Left Ventricle Postinfarction Pseudoaneurysm: Anatomical Forms and Surgical Management

Introduction: Left Ventricle Postinfarction Pseudoaneurysm (LVPS)—false aneurysm occurs after a free-wall rupture contained by the adjacent pericardium. LVPS lacks the normal structure of the ventricular wall and disrupts the normal chamber anatomy. However, the natural history, clinical presentation and surgical outcome are still unclear. For that reason, it is necessary to describe the most relevant anatomical characteristics of LVPS and the appropriate surgical strategies currently applied. Methods: We reviewed the anatomical characteristics of several patients diagnosed of LVPS and the surgical technique performed. In this work two different anatomical types of LVPS are described in detail, with the surgical and structural implications for left ventricle reconstruction. Results: There are two different anatomical forms of LVPS: 1) Typical pseudoaneurysm, with a small gateway neck between the Left Ventricle and the false aneurysm chamber (Figure 1(A));2) Atypical pseudoaneurysm, in which the anatomical defect is bigger, without well-defined edges, extends over a large segment of infarcted and thinned myocardial tissue. In both cases, the therapeutics targets and the surgical techniques used were directed to restore the normal geometry of Left Ventricle, keeping the optimal mitral valve function. Conclusions: The surgical key-step is to preserve or to remodel the ventricular chamber anatomy. This fact restores the ventricular geometry, not only removing the wall discontinuity that generated the pseudoaneurysm. Nevertheless, final prognosis depends on the underlying ischemic cardiomyopathy and mechanical complications, such us mitral regurgitation or ventricular septal defect.

Avian malaria,haematocrit,and body condition in invasive wetland passerines settled in southwestern Spain

Avian malaria and related haemosporidian parasites can negatively impact fitness in many songbirds.Research on the malaria infection and its physiological costs on their avian hosts is heavily skewed toward native passerines,with exotic species underrepresented.However,introduced species may carry on and spread new pathogens to native species,and play a role on parasite transmission cycle in invaded bird communities as pathogen reservoir.Here,we molecularly assess the prevalence and diversity of haemosporidian parasites in three introduced wetland passerines(the Red Avadavat Amandava amandava,the Yellow-crowned Bishop Euplectes afer,and the Common Waxbill Estrilda astrild)captured during the same season in southwestern Spain.We also explored the relation between parasite infection,body condition,haematocrit,and uropygial gland volume.We detected an overall parasite prevalence of 3.55%,where Common Waxbills showed higher prevalence(6.94%)than Red Avadavats(1.51%).None Yellow-crowned Bishops were infected with haemosporidians.Almost 60%of infections were caused by Leucocytozoon,and about 40%by Plasmodium.We identified four unique lineages of Plasmodium and three of Leucocytozoon.Moreover,91%of the identified host-parasite interactions represented new host records for these haemosporidian parasites.Parasite infection was not related to body condition,haematocrit,and uropygial gland volume of the wetland passerines.Haematocrit values varied seasonally among bird species.Additionally,haematocrit was positively related to body condition in the Yellow-crowned Bishops,but not in the other species.Red Avadavats had higher haematocrit levels than Yellow-crowned Bishops,whereas Common Waxbills showed the lower haematocrit values.The uropygial gland volume was positively correlated with body condition in all bird species.Common Waxbills showed higher uropygial gland volumes related to their body size than birds from other two species.These outcomes highlight the importance of exotic invasive species in the transmission dynamics of haemosporidian parasites.

Cerebrospinal fluid and neural stem cell niche control

Neurogenesis from inner brain neural stem cells （NSCs） is a process which takes place continuously in mammals through- out their life. However, the main ontogenic difference is the intensity of neurogenesis, which commences as a very intensive and global activity in the early embryonic brain （neural tube）, persists in fetal and newborn stages, and declines significantly in adulthood, becoming restricted to specific places with low neurogenic activity such as the subventricular zone （SVZ） and the subgranular zone （SGZ） in the dentate gyrus （DG） of the hippocampus.

