The plant diterpene epoxysiderol targets Hsp70 in cancer cells, affecting its ATPase activity and reducing its translocation to plasma membrane.

The ATP-dependent molecular chaperone Hsp70 is over-expressed in cancer cells where it plays pivotal roles in stabilization of onco-proteins, promoting cell proliferation and protecting cells from apoptosis and necrosis. Moreover, a relationship between the ability of cancer cells to migrate and the abundance of membrane-associated Hsp70 was shown. However, although Hsp70 is a promising target for cancer therapy, there is a still unsatisfied requirement of inhibitors possibly blocking its cancer-associated activities. Moving from the evidence that the plant diterpene oridonin efficiently targets Hsp70 1A in cancer cells, we set up a small kaurane diterpenoids collection and subjected it to a Surface Plasmon Resonance-screening, to identify new putative inhibitors of this chaperone. The results obtained suggested epoxysiderol as an effective Hsp70 1A interactor; therefore, using a combination of bioanalytical, biochemical and bioinformatics approaches, this compound was shown to bind the nucleotide-binding-domain of the chaperone, thus affecting its ATPase activity. The interaction between epoxysiderol and Hsp70 1A was also demonstrated to actually occur inside cancer cells, significantly reduced the translocation of the chaperone to the cell membrane, thus suggesting a possible role of epoxysiderol as an anti-metastasis agent.

Chemoradiation for anal squamous cell carcinoma: case report.

INTRODUCTION: Anal squamous cell carcinoma is rare and seems to be associated with chronic inflammatory conditions, infections and immunosuppression. Their incidence has been arising since the last 25 years. Compared to adenocarcinoma of the rectum and squamous cell cancer of the anal canal, squamous cell carcinoma is a distinct entity with a different etiology, pathogenesis, prognosis and requires a different therapeutic approach. Even if surgery remains the main therapeutic option, recent advances have made chemoradiation a valuable therapeutic addition. This case discuss the efficacy of chemoradiation wich can prevent complications and can improve the quality of life. CASE REPORT: A 63-year-old woman presented with history of bloody stool for the last past month. The colonoscopy showed a 2 cm circular lesion on the posterior wall of the anal canal. Biopsy was positive for squamous cell carcinoma and afterwards the patient underwent chemoradiation. At 1 year of follow-up the patient is disease free, with a good sphincter control and had no late complications. CONCLUSION: Since the first studies in 1974, chemoradiation seems to be a good option for most patients with squamous cell carcinoma avoiding surgery.

Late type IIIb endoleak after endovascular aneurysm repair: case report and review of the literature.

PURPOSE: To report a case of type IIIb endoleak developed six years after endovascular abdominal aortic aneurysm repair (EVAR). CASE REPORT: A 75-year-old man underwent successful Talent™ stent-graft positioning to treat a 53 mm abdominal aortic aneurysm. Subsequently the patient did well and yearly routine control computerized tomography (CT) was unremarkable. Six years later the patient suddenly developed abdominal pain irradiating to the back. An emergency angio-CT showed the presence of a type IIIb endoleak arising from the main body of the endograft. There weren't signs of fissuration or rupture. Aneurysm diameter was 85 mm as compared to 52 mm on a CT performed ten months earlier. The patient underwent successful positioning of an aorto-monoiliac endograft followed by the occlusion of the controlateral limb and a femoro-femoral crossover dacron bypass graft. Three months later the patient presented again because of the sudden onset of abdominal pain. On angio-CT aneurysm size was increased up to 11 cm. A distal type I endoleak was found and treated by placing an iliac extension to the right external iliac artery. After uneventful postoperative course the patient was discharged in good general conditions. Control angio-CT done after six months showed the complete exclusion of the large aneurysm sac. CONCLUSIONS: Type IIIb endoleaks can be safely treated by endovascular positioning of an aorto-monoiliac stent-graft followed by the occlusion of the controlateral limb and a femoro-femoral crossover dacron bypass graft. Continuous surveillance after EVAR is mandatory.

[Double ileo-ileal and ileo-cecocolic intussusception due to submucous lipoma: case report]. / Doppia invaginazione ileo-ileale e ileo-ciecocolica da lipoma sottomucoso del tenue: case report.

Intestinal intussusception is a rare pathology in adults and counts for approximately 5-16% of all invaginations, according to literature. We report the case of a 54 years-old male affected by a double ileo-ileal and ileocecocolic invagination secondary to a submucosal intestinal lipoma. Because of a bowel obstruction symptomathology, the diagnosis was based on abdomen X-rays, abdominal ultrasound and multislice CT scan that showed a probable pre-operative diagnosis of intestinal intussusception. The diagnosis of double invagination was confirmed intraoperatively and was therefore performed a right colectomy extended to a long tract of ileum. Opening the specimen demonstrated the evidence of a submucosal lipoma on the head of the intussusceptum. After the description of this case, we proceed with review of the literature of adult intestinal invagination.

[Modern orientation in parotid surgery]. / Moderni orientamenti nella chirurgia della parotide.

The choice of the surgical approach is very relevant in parotid surgery because of the extreme anatomic variability of the parotideal district and the functional importance of the branches of facial nerve. The aim of this paper is to prove how an accurate knowledge of the anatomy and a careful execution of surgery permit radicality in case of tumors and respect of nerves and other structures of the region. We studied anatomy of the different intra- and periparotideal structures to compare two different approaches in parotidectomy, proving how the orthograde technique is safer and more effective in preventing hyatrogenous nerve injuries and other major complications.