Anorectal melanoma is an uncommon and aggressive mucosal melanocytic malignancy. Due to its rarity, the pre-operative diagnosis remains difficult. The first symptoms are non-specific such as anal bleeding, anal mass or pain. Although anorectal melanoma carries a poor prognosis; optimal therapeutics strategies are unclear.Surgical resection remains the mainstay of treatment. The optimal surgical procedure for primary tumours is controversial and can vary from wide local excision or endoscopic mucosal resection (EMR) to an abdomino-perineal resection.A high degree of uncertainly exists regarding the benefit of radiation therapy or chemotherapy. The treatment of advanced melanoma is evolving rapidly with better understanding of the disease biology and immunology. Considerable effort has been devoted to the identification of molecular determinants of response to target therapies and immunotherapy.
Giant cell tumor of the tendon sheath (GCTTS) is the second most common tumor of the hand after ganglion cysts (1,2). It is a slowly growing, usually painless benign lesion of soft tissues. The tumor affects individuals between the age of 30 and 50 years old and is found more often in women than men (3-6). Despite its benign character, local recurrence after excision has been reported in up to 45% of cases (7); there isn't still a defined treatment protocol and local excision with or without radiotherapy is the treatment of choice to date (1,2,7-13).We made a retrospective study of literature of the last 15 years and evaluated the demographic, clinical and histological aspects of the GCTTS of the hand and compared the results with our experience in a series of 64 cases from 2000 to 2012 to assess the factors that mostly contribute to incidence and recurrence of this tumor. Patients and methodsWe searched for published articles regarding the GCTTS from 1998 using the PubMed search engine. The keywords used were as follows: "giant cell tumor, tumor tendon, hand tumor"; all retrieved papers were analysed and their reference list were also screened if relevant. For each report, information was gathered on characteristics of the trial and study population, location and multicentricity of lesion, kind and severity of symptoms. We also recorded the applied treatment modality, histopathological examination of the excised tumor and recurrence rate.A retrospective study was conducted in our Department of Plastic and Reconstructive Surgery and all data were collected from medical records of 64 GCTTS patients within this Department from 2000 to 2012. Medical record included the age, gender, tumor location, presentation and size, clinical features, treatment modality, histopathological report and neurovascular or tendon involvement.All cases were operated under tourniquet control, using a magnifying loupe. Special care was taken to excise the tumor in total, retaining the capsule, if present, with margin of normal tissue. The operating field is searched for presence of satellite lesions.The histopathological diagnosis and immunohistochemical studies were conducted by the Department of Pathology within the same Hospital. Follow-up ranged from 2-153 months.
Understanding mechanisms of aging and determinants of life span will help to reduce age-related morbidity and facilitate healthy aging. Average lifespan has increased over the last centuries, as a consequence of medical and environmental factors, but maximal life span remains unchanged. Extension of maximal life span is currently possible in animal models with measures such as genetic manipulations and caloric restriction (CR). CR appears to prolong life by reducing reactive oxygen species (ROS)-mediated oxidative damage. But ROS formation, which is positively implicated in cellular stress response mechanisms, is a highly regulated process controlled by a complex network of intracellular signaling pathways. By sensing the intracellular nutrient and energy status, the functional state of mitochondria, and the concentration of ROS produced in mitochondria, the longevity network regulates life span across species by coordinating information flow along its convergent, divergent and multiply branched signaling pathways, including vitagenes which are genes involved in preserving cellular homeostasis during stressful conditions. Vitagenes encode for heat shock proteins (Hsp) Hsp32, Hsp70, the thioredoxin and the sirtuin protein systems. Dietary antioxidants, have recently been demonstrated to be neuroprotective through the activation of hormetic pathways, including vitagenes. The hormetic dose–response, challenges long-standing beliefs about the nature of the dose–response in a lowdose zone, having the potential to affect significantly the design of pre-clinical studies and clinical trials as well as strategies for optimal patient dosing in the treatment of numerous diseases. Given the broad cytoprotective properties of the heat shock response there is now strong interest in discovering and developing pharmacological agents capable of inducing stress responses. Here we focus on possible signaling mechanisms involved in the activation of vitagenes resulting in enhanced defense against energy and stress resistance homeostasis dysiruption with consequent impact on longevity processes.
BackgroundAdipose-derived stem cells are recognized as being an effective mesenchymal stem cell population with enormous potential in different fields of regenerative medicine and stem cell therapy. Although there is unanimous agreement on the harvesting procedure for adipose tissue, there are various protocols for adipose-derived stem cell isolation. The aim of this study was compare two methods of adipose-derived stem cells (ASCs) isolation, one based on a mechanical + enzymatic (ME) procedure and the other one exclusively mechanical (MC), in order to determine which one was superior to the other in accordance with current European and US legislation.MethodsWe reported step by step the two different methods ASCs isolation by comparing them. The ME procedure included the use of a centrifuge, an incubator and collagenase digestion solution (Collagenase NB 6 GMP Grade 17458; Serva GmbH, Heidelberg, Germany). The MC procedure was performed by vibrating shaker and centrifuge, both placed in a laminar airflow bench.ResultsWith the ME procedure, a mean of 9.06 × 105 ASCs (range, 8.4 to 9.72 × 105; SD ± 6.6 × 105) was collected, corresponding to 25.9% of the total number of harvested cells. With the MC procedure, a mean of 5 × 105 ASCs (range: 4.0 to 6.0 × 105; SD, ±1 × 105) was collected, corresponding to 5% of the total number of harvested cells.ConclusionBased on data collected, from the same amount of lipoaspirate the ME procedure allowed to isolate a greater number of ASCs (25,9%) compared to the MC one (5%).
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