Genetic Insights into Colorectal Cancer: Evaluating PI3K/AKT Signaling Pathway Genes Expression.

The PI3K/AKT pathway plays a pivotal role in cellular processes, and its dysregulation is implicated in various cancers, including colorectal cancer. The present study correlates the expression levels of critical genes (PIK3CA, PTEN, AKT1, FOXO1, and FRAP) in 60 tumor tissues with clinicopathological and demographic characteristics. The results indicate age-related variation in FOXO1 gene expression, with higher levels observed in patients aged 68 and above. In addition, tumors originating from the rectum exhibit higher FOXO1 expression compared to colon tumors, suggesting region-specific differences in expression. The results also identify the potential correlation between PTEN, PIK3CA gene expression, and parameters such as tumor grade and neuroinvasion. The bioinformatic comparative analysis found that PTEN and FOXO1 expressions were downregulated in colorectal cancer tissue compared to normal colon tissue. Relapse-free survival analysis based on gene expression identified significant correlations, highlighting PTEN and FRAP as potential indicators of favorable outcomes. Our findings provide a deeper understanding of the role of the PI3K/AKT pathway in colorectal cancer and the importance of understanding the molecular basis of colorectal cancer development and progression.

Blood cell count indexes as predictors of anastomotic leakage in elective colorectal surgery: a multicenter study on 1432 patients.

BACKGROUND: The aim of this study was to evaluate a series of blood count inflammation indexes in predicting anastomotic leakage (AL) in elective colorectal surgery. METHODS: Demographic, pathologic, and clinical data of 1432 consecutive patients submitted to colorectal surgery in eight surgical centers were retrospectively evaluated. The neutrophil to lymphocyte (NLR), derived neutrophil to lymphocyte (dNLR), lymphocyte to monocyte (LMR), and platelet to lymphocyte (PLR) ratios were calculated before surgery and on the 1st and 4th postoperative days, in patients with or without AL. RESULTS: There were 106 patients with AL (65 males, mean age 67.4 years). The NLR, dNLR, and PLR were significantly higher in patients with AL in comparison to those without, on both the 1st and 4th postoperative days, but significance was greater on the 4th postoperative day. An NLR cutoff value of 7.1 on this day showed the best area under the curve (AUC 0.744; 95% CI 0.719-0.768) in predicting AL. CONCLUSIONS: Among the blood cell indexes of inflammation evaluated, NLR on the 4th postoperative day showed the best ability to predict AL. NLR is a low cost, easy to perform, and widely available index, which might be potentially used in clinical practice as a predictor of AL in patients undergoing elective colorectal surgery.

Phantom pain as an adverse effect after maggot (Lucilia sericata) debridement therapy: a case study.

Maggot debridement therapy, also known as larval therapy, is a well known method of treatment for hard-to-heal and intractable wounds. This case study describes severe phantom pain as a rare adverse event of maggot therapy in patients after post-traumatic amputation of the leg. We also hypothesise and discuss the possibility that the phantom pain may be a result of maggot activity, not only through tissue debridement but also through nerve nourishment and nerve regeneration.

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery.

PURPOSE: To assess the prognostic value of postoperative C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in the development of anastomotic leak (AL) in patients after surgery for colorectal cancer (CRC). METHODS: Patients operated on for CRC between 2010 and 2014 were enrolled into the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPVs) were calculated for the CRP and NLR measured on the 4th postoperative day (POD). RESULTS: Among 724 patients, AL was diagnosed in 33 (4.6%). The accuracy of CRP in the detection of AL using area under curve was 0.83 with the optimal cut-off value of 180 mg/L, sensitivity 75%, specificity 91%, PPV 52% and NPV 87%. Also, NLR on POD4 was higher in the AL group: 9.03 ± 4.13 vs. 4.45 ± 2.25; p = 0.0012; sensitivity 69%, specificity 78%, PPV 49%, NPV 88% at cut-off point of 6.5. Moreover, CRP and NLR on POD4 were significantly higher in patients who died in the postoperative period: 239 ± 24 mg/L vs. 199 ± 41 mg/L; p = 0.034 and 10.71 ± 2.08 vs. 8.65 ± 4.67; p = 0.029, respectively). CONCLUSIONS: CRP and NLR on POD4 possess the ability to predict the development of AL and postoperative mortality after CRC operation. Based on our results, high NPV might be indicative of patients with low risk of AL in their postoperative period.

