Connective Tissue Degradation Research Articles

Advances in molecular mechanisms of pelvic organ prolapse (Review).

Pelvic organ prolapse (POP) is a common gynecological benign disease occurring in middle-aged and elderly females. Its incidence increases every year. To date, the majority of studies investigating its etiology have not evaluated the underlying molecular mechanisms, which has caused substantial difficulties in the prevention, treatment and prognosis of POP. In the present narrative review, recent research studies concerning the molecular mechanisms of POP were systematically reviewed and the advances were summarized. The association between the incidence of POP and the reduction of the extracellular matrix, activation of oxidative stress, genetic susceptibility, denervation of the pelvic floor and reduction of estrogen infiltration were explored. POP is mainly associated with damage of pelvic floor muscles and connective tissue, which are directly caused by pregnancy and vaginal delivery. The majority of the molecular and genetic mutations associated with POP involve specific components of connective tissue synthesis and degradation. It is likely that macroscopic parameters, such as anatomy, lifestyle and reproductive factors, interact with microscopic parameters, such as physiology and genetics in the female pelvic floor, leading to POP. Additional research studies investigating the molecular mechanisms of POP should be performed, since they may aid public health strategies. In the present narrative review, a summary of these molecular mechanisms underlying the development of POP is provided. This included the relevant proteins and genes involved. On this basis, countermeasures were proposed.

Targeting hepatocyte growth factor in epithelial\u2013stromal interactions in an in vitro experimental model of human periodontitis

Periodontitis is a chronic inflammatory disease leading to progressive connective tissue degradation and loss of the tooth-supporting bone. Clinical and experimental studies suggest that hepatocyte growth factor (HGF) is involved in the dysregulated fibroblast–epithelial cell interactions in periodontitis. The aim of this study was to explore effects of HGF to impact fibroblast-induced collagen degradation. A patient-derived experimental cell culture model of periodontitis was applied. Primary human epithelial cells and fibroblasts isolated from periodontitis-affected gingiva were co-cultured in a three-dimensional collagen gel. The effects of HGF neutralizing antibody on collagen gel degradation were tested and transcriptome analyses were performed. HGF neutralizing antibody attenuated collagen degradation and elicited expression changes of genes related to extracellular matrix (ECM) and cell adhesion, indicating that HGF signaling inhibition leads to extensive impact on cell–cell and cell–ECM interactions. Our study highlights a potential role of HGF in periodontitis. Antagonizing HGF signaling by a neutralizing antibody may represent a novel approach for periodontitis treatment.

TEMPORAL SPACE INFECTION SECONDARY TO RECURRENT BUCCAL SPACE INFECTION FROM MANDIBULAR DECIDUOUS MOLAR IN 7-YEAR-OLD CHILD: A CASE REPORT

Head and neck space infections are usually secondary to odontogenic infec­tions due to translocation of oral microbes to fascial space via odontogenic route resulting in progression by enzymatic degradation of connective tissue. Various factors like microbiological, host, nutritional and socioeconomic fac­tors are responsible for progression of fascial space infection that might take fatal course if not treated in time. The present case report describes a child with fascial space infection of oral and maxillofacial region who was treated by incision and drainage in department of oral and maxillofacial surgery of this hospital. Fascial space infections are one of the surgical emergencies and need to be addressed in early stage as it has rapid regional and systemic progression leading to fatal outcome. It is multifactorial and all need to be addressed. Incision and drainage with removal of cause with antimicrobial therapy is treatment modality of space infection. Inadequate drainage might lead to recurrence of infection and progression to distant secondary spaces.

Status of the collagen metabolism and intracardiac hemodynamics in patients with mitral valve prolapse and diabetes mellitus type 1