Development and postnatal neurogenesis in the retina: a comparison between altricial and precocial bird species

The visual system is affected by neurodegenerative diseases caused by the degeneration of specific retinal neurons,the leading cause of irreversible blindness in humans.Throughout vertebrate phylogeny,the retina has two kinds of specialized niches of constitutive neurogenesis:the retinal progenitors located in the circumferential marginal zone and Müller glia.The proliferative activity in the retinal progenitors located in the circumferential marginal zone in precocial birds such as the chicken,the commonest bird model used in developmental and regenerative studies,is very low.This region adds only a few retinal cells to the peripheral edge of the retina during several months after hatching,but does not seem to be involved in retinal regeneration.Müller cells in the chicken retina are not proliferative under physiological conditions,but after acute damage some of them undergo a reprogramming event,dedifferentiating into retinal stem cells and generating new retinal neurons.Therefore,regenerative response after injury occurs with low efficiency in the precocial avian retina.In contrast,it has recently been shown that neurogenesis is intense in the retina of altricial birds at hatching.In particular,abundant proliferative activity is detected both in the circumferential marginal zone and in the outer half of the inner nuclear layer.Therefore,stem cell niches are very active in the retina of altricial birds.Although more extensive research is needed to assess the potential of proliferating cells in the adult retina of altricial birds,it emerges as an attractive model for studying different aspects of neurogenesis and neural regeneration in vertebrates.

Body and Muscle Growth of Pre-Larvae and Larvae of Turbot, <i>Scophthalmus Maximus</i>L., Reared at Three Different Temperatures

Three turbot groups were kept at 15℃ - 16℃ (Cold Temperature, T), 17℃ - 18℃ (ambient T) and 21℃ - 22℃(warm T) during the larval development in order to study the thermal influence on muscle growth and larval development in this species. During the early stages (2 - 6 days of post-hatching), the body and the muscle growth was scarce, although the hyperplasia increased slightly, being higher at ambient and at cold T than at warm T. In contrast, the highest value of hypertrophy was found in the warm group. At 15 days of age, the body length and muscle growth increased in all the groups, being significantly higher in the warm than in the rest of groups. Thus, the highest values of both the hypertrophy and the hyperplasia of the white muscle fibres were reached at warm T, although it was only significant for the hyperplasia. The end of the metamorphosis was reached at 29 days of age in the warm group, whereas in the rest of groups it was no observed yet. At this developmental stage, the warm group showed the typical morphological mosaic of the myotome, and it was accompanied by an increase of the transverse area of the white and the red muscles, parallel to an increase of both the hypertrophy and the hyperplasia of the muscle fibres. The hyperplasia of the white fibres was the parameter most significantly increased. Also, the body length increased significantly in this group, reaching ≈ 1.6 cm at this stage.

Stem cell therapy applied for digestive anastomosis: Current state and future perspectives

BACKGROUND Digestive tract resections are usually followed by an anastomosis.Anastomotic leakage,normally due to failed healing,is the most feared complication in digestive surgery because it is associated with high morbidity and mortality.Despite technical and technological advances and focused research,its rates have remained almost unchanged the last decades.In the last two decades,stem cells(SCs)have been shown to enhance healing in animal and human studies;hence,SCs have emerged since 2008 as an alternative to improve anastomoses outcomes.AIM To summarise the published knowledge of SC utilisation as a preventative tool for hollow digestive viscera anastomotic or suture leaks.METHODS PubMed,Science Direct,Scopus and Cochrane searches were performed using the key words“anastomosis”,“colorectal/colonic anastomoses”,“anastomotic leak”,“stem cells”,“progenitor cells”,“cellular therapy”and“cell therapy”in order to identify relevant articles published in English and Spanish during the years of 2000 to 2021.Studies employing SCs,performing digestive anastomoses in hollow viscera or digestive perforation sutures and monitoring healing were finally included.Reference lists from the selected articles were reviewed to identify additional pertinent articles.METHODS Given the great variability in the study designs,anastomotic models,interventions(SCs,doses and vehicles)and outcome measures,performing a reliable meta-analysis was considered impossible,so we present the studies,their results and limitations.RESULTS Eighteen preclinical studies and three review papers were identified;no clinical studies have been published and there are no registered clinical trials.Experimental studies,mainly in rat and porcine models and occasionally in very adverse conditions such as ischaemia or colitis,have been demonstrated SCs as safe and have shown some encouraging morphological,functional and even clinical results.Mesenchymal SCs are mostly employed,and delivery routes are mainly local injections and cell sheets followed by biosutures(sutures coated by SCs)or purely topical.As potential weaknesses,animal models need to be improved to make them more comparable and equivalent to clinical practice,and the SC isolation processes need to be standardised.There is notable heterogeneity in the studies,making them difficult to compare.Further investigations are needed to establish the indications,the administration system,potential adjuvants,the final efficacy and to confirm safety and exclude definitively oncological concerns.CONCLUSION The future role of SC therapy to induce healing processes in digestive anastomoses/sutures still needs to be determined and seems to be currently far from clinical use.

