Extracellular Vesicles From Osteotropic Breast Cancer Cells Affect Bone Resident Cells.

Extracellular vesicles (EVs) are emerging as mediators of a range of pathological processes, including cancer. However, their role in bone metastases has been poorly explored. We investigated EV-mediated effects of osteotropic breast cancer cells (MDA-MB-231) on bone resident cells and endothelial cells.

A Case of Acute Aortoiliac Occlusive Disease Presenting as Cauda Equina Syndrome and Fournier´s Gangrene.

Aortoiliac occlusive disease presents itself more frequently as chronic claudication, erectile dysfunction, and absent femoral pulses. Its acute manifestation is less frequently encountered in a clinical practice; hence, it presents sometimes as a diagnostic challenge. We illustrate a case of acute aortoiliac occlusive disease presenting with spinal cord ischemia and gluteal and scrotal necroses, which was initially diagnosed and treated as spinal cord compression.

Osteoblasts Regulate Angiogenesis in Response to Mechanical Unloading.

During mechanical unloading, endothelial cells reduce osteogenesis and increase bone resorption. Here we describe the feedback response of endothelial cells to unloaded osteoblasts. Primary endothelial cells, ex vivo mouse aortic rings and chicken egg yolk membranes were incubated with conditioned medium from mouse primary osteoblasts (OB-CM) subjected to unit gravity or simulated microgravity, to assess its effect on angiogenesis.

Venous Stent Migration into Right Ventricle.

Venous stents (VS) are used to treat central and peripheral stenoses. Stent embolization into a cardiac chamber is a rare, yet serious complication. We present a case of a 61-year-old man with a recently stented arteriovenous graft venous stenosis who developed VS migration into the right ventricle, associated with S.

Serotonin-reuptake inhibitors act centrally to cause bone loss in mice by counteracting a local anti-resorptive effect.

The use of selective serotonin-reuptake inhibitors (SSRIs) has been associated with an increased risk of bone fracture, raising concerns about their increasingly broader usage. This deleterious effect is poorly understood, and thus strategies to avoid this side effect remain elusive. We show here that fluoxetine (Flx), one of the most-prescribed SSRIs, acts on bone remodeling through two distinct mechanisms.

Interleukin-1β, lipocalin 2 and nitric oxide synthase 2 are mechano-responsive mediators of mouse and human endothelial cell-osteoblast crosstalk.

Endothelial cells are spatially close to osteoblasts and regulate osteogenesis. Moreover, they are sensitive to mechanical stimuli, therefore we hypothesized that they are implicated in the regulation of bone metabolism during unloading. Conditioned media from endothelial cells (EC-CM) subjected to simulated microgravity (0.

Is Early Reperfusion a Good Thing? Optimal Timing of CABG Surgery Postacute Myocardial Infarction.

Objectives: The optimal timing of coronary artery bypass grafting (CABG) following an acute myocardial infarction (AMI) is a topic of debate. The present study was designed to evaluate patients undergoing CABG both early (<5 days) and late (>5 days) after AMI in the era of percutaneous coronary intervention.

Methods: The medical records at our institution from 2008 through 2012 were reviewed.

Detection of atherosclerotic lesions and intimal macrophages using CD36-targeted nanovesicles.

Current approaches to the diagnosis and therapy of atherosclerosis cannot target lesion-determinant cells in the artery wall. Intimal macrophage infiltration promotes atherosclerotic lesion development by facilitating the accumulation of oxidized low-density lipoproteins (oxLDL) and increasing inflammatory responses. The presence of these cells is positively associated with lesion progression, severity and destabilization.

Surgical Treatment of Atrial Fibrillation.

Atrial fibrillation (AF) is the most common chronic arrhythmia in the adult population. Ablation lines have largely replaced the historical and challenging cut and sew techniques. Surgical ablation of AF is commonly performed in cases with other indications for cardiac surgery and less commonly as a stand-alone therapy.

Biotechnological approach for systemic delivery of membrane Receptor Activator of NF-κB Ligand (RANKL) active domain into the circulation.

Deficiency of Receptor Activator of NF-κB Ligand (RANKL) prevents osteoclast formation causing osteopetrosis. RANKL is a membrane-bound protein cleaved into active soluble (s)RANKL by metalloproteinase 14 (MMP14). We created a bio-device that harbors primary osteoblasts, cultured on 3D hydroxyapatite scaffolds carrying immobilized MMP14 catalytic domain.

Foxo1 regulates Dbh expression and the activity of the sympathetic nervous system in vivo.

The transcription factor FoxO1 regulates multiple physiological processes. Here, we show that FoxO1 is highly expressed in neurons of the locus coeruleus and of various sympathetic ganglions, but not in the adrenal medulla. Consistent with this pattern of expression, mice lacking FoxO1 only in sympathetic neurons (FoxO1 Dbh-/-) display a low sympathetic tone without modification of the catecholamine content in the adrenal medulla.

Familial thoracic aortic aneurysm with dissection presenting as flash pulmonary edema in a 26-year-old man.