Summary. Mitral valve prolapse is a significant cardiovascular risk factor in young adults. Its combination with type 1 diabetes mellitus can influence the nature and development of the disease. Objective – a comparative analysis of free and peptide-bound oxyproline levels and basic echocardiographic parameters (ECP) in patients with mitral valve prolapse, type 1 diabetes and their combination. Materials and methods – 93 people aged 19–33 years were examined, including 24 people with mitral valve prolapse without concomitant pathology; 33 patients with mitral valve prolapse and type 1 diabetes; 36 patients with type 1 diabetes without mitral valve prolapse. Results. The level of free and peptide-bound oxyproline in blood serum and their ratio were assessed as a marker of collagen metabolism. The levels of free oxyproline were significantly higher only for the group of MVP patients with type 1 diabetes (p < 0.05) compared to the control group. Severity of destructive processes was demonstrated by a high level of peptide-bound oxyproline, both in combined pathology compared with control group, and compared with groups of patients with monomorbid diabetes and MVP (p < 0.05). In patients with mitral valve prolapse and type 1 diabetes for more than 10 years in anamnesis were found significant differences in the echocardiography parameters (ventricular septum thickness, posterior wall of the left ventricle thickness) compared with the subgroup of patients with less than 10 years of type 1 diabetes in anamnesis and the group with isolated mitral valve prolapse. Conclusions. The data obtained indicate an aggravation in collagen metabolism disorders in patients with mitral valve prolapse depending on the duration of type 1 diabetes, and demonstrate the effect of carbohydrate metabolism disorders on the risk of developing connective tissue degradation of the heart valve apparatus.

Standardised Forms of Chondroitin Sulfate as a Pathogenetic Treatment of Osteoarthritis in the Context of Post-Genomic Studies

A systematic analysis of 37 post-genomic osteoarthritis (OA) studies (genomics, transcriptomics, proteomics, metabolomics) allowed to isolate 483 genes and corresponding proteins, their levels and activity disturbances are involved in the pathogenesis of the disease. These proteins can be conditionally subdivided into three groups: 1) structural proteins of connective tissue (CT); 2) proteins that support the activity of CT growth factors; 3) proteins that promote CT remodeling and degradation, as well as proteins associated with the regulation of inflammation (cellular response to tumor necrosis factor α, interleukin 1, bacterial lipopolysaccharides, NF-κB activation, etc.). It is important to note the epigenetic effects (DNA hypomethylation) associated with the pathogenesis of OA, which indicates the need for the use of vitamins group B in the therapy. Chondroprotectors (symptomatic slow-acting drugs) – chondroitin sulfate (CS) and glucosamine sulfate (GS), – in addition to reducing inflammation through inhibition of NF-κB and lipopolysaccharide receptors (Toll-receptors), also contribute to an increase in the expression of genes for structural CT proteins, CT growth factors and modulate the activity of CT remodeling and degradation proteins. These effects of CS/GS allowed to describe the complex mechanisms of the pathogenetic action of CS/GS in the treatment of OA.

The combined effect of asparagus juice and balsamic vinegar on the tenderness, physicochemical and structural attributes of beefsteak.

The adverse effects of chemical compounds have limited their usage despite their relative success in improving meat tenderness. Thus, natural tenderizers have attracted attention. The present study aimed to evaluate the tenderization effects of asparagus (Asparagus officinalis L.) juice and balsamic vinegar on beefsteak; marination at 4°C for 48h significantly increased the water-holding capacity, total protein solubility, myofibrillar fragmentation index and hydroxyproline content but significantly decreased the pH value, Warner-Bratzler shear force, and energy to the peak rates (P < 0.05). Scanning electron microscopy images and electrophoresis findings revealed extensive degradation of connective tissues and changes in protein band patterns, respectively. The tenderness of the beefsteak samples was optimum by applying 25% asparagus juice, and 25% asparagus juice + 10% balsamic vinegar. Therefore, marinade solutions containing asparagus juice and balsamic vinegar can be considered as natural tenderizing agents in formulation of seasonings and sauces to promote tenderness in tough beefsteak and possibly improve other quality-related properties.

A Case Report of a Submental and Submandibular Space Infection

In most of the cases of space infections are secondary to an odontogenic infection. In space infection,spread occurs through the fascial plane because of the degradation of connective tissue by action of differentenzymes produced by microorganisms. Different factors like age, nutritional status of the host, host defense,virulence of the microorganism play an important role in the spread of the infection. Sometimes it may takethe fetal course if not treated on time because of its local and systemic complications. It should be treatedas an emergency condition to prevent its rapid progression leading to fatal outcome. Here the case reportdescribes an old lady suffering from fascial space infection and treated by incision and drainage. Incompleteremoval of any odontogenic infection may cause the recurrence of the infection or infection that may spreadto fascial spaces.

Ultra-rare cystic disease.

