Transcatheter aortic valve implantation

Aortic stenosis is the most common valvular heart disease, with it’s incidence growing in developed countries, as the population ages. When it becomes symptomatic it tends to take a rapidly progressive course and soon requires intervention in the form of aortic valve replacement. If left untreated, mortality rates are as high as 50% within 2 years of symptom onset. Surgical replacement of the aortic valve can significantly increase survival in such patients and reduce symptoms of the disease. Unfortunately, the existence of many comorbidities are often found in such patients and may severely influence the operative risk and outcome of the aortic valve replacement surgical procedure, thence many patients are doomed inoperable and unfit for surgery. This category of inoperable patients comprises up to 30% of cases of severe symptomatic AS. Up until 2002, this group of patients did not have a viable alternative treatment. In 2002, however, the first transcatheter aortic valve implantation procedure was performed where the valve was introduced to the appropriate position by means of a catheter. Transcatheter aortic valve implantation is now the treatment of choice for high risk and inoperable patients with severe symptomatic aortic stenosis. Despite increasing advantages of transcatheter aortic valve implantation, however, several important setbacks and complications still exist and many improvements to the procedure are possible and necessary

Transcatheter aortic valve implantation

Aortic stenosis is the most common valvular heart disease, with it’s incidence growing in developed countries, as the population ages. When it becomes symptomatic it tends to take a rapidly progressive course and soon requires intervention in the form of aortic valve replacement. If left untreated, mortality rates are as high as 50% within 2 years of symptom onset. Surgical replacement of the aortic valve can significantly increase survival in such patients and reduce symptoms of the disease. Unfortunately, the existence of many comorbidities are often found in such patients and may severely influence the operative risk and outcome of the aortic valve replacement surgical procedure, thence many patients are doomed inoperable and unfit for surgery. This category of inoperable patients comprises up to 30% of cases of severe symptomatic AS. Up until 2002, this group of patients did not have a viable alternative treatment. In 2002, however, the first transcatheter aortic valve implantation procedure was performed where the valve was introduced to the appropriate position by means of a catheter. Transcatheter aortic valve implantation is now the treatment of choice for high risk and inoperable patients with severe symptomatic aortic stenosis. Despite increasing advantages of transcatheter aortic valve implantation, however, several important setbacks and complications still exist and many improvements to the procedure are possible and necessary

Transcatheter aortic valve implantation

Aortic stenosis is the most common valvular heart disease, with it’s incidence growing in developed countries, as the population ages. When it becomes symptomatic it tends to take a rapidly progressive course and soon requires intervention in the form of aortic valve replacement. If left untreated, mortality rates are as high as 50% within 2 years of symptom onset. Surgical replacement of the aortic valve can significantly increase survival in such patients and reduce symptoms of the disease. Unfortunately, the existence of many comorbidities are often found in such patients and may severely influence the operative risk and outcome of the aortic valve replacement surgical procedure, thence many patients are doomed inoperable and unfit for surgery. This category of inoperable patients comprises up to 30% of cases of severe symptomatic AS. Up until 2002, this group of patients did not have a viable alternative treatment. In 2002, however, the first transcatheter aortic valve implantation procedure was performed where the valve was introduced to the appropriate position by means of a catheter. Transcatheter aortic valve implantation is now the treatment of choice for high risk and inoperable patients with severe symptomatic aortic stenosis. Despite increasing advantages of transcatheter aortic valve implantation, however, several important setbacks and complications still exist and many improvements to the procedure are possible and necessary

TGF-beta i nastanak karcinoma prostate

All transforming growth factors beta (TGFß) are cytokines that regulate several cellular functions such as cell growth, differentiation and motility. They may also have a role in immunosuppression. Their role is important for normal prostate development. TGFß is active in the regulation of balance between epithelial cell proliferation and apoptosis through stromal epithelia via the androgen receptor action. TGFß protects and maintains prostate stem cells, an important population necessary for prostate tissue regeneration. However, TGFß is shown to have a contrasting role in prostate tumor genesis. In the early stages of tumor development, TGFß acts as a tumor suppressor, whereas in the later stages, TGFß becomes a tumor promoter by inducing proliferation, invasion and metastasis. In this review, we outline complex interactions that TGFß-mediated signaling has on prostate tumor genesis, focusing on the role of these interactions during the course of prostate cancer and, in particular, during disease progression.Svi transformacijski faktori rasta beta (TGFß) su citokini koji reguliraju nekoliko staničnih funkcija kao što su rast, diferencijacija i pokretljivost stanice. Oni također imaju značajnu ulogu u imunosupresiji. Njihova je uloga osobito značajna za normalan razvoj prostate. TGFß je aktivan u regulaciji ravnoteže između proliferacije epitelnih stanica i apoptoze kroz stromalni epitel preko djelovanja androgenog receptora. TGFß štiti i održava matične stanice prostate, značajan čimbenik za regeneraciju tkiva prostate. Do danas publicirani rezultati iznalaze da TGFß ima suprotnu ulogu u nastanku tumora prostate. U ranim fazama razvoja tumora TGFß djeluje kao supresor tumora, dok u kasnijim fazama TGFß postaje tumorski promotor inducirajući proliferaciju, invazivni rast i razvoj metastaza. U ovom preglednom članku opisuju se složene interakcije koje TGFß-posredovani mehanizmi imaju na nastanak tumora prostate, s osobitim naglaskom na mehanizme djelovanja tijekom nastanka karcinoma prostate i naročito tijekom progresije osnovne bolesti