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Annals of Diagnostic Pathology Jun 2024Upper tract urothelial carcinoma (UTUC) is a relatively rare yet aggressive malignancy. While radical nephroureterectomy (RNU) remains the cornerstone treatment, UTUC...
Clinicopathological risk factors associated with tumor relapse of upper tract urothelial carcinoma after radical nephroureterectomy: A single institution 20-year experience.
Upper tract urothelial carcinoma (UTUC) is a relatively rare yet aggressive malignancy. While radical nephroureterectomy (RNU) remains the cornerstone treatment, UTUC has high local and metastatic relapse rates, leading to a dismal prognosis. To identify the clinicopathological factors associated with an increased risk of local and metastatic relapse in UTUC, we conducted a retrospective analysis of 133 consecutive UTUC patients who underwent RNU from 1998 to 2018. Patients lost to follow-up or with a history of bladder cancer were excluded from the study. The remaining 87 patients were categorized into two subgroups: those with tumor recurrence/relapse (40 cases) and those without recurrence/relapse (47 cases). Clinical and pathological characteristics were compared across the two groups. Multiple factors are associated with UTUC recurrence/relapse including larger tumor size, histology divergent differentiations/subtypes, high tumor grade, advanced pathologic T stage, positive margin, lymphovascular invasion (LVI), positive lymph node status, and preoperative hydronephrosis. Multivariate Cox regression analysis revealed that squamous differentiation predicted recurrence/relapse (p = 0.012), independent of tumor stage. Moreover, compared to the conventional histology type, UTUC with squamous differentiation had a significantly higher relapse rate (p = 0.0001) and poorer survival (p = 0.0039). This observation was further validated in invasive high-grade UTUC cases. Our findings suggest that many pathological factors contribute to UTUC recurrence/relapse, particularly, squamous differentiation may serve as an independent risk predictor for relapse and a potent prognosticator for adverse cancer-specific survival in UTUC patients. Recognizing and thoroughly assessing the pathological factors is essential for better oncologic management of UTUC.
PubMed: 38941945
DOI: 10.1016/j.anndiagpath.2024.152357 -
Biomedicine & Pharmacotherapy =... Jun 2024This study investigated the chemical constituents, antioxidant potential, and in vitro and in silico antidiabetic activity of Gymnema sylvestre. Column chromatography...
This study investigated the chemical constituents, antioxidant potential, and in vitro and in silico antidiabetic activity of Gymnema sylvestre. Column chromatography and spectroscopic techniques identified twelve compounds from the methanol extract, including 4 sterols (1-4), 5 triterpenoids (5-9), and 3 flavonoids (10-12). The chemophenetic significance of all compounds was also investigated. The antioxidant capacity of the extract and compounds (1-4) was evaluated using FRAP and DPPH assays. The extract exhibited strong free radical scavenging activity (IC = 48.34 µg/mL), while compounds (1-4) displayed varying degrees of efficacy (IC = 98.30-286.13 µg/mL). The FRAP assay indicated significant reducing power for both extract and compounds (58.54, 47.61, 56.61, and 49.11 mg Eq.VitC/g for extract and compounds 1 & 2, 3, and 4, respectively). The antidiabetic potential was assessed through α-amylase and α-glucosidase enzyme inhibition assays. The crude extract demonstrated the most potent inhibition (IC = 218.46 and 57.42 µg/mL for α-glucosidase and α-amylase respectively) suggesting its potential for managing postprandial hyperglycaemia. In silico studies employed molecular docking and dynamics simulations to elucidate the interactions between identified compounds and α-amylase/α-glucosidase enzymes. The results revealed promising binding affinities between the compounds and target enzymes, with compound 6 demonstrating the highest predicted inhibitory activity with -10 kcal/mol and -9.1 kcal/mol for α-amylase and α-glucosidase, respectively. This study highlights the presence of diverse bioactive compounds in Gymnema sylvestre. The extract exhibits antioxidant properties and inhibits carbohydrate-digesting enzymes, suggesting its potential as a complementary therapeutic approach for managing hyperglycaemia associated with type 2 diabetes.
PubMed: 38941896
DOI: 10.1016/j.biopha.2024.117043 -
Biochemical and Biophysical Research... Jun 2024Neonates undergo numerous painful procedures throughout their hospitalization. Repeated procedural pain may cause adverse long-term effects. Glucose as a...
BACKGROUND
Neonates undergo numerous painful procedures throughout their hospitalization. Repeated procedural pain may cause adverse long-term effects. Glucose as a non-pharmacological analgesia, is used for neonate pain management. In this study, potential mechanism of attenuate pain induced by glucose in neurodevelopment effect of neonate pain stimulus was investigated.
METHODS
Neonatal rats to perform a repetitive injury model and glucose intervention model in the postnatal day 0-7(P0-7). Pain thresholds were measured by von Frey test weekly. The puberty behavioral outcome, tissue loss and protein expression in hippocampus were analyzed.