Diffuse cystic lung diseases include a group of heterogeneous disorders characterised by the presence of cysts within the lung parenchyma, sometimes showing a characteristic computed tomography scan pattern that allows diagnosis. The pathogenetic mechanisms underlying cyst formation in the lung are still not clear and a number of hypotheses have been postulated according to the different aetiologies: ball-valve effect, ischaemic dilatation of small airways and alveoli related to infiltration and obstruction of small vessels and capillaries that supply the terminal bronchioles and connective tissue degradation by matrix metalloproteases. A wide number of lung cyst diseases have been classified into six diagnostic groups according to the aetiology: neoplastic, congenital/genetic, lymphoproliferative, infective, associated with interstitial lung diseases, and other causes. This article focuses on lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and Erdheim-Chester disease, Birt-Hogg-Dubé, follicular bronchiolitis and lymphocytic interstitial pneumonia, light-chain deposition disease and amyloidosis, congenital lung disease associated with aberrant lung development and growth, and cystic lung disease associated with neoplastic lesion. These cystic diseases are epidemiologically considered as ultra-rare conditions as they affect fewer than one individual per 50 000 or fewer than 20 individuals per million. Despite the rarity of this group of disorders, the increasing use of high-resolution computed tomography has improved the diagnostic yield, even in asymptomatic patients allowing prompt and correct therapy and management without the need for a biopsy.

Effects of biocidal solutions and wet tissue treatment on the biological properties of porcine aortic wall

Aim.To evaluate the effects of long-term wet treatment of porcine aortic wall fragments with biocidal solutions (glutaraldehyde, antibiotics, alcohol-glycerin mixture, complex alcohol solution (CAS)) on the severity of degradation of samples’ connective matrix and their long-term ability to accumulate calcium during subcutaneous implantation in laboratory rats (1 and 3 months).Methods.Histological analysis of freshly collected material was performed after 50 days of treatment with various biocidal solutions and after subcutaneous implantation of samples in small laboratory animals at 1 and 3 months. Calcium was measured with the atomic absorption spectroscopy after 3 months of subcutaneous implantation.Results.Histological analysis reported that connective matrix of samples treated with glutaraldehyde, antibiotics, and CAS was similar to the native one (with the exception of partial loss of cellular components in samples). After 1 month of implantation, a moderate degradation of connective tissue was found. The treatment with the alcohol-glycerin mixture was associated with the most severe degradation. After 3 months of implantation, glutaraldehyde-treated samples had the most preserved connective matrix, while alcohol-glycerin-treated samples demonstrated severe connective matrix injury. However, severe calcific deposits were found in samples treated with glutaraldehyde, whereas mild ones were detected in samples treated with alcohol-glycerin. Atomic absorption spectroscopy reported that calcific deposits in Cas- and alcohol-glycerin-treated samples were 2.3 and 1.8 times lower than those in glutaraldehyde-treated samples. The calcium content in samples treated with antibiotics did not differ significantly from those in glutaraldehyde-treated samplesConclusion.The comprehensive analysis of the effects of various treatment media on the stability of connective matrix to subsequent degradation and its ability to accumulate calcium found that CAS was the most preferred medium for long-term wet treatment of xenoprosthetic vascular tissue.

Optimization of a protease extraction using a statistical approach for the production of an alternative meat tenderizer from Manihot esculenta roots.

Meat tenderness is the most important criterion in food quality because it strongly influences the consumer's satisfaction. Tenderness generally depends on connective tissue and sarcomere length of muscle. One of the effective methods for meat tenderizing is protease treatment. In this study, Manihot esculenta root was chosen as a protease source due to its skin blistering effect, suggesting the presence of strong proteolytic activity. The extraction of the crude protease was optimized by using response surface methodology (RSM) with four independent variables, which were pH (X1), CaCl2 (X2), Triton X-100 (X3) and 2-mercaptoethanol (X4). Based on the RSM model, all the independent variables were significant and the optimum extraction conditions were pH 9, 3.24mM CaCl2, 4.12% Triton X-100 and 6.32mM 2-mercaptoethanol. Tukey's test results showed that the difference between the expected and experimental protease activity value was 0.05%. A reduction of meat firmness was observed when samples treated with enzyme were compared with a control by using a texture analyser. Electrophoretic patterns also showed extensive proteolysis and a reduction of intensity and number of the protein bands in the treated sample. SEM clearly revealed the degradation of muscle fibres and connective tissue of meat treated with crude protease.

