Peritoneal dialysis (PD) is a valuable ‘home treatment’ option, even more so during the ongoing Coronavirus pandemic. However, the long-term use of PD is limited by unfavourable tissue remodelling in the peritoneal membrane, which is associated with inflammation-induced angiogenesis. This appears to be driven primarily through vascular endothelial growth factor (VEGF), while the involvement of other angiogenic signaling pathways is still poorly understood. Here, we have identified the crucial contribution of mesothelial cell-derived angiogenic CXC chemokine ligand 1 (CXCL1) to peritoneal angiogenesis in PD. CXCL1 expression and peritoneal microvessel density were analysed in biopsies obtained by the International Peritoneal Biobank (NCT01893710 at www.clinicaltrials.gov), comparing 13 children with end-stage kidney disease before initiating PD to 43 children on chronic PD. The angiogenic potential of mesothelial cell-derived CXCL1 was assessed in vitro by measuring endothelial tube formation of human microvascular endothelial cells (HMECs) treated with conditioned medium from human peritoneal mesothelial cells (HPMCs) stimulated to release CXCL1 by treatment with either recombinant IL-17 or PD effluent. We found that the capillary density in the human peritoneum correlated with local CXCL1 expression. Both CXCL1 expression and microvessel density were higher in PD patients than in the age-matched patients prior to initiation of PD. Exposure of HMECs to recombinant CXCL1 or conditioned medium from IL-17-stimulated HPMCs resulted in increased endothelial tube formation, while selective inhibition of mesothelial CXCL1 production by specific antibodies or through silencing of relevant transcription factors abolished the proangiogenic effect of HPMC-conditioned medium. In conclusion, peritoneal mesothelium-derived CXCL1 promotes endothelial tube formation in vitro and associates with peritoneal microvessel density in uremic patients undergoing PD, thus providing novel targets for therapeutic intervention to prolong PD therapy.
IntroductionTreatment of unresectable liver metastases (LM) from uveal melanoma (UM) remains a major clinical challenge. Systemic chemotherapy and chemoimmunotherapy regimens extrapolated from cutaneous melanoma are considered to be ineffective in therapy of metastases from uveal melanoma. Studies suggest that the progression of hepatic metastases rather than the primary tumor or metastases in other organs determines survival.Case reportWe report a case of transarterial chemoembolization of 57-year-old man diagnosed with unresectable liver metastases from uveal melanoma with irinotecan eluting beads. Therapy resulted in long progression free survival and overall survival, 41 months and 45 months after diagnosis of metastatic disease respectively. Patient did not experience any major side effects of the therapy. Follow-up CTs indicate stable disease in mRECIST criteria and partial response in CHOI criteria.ConclusionsTransarterial chemoembolization with drug eluting beads loaded with irinotecan may be an effective treatment of unresectable liver metastases from uveal melanoma.
Kierownik: prof. dr hab. M. Drews the aim of the study was to present and compare own results of abdominal rectopexy performed with absorbable and nonabsorbable materials used in surgical repair of rectal prolapse. material and methods. In the years 1991-2009, 50 patients were operated on for rectal prolapse. The first 8 patients (group I) were operated using absorbale polyglycolic acid mesh. The next 42 patients were operated using non-absorbable polypropylene mesh (group II). 12 patients with chronic, incurable constipation had sigmoidectomy and rectopexy performed at the same operation. Rectopexy was performed with the mesh and fixed to the pelvic fascia and periosteum and mesorectum, leaving the anterior one third of the rectum free. 6 months after surgery functional outcomes were evaluated. Statistic analysis with the level of statistical significance p<0,005 was applied to obtained functional results. results. On the follow up visits, there were no symptoms of the recurrence of rectal prolapse in 5 patients (62.5%) from group I and in 25 patients (92.6%) from group II. Patients relapsing were reoperated 24 to 98 months after primary surgery. In all patients from group I (absorbable mesh), prosthetic material was not found at reoperation. In redo surgery only non-absorbable mesh was used. conclusions. The effectiveness of rectal fixation depends on the on the durability of the prosthetic material. In the studied group polypropylene mesh was superior in rectopexy to absorbable mesh.
The aim of the study was to present different methods of reconstruction in case of rectovaginal septum defects, considering female patients with impaired colorectal voiding. material and methods. During the period between 2001 and 2010, 39 female patients, aged between 42 and 75 years (mean age-58 years) were subject to surgical intervention. Patients complained of voiding disturbances, sensation of a "mass" in the pelvis (64.1%), dyspareunia (30.8%), anal sphincter insufficiency (17.9%) and urinary incontinence (10.3%). Defecography and MRI examinations confirmed rectocele (100%), enterocele (46.6%), pelvic floor prolapse (35.9%), vaginal prolapse (30.8%), and rectal prolapse (25.6%). Considering the surgical treatment of rectocele the following prosthetic material was used: polypropylene mesh and collagen implants (Pelvicol ® ). In case of 19 patients with low rectocele the transvaginal approach was used. In case of high rectocele and coexisting pelvic organ prolapse the mesh was implanted by means of laparotomy (12 pts) or the abdomino-vaginal approach (8 pts). Results. Permanent reconstruction of the rectovaginal septum and withdrawal of voiding disturbances was observed in all patients operated by means of the transvaginal approach. Dyschesia symptoms were present in 16.6% of patients after mesh implantation by means of laparotomy, and in 12.5% of patients after the abdomino-vaginal approach. 10.3% of patients complained of pelvic pain and rectal tenesmus. All the above-mentioned symptoms were observed after polypropylene mesh implantation. The percentage of reoperations, due to complications amounted to 17.9%. Insignificant erosion of the prosthetic material was diagnosed in 7.7% of patients. 94.6% of patients were satisfied with the proposed treatment. conclusions. The use of prosthetic material in the treatment of pelvic floor anatomical defects is an effective and safe method, considering patients with colorectal voiding disturbances.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.