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Colorectal cancer (CRC) represents a significant challenge in oncology, with increasing incidence and mortality rates worldwide, particularly among younger adults. Despite advancements in treatment modalities, the urgent need for more effective therapies persists. Immunotherapy has emerged as a beacon of hope, offering the potential for improved outcomes and quality of life. This review delves into the critical interplay between ferroptosis, an iron-dependent form of regulated cell death, and immunotherapy within the CRC context. Ferroptosis's influence extends beyond tumor cell fate, reshaping the tumor microenvironment (TME) to enhance immunotherapy's efficacy. Investigations into Ferroptosis-related Genes (OFRGs) reveal their pivotal role in modulating immune cell infiltration and TME composition, closely correlating with tumor responsiveness to immunotherapy. The integration of ferroptosis inducers with immunotherapeutic strategies, particularly through novel approaches like ferrotherapy and targeted co-delivery systems, showcases promising avenues for augmenting treatment efficacy. Furthermore, the expression patterns of OFRGs offer novel prognostic tools, potentially guiding personalized and precision therapy in CRC. This review underscores the emerging paradigm of leveraging ferroptosis to bolster immunotherapy's impact, highlighting the need for further research to translate these insights into clinical advancements. Through a deeper understanding of the ferroptosis-immunotherapy nexus, new therapeutic strategies can be developed, promising enhanced efficacy and broader applicability in CRC treatment, ultimately improving patient outcomes and quality of life in the face of this formidable disease. [ABSTRACT FROM AUTHOR]

The pressure in either the radial (n = 88) or proximal brachial artery (n = 82) was compared with aortic pressure before and after cardiopulmonary bypass (CPB) in patients receiving coronary artery bypass grafts. Radial artery pressures were measured via 20-G 5-cm long catheters, brachial artery pressures via 20-G 12.7-cm catheters, and aortic pressures were measured via a luer port in the aortic perfusion cannula. Transducers were connected via 122-cm long tubing. For the various systems, mean natural frequencies were 16.1 to 17.7 Hz and damping coefficients were 0.16 to 0.27. Before CPB the brachial systolic, diastolic, and mean pressures were 108.2 +/- 5.2%, 100.9 +/- 2.8%, and 99.6 +/- 2.3% of aortic; respective radial pressures were 113.9 +/- 9.6%, 99.5 +/- 2.8%, and 98.4 +/- 2.8% of aortic. Immediately after CPB the brachial pressures were 99.5 +/- 7.5%, 98.9 +/- 3.5%, and 97.4 +/- 2.9% of aortic, whereas respective radial pressures were 92.1 +/- 14.6%, 94.7 +/- 5.6%, and 90.8 +/- 7.4%. All brachial and radial as a per cent of aortic pressure medians were significantly different, and except for prebypass diastolic and mean, the variance for brachial pressures was significantly less than that for pressures in the radial artery. The prebypass brachial correlation (r) with aortic for systolic, diastolic, and mean were 0.90, 0.98, and 0.98; respective radial correlations with aortic were 0.78, 0.97, and 0.95. Postbypass brachial systolic, diastolic, and mean correlations were 0.91, 0.97, and 0.98; radial were 0.50, 0.93, and 0.83. Brachial artery pressures were more accurate and reliable than radial artery pressures.

In order to determine the relationship of restenosis following percutaneous transluminal coronary angioplasty (PTCA) to risk factors such as hypercholesterolemia, hyperglycemia, smoking, and weight, we performed a univariate analysis to test the association of these variables with restenosis in 723 patients who had percutaneous transluminal coronary angioplasty and follow-up catheterization. Cholesterol levels were higher in younger and female subjects (less than 0.0001). Initial cholesterol did not predict restenosis, and follow-up cholesterol levels showed an inverse relationship with restenosis (P less than .02). There was a trend (P less than .09) toward decreased restenosis in those who were active smokers at the time of follow-up catheterization. No differences were seen in diabetics with hyperglycemia, in both treated and untreated groups (P = NS). A stepwise multiple logistic regression was used to simultaneously test the association of the above risk factor variables to restenosis. None of the interactions were found to be significant, except cholesterol at follow-up (P = .001). Therefore, the status of serum cholesterol, blood sugar, smoking, and weight during the time of PTCA and at follow-up catheterization may be unimportant in predicting restenosis. Thus, we conclude 1) that to better determine the effect of these variables on restenosis, they should be estimated at times other than follow-up and 2) that the pathophysiological mechanism of restenosis may have different risk factors than progression of atherosclerotic coronary artery disease.

