Impact of proteolytic enzymes in colorectal cancer development and progression.

Tumor invasion and metastasis is a highly complicated, multi-step phenomenon. In the complex event of tumor progression, tumor cells interact with basement membrane and extracellular matrix components. Proteolytic enzymes (proteinases) are involved in the degradation of extracellular matrix, but also in cancer invasion and metastasis. The four categories of proteinases (cysteine-, serine-, aspartic-, and metalloproteinases) are named and classified according to the essential catalytic component in their active site. We and others have shown that proteolytic enzymes play a major role not only in colorectal cancer (CRC) invasion and metastasis, but also in malignant transformation of precancerous lesions into cancer. Tissue and serum-plasma antigen concentrations of proteinases might be of great value in identifying patients with poor prognosis in CRC. Our results, in concordance with others indicate the potential tumor marker impact of proteinases for the early diagnosis of CRC. In addition, proteinases may also serve as potential target molecules for therapeutic agents

Circulating mitochondrial stress 70 protein/mortalin and cytosolic Hsp70 in blood: Risk indicators in colorectal cancer.

Mitochondrial mortalin and cytosolic Hsp70 are essential chaperones overexpressed in cancer cells. Our goals were to reproduce our earlier findings of elevated circulating levels of mortalin and Hsp70 in colorectal cancer (CRC) patients with a larger patient cohort, to compare death risk assessment of mortalin, Hsp70, CEA and C19-9 and to assess their prognostic value in various CRC stages. Mortalin, Hsp70, CEA and CA19-9 levels were determined in sera of 235 CRC patients enrolled in the study and followed up 5 years after surgery. Association between their concentrations and patients' survival was analyzed by Kaplan-Meier estimator and subjected to Cox Proportional hazards analysis. Serum level of mortalin was independent of that of Hsp70, CEA and CA19-9, whereas Hsp70 level weakly correlated with CEA and CA19-9 levels. Improved short-term survival was found in early or advanced disease stages associated with lower mortalin and Hsp70 levels. Cox regression analysis showed a high mortality hazard (HR = 3.7, p < 0.001) in patients with both high mortalin and Hsp70 circulating levels. Multivariate analysis showed that high mortalin and Hsp70 significantly enhances risk score over a baseline model of age, number of affected lymph nodes, CEA, CA19-9, disease stage and perioperative therapy. Analysis of mortalin and Hsp70 in CRC patients' sera adds a high prognostic value to TNM stage and to CEA and CA19-9 and identifies patients with lower or higher survival probability in all CRC stages. Determination of mortalin and Hsp70 in blood could be a useful additive prognostic tool in guiding clinical management of patients

Motion Capturing / Performance Capturing in James Cameron's AVATAR : an rapprochement

Motion capturing is a method that allows you to follow real movements in space and translate them into mathematical formulas by means of which a virtual figure or a virtual skeleton move in the same way. The present thesis gives an overview of the theoretical aspects of motion capturing and performance capturing. Some of these are essential to understand the making of the blockbuster Avatar. Through this movie, a seminal example of perfect illusions and great expressions, the bounderies of animation were shifted

Laparoscopos csomózás [Laparoscopic knot tying]

Wound closure with sutures has been routinely used as a result of the technical and surgical development since the 20th Century. Knot tying in open surgery can be easily learned and performed; however, knot tying becomes challenging and frustrating when performed laparoscopically. Laparoscopic vessel ligation, suturing and performing anastomosis opened up a new horizon for laparoscopy. Laparoscopic knots can be performed extracorporally or intraabdominally. The most common intracorporal knots are the tumble square, Dundee, Aberdeen, midship and blood knots. Inherent disadvantages of intracorporal laparoscopic knot tying are decreased sensation of the tension applied to the tissues and the knot; and difficulty in knotting because of technical requirements and limited space. The most common extracorporal knots: Duncan, Roeder, modified 4-S Roeder, Tayside, Yanni and GEA knots. Extracorporally tied knots are obviously much easier to tie than intracorporal one;, but they can cause tissue trauma from pulling long lengths of suture through the needle tract, excessive tension on the tissue while pushing the knot into position, and loss of focus on the operative field during knotting. One kind of knot-pusher would not fit for all and we suggest to use different knot-pushers for different suture materials. In robotic assisted suturing the operative time decreased, the stability has increased and the skills can be developed in simulation labs

Colon- és csepleszmetastasis okozta ileus mint a ductalis emlőrák első klinikai jele

Distant spread from breast cancer is commonly found in bones, lungs, liver and central nervous system. Metastatic involvement of peritoneum, omentum or/and gastro-intestinal tract is unusual and unexpected. We present the case of a 48 year-old woman who presented with gastro-intestinal symptoms as signs of omental and colonic metastasis of an invasive ductal breast cancer, which was not diagnosed before her admission. Ileus was diagnosed and urgent surgery was performed. Histology revealed metastatic ductal breast carcinoma. Mastectomy and axillary lymphadenectomy were performed therefore. Reviewing the literature--to the best of our knowledge--such a case has never been published before

Poupart-szalag rekonstrukciója autológ fascia lata lebennyel. Az első ismertetett hazai eset

INTRODUCTION: A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described. PRESENTATION OF CASE: A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with 15x13 cm sheet of polypropylene mesh, placed preperitoneal and sutured to the remaining abdominal wall muscles and to the neo-Pouoart ligament. DISCUSSION: Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. Published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues. CONCLUSION: This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and general surgeons. This is the first reported case in Hungary

Két műtéti technika elemzése laparoscopos splenectomiák kapcsán [Analysis of two different operative techniques for laparoscopic splenectomy]

Laparosocopic splenectomy gradually became the gold standard procedure in the surgical treatment of certain haematological disorders. Operative experience in laparoscopic procedures facilitates the comparison of various techniques. Two variants in laparoscopic spelenectomy are analysed and presented. Sixteen patients underwent laparoscopic spelenectomy. Anterior- and postero-anterior laparoscopic approaches are compared with respect to clinicopathologic features. Using the postero-anterior technique dissection of splenic hilum is more straightforward, recognition of accessory spleen is easier and the likelihood of intraoperative complications is less. In selected cases of splenomegaly the anterior technique is recommended though

Kizárt combsérv klinikai képét mutató recidív retroperitonealis liposarcoma

56-year-old man was admitted to our hospital 18 month after extirpation of retroperitoneal liposarcoma. We diagnosed recurrent tumor in the inguinal fossa. The tumor situated along the femoral artery and propagated to the thigh among the muscles, mimicking incarcerated femoral hernia. We performed resection with synchronous abdominal and femoral exploration. By our knowledge this is the first case report about recurrent retroperitoneal liposarcoma presenting as an incarcerated femoral hernia

A pancreas praecancerosisai: intraepithelialis neoplasia (PanIN) és intraductalis papillaris mucinosus neoplasia (IPMN)

Pancreatic Intraepithelial Neoplasia (PanIN1-3) and Intraductal Papillary Mucinous Neoplasms (IPMN) putative precursors of and associated to pancreatic cancer represent a distinct, however pathologically heterogenous entity. Recently a new classification and nomenclature was established. We review the clinicopathologic and cytogenetic characteristics of PanIN and IPMN highlighting the nonaggressive biological behavior of intraepithelial and intraductal neoplasms which, in part explain their favorable prognosis