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41 ± 0.89 km/hr in males, and 3.78 ± 0.76 km/hr in females, lower than that achieved at the VT. COP was not correlated with VO2max (56.32 ± 6.36 ml/kg/min and 44.78 ± 3.65 ml/kg/min) nor with VT (34.81 ± 10.13 ml/kg/min and 34.13 ± 5.87 ml/kg/min) in male and female young volleyball players, respectively. CONCLUSIONS The novel submaximal cardiorespiratory index of COP does not seem to be associated with the traditional aerobic capacity indices in athletes such as VO2max and VT. [https://www.selleckchem.com/products/gsk864.html GSK864] Thus, it probably constitutes a separate parameter that needs to be further evaluated regarding its significance both in clinical evaluation and sports performance assessment of athletes. HIPPOKRATIA 2019, 23(2) 70-74. Copyright 2019, Hippokratio General Hospital of Thessaloniki.BACKGROUND Autophagy is an inducible intracellular process that has been studied mostly in cancer and less in inflammatory diseases. To establish the relation between cholecystitis (calculous and acalculous) and autophagy, we studied the expressions of immunohistochemical markers Beclin-1, LC3A, and Ki-67 in gallbladder epithelium and their significance in the induction of autophagy. METHODS Adult human gallbladder tissues were obtained from 100 patients (45 male, 55 female) who underwent cholecystectomy. According to the findings, the patients were divided into two groups group A (calculous gallbladder 24 male, 46 female; mean age 52.6 ± 16.0 years) and group B (acalculous gallbladder 21 male, nine female; mean age 65.3 ± 12.4 years). The expressions of immunohistochemical markers Beclin-1, LC3A, and Ki-67 in gallbladder epithelium were studied using immunohistochemistry techniques. RESULTS Beclin-1 expression was correlated with LC3A expression in group A with increased Beclin-1 expression promoting LC3A expression (p =0.0001). In group B, the LC3A expression did not follow Beclin-1 expression (p =0.09). The mean percentage of Beclin-1 expression in group A patients was 23.8 % compared to group B patients, where the corresponding percentage was only 17.3 %. Corresponding mean percent expressions of LC3A in groups A and B were 38.9 % and 50.7 %, respectively. The expression of Ki-67 was higher in group A patients compared to group B patients. The mean percentage of Ki-67 expression in group A patients was 3.75 %, whereas, in group B patients, it was only 0.5 % (statistically significantly different; p =0.0003). CONCLUSION In the epithelium of calculous cholecystitis, overexpression of LC3A is related to Beclin-1 overexpression, which reinforces the view that Beclin-1 promotes autophagy in stone cholecystitis. HIPPOKRATIA 2019, 23(2) 64-69. Copyright 2019, Hippokratio General Hospital of Thessaloniki.BACKGROUND Intramedullary nailing is the "gold standard" treatment modality of diaphyseal fractures of the tibia. However, when the same method is used for extra-articular fractures of the proximal tibia, various problems may occur, like malalignment, loss of reduction, and non-union. The objective of the present biomechanical study was to compare the stability of six tibial nails when these are used for the treatment of unstable, extra-articular, proximal tibial fractures. METHODS Thirty composite tibia models were divided into six groups, and a corresponding number of nails from six manufacturers (Citieffe, Braun Aesculap, Orthoselect, Orthofix, Stryker, and Depuy Synthes) was implanted in each group. The maximum number of proximal screws was used for each specimen, and a proximal gap osteotomy was performed. Each bone model was then submitted in dynamic, followed by static loading, and the passive construct stiffness was calculated, representing the specimen's rigidity. Furthermore, for each specimen, the force needed to cause a displacement of more than one millimeter at the fracture site was calculated. RESULTS Stiffness values of a solid nail with two proximal screws and a cannulated nail with five screws were significantly higher compared to all other groups. On the other hand, a titanium cannulated nail with three screws showed the lowest rigidity. CONCLUSION Solid nails provide more rigidity compared to cannulated ones, and the maximum number of proximal screws in all possible directions should be used in order to achieve maximum stability. HIPPOKRATIA 2019, 23(2) 58-63. Copyright 2019, Hippokratio General Hospital of Thessaloniki.BACKGROUND Arthroscopic meniscus surgery can lead to pain at various levels. In this study, we aimed to compare, in patients undergoing arthroscopic meniscectomy under spinal anesthesia, the efficacy of the combination of magnesium sulfate and dexmedetomidine with local anesthetics administered intraarticularly for postoperative pain management Methods This prospective, randomized, controlled, double-blind study comprised of 52 patients who were randomly assigned into two groups depending on the combination injected intraarticularly at the end of the procedure bupivacaine and dexmedetomidine (group D) or bupivacaine and magnesium sulfate (group M). Perioperative data, postoperative visual analog scale (VAS) scores, and total analgesic consumption were recorded. CLINICAL TRIAL REGISTRATION NCT03479216 Results No statistically significant differences were found in mobilization times, rescue analgesic times, and non-steroidal anti-inflammatory consumption. The maximum mean VAS values at rest and during movement in group D were measured at the 6th hour while in group M peaked at the 8th hour. CONCLUSION Both intraarticular dexmedetomidine and magnesium sulfate, in combination with bupivacaine, have similar effects on reducing postoperative pain in arthroscopic knee surgery. HIPPOKRATIA 2019, 23(2) 51-57. Copyright 2019, Hippokratio General Hospital of Thessaloniki.Background The development of devices that can be used to tract organs or other structures and secure an appropriate surgical field during laparoscopic surgery is clinically important. Methods We developed a novel traction stitch, the Laptraction, which can be used to achieve peritoneal traction during laparoscopic surgery. This study examines the utility and safety of using the Laptraction to achieve peritoneal traction during laparoscopic transperitoneal paraaortic lymphadenectomy (as part of comprehensive staging surgery) in seven endometrial cancer patients. Results Peritoneal traction was successfully and safely achieved using the Laptraction in all cases, without causing any complications. In all cases, time to deploy Laptraction was less then 5 min. Conclusions Laptraction, a newly developed stitch, allows peritoneal traction to be achieved easily and facilitates the identification of essential landmarks during robotic-assisted laparoscopic hysterectomy, which helps to save time and prevent surgical complications.