Fabrication of cost-effective and robust metal-based electrocatalysts for hydrogen evolution reactions (HER) across the entire pH range has garnered significant attention in harvesting renewable energy. Herein, the fabrication of 3D high-surface Ni Foam-Graphene-Carbon Nanotubes (NGC) decorated with phosphorous-inserted tin selenide (SnSe-P) showcases unprecedented HER activity with minimal overpotentials across all pH ranges (52 mV in acidic, 93 mV in basic, and 198 mV in neutral conditions@10 mA cm -2 ) and stability at 1 A cm -2 for 72 h. The as-designed catalyst shows a low overpotential of 122 mV@10 mA cm -2 in alkaline seawater, achieved through controlled electronic distribution on Sn site after incorporation of P in NGC-SnSe-P. A stable cell voltage of 1.56 V@10 mA cm⁻ 2 is achieved for prolonged time in 1 m KOH toward overall water electrolysis. Experimental and theoretical investigation reveals that the insertion of P in layered SnSe enables s orbitals of H * and p orbitals of Sn to interact, favoring the adsorption of the H * intermediate. A renewable approach is adopted by using silicon solar cells (η = 10.66%) to power up the electrolyzer, yielding a solar-to-hydrogen (STH) conversion efficiency of 7.70% in 1 m KOH and 5.65% in alkaline seawater, aiming toward green hydrogen production., (© 2024 Wiley‐VCH GmbH.)

Background: Local excision by transanal endoscopic microsurgery (TEM) is considered an acceptable treatment for rectal adenomas with high-grade dysplasia (HGD). This study aims to assess the likelihood of harboring an invasive carcinoma in preoperatively diagnosed HGD polyps and evaluate the risk factors for tumor recurrence in patients with final HGD pathology. Methods: Data from patients who underwent TEM procedures for adenomatous lesions with HGD from 2005 to 2018 at the Rabin Medical Center, Hasharon Hospital, were analyzed. Collected data included patient demographics, preoperative workup, tumor characteristics and postoperative results. Follow-up data including recurrence assessment and further treatments were reviewed. The analysis included two subsets: preoperative pathology of HGD (sub-group 1) and postoperative final pathology of HGD (sub-group 2) patients. Results: Forty-five patients were included in the study. Thirty-six patients had a preoperative diagnosis of HGD, with thirteen (36%) showing postoperative invasive carcinoma. Thirty-two patients had a final pathology of HGD, and three (9.4%) experienced tumor recurrence. Large tumor size (>5 cm) was significantly associated with recurrence (p = 0.03). Conclusions: HGD rectal polyps are associated with a significant risk of invasive cancer. Tumor size was a significant factor in predicting tumor recurrence in patients with postoperative HGD pathology. The TEM procedure is an effective first-line treatment for such lesions. [ABSTRACT FROM AUTHOR]

For the first time, the low-frequency electrical properties of two nanocomposites based on a classical ferroelectric of triglycine sulfate (TGS) with multiwalled carbon nanotubes in pristine (MWCNT) or oxidized (OMWCNT) forms are investigated. A comparative analysis has been carried out over frequency spectra of several electrophysical parameters of impedance, electrical conductivity, permittivity, dielectric loss tangent, and electrical modulus in the region of 10−3–104 Hz. The results demonstrated the strong dielectric dispersion of permittivity and the appearance of electrode effects for both composites in the studied frequency range. Besides, the composite with oxidized MWCNT had less influence of electrode effects than with the pristine one, even though the dielectric dispersion of permittivity was slightly weaker. The obtained anomalies were assumed to be related to the high electrical conductivity of multiwalled carbon nanotubes. [ABSTRACT FROM AUTHOR]

The results of secondary cadaver renal transplantation in 42 patients treated from 1980 to 1986 have been reviewed. The initial graft was from a cadaver donor in all cases. All patients were managed with a maintenance immunosuppressive regimen, including either antilymphoblast globulin and/or cyclosporine. The over-all 1 and 2-year patient survival rates were 97 and 94 per cent, respectively. The over-all 1 and 2-year graft survival rates were 69 and 63 per cent, respectively. Graft success was not influenced by patient age greater than 50 years, diabetes, initial graft removal, interval between initial graft removal and retransplantation, duration of initial graft function, level of presensitization or HLA-Dr antigen matching. Currently, cadaver renal retransplantation can be performed safely and with an improved opportunity for graft success. Patients who return to dialysis after losing an allograft should be encouraged to consider another transplant for the same reasons that prompted initial transplantation.

