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Background: While many studies evaluated outcomes of abdominal wall reconstruction with biologic mesh, long-term data is lacking. In this study, we sought to analyze the outcomes of complex AWR with biologic mesh in a robust cohort of patients with a mean follow up of 8 years., Methods: We conducted a longitudinal study of AWR patients from 2005 to 2019. Hernia recurrence was the primary outcome, and surgical site occurrence was the secondary outcome. Predictive/protective factors were identified using a Cox proportional hazards regression models., Results: We identified 109 consecutive patients who met the inclusion criteria. Patient's mean (± SD) age was 57.5 ± 11.8 years, mean body mass index was 30.7 ± 7.2 kg/m 2 , and mean follow-up time was 96.2 ± 15.9 months. Fifty-six percent had clean defects, 34% had clean-contaminated defects, and 10% had contaminated/infected defects. Patients had a mean defect size of 261 ± 199.6 cm 2 and mean mesh size of 391.3 ± 160.2 cm 2 . Nineteen patients (17.4%) developed HR at the final follow-up date. Obesity was independently associated with a four-fold higher risk of HR (hazard ratio, 3.98; 95%CI, 1.34 to 14.60, p = 0.02). SSOs were identified in 24.8% of patients. A prior hernia repair was associated with a three-fold higher risk of SSOs (Odds ratio, 3.13; 95%CI, 1.10 to 8.94, p = 0.03). No patient developed mesh infection., Conclusion: These longitudinal data demonstrate that complex AWR with biologic mesh provides long-term durable outcomes with acceptable HR and SSO rates despite high contamination levels, patients complexity, and large defect size., (© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.)

Epithelial cell invasion by the protozoan parasite Trypanosoma cruzi is enhanced by the presence of an enzyme expressed on its cell surface during the trypomastigote life cycle stage. The enzyme, trans-sialidase (TS), is a member of one of the largest gene families expressed by the parasite and the role of its activity in mediating epithelial cell entry has not hitherto been understood. Here we show that the T. cruzi TS generates an eat me signal which is capable of enabling epithelial cell entry. We have utilized purified, recombinant, active (TcTS) and inactive (TcTS2V0) TS coated onto beads to challenge an epithelial cell line. We find that TS activity acts upon G protein coupled receptors present at the epithelial cell synapse with the coated bead, thereby enhancing cell entry. By so doing, we provide evidence that TS proteins bind glycans, mediate the formation of distinct synaptic domains and promote macropinocytotic uptake of microparticles into a perinuclear compartment in a manner which may emulate entosis., (© 2013 The Authors. Traffic published by John Wiley & Sons Ltd.)

It is widely accepted that Trypanosoma cruzi can exploit the natural exocytic response of the host to cell damage, utilizing host cell lysosomes as important effectors. It is, though, increasingly clear that the parasite also exploits endocytic mechanisms which allow for incorporation of plasma membrane into the parasitophorous vacuole. Further, that these endocytic mechanisms are involved in cross-talk with the exocytic machinery, in the recycling of vesicles and in the manipulation of the cytoskeleton. Here we review the mechanisms by which T. cruzi exploits features of the exocytic and endocytic pathways in epithelial and endothelial cells and the evidence for cross-talk between these pathways., (© 2012 Blackwell Publishing Ltd.)

STI571 (imatinib mesylate; Gleevec) is a selective inhibitor of the bcr-abl, c-kit, and platelet-derived growth factor receptor tyrosine kinases. Mild periorbital edema has been noted as a common side effect in Phase I and II trials of this drug for the treatment of patients with chronic myelogenous leukemia and gastrointestinal stromal tumors. The authors report the case of male patient age 63 years who developed severe periorbital edema after treatment with STI571 for chronic myelogenous leukemia. His edema was severe enough to cause visual obstruction due to lower eyelid festoons that ultimately required surgical debulking. Histopathologic analysis of specimens of the excised upper and lower eyelid tissue revealed dermal dendrocytes that expressed the platelet-derived growth factor receptor and c-kit tyrosine kinases, suggesting a possible role for dermal dendrocytes in the development of this toxic effect., (Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10729)

Structural biomaterials can restore abdominal wall integrity but may cause adhesions to the underlying viscera. Collagen-glycosaminoglycan (CG) matrices induce the formation of connective tissue and may reduce adhesion formation to permanent biomaterials such as polypropylene (PP) mesh. Composite implants were created by interposing PP mesh within a porous CG matrix created composite implants. The implants were cross-linked with glutaraldehyde one group (CG-G/PP) or left untreated (CG-nG/PP) and compared to PP mesh. At 4 weeks, the abdominal wall was assessed for the degree of adhesions. The composite implants developed a nascent connective tissue-like structure that reduced adhesions to the bowel. The thickest connective tissue developed in the CG-G/PP group (0.7 +/- 0.1 mm) and thinnest in the PP mesh (0.05 +/- 0.01 mm). The surface area covered with adhesions was greatest in the PP group (72 +/- 17%) compared with the CG-G/PP group (28 +/- 15%) or the CG-nG/PP group (21 +/- 8%). Bowel preferentially adhered to the PP mesh, whereas omentum had some adherence to all constructs. Integrating a biodegradable extracellular matrix analog with a permanent structural biomaterial reduced adhesions in this animal model. Alterations in cross-linking of the CG matrix altered the biological response. This technology may be useful in reconstructive surgery by reducing adhesion formation, while maintaining the strength of permanent structural biomaterials., (Copyright 2000 John Wiley & Sons, Inc.)