A case of descending necrotizing mediastinitis: Extra-pleural treatment.

AIM: Descending necrotising mediastinitis (DNM) is a rare but life-threatening condition. Diagnosis is challenging and prompt treatment is essential. We report a case of DNM in a 44-year-old man. METHODS: The patient was hospitalized because of worsening general health after pharyngeal infection, 10 days earlier, and with dyspnea and arrhythmia and suspected sepsis. Echocardiography revealed pericardial effusion. Empirical antibiotic therapy was started immediately. Subsequent evaluation with computed tomography (CT)-scan resulted in a diagnosis of DNM with fluid collections in the lower anterior mediastinum and facilitated surgical planning. The day after, surgery was promptly performed through a vertical epigastric incision permitting effective abscess drainage and debridement of necrotic tissue. RESULTS: There were no intraoperative or postoperative complications. After 5 days in the Intensive Care Unit, the patient was transferred to the Emergency Surgery Unit. A chest CT-scan on postoperative day 10 showed improvement and the patient was discharged on postoperative day 15. CONCLUSIONS: In a patient with DNM access through a vertical epigastric incision allows mediastinal drainage and debridement,and avoids thoracotomy or thoracoscopy and the related complications. KEY WORDS: Descending Necrotizing Mediastinitis, Emergency Surgery.

Calcineurin Gamma Catalytic Subunit PPP3CC Inhibition by miR-200c-3p Affects Apoptosis in Epithelial Ovarian Cancer.

Epithelial ovarian cancer (EOC) outpaces all the other forms of the female reproductive system malignancies. MicroRNAs have emerged as promising predictive biomarkers to therapeutic treatments as their expression might characterize the tumor stage or grade. In EOC, miR-200c is considered a master regulator of oncogenes or tumor suppressors. To investigate novel miR-200c-3p target genes involved in EOC tumorigenesis, we evaluated the association between this miRNA and the mRNA expression of several potential target genes by RNA-seq data of both 46 EOC cell lines from Cancer Cell line Encyclopedia (CCLE) and 456 EOC patient bio-specimens from The Cancer Genome Atlas (TCGA). Both analyses showed a significant anticorrelation between miR-200c-3p and the protein phosphatase 3 catalytic subunit γ of calcineurin (PPP3CC) levels involved in the apoptosis pathway. Quantitative mRNA expression analysis in patient biopsies confirmed the inverse correlation between miR-200c-3p and PPP3CC levels. In vitro regulation of PPP3CC expression through miR-200c-3p and RNA interference technology led to a concomitant modulation of BCL2- and p-AKT-related pathways, suggesting the tumor suppressive role of PPP3CC in EOC. Our results suggest that inhibition of high expression of miR-200c-3p in EOC might lead to overexpression of the tumor suppressor PPP3CC and subsequent induction of apoptosis in EOC patients.