Clinical and angiographic characteristics, procedural details and outcome were analyzed in 2,677 consecutive patients who underwent elective single-artery, single-lesion percutaneous transluminal coronary angioplasty (PTCA) between December 1980 and May 1987. Primary success was achieved in 2,479 (93%) patients. The primary success rate was significantly lower during the first period, when nonsteerable systems were used (73%), than in later periods (94%) (p less than 0.0001), when steerable and low-profile systems became available. Univariate analysis revealed the following variables as predictors of lower primary success: totally obstructed arteries (p less than 0.0001), presence of calcium in the narrowing (p = 0.002), prior myocardial infarction (p = 0.005), stenoses located in the right coronary artery (p = 0.02), narrowings between 90 and 99% in diameter (p = 0.02) and patients older than 60 years of age (p = 0.07). Multivariate analysis revealed the following 4 independent predictors of lower primary success: 100% obstruction (p less than 0.0001), calcium (p = 0.005), previous myocardial infarction (p = 0.029) and patients older than 60 years of age (p = 0.036). With present technology, single-narrowing elective PTCA can be performed with a high success rate in most patients. Although total occlusion, presence of calcium, older age and history of myocardial infarction influence the outcome unfavorably, PTCA can still be performed with acceptable primary success rates.

A total of 33 patients age 35 years or younger underwent percutaneous transluminal coronary angioplasty (PTCA) at The Cleveland Clinic Foundation between January 1981 and October 1987. Arteriography showed one-, two-, and three-vessel disease in 16, 12, and 5 patients, respectively. Twenty-four patients (73%) had functional Class 3 or 4 angina and 17 (52%) had unstable angina. PTCA was performed in one vessel each in 22 patients and in multiple vessels in 11 patients. Of 47 vessels, 44 (94%) were successfully dilated. There were no deaths, emergency bypass procedures, or myocardial infarctions during hospitalization. At a mean follow-up of 30 months, there were two late deaths, nine repeat PTCA procedures, one coronary bypass, and one nonfatal myocardial infarction. Due to the progressive nature of coronary artery disease in the young adult, PTCA appears to be a good therapeutic modality for selected patients in this age group.

The major limitation of coronary angioplasty is recurrent stenosis. Patient, clinical, and procedural factors at the time of angioplasty were correlated with the presence or absence of angiographically documented recurrent stenosis or continued patency. Patients with single-vessel, multilesion disease had a lower incidence of recurrence than those with single-vessel, single-lesion disease (22.2% v 37.3%). Patients with multivessel disease had the highest rate of recurrent stenosis (45%). Sex and age did not predict recurrence. Patients with more severe symptoms, patients without prior myocardial infarction (MI), and insulin-dependent diabetic patients were more likely to have recurrent stenosis. Of the lesion variables, a severe stenosis or a low gradient before angioplasty, the absence of an intimal tear after angioplasty, and left anterior descending artery lesions correlated with a higher recurrence rate. Inflation times greater than or equal to 30 seconds and a greater total number of inflations correlated with a higher recurrence rate. Multivariate analysis showed the following variables to be important predictors of recurrence: Canadian Heart Class, history of myocardial infarction, gradient before angioplasty, artery dilated, number of inflations, severity of stenosis before angioplasty, and insulin-dependent diabetes mellitus.

