Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.
Background/Aim: The occurrence of an incisional hernia after liver transplantation consists of a potential complication that may seriously affect the postoperative course and the quality of patient's life in general. The purpose of this study was to report the current epidemiological data, analyze the risk factors, evaluate the role of laparoscopic repair in this condition, and present the technical difficulties in the management of this special patient group. Materials and Methods: A literature search was performed through PubMed. Our criteria included all studies published from March 1982 to February 2019 in English, regarding incisional posttransplant hernias and open or laparoscopic repair. Finally, we collected 19 relevant studies. Results: Incisional hernia may occur independently of the type of abdominal incision. Risk factors are both patient-and technique-related. Conclusion: Well-organized randomized controlled studies are needed, in order to estimate the best treatment strategy for these patients. An incisional hernia may complicate any abdominal incision, regardless of the type of incision (Figure 1A and B). However, median abdominal incisions have been documented to be more prone to incisional hernia formation, compared with other abdominal incisions (1, 2). According to a systematic review, median incisions carry a significantly higher risk of herniation compared to transversal [relative risk (RR) 1.77, 95%CI=1.09-2.87], and paramedian incisions (RR=3.41, 95%CI=1.02-11.45), respectively (3). Risk factors predisposing to incisional hernia are both patient-and technique-related. Patient-related factors that increase such a risk include obesity, smoking, malnutrition, connective tissue disorders, preoperative chemo-radiation and immunosuppressive therapy (4, 5). As for techniquerelated factors, excess wound tension, suturing material failure, poor surgical technique, as well as the need for emergency surgery, are amongst the most important factors predisposing to the development of incisional hernia. The development of an incisional hernia following liver transplantation (LT) comprises a potential complication that may seriously affect the postoperative course and the quality of patient's life. The purpose of the present study was to investigate the current epidemiological data, analyse the risk 1059 This article is freely accessible online.
Uveal melanoma is the most common intraocular malignancy in adults, representing approximately 3% of all melanoma cases. Despite progress in chemotherapy, radiation and surgical treatment options, the prognosis and survival rates remain poor. Acetylation of histone proteins causes transcription of genes involved in cell growth, DNA replication and progression of cell cycle. Overexpression of histone deacetylases occurs in a wide spectrum of malignancies. Histone deacetylase inhibitors block the action of histone deacetylases, leading to inhibition of tumor cell proliferation. This article reviewed the potential therapeutic effects of histone deacetylase inhibitors on uveal melanoma. MEDLINE database was used under the key words/phrases: histone deacetylase, inhibitors, uveal melanoma and targeted therapies for uveal melanoma. A total of 47, English articles, not only referring to uveal melanoma, published up to February 2018 were used. Valproic acid, trichostatin A, tenovin-6, depsipeptide, panobinostat (LBH-589), vorinostat (suberanilohydroxamic acid) entinostat (MS-275), quisinostat, NaB, JSL-1, MC1568 and MC1575 are histone deacetylase inhibitors that have demonstrated promising antitumor effects against uveal melanoma. Histone deacetylase inhibitors represent a promising therapeutic approach for the treatment of uveal melanoma.
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