Plasma rich in growth factor gel as an autologous filler for facial volume restoration.

Skin aging is characterized by moderate to severe wrinkles, laxity, roughness, and volume loss as a result of cutaneous atrophy and connective tissue degradation. Plasma rich in growth factor gel (PRGF-gel) is a novel formulation obtained from the patient's own blood that has demonstrated optimal biomechanical and bioactive properties for soft tissue restoration. Following a retrospective design, the clinical safety and efficacy of PRGF-gel for facial volume restoration and skin rejuvenation were evaluated. Twenty women clinically diagnosed for aged skin symptoms were treated with PRGF-gel. Participants received an individualized regimen depending on their therapeutic needs. At the end of the follow-up periods, clinical performance analysis was evaluated by standardized macrophotographs along with clinical and patient surveys based on Likert's scales. Based on their initial expectations, patients referred to be highly satisfied after PRGF-gel treatment in terms of fine line amelioration, wrinkle reduction, and sagging improvement (overall satisfaction of 8/10). Pre/post-photograph clinical evaluation showed an improvement of 2.5/3 and patients presented a noticeable face rejuvenation due to the soft tissue augmentation effect which was translated into surface texture softening and tone recovery. Although additional randomized clinical trials should be carried out, this study provides preliminary data supporting the use of PRGF-gel for facial volume restoration.

Opsin 3 is a key regulator of ultraviolet A-induced photoageing in human dermal fibroblast cells.

SummaryBackgroundChronic exposure to ultraviolet (UV) radiation (mainly UVA) induces a sustained increase of matrix metalloproteinases (MMPs), especially MMP1, MMP2, MMP3 and MMP9 in human skin fibroblasts. MMPs can lead to the degradation of fibrous connective tissue, which is the main cause of skin photoageing. The molecular mechanisms through which fibroblasts sense UVA and trigger the cell signalling pathways involved in the upregulation of MMPs have not been well elucidated.ObjectivesHere, we investigated the function and potential mechanisms of photoageing of opsin (OPN)3 in normal human dermal fibroblasts (NHDFs).MethodsReal‐time polymerase chain reaction and Western blot analysis were used to analyse the expression levels of OPN3 in NHDFs and photoageing models. Subsequently, NHDFs transfected with OPN3 inhibitors and indicators related to photoageing before and after UVA irradiation included expression levels of MMP1, MMP2, MMP3 and MMP9, and signalling pathway protein molecules were examined.ResultsWe provide evidence that OPN3 initiates UVA phototransduction in NHDFs. OPN3 triggers phosphorylation of activator protein 1 and ultimately upregulates MMP1, MMP2, MMP3 and MMP9 in NHDFs through activating Ca2+/calmodulin‐dependent protein kinase II, cyclic adenosine monophosphate response element‐binding protein, extracellular signal‐regulated kinase, c‐JUN N‐terminal kinase and p38. Here, we demonstrate for the first time that OPN3 is the key sensor responsible for upregulating MMP1, MMP2, MMP3 and MMP9 in NHDFs following UVA exposure via the calcium‐dependent G protein‐coupled signalling pathway.ConclusionsOur studies provide insights into the understanding of the molecular mechanisms through which human skin cells respond to UVA radiation and may reveal molecular targets for skin photoageing prevention or clinical management. What's already known about this topic? Photoaged fibroblasts accumulate with long‐term ultraviolet (UV) exposure.Matrix metalloproteinases (MMPs) play an important role in the pathogenesis of photoageing.MMP1, MMP2, MMP3 and MMP9 are responsible for the destruction of fibroblast collagen in severely photodamaged skin.Opsins (OPNs) are light‐sensitive members of the superfamily of heptahelical G protein‐coupled receptors, a family of cell surface receptors that are activated by a variety of stimuli and mediate signalling across membranes. What does this study add? OPN3 is highly expressed in fibroblasts and responds to UVA irradiation.OPN3 regulates the expression of MMP1, MMP2, MMP3 and MMP9 via the calcium‐dependent G protein‐coupled signalling pathway.OPN3 is a light‐sensitive sensor that plays an important role in photoageing of the skin.

