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Until the fifteenth century, the knowledge about anatomy and function of the nervous system had been significantly influenced by theological notions. Andreas Vesalius of Brussels (1514–1564), based on human cadavers’ dissections, criticized his predecessors and contributed to the construction of the current knowledge about functional neuroanatomy. Although he did not avoid mistakes, he successfully demonstrated the high value of human cadavers’ dissection in anatomical teaching. © 2020 The Royal Belgian Society for Surgery.

Total hip replacement remains one of the most successful and popular operative techniques in orthopedic surgery. Over several decades, several patients have been benefited by this mechanical and surgical achievement. It is an innovation that stands among the most significant surgical and technological achievements of the 20th century. The purpose of this review was to summarize the main landmarks on the evolution of hip surgery and the resulting modern total hip arthroplasty technique. © The Author(s) 2020.

Purpose: To summarize the available information from mythology, archeology, and classical literature aiming to compose the image of Asclepieia, Asclepius, and the Asclepiads, and to depict the atmosphere of medicine in its infancy. Method: A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece. Results: The antiquity of medicine is confirmed by the worship of God Apollo and Asclepius, who were the persons who possessed the knowledge of medicine and surgery, and delivered it to mortals. The available archaeological data, stone offerings, and inscriptions from Asclepieia were the first testimonies of divine and human knowledge and provide insights on individual cases of patients cured by the Asclepiads. Sparse descriptions offer a first glimpse of the methods and means used by the first priests-physicians for wound healing and diseases treatment. Conclusion: Asclepieia established the roots of medicine and the first step of human knowledge, and contributed to the field of surgery and pharmacology that gave birth to the rational medicine. With Hippocrates and his research, the circle of Asclepieia ended, and the era of the organized medical schools with theories and experiments on every aspect of medicine begun. © 2020, SICOT aisbl.

Purpose: The critical literature review investigates the extent to which the current evidence supports that three-dimensional printing (3DP) could play an important role in human anatomy education. Methods: PubMed, ERIC, and Cochrane databases were searched for papers dealing with the outcomes of 3DP implementation in human undergraduate anatomy education. The following data were extracted from each paper: authors, year of publication, type of study (comparative or not), number of participants, level of outcome according to Kirkpatrick hierarchy, influence of 3DP on acquisition of anatomical knowledge and skills, as well as perceptions about the 3DP use in anatomy teaching. Results: Eight papers were eligible for analysis. All of them comprised comparison of 3DP with other anatomy teaching tools. Two papers evaluated only students’ perceptions about 3DP, while six papers explored its impact on students’ knowledge. The 3DP was statistically significantly superior to two-dimensional images in terms of the investigated parameters. However, comparison between 3DP and cadavers’ dissection by students did not take place in any study. Conclusion: The 3DP implementation in anatomy education showed promising outcomes. However, the lack of studies which compared the educational effectiveness of 3DP with that of cadavers’ dissection is highlighted. It seems that 3DP could certainly be used as an adjunct to cadavers’ dissection. Further research could clarify if 3DP could obtain a more prominent role in anatomy pedagogy compared to other anatomy teaching modalities. © 2020, Springer-Verlag France SAS, part of Springer Nature.

Purpose: To highlight the most important innovations and milestones in the historical evolution of amputation and disarticulation surgery through the ages, from the early antiquity until the modern era. Method: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on the hallmarks of the history of amputation surgery in the course of medical history. Results: Amputation of a limb is one of the oldest surgical procedures. Initially, it was fraught with complications and dismal outcome of the patients because of hemorrhage and infection. Due to lack of analgesics and narcotics the operation had to take only a few minutes. Obtaining experience, the surgeons evolved the operative technique and refined the procedure, anesthesia and perioperative analgesia was introduced, instruments were developed, and rehabilitation has enabled functional and social reintegration of amputees. Conclusion: From the Hippocratic era until currently, the surgical approach to amputation has changed little. However, the indications for amputations have changed a lot and had been refined, especially in diabetic patients and in those with severe chronic peripheral vascular disease. An exponential decrease in mortality for an operation once fraught with complications was due to the development of the tourniquet, proper vessel ligation and repair, antisepsis, and anesthesia. © 2018, SICOT aisbl.

