No abstract

Ovarian cancer is the leading cause of cancerassociated mortality in the female reproductive system. Interleukin (IL)-33 and its receptor IL 1 receptor like 1 (also termed ST2) are expressed by many cell types including epithelial cells. The role of IL-33 in the pathogenesis of neoplasia remains controversial. The authors previously demonstrated that IL-33 inhibits the growth of pancreatic cancer cells. The present study was performed to explore if IL-33 has any direct effects on ovarian cancer cells. A clonogenic survival assay, immunohistochemistry (IHC), proliferation kit and caspase-3 activity kit were all used to evaluate the direct effects of IL-33 on cell proliferation and apoptosis of a widely studied ovarian cancer cell line, A2780. The possible molecular mechanisms were further evaluated with reverse transcription-polymerase chain reaction and IHC. It was demonstrated that the percentage of colonies and the optical density value of cancer cells were all increased in the presence of IL-33; however, the relative caspase-3 activity in cancer cells was decreased in the presence of IL-33. Molecular mechanism studies revealed that the pro-proliferative effect of IL-33 on cancer cells was associated with decreased levels of p27, and the anti-apoptotic effect of IL-33 was associated with levels of Fas cell surface death receptor (Fas) and tumor necrosis factor-related apoptosis-inducing ligand receptor 1 (TRAILR1). Therefore, IL-33 promoted proliferation and inhibited apoptosis of ovarian cancer cells by downregulation of p27, Fas and TRAILR1. Contrary to previous studies demonstrating an anti-tumor effort in pancreatic cancer, the results of the present study indicated that IL-33 exhibited a significant onco-promoting effect on ovarian cancer. Accordingly, the inhibition of IL-33 may be a promising therapeutic strategy for ovarian cancer.

Behcet’s disease (BD) is a rare autoimmune disorder that results in diffuse full-thickness vasculitis. Pulmonary artery aneurysms (PAAs) and hemoptysis are known complications of this disease process, with high morbidity and mortality for affected patients. Although medical, endovascular, and surgical treatment strategies have all been described in the literature, there are little data to describe the long-term outcomes of these various treatment modalities and there continues to be a lack of clearly defined algorithms for the management of these patients. We report a case of PAA in the setting of BD who was treated over the course of many years with medical therapy and coil embolization but ultimately failed treatment, sustained a complication of coil erosion and migration into the trachea twice, and required surgical lobectomy for definitive management. We discuss an algorithm for the management of patients with BD who have PAAs.

A historical review and case report of the first appendectomy ever performed on a submarine 120 feet below sea level and far behind enemy lines during World War II. This case history will be told uniquely from the perspective of a modern-day rural surgeon with an emphasis on the extraordinary leadership, teamwork, and heroism of the endeavor. All health care providers and administrators are in desperate need of these qualities to successfully unite, navigate, and conquer the attacks on today’s health care system.