Responding to a survey about their practice in 1985, 2,969 (70%) Board-certified thoracic surgeons provided data that were compared with data from manpower surveys in 1980 and 1976. (table; see text) Thoracic surgeons were most active between ages 35 and 54 years when they accomplished 61% of all general thoracic and 85% of cardiac operations. Surgeons older than 50 years performed significantly more general thoracic operations than younger surgeons, and the younger group performed significantly more cardiac operations than their older counterparts. Solo practice continued to decline. In smaller referral areas, the number of general thoracic procedures per surgeon increased, but the number of cardiac operations have decreased compared with 1980. Overall, general thoracic and cardiac operations increased, but peripheral vascular procedures and pacemaker insertions decreased in almost all nine census regions. Fewer general thoracic and cardiac operations were performed per thoracic surgeon in the western United States than in central and eastern regions. In response to questions about work load, 55% believed that their clinical activity was satisfactory, 42% operated too little, and 3% operated too much. The 363 non-Thoracic Board-certified surgeons who responded performed 14% of general thoracic and 8% of cardiac surgery in 1985. During the first half of the 1980s, our specialty certified an average of 134 thoracic surgeons annually, which is higher than the 120 surgeons per year estimated to meet the projected demand.

We analyzed the impact of evolving technology on percutaneous transluminal coronary angioplasty in 2677 patients. There were 168 patients in period 1 when fixed-wire catheters were used, 1117 patients in period 2 when steerable catheters were available, and 1392 patients in period 3 when low-profile systems were utilized. The age of patients (55 to 57 to 59 years) and the proportion of patients with severe angina increased over the three periods (25% to 36% to 54%). The percentage of high-grade stenosis and the proportion of distal lesions also increased. Primary success rate improved from 73% in period 1 to 94% in periods 2 and 3. Emergency bypass surgery decreased (8.3% to 4.2% to 2.5%), as did the incidence of myocardial infarction (7.1% to 3.3% to 2.4%). Mortality was 0% in period 1, 0.2% in period 2, and 0.4% in period 3. These results indicate that technological advancements and increased operator experience significantly improved the primary success rate and decreased the incidence of major complications.

The records of 1,040 patients with 1,440 villous and tubulovillous adenomas of the colon and rectum treated at the Cleveland Clinic over a 21 year period were reviewed. The incidence of invasive adenocarcinoma was higher in patients with multiple adenomas at the time of presentation, in patients with a family history of colorectal cancer, and in those with adenomas greater than 4 cm in diameter. Eighty percent of the adenocarcinomas were Dukes' A or B, 15 percent were Dukes' C, and 5 percent presented with distant metastases. Clinical impression on examination was more accurate than biopsy in assessing the presence of malignancy in these tumors. Recurrence after local treatment of both benign and malignant tumors was high. Recurrence was significantly related to the size of the adenoma (more common when the tumor was more than 4 cm in diameter), location (more common when it was located in the rectum), and the type of treatment. Only 4 percent of the patients had died from colorectal cancer at the time of follow-up. The overall 5 year actuarial survival rate was 85 percent.

Thirty-four patients with history of congestive heart failure, dilated cardiomyopathy, and biopsy-proven lymphocytic myocarditis were treated for six months with immunosuppressive agents (prednisone and azathioprine) in addition to standard therapy for congestive heart failure. Seventy-three percent had improvement or resolution of the lymphocytic infiltrate, whereas 27% had persistent infiltrates. Improvement in myocardial histologic findings was unpredictable and did not correlate with age, gender, duration of symptoms, initial functional class, severity of left ventricular dysfunction, intensity of initial inflammatory infiltrate, or degree of myocardial cell injury. Histologic response was associated with significant improvement in left ventricular ejection fraction, but not cardiothoracic ratio, left ventricular dimensions, or survival. Functional class improved equally whether patients' disease did or did not respond to the treatment, and was not necessarily associated with objective improvement in cardiac function. Immunosuppressive therapy resulted in serious or fatal side effects in 24% of patients. Overall long-term survival was 79% at one year and 76% at two years. Poor survival was related to left ventricular ejection fraction less than 20%, male sex, age less than 50 years, and marked left ventricular dilation, but not to myocardial histologic findings. These findings indicate that the potential benefits nu the risks of immunosuppressive therapy must be weighed carefully in the individual patient.