Purpose: To summarize pharmacies for pain and trauma in ancient Greece, to present several pharmaceutical/therapeutical methods reported in myths and ancient texts, and to theorize on the medical explanation upon which these pharmacies were used. Method: A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece. Results: Archeological findings and historical texts have revealed that humans have always suffered from diseases and trauma that were initially managed and healed by priests and magicians. In early Greek antiquity, the term pharmacy was related to herbal inquiries, with the occupants called charmers and pharmacists. Additionally, apart from therapeutic methods, ancient Greeks acknowledged the importance of pain therapy and had invented certain remedies for both acute and chronic pain management. With observations and obtaining experience, they used plants, herbs, metals and soil as a therapeutic method, regardless of the cultural level of the population. They achieved sedation and central and peripheral analgesia with opium and cold, as well as relaxation of smooth muscle fibers and limiting secretions with atropina. Conclusion: History showed a lot of experience obtained from empirical testing of pain treatment in ancient people. Experience and reasoning constructed an explanatory account of diseases, therapies and health and have provided for the epistemology of medicine. © 2018, SICOT aisbl.

Enhanced recovery after surgery or ‘fast-track’ methods are evidence-based protocols designed to standardize post-operative medical care, improve patient outcomes, promote early recovery, and reduce healthcare expenditure. Fast-track surgery is a multifunctional concept involving pre-, peri- and post-operative measures aiming to reduce the length of hospital stay and morbidity and complication rates, following elective abdominal surgery. Through the optimization of peri-operative care and the recovery process in adherence to these fast-track protocols, improved outcomes are reached, surgical trauma and postoperative stress are reduced, with less surgical pain, reduced complications, and shorter length of hospital stay. Fast-track care requires a multidisciplinary collaboration of all healthcare professionals, as well as a high rate of protocol compliance and a good organizational structure. Despite the existing evidence of the benefits of fast-track protocols in a variety of surgical procedures and the similar outcomes of laparoscopic colonic surgery compared to open surgery, clear evidence of the benefits of fast-track care after laparoscopic colonic surgery is yet to be clearly demonstrated. © 2019 International Institute of Anticancer Research. All rights reserved.

Pierre Franco (1505-1578) was a brilliant surgeon of the Renaissance, a contemporary of Ambroise Paré. He made an impact on the history of surgery with his innovative approaches in the treatment of hernia, lithotomy, and the use of the suprapubic incision. The purpose of this study is to present a detailed account of his work, innovations, and achievements as well as the impact he made on the surgery of the Renaissance. © The Author(s) 2018.

Microsurgery is a term used to describe the surgical techniques that require an operating microscope and the necessary specialized instrumentation, the three “Ms” of Microsurgery (microscope, microinstruments and microsutures). Over the years, the crucial factor that transformed the notion of microsurgery itself was the anastomosis of successively smaller blood vessels and nerves that have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Currently, with obtained experience, microsurgical techniques are used by several surgical specialties such as general surgery, ophthalmology, orthopaedics, gynecology, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery and more. This article highlights the most important innovations and milestones in the history of microsurgery through the ages that allowed the inauguration and establishment of microsurgical techniques in the field of surgery. © 2019, Springer-Verlag France SAS, part of Springer Nature.

Galen of Pergamum (129-216/217 AD), an important Greek physician, influenced the history of medicine for more than 1400 years. However, Andreas Vesalius (1514–1564), after performing dissections of human cadavers, remarked that Galen made several mistakes due to the fact that his dissections were on animals, particularly on apes. The current study summarizes the main points in which Vesalius criticized Galen in terms of the musculoskeletal anatomy. © 2018, © 2018 The Royal Belgian Society for Surgery.

