Laparoscopic bilateral hand-assisted nephrectomy: end-stage renal disease from tuberculosis, an unusual indication for nephrectomy before transplantation.

The purpose of the study was to sterilize renal tuberculous foci in a pretransplantation patient with a laparoscopic hand-assisted approach and to verify the feasibility of bilateral nephrectomy for this indication. This case report is the first description of hand-assisted laparoscopic bilateral nephrectomy for this pathologic condition. The 33-year-old patient had end-stage renal disease from renal tuberculosis. A commercially available hand-assistance device was used through a midline 8-cm supraumbilical incision and with four ports. The procedure was successfully completed. The total operative time was 3 hours and 40 minutes. Estimated blood loss was 250 mL. The postoperative course was uneventful, and clinical follow-up at 3 weeks revealed a successful outcome. Hand-assisted bilateral laparoscopic nephrectomy in patients with chronic renal failure from tuberculosis represents a viable option because it is feasible and effective. The hand-assisted approach increases the safety of the procedure while retaining all the advantages of minimally invasive surgery

Stacked optical antennas for plasmon propagation in a 5 nm-confined cavity

The sub-wavelength concentration and propagation of electromagnetic energy are two complementary aspects of plasmonics that are not necessarily co-present in a single nanosystem. Here we exploit the strong nanofocusing properties of stacked optical antennas in order to highly concentrate the electromagnetic energy into a 5 nm metal-insulator-metal (MIM) cavity and convert free radiation into guided modes. The proposed nano-architecture combines the concentration properties of optical nanoantennas with the propagation capability of MIM systems, paving the way to highly miniaturized on-chip plasmonic waveguiding

Membrane Microvesicles as Actors in the Establishment of a Favorable Prostatic Tumoral Niche: A Role for Activated Fibroblasts and CX3CL1-CX3CR1 Axis

Tumor microenvironment is enriched in plasma membrane microvesicles (MV) shed from all cell types that constitute the tumor mass, reflecting the antigenic profile of the cells they originate from. Fibroblasts and tumor cells mutually communicate within tumor microenvironment. Recent evidences suggest that tumor-derived MVs (TMV) exert a broad array of biological functions in cell-to-cell communication. To elucidate their role in cancer-to-fibroblast cell communication, TMV obtained from two prostate carcinoma cell lines with high and weak metastatic potential (PC3 and LnCaP, respectively) have been characterized. TMV exhibit matrix metalloproteinases (MMP) and extracellular MMP inducer at their surface, suggesting a role in extracellular matrix degradation. Moreover, TMV not only induce the activation of fibroblasts assessed through extracellular signal-regulated kinase 1/2 phosphorylation and MMP-9 up-regulation, increase motility and resistance to apoptosis but also promote MV shedding from activated fibroblasts able in turn to increase migration and invasion of highly metastatic PC3 cells but not LnCaP cells. PC3 cell chemotaxis seems, at least partially, dependent on membrane-bound CX3CL1/fractalkine ligand for chemokine receptor CX3CR1. The present results highlight a mechanism of mutual communication attributable not only to soluble factors but also to determinants harbored by MV, possibly contributing to the constitution of a favorable niche for cancer development. [Cancer Res 2009;69(3):785–93

Cyclooxygenase-2-Derived Prostacyclin Protective Role on Endotoxin-Induced Mouse Cardiomyocyte Mortality

Cardiovascular dysfunction characterizes septic shock, inducing multiple organ failure and a high mortality rate. In the heart, it has been shown an up-regulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expressions with subsequent overproduction of nitric oxide (NO) and eicosanoids. This study is focused on the links between these products of inflammation and cell loss of mouse cardiomyocytes during treatment by the Salmonella typhimurium lipopolysaccharide (LPS) in presence or in absence of NOS or COX inhibitors. LPS induced RelA/NF-κB p65 activation, iNOS and COX-2 up-regulations, resulting in NO and prostacyclin releases. These effects were reversed by the NO-synthase inhibitor and increased by the specific COX-2 inhibitor. Immunostainings with FITC-conjugated anti-Annexin-V and propidium iodide and caspase 3/7 activity assay showed that cardiomyocyte necrosis was inhibited by L-NA during LPS treatment challenge, while apoptosis was induced in presence of both LPS and NS-398. No effect on LPS cellular injury was observed using the specific cyclooxygenase-1 (COX-1) inhibitor, SC-560. These findings strongly support the hypothesis of a link between iNOS-dependent NO overproduction and LPS-induced cell loss with a selective protective role allotted to COX-2 and deriving prostacyclins

