteins vitronectin and tenascin. The dual action of this peptide explains its potent growth suppression of orthotopically transplanted brain tumors.     

Cancer among Hispanic women in South Florida: an 18-year assessment: a report from the Florida Cancer Data System

BACKGROUND: The Hispanic population now represents the majority of residents in Miami-Dade County, Florida. The authors present cancer incidence and mortality data for South Florida's Hispanic women for the period 1990-1998 and compare these data to previously reported data from 1981-1989. Cancer incidence, risk, and mortality data should reflect current population distribution, lifestyle, and environmental risk factors so that cancer prevention and control activities are informed optimally. METHODS: The study population consisted of all women with malignant disease during 1981-1998 from Miami-Dade County found in the Florida Cancer Data System data base; patients were divided into 2 9-year periods for analysis. Age-standardized incidence and mortality rates were computed for common disease sites; rates for Hispanic women were compared with the rates for non-Hispanic white (NHW) women as standardized rate ratios (SRR) with 95% confidence intervals (95%CIs). Incidence and mortality trends were analyzed using linear regression. RESULTS: Over 70,000 cancer incidents were analyzed. The overall decreased cancer risk for Hispanic women (SRR, 0.65; 95%CI, 0.64-0.67), compared with NHW women, remained essentially constant over the two study periods. Cancer incidence increased similarly for the two racial-ethnic groups. The incidence of lung carcinoma increased in both groups, becoming the second most common disease site for NHW women and the third most common disease site for Hispanic women. CONCLUSIONS: The decreased relative cancer risk for Hispanic women in South Florida has remained stable over the past 18 years. Lung carcinoma is increasing among women in both racial-ethnic groups.