The purpose of this study is to summarize the life and work of the French anatomist and surgeon Antoine Ferrein (1693-1769). Ferrein made an impact in the history of anatomy and physiology through his work and especially with the description of phonation, renal anatomy, and liver and biliary structure. He also made an impact on ophthalmology with the description of the eyelid and its diseases. After a thorough review of the literature, we present in this review his life and his main discoveries with special emphasis on the anatomic description of the vocal chords resembling the chords of a violin tempered by the air exhaled from the lungs and how the physiology of phonation and the surgery of the larynx were revolutionized after that. © The Author(s) 2019.

Aim of the study: The purpose of this historic review is to summarize the life and work of Avicenna (980–1037) and his contribution to the diagnosis and treatment of spinal deformities and trauma. Method: We conducted an extensive search in libraries as well as online in Pubmed and Google Scholar. Results: Avicenna in his work Canon of Medicine combines the knowledge of ancient Greek and Roman physicians and surgeons and he combines them with the extensive of Arabic medicine and pharmacology. Conclusion: Avicenna made an impact with his medical writings in which he summarized the works of ancient Greek and Roman physicians like Hippocrates and Galen with the influence of medieval authors and the knowledge of the Arabic medicine and pharmacology. His descriptions and comments in his work Canon of Medicine summarize and comment the work of his predecessors and it remained a work of reference until at least the sixteenth century. © 2018, SICOT aisbl.

Aim of the study: The purpose of this historic review is to summarize the life and work of Abulcasis (936–1013) and his contribution to surgery and orthopaedics. Method: We conducted an extensive search in libraries as well as online in PubMed and Google Scholar. Results: Abulcasis in his work combines the knowledge of ancient Greek and Roman physicians and surgeons with the extensive knowledge of Arabic medicine and pharmacology. He also pioneered surgical technique with the invention of numerous surgical instruments and with several revolutionary surgical techniques. Conclusion: Abulcasis made an impact with his medical writings in which he summarized the works of ancient Greek and Roman physicians like Hippocrates and Galen with the influence of medieval authors and the knowledge of the Arabic medicine and pharmacology. His descriptions and innovations in his work remained a work of reference in the West and East for many centuries to come. © 2019, SICOT aisbl.

The purpose of this study is to summarize the innovations of Ambroise Paré (1510-1590) on the treatment of war wounds and improving amputation technique through ligature in arteries and veins. Ambroise Paré debunked the widely accepted idea that gun powder was poisonous for wounds. He also minimized the use of cautery of wounds by his dressing methods and the application of ligature during amputations. All these innovative rationales revolutionized the practice of war surgery during the Renaissance and paved the way for the introduction of modern surgery. Nevertheless, although his wound dressing innovations became widely accepted, the same did not happen with ligature and amputation; those techniques could become widely applicable if one could somehow control bleeding until the blood vessels had been tied. This became possible much later in the 18th century when Jean Louis Petit invented the first useful and efficient tourniquet. © The Author(s) 2017.

The purpose of this historical review is to summarize the work of Paul of Aegina, especially his contribution to the treatment of neurosurgical disorders and trauma. Paul performed trephinations for head injuries in the tradition of the Egyptian and the Greek schools of medicine. However, he was an innovator in the treatment of several spine injuries, as his choice to perform laminectomies and his description of them as safe and successful is unprecedented in the history of the recorded medicine and surgery. Our search of the literature shows that Paul was the first to include in his practice such a surgical technique, and, in this way, he is an innovator, since Hippocrates described the results of spine surgery as disastrous for the patient. Thus, he may be considered the historic father of spine surgery for his pioneering surgical innovations. This shows clearly that innovation in science and medicine was significantly increased through the rise of Islam and the Arabic conquest of the Middle East. The so-called “Dark Ages” were not so dark after all. © 2017 Elsevier Inc.

Non-small cell lung cancer constitutes the most common type of lung cancer, accounting for 85-90% of lung cancer, and is a leading cause of cancer-related death. Despite the progress during the past years, poor prognosis remains a challenge and requires further research and development of novel antitumor treatment. Recently, the role of histone deacetylases in gene expression has emerged showing their regulation of the acetylation of histone proteins and other non-histone protein targets and their role in chromatin organization, while their inhibitors, the histone deacetylase inhibitors, have been proposed to have a potential therapeutic role in diverse malignancies, including non-small cell lung cancer. This review article focuses on the role of histone deacetylase inhibitors in the treatment of non-small cell lung cancer and the major molecular mechanisms underlying their antitumor activity recognized so far.