From 1975 to 1984, 107 patients greater than or equal to 60 years of age had surgical revascularization at the Cleveland Clinic for correction of atherosclerotic renal arterial disease. To evaluate the effect of baseline renal function (RF) on outcome in older patients, the patients were retrospectively divided according to their preoperative serum creatinine levels into Group I, less than or equal to 1.4 (N = 26), and Group II, greater than or equal to 1.5 (N = 81). Extrarenal atherosclerosis was more frequent in Group II (P less than .005). Higher rates of complications were seen both in Group II and with extrarenal atherosclerosis, but these associations did not achieve statistical significance (P = .07). Baseline RF did not affect results, but after revascularization, the fall in diastolic blood pressure was greater in Group I (28.2 +/- 4.4 mmHg v 17.4 +/- 1.8 mmHg, P less than .05). No such effect was noted in systolic blood pressure or in the frequency of cure or improvement v failure. Operative mortality for the entire group was 2.8%.

Micro and nanobots (MNBs) are unprecedented in their ability to be chemically tuned for autonomous tasks with enhanced targeting and functionality while maintaining their mobility. A myriad of chemical modifications involving a large variety of advanced materials have been demonstrated to be effective in the design of MNBs. Furthermore, they can be controlled for their autonomous motion, and their ability to carry chemical or biological payloads. In addition, MNBs can be modified to achieve targetability with specificity for biological implications. MNBs by virtue of their chemical compositions may be limited by their biocompatibility, tissue accumulation, poor biodegradability and toxicity. This review presents a note on artificial intelligence materials (AIMs), their importance, and the dimensional scales at which intrinsic autonomy can be achieved for diverse utility. We briefly discuss the evolution of such systems with a focus on their advancements in nanomedicine. We highlight MNBs covering their contemporary traits and the emergence of a few start-ups in specific areas. Furthermore, we showcase various examples, demonstrating that chemical tunability is an attractive primary approach for designing MNBs with immense capabilities both in biology and chemistry. Finally, we cover biosafety and ethical considerations in designing MNBs in the era of artificial intelligence for varied applications. [ABSTRACT FROM AUTHOR]

Here, chemically powered and magnetically guided janus magneto‐fluorescent dual‐engine nanobots (MFDEN) that harvest their energy from the reactions with two different fuels are reported. The Mg‐Fe3O4 Janus nanobots prepared by depositing Fe3O4 hemispherical layer on Mg nanoparticles are propelled efficiently by the thrust of oxygen bubble generated from the reactions of Fe3O4 in H2O2 media, and by hydrogen bubble produced at the partial Mg opening in aqueous media. High speeds and long lifetimes are achieved in complex biological media with H2O2 or with NaHCO3, respectively. For the first time, this study demonstrates the utility of nanobots for efficient isolation of trophoblastic cells from blood. Considering the extreme rarity of these cells in blood, efficient technique that enriches sufficient cells rapidly and with specificity is desired. The nanobots exhibit excellent capture efficiency of almost 100%, both in serum and whole blood for trophoblastic Be‐Wo cells. Furthermore, the high capture efficiency is achieved in 5 min. Feasibility of obtaining an isolated cell based diagnosis from whole blood is demonstrated. Although determining the exact sensitivity and specificity will require more data, this study supports the potential of the multiple fuel‐powered nanorobots for clinical translation of circulating fetal cell based non‐invasive prenatal testing. [ABSTRACT FROM AUTHOR]

Escaping from primary tumors and entering into blood flow, circulating tumor cells (CTCs) contain significant information for both the original tumors and metastasis mechanisms. CTCs detection has become an effective liquid biopsy of tumors and shows great promise in early cancer detection, disease monitoring, prognosis and personalized medicine. Despite the urgent need from clinics, CTCs isolation from blood is still a huge challenge due to their extreme rareness in blood. Well‐defined micro/nanostructures and nature‐inspired hierarchical architectures offer unique avenues to address this challenge by matching well with the special physical properties of CTCs to sort cells or forming local topographic interactions to strengthen cell adhesion, thereby improving the CTC‐isolation performance. In this review, we first summarize researches on CTCs isolation with diverse micro/nanostructured substrates, which mainly include nanomaterials, microfluidics, DNA nanostructures, micromotors and in vivo detection devices. In sequence, various CTC‐isolation biomimetic architectures, which are inspired by different natural creatures (e.g., viruses, cells, extracellular matrix [ECM], plants, and animals), have been highlighted. At last, remaining challenges and future perspectives in designing CTC‐isolation platforms for clinical applications are also discussed. [ABSTRACT FROM AUTHOR]

