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Journal of Vascular Surgery Cases and... Dec 2023We present a case of medication-induced priapism that was refractory to conventional urologic methods and required treatment with a caverno-saphenous bypass. The patient...
We present a case of medication-induced priapism that was refractory to conventional urologic methods and required treatment with a caverno-saphenous bypass. The patient had been misusing an injectable erectile dysfunction medication consisting of alprostadil, papaverine, and phentolamine (Trimix), resulting in multiple episodes of priapism. His initial episodes of priapism were successfully treated with the traditional urologic algorithm, including phenylephrine, aspiration, and distal shunting. However, due to his continued medication misuse, these became ineffective, requiring proximal shunt surgery. Priapism requiring an extra-anatomic bypass is exceedingly rare. Following our proximal shunt surgery, he maintained partial sexual function, and his bypass remained patent.
PubMed: 38106342
DOI: 10.1016/j.jvscit.2023.101359 -
Deutsches Arzteblatt International Nov 2023
Topics: Humans; Cause of Death; Alprostadil; International Classification of Diseases; Death Certificates
PubMed: 38099602
DOI: 10.3238/arztebl.m2023.0190 -
Scientific Reports Dec 2023Rapid and precise intraoperative diagnosing systems are required for improving surgical outcomes and patient prognosis. Because of the poor quality and time-intensive...
Deep UV-excited fluorescence microscopy installed with CycleGAN-assisted image translation enhances precise detection of lymph node metastasis towards rapid intraoperative diagnosis.
Rapid and precise intraoperative diagnosing systems are required for improving surgical outcomes and patient prognosis. Because of the poor quality and time-intensive process of the prevalent frozen section procedure, various intraoperative diagnostic imaging systems have been explored. Microscopy with ultraviolet surface excitation (MUSE) is an inexpensive, maintenance-free, and rapid imaging technique that yields images like thin-sectioned samples without sectioning. However, pathologists find it nearly impossible to assign diagnostic labels to MUSE images of unfixed specimens; thus, AI for intraoperative diagnosis cannot be trained in a supervised learning manner. In this study, we propose a deep-learning pipeline model for lymph node metastasis detection, in which CycleGAN translate MUSE images of unfixed lymph nodes to formalin-fixed paraffin-embedded (FFPE) sample, and diagnostic prediction is performed using deep convolutional neural network trained on FFPE sample images. Our pipeline yielded an average accuracy of 84.6% when using each of the three deep convolutional neural networks, which is a 18.3% increase over the classification-only model without CycleGAN. The modality translation to FFPE sample images using CycleGAN can be applied to various intraoperative diagnostic imaging systems and eliminate the difficulty for pathologists in labeling new modality images in clinical sites. We anticipate our pipeline to be a starting point for accurate rapid intraoperative diagnostic systems for new imaging modalities, leading to healthcare quality improvement.
Topics: Humans; Lymphatic Metastasis; Alprostadil; Neural Networks, Computer; Microscopy, Fluorescence
PubMed: 38049475
DOI: 10.1038/s41598-023-48319-7 -
Skin Research and Technology : Official... Nov 2023To observe the morphological characteristics of clusters of Muse cells from normal human dermal fibroblasts (NHDFs) under different culture conditions.
OBJECTIVE
To observe the morphological characteristics of clusters of Muse cells from normal human dermal fibroblasts (NHDFs) under different culture conditions.
METHODS
Muse cells were sorted by magnetic activated cell sorting (MACS) from NHDFs, and were evaluated by flow cytometry. Muse cells were cultured in suspension and in adherent conditions to obtain Muse cell clusters (M-clusters), which were further characterized by alkaline phosphatase (AP) staining, immunofluorescence (IF) staining and transmission electron microscopy (TEM). The M-clusters were further cultured on Lando artificial dermal regeneration matrix (LADRM) for analysis by scanning electron microscopy (SEM) and IF staining of frozen sections.
RESULTS
The proportion of SSEA3 and CD105 double-positive cells obtained by MACS was 87.4%. The sorted cells rapidly formed M-clusters after suspension culture, and showed internal characteristics of stem cells under TEM. After adherent culture, M-clusters stained positively for AP, SSEA-3 and OCT-4. Each M-cluster on the surface of the LADRM displayed an outer membrane of amorphous materials under SEM. Frozen sections and fluorescence staining of LADRM loaded with M-clusters showed an uneven fluorescence intensity of SSEA-3 within the clusters.
CONCLUSIONS
Muse cells sorted by MACS from NHDFs could generate M-clusters, which included cells of different stemness and are wrapped in membrane-like structures.