Congenital anomalies of the limbs have been observed since ancient human civilizations, capturing the imagination of ancient physicians and people. The knowledge of the era could not possibly theorize on the biologic aspects of these anomalies; however, from the very beginning of civilization the spiritual status of people attempted to find a logical explanation for the existence of such cases. The next logical step of the spiritual and religious system of the ancients was to correlate these anomalies with the Gods and to attribute them to a different level of existence in order to rationalize their existence. In these settings, the mythology and religious beliefs of ancient civilizations comprised several creatures that were related to the observed congenital anomalies in humans. The purpose of this historic review is to summarize the depiction of congenital anomalies of the limbs in mythology and antiquity, to present several mythological creatures with resemblance to humans with congenital anomalies of the limbs, to present the atmosphere of the era concerning the congenital anomalies, and to theorize on the anomaly and medical explanation upon which such creatures were depicted. Our aim is to put historic information in one place, creating a comprehensive review that the curious reader would find interesting and enjoyable. © 2018, SICOT aisbl.

The purpose of this study was to summarise the life and work of the Cypriot physician Apollonius of Citium (first century BC). His overall work on medicine is presented, and special emphasis is given to his work on the treatment of joint dislocations. The most famous work of Apollonius is Treatise On Joints, which was preserved on the whole in a manuscript of the tenth century AD. In that manuscript, Apollonius is obviously influenced by the Hippocratic Corpus of Medicine. His description, diagnostic methods and reduction techniques are all based on those described by Hippocrates in his work “On Joints”. Apollonius’ contribution to this subject concerns accurate depiction in images of the reduction techniques he proposes. His simplifications describe the techniques of Hippocrates in a way they can be understood and used by athletes and nonphysicians in the Greek gymnasia. Perhaps his treatise is one of the earliest works of popularised medicine and surgery in the history of human civilisation. © 2018, SICOT aisbl.

The purpose of this article is to summarize the work and pioneering achievements in the field of orthopedic surgery of the German orthopedic surgeon Karl Ludloff. Ludloff had an impact in the diagnostics, physical examination, orthopedic imaging, and orthopedic surgical technique of his era. He was a pioneer in the surgical treatment of dysplastic hip, anterior cruciate ligament reconstruction, and hallux valgus. His surgical technique for the correction of hallux valgus, initially stabilized with plaster of Paris, remained unpopular among other orthopedic surgeons for decades. In the 1990s, the advent and use of improved orthopedic materials for fixation attracted the interest of numerous orthopedic surgeons in the Ludloff osteotomy for its ability to correct the deformity in all 3 dimensions, its anatomic outcomes, and its low recurrence rate and patient satisfaction. © The Author(s) 2018.

The original version of this article was revised: The published online version contain mistake in author list. The corrected name is shown above. © 2017, SICOT aisbl.

