Factors that influence lymph node retrieval in the surgical treatment of colorectal cancer: a comparison of the laparoscopic versus open approach.

BACKGROUND: The purpose of this study was to determine whether surgical approach and patient demographics are important factors that influence lymph node retrieval. METHODS: This was a retrospective review of patients receiving surgical treatment for colorectal cancer at a single institution. RESULTS: Two hundred three patients underwent resection for colorectal cancer. The total number of lymph nodes recovered and the number of lymph nodes involved were similar in both the laparoscopic group and the open group. Patients who had right-sided colon resection had a higher total number of lymph nodes recovered. There was no effect of age, sex, race, or body mass index (BMI) on the total number of lymph nodes harvested or on the number of positive lymph nodes. CONCLUSIONS: Adequate regional lymphadenectomy for colorectal cancer can be successfully performed using a laparoscopic approach. Patient demographics did not make a difference in the number of total or positive lymph nodes recovered.

Survival and cardiac remodeling after myocardial infarction are critically dependent on the host innate immune interleukin-1 receptor-associated kinase-4 signaling: a regulator of bone marrow-derived dendritic cells.

BACKGROUND: The innate immune system greatly contributes to the inflammatory process after myocardial infarction (MI). Interleukin-1 receptor-associated kinase-4 (IRAK-4), downstream of Toll/interleukin-1 receptor signaling, has an essential role in regulating the innate immune response. The present study was designed to determine the mechanism by which IRAK-4 is responsible for the cardiac inflammatory process, which consequently affects left ventricular remodeling after MI. METHODS AND RESULTS: Experimental MI was created in IRAK-4(-/-) and wild-type mice by left coronary ligation. Mice with a targeted deletion of IRAK-4 had an improved survival rate at 4 weeks after MI. IRAK-4(-/-) mice also demonstrated attenuated cardiac dilation and decreased inflammation in the infarcted myocardium, which was associated with less proinflammatory and Th1 cytokine expression mediated by suppression of nuclear factor-kappaB and c-Jun N-terminal kinase activation. IRAK-4(-/-) mice had fewer infiltrations of CD45+ leukocytes and CD11c+ dendritic cells, inhibition of apoptosis, and reduced fibrosis and nitric oxide production. Cardiac dendritic cells in IRAK-4(-/-) mice were relatively immature or functionally naïve after MI in that they demonstrated less cytokine and costimulatory molecule gene expression. Furthermore, IRAK-4(-/-) dendritic cells have less mobilization capacity. Transfer of wild type-derived bone marrow dendritic cells into IRAK-4(-/-) mice for functional dendritic cell reconstitution negated the survival advantage and reduced the cardiac dilation observed with IRAK-4(-/-) mice at 28 days after MI. CONCLUSIONS: Deletion of IRAK-4 has favorable effects on survival and left ventricular remodeling after MI through modification of the host inflammatory process by blunting the detrimental bone marrow dendritic cells mobilization after myocardial ischemia.