Robotic partial splenectomy for hydatid cyst of the spleen.

BACKGROUND: Primary splenic involvement is an uncommon manifestation of hydatid disease. Partial laparoscopic splenectomy can be performed with lower risks and good hematological results by preserving the immunological function of the spleen. The aim of this study was to outline the advantages of robotic partial splenectomy as a treatment for splenic hydatid cysts. MATERIALS AND METHODS: Four patients with splenic hydatidosis were treated by robotic approach. The patients included one man and three women, with a mean age of 24 years (range 16­34). The localization was in the upper pole in one case and voluminous cysts in the hilar region in the other three. RESULTS: Robotic hemisplenectomy was performed in the upper pole localized cyst and robotic subtotal splenectomy with lower pole preservation in the other three. The mean operative time was 120 min (±37 min) with a console time of 95 min (±28 min); the mean hospital stay was 5 days (±2 days). CONCLUSION: Partial robotic splenectomy seems to offer safety and all benefits of minimally invasive surgery, preserves the immune function of the spleen and allows the surgeon to conserve as much of the splenic parenchyma as possible.

[Role of the spleen in immunity. Immunologic consequences of splenectomy]. / Rolul splinei în imunitate. Consecinte imune ale splenectomiei.

The spleen is a lymphatic organ that plays a fundamental role in protecting the body from invading pathogens. Being an organ that is interposed in the blood stream, it also stands as the body's largest blood filter that furthermore brings contribution to detecting senescent, mechanically damaged and aberrant cells. The spleen combines the innate and adaptive immune system in a unique way, releasing an immediate innate reaction to microbial penetration, but also an adaptive immune response that involves the interaction of cells that recognize a particular antigen, implicating MHC molecules presented by antigen-presenting cells. Clinical manifestations of some hematologic conditions can be controlled by splenectomy. The use of this procedure, although, has been restricted due to many observations of overwhelming post-splenectomy bacterial infections in splenectomized patients. After splenectomy, the mechanisms that play a fundamental role in bacterial clearance are altered, leading to gram-positive, but also gram-negative sepsis. Subtotal splenectomy is, therefore, a logical alternative that controls the manifestations of hematologic diseases while maintaining splenic function.

N-BLR, a primate-specific non-coding transcript leads to colorectal cancer invasion and migration.

BACKGROUND: Non-coding RNAs have been drawing increasing attention in recent years as functional data suggest that they play important roles in key cellular processes. N-BLR is a primate-specific long non-coding RNA that modulates the epithelial-to-mesenchymal transition, facilitates cell migration, and increases colorectal cancer invasion. RESULTS: We performed multivariate analyses of data from two independent cohorts of colorectal cancer patients and show that the abundance of N-BLR is associated with tumor stage, invasion potential, and overall patient survival. Through in vitro and in vivo experiments we found that N-BLR facilitates migration primarily via crosstalk with E-cadherin and ZEB1. We showed that this crosstalk is mediated by a pyknon, a short ~20 nucleotide-long DNA motif contained in the N-BLR transcript and is targeted by members of the miR-200 family. In light of these findings, we used a microarray to investigate the expression patterns of other pyknon-containing genomic loci. We found multiple such loci that are differentially transcribed between healthy and diseased tissues in colorectal cancer and chronic lymphocytic leukemia. Moreover, we identified several new loci whose expression correlates with the colorectal cancer patients' overall survival. CONCLUSIONS: The primate-specific N-BLR is a novel molecular contributor to the complex mechanisms that underlie metastasis in colorectal cancer and a potential novel biomarker for this disease. The presence of a functional pyknon within N-BLR and the related finding that many more pyknon-containing genomic loci in the human genome exhibit tissue-specific and disease-specific expression suggests the possibility of an alternative class of biomarkers and therapeutic targets that are primate-specific.