Ice-templated collagen-based tissue-engineering scaffolds are ideal for controlled tissue regeneration since they mimic the micro-environment experienced in vivo. The structure and properties of scaffolds are fine-tuned during fabrication by controlling a number of experimental parameters. However, this parameter space is large and complex, rendering the interpretation of results and selection of optimal parameters to be challenging in practice. This paper investigates the impact of a cross section of this parameter space (drying conditions and solute environment) on the scaffold microstructure. Qualitative assessment revealed the previously unreported impact of drying temperature and pressure on pore wall roughness, and confirmed the influence of collagen concentration, solvent type, and solute addition on pore morphology. For quantitative comparison, we demonstrate the novel application of random forest regression to analyze multi-dimensional biomaterials datasets, and predict microstructural attributes for a scaffold. Using these regression models, we assessed the relative importance of the input experimental parameters on quantitative pore measurements. Collagen concentration and pH were found to be the largest factors in determining pore size and connectivity. Furthermore, circular dichroism peak intensities were also revealed to be a good predictor for structural variations, which is a parameter that has not previously been investigated for its effect on a scaffold microstructure. Thus, this paper demonstrates the potential for predictive models such as random forest regressors to discover novel relationships in biomaterials datasets. These relationships between parameters (such as circular dichroism spectra and pore connectivity) can therefore also be used to identify and design further avenues of investigation within biomaterials. [ABSTRACT FROM AUTHOR]

Micro/nanomotors bring new possibilities for the detection and therapy of diseases related to the blood environment with their unique motion effect. This work reviews the research progress of using micro/nanomotors in the detection and therapy of diseases related to the blood environment. First, we outline the advantages of using micro/nanomotors in blood-related disease detection. To be specific, the motion capability of micro/nanomotors can increase plasma or blood fluid convection and accelerate the interaction between the sample and the capture probe. This allows the effective reduction of the amount of reagents and treatment steps. Therefore, the application of micro/nanomotors significantly improves the analytical performance. Second, we discuss the key challenges and future prospects of micro/nanomotors in the treatment of blood-environment related diseases. It is very important to design a unique treatment plan according to the etiology and specific microenvironment of the disease. The next generation of micro/nanomotors is expected to bring exciting progress to the detection and therapy of blood-environment related diseases. [ABSTRACT FROM AUTHOR]

Advances in medical robots promise to improve modern medicine and the quality of life. Miniaturization of these robotic platforms has led to numerous applications that leverages precision medicine. In this review, the current trends of medical micro and nanorobotics for therapy, surgery, diagnosis, and medical imaging are discussed. The use of micro and nanorobots in precision medicine still faces technical, regulatory, and market challenges for their widespread use in clinical settings. Nevertheless, recent translations from proof of concept to in vivo studies demonstrate their potential toward precision medicine. [ABSTRACT FROM AUTHOR]

Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an arterial catheter. A key prerequisite for correct invasive BP monitoring using an arterial catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an arterial catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the catheter insertion site, (2) how to choose the type of arterial catheter, (3) how to place the arterial catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform. [ABSTRACT FROM AUTHOR]

Micromotors are man‐made nano/microscale devices capable of transforming energy into mechanical motion. The accessibility and force offered by micromotors hold great promise to solve complex biomedical challenges. This Review highlights current progress and prospects in the use of nano and micromotors for diagnosis and treatment of infectious diseases and cancer. Motion‐based sensing and fluorescence switching detection strategies along with therapeutic approaches based on direct cell capture; killing by direct contact or specific drug delivery to the affected site, will be comprehensively covered. Future challenges to translate the potential of nano/micromotors into practical applications will be described in the conclusions. [ABSTRACT FROM AUTHOR]

The desired mechanical and biological performances of collagen that have led to its broad application as a building block in the biomedical field attributed to its intrinsic hierarchical structure from the nanoscale to macroscale, are discussed herein. Modulating the self-assembly process using regulatory factors can lead to obtaining collagenous materials with tuneable functional performance, which can then determine distinctive cellular responses. Herein, we present an overview of the corresponding characterization techniques used to detect the changes in light transmittance, architecture and mechanics during collagen fibrillogenesis. By combining regulatory parameters with characterization methods, researchers can selectively fabricate collagenous biomaterials with various functional responses. [ABSTRACT FROM AUTHOR]

