Volume overload is an important, may be the foremost, independent prognostic factor determining the outcome of hemodialysis patients. Therefore, it is crucial to measure fluid status of these patients and avoid volume overload. This review aims to evaluate volume overload, its effects on patients with renal diseases and current methodologies measuring volume status in the body. These techniques will be first classified as clinical evaluation and non-clinical and/or instrumental techniques, which includes biomarkers, ultrasonography, relative blood volume monitoring, bioimpedance, echocardiography, pulmonary artery catheterization, esophageal and/or suprasternal Doppler, and blood viscosity. Advantages and limitations of these different techniques will be reviewed extensively by comparing each other. At last, insights gained from this review can highlight the future prospects in this active area of research.

Tumors of the CNS are composed of a complex mixture of neoplastic cells, in addition to vascular, inflammatory and stromal components. Similar to most other tumors, brain tumors contain a heterogeneous population of cells that are found at different stages of differentiation. The cancer stem cell hypothesis suggests that all tumors are composed of subpopulation of cells with stem-like properties, which are capable of self-renewal, display resistance to therapy and lead to tumor recurrence. One of the most important transcription factors that regulate cancer stem cell properties is SOX2. In this review, we focus on SOX2 and the complex network of signaling molecules and transcription factors that regulate its expression and function in brain tumor initiating cells. We also highlight important findings in the literature about the role of SOX2 in glioblastoma and medulloblastoma, where it has been more extensively studied.

One of the most prominent features of glioblastoma (GBM) is hyper-vascularization. Bone marrow-derived macrophages are actively recruited to the tumor and referred to as glioma-associated macrophages (GAMs) which are thought to provide a critical role in tumor neo-vascularization. However, the mechanisms by which GAMs regulate endothelial cells (ECs) in the process of tumor vascularization and response to anti-angiogenic therapy (AATx) is not well-understood. Here we show that GBM cells secrete IL-8 and CCL2 which stimulate GAMs to produce TNFα. Subsequently, TNFα induces a distinct gene expression signature of activated ECs including VCAM-1, ICAM-1, CXCL5, and CXCL10. Inhibition of TNFα blocks GAM-induced EC activation both in vitro and in vivo and improve survival in mouse glioma models. Importantly we show that high TNFα expression predicts worse response to Bevacizumab in GBM patients. We further demonstrated in mouse model that treatment with B20.4.1.1, the mouse analog of Bevacizumab, increased macrophage recruitment to the tumor area and correlated with upregulated TNFα expression in GAMs and increased EC activation, which may be responsible for the failure of AATx in GBMs. These results suggest TNFα is a novel therapeutic that may reverse resistance to AATx. Future clinical studies should be aimed at inhibiting TNFα as a concurrent therapy in GBMs.

Introduction: Perforator-based flaps can be planned in any anatomic location in the body when there is a detectable perforator. Although preoperative perforator mapping ensures safety and versatility of these flaps, there is no consensus yet about flap planning in different anatomical locations. Material and Method: 28 patients underwent perforator-based flap surgery for different anatomical locations as face (5), sternum (3), back (5), lomber (4), sacral (4) and scrotal (4) areas, leg (2) and foot (1). 19 of the patients were male while 9 were female. The mean age was 58.1±13.5 (22-80 years). Perforator-based flaps were planned as V-Y design in face, sacral and scrotal areas while as perforator plus transposition flaps for lomber area, leg and sternum. On the other hand, for foot the flap was planned as subcutaneous-pedicled turnover flap. Results: The mean follow-up time was 10 months (3-36 months). Partial flap necrosis is seen in all 3 patients who had underwent flap surgery on the lower extremity. There were no other complications seen in short- or long-term follow-ups. Comorbid diseases were not statistically significant on complications rates (P>0.05). Conclusion: V-Y flap for the face and the sacral area; and perforator plus transposition flap for back ,lomber area and sternum are suggested as the ideal flap modifications for these anatomical locations. On the other hand, perforator-based flaps should not be used as a first choice in reconstruction of lower extremity defects.

The RNAse III endonuclease DICER is a key regulator of microRNA (miRNA) biogenesis and is frequently decreased in a variety of malignancies. We characterized the role of DICER in glioblastoma (GB), specifically demonstrating its effects on the ability of glioma stem-like cells (GSCs) to form tumors in a mouse model of GB. DICER silencing in GSCs reduced their stem cell characteristics, while tumors arising from these cells were more aggressive, larger in volume, and displayed a higher proliferation index and lineage differentiation. The resulting tumors, however, were more sensitive to radiation treatment. Our results demonstrate that DICER silencing enhances the tumorigenic potential of GSCs, providing a platform for analysis of specific relevant miRNAs and development of potentially novel therapies against GB.

A 35-year-old woman with a history of polyacrylamide hydrogel filler injection was referred with a fluctuating facial abscess after decayed tooth extraction. MRI imaging confirmed the diagnosis of an abscess. After appropriate treatment, the patient healed with a little hyperpigmentation and deformity in the zygomaticotemporal area. Although polyacrylamide hydrogel filler injection is considered non-toxic, nonimmunogenic, and biocompatible; as a permanent material, physicians should be aware of the risk of its late complications such as late infections. In addition to antiseptic measures, antibiotic prophylaxis may be necessary before the procedures which have a risk of bacteremia and close to the permanent filler location.

Background/Aim: Nasal obstruction is caused mainly by nasal septal deviation, and submucosal resection is usually performed to treat this problem. However, if over-resected, nasal tip deprojection, deprojection of the dorsum, or pseudo-hump formation may be seen. Spreader grafts are used to restore the nasal septum in these cases, and different techniques have been described for this restoration; however, these techniques may not be the best fit for such restoration. This study presents a novel and effective method for septal reconstruction in patients with previous septal resections. Methods: Between March 2012 and October 2014, a case series of 14 male patients with tip deprojection and pseudo-hump formation who had undergone corrective surgery in our clinic was retrospectively examined. Partial-split, caudal extension costal spreader grafts were used and were fixed to the dorsum of the remnant septum cranially to prevent warping while avoiding nasal dorsum widening. Pre- and post-operative comparisons were performed, and the Nasal Obstructive Symptoms Evaluation questionnaire for the functional results and subjective Esthetic Appearance test for the esthetic outcomes were administered. Results: The mean age was 36.8 years (19–56 years), and the mean follow-up time was 14.6 months. Functional outcomes and esthetic appearance led to significantly improvements in all post-operative categories (P < 0.05) without any major complications. Common complaints were usually the same as seen in conventional rhinoplasty procedures, such as facial swelling, nasal stuffiness, pain, and/or epistaxis. None of the patients requested revision surgery. Conclusion: Using partial-split, caudal extension costal spreader grafts in the reconstruction of dorsocaudal septum in patients with previous septal resections appears to provide favorable functional and esthetic results.

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