Splenic rupture following lenograstim in post-autologous stem cell transplantation treated with emergency open splenectomy: a case report and literature review.

Granulocyte-colony stimulating factors (G-CSFs) are the cornerstone of peripheral blood stem cell mobilization and apheresis. However, splenic rupture following G-CSF treatment represents a serious and potentially fatal adverse event. Here, we report the case of a patient in their late 50s with severe pancytopenia post-autologous stem cell transplantation reinfusion suffering from splenic rupture after treatment with lenograstim. We also reviewed the literature describing cases of splenic rupture during G-CSF administration.

Laparoscopic ventral hernia repair: Results of a two thousand patients prospective multicentric database.

Laparoscopic incisional and ventral hernia repair (LIVHR) has been largely employed by the surgical community worldwide, despite the use of different types of mesh and fixation devices. A large nationwide prospective multicentric database collected 2005 operations from 8 high-volume centers, to investigate the perioeperative and long-term outcomes. The laparoscopic operations were completed in 1979 patients (98.7%), with a mean age of 60.7 years and a Body Mass Index of 28.8 kg/m2. Two hundred and one patient (18.8%) had a previous failed open repair. The average surface areas of the major defects were 47.4 and 18.2 cm 2 for postincisional and primary hernias. The mean operation time and postoperative stay were 94.4 min and s 3.7 days, respectively. We collected a total of 50 (2.5%) intraoperative and 414 (20.6%) postoperative complications, with reoperation needed in 38 cases (1.8%). After a mean follow-up period of 24 months, we recorded 62 (3.8%) confirmed recurrences. Length of surgery, hospital stay, and a previous recurrence were all risk factors for recurrence. Primary hernias had better perioperative outcomes compared to incisional hernias, except for the pain. The laparoscopic approach of both post-incisional and primary hernias seemed to be safe and feasible in short-to medium-term periods.

Inhibition of histone deacetylase 4 increases cytotoxicity of docetaxel in gastric cancer cells.

PURPOSE: New treatment options for gastric cancer are in great demand. Histone deacetylases (HDACs) are exciting therapeutic targets, but only the class I HDACs 1, 2, and 3 have been studied in gastric cancer. We have investigated class IIa HDAC expression and inhibition in gastric cancer cells. EXPERIMENTAL DESIGN: We measured the level of 27 (phospho)proteins related to class IIa HDAC expression and function in ten laser-capture microdissection gastric tumor samples compared to patient-matched adjacent normal mucosa. Following, we evaluated class IIa HDAC inhibition by MC1568 in SNU-16 gastric cancer cells alone and in combination with cisplatin or docetaxel. RESULTS: We demonstrate for the first time an increase of HDAC4 in gastric tumor cells. HDAC4 inhibition had a synergistic effect with docetaxel treatment, shifting the cellular response from a cytostatic to a cytotoxic phenotype. This effect was associated with increased levels of cleaved caspases 3 and 9 and increased acetylated histone H3 Lys9/Lys14. CONCLUSIONS AND CLINICAL RELEVANCE: These data support in vivo studies investigating the potential clinical use of HDAC4 inhibitors in combination with docetaxel for the treatment of gastric cancer, lowering treatment doses of docetaxel to reduce the burden of adverse side effects on patients.

Abdominal wall reconstruction with intraperitoneal prosthesis in desmoid tumors surgery.

Desmoid tumor (DT), also known as aggressive fibromatosis, is a rare soft tissue neoplasm. For those tumors localized in the anterior abdominal wall, radical resection and reconstruction with mesh are indicated. Due to the rarity of this disease, there have been no randomized trials, but in reported retrospective series, although it is considered a benign lesion, it is clear that local recurrence is not uncommon. Records from seven consecutive patients (1 man, 6 women; mean age 35 years, range 25-60 years) presenting with desmoid tumors of the anterior abdominal wall were analyzed. In all cases the surgical strategy was the same: wide surgical excision and immediate plastic reconstruction with ePTFE mesh after intraoperative confirmation by frozen section of disease-free margins >1 cm. No immediate postoperative complications were recorded, and no patients developed recurrence after a median follow-up period of 60 months. The long-term mean of global health status recorded was 100%. Radical resection aided by intraoperative margin evaluation by frozen sections, followed by immediate mesh reconstruction, is a safe procedure and can provide a definitive cure without functional limitations for patients with desmoid tumors of the anterior abdominal wall.