Preoperative oral antibiotics reduce infections after colorectal cancer surgery.

AIM: The objectives were to recognize the risk factors for surgical site infections (SSIs) after surgery due to colorectal cancer and to assess the impact of mechanical bowel preparation (MBP) and oral antibiotic prophylaxis (ABX) on SSIs. METHODS: Records from two colorectal centers were used. Risk factors of SSIs were categorized into patient-, disease-, and treatment-dependent. RESULTS: A group of 2240 patients was included. SSIs were noted in 364 patients (16.3 %). MBP+/ABX+ was connected with a lower incidence of anastomotic leak (AL) and organ-space SSIs: 2.4 vs. 6.3 %; p = 0.008 and 3.6 vs. 7.2 %; p = 0.017, respectively. Patient-dependent factors: obesity increased the risk of skin superficial SSIs, adjusted OR 1.53 (1.47-1.59 95 % confidence interval (95 % CI)), and deep incisional SSIs 1.42 (1.39-1.45 95 % CI). Disease-dependent factors: rectal cancer was associated with a higher risk of skin superficial and deep incisional SSIs, adjusted OR 1.28 (1.22-1.34 95 % CI) and 1.13 (1.09-1.15 95 % CI). Treatment-dependent factors: MBP+/ABX+ was associated with a lower risk of organ-space SSIs, adjusted OR 0.53 (0.44-0.59 95 % CI). Radiotherapy increased the risk of organ-space SSIs, adjusted OR 1.78 (1.75-1.80 95 % CI). The risk of organ-space SSIs was the highest after low anterior resection, adjusted OR 1.62 (1.60-1.64 95 % CI). CONCLUSIONS: If possible, MBP and ABX should always be administered to decrease the risk of AL and organ-space SSIs. Factors strictly related to the treatment mostly increased the risk of organ-space SSIs.

Matrix metalloproteinase-2 cleavage of the ß1 integrin ectodomain facilitates colon cancer cell motility.

Cancer cell invasion is a key element in metastasis that requires integrins for adhesion/de-adhesion, as well as matrix metalloproteinases (MMPs) for focalized proteolysis. Herein we show that MMP-2 is up-regulated in resected colorectal tumors and degrades ß1 integrins with the release of fragments containing the ß1 I-domain. The ß1 cleavage pattern is similar to that produced by digestion of α5ß1 and α2ß1 with MMP-2. Two such fragments, at 25 and 75 kDa, were identified after immunoprecipitation, with monoclonal antibody BD610468 reacting with the NH(2)-terminal I-like ectodomain followed by SDS-PAGE and microsequencing using electrospray (ISI-Q-TOF-Micromass) spectrometry. Cleavage of the ß1 integrin can be abolished by inhibition of MMP-2 activity; it can be induced by up-regulation of MMP-2 expression, as exemplified by HT29 colon cancer cells transfected with pCMV6-XL5-MMP-2. Co-immunoprecipitation studies of colon cancer cells showed that the ß1 integrin subunit is associated with MMP-2. The MMP-2-mediated shedding of the I-like domain from ß1 integrins resulted in decreased adhesion of colon cancer cells to collagen and fibronectin, thus abolishing their receptivity. Furthermore, such cells showed enhanced motility as evaluated by a "wound healing-like" assay and time-lapse microscopy, indicating their increased invasiveness. Altogether, our data demonstrate that MMP-2 amplifies the motility of colon cancer cells, not only by digesting the extracellular matrix components in the vicinity of cancer cells but also by inactivating their major ß1 integrin receptors.

Risk factors and clinical characteristics of rectal cancer recurrence after radical surgical treatment.

