The Therapeutic Potential of Targeting Key Signaling Pathways as a Novel Approach to Ameliorating Post-Surgical Adhesions.

BACKGROUND: Peritoneal adhesions (PA) are a common complication of abdominal operations. A growing body of evidence shows that inhibition of inflammation and fibrosis at sites of peritoneal damaging could prevent the development of intra-abdominal adhesions. METHODS: A search of PubMed, Medline, CINAHL and Embase databases was performed using the keywords 'postsurgical adhesion', 'post-operative adhesion', 'peritoneal adhesion', 'surgery-induced adhesion' and 'abdominal adhesion'. Studies detailing the use of pharmacological and non-pharmacological agents for peritoneal adhesion prevention were identified, and their bibliographies were thoroughly reviewed to identify further related articles. RESULTS: Several signaling pathways, such as tumor necrosis factor-alpha, tissue plasminogen activator, and type 1 plasminogen activator inhibitor, macrophages, fibroblasts, and mesothelial cells play a key part in the development of plasminogen activator. Several therapeutic approaches based on anti-PA drug barriers and traditional herbal medicines have been developed to prevent and treat adhesion formation. In recent years, the most promising method to prevent PA is treatment using biomaterial-based barriers. CONCLUSION: In this review, we provide an overview of the pathophysiology of adhesion formation and various agents targeting different pathways, including chemical agents, herbal agents, physical barriers, and clinical trials concerning this matter.

Rare Case of Small Cell Metastatic Prostatic Adenocarcinoma, Properly Staged by 68Ga-PSMA PET/CT Scan.

ABSTRACT: Small cell carcinoma (SCC) of the prostate is a very rare entity and one of most aggressive neuroendocrine malignancies of prostate. We present a 60-year-old man with pathology-proven prostatic SCC by transrectal biopsy with ultrasonography guidance and Gleason score of 5 + 5. He was referred to perform 68Ga-PSMA PET/CT scan for staging. The scan showed PSMA uptake in the prostate bed and multiple large pelvic lymph nodes. As we know, 68Ga-PSMA uptake in the de novo form of SCC of prostate is not commonly found in the literature.

Ureterocystoplasty is safe and effective in patients awaiting renal transplantation.

OBJECTIVES: Surgical outcomes and bladder function were assessed in a group of patients who had undergone ureterocystoplasty while awaiting renal transplantation. METHODS: An observational cohort study was performed. A chart review was performed of 16 patients who had undergone ureterocystoplasty between 1997 and 2006. The postoperative assessment included measurement of bladder capacity and voiding cystourethrography findings. RESULTS: The median patient age at operation was 17 years (range, 3 to 44 years). The median follow-up was 38 months (range, 3 to 60 months). All patients achieved continence. The median increase in bladder capacity was 162 mL (range, 65 to 265 mL), representing a median proportional increase of 226% (range, 167% to 340%) of the original bladder capacity. None of the patients developed vesicoureteral reflux. Only 4 patients required subsequent intermittent catheterization to fully empty their bladders. Seven patients underwent renal transplantation within 3 to 7 months of ureterocystoplasty. CONCLUSIONS: Ureterocystoplasty in patients awaiting renal transplantation is safe and effective. Good results can be achieved when care is taken to preserve the blood supply of the ureter. The results of this study have confirmed the desirability of preserving the ureters in patients awaiting transplantation who might require bladder augmentation.