Lens Capsule HSPG-Perlecan Regulates Lens Fibre Differentiation during Chick Embryo Development

Lens fibre differentiation is a life-long process related with lens transparency, and is particularly intense during development, being related with an FGF-2 antero-posterior gradient at the equator level as the main growth factor involved which has been related with the basal membrane of the lens anlagen known as “Lens capsule”. However the lens fibre differentiation induced by FGF2 depends, as in other biological systems, on the local bioavailability of FGF-2 regulated by their relationship with extracellular matrix molecules as Heparan Sulphate Proteoglycans. Here, we try to clarify how Perlecan (a heparan sulphate proteoglycan specific from basement membranes) is involved in lens fibre differentiation at earliest stages of eye development. Our results show that Perlecan, is a major component in the lens capsule during the earliest stages of lens development in chick embryos being present during lens plate induction, lens vesicle stage and the onset of lens fibre differentiation. In order to demonstrate a direct involvement of HSPG-Perlecan in lens fibre differentiation, we generate depleted lenses by HSPG-Perlecan synthesis disruption and specific enzymatic digestion. The HSPG-Perlecan depleted lens show a significant delay or abolition in the lens fibre differentiation which remains in an immature cells displaying DNA synthesis in the posterior epithelium and a decrease in FGF2 lens expression. These data support the hypothesis that lens capsule HSPG-Perlecan is a key molecule involved in lens fibre differentiation during development, probably by involvement in FGF-2 biodisponibility.

Myxoid and Lipomatous Solitary Fibrous Tumor of Soft Tissue: A Case Description

We present a case of a myxoid and lipomatous solitary fibrous tumor that was observed in a 67-year-old man. The tumor, which had a maximum diameter of 10 cm, was located in the soft tissues of the dorsal region and appeared macroscopically well delimited and encapsulated. Upon cutting, a markedly gelatinous internal surface was observed. A microscopic study revealed an intense and diffusely myxoid neoplasia, with small areas of adipose aspect, in which histological (staghorn vessels, perivascular hyalinization, fusiform cells of benign aspect) and immunohistochemical (intensive positivity for CD34, Bcl-2 and Cd99 and negativity for muscle markers) data were consistent with a solitary fibrous tumor were observed. To conclude, the main characteristics of this lesion are discussed, and a differential diagnosis is established with other entities.

Hypertension effects on p73 expression in the rat circumventricular organs and cerebrospinal fluid

It has been reported that spontaneously hypertensive rats (SHR) show ventricular dilation, changes in CSF proteins and variations in the circumventricular organs (CVO) such as: the subcommissural organ (SCO), the subfornical organ (SFO) and the area postrema (AP) which are located in the walls of the third and fourth ventricles. On the other hand, p73 proteins are present in cells of the central nervous system (CNS) such as circumventricular structures and the neuroepithelium which are altered in ventricular dilation. The purpose of the present work is to study the TAp73 isoform expression in the circumventricular organs (CVO) and their variations in ventricular dilatation and arterial hypertension. Brains and cerebrospinal fluid (CSF) from control Wistar-Kyoto rats (WKY) and SHR were used. The paraffin sections containing the CVO were immunohistochemically proc-essed with anti-TAp73 and by western blot, p73 bands in the CSF and circumventricular organ extract were also identified. The western blot study showed bands marked with p73 in the CSF and CVO, the p73 band expression was bigger in the SHR than in the WKY rats. We also found stronger markings in the SFO, SCO and AP of the hypertensive rats than in the WKY rats. It could be concluded that hypertension in the SHR produces altera-tions in the relationship between the p73 protein, circumventricular structures and CSF.

