Integrating developmental signals: a Hippo in the (path)way.

The Hippo pathway, a signaling cascade that controls cell cycle progression, apoptosis and cell differentiation, has emerged as a fundamental regulator of many physiological and pathological processes. Recent studies have revealed a complex network of interactions directing Hippo pathway activity, and have connected this pathway with other key signaling pathways. Such crosstalk has uncovered novel roles for Hippo signaling, including regulation of TGFß/SMAD and WNT/ß-catenin pathways. This review highlights some of the recent findings in the Hippo field with an emphasis on how the Hippo pathway is integrated with other pathways to mediate diverse processes.

[Conservative therapy adapted to findings of superficial chronic venous ulcers]. / Konservative befundadaptierte Therapie von superinfizierten chronischen venös bedingten Ulcera cruris.

A successful treatment of venous ulcers represents a special clinical challenge. The following conservative wound management of a high-risk patient presents an alternative to primary surgical treatment. A patient of 79 years in reduced general state with multiple underlying concomitant diseases is hospitalized with superinfected, necrotic and painful ulcers. Due to the severe morbidity of the patient the regular therapy of the underlying venous insufficiency consisting of stripping of great saphenous vein and ligation of perforator veins, is contraindicated. After interdisciplinary discussion conservative therapy is carried on. The conservative therapy includes initial local debridement, moist wound-healing dressings, compression therapy, systemic antibiotic and analgesic therapy, completed by stabilization of patient's general state. In regular intervals a photographic documentation of the wound is carried out. The period of treatment and observation is 63 days. Due to conservative wound management a clear improvement of the wound condition and of the patient's general state is observed. The period needed for change of wound dressing can be reduced from 2 hours to 30 minutes. The painscore is reduced from 8/10 to 4/10 as well as the analgesic need. The photographic documentation shows a clear progress of healing within 9 weeks. Under antibiotic therapy and conservative wound management the increased inflammation parameters are declining. By choosing a conservative therapeutical regime adapted to clinical findings superinfected, chronic venous ulcers are turned into a stable condition.