Liver fibrosis mechanisms – the role of stellate cells, oxidative and nitrosative stress

Liver fibrosis is a chronic and complex pathological process, occuring in patients with chronic liver diseases. The most common cause of liver fibrosis is the alcoholic liver disease, viral hepatitis type B, C and D, as well as autoimmune diseases. Other causes include metabolic dysfunctions like hemachromatosis and Wilson’s disease, biliary duct disorders, damaging effects of medicine and parasite infections. Fibrosis’ dynamics and progres speed depend on the nature of underlying mechanisms and are characterized by accumulation of ECM elements. They vary from patient to patient and are directly correlated to aberrations of homeostasis degradation and production of liver connective tissue. In liver fibrosis the main source of ECM are hepatic stellate cells (HSCS), although other cells are also able to produce ECM such as: portal fibroblasts, narrow-derived cells, biliary duct epithelial cells and epithelial mesenchymal transition hepatocytes. The HSCS activity is stimulated by proinflammatory cytokines, oxidative and nitrosative stress which lead to different pathologies such as: inflammation, steatosis, fibrosis, cirrhosis, liver-cell cancer. Alcohol, the main fibrotic agents is metabolized almost entirely in the liver, so the organ is extremely sensitive to its negative intermediate and mediate influence. Factors influencing alcoholic liver failure are not only oxidative and nitrosative stress and proinflammatory cytokines activity, but also reductive stress, hepatocytes; hypoxia, mucous membranę dysfunction and intestine flora influence, as well as genetic and immunological factors. Though in last several yers there has been a great advancement in our knowledge of liver fibrosis mechanisms, it remains tough to diagnose the proces in its early stages and consequently apply an efficient therapy. The challenge for the futur is finding useful biomarkers and new therapeutic goals.

A keratinocyte and integrated fibroblast culture model for studying particulate matter-induced skin lesions and therapeutic intervention of fucosterol

Increased levels of particulate matter (PM) air pollutants in East Asia have resulted in detrimental health impacts increasing morbidity and mortality. Epidemiological studies suggest a possible relation between the cutaneous exposure of PM and increased oxidative stress and inflammation which lead to skin lesions. The present study utilizes an integrated cell culture model of keratinocytes and fibroblasts to mimic viable skin layers and investigate the possible effects of PM exposure after penetration through corneocytes. The skin perfection is upheld by homeostatic functionality of epidermal cells and the integrity of connective tissues. Exposure to xenobiotics could alter the skin cell homeostasis aggravating premature skin aging. Stimulation of HaCaT keratinocytes by PM collected from Beijing, China (CPM) increased the intracellular ROS levels triggering a cascade of events aggravating inflammatory responses and connective tissue degradation. In HDF fibroblasts, treatment with preconditioned keratinocyte culture media augmented inflammatory responses, cellular differentiation, and connective tissue degradation. Above events were marked by the increased intracellular ROS, inflammatory mediators, pro-inflammatory cytokines, matrix metalloproteinases (MMP)-1 and -2 levels, collagenase, and elastase activity. Fucosterol treatment of keratinocytes dose-dependently attenuated the detrimental effects both in keratinocytes and fibroblasts restoring the conditions near to physiological levels. Further evaluations could be advanced on developing fucosterol, in forms such as rejuvenating cosmeceuticals which could attenuate detrimental responses of CPM exposure.

Composition and dynamics of the bacterial communities present in the post-slaughter environment of farmed Atlantic salmon (Salmo salarL.) and correlations to gelatin degrading activity

