Topp Summers (bearfeet18)

Glioblastoma multiforme (GBM) is a lethal and highly vascular type of brain tumor. We previously reported that isolinderalactone enhances GBM apoptosis in vitro and in vivo, but its role in tumor angiogenesis is unknown. Here, we investigated the anti-angiogenic activity of isolinderalactone and its mechanisms. In a human GBM xenograft mouse model, isolinderalactone significantly reduced tumor growth and vessels. Isolinderalactone decreased the expression of vascular endothelial growth factor (VEGF) mRNA, protein, and VEGF secretion in hypoxic U-87 GBM cells and also in xenograft GMB tissue. In addition, we demonstrated that isolinderalactone significantly inhibited the proliferation, migration, and capillary-like tube formation of human brain microvascular endothelial cells (HBMECs) in the presence of VEGF. We also found that isolinderalactone decreased sprout diameter and length in a 3D microfluidic chip, and strongly reduced VEGF-triggered angiogenesis in vivo Matrigel plug assay. Isolinderalactone downregulated hypoxia-inducible factor-1α (HIF-1α) and HIF-2α proteins, decreased luciferase activity driven by the VEGF promoter in U-87 cells under hypoxic conditions, and suppressed VEGF-driven phosphorylation of VEGFR2 in HBMECs. Taken together, our results suggest that isolinderalactone is a promising candidate for GBM treatment through tumor angiogenesis inhibition. BACKGROUND & AIMS There is debate over the type of electrosurgical setting that should be used for polyp resection. Some endoscopists use a type of blended current (yellow) whereas others prefer coagulation (blue). We performed a single-blind, randomized trial to determine whether type of electrosurgical setting affects risk of adverse events or recurrence. METHODS Patients undergoing endoscopic mucosal resection of non-pedunculated colorectal polyps 20 mm or larger (n=928) were randomly assigned, in a 2x2 design, to groups that received clip closure or no clip closure of the resection defect (primary intervention) and then to either a blended current (Endocut Q) or coagulation current (forced coagulation; Erbe Inc.) (secondary intervention and focus of the study). The study was performed at multiple centers, from April 2013 through October 2017. Patients were evaluated 30 days after the procedure (n=919), and 675 patients underwent a surveillance colonoscopy at a median 6 months after the procedure. The primgulation), we found no difference in risk of serious adverse events, complete resection rate, or polyp recurrence. Electrosurgical settings can therefore be selected based on endoscopist expertise and preference. Clinicaltrials.gov no NCT01936948. BACKGROUND Chronic iliocaval obstruction is a challenging clinical entity to treat. Endovenous iliocaval stenting is becoming the treatment of choice for central vein stenosis and occlusion. However, outcomes in thrombotic disease have not been as robust as non-thrombotic disease. In this article we describe our experience utilizing covered stents as a novel tool for chronic total occlusions of the iliocaval veins. METHODS We performed a retrospective review of a prospectively maintained database of all patients undergoing endovenous stenting with a covered stent for chronic occlusive iliocaval disease over a 3 year period at our institution. Patients were followed clinically and with venous duplexes to assess the feasibility, safety, and outcomes of iliocaval endovenous stenting with covered stents. RESULTS A total of 10 patients (8 men and 2 women) underwent iliocaval stenting with covered stents from July 2015 - May 2018. A total of 20 self-expanding covered stents (SECS) and 13 balloon expandable covered promising procedure. Their use may improve the short and long term outcomes in this challenging patient population. Further studies are required to evaluate the long term efficacy and cost of their use. INTRODUCTION Abdominal aortic aneurysm (AAA) is a progressive dilation of the aortic wall, determi