High Blood Pressure Effects on the Brain Barriers and Choroid Plexus Secretion

High blood pressure produces ventricular dilation, variations in circumventricular organs and changes in the cerebrospinal fluid compositions. On the other hand, chronic hypertension in spontaneously hypertensive rats can cause changes in the integrity of the brain barriers: blood-cerebrospinal fluid barrier and blood brain barrier. The permeability of the brain barriers can be studied by using transthyretin and S-100β. In the present work we study the integrity of the brain barrier and the choroid plexus function variations in arterial hypertension. Control rats and spontaneously hypertensive rats were used and the choroid plexus were processed by immunohistochemistry with anti-transthyretin and anti-vasopressin. Western blot was also performed in cerebrospinal fluid, serum and choroid plexus using anti-S-100β, anti-transthyretin. The accumulation of transthyretin immunoreactive was bigger in spontaneously hypertensive rats with respect to the control. Vasopressin was also higher in spontaneously hypertensive rats with respect to the control. Western blot showed that transthyretin tetramer was higher in the spontaneously hypertensive rats than in the control rats. The expression of transthyretin monomer was lower in hypertensive rats than the control in the cerebrospinal fluid, the transthyretin monomer reaction in the blood was stronger in hypertensive than in control rats. Western blot for the S-100 β showed an increase in blood and cerebrospinal fluid of hypertensive rats. The high blood pressure produces a disruption of the blood brain barrier and blood to cerebrospinal fluid barrier that allows extravasations from the cerebrospinal fluid to the blood and from the blood to the cerebrospinal fluid.

A new treatment for sarcoma extracted from combination of miRNA deregulation and gene association rules

Dear Editor Sarcomas are a group of heterogeneous mesodermic rare tumors with high incidence in children,reaching up to 20%of neoplasms.Standard treatment for sarcomas is surgical resection,and only some patients are treated with chemotherapy and/or radiation therapy.The 5-year relative survival rate for patients with metastatic sarcoma is only 15%.

Sarcoma stratification by combined pH2AX and MAP17(PDZK1IP1)levels for a better outcome on doxorubicin plus olaparib treatment

Sarcomas constitute a rare heterogeneous group of tumors,including a wide variety of histological subtypes.Despite advances in our understanding of the pathophysiology of the disease,first-line sarcoma treatment options are still limited and new treatment approaches are needed.Histone H2AX phosphorylation is a sensitive marker for double strand breaks and has recently emerged as biomarker of DNA damage for new drug development.In this study,we explored the role of H2AX phosphorylation at Ser139 alone or in combination with MAP17 protein,an inducer of DNA damage through ROS increase,as prognostic biomarkers in sarcoma tumors.Next,we proposed doxorubicin and olaparib combination as potential therapeutic strategies against sarcomas displaying high level of both markers.We evaluate retrospectively the levels of pH2AX(Ser139)and MAP17 in a cohort of 69 patients with different sarcoma types and its relationship with clinical and pathological features.We found that the levels of pH2AX and MAP17 were related to clinical features and poor survival.Next,we pursued PARP1 inhibition with olaparib to potentiate the antitumor effect of DNA damaging effect of the DNA damaging agent doxorubicin to achieve an optimal synergy in sarcoma.We demonstrated that the combination of olaparib and doxorubicin was synergistic in vitro,inhibiting cell proliferation and enhancing pH2AX intranuclear accumulation,as a result of DNA damage.The synergism was corroborated in patient-derived xenografts(PDX)where the combination was effective in tumors with high levels of pH2AX and MAP17,suggesting that both biomarkers might potentially identify patients who better benefit from this combined therapy.

Mitochondrial DNA as a Risk Factor for False Positives in Case-Control Association Studies

During the last decade, hundreds of studies have been pub- lished examining whether significant associations exist be- tween mitochondrial DNA （mtDNA） variants and/or haplogroups （clades） and particular diseases （generally com- mon/complex diseases） （Fig. 1）. However, several authors have gathered evidence indicating a high incidence of false positive findings in mtDNA case-control association studies. Raule et al. （2007） and Herrnstadt and Howell （2004） showed various problems affecting mtDNA case-control association studies. Salas et al.

Diagnosis and management of brain metastases:an updated review from a radiation oncology perspective

Brain metastasis are the most common intracranial malignancy in the adult population. Their incidence has increased dramatically over the last 20 years, as a result of the increasing number of cases stemming from lung and breast cancer together with the higher cancer survival rates due to diagnostic and therapeutic advances. More than 40%of cancer patients develop brain metastases during the course of their disease: specifically, they appear in 50%of patients with lung cancer, more than 25% of patients with breast cancer, and 20% of patients with melanoma. Diagnosis is made using different imaging approaches, such as computed tomography and magnetic resonance imaging, accompanied by clinical manifestations and a history of malignancy supporting the diagnosis of a brain metastasis. Current treatment options should be oriented to the patient's current performance, the number of intracranial and extracranial lesions, and related factors. Although surgical resection and whole-brain radiotherapy have been standard treatments for many years, numerous treatment modalities have become more easily available and accepted worldwide, producing more favorable and reliable results. Among these is stereotactic radiosurgery, and the latest clinical trials support this treatment.