Circulating nucleic acids (CNAs) are under investigation as a liquid biopsy in cancer as potential non-invasive biomarkers, as stable structure in circulation nucleosomes could be valuable sources for detection of cancer-specific alterations in histone modifications. Our interest is in histone methylation marks with a focus on colorectal cancer, one of the leading cancers respective the incidence and mortality. Our previous work included the analysis of trimethylations of lysine 9 on histone 3 (H3K9me3) and of lysine 20 on histone 4 (H4K20me3) by chromatin immuno- precipitation-related PCR in circulating nucleosomes. Here we asked whether global immunologic measurement of histone marks in circulation could be a suitable approach to show their potential as biomarkers. In addition to H3K9me3 and H4K20me3 we also measured H3K27me3 in plasma samples from CRC patients (n = 63) and cancer free individuals (n = 40) by ELISA-based methylation assays. Our results show that of three marks, the amounts of H3K27me3 (p = 0.04) and H4K20me3 (p < 0.001) were significantly lower in CRC patients than in healthy controls. For H3K9me3 similar amounts were measured in both groups. Areas under the curve (AUC) in receiver operating characteristic (ROC) curves indicating the power of CRC detection were 0.620 for H3K27me3, 0.715 for H4K20me3 and 0.769 for the combination of both markers. In conclusion, findings of this preliminary study reveal the potential of blood-based detection of CRC by quantification of histone methylation marks and the additive effect of the marker combination.

Background: The radial artery (RA) is widely used as a conduit in coronary artery bypass grafting. Its fascial layer provides mechanical stability but may reduce graft flexibility and promote kinking when routed over the margo acutus during right coronary artery bypass. This study investigated the impact of graft fascial orientation on RA patency and clinical outcomes. Methods: In this retrospective observational cohort study with prospective follow-up, 100 patients undergoing CABG with the RA grafted to the right coronary artery were included. Patients were assigned to a “prone” group (n = 50), with the fascial side oriented toward the sternum, or a “supine” group (n = 50), with the fascia facing the epicardium. Clinical follow-up was performed after a mean of 4.25 years. MDCT-based graft patency assessment was available in 89 patients. Results: Overall survival at follow-up was 100%, with no postoperative myocardial infarctions or reoperations. Overall RA patency was 94%, with patency rates of 91.5% in the supine group and 97.6% in the prone group (p = 0.37). Internal mammary artery and saphenous vein graft patency rates were 92.8% and 96.4%, respectively. Competitive flow showed a near-significant association with RA occlusion (p = 0.09). Conclusions: RA grafts demonstrated excellent mid-term patency. Fascial orientation of the pedicled RA graft was not significantly associated with graft patency.

Background: Extracorporeal membrane oxygenation (ECMO) is a vital intervention for acute respiratory and cardiac failure. This study evaluates the outcomes, safety, and long-term survival of patients stabilized at external hospitals and transferred to a supra-regional center under ECMO support, comparing results with current global standards. Methods: A retrospective analysis was conducted on 20 patients (14 male, 6 female, mean age 50.6 years) transferred to our hospital. The cohort was divided into veno-venous (vv-ECMO, n = 16) and veno-arterial (va-ECMO, n = 4) support. Key metrics included weaning success, complication rates, and long-term survival determined via follow-up with a median follow-up of 23 months. Results: Inter-hospital transfer was highly safe; 0% mortality occurred during transport despite a mean distance of 28.7 km (max. 54 km). In the mixed cohort, weaning was successful in 60% of cases, evaluated via 30-day survival. Major complications occurred in eight patients (40%), including bleeding (n = 6) and compartment syndrome (n = 2). Long-term survival analysis showed that patients who survived the first 30 days had a high probability of continued long-term stability. Conclusions: Remote ECMO cannulation followed by inter-hospital transfer is a safe strategy. While va-ECMO patients face higher mortality due to the underlying severity of cardiac failure, vv-ECMO shows favorable survival rates for ARDS. The specialized “ECMO-retrieval team” model is essential for extending advanced life support to peripheral hospitals.

Acute type-A aortic dissection is a life-threatening emergency requiring prompt surgical intervention. However, the management of patients presenting with concomitant intracerebral haemorrhage remains challenging, as the risk of neurological deterioration during surgery must be balanced against the risk of fatal aortic rupture. We report the rare case of a 68-year-old patient diagnosed with acute intracerebral haemorrhage involving the parietal lobe and right frontal region in association with acute type-A aortic dissection. Due to the neurological condition, a delayed surgical strategy was chosen. Six weeks after the initial diagnosis, supracoronary hemiarch replacement of the ascending aorta was successfully performed without postoperative neurological complications. This case highlights the complexity of decision-making in patients with simultaneous acute aortic pathology and intracranial bleeding. This educational report emphasises that immediate surgical repair remains the standard of care. The delayed strategy described here was dictated by an absolute contraindication to anticoagulation and reflects an exceptional, individualised management approach rather than a general therapeutic recommendation.

Background: Arterial grafts are widely believed to offer superior long-term patency compared with saphenous vein grafts, yet in multisegmental coronary artery disease the diseased runoff bed may attenuate this advantage. In this study, we compared the long-term patency of arterial and venous conduits in patients revascularised for multisegmental coronary artery disease. Methods: We retrospectively analysed 467 bypass grafts (100 arterial internal thoracic artery grafts, 351 saphenous vein grafts and 16 radial artery grafts) in 133 patients with multisegmental coronary artery disease treated by coronary artery bypass grafting, including long anastomoses where required. Graft patency was assessed by multidetector computed tomography or coronary angiography. Patency over time was estimated by the Kaplan–Meier method and compared with the log-rank test. Because imaging was symptom-driven rather than protocol-based, patency estimates apply to the imaged subgroup. Results: Early patency was comparably high for arterial (97%) and venous (96%) conduits. Patency curves diverged progressively: at 12 years, estimated patency was 83% for arterial grafts versus 65% for venous grafts (p < 0.01). Radial artery grafts maintained 87% patency over the available follow-up. Conclusions: These findings suggest that the long-term patency advantage of arterial conduits may be preserved in patients with multisegmental coronary artery disease, including where long anastomoses are required, and warrant confirmation in larger cohorts with systematic imaging follow-up.