ABSTRACT
mTOR signaling has long been implicated in the mechanisms of cardiomyocyte survival in response to volume or pressure overload. Several studies have focused on the significance of mTORC1 in cardiomyocyte survival, questioning the role of mTORC2. mTORC2Akt signaling is an emerging axis implicated in cardiomyocyte compensation and thus heart failure. Upon being subjected to chronic stress, cardiomyocytes activate mTORC2Akt signaling pathway to promote survival by activating the ubiquitin proteasome system, inducing the degradation of pro-apoptotic proteins, and altering the actin cytoskeleton. Given the importance of mTORC2 in cardiomyocyte survival, studies suggest that loss of mTORC2 signaling would result in loss of cardiomyocytes, fibrosis, and heart failure. This review serves to elaborate on how mTORC2-Akt signaling plays a role in cardiomyocyte growth and survival under stress and how the loss of the axis would result in fibrosis and heart failure.
Subject(s)
Heart Failure/etiology , Multiprotein Complexes/physiology , Myocardium/pathology , Proto-Oncogene Proteins c-akt/physiology , Signal Transduction/physiology , TOR Serine-Threonine Kinases/physiology , Actins/metabolism , Cell Survival , Fibrosis , Humans , Mechanistic Target of Rapamycin Complex 2 , Myocytes, Cardiac/pathology , Proteasome Endopeptidase Complex/physiologyABSTRACT
The use of a ventriculoatrial shunt for long-term CSF diversion for reconstruction after resection of large skull base tumors with intradural extension has been discontinued. The concern about placing a permanent foreign body in a wound open for 12 to 18 hours is our primary reason for changing the technique. Our present approach uses a rectus abdominis microvascular free flap over the fascial closure of the dural defect. Although our experience with this technique is limited, the advantages over the technique used previously warrant its continued use.
Subject(s)
Dura Mater/surgery , Head/surgery , Surgical Flaps/methods , Abdominal Muscles , Humans , Postoperative ComplicationsABSTRACT
The carbon dioxide (CO2) laser is safe and efficacious when used in conjunction with endoscopic excision of selected premalignant and malignant tumors of the larynx. Cure rates parallel those obtained with traditional surgical instruments. Advantages of laser excision of early glottic carcinomas include greater accuracy in establishing the true extent of the disease, minimal morbidity, and cost effectiveness.
