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ACS Nano Jun 2023Obesity is a major risk factor for multiple chronic diseases. Anthropometric and imaging approaches are primarily used to assess adiposity, and there is a dearth of...
Obesity is a major risk factor for multiple chronic diseases. Anthropometric and imaging approaches are primarily used to assess adiposity, and there is a dearth of techniques to determine the changes in adipose tissue (AT) at the molecular level. Extracellular vesicles (EVs) have emerged as a novel and less invasive source of biomarkers for various pathologies. Furthermore, the possibility of enriching cell or tissue-specific EVs from the biofluids based on their unique surface markers has led to classifying these vesicles as "liquid biopsies", offering valuable molecular information on hard-to-access tissues. Here, we isolated small EVs from AT (sEV) of lean and diet-induced obese (DIO) mice, identified unique surface proteins on sEV by surface shaving followed by mass spectrometry, and developed a signature of five unique proteins. Using this signature, we pulled out sEV from the blood of mice and validated the specificity of isolated sEV by measuring the expression of adiponectin, 38 adipokines on an array, and several adipose tissue-related miRNAs. Furthermore, we provided evidence of sEV applicability in disease prediction by characterizing sEV from the blood of lean and DIO mice. Interestingly, sEV cargo showed a stronger pro-inflammatory effect on THP1 monocytes compared to sEV and a significant increase in obesity-associated miRNA expression. Equally important, sEV cargo revealed an obesity-associated aberrant amino acid metabolism that was subsequently validated in the corresponding AT. Lastly, we show a significant increase in inflammation-related molecules in sEV isolated from the blood of nondiabetic obese (>30 kg/m) individuals. Overall, the present study offers a less-invasive approach to characterize AT.
Topics: Adipose Tissue; Liquid Biopsy; Extracellular Vesicles; Obesity; Humans; Animals; Mice; Biomarkers
PubMed: 37224410
DOI: 10.1021/acsnano.3c00422 -
Clinical Anatomy (New York, N.Y.) Apr 2024Endometriosis is a common benign gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus. It can be defined as...
Endometriosis is a common benign gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus. It can be defined as endometrioma, superficial peritoneal endometriosis or deep infiltrating endometriosis (DIE) depending on the location and the depth of infiltration of the organs. In 5%-12% of cases, DIE affects the digestive tract, frequently involving the distal part of the sigmoid colon and rectum. Surgery is generally recommended in cases of obstructive symptoms and in cases with pain that is non-responsive to medical treatment. Selection of the most optimal surgical technique for the treatment of bowel endometriosis must consider different variables, including the number of lesions, eventual multifocal lesions, as well as length, width and grade of infiltration into the bowel wall. Except for some major and widely accepted indications regarding bowel resection, established international guidelines are not clear on when to employ a more conservative approach like rectal shaving or discoid resection, and when, instead, to opt for bowel resection. Damage to the pelvic autonomic nervous system may be avoided by detection of the middle rectal artery, where its relationship with female pelvic nerve fibers allows its use as an anatomical landmark. To reduce the risk of potential vascular and nervous complications related to bowel resection, a less invasive approach such as shaving or discoid resection can be considered as potential treatment options. Additionally, the middle rectal artery can be used as a reference point in cases of upper bowel resection, where a trans mesorectal technique should be preferred to prevent devascularization and denervation of the bowel segments not affected by the disease.
Topics: Female; Humans; Rectum; Endometriosis; Laparoscopy; Rectal Diseases; Treatment Outcome
PubMed: 37165994
DOI: 10.1002/ca.24059 -
Skinmed 2023A 22-year-old man without previously known skin disease presented with multiple asymptomatic, skin-brown to red-brown papules on the head and neck for 1 year (Figure 1)....
A 22-year-old man without previously known skin disease presented with multiple asymptomatic, skin-brown to red-brown papules on the head and neck for 1 year (Figure 1). The diagnoses considered included benign intradermal or compound nevi, atypical nevi, and neurofibromas. Shave biopsies of three lesions revealed intradermal melanocytic lesions comprising large epithelioid melanocytes flanked by small banal melanocytes (Figure 2). All nevi had a low proliferation index, absent junctional component as demonstrated by a dual Ki-67/Mart-1 immunostain, and no dermal mitotic figures. Immunostaining demonstrated lesional melanocytes positive for p16, but the larger epithelioid melanocytes in these lesions lacked nuclear expression of ubiquitin carboxyl-terminal hydrolase protein (; Figure 3). The diagnosis of a -inactivated nevus was made, and the patient was referred for genetic counseling and screening for associated malignancies. Given that the lesions involved deep margins, the same were completely excised.
