Elevated hemoglobin A1c level and bariatric surgery complications.

Introduction: In cardiac and orthopedic surgery, elevated glycosylated hemoglobin (HbA1c) is a modifiable risk factor for postoperative complications. However, in bariatric surgery, there is insufficient evidence to assess the effectiveness of preoperative HbA1c assessment and its association with postoperative complications. The objective of this study was to assess the impact of HbA1c on early postoperative outcomes in bariatric surgery patients.

Diagnosis and operative management of a perforated de Garengeot hernia.

Introduction: A de Garengeot hernia, a femoral hernia containing the appendix, is a difficult diagnosis often made intra-operatively when the hernia sac is opened. It is a rare finding, and complications are more frequent with a de Garengeot hernia.

Presentation Of Case: A 92 year-old female presented to the emergency department (ED) complaining of abdominal pain.

IL-15 enhances the antitumor effect of human antigen-specific CD8 T cells by cellular senescence delay.

Optimal expansion protocols for adoptive human T-cell therapy often include interleukin (IL)-15; however, the mechanism by which IL-15 improves the antitumor effect of T cells remains to be elucidated. Using human T cells generated from HLA-A2+ donors against novel T-cell epitopes derived from the human U266 myeloma cell line Ig light chain V-region (idiotype) as a model, we found that T cells cultured with IL-15 provided superior resistance to tumor growth , compared with IL-2, after adoptive transfer into immunodeficient hosts. This effect of IL-15 was associated with delayed/reversed senescence in tumor antigen-specific memory CD8 T cells mediated through downregulation of P21, P16, and P53 expression.

Targeting B-cell malignancies through human B-cell receptor specific CD4 T cells.

The B-cell receptor (BCR) expressed by a clonal B cell tumor is a tumor specific antigen (idiotype). However, the T-cell epitopes within human BCRs which stimulate protective immunity still lack detailed characterization. In this study, we identified 17 BCR peptide-specific CD4 T-cell epitopes derived from BCR heavy and light chain variable region sequences.

Toward stratification of patients with pancreatic cancer: Past lessons from traditional approaches and future applications with physical biomarkers.

Pancreatic ductal adenocarcinoma (PDAC) has a high mortality rate and outcomes have not improved substantially for decades. Significant attention has focused on the biological drivers of the disease, and preclinical work has pointed to multiple biomarker candidates and therapeutic avenues. However, translation of these promising biomarkers and treatment strategies to patients has not been overwhelmingly successful.

Intra-tumoral heterogeneity of gemcitabine delivery and mass transport in human pancreatic cancer.

There is substantial heterogeneity in the clinical behavior of pancreatic cancer and in its response to therapy. Some of this variation may be due to differences in delivery of cytotoxic therapies between patients and within individual tumors. Indeed, in 12 patients with resectable pancreatic cancer, we previously demonstrated wide inter-patient variability in the delivery of gemcitabine as well as in the mass transport properties of tumors as measured by computed tomography (CT) scans.

Towards an off-the-shelf vaccine therapy targeting shared B-cell tumor idiotypes.

The ideal tumor antigen is one expressed selectively by the tumor, present in all cancer patients, essential for tumor survival and nonetheless able to induce both humoral and cellular immune response. The personalized idiotype (Id) of the surface immunoglobulin is a tumor specific antigen in that it is expressed on clonal B-cell tumors, mediates B-cell survival, and induces tumor specific immunity in both human and animal models. With the availability of monoclonal antibodies against B cells, such as rituximab, the cellular immune response mediated by specific T cells has gained more importance as a combination therapy for the complete elimination of residual tumor cells in lymphoma and myeloma.

Nonstereotyped lymphoma B cell receptors recognize vimentin as a shared autoantigen.

Ag activation of the BCR may play a role in the pathogenesis of human follicular lymphoma (FL) and other B cell malignancies. However, the nature of the Ag(s) recognized by tumor BCRs has not been well studied. In this study, we used unbiased approaches to demonstrate that 42 (19.