The concept of psychosomatic disorders, as defined by modern medicine, was difficult to be perceived by the ancient Greek physicians. Two main reasons contributed to this. One was that physicians in Greek antiquity had formed the idea that the mental illnesses that were recognized at that time, namely mania, melancholy, frenzy, caros, lethargy, apoplexy, but even epilepsy, was the result of a disturbance of the essential elements of the body, the balance of them contributed to the preservation of health. Thus, depending on the school of medical thought of each physician in antiquity, mental and corporal illnesses were the result of various disorders such as the dyscrasia of humors for the physicians of the Dogmatic school that followed the Hippocratic principles or the disorder of the qualitative characteristics of the humor and the pneuma (air), as the physicians of the Pneumatic School considered, but also of the stenosis or the expansion of the pores as the physicians of the Methodic school thought. Although there was the perception that the diseases were the result of various combinations of the previous theories, as concluded by the physicians who constituted the Eclectic school. The second reason was that ancient physicians could not perceive the autonomy of man's psychic world as an element of human nature in which emotional distress and irrational mental processing of stimuli from the social, cultural and natural environment of the individual would be aggravating to the challenge of mental imbalance. Nevertheless, many physicians such as physicians who wrote various work of Corpus Hippocraticum, Soranus of Ephesus (1st - 2nd c. AD) Galen (1st - 2nd c. AD), Aretaeus of Cappadocia (1st - 2nd or 4th c. AD) and Caelius Aurelianus (5th c. AD) did not forget to describe in their works psychosomatic disorders as they are defined by modern medicine. In their works there are the observations about intense sweating, tremor, eating disorders, hysteria and even death as a result of an intense and long psychological unrest. These corporal symptoms, although were onset due to a psychological unequilibrium they could not been listed by the ancient Greek physicians in any of the mental diseases as they were defined in antiquity. The psychological disturbance which could provoke the above corporal disorders arose by various phobias, shame, sorrow, anger, envy, excessive drinks and food, excessive sexual desire, passion for gambling and anxiety of everyday life.

Purpose: The purpose of this review is to summarize the life and work of Jean-Louis Petit, his inventions, his discoveries, and his impact on the evolution of surgery of his era. Method: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on Petit. Results: Jean-Louis Petit (1674–1750) was an eminent anatomist and surgeon of his era with an invaluable contribution to clinical knowledge, surgical technique, and instrumentation as well as innovative therapeutic modalities and basic scientific discoveries. Conclusion: Jean-Louis Petit was an innovative anatomist and surgeon as well as an excellent clinician of his era. He revolutionized the surgical technique of his era with a significant contribution to what would later become orthopaedic surgery. © 2018, SICOT aisbl.

Pycnodysostosis or Maroteaux–Lamy syndrome is a genotypic bone disorder, with autosomal recessive inheritance, individualized by Lamy and Maroteaux in 1962. It is characterized by diffuse condensation of the skeleton with thickening of the cortex and narrowing of the medullary cavity. This condensation is reminiscent of the one observed in Albers-Schönberg disease, which differs essentially in dysmorphism of the skull (no closure of fontanelles, gaping sutures, hypoplasia of the lower jaw with open mandibular angle) and extremities (hypoplasia or osteolysis of the phalanges). The patients have a short stature, short hands and feet, and malformed nails. The first scientifically correct diagnosis was made by Dr. G. Séjournet who, under the guidance of his teacher Professor J.-A. Lièvre, performed extensive research and diagnosed Henri de Toulouse-Lautrec with achondroplasia-related dwarfism. This article describes pycnodysostosis and reports the life of the painter Henri de Toulouse-Lautrec who died from the disease. © 2018, Springer-Verlag France SAS, part of Springer Nature.

The objective of this article is to showcase the use of opium in ancient times, as well as the beliefs surround‑ ing it, focusing on the opinion of Diagoras of Cyprus, a physician with great knowledge of pharmacology who probably practiced ophthalmology, composing a rose‑based collyrium. Opium, a drug produced from poppy, used to have several uses such as in anesthesia, pain relief and ritualistic purposes. There is evidence of its creation since before 5000BC. In Greece, the first documentation dates back to around 2600‑1100 BC in Crete. Many ancient medico‑philosophers used to utilize it in their practice, mentioning it in the majority of the medical texts of that time. However, there were others that disapproved of its use due to the possible side effects. Diagoras was one of them, as he categorized opium as a lethal substance that could cause severe problems to the vision. He may even have thought of the possible addiction that it can cause be‑ cause of the euphoric state it puts a person in. Some practitioners mentioned Diagoras’s opinion on opium, such as Erasistratus and Pliny the Elder. Despite his contributions in opium usage and ophthalmology, Diagoras is still unappreciated as a medical figure. Copyright © 2018 Balkan Medical Union.