We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates.

Osteoblast and osteocyte: games without frontiers.

The portrait of osteoblasts and osteocytes has been subjected to a revision, since a large body of evidence is attributing these cells amazing roles both inside and outside the bone. The osteoblast, long confined to its bone building function, is actually a very eclectic cell, actively regulating osteoclast formation and function as well as hematopoietic stem cells homeostasis. It is also an endocrine cell, affecting energy metabolism, male fertility and cognition through the release of osteocalcin, a perfect definition-fitting hormone in its uncarboxylated state.

Isolated Pulmonary Valve Endocarditis Complicated With Septic Emboli to the Lung Causing Pneumothorax, Pneumonia, and Sepsis in an Intravenous Drug Abuser.

Intravenous drug users are at increased risk for developing right-sided infective endocarditis involving the tricuspid and pulmonary valves. Isolated pulmonary valve endocarditis in intravenous drug users is very rare, and these patients often have more complications, such as pulmonary embolism, sepsis, and pneumonia. We report a case with pulmonary valve endocarditis and extensive pulmonary complications, including sepsis, septic emboli, pneumonia, and pneumothorax.

Does blood transfusion affect intermediate survival after coronary artery bypass surgery?

Background: The aim of this study was to investigate the impact of transfusion of blood products on intermediate outcome after coronary artery bypass surgery.

Patients: Complete data on perioperative blood transfusion in patients undergoing coronary artery bypass surgery were available from 2001 patients who were operated at our institution.

Results: Transfusion of any blood product (relative risk = 1.

Stand alone surgical ablation for atrial fibrillation.

Background: Trials to maintain sinus rhythm in patients with atrial fibrillation (AF) and refractory symptoms have been complicated by lack of success or intolerance of medications. Experience with minimally invasive AF surgery is relatively new, and early results have been promising. However, the study populations and techniques were heterogeneous, and the follow-up periods were short in many series.

Current treatment and outcome of esophageal perforations in adults: systematic review and meta-analysis of 75 studies.

Background: The current prognosis of esophageal perforation and the efficacy of available treatment methods are not well defined.

Methods: We performed a systematic review of esophageal perforations published from January 2000 to April 2012 and subjected a proportion of the retrieved data to a meta-analysis. Meta-regression was performed to determine predictors of mortality immediately after esophageal perforation.

Diagnostic accuracy of computed tomography in patients with suspected abdominal aortic aneurysm rupture.

Objectives: This study was planned to evaluate the accuracy of computed tomography angiography (CTA) for suspected rupture of abdominal aortic aneurysm (AAA).

Design: Retrospective, observational study.

Patients: A total of 97 patients who underwent open aneurysm repair for suspected rupture of AAA.

Giant coronary artery aneurysm seen on blood-pool study.

An 81-year-old man was incidentally found to have a large pericardial cyst on a chest computed tomography. Before surgical removal, an echocardiogram demonstrated that the cyst was more likely a large (7.5 cm) right coronary arterial aneurysm.

Outcome of patients aged ≥80 years undergoing combined aortic valve replacement and coronary artery bypass grafting: a systematic review and meta-analysis of 40 studies.

Aim: This study was planned to evaluate the outcome of patients aged ≥80 years undergoing combined conventional aortic valve replacement (AVR) and coronary artery bypass grafting (CABG).

Methods: This is a systematic review of the literature and meta-analysis of data on patients aged ≥80 years who underwent combined AVR and CABG.

Results: The literature search yielded 40 observational studies reporting on 8,975 patients aged ≥80 years.

Outcome after open repair of ruptured abdominal aortic aneurysm in patients>80 years old: a systematic review and meta-analysis.

Background: The role of open repair in the management of ruptured abdominal aortic aneurysm (RAAA) in patients>80 years old is questioned by the perceived high operative risk of these patients. This issue has been investigated in the present meta-analysis of observational studies.

Methods: Studies on open repair of RAAA in patients>80 years old were identified in July 2010.

Managing dyslipidemias: update on guidelines and pharmacotherapy.

New guidelines, the Adult Treatment Panel III (ATP III), for diagnosis and treatment of dyslipidemias are more stringent than older ones. Based on ATP III, 65 million Americans need therapeutic lifestyle changes, 36.5 million of whom require drug therapy.

Transradial approach for coronary procedures: initial experience and results.

Background: Due to the recent miniaturization of angioplasty equipment, the transradial approach has gained favor as an alternative catheterization method for coronary procedures. The purpose of this study was to assess the practical clinical application of this method.

Methods: Between June 1997 and February 1998, one operator (MG) attempted the percutaneous transradial approach in 185 consecutive unselected patients with functional radial arch attested using Allen's test.

Traumatic aortic incompetence associated with transection of the thoracic aorta.

A case of blunt chest trauma resulting in transection of the descending thoracic aorta and disruption of the aortic valve is presented. Successful treatment required graft repair of the aortic injury followed by aortic valve replacement.