RESULTS
Oral administration of glucose after repeated pain stimulation can maintain the hippocampal structure in, and reduce the expressions of corticotropin releasing factor (CFR) and glucocorticoid receptor (GR), therefore, resulted in long-term threshold of pain and cognitive improvement.
CONCLUSION
Exposure to neonatal repeated procedural pain causes persistent mechanical hypersensitivity and the dysfunction of spatial memory retention at puberty. In addition, glucose can relieve these adverse effects, possibly via decreasing CRF/GR levels to change the hypothalamus-pituitary-adrenal (HPA) axis.
PubMed: 38941883
DOI: 10.1016/j.bbrc.2024.150219 -
Seizure Jun 2024Refractory (RSE) and super-refractory status epilepticus (SRSE) are serious medical emergencies whose long-term outcomes depend on the timeliness of their management....
PURPOSE
Refractory (RSE) and super-refractory status epilepticus (SRSE) are serious medical emergencies whose long-term outcomes depend on the timeliness of their management. Population-based clinical and epidemiological data on these conditions are sparse. We aimed to provide a detailed description of the epidemiology and clinical course of RSE and SRSE in children and adolescents and identify potential prognostic biomarkers.
METHODS
In this retrospective population-based study, patients aged one month to 18 years who fulfilled the RSE/SRSE diagnostic criteria and were admitted to the intensive care unit of Haukeland University Hospital from 2012 to 2021 were considered eligible. Detailed clinical and laboratory findings along with information on management and outcomes were systematically analyzed.
RESULTS
Forty-three patients with 52 episodes of RSE/SRSE were identified. The incidence rate was 3.13 per 100,000 per year. The median time from SE onset to the administration of the first rescue drug was 13 min, and from the first rescue drug to second- and third-line treatments, 83 and 66 min, respectively. All patients were alive at discharge.
CONCLUSION
Delays in treatment were observed in various stages of the clinical course of RSE/SRSE. Improvement measures targeting the prompt administration of recuse mediation and subsequent treatment escalation are needed.
PubMed: 38941802
DOI: 10.1016/j.seizure.2024.06.023 -
Poultry Science Jun 2024Newcastle disease virus, a member of the Paramyxoviridae family, causes significant economic losses in poultry worldwide. To identify novel antiviral agents against NDV,...
Newcastle disease virus, a member of the Paramyxoviridae family, causes significant economic losses in poultry worldwide. To identify novel antiviral agents against NDV, 36 canthin-6-one analogs were evaluated in this study. Our data showed that 8 compounds exhibited excellent inhibitory effects on NDV replication with IC values in the range of 5.26 to 11.76 μM. Besides, these analogs inhibited multiple NDV strains with IC values within 12 μM and exerted antiviral activity against peste des petits ruminants virus (PPRV) and canine distemper virus (CDV). Among these analogs, 16 presented the strongest anti-NDV activity (IC = 5.26 μM) and minimum cytotoxicity (CC > 200 μM) in DF-1 cells. Furthermore, 16 displayed antiviral activity in different cell lines. Our results showed that 16 did not affect the viral adsorption while it can inhibit the entry of NDV by suppressing the Akt pathway. Further study found that 16-treatment inhibited the NDV-activated ERK pathway, thereby promoting the expression of interferon-related genes. Our findings reveal an antiviral mechanism of canthin-6-one analogs through inhibition of the Akt and ERK signaling pathways. These results point to the potential value of canthin-6-one analogs to serve as candidate antiviral agents for NDV.
PubMed: 38941786
DOI: 10.1016/j.psj.2024.103944 -
Biomaterials Advances Jun 2024Additive manufacturing (AM) of Ti-based biomedical implants is a pivotal research topic because of its ability to produce implants with complicated geometries. Despite...
A novel titanium alloy for load-bearing biomedical implants: Evaluating the antibacterial and biocompatibility of Ti536 produced via electron beam powder bed fusion additive manufacturing process.
Additive manufacturing (AM) of Ti-based biomedical implants is a pivotal research topic because of its ability to produce implants with complicated geometries. Despite desirable mechanical properties and biocompatibility of Ti alloys, one major drawback is their lack of inherent antibacterial properties, increasing the risk of postoperative infections. Hence, this research focuses on the Ti536 (Ti5Al3V6Cu) alloy, developed through Electron Beam Powder Bed Fusion (EB-PBF), exploring bio-corrosion, antibacterial features, and cell biocompatibility. The microstructural characterization revealed grain refinement and the formation of TiCu precipitates with different morphologies and sizes in the Ti matrix. Electrochemical tests showed that Cu content minimally influenced the corrosion current density, while it slightly affected the stability, defect density, and chemical composition of the passive film. According to the findings, the Ti536 alloy demonstrated enhanced antibacterial properties without compromising its cell biocompatibility and corrosion behavior, thanks to TiCu precipitates. This can be attributed to both the release of Cu ions and the TiCu precipitates. The current study suggests that the EB-PBF fabricated Ti536 sample is well-suited for use in load-bearing applications within the medical industry. This research also offers an alloy design roadmap for novel biomedical Ti-based alloys with superior biological performance using AM methods.