Topics: Humans; Male; Young Adult; Melanocytes; Nevus; Nevus, Epithelioid and Spindle Cell; Nevus, Pigmented; Skin Neoplasms
PubMed: 37158355
DOI: No ID Found -
Journal of Cutaneous Pathology Jan 2024Superficial CD34 fibroblastic tumors (SCD34FT) and PRDM10-rearranged tumors (PRTs) are mesenchymal tumors that have recently received increased scientific attention due...
Superficial CD34 fibroblastic tumors (SCD34FT) and PRDM10-rearranged tumors (PRTs) are mesenchymal tumors that have recently received increased scientific attention due to their irrefutable similarities yet debatable relationship. A 74-year-old male presented to the dermatology clinic with a violaceous, well-defined nodule on the left medial knee of 2-year duration. Shave biopsy demonstrated spindle cells arranged in a vaguely storiform pattern forming fascicles. Immunohistochemical stains were positive for vimentin, CD68, CD10, and CD34 diffusely. ERG, S-100, HMB45, and SOX-10 were negative. Molecular studies identified a mediator complex subunit 12 (MED12)-PR/SET Domain 10 (PRDM10) gene fusion thus favoring confirming the diagnosis of a PRT. Our patient underwent wide local excision with negative margins and had no complications. This case aims to provide context for considering SCD34FT and PRT as intersecting entities and to discuss a diagnostic approach when encountering these tumors.
Topics: Male; Humans; Aged; Soft Tissue Neoplasms; Transcription Factors; Neoplasms, Fibrous Tissue; Antigens, CD34; Biopsy; Biomarkers, Tumor; DNA-Binding Proteins
PubMed: 37150806
DOI: 10.1111/cup.14443 -
European Journal of Obstetrics,... Jun 2023To present a new technique for complete endometrial polypectomy, using the bipolar loop hysteroscope, but without the activation of electrical energy, and follow its...
OBJECTIVE
To present a new technique for complete endometrial polypectomy, using the bipolar loop hysteroscope, but without the activation of electrical energy, and follow its efficiency and safety for the patient.
STUDY DESIGN
This is a prospective descriptive study conducted at a university hospital. Forty four patients were recruited to the study according to an intra uterine polyp diagnosed by transvaginal ultrasound (TVS). Out of them 25 really had an endometrial polyp which was inspected by hysteroscopy. Eighteen were at menopause age and seven in their reproductive age. The hysteroscopic removal of the endometrial polyp was performed using the operative loop resectoscope without using electricity, meaning by cold loop. We called this unique technique SHEPH: Shaving of Endometrial Polyp by Hysteroscopy.
RESULTS
The range age was 21-77 years old. All patients with apparently endometrial polyp, underwent a complete removal of the polyp which could be directly seen through hysteroscopy. No bleeding was seen in all cases. The other nineteen patients had normal uterine cavity, so a biopsy was taken according to the indication. The specimen from all cases were sent to histological evaluation. An endometrial polyp was histologically confirmed in all cases who underwent the SHEPH technique, while fragments of an endometrial polyp was revealed by histology in six cases from the group that had normal uterine cavity. No complications were noted for the short and long periods.
CONCLUSIONS
Nonelectric Shaving of Endometrial Polyp by Hysteroscopy (SHEPH technique) is a safe and effective procedure which allows the surgeon to achieve a complete endometrial polypectomy but without using electrical energy within the body of the patient. The technique which is easy to learn, is new and unique by eliminate thermal damage in a very common gynecologic indication.
Topics: Pregnancy; Humans; Female; Young Adult; Adult; Middle Aged; Aged; Hysteroscopy; Uterine Neoplasms; Endometrium; Prospective Studies; Polyps
PubMed: 37146506
DOI: 10.1016/j.ejogrb.2023.04.018 -
BMJ Case Reports May 2023A woman in her 60s presented with a longstanding history of a purplish, fleshy and pedunculated nodule on the right shin on a background of bilateral lower limb...
A woman in her 60s presented with a longstanding history of a purplish, fleshy and pedunculated nodule on the right shin on a background of bilateral lower limb lymphoedema. A shave biopsy with double curettage of the base of the lesion revealed a nodular tumour with hyperchromatic basaloid cells arranged in a cribriform pattern and encircling eosinophilic substance. Immunohistochemistry staining showed cells positive for pancytokeratin, low molecular weight keratin, BerEP4 and negative for cytokeratin 20. There were no clinical or radiological features of primary visceral malignancy. These histological and immunohistochemical features favour a diagnosis of primary cribriform carcinoma of the skin. This is a rare, indolent skin appendage tumour of presumed apocrine origin with no reported cases in the literature of metastasis or local recurrence after excision.