<b><br>Introduction:</b> Recurrence of rectal cancer affects from 4% to even 50% of patients after surgical treatment. The incidence may be influenced by numerous factors depending on the patient, the characteristics of the tumor and the type and quality of the surgical technique used.</br> <b><br>Aim:</b> The aim of this study was to assess the clinical characteristics of rectal cancer recurrence, identify potential risk factors and role of patient surveillance after primary resection of rectal cancer.</br> <b><br>Materials and methods:</b> The study comprised patients operated on due to recurrence of rectal cancer at the Department of General and Colorectal Surgery of Medical University of Lodz between 2014 and 2020, who were in the follow-up program at the hospital's outpatient clinic after the primary surgery. Risk factors for disease recurrence were sought by analyzing the characteristics of the primary tumor, treatment history and postoperative care.</br> <b><br>Results:</b> Twenty-nine patients were included in the study, the majority (51.7%) of the patients were men. The largest group was represented by patients with stage II and III disease. The most frequently performed primary surgery was low anterior resection (LAR) (62.8%). 35% of patients received neoadjuvant treatment prior to primary surgery. We demonstrated that the lack of neoadjuvant treatment before primary surgery increases the risk of cancer recurrence nine times. Higher stage of disease at the point of primary surgery is associated with nearly seven times the risk of recurrence compared to stage I disease.</br> <b><br>Conclusions:</b> Optimal preoperative staging, reasonable neoadjuvant treatment, proper surgical technique and precise follow-up regimen are essential for further improvement of rectal cancer outcomes.</br>.

Colorectal Cancer: Is it Still a Disease of the Elderly?

<b><br>Introduction:</b> Colorectal cancer is becoming an increasingly significant health issue, being one of the more commonly diagnosed malignancies. Colorectal tumors account for 10% of all malignant cancers in women and 12% in men. Incidence is higher in the male population, especially among younger individuals. It is commonly believed that colorectal cancer is predominantly associated with advanced age. However, colorectal surgeons, who specialize in the treatment of this type of cancer, are observing a growing number of cases among middle-aged and younger individuals.</br> <b><br>Aim:</b> The aim of our study was to investigate whether colorectal cancer still predominantly affects elderly individuals, how frequently it is diagnosed in younger patients, and whether the location of tumors in the intestines of younger patients aligns with data from elderly individuals.</br> <b><br>Materials and methods:</b> The study was conducted retrospectively and included a cohort of 1771 patients who underwent surgical procedures due to colorectal cancer between 2012 and 2015 at the Department of General and Colorectal Surgery at the Medical University of Lódz and between 2014 and 2017 at the Department of General Surgery with a Division of Surgical Oncology at the District Health Center in Brzeziny. Data were analyzed regarding the frequency of colorectal cancer occurrence by age, tumor location in different age groups, and disease stage according to age. Age groups included <40 years, 41-50 years, 51-70 years, and >70 years.</br> <b><br>Results:</b> The study encompassed a total of 1771 patients, with 988 (55.79%) being males and 783 (44.21%) females. The mean age of the patients was 65.27 11.12 years. The highest number of cases was observed in the age range of 60-70 years and 70-80 years. It was found that colorectal tumors in males more frequently occurred on the left side of the colon and rectum, while in females, they were more commonly located on the right side of the colon, which was statistically significant (P = 0.007). Younger age groups of patients (<40 years, 40-50 years) had a similar male-to-female ratio, whereas in age groups above 50 years, males significantly outnumbered females (P = 0.049). The study revealed that in the group of patients below 40 years of age, an advanced stage of colorectal cancer was significantly more common; stage D occurred over twice as often as in the 51-70 age group and over three times as often as in the >70 age group.</br> <b><br>Conclusions:</b> The incidence of colorectal cancer in Poland is steadily increasing, with a growing number of diagnoses in younger individuals. Research findings demonstrate that males, especially those in younger age groups, are at a higher risk of developing colorectal cancer. A higher disease stage is more frequently observed in younger patients, possibly due to delayed diagnosis and symptomatic treatment. Screening programs should be adjusted to the changing age groups at higher risk. Our study underlines the need to raise public awareness regarding colorectal cancer, particularly among the younger population.</br>.

