Purpose To investigate the effects of male ageing on DNA fragmentation and chromatin packaging in the spermatozoa of oligoasthenoteratozoospermic (OAT) patients. Methods Sixty-one OAT patients and 49 men with proven fertility (controls) were included in the present study. DNA fragmentation was detected by terminal deoxynucleotidyl transferase-mediated dUTP-nick end labelling (TUNEL) assay, while chromatin packaging was assessed by chromomycin A 3 (CMA 3 ) staining. Results In the patient group, semen volume, percentage of normally shaped spermatozoa and sperm motility decreased significantly (P<0.05) with age, while sperm concentration and the percentage of TUNEL and CMA 3 positive spermatozoa showed a statistically significant increase with age (P<0.05). In the control group, conventional semen parameters as well as DNA fragmentation and chromatin packaging did not show a statistically significant change with age (P>0.05). Conclusion Increased age in OAT patients is associated with an increase in sperm concentration, DNA fragmentation and poor chromatin packaging, as well as a decline in semen volume, sperm morphology and motility.

Primary mucosal melanoma is a rare disease, with a worse prognosis than cutaneous melanoma. We present a patient with primary melanoma of the stomach and small intestine, with good outcome after radical surgical excision and adjuvant ipilimumab therapy.

Both primary and secondary gallbladder melanomas are rare and, when a solitary melanoma is found in the gallbladder, it is difficult to determine if it is primary or metastatic disease. We report the case of a young woman found to have a single metastatic gallbladder melanoma. Surgical removal of a solitary metastatic focus remains the treatment of choice for isolated metastasis of a malignant melanoma; however, the effectiveness of complementary chemotherapy and immunotherapy is still being examined.

Triple-negative breast cancer (TNBC) is characterized by a lack of expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) and unfortunately is not associated with good prognosis. Treatment of breast cancer mainly depends on chemotherapy, due to the lack of specifically approved targeted therapies for TNBC. It is of paramount importance to find new therapeutic approaches, as resistance to chemotherapy frequently occurs. Herein, we present clinical studies published within the last five years, in order to reveal possible targeted therapies against TNBC. We aimed to discuss factors against TNBC, such as tyrosine kinase inhibitors, anti-androgens, poly ADP-ribose polymerase-1 (PARP-1) inhibitors, anti-angiogenic factors, immune checkpoints and histone deacetylase inhibitors (HDACI). Furthermore, the PI3K/AKT/mTOR pathway seems to be a promising field for the development of new anti-TNBC targeted therapies. Data from 18 clinical trials with patients suffering from TNBC were summarized and presented descriptively. Breast cancer is one of the most common cancers in females, comprising heterogeneous tumors with a variety of biological features, clinical course, prognosis and response to therapy (1, 2). In 2017, triple-negative breast cancer (TNBC) accounted for about 15% of all the new cases of breast cancer in the United States (3-7). Many different epidemiological studies have revealed that TNBC was more likely to arise among females characterized by early menarche, higher waist to hip ratio, higher parity, shorter duration of breast feeding, higher body mass index, and was more common among pre-menopausal patients (8). TNBC is a disease defined by the absence of human epidermal growth factor receptor 2 (HER2) and hormone receptors (HR), specifically the progesterone (PR) and the estrogen receptor (ER) (9) (Figure 1). There are at least 6 different subtypes, which demonstrate different biological behavior, including the basal-like 1 and 2 (BL-1 and BL-2), mesenchymal (M), mesenchymal stem-like (MSL), immunomodulatory (IM), luminal androgen receptor (LAR) and unstable subtype (7, 10).