The emerging role of curcumin in the modulation of TLR-4 signaling pathway: Focus on neuroprotective and anti-rheumatic properties

Natural products have been used in medicine for thousands of years. Given their potential health benefits, they have gained significant popularity in recent times. The administration of phytochemicals existed shown to regulate differential gene expression and modulate various cellular pathways implicated in cell protection. Curcumin is a natural dietary polyphenol extracted from Curcuma Longa Linn with different biological and pharmacological effects. One of the important targets of curcumin is Toll-like receptor-4 (TLR-4), the receptor which plays a key role in the modulation of the immune responses and the stimulation of inflammatory chemokines and cytokines production. Different studies have demonstrated that curcumin attenuates inflammatory response via TLR-4 acting directly on receptor, or by its downstream pathway. Curcumin bioavailability is low, so the use of exosomes, as nano drug delivery, could improve the efficacy of curcumin in inflammatory diseases. The focus of this review is to explore the therapeutic effect of curcumin interacting with TLR-4 receptor and how this modulation could improve the prognosis of neuroinflammatory and rheumatic diseases

Guidelines for the implementation of workforce planning (WFP) in project-driven environments

A core activity of human resource management, facing the huge challenge of matching the staffing needs in terms of right amount of skilled workers at the right moment, so as to make the whole organization able to deliver a project within a scope, on time, and budget

Workforce planning in project-driven companies: a high-level guideline

Workforce Planning (WFP) has become a crucial part of the governance of project-driven companies and has been deemed fundamental to drive critical decisions on resource management. To manage manpower planning, companies independently developed internal procedures according to their sector, size, and skills. Despite the efforts to create a reliable workforce planning process, a lack of knowledge, standardization and sharing might lead to misalignment and to heterogeneous approaches among different organizations. This study aims at investigating the current knowledge of the WFP, pointing at the detection of its key factors in terms of process steps, application context, methods, input data, actors, tools and reports’ frequency. Additionally, it attempts to define WFP high-level guidelines which can be generally valid for project-driven organizations. The research seeks to meet these goals by combining the results of the academic literature review on the WFP with the findings of the empirical study in which the representatives of ten project-based enterprises participated. The paper describes the key principles of WFP and its main process’ sections, offering high-level guidelines in terms of recommended process steps, actors involved, operative models, data input, report’s frequency, and tools. The presented features, generated by the literature review and the empirical study, are meant to be generally applicable to project-driven companies and to support the practitioners initiating this process in their organization

Navigation liver surgery for complex hydatid cyst with biliary tree communication

INTRODUCTION: Today, liver surgery navigation is utilized only in high-specialized centers for patients affected by malignant diseases. However, navigated surgery may also be of great interest for benign diseases such as hydatidosis in particular if the hydatid cyst is communicating with the biliary tree. With navigation we know exactly in each moment during the surgery the relationship of the cyst with the vascular/biliary structures around it. PRESENTATION OF CASE: Herein, we report a case of a 20-year-old W/M affected by hepatic hydatid cyst communicating with the right bile duct, causing recurrent cholangitis. The diagnosis was confirmed by endoscopic retrograde cholangiography and magnetic resonance imaging. The liver cystectomy was easily performed using a navigation system incorporating instrument tracking and three-dimensional CT-reconstruction, thus permitting a selective suture of the bile duct communicating with the cyst. CONCLUSIONS: The navigated system may guide the surgeon in patients with severe and complicated hydatid cysts