Topics: Humans; Cell Differentiation; Cells, Cultured; Alprostadil; Fibroblasts; Skin
PubMed: 38009041
DOI: 10.1111/srt.13528 -
Frontiers in Bioscience (Landmark... Oct 2023Ischemic stroke is one of the major causes of death and disability. Since the currently used treatment option of reperfusion therapy has several limitations, ongoing... (Review)
Review
Ischemic stroke is one of the major causes of death and disability. Since the currently used treatment option of reperfusion therapy has several limitations, ongoing research is focusing on the neuroprotective effects of microglia and stem cells. By exerting the bystander effect, secreting exosomes and forming biobridges, mesenchymal stem cells (MSCs), neural stem cells (NSCs), induced pluripotent stem cells (iPSCs), and multilineage-differentiating stress-enduring cells (Muse cells) have been shown to stimulate neurogenesis, angiogenesis, cell migration, and reduce neuroinflammation. Exosome-based therapy is now being extensively researched due to its many advantageous properties over cell therapy, such as lower immunogenicity, no risk of blood vessel occlusion, and ease of storage and modification. However, although preclinical studies have shown promising therapeutic outcomes, clinical trials have been associated with several translational challenges. This review explores the therapeutic effects of preconditioned microglia as well as various factors secreted in stem cell-derived extracellular vesicles with their mechanisms of action explained. Furthermore, an overview of preclinical and clinical studies is presented, explaining the main challenges of microglia and stem cell therapies, and providing potential solutions. In particular, a highlight is the use of novel stem cell therapy of Muse cells, which bypasses many of the conventional stem cell limitations. The paper concludes with suggestions for directions in future neuroprotective research.
Topics: Humans; Microglia; Ischemic Stroke; Stroke; Alprostadil; Mesenchymal Stem Cells
PubMed: 37919085
DOI: 10.31083/j.fbl2810269 -
International Journal of Molecular... Sep 2023Multilineage-differentiating stress-enduring (Muse) cells are newly established pluripotent stem cells. The aim of the present study was to examine the potential of the...
Multilineage-differentiating stress-enduring (Muse) cells are newly established pluripotent stem cells. The aim of the present study was to examine the potential of the systemic administration of Muse cells as an effective treatment for subacute SCI. We intravenously administered the clinical product "CL2020" containing Muse cells to a rat model two weeks after mid-thoracic spinal cord contusion. Eight experimental animals received CL2020, and twelve received the vehicle. Behavioral analyses were conducted over 20 weeks. Histological evaluations were performed. After 20 weeks of observation, diphtheria toxin was administered to three CL2020-treated animals to selectively ablate human cell functions. Hindlimb motor functions significantly improved from 6 to 20 weeks after the administration of CL2020. The cystic cavity was smaller in the CL2020 group. Furthermore, larger numbers of descending 5-HT fibers were preserved in the distal spinal cord. Muse cells in CL2020 were considered to have differentiated into neuronal and neural cells in the injured spinal cord. Neuronal and neural cells were identified in the gray and white matter, respectively. Importantly, these effects were reversed by the selective ablation of human cells by diphtheria toxin. Intravenously administered Muse cells facilitated the therapeutic potential of CL2020 for severe subacute spinal cord injury.
Topics: Rats; Humans; Animals; Alprostadil; Diphtheria Toxin; Spinal Cord Injuries; Cell Differentiation; Spinal Cord; Administration, Intravenous
PubMed: 37834052
DOI: 10.3390/ijms241914603 -
Medicine Oct 2023It is rare for newly diagnosed (de novo) or newly treated acute myeloid leukemia (AML) complicated with thrombotic complications, especially combined arterial and venous...
BACKGROUND
It is rare for newly diagnosed (de novo) or newly treated acute myeloid leukemia (AML) complicated with thrombotic complications, especially combined arterial and venous thrombosis.
METHODS
We reported a 13-year-old boy diagnosed with AML and leukocytosis, who developed right femoral vein and right dorsal artery thrombosis during chemotherapy. After treatment with low molecular weight heparin, diosmin, and alprostadil, symptoms were relieved. Unfortunately, the child suffered from coagulopathy afterward, which was unexpectedly caused by vitamin K deficiency.
RESULTS
After supplementation with vitamin K and prothrombin complex concentrate, coagulation function recovered.
CONCLUSION
For childhood AML patients with high thrombotic risks, close monitoring during anticoagulant treatment was necessary. Concomitantly, we should be alert to past medication history and combined medication use, especially those that may lead to vitamin K deficiency, secondary bleeding, and coagulation disorders. Rational use of antibiotics, anticoagulants, and antitumor drugs must be guaranteed.
Topics: Male; Humans; Child; Adolescent; Femoral Vein; Anticoagulants; Thrombosis; Blood Coagulation Disorders; Leukemia, Myeloid, Acute; Vitamin K Deficiency; Arteries
PubMed: 37832057
DOI: 10.1097/MD.0000000000035121 -
Academic Radiology Mar 2024This study aimed to investigate the value of multiplexed sensitivity encoding with reversed polarity gradients in improving the quality of diffusion-weighted imaging...