Background: Salvage surgery after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to conventional salavge TME (sTME).Methods: Consecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional sTME. The primary outcome was the ability to perform an appropriate oncologic procedure defined by a composite outcome (negative distal margins, negative radial margins and complete or near complete mesorectum specimen).Results: During the study period, 41 patients had salvage surgery after TEM. Of those, 11 patients had TaTME while 30 patients had sTME. All patients in the TaTME group met the composite outcome of appropriate oncologic procedure compared to 76.7% for the conventional sTME group (p = 0.19). TaTME was associated with significantly higher rates of sphincter preservation (100 vs. 50%, p = 0.01), higher rates of laparoscopic surgery (100 vs. 23.3%, p < 0.001) and lower rates of conversion to open surgery (9.1 vs. 57%, p < 0.001). No difference was found in postoperative morbidity (36.3 vs. 36.7%, p = 0.77).Conclusions: The present study demonstrates that for patients requiring salvage surgery after TEM, TaTME is associated with significantly higher rates of sphincter-sparing surgery when compared to conventional transabdominal TME while producing adequate short-term oncologic outcomes. Salvage surgery after TEM might be a clear indication for TaTME rather than conventional surgery. [ABSTRACT FROM AUTHOR]

Puprpose: Benign polyps that are technically challenging and unsafe to remove via polypectomy are known as complex polyps. Concerns regarding safety and completeness of resection dictate they undergo advanced endoscopic techniques, such as endoscopic mucosal resection or surgery. We provide a comprehensive overview of complex polyps and current treatment options. Methods: A review of the English literature was conducted to identifyarticles describing the management of complex polyps of the colon and rectum. Results: Endoscopic mucosal resection is the standard of care for the majority of complex polyps. Only polyps that fail endoscopic mucosal resection or are highly suspicious of invasive cancer but which cannot be removed endoscopically warrant surgery. Conclusion: Several factors influence the treatment of a complex polyp; therefore, there cannot be a 'one-size-fitsall' approach. Treatment should be tailored to the lesion's characteristics, the risk of adverse events, and the resources available to the treating physician. [ABSTRACT FROM AUTHOR]

Backgrounds: Although transanal endoscopic surgery is practiced worldwide, there is no consensus on comparative outcomes between transanal endoscopic operation (TEO) and transanal excision (TAE). In this study, we reviewed our experiences with these techniques and compared patients who underwent TEO and TAE using propensity score matching (PSM). Methods: A total of 207 patients underwent local rectal tumor excision between January 2008 and November 2015. To overcome selection bias, we used PSM to achieve a one-to-one TEO: TAE ratio. We included baseline characteristics, age, sex, surgeon, American Society of Anesthesiologists score, tumor location (clockwise direction), involved circumference quadrants, tumor size, and pathology. Results: After PSM, 72 patients were included in each group. The tumor distance from the anal verge was higher in the TEO group (8.0 [5-10] vs. TAE: 4.0 [3-5], p < 0.001). Complication rates did not differ between the groups (TEO: 8.3% vs. TAE: 11.1%, p = 0.39). TEO was associated with a shorter hospital stay (3.01 vs. 4.68 days, p = 0.001), higher negative margin rate (95.8 vs. 86.1%, p = 0.039), and non-fragmented specimen rate vs. TAE (98.6 vs. 90.3%, p = 0.029). Conclusions: TEO was more beneficial for patients with higher rectal tumors. Regardless of tumor location, involved circumference quadrants, and tumor size, TEO may more effectively achieve negative resection margins and non-fragmented specimens. Consequently, although local excision method according to tumor distance may be important, TEO will become the standard for rectal tumors. [ABSTRACT FROM AUTHOR]