PubMed: 38941776
DOI: 10.1016/j.bioadv.2024.213928 -
Healthcare (Amsterdam, Netherlands) Jun 2024
PubMed: 38941775
DOI: 10.1016/j.hjdsi.2024.100747 -
Respiratory Investigation Jun 2024Gastroesophageal reflux disease (GERD) is one of the most common comorbidities of chronic obstructive pulmonary disease (COPD). Decreased lower and upper esophageal... (Review)
Review
Gastroesophageal reflux disease (GERD) is one of the most common comorbidities of chronic obstructive pulmonary disease (COPD). Decreased lower and upper esophageal sphincter pressures, esophageal dysmotility, high transdiaphragmatic pressure, and decreased saliva secretion have been implicated as mechanisms leading to the development of GERD in COPD. Clinically, comorbid GERD in COPD is reportedly associated with worse symptoms, quality of life, and lung function, as well as a high risk of exacerbations. Aspiration of regurgitation and the cholinergic-mediated esophagobronchial reflex play a significant role in the pathophysiology. Abnormal swallowing reflexes and discoordination of swallowing can worsen aspiration. The diagnosis of GERD is not based on a single criterion; however, various approaches, including questionnaires and endoscopic evaluations, can be widely applied in clinical settings. Due to the increased risk of esophageal and gastric cancers in patients with COPD, the threshold for endoscopic examination should be low. Acid inhibitory agents, such as proton pump inhibitors and histamine H2 receptor antagonists, and prokinetic agents, including mosapride and itopride, are clinically used to treat GERD. Endoscopic fundoplication can be performed in patients with GERD refractory to medical treatment. There is still insufficient evidence, but an increasing number of studies have suggested the clinical efficacy of treatment in patients with COPD and GERD. As GERD is an evaluative and treatable common disease, and access to evaluation and treatment is relatively easy, clinicians should provide adequate care for GERD in the management of COPD.
PubMed: 38941760
DOI: 10.1016/j.resinv.2024.06.004 -
International Journal of Surgery Case... Jun 2024Adamantinomas are rare, low-grade, malignant skeletal tumors accounting for only 0.33-0.48 % of primary malignant bone tumors.
INTRODUCTION AND IMPORTANCE
Adamantinomas are rare, low-grade, malignant skeletal tumors accounting for only 0.33-0.48 % of primary malignant bone tumors.
CASE PRESENTATION
An 11-year-old boy with adamantinoma of the ulna was treated with en bloc resection, kryptonite bone cement, and plate fixation. The surgery resulted in marked pain relief and good functional recovery. No evidence of recurrence was observed for 5 years postoperatively, and the Musculoskeletal Tumor Society score was 93.
CLINICAL DISCUSSION
This case of an 11-year-old previously treated for an aneurysmal bone cyst (ABC) illustrates the complexity of diagnosing adamantinoma, especially in atypical locations like the ulna. The successful use of en bloc resection and synthetic bone graft highlights the importance of accurate diagnosis and advanced surgical methods in achieving favorable outcomes in pediatric orthopedic oncology.
CONCLUSION
Ulnar adamantinomas are rare and can be difficult to diagnose. The successful treatment of this tumor, as described in this case report, can help guide the management of similar cases in the future.
PubMed: 38941733
DOI: 10.1016/j.ijscr.2024.109935 -
International Journal of Surgery Case... Jun 2024Iliac artery aneurysms are rare, with isolated iliac artery aneurysms responsible for only 2 % of all aneurysmal diseases. External iliac artery (EIA) aneurysms are...
INTRODUCTION
Iliac artery aneurysms are rare, with isolated iliac artery aneurysms responsible for only 2 % of all aneurysmal diseases. External iliac artery (EIA) aneurysms are extremely rare, and the exact cause is unknown. In this case, we report a giant aneurysm without any risk factor presented with rupture and managed by open repair.
PRESENTATION OF CASE
An 85-year-old man presented to the emergency department with sudden onset right lower quadrant abdominal pain and vague right lower limb pain. After a complete physical examination, an abdominopelvic CT scan revealed an 80 mm EIA aneurysm containing thrombosis and active leakage. The patient underwent open repair of an aneurysm using a graft between the Aorta and EIA. The surgery was uneventful. Later in the ICU, the patient experienced a cardiac arrest and unfortunately could not recover from it.
DISCUSSION
In this case, a patient with a relatively large aneurysm presented with abdominal pain and lower limb discomfort. Although endovascular surgery is recommended for the repair of iliac aneurysms, open repair is common for ruptured aneurysms. Endovascular repair is less invasive but may lead to contrast-induced renal dysfunction. Open repair may induce complications such as sexual dysfunctions, graft infection, and pelvic ischemic conditions.
CONCLUSION
EIA aneurysms are exceedingly rare. They may present with a Rupture that puts the patient in critical condition, such as in this case. Due to the hemodynamic instability, open repair is considered one of the main approaches for repairing the aneurysm.
PubMed: 38941729
DOI: 10.1016/j.ijscr.2024.109964