Polymorphism association of NIL1, NIL2, CYP1A1 xenobiotic metabolism genes and their expression with the risk of colorectal cancer in the Polish population.

<b>Introduction:</b> Colorectal cancer (CRC), despite intensive research on the improvement of diagnosis and treatment, is still the second most deadly cancer in Poland in terms of mortality. One of the factors predisposing to a higher risk of CRC may be the individual differences in the effectiveness of proteins responsible for the metabolism of xenobiotics - it seems that the removal of potentially harmful exogenous substances significantly reduces the risk of carcinogenesis. </br></br> <b>Aim:</b> In this work, we analyzed the effect of polymorphisms of genes responsible for metabolizing xenobiotics on the risk of CRC - rs72554606 polymorphism of N AT 1 gene, rs1799930 polymorphism of N AT 2 gene and rs1799814 polymorphism of CYP1A1 gene, as well as the level of expression of these genes. </br></br> <b> Conclusions:</b> The results indicate that the GC genotype for N AT 1 and the GA genotype for CYP1A1 may increase the risk of CRC, and in those already diagnosed with colorectal cancer, the expression level of NAT1 is significantly lower than in the control. We believe that these factors may have potential prognostic and diagnostic significance in the treatment of CRC.

Health locus of control among patients operated on for colorectal cancer.

<b>Introduction:</b> An important factor determining health-oriented behavior is the health locus of control (HLC). Patients with cancer differ in health practices and perception of the disease. <br/><b>Aim:</b> Assessment of the influence of demographic factors and somatic symptoms of the disease on HLC in patients treated for colorectal cancer. <br/><b>Materials and methods:</b> The study included 160 people divided into patients with colorectal cancer (CRC) and healthy people. The Multidimensional Health Locus of Control Scale was used in the adaptation of Z. Juczynski. The scale includes three dimensions of health perception, which depends on internal control, impact of others and random. <br/><b> Results:</b> The study group consisted of 80 patients with CRC (51.2% women), and the control group 80 healthy people (57.7% women). In our analysis, we found that people with CRC were significantly more dependent on their own health control on the influence of external factors, such as doctors and nurses, than healthy people (27.11±5.43 vs. 19.64±7.77; p=<0.001). Similarly, patients with CRC significantly more than healthy people considered random as a dimension responsible for HLC (23.05±5.95 vs 20.36±7.45; p=0.012). Men with CRC more than women conditioned HLC on random influence (24.21±5.94 vs. 21.95±5.91; p=0.044). People with secondary and higher education made the HLC more dependent on internal control (26.98±5.98 vs. 23.14±5.74; p=0.041). <br/><b>Conclusions:</b> Patients with CRC made their sense of health control dependent on external dimensions: influence of others and random. Men with CRC were more likely to condition their health control on random events than women. Secondary and higher education guaranteed greater autonomy in undertaking health behaviors.

Association of GEMIN4 gene polymorphisms with the risk of colorectal cancer in the Polish population.

<br><b>Aim:</b> Gem-associated protein 4 (GEMIN4), a member of the GEMIN gene family, is a key compound of the regulating factors responsible for miRNA biogenesis. Genetic variability within this gene can alter the risk for development of colorectal cancer (CRC) as was shown for other genes involved in miRNA biogenesis. Therefore, presented study was intended to identify genetic variants of three single nucleotide polymorphisms (SNPs) in the GEMIN4 gene (rs1062923, rs2740348 and rs910925) and their relationship with CRC.</br> <br><b>Methods:</b> The study comprised 203 patients and 179 age and sex matched controls. Genotyping of GEMIN4 gene variants was done using Taqman® assay. The association of GEMIN4 variants with CRC was done by odds ratio analysis. Haplotype analysis was done to see the combined effect of studied variants on CRC.</br> <br><b>Results:</b> Patients carrying all variant genotypes for GEMIN4 rs1062923 (odds ratio [OR]= 0.205; 95% confidence interval [CI] = 0.1034-0.4065 for CC variant and [OR] = 0.1436; [CI] = 0.0869-0.2373 for CT variant, respectively) and GEMIN4 rs2740348 (odds ratio [OR] = 0.4498; 95% confidence interval [CI] = 0.2342-0.8637 for CC variant and [OR] = 0.3986; [CI] = 0.2043-0.7776 for CG variant, respectively) showed significant association in lower occurrence of cancer, whereas in case of GEMIN4 G/C rs910925 variant genotype, no significance correlation was found.</br> <br><b>Conclusion:</b> Our study gives a substantive support for the association between the GEMIN4 gene variants/miRNA biogenesis and CRC risk.</br>.

