A prospective, randomized, controlled study comparing Gynemesh®, a synthetic mesh, and Pelvicol®, a biologic graft, in the surgical treatment of recurrent cystocele

We compared safety and efficacy of Gynemesh PS® and Pelvicol® for recurrent cystocele repair. One hundred ninety patients were randomly divided into Gynemesh PS® and Pelvicol® groups and underwent tension-free cystocele repair. The Chi-square test was used to compare categorical variables, the paired t test for continuous parametric variables, and the Mann–Whitney test for continuous nonparametric variables. Ninety-six Gynemesh PS® patients and 94 Pelvicol® patients were studied. Mesh erosions occurred in 6.3% of Gynemesh PS® patients. No erosions were observed in Pelvicol® patients (p?=?0.02). Objective cure was 71.9% for Gynemesh PS® and 56.4% for Pelvicol® (p?=?0.06). Subjective cure was the same in both groups except for better sexuality in the Pelvicol® group. At 24 months follow-up, only Gynemesh PS® patients had mesh erosions. Anatomical outcome was similar in the two groups. Pelvicol® gave a better impact on voiding and sexuality.     

Colorectal carcinogenesis. 2. Underlying epigenetic and genetic alterations and molecular classification of colorectal cancers

Gene alterations which have been implicated in colorectal carcinogenesis are characterized by three major mechanisms: chromosomal instability, microsatellite instability, and epigenetic mechanisms (i.e., CpG island hypermethylation). Progress in understanding of these genetic and epigenetic instabilities has led to advances in the individualization and characterization of more homogeneous sub-groups of colorectal tumors with regard to progression, prognosis and response to therapy.     

Prognosis of stage II colon cancer by non-neoplastic mucosa gene expression profiling

We have assessed the possibility to build a prognosis predictor (PP), based on non-neoplastic mucosa microarray gene expression measures, for stage II colon cancer patients. Non-neoplastic colonic mucosa mRNA samples from 24 patients (10 with a metachronous metastasis, 14 with no recurrence) were profiled using the Affymetrix HGU133A GeneChip. Patients were repeatedly and randomly divided into 1000 training sets (TSs) of size 16 and validation sets (VS) of size 8. For each TS/VS split, a 70-gene PP, identified on the TS by selecting the 70 most differentially expressed genes and applying diagonal linear discriminant analysis, was used to predict the prognoses of VS patients. Mean prognosis prediction performances of the 70-gene PP were 81.8% for accuracy, 73.0% for sensitivity and 87.1% for specificity. Informative genes suggested branching signal-transduction pathways with possible extensive networks between individual pathways. They also included genes coding for proteins involved in immune surveillance. In conclusion, our study suggests that one can build an accurate PP for stage II colon cancer patients, based on non-neoplastic mucosa microarray gene expression measures.     

Arcus Marginalis Release in Blepharoplasty I: Technical Facilitation

Resection of intraorbital fat compartments in lower-lid blepharoplasty has been widely replaced by their realignment over the orbital rim. For older patients this usually includes an open subciliary approach with skin resection and orbicularis muscle modification. In younger patients this may be done transconjunctivally. Fixation of the adipose tissue is controversial. Whereas reliance of realignment on spontaneous prolapse may be unpredictable, suture fixations may be tedious and even cause scleral show or ectropion. A monofilament, double-armed, polypropylene suture on bent straight needles can be used safely to transfix the three compartments across maxilla and zygoma. These transcutaneous pullout sutures are simply fixed with steri-strips. After only 2 days the orbital fat will be sufficiently adherent to its new bed.     

A rare association of systemic lupus erythematosus, morbid obesity and Takotsubo Syndrome

The authors report a 68-year-old white female with long-term systemic lupus erythematosus as well as morbid obesity, characterized by very elevated body mass index, who presented a classical picture of acute coronary failure ascribed to Takotsubo syndrome.