OBJECTIVE: Endometrial cancer is increasingly prevalent in western societies and affects mainly postmenopausal women; notably incidence rates have been rising by 1.9% per year on average since 2005. Although the early-stage endometrial cancer can be effectively managed with surgery, more advanced stages of the disease require multimodality treatment with varying results. In recent years, endometrial cancer has been extensively studied at the molecular level in an attempt to develop effective therapies. Recently, a family of compounds that alter epigenetic expression, namely histone deacetylase inhibitors, have shown promise as possible therapeutic agents in endometrial cancer. The present review aims to discuss the therapeutic potential of these agents. MATERIALS AND METHODS: This literature review was performed using the MEDLINE database; the search terms histone, deacetylase, inhibitors, endometrial, targeted therapies for endometrial cancer were employed to identify relevant studies. We only reviewed English language publications and also considered studies that were not entirely focused on endometrial cancer. Ultimately, sixty-four articles published until January 2018 were incorporated into our review. RESULTS: Studies in cell cultures have demonstrated that histone deacetylase inhibitors exert their antineoplastic activity by promoting expression of p21WAF1 and p27KIP1, cyclin-dependent kinase inhibitors, that have important roles in cell cycle regulation; importantly, the transcription of specific genes (e.g., E-cadherin, PTEN) that are commonly silenced in endometrial cancer is also enhanced. In addition to these abstracts effects, novel compounds with histone deacetylase inhibitor activity (e.g., scriptaid, trichostatin, entinostat) have also demonstrated significant antineoplastic activity both in vitro and in vivo, by liming tumor growth, inducing apoptosis, inhibiting angiogenesis and potentiating the effects of chemotherapy. CONCLUSIONS: The applications of histone deacetylase inhibitors in endometrial cancer appear promising; nonetheless, additional trials are necessary to establish the therapeutic role, clinical utility, and safety of these promising compounds.

The purpose of this historic review is to summarize the life, work, and contribution to anatomy of Charles Estienne (also known by the Latin name Carolus Stephanus). Charles Estienne was an early exponent of the science of anatomy in France. Although he remained under the influence of the Galenic tradition of medicine, anatomy, and surgery throughout his distinguished career, he had a significant influence on the scientific revolution and anatomy reformation of the 16th century. Nevertheless, he cannot be placed at the same level of contribution as Vesalius, because of his lack of discipline in his work, hesitation to diverge totally from traditional beliefs, and his hesitation for a total criticism of the Galenic tradition. © 2017 Elsevier Inc.

In this historical review we summarize the work of the Dutch physician, chemist, and anatomist Gerard Blaes (Blasius). A detailed account of his life and work is presented with emphasis on his contribution to anatomy. In particular, special reference is made to his innovative description of the spinal cord and spinal nerves. Blasius's contributions to neuroanatomy are remarkable when taking into account the limited technology of his era. As a true man of his era, he made significant contributions in research and teaching of anatomy, botany, and chemistry. He published a detailed description of the spinal cord with its gray and white matter and the spinal nerve roots, which significantly increased the knowledge of neuroanatomy in his era. He also is considered one of the founders of comparative anatomy through his work in both humans and animals. © 2017 Elsevier Inc.

The purpose of our study was to summarize all the knowledge concerning the innovative pioneer in the field of orthopedic surgery and especially hip replacement, Alexandros Zaoussis (1923-2005). He was a pioneer in hip replacement, and he contributed to several fields of orthopedic surgery with his clinical work and his international publications. He was also an eminent historian of World War II and of the Greek Resistance to the Nazi occupation in which he played a significant part. A thorough study of texts, medical books, and reports in the field of history of medicine, together with a review of the available literature in PubMed, was undertaken. He was an eminent clinical director of orthopedics who had significant contribution in teaching, practicing, and expanding the horizons of orthopedic surgery in the 20th century. A thorough review of medical texts, books, and publications in the Greek academic press was undertaken to summarize his contributions and his turbulent life to commemorate the 10th anniversary of his death. © The Author(s) 2016.

