Hyperthermia enhances bortezomib-induced apoptosis in human white blood cancer cells.

At present, the current therapeutic strategy for apoptosis induction mainly relies on the administration of pharmacological apoptotic modulators. Apart from that, apoptosis can be induced by various external stimuli such as hyperthermia, ionizing radiation, and electric fields. Despite advantages, both physical and pharmacological approaches bear some limitations as well. The rationale of this study was to overcome the limitations by combining hyperthermia and apoptotic modulator 'bortezomib' (Velcade). Two types of human blood cancer cell lines were utilized: human leukemic monocyte lymphoma cell U937 line and peripheral blood mononuclear cells (PMBCs) derived from the patient diagnosed with acute myeloid leukemia. Prior to apoptosis experiments, cytotoxicity tests were performed at three types of temperature regimes (40°, 42° and 44°C). We observed a gradual inhibition of cell viability correlating with an increase of temperature and drug concentration in both cell lines. However, there was no significant difference between sham group and groups of leukemic PMBCs treated by high temperature (44°C) and bortezomib. In U937 cells, combined treatment by heat shock and bortezomib led to an increase the number of cells underwent the late apoptosis stage. At the same time, similar treatment of PMBCs resulted in the stimulation of early apoptosis. Our data suggest that combination of bortezomib and hyperthermia enhances apoptosis induction in human cancer white blood cells, indicating a therapeutic potential for blood cancer therapy.

Open inguinal herniotomy: Analysis of variations.

BACKGROUND: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. MATERIALS AND METHODS: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). RESULTS: A total of 458 repairs were done. Patients' age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 × 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 × 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 × 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 × 4.19 (median, 4). Operation time per repair was 26.50 × 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 × 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 × 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 × 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 × 1.43, 2.94 × 0.81, 2.18 × 0.69, 1.87 × 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. CONCLUSION: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers no advantage.

Herniotomy in resource-scarce environment: Comparison of incisions and techniques.

BACKGROUND: There are various methods for surgical treatment of hernia and hydrocele in children with variable cost-effectiveness, recovery and cosmetic outcomes. This study analyses our experience with mini-incision/invasive herniotomy in children in resource-limited centre. MATERIALS AND METHODS: Seven hundred and eighty-four n = 784 patients underwent herniotomy via conventional and mini-invasive methods were assigned into Group A and Group B. Three hundred and seventy-six n = 376 (47.95%) in Group A while four hundred and eight n = 408 (52.04%) in Group B. Eight hundred and seventeen (817) herniotomy was performed. Demographic data, hernia/hydrocele sides, volume of surgical suture used, surgery duration, and complications analysed. RESULTS: Right side hernia and/or hydrocele were 464 (59.18%). 287 (36.60%) had left sided while 33 (4.21%) had bilateral hernia and/or hydrocele. There were 14 bilateral hernia repair in Group A and 19 in Group B. The lengths of operation time for unilateral repair ranged from 14 to 54 min in Group A (median, 23 min) and 7-44 min in Group B (median, 15 min) with a mean surgical duration of 15.48 ± 4.16 min in Group B versus 23.41 ± 5.94 min in Group A (P < 0.001) while the range of the lengths of operation time for bilateral repair in Group A was 20-54 min (median, 36) and 12-30 min (median, 21) in Group B with a mean duration of 36.35 ± 9.89 min in Group A versus 20.42 ± 4.83 min in Group B P = 0.00563. 376 sachets of 45 cm suture material were used in Group A versus 137 in Group B. There were total of 87 (23.13%) complications in Group A versus 3 (1.47%) in Group B P = 0.000513. Superficial wound infection and abscess were 9 (2.36%) and 16 (4.25%) in Group A versus none (0) in Group B. CONCLUSION: Mini-incision/invasive herniotomy in children and adolescents is fast, cost-effective with satisfactory cosmetic outcome and limited complications.