Topics: Female; Humans; Leg; Skin Neoplasms; Adenocarcinoma; Diagnosis, Differential
PubMed: 37142284
DOI: 10.1136/bcr-2023-254781 -
JAAD International Jun 2023
PubMed: 37138829
DOI: 10.1016/j.jdin.2023.02.012 -
Fertility and Sterility Jul 2023To present laparoscopic shaving of rectosigmoid endometriosis using the novel approach of laparoscopic ultrasound guidance to enhance complete excision.
OBJECTIVE
To present laparoscopic shaving of rectosigmoid endometriosis using the novel approach of laparoscopic ultrasound guidance to enhance complete excision.
DESIGN
Video article.
SETTING
Academic Tertiary Hospital.
PATIENT(S)
A 41-year-old G3P2012 female with longstanding history of pelvic pain refractory to medical management. Imaging was suggestive of deep infiltrating endometriosis involving the rectosigmoid colon.
INTERVENTION(S)
Laparoscopy for rectosigmoid endometriosis with the use of intraoperative ultrasound.
MAIN OUTCOME MEASURE(S)
Laparoscopic excision of rectosigmoid endometriosis under ultrasound guidance.
RESULT(S)
N/A.
CONCLUSION(S)
It is important to perform a complete pre-operative evaluation to determine the extent of disease and the necessity of a multidisciplinary approach. Intraoperative laparoscopic ultrasound can provide additional information including size and depth of lesions, which could play a role in surgical decision making. Laparoscopic ultrasound may enhance complete excision of deep endometriosis lesions and decrease the incidence of recurrence.
Topics: Female; Humans; Adult; Endometriosis; Rectal Diseases; Treatment Outcome; Colon; Laparoscopy
PubMed: 37116640
DOI: 10.1016/j.fertnstert.2023.04.026 -
Journal of Cutaneous Pathology Aug 2023PRAME (PReferentially expressed Antigen in MElanoma) is a tumor-associated antigen that has been studied in various cutaneous melanocytic lesions. p16, on the other...
BACKGROUND
PRAME (PReferentially expressed Antigen in MElanoma) is a tumor-associated antigen that has been studied in various cutaneous melanocytic lesions. p16, on the other hand, has been proposed to aid in distinguishing between benign and malignant melanocytic neoplasms. Studies on the diagnostic utility of PRAME and p16 in combination in differentiating nevi from melanoma are limited. We aimed to assess the diagnostic utility of PRAME and p16 in melanocytic tumors and their role in distinguishing between malignant melanomas and melanocytic nevi.
METHODS
This is a single-center retrospective cohort analysis over a 4-year period (2017-2020). We used the pathological database of malignant melanomas (77 cases) and melanocytic nevi (51 cases) specimens from patients who underwent shave/punch biopsies or surgical excisions and evaluated immunohistochemical staining percentage positivity and intensity for PRAME and p16.
RESULTS
Most malignant melanomas showed positive/diffuse PRAME expression (89.6%); on the other hand, 96.1% of nevi did not express PRAME diffusely. p16 was expressed consistently in nevi (98.0%). However, p16 expression in malignant melanoma was infrequent in our study. PRAME had a sensitivity and specificity of 89.6% and 96.1%, respectively, for melanomas versus nevi; on the other hand, p16 had a sensitivity and specificity of 98.0% and 28.6%, respectively, for nevi versus melanoma. Also, a PRAME+/p16- melanocytic lesion is unlikely to be a nevus where most nevi were PRAME-/p16+.
CONCLUSION
In conclusion, we confirm the potential utility of PRAME and p16 for distinguishing melanocytic nevi from malignant melanomas.
Topics: Humans; Retrospective Studies; Immunohistochemistry; Biomarkers, Tumor; Melanoma; Skin Neoplasms; Nevus, Pigmented; Nevus; Nevus, Epithelioid and Spindle Cell; Antigens, Neoplasm; Diagnosis, Differential; Melanoma, Cutaneous Malignant
PubMed: 37114299
DOI: 10.1111/cup.14438 -
Actas Dermo-sifiliograficas Sep 2023Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVE
Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision.
MATERIAL AND METHODS
Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible.
RESULTS
In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes).
CONCLUSIONS
The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics.
Topics: Male; Humans; Aged; Female; Skin Neoplasms; Spain; Carcinoma, Basal Cell; Biopsy; Margins of Excision
PubMed: 37100344
DOI: 10.1016/j.ad.2023.04.026