BackgroundMicrobial analyses performed in connection with the post-slaughter environment of farmed Atlantic salmon (Salmo salar L.) have mostly focused on specific bacteria that may have negative effects on the health of consumers. However, bacteria may also affect other quality variables. The objective of this study was to provide general knowledge about composition and dynamics of the bacterial communities present at slaughter and cold storage of farmed Atlantic salmon, as well as reveal any possible correlations to gelatinase activity, which may affect fillet quality. Thus, these data may provide a basis for optimization opportunities in the aquaculture industry.MethodsSamples were taken from the digestive system harvested from 15 salmon immediately after slaughter. Another 17 salmon were taken from the processing line just before the final cleaning stage; of these eight were distributed in three iced storage boxes while the other nine were rinsed an extra time with industrial water before being distributed into another three storage boxes. In the following 6 days, samples were taken of skin mucus, liquids in the abdominal cavity and the storage ice. The compositions of the bacterial communities were analyzed by next-generation sequencing and gelatinase activity was measured in all samples except the storage ice.ResultsThe bacterial communities in the digestive tract samples were dominated by the family Mycoplasmataceae. The genus Aliivibrio was also relatively abundant. Bacterial communities in the abdominal cavity were generally more diverse than the intestinal samples. However, all of the abdominal samples from storage box no. 3 had a high relative abundance of Mycoplasmataceae, and could not be distinguished from the intestinal samples (Q = 1.27, p = 0.633) while being significantly different from the other abdominal samples (Q = 9.02, p = 0.01). In addition, the abdominal samples from storage box no. 3 had a significantly higher gelatin degrading activity (Q = 9.43, p = 0.001) than those from the other storage boxes and similar to the high gelatinase activity in the intestinal samples. This indicated that in storage box no. 3 there was a transfer of intestinal fluids to the abdominal cavities, which was not removed by the cleaning procedure. There was a significant difference of the major phyla detected in the skin mucus of salmon rinsed an additional time, as these salmon had a higher relative amount of Firmicutes (F = 4.76, p = 0.04) and lower amount of Proteobacteria (F = 4.41, p = 0.047).ConclusionsThe study showed a correlation between intestinal fluids and bacteria left in the abdominal cavity and gelatinase activity. This suggested that intestinal fluids and/or bacteria could enhance the degradation of connective tissue in the abdominal cavity and hence negatively affect the fillet quality. In addition, the study provided general knowledge of the composition and dynamics of bacterial communities present.

Pelvic floor preservation

The pelvic floor in women is a highly vulnerable structure and a complex functional unit. The anatomical and functional defect of this complex system determines a variable association of complaints related to the urinary, genital and low intestinal tracts. Pelvic floor laxity depends on muscle injury and progressive pelvic floor weakening; connective tissue degradation, pelvic denervation and devascularization and anatomic modifications determ a decline in mechanical strength and dyssinergic pelvic floor function, predisposing to prolapsed. Female pelvic organ prolapse (POP), sexual dysfunction, urinary incontinence (UI), chronic obstructive defecation syndrome (OFD), constipation are different faces of pelvic floor dysfunction, and their incidence increases dramatically with age and menopause.The hormonal changes in menopause can cause weakening of the pelvic floor muscles. Pregnancy, childbirth, chronic straining to open bowels and heavy lifting can also weaken pelvic floor muscles, and during menopause incontinence, pelvic organ prolapse, bowel or bladder urgency may become more and more frequent, impairing significantly the quality of life. Pelvic floor exercises have shown to improve incontinence (bladder and bowel), pelvic organ prolapse and urinary urgency: if correctly done, pelvic floor exercises are a strategy to preserve pelvic floor anatomy and function. In aging women, a multitude of factors affects the final result of the pelvic floor preservation or the reconstructive surgery such as aging-associated changes in muscle tone and nerve function or changes in the function of the bladder or of the rectum: an understanding of the underlining functional status of pelvic organs is very important in aging women before proceeding to surgery. Vaginal atrophy is frequent in menopausal women and it also carries a higher risk of complications for pelvic floor reconstruction, particularly when trans-vaginal prostheses are needed. Risk of mesh erosion is higher in women affected by vaginal atrophy, and shrinkage of the prosthetic material can lead to intractable dyspareunia in women with an atrophic vagina. Pelvic floor surgeons frequently use pre- and post-operative administration of local estrogen preparations to overcome such problems. The pelvic floor dysfunction, particularly in elderly women, should be evaluated in a multidisciplinary centres where urologists, gynaecologists and colorectal specialists can interact to manage a complex patient.

Temporal space infection secondary to recurrent buccal space infection from mandibular deciduous molar in 7-year-old child: a case report

Head and neck space infections are usually secondary to odontogenic infections due to translocation of oral microbes to fascial space via odontogenic route resulting in progression by enzymatic degradation of connective tissue. Various factors like microbiological, host, nutritional and socioeconomic factors are responsible for progression of fascial space infection that might take fatal course if not treated in time. The present case report describes a child with fascial space infection of oral and maxillofacial region who was treated by incision and drainage in department of oral and maxillofacial surgery of this hospital. Fascial space infections are one of the surgical emergencies and need to be addressed in early stage as it has rapid regional and systemic progression leading to fatal outcome. It is multifactorial and all need to be addressed. Incision and drainage with removal of cause with antimicrobial therapy is treatment modality of space infection. Inadequate drainage might lead to recurrence of infection and progression to distant secondary spaces.