The medial collateral ligament (MCL) is the most important stabilizer of the medial side of the knee together with the capsuloligamentous complex. As such, it has a distinctive role in joint stability, as far as its biomechanics are concerned, and major joint stability issues onset when it is injured or deficient. One of the main functions of the medial collateral ligament is mechanical as it passively stabilizes the knee and help in guiding it through its normal range of motion when a tensile load is applied. It exhibits nonlinear anisotropic mechanical behaviour, like all ligaments, and under low loading conditions it is relatively compliant, perhaps due to recruitment of "crimped" collagen fibres as well as to viscoelastic behaviours and interactions of collagen and other matrix materials. Continued ligament-loading results in increasing stiffness until a stage is reached where it exhibits nearly linear stiffness and beyond this it continues to absorb energy until it is disrupted. In addition, the function of the MCL has to do with its viscoelasticity which assists the maintainance of joint congruity and homeostasis. The treatment of grade III medial collateral ligament injuries (with gross valgus instability at 0° of flexion) is still controversial. The most severe injuries (especially with severe valgus alignment, intra-articular medial collateral ligament entrapment, large bony avulsions, or multiple ligament involvement) may require acute operative repair or augmentation. In addition, surgical reconstruction is indicated for isolated symptomatic chronic medial collateral ligament laxity. The optimal surgical treatment remains controversial. More studies with evidence of level I and II are required in order to clarify the pros and cons of any solution. © 2016 Firenze University Press.

Besides the vast success and reliability of lower extremity joint replacement, deep and periprosthetic infection remains a serious complication of such operations. Many publications addressing periprosthetic infection have remarked about this "devastating" complication, with a risk around 1% after total hip arthroplasty and between 1% and 2% after total knee arthroplasty. The purpose of this study is to assess current trends in prevention of contamination with improved up-to-date pre-operative skin preparation methods and intra-operative draping. Methods: A literature review was conducted in MEDLINE, Web of Science, and the Cochrane database, looking for high-quality papers summarizing the most widely held and up-to-date concepts of perioperative measures for reducing infection, focusing on the best available evidence concerning skin preparation for joint arthroplasty (THR and THR) and surgical draping. Results: Current evidence suggests the use of alcohol solutions for pre-operative painting with emphasis on the use of chlorhexidine gluconate solutions beginning the night before surgery. Hair removal should be performed in the operating room with electric clippers, not razor blades. In order to enhance drape adhesion to the skin, the use of iodophor-in-alcohol solutions is recommended over the traditional scrub-and-paint technique. Disposable non-woven drapes are superior to reusable woven cotton/linen drapes in resisting bacterial penetration. Finally, the use of adherent plastic adhesive incision drapes for the prophylaxis of post-operative surgical site infections is considered not necessary in orthopedic surgery. Conclusions: The importance of skin preparation and adequate and reliable draping cannot be overemphasized for infection prevention, especially in clean operations such as THR and TKR. Thorough and strict protocols are mandatory for every department, as well as education curricula for operating room personnel. Further randomized studies are mandatory to specify the effect of the above measures, their pitfalls, and their improvement, along with further crucial details such as cost-benefit analysis of different pre-operative preparations in preventing infections. © 2015 Mary Ann Liebert, Inc.

Aim: Posterior cervical spine fixation has undergone tremendous advancement in recent years. The purpose of this study is to present our experience with the Roy-Camille instrumentation for posterior cervical stabilization after injury in a long-term follow-up. Patients and methods: From 1985 to 1995, 76 patients with a lower cervical spine traumatic lesion were treated in a single institution by posterior plate stabilization using the Roy-Camille plates (R-C plates). Fifty-four men and 22 women with a mean age of 43.2 years were involved. In 59 patients the injuries were due to a road traffic accident, in 14 cases the fall from a high was responsible, while in two cases the injuries were due to sport activities. There were four bilateral dislocations, nine unilateral dislocations, 56 fracture dislocations, five fracture separations of a lateral mass and two burst fractures. Neurological lesions were present in 65 patients (9 ASIA A, 16 ASIA B, 22 ASIA C, 18 ASIA D and 11 ASIA E). All patients had minimum follow-up of 7 years. Fifty-nine patients were followed up for a mean period of 21 years (14-27 years). Results: Stability was obtained in all but two cases. Reoperation was done in two cases: in one for the correction of the lost reduction and in a second for the reinsertion of a screw irritating a nerve root. No case in the ASIA A group showed neurological improvement, a fact observed in the other groups. Conclusions: The R-C plates were used in the last quarter of the last century. This technique showed good short-time results, and we have shown good results in a long-term follow-up as well. The literature referred to this technique was favorable, as far as the biomechanical behavior and also clinical application concern. The question about this plating system abundance still remains unanswered. © 2013 Springer-Verlag France.

