ABSTRACT
Progression of cancer is often associated with interactions between cancer cells and extracellular matrix (ECM) surrounding them. Increasing evidence has suggested that accumulation of hyaluronan (HA), a major component of ECM, provides a favorable microenvironment for cancer progression. Pancreatic ductal adenocarcinoma (PDAC) is characterized typically by a dense desmoplastic stroma with a large amount of HA, making this molecule as an attractive target for therapy. Several studies have shown efficacy of inhibitors of HA synthesis or signaling for the treatment of PDAC. Recent studies have also demonstrated substantial improvements in the effects of chemotherapy by a targeted depletion of stromal HA in PDAC using an enzymatic agent. Thus, targeting HA has been recognized as a promising therapeutic strategy to treat this highly aggressive neoplasm. In this review article, we summarize our current understanding of the role of HA in the progression of PDAC and discuss possible therapeutic approaches targeting HA.
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the surgical skill, treatment effect and indications for reconstruction of vertebral lamina with skull titanium plate and autograft in the treatment of thoracolumbar vertebrae fracture.</p><p><b>METHODS</b>From March 1999 to April 2007, 33 patients with thoracolumbar vertebrae fracture combined nerve injury were treated by reconstruction of vertebral lamina with skull titanium plate and autograft including 30 males and 3 females with an average age of 41 years ranging from 21 to 66. The fracture involved 3 cases in T11, 9 in T12, 16 in L1, 3 in L2 and 2 in L3. There were 12 cases with flexion fracture, 8 with extension fracture, and 13 with burst fracture. Five cases performed emergency operation and in the others the time from injury to operation was 5 to 12 days. GSS fixation was applied in 25 cases and AF in 8. The volume of vertebral canal, the stability of the spine, the height of vertebrae, and the nerve function were observed before and after operation.</p><p><b>RESULTS</b>These 33 patients were followed up for 1 to 3 years (means 25 months). The height of anterior column of the involved vertebrae changed from 58% to 96%, the cobb angle return from average of 26 degree to 2 degree, the volume of vertebral canal extended from 43% to 92%, respectively, when compared between preoperatively and postoperatively.</p><p><b>CONCLUSION</b>Reconstruction of vertebral lamina with skull titanium plate and autograft which is a simple and safe treatment for thoracolumbar vertebrae fracture can increase the stability of spine and avoid second canal stenosis.</p>