Abstract.A growing body of evidence suggests that oncogenesis is associated with systemic inflammation. The present study investigated white blood cell and platelet indices, whose values change during the inflammatory response, in women with invasive ductal breast carcinoma. Preoperatively obtained white blood cell and platelet counts from 53 patients with early breast cancer, who developed systemic metastases over a mean follow-up period of 65 months, were analyzed and compared with those of a matching control group formed of 37 patients with the same characteristics, who remained recurrence-free during the same time period. Patients who developed distant metastasis had a significantly higher mean platelet volume and lower neutrophil count than patients who did not present with distant metastasis. Furthermore, time to distant metastasis development was longer in patients with a lower mean platelet volume, whilst patients with a lower neutrophil count had a shorter systemic disease-free time interval. However, receiver operating characteristic curve analysis demonstrated that these parameters provided moderate accuracy in predicting which patients may develop distant metastasis. No differences were detected between patient groups regarding additional parameters. Patients who developed systemic disease during a mean follow-up period of 65 months were observed to have an increased mean platelet volume and decreased neutrophil count preoperatively. These results indicate that such parameters may be of prognostic value in patients with breast cancer. Studies with a larger number of patients are required to further investigate this hypothesis.

Abstract. Background

Over the last few years, autologous fat grafting has been at the forefront of aesthetic plastic surgery clinical practice, since it provides exceptional results for the treatment of soft-tissue contour deformities (1, 2). Similar to bone marrow, the adipose tissue is derived from the embryonic mesenchyme and contains a supportive stromal vascular fraction (SVF) that can be easily isolated (3). Typically, SVF from adipose tissue contains different types of cells, including endothelial cells, smooth muscle cells, pericytes, leukocytes and pre-adipocytes, otherwise named as adipose-derived stem cells (ASCs) (4).The potential of ASCs to differentiate into diverse cell types both in vitro and in vivo, offers outstanding opportunities for their clinical application as therapeutic agents (5). In particular, preclinical studies have revealed their capacity to differentiate toward the osteogenic, adipogenic, myogenic, and chondrogenic lineages (6, 7). Nevertheless, adipose tissue displays a significant heterogeneity in terms of stem cell yield, proliferation, and differentiation capacity not only among individuals, but even when comparing different fat depots within one individual (8). 1229This article is freely accessible online.Correspondence to: Diamantis I. Tsilimigras, MD,

Current literature indicates that there is a strong correlation between coronary artery disease (CAD) and type 2 diabetes. The arteriosclerotic progression occurs earlier and in a greater extent in the diabetic than in the non-diabetic population. In diabetic subjects, the detection of arterial disease does not always precede the development of an acute arterial incident. Herein, we reviewed studies published within the last 5 years in order to reveal the risk factors for coronary artery disease in patients with type 2 diabetes. In addition, we aimed to discuss how to diagnose in an early stage or even screen the presence of coronary artery disease in asymptomatic diabetic patients. Possible blood markers as predictors of CAD, which are mostly related to the lipidemic profile of subjects, are included in this review. Less invasive imaging methods than conventional coronary angiography, included in the article, are gradually used more in the diagnosis of CAD and show high effectiveness. Data from 23 articles with 22,350 patients having type 2 diabetes were summarized and presented descriptively. The rates of diabetes are increasing worldwide. The scientific community estimates that the number of people living with diabetes will rise dramatically the following years and will reach the number of 592 million by 2035 (1). Diabetes mellitus has a wide range of complications which includes both microvascular (renal, retinal, and neuropathic disease) and macrovascular complications [vascular disease and coronary artery disease (CAD)] (2). The main system affected by diabetes, causing death, is the cardiovascular one. As a result, patients suffering from diabetes are prone to more severe cardiovascular diseases and have greater complication rates than non-diabetic patients (3). Inflammatory elements, vascular smooth muscle cell proliferation and endothelial dysfunction, which characterize atherosclerosis, result in atherosclerotic plaque instability and progression (4-10). Atherosclerosis leading to CAD results in restriction of blood flow to the heart (11). It is common knowledge that the degree of stenosis varies among patients. Therefore, the clinical presentation of patients also varies from asymptomatic to stable angina and acute coronary syndrome (ACS), which includes unstable angina, stemi and non-stemi myocardial infraction (12). Diabetes is regarded as a CAD risk equivalent. This means that diabetic patients are at risk of having coronary events alike non-diabetic patients, who previously had one (13). Many factors contribute to the appearance of CAD in diabetes type 2 patients and only 25% of these are already known (14). As CAD constitutes a challenging task among practitioners, the aim of our review is to present the correlation between type 2 diabetes mellitus and CAD, according to current scientific reports, and to reveal possible 1039 This article is freely accessible online.