Overexpression of the matrix metalloproteinase 11 gene is a potential biomarker for type 1 endometrial cancer.

Metalloproteinase matrix 11 (MMP11) is a member of the matrix metalloproteinase family, which are able to degrade extracellular matrix components, and may serve a central function in the enhancement of tumor-induced angiogenesis, cell migration, proliferation, apoptosis and connective tissue degradation. In the present study, MMP11 gene expression was investigated using the reverse transcription-polymerase chain reaction in 68 cases of type I endometrial carcinoma, and all data were analyzed in association with clinical characteristics. Overexpression of MMP11 was demonstrated in 75%, and sub-expression was demonstrated in 25%, of endometrial cancer cases. Sub-expression cases were associated with good histological parameters, including low histological grade (G1 and G2), early pathological stage, and absence of vascular invasion, metastasis and recurrence. In total, 76.4% of endometrial cancer cases with sub-expression were identified as early stage 1A and B; however, 23.6% of cases were identified as stage 2, with vascular invasion present in 29.4% of cases. On the other hand, cases which demonstrated overexpression with high ranges (>10 times more than control) were associated with adverse histopathological characteristics, including high grade tumor (G3) and vascular invasion. In conclusion, the increased expression of MMP11 may be used as a prognostic biomarker in patients with type 1 endometrial cancer.

Transcriptional profiling of synovium in a porcine model of early post-traumatic osteoarthritis.

To determine the transcriptional profile of synovium during the molecular phase of post-traumatic osteoarthritis, anterior cruciate ligament transections (ACL) were performed in 36 Yucatan minipigs. Equal numbers were randomly assigned to no further treatment, ACL reconstruction or repair. Perimeniscal synovium for histopathology and RNA-sequencing was harvested at 1 and 4 weeks post-operatively and from six healthy control animals. Microscopic synovitis scores significantly worsened at 1 (p < 0.001) and 4 weeks (p = 0.003) post-surgery relative to controls, and were driven by intimal hyperplasia and increased stromal cellularity without inflammatory infiltrates. Synovitis scores were similar between no treatment, reconstruction, and repair groups (p ≥ 0.668). Relative to no treatment at 1 week, 88 and 367 genes were differentially expressed in the reconstruction and repair groups, respectively (227 and 277 at 4 weeks). Relative to controls and with the treatment groups pooled, 1,683 transcripts were concordantly differentially expressed throughout the post-surgery time-course. Affected pathways included, proteolysis_connective tissue degradation (including upregulations of protease-encoding MMP1, MMP13, and ADAMTS4), and development_cartilage development (including upregulations of ACAN, SOX9, and RUNX2), among others. Using linear regression, significant associations of post-surgery synovial expression levels of 20 genes with the articular cartilage glycosaminoglycan loss were identified. These genes were predominantly related to embryonic skeletal system development and included RUNX2. In conclusion, this study confirmed an increased synovial expression of genes that may serve as targets to prevent cartilage degradation, including MMP1, MMP13, and ADAMTS4, in knees with microscopic synovitis and cartilage proteoglycan loss. Attractive novel targets include regulators of embryonic developmental processes in synovium. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

Genitourinary syndrome of menopause treatment using lasers and temperature-controlled radiofrequency.

Perimenopausal changes caused by oestrogen deficiency are accompanied by a decrease in the content of collagen and elastin in the tissues, leading to thinning of the epithelium and the resultant disappearance of the superficial layer, which leads to smooth muscle dysfunction as well as connective tissue degradation. This aetiopathogenetic chain results in a set of symptoms experienced by approximately 50% of women in the peri- and postmenopausal period. Symptoms of dryness, burning, dyspareunia and urgency contribute to a significant reduction in the quality of sexual function and general comfort of life due to recurrent infections of the vagina, vulva and urinary tract. Different therapeutic methods may benefit genitourinary syndrome of menopause (GSM), while innovative methods such as lasers or radiofrequency deserve further study in this area.