Improved Value of Multiplexed Sensitivity Encoding DWI with Reversed Polarity Gradients in Diagnosing Prostate Cancer: A Comparison Study with Single-Shot DWI and MUSE DWI.
RATIONALE AND OBJECTIVES
This study aimed to investigate the value of multiplexed sensitivity encoding with reversed polarity gradients in improving the quality of diffusion-weighted imaging (DWI) images of the prostate and the diagnostic efficacy of prostate cancer.
MATERIALS AND METHODS
Seventy-three patients with prostate disease underwent multiplexed sensitivity encoding with reversed polarity gradients (RPG-MUSE), multiplexed sensitivity encoding (MUSE), and single-shot echo-planar imaging (ssEPI) DWI. Three radiologists performed a qualitative image analysis of the three DWI sequences. Qualitative image analysis included artifact minimization, anatomical detail, and sharpness of prostate edges. Two radiologists measured the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), geometric distortion rate, and the apparent diffusion coefficient (ADC) values of the prostate disease tissue. Two radiologists jointly performed Prostate Imaging Reporting and Data System scoring of prostate lesions and compared the diagnostic efficacy of the three DWI sequences for prostate cancer.
RESULTS
There was good agreement among radiologists in the evaluation and measurement of the three DWI sequence images (intraclass correlation coefficient >0.75, P < 0.05). The RPG-MUSE DWI images were rated higher than those of MUSE and ssEPI in terms of artifact minimization, anatomical details, and sharpness of prostate edges (P < 0.05). The SNR and CNR of the RPG-MUSE DWI images were higher than those of MUSE and ssEPI (P < 0.05), and the geometric distortion rate was lower than that of the other two sequences (P < 0.05). There were no statistical differences in ADC values between the three DWI sequences (P > 0.05). The diagnostic efficacy of RPG-MUSE and MUSE DWI was higher than that of ssEPI (P < 0.017).
CONCLUSION
RPG-MUSE can reduce the artifacts and geometric distortion in DWI images of the prostate, improve the SNR and CNR of the images, improve the clarity of anatomical details and boundaries without affecting the measurement of ADC values, has the potential to improve the diagnostic efficacy of prostate lesions, and facilitates the clear display and accurate assessment of prostate lesions.
Topics: Male; Humans; Alprostadil; Diffusion Magnetic Resonance Imaging; Prostatic Neoplasms; Prostate; Echo-Planar Imaging; Reproducibility of Results
PubMed: 37778902
DOI: 10.1016/j.acra.2023.08.027 -
Journal of Personalized Medicine Sep 2023Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that... (Review)
Review
Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.
PubMed: 37763138
DOI: 10.3390/jpm13091370 -
Scientific Reports Sep 2023Colonoscopy is considered the standard procedure for early detection and prevention of colorectal cancer. Adequate bowel cleansing is an important determinant of the... (Randomized Controlled Trial)
Randomized Controlled Trial
Colonoscopy is considered the standard procedure for early detection and prevention of colorectal cancer. Adequate bowel cleansing is an important determinant of the efficacy of colonoscopy screening. Currently, there is no standard method of bowel preparation for patients with chronic constipation. The aim was to access the rate of adequate bowel cleansing achieved using split-dose polyethylene glycol electrolyte lavage solution (PEG-ELS) plus lubiprostone in comparison with split-dose PEG-ELS alone. A single-centre, endoscopist-blinded, randomized controlled trial was conducted. Seventy-eight constipated patients aged 18-75 years who were indicated for colonoscopy in the gastroenterology unit of Srinagarind Hospital, Khon Kaen University, between February 2020 and February 2021 were randomly allocated to receive either split-dose PEG-ELS in combination with lubiprostone (N = 39) or split-dose PEG-ELS alone (N = 39) before colonoscopy. Adequate bowel cleansing was defined as an Ottawa bowel preparation score ≤ 7. The rate of adequate bowel cleansing was comparable between the PEG-ELS plus lubiprostone group and the PEG-ELS alone group (50% vs. 52.9%, p value = 0.81) with a relative risk of 1.13 (95% CI = 0.43-2.91). There were no significant differences in adenoma detection rate (41.2% vs. 35.3%, p value = 0.62), adverse events, acceptance, compliance, or patient satisfaction between the 2 groups. No additional benefit to successful bowel preparation was achieved by the combination of lubiprostone and PEG-ELS in chronic constipation patients undergoing colonoscopy.
Topics: Humans; Lubiprostone; Polyethylene Glycols; Therapeutic Irrigation; Thailand; Constipation; Colonoscopy; Electrolytes
PubMed: 37759079
DOI: 10.1038/s41598-023-43598-6