Application of endoscopic tattooing in intraoperative localization of colon tumours and sentinel lymph nodes

Introduction. Minimally invasive techniques in colorectal surgery have become increasingly popular and are considered a standard of care in most surgical cenres. Locating the tumour during laparoscopic procedure can be technically challenging. Incorrect localization of the primary lesion may lead to a non-radical resection margin. The technique of endoscopic tattooing (ET) prior to surgery or endoscopic treatment is considered a useful tool. Various dyes can be used for this purpose, such as: Indian ink, methylene blue, indigocarmine, toluidine blue, isosulfan blue, haematoxylin and eosin, indoxin green. This procedure is recommended by international scientific societies (ASGE and ESGE). Objective. The purpose of the study is to review the current literature on the use of ET in large intestine tumour lesions. Materials and method. A MEDLINE literature search of English language articles addressing the use of ET to enable intraoperative tumour localization in colorectal surgery was performed to evaluate and summarize the feasibility of this technique. Results. The use of ET enables the easy and safe localization of colorectal tumurs during minimally invasive colorectal procedures. The percentage of complications is insignificant. Conclusions. The available literature proves the safety and benefits of using the ET prior to surgical or endoscopic treatment. ASGE and ESGE recommend the use of ET in marking tumours before surgical treatment, and the area after endoscopic resection for further evaluation

Heat shock protein-27 is upregulated in the temporal cortex of patients with epilepsy

Heat shock protein-27 (HSP-27) belongs to the group of small heat shock proteins that become induced in response to various pathologic conditions. HSP-27 has been shown to protect cells and subcellular structures, particularly mitochondria, and serves as a carrier for estradiol. It is a reliable marker for tissues affected by oxidative stress. Oxidative stress and related cellular defence mechanisms are currently thought to play a major role during experimentally induced epileptic neuropathology. We addressed the question whether HSP-27 becomes induced in the neocortex resected from patients with pharmacoresistant epilepsy.Human epileptic temporal neocortex was obtained during neurosurgery, and control tissue was obtained at autopsy from subjects without known neurologic diseases. The tissues were either frozen for Western blot analysis or fixed in Zamboni's fixative for the topographic detection of HSP-27 at the cellular level by means of immunohistochemistry.HSP-27 was highly expressed in all epilepsy specimens and in the cortex of a patient who died in the final stage of multiple sclerosis (positive control), whereas only low amounts of HSP-27 were detectable in control brains. In epilepsy patients, HSP-27 was present in astrocytes and in the walls of blood vessels. The intracortical distribution patterns varied strongly among the epilepsy specimens.These results demonstrate that HSP-27 becomes induced in response to epileptic pathology. Although the functional aspects of HSP-27 induction during human epilepsy have yet to be elucidated, it can be concluded that HSP-27 is a marker for cortical regions in which a stress response has been caused by seizures