Circulating tumor cells (CTCs) from peripheral blood account genetic information for cancer diagnosis and overall disease monitoring. Analysis of 'liquid biopsy' holds immense promise as it may lead to new approaches for cancer treatment. The study reports effective and continuous flow microchannel system for isolating CTCs using transferrin conjugated 3D matrix synthesized by crosslinking polyethylene glycol-Fe3O4 nanostructures for rapid and efficient capturing of CTCs. The platform provides option of using multiple microchannel units in series that can influence higher cell-capture efficiency due to increasing cell-substrate contact frequency. CTCs are captured with high efficiency even at low concentration of target cells (~90% at 25 cells per mL blood). Furthermore, the study demonstrates that the cell-capture performance is influenced by topographic interactions between nanostructure based matrix and cancer cells of interest. In addition, this study demonstrates the 'proof of concept' using 3D microchannel system having capacity of simultaneously capturing and permanently eliminating CTCs from peripheral blood samples. Further, the study evaluates clinical samples of colon and breast cancer patients for rapid isolation of CTCs. Conclusively, the present platform demonstrates inordinate capacity for cancer cell sorting, biological studies of CTCs, and cancer metastasis, potentially benefiting the real time liquid biopsy and early prognosis of cancer. [ABSTRACT FROM AUTHOR]

Introduction: Inorganic nitrate ingestion has been posited to affect arterial blood pressure and vascular function. Purpose: We sought to determine the acute effect of a red spinach extract (RSE) high in inorganic nitrate on vascular reactivity 1-h after ingestion in peripheral conduit and resistance arteries. Methods: Fifteen ( n = 15; males 8, females 7) apparently healthy subjects (aged 23.1 ± 3.3 years; BMI 27.2 ± 3.7 kg/m) participated in this crossover design, double-blinded study. Subjects reported to the lab ≥2-h post-prandial and consumed RSE (1000 mg dose; ~90 mg nitrate) or placebo (PBO). Venipuncture was performed on three occasions: baseline, 30-min post-ingestion and between 65 to 75-min post-ingestion. Baseline vascular measurements [i.e., calf venous occlusion plethysmography, brachial artery flow-mediated dilation (FMD)], 30-min of continuous blood pressure (BP) and heart rate (HR) analysis, and follow-up vascular measurements beginning at 40-min post-ingestion were also performed. Results: Humoral nitrate following RSE ingestion was significantly higher at 30- (+54 %; P = 0.039) and 65 to 75-min post-ingestion compared to baseline (+255 %, P < 0.001) and PBO at the same time points ( P < 0.05). No significant changes in BP or HR occurred in either condition. Peak reactive hyperemia (RH) calf blood flow increased significantly (+13.7 %; P = 0.016) following RSE ingestion, whereas it decreased (−14.0 %; P = 0.008) following PBO ingestion. No significant differential FMD responses were detected ( P > 0.05), though RH was decreased following the baseline measure in both conditions. Conclusions: RSE significantly increased plasma nitrate 30-min post-ingestion, but acute microvascular (i.e., resistance vasculature) reactivity increases were isolated to the lower limb and no appreciable change in brachial artery FMD was observed. [ABSTRACT FROM AUTHOR]

Cells reorganize their membrane biomechanical dynamics in response to environmental stimuli or inhibitors associated with their physiological/pathological processes, and disease therapeutics. To validate the biophysical dynamics during cell exposure to anti-cancer drugs, we investigate the nanoscale biological characterization in melanoma cells undergoing cisplatin treatment. Using atomic force microscopy, we demonstrate that the cellular morphology and membrane ultrastructure are altered after exposure to cisplatin. In contrast to their normal spindle-like shape, cisplatin causes cell deformation rendering cells flat and enlarged, which increases the cell area by 3–4 fold. Additionally, cisplatin decreases the topography height values for both the cytoplasmic and nuclear regions (by 40–80% and 60%, respectively). Furthermore, cisplatin increases the cytoplasmic root mean square roughness by 110–240% in correlation with the drug concentration and attenuates the nuclear RMS by 60%. Moreover, the cellular adhesion force was enhanced, while the Young's modulus elasticity was attenuated by ∼2 and ∼2.3 fold, respectively. F-actin phalloidin staining revealed that cisplatin enlarges the cell size through enhanced stress fiber formation and promotes cytoskeletal reorganization. Immunoblot analyses further revealed that the activities of focal adhesion proteins, such as FAK and c-Src, are upregulated by cisplatin through phosphorylation at tyrosine 397 and 530, respectively. Collectively, these results show that cisplatin-treated melanoma cells not only exhibit the upregulation of FAK-mediated signaling to enhance the cytoskeleton mechanical stretch, but also promote the cytoskeletal rearrangement resulting in 43% decrease in the cell modulus. These mechanisms thus promote the malignancy and invasiveness of the melanoma cells. [ABSTRACT FROM AUTHOR]