C reactive protein to albumin ratio (CAR) as predictor of anastomotic leakage in colorectal surgery.

BACKGROUND: Anastomotic leakage (AL) is one of the most severe complications in colorectal surgery. Currently, no predictive biomarkers of AL are available. The aim of this study was to investigate the role of C reactive protein (CRP) to albumin ratio (CAR) as a predictor of AL in patients undergoing elective surgery for colorectal cancer. MATERIALS AND METHODS: Data on 1183 consecutive patients surgically treated for histologically proven colorectal cancer in the surgical units involved in the study were collected. Data included sex, age, BMI, ASA score, Charlson comorbidity index, localization, histology and stage of the disease, as well as blood tests including albumin and CRP at the 4th postoperative day. Differences in CAR between patients who developed AL and those who did not were analyzed, and the ability of CAR to predict AL was investigated with ROC analysis. RESULTS: CAR was significantly higher in patients with AL in comparison to those without, at the 4th postoperative day. In ROC analysis CAR showed a good ability in detecting AL (AUC 0.825, 95%CI: 0,786-0,859), greater than those of CRP and albumin alone. CAR also showed a high ability in detecting postoperative deaths (AUC 0.750, 95% CI 0,956-0,987). These findings were confirmed in multivariate analysis including the most relevant risk factors for AL. CONCLUSION: Our study evidenced that CAR, an inexpensive and widely available laboratory biomarker, adequately predicts AL and death in patients who underwent elective surgery for colorectal cancer.

How the location of the internal opening of anal fistulas affect the treatment results of primary transsphincteric fistulas.

PURPOSE: The purpose of this study was to assess the influence of identification of the location of the internal opening of anal fistula on the recurrence rate after surgical treatment in patients with primary transsphincteric anal fistulas. The influence of preoperative rectal ultrasound on the treatment results was studied. METHODS: One hundred thirty-one patients operated in the period February 1992 to July 2005 were analyzed. Endorectal ultrasound (ERUS) was not performed (till February 2004) on 103 out of the 131 patients, while the other 28 received ERUS (from March 2004). We performed either cutting seton technique or fistulectomy according to the course of fistulous tract (high or low transsphincteric fistulas). The recurrence rate of anal fistula was assessed after the complete healing of the anal fistula after 6 months. RESULTS: In patients in whom ERUS was not performed, the internal opening was identified by endoscopy in 41.7% and in 47.6% intraoperatively. In patients in whom ERUS was preoperatively performed, the internal opening was identified in 85.8%. In all the studied groups, the internal opening of anal fistula was not localized in 13 patients (9.9%). Recurrence of the fistulas occurred in ten patients (7.6%); in seven out of 13 patients, the internal opening was not found (53.85%), and in three out of 118, the internal opening was identified (2.54%). CONCLUSIONS: Relative risk of anal fistula recurrence was 20-fold higher in patients in whom the internal opening was not identified than in those with the internal opening identified. Preoperative ERUS doubled the identification rate and thus decreased the risk of recurrence.

Malignant melanoma of the anorectum--a rare entity.