The anterior cruciate ligament (ACL) anatomy is very significant if a reconstruction is attempted after its rupture. An anatomic study should have to address, its biomechanical properties, its kinematics, its position and anatomic correlation and its functional properties. In this review, an attempt is made to summarize the most recent and authoritative tendencies as far as the anatomy of the ACL, and its surgical application in its reconstruction are concerned. Also, it is significant to take into account the anatomy as far as the rehabilitation protocol is concerned. Separate placement in the femoral side is known to give better results from transtibial approach. The medial tibial eminence and the intermeniscal ligament may be used as landmarks to guide the correct tunnel placement in anatomic ACL reconstruction. The anatomic centrum of the ACL femoral footprint is 43 % of the proximal-to-distal length of lateral, femoral intercondylar notch wall and femoral socket radius plus 2.5 mm anterior to the posterior articular margin. Some important factors affecting the surgical outcome of ACL reconstruction include graft selection, tunnel placement, initial graft tension, graft fixation, graft tunnel motion and healing. The rehabilitation protocol should come in phases in order to increase range of motion, muscle strength and leg balance, it should protect the graft and weightbearing should come in stages. The cornerstones of such a protocol remain bracing, controlling edema, pain and range of motion. This should be useful and valuable information in achieving full range of motion and stability of the knee postoperatively. In the end, all these advancements will contribute to better patient outcome. Recommendations point toward further experimental work with in vivo and in vitro studies, in order to assist in the development of new surgical procedures that could possibly replicate more closely the natural ACL anatomy and prevent future knee pathology. © 2012 Springer-Verlag.

Endometrial cancer is increasingly prevalent in western societies and affects mainly postmenopausal women; notably incidence rates have been rising by 1.9% per year on average since 2005. Although the early-stage endometrial cancer can be effectively managed with surgery, more advanced stages of the disease require multimodality treatment with varying results. In recent years, endometrial cancer has been extensively studied at the molecular level in an attempt to develop effective therapies. Recently, a family of compounds that alter epigenetic expression, namely histone deacetylase inhibitors, have shown promise as possible therapeutic agents in endometrial cancer. The present review aims to discuss the therapeutic potential of these agents.This literature review was performed using the MEDLINE database; the search terms histone, deacetylase, inhibitors, endometrial, targeted therapies for endometrial cancer were employed to identify relevant studies. We only reviewed English language publications and also considered studies that were not entirely focused on endometrial cancer. Ultimately, sixty-four articles published until January 2018 were incorporated into our review.Studies in cell cultures have demonstrated that histone deacetylase inhibitors exert their antineoplastic activity by promoting expression of p21WAF1 and p27KIP1, cyclin-dependent kinase inhibitors, that have important roles in cell cycle regulation; importantly, the transcription of specific genes (e.g., E-cadherin, PTEN) that are commonly silenced in endometrial cancer is also enhanced. In addition to these abstracts effects, novel compounds with histone deacetylase inhibitor activity (e.g., scriptaid, trichostatin, entinostat) have also demonstrated significant antineoplastic activity both in vitro and in vivo, by liming tumor growth, inducing apoptosis, inhibiting angiogenesis and potentiating the effects of chemotherapy.The applications of histone deacetylase inhibitors in endometrial cancer appear promising; nonetheless, additional trials are necessary to establish the therapeutic role, clinical utility, and safety of these promising compounds.