Characterization and significance of ACE2 and Mas receptor in human colon adenocarcinoma

Introduction: A new arm of the renin–angiotensin system (RAS) has been recently characterized; this includes angiotensin converting enzyme (ACE)2 and angiotensin (Ang)1-7, a heptapeptide acting through the Mas receptor (MasR). Recent studies show that Ang1-7 has an antiproliferative action on lung adenocarcinoma cells. The aim of this study was to characterize RAS expression in human colon adenocarcinoma and to investigate whether Ang1-7 exerts an antiproliferative effect on human colon adenocarcinoma cells. Materials and methods: Gene, protein expression and enzymatic activity of the main components of the RAS were determined on non-neoplastic colon mucosa as well as on the tumor mass and the mucosa taken 5 cm distant from it, both collected from patients with colon adenocarcinoma. Two different human colon cancer cell lines were treated with AngII and Ang1-7. Results: The novel finding of this study was that MasR was significantly upregulated in colon adenocarcinoma compared with non-neoplastic colon mucosa, which showed little or no expression of it. ACE gene expression and enzymatic activity were also increased in the tumors. However, AngII and Ang1-7 did not have any pro-/antiproliferative effects in the cell lines studied. Conclusions: The data suggest that upregulation of the MasR could be used as a diagnostic marker of colon adenocarcinoma

Postoperative Complications

In this chapter we classify the complications of rectal surgery into early and late, according to the moment when they usually occur. For all the complications we have indicated the therapy, in some cases more than one, recently reported in literature. Late complications connected to lesions of the nerve plexus are treated in the dedicated chapter

Epidemiology

This chapter analyzes the epidemiology of rectal cancer, first of all on a global scale, then concentrating on the situation in the USA, with reference to the great number of publications available, and finally looking at the situation in Italy, which the authors are most familiar with

Outcome of laparoscopic gastric bypass in obese and diabetic patients: when surgery fails.

BACKGROUND: The beneficial effects of bariatric surgery on diabetes and obesity have been widely demonstrated in literature. The aim of our study was to evaluate the rate of failure of laparoscopic gastric bypass both in terms of weight loss and metabolic remission after one follow-up year. METHODS: A longitudinal, multicentric prospective study was carried out on 771 patients affected by pathological obesity. The following parameters were recorded for each patient before surgery: anthropometric, metabolic, social, smoking habits and previous failure of other bariatric procedures. After 1 follow-up year, final weight, final BMI, final percentage of lost excess body weight and percentage of lost BMI were evaluated. RESULTS: Statistical analysis showed a correlation between BMI > 50 Kg/m2 , presence of metabolic syndrome, presence of diabetes, gastric pouch volume greater than 60 ml and failure of weight loss outcome. Statistical analysis of metabolic failure has recognized a high preoperative HbA1c % value as a statistically significant negative predictive factor. CONCLUSIONS: Bariatric Surgery is the most effective treatment for weight loss and metabolic improvement. However, in our study, surgery did not achieve the expected outcome in patients with specific metabolic, anthropometric and surgical characteristics (BMI > 50 Kg/m2, presence of metabolic syndrome, presence of T2DM with high preoperative HbA1c % level and gastric pouch volume greater than 60 ml