Transcriptional silencing of ETS-1 efficiently suppresses angiogenesis of pancreatic cancer.

In this study, we addressed the hypothesis that transcriptional suppression of erythroblastosis virus E26 oncogene homolog 1 (ETS-1) is an efficient therapeutic approach to pancreatic adenocarcinoma by investigating the effect of ETS-1 suppression in human pancreatic cancer cells. We accomplished this by using an adenoviral vector encoding only the DNA-binding domain of wild-type ETS-1 (ETS-1 dominant negative, ETS-1-DN). ETS-1-DN decreases ETS-1-binding by competing for its binding to DNA. Adenoviral-mediated transfer of ETS-1-DN (adenoviral ETS-1-DN construct, AdETS-1-DN) into pancreatic tumor cell lines did not affect their proliferation rate in vitro but did significantly inhibit their in vivo growth in nude mice. Furthermore, to test the efficacy of ETS-1-DN in vivo, we injected the AdETS-1-DN into established human pancreatic adenocarcinomas grown in nude mice. This treatment significantly reduced tumor size as compared to saline injection, without any detectable side effects. Microvessel density in mouse xenografts displayed significantly lower values in tumors in which ETS-1 was downregulated. In addition, expression of the ETS-1-DN in the pancreatic cancer cells resulted in downregulation of urokinase-type plasminogen activator (u-PA) and metalloproteinase-1 (MMP-1) expression. Taken together, these data suggest that transcriptional inactivation of ETS-1 is able to significantly affect angiogenesis and growth of pancreatic cancer. This effect may be due in part to downregulation of MMP-1 and u-PA expression. Our results suggest that ETS-1-DN is a promising candidate for antiangiogenic gene therapy in pancreatic cancer.

Safety and efficacy of conservative management in acute severe pancreatitis.

Acute severe pancreatitis represents a disease with multiple complications and a high mortality rate. The clinical evolution is related to the acute systemic inflammatory response syndrome, due mainly to inflammatory mediators and pancreatic enzymes and to the infectious complications representing a peak in the incidence of death. This study aims to retrospectively analyse the outcome of patients diagnosed with acute severe pancreatitis, conservatively treated versus those surgically managed. This study includes 151 patients, each having been diagnosed with acute severe pancreatitis (CT using Balthazar's) distributed in term of age, sex and severity parameters. The conservative treatment has included antibiotics, and anti-inflammatory drugs. The imaging and biological parameters were further statistically analysed. The clinical-biological evolution has been paralleled by the CT severity index. The conservatively treated group had a better clinical-biological outcome (p<0.05), when compared with the surgically treated group. Morbidity was significantly higher in the group exposed to surgical treatment. Conservative treatment should be the first option in acute severe pancreatitis management.

[Surgical treatment of esophageal strictures secondary to gastroesophageal reflux disease]. / Tratamentul chirurgical al stenozelor esofagiene secundare bolii de reflux gastro-esofagian.

The end point in gastro-oesophageal reflux disease (GERD) evolution is oesophageal stenosis. The aim of this study is merely to establish the absolute requisite of treating simultaneously the oesophageal stenosis and the causal disorder, GERD. This article analyses the diversity of surgical treatment in relationship with the location and length of the oesophageal stenosis using a group of 35 patients with GERD over a period of 25 years. Treatment of this condition has enriched and diversified in the last decades with more conservative and complex techniques, having the task to preserve, whenever possible, the oesophagus. The ability to decide the optimal moment for the surgical treatment, to elect the most suitable procedure, to treat simultaneously the stenosis and to prevent further reflux guarantee a successful, free of recurrence outcome.

[Rare caecal pseudotumours]. / Pseudotumora cecala de cauza rara.

Among the rarely caecal pseudotumours are those caused by a coagulation disorder. The clinical course of caecal pseudotumours is highly variable. Most patients are diagnosed with acute appendicitis, but the real diagnosis is confirmed after laboratory investigation and histopathologic exam. Our patient presented the symptoms of an inferior digestive bleeding. The persistence of the clinical symptoms and the haematological degradation determined the surgical intervention. Intraoperative were found two caecal tumours. The hystological exam, biochemical and haematological analysis worked up the final diagnosis: a caecal pseudotumour in the context of Antithrombin III deficiency.

[Evidence-based colorectal cancer screening]. / Metode de screening in cancerul colorectal.

Colorectal cancer has been identified as an appropriate candidate for early detection and treatment of both asymptomatic individuals and those at risk of the disease. The lifetime incidence of colorectal cancer among persons at average risk is sufficiently high to justify screening the general population. This review presents the latest strategies employed in early detection of the colorectal cancer. An ideal screening test should satisfy some basic criteria: must be simple, secure, accepted by the population with valid and reproductive results. Despite the demonstrated benefits of colorectal cancer screening, incidence and mortality rates of this common cancer remain high. More optimally tailored screening tools are needed that combine the features of a potentially ideal screening test.

[Differentiated thyroid cancer--peculiar morphological and clinical forms]. / Cancerul tiroidian diferentiat forme anatomoclinice particulare.

The most common clinical presentation of differentiated thyroid cancer (DTC), consisting of papillary and follicular adenocarcinoma (with their histological variants), is the solitary thyroid nodule. A review of the literature is performed in order to describe particular forms of DTC, in terms of incidence, diagnosis and treatment: occult carcinoma, carcinoma on aberrant thyroid tissue, "functional" thyroid carcinoma and familial non-medullary carcinoma. A particular interest is shown to the coexistence of malignancy with benign thyroid diseases, such as goiter, hyperthyroidism and Hashimoto's thyroiditis, as well as parathyroid adenoma. In conclusion, the authors emphasize that the association of carcinoma with benign thyroid conditions is not rare and it substantiate an aggressive approach in regard to diagnosis and treatment, increasing the indication for surgery and, moreover, for total thyroidectomy.

[Metachronous primary cancers of the colon and stomach]. / Cancere primare metacrone la nivelul colonului si stomacului.

We report herein a case of 69 years old woman who, in the course of 11 years, developed two cancers: carcinoma of the colon fistulization in duodenum and adenocarcinoma of the stomach. No polyposis has been found. This patient successfully underwent a right hemicolectomy with pancreaticoduodenectomy (Traverso-Longmire procedure). A decade later, she suffered a total gastrectomy with distal pancreatectomy for gastric adenocarcinoma. The patient made an uneventful postoperative recovery. Although patients with primary multiple cancers are not common, it is nonetheless important for clinicians to consider the possibility of metachronous cancers in patients who were treated for a primary malignant tumor.

[Current strategy in colorectal cancer screening]. / Strategia actuala de screening in cancerul colorectal.

Screening programs should begin by classifying the individual patient's level of risk based on personal, family, and medical history, which will determine the appropriate approach for each subject. The individual's risk status determines when screening should be initiated and what tests and frequency are appropriate. To achieve these aims, care systems should establish standards and operating procedures. This review focuses on colorectal cancer screening methodology highlighting the latest available strategies.