OBJECTIVE: Primary anorectal melanoma is a rare entity with a poor prognosis accounting for approximately 0.1-4.6% of anal tumours and 0.5-1.6% of all melanomas. Almost 60% of patients have already disseminated disease at initial diagnosis. METHOD: We report four cases of anorectal melanoma treated at our department from November 2006 to September 2008, as well as a review of the literature. RESULTS: There were two females and two males, of median age 69 years (range: 59-81 years). Most frequent complaints were rectal bleeding and/or anorectal pain. Three of our four patients had amelanotic melanomas. We found the positive expression of S-100 protein and HMB-45 in two patients and melanin A cells in one case. Abdominoperineal resection was performed in two patients, colostomy in one patient and a wide local excision also in one case. Three patients died on account of dissemination of melanoma, one patient is still alive. CONCLUSION: Anal melanoma remains a deadly problem. Clear guidelines for the therapy of anorectal melanoma have not been established. This mainly results from the rarity of this tumour. Treatment is based on retrospective studies, which report a limited number of cases.

Knowledge and Awareness of Colorectal Cancer.

INTRODUCTION: Colorectal cancer (CRC) is the third most common malignancy in men and the second most common in women. The disease constitutes a significant civilization and social problem. THE AIM: The aim of the study is to assess the sudy group's awareness and knowledge about CRC, as well as about its diagnostics and treatment. MATERIAL AND METHODS: An online questionaire form was distributed in the study group regarding issues related to CRC, and followed by statistical analysis and interpretation of the obtained survey results. RESULTS: After analysis, we found that a significant percentage of the surveyed sample group had basic knowledge and awareness in the area of CRC, whereas about half of the respondents did not consider themselves sufficiently informed about the disease. CONCLUSIONS: Considering the scale of the problem posed by CRC, it is necessary to undertake broader action to promote knowledge about this disease and to carry out this type of research on a larger and more socioeconomically diverse population.

Assessment of DNA damage profile and oxidative /antioxidative biomarker level in patients with inflammatory bowel disease.

<b>Aim:</b> The purpose of this study was to investigate the oxidative DNA damage, pro-antioxidant status in Polish patients with inflammatory bowel disease (IBD). <br><b>Methods:</b> Oxidative DNA damage was measured by comet assay techniques; nitric oxide (NO) and plasmatic lipid peroxidation (MDA) as oxidative stress were valuated by colometric methods; superoxide dismutase (SOD1), catalase (CAT) and glutathione peroxidase (GPx1) as antioxidative defense were determined by spectrophotometric methods. <br><b>Results:</b> The level of oxidative DNA damage in IBD patients was significantly higher in relation to controls (P = 0.01). Alike, in control subject as well as in patients with IBD, lymphocytes are characterized by complete repair of DNA damage. A significant decrease of SOD (P = 0.031), CAT (P = 0.006), GPx1 (P = 0.001) activity was seen in IBD patients vs control. MDA (P = 0.001) and NO (P = 0.001) concentrations were significantly increased in IBD patients as compared to healthy subjects. <br><b>Conclusions:</b> Our results may be due to the induction of DNA repair genes which may occur at the stage of the pathological changes (IBD) that may be caused by excessive oxidative stress. However, the cause of this relationship, and whether it is direct or indirect, remains to be explored.

Sexual activity in patients after proctocolectomy with ileal pouch-anal anastomosis.

<b>Introduction:</b> Proctocolectomy with ileal pouch-anal anastomosis is the gold standard in the surgical treatment of patients with ulcerative colitis, familial adenomatous polyposis and other colorectal diseases requiring colectomy. The treatment consists in removing the large intestine and creating an intestinal reservoir from the last ileum loop and then anastomosing the intestinal reservoir with the anal canal. Like any surgical procedure, RPC-IPAA also carries the risk of complications, both early and late. Late postoperative complications include sexual dysfunction. <br><b>Aim:</b> The main goal of the following work is to assess the quality of life and sexual activity in patients having undergone the RPC-IPAA procedure at the General and Colorectal Surgery Clinic. <br><b>Material and methods:</b> The study group consisted of patients aged 19-79 who had been subjected to RPC-IPAA procedures at the General and Colorectal Surgery Clinic in years 2010-2019. The study was conducted on the basis of a survey consisting of 50 questions about the social and mental condition, medical history and previous treatment as well as the quality of sexual life before and after surgery. The scale used for the assessment of the quality of sex life consisted of 5 grades: very low, low, medium, high, very high. Thirty subjects (21 men and 9 women) took part in the survey. Ulcerative colitis (86.6%) was the most common reason for qualification for restorative proctectomy among the examined patients; less common reasons included familial adenomatous polyposis (13.3%) and synchronous colorectal cancer (3.3%). A vast majority of the surgeries had been performed after 10 years' duration of ulcerative colitis, and the intestinal reservoir had been functioning for over a year at the time of the examination. In addition, the effect of taking steroids and the impact of early postoperative complications on the quality of sex life of patients was assessed. <br><b>Results:</b> High or very high sexual activity before surgery was reported by 46% of patients whereas low or very low quality was reported by 13%. The rest of the responders assessed their pre-operative sexual activity as average. After surgery, 23% of patients rated their sexual activity as high or very high while 36.6% of patients rated it as low or very low (P = 0.07). It was also noted that taking corticosteroids before surgery decreased the quality of sex life after surgery (P = 0.07 for activity, P = 0.04 for quality). None of the women surveyed used artificial moisturizing of intimate places during sex. Only 1 person stated that they started using artificial moisturization of intimate places after the procedure (P = 0.5). None of the men surveyed had used pharmacological agents to help them obtain an erection before surgery while as many as 33% of responders reported the need for their use after surgery (P = 0.008). Other postoperative sexual dysfunctions were also registered, such as dyspareunia (13.3%), sensory disorder within the intimate region, fecal incontinence, and urinary incontinence. <br><b>Conclusions:</b> To sum up, sexual activity and quality of sexual life deteriorated after RPC-IPAA in our patients.

[Inflammatory fibroid polyp of the stomach--a case report]. / Wlóknisty polip zapalny zokldka--opis przypadku.

Inflammatory fibroid polyp of the stomach is a rare benign mass of unknown etiology, mostly located within the pyloric area. Histopathological findings mainly reveal the presence of mononuclear fusiforme cells forming loose extensive bundles or rotary structures of rotated spirals with abundant amount of eosinophilic cytoplasm. These cells are negatively stained for S-100 protein and desmine and positively stained for CD-34. Symptoms of the disease depend on the localization and the size of the polyp. We report a case of 50-year-old woman with a large inflammatory fibroid polyp with a diameter of 60 x 50 x 40 mm imitating benign gastric tumour. She mainly suffered from abdominal pain and lab tests revealed symptoms of severe anaemia. We performed partial gastrectomy with Hofmeister-Finsterer modification. Postoperative pathological findings certified sings of inflammatory fibroid polyp. During the two year followup period we did not report any signs of recurrence or dissemination. Clinical manifestation of large inflammatory fibroid polyp of the stomach can imitate symptoms of gastric cancer. Partial gastrectomy with an unaltered, healthy wall margin of 2 to 3 cm is sufficient, curative treatment modality in such cases.

Sirt3 regulates the level of mitochondrial DNA repair activity through deacetylation of NEIL1, NEIL2, OGG1, MUTYH, APE1 and LIG3 in colorectal cancer.

Colorectal cancer (CRC) is one of the most common malignant tumors. One of the factors increasing the risk of its occurrence may be the reduced efficiency of repairing DNA damage, both nuclear and mitochondrial. The main mechanism for repairing oxidative damage is the BER system (in mitochondria mtBER), whose key proteins NEIL1, NEIL2, OGG1, MUTYH, APE1 and LIG3 obtain full efficiency only at the appropriate level of acetylation. Sirtuin 3 is a key protein for mitochondrial homeostasis, regulating a number of metabolic processes related mainly to the control of the level of reactive oxygen species. Because Sirt3 possesses acetylase activity, it can modulate the level of activity of mtBER proteins by their deacetylation. The conducted study showed that the tested proteins NEIL1, NEIL2, OGG1, MUTYH, APE1 and LIG3 are the substrate for the enzymatic deacetylation activity of Sirt3, which may lead to modulation of the risk of CRC, and in cancer cells may be a potential therapeutic target enhancing the action of cytostatic drugs.