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Turkish Journal of Medical Sciences 2023To present the incidence of recurrent lumbar disc herniation (RLDH) and to identify radiological and patient-related risk factors that lead to recurrence after lumbar...
BACKGROUND/AIM
To present the incidence of recurrent lumbar disc herniation (RLDH) and to identify radiological and patient-related risk factors that lead to recurrence after lumbar disc herniation (LDH) treatment with microdiscectomy.
MATERIALS AND METHODS
Between January 2013 and December 2021, 1214 patients who had undergone microdiscectomy for LDH were included in this retrospective study. Patients were divided into two groups, the recurrent group and the non-recurrent group, and their demographic, clinical and radiologic characteristics were recorded. The association between the variables and RLDH was assessed by univariate and multivariable logistic regression analyses.
RESULTS
Mean ages were similar in the recurrent (51.48 ± 13.63) and non-recurrent(50.38 ± 14.53) groups (p=0.232). Males represented 59.6% of the recurrent group and 49.8% of the non-recurrent group (p=0.002). Multivariable logistic regression revealed that being a male (p=0.009), diabetes mellitus (p=0.038), smoking (p<0.001), grade 4&5 disc degeneration (p<0.001), and having protruded (p=0.002), extruded LDH (p<0.001), paracentral (p=0.008) and foraminal LDH (p=0.008) were independently associated with recurrence.
CONCLUSION
To reduce RLDH frequency and need for revision surgery, modifiable risk factors should be minimized before and after the initial surgery. Also, in patients with unmodifiable risk factors, patients should be clearly informed about the risk for recurrence and possible alternative treatment methods should be considered.
Topics: Humans; Intervertebral Disc Displacement; Male; Retrospective Studies; Diskectomy; Female; Risk Factors; Middle Aged; Lumbar Vertebrae; Recurrence; Adult; Microsurgery; Aged
PubMed: 38813020
DOI: 10.55730/1300-0144.5691 -
Radiology Case Reports Aug 2024Uterine adenomyomas of endocervical type are rare benign tumors of the uterine cervix commonly presented as cyst-like, dilated glandular structures within polypoid...
Uterine adenomyomas of endocervical type are rare benign tumors of the uterine cervix commonly presented as cyst-like, dilated glandular structures within polypoid masses. A premenopausal woman in her 50s was referred to our hospital because of an increasing watery vaginal discharge. A multifocal cyst measuring 5 × 4.5 cm in size projecting into the endocervical canal was revealed on a contrast-enhanced MRI. The fluid within the tumor showed a hypointense signal on T1-weighted imaging (T1WI) and a hyperintense signal on T2-weighted imaging (T2WI). On T2WI, most of the septa within the tumor showed a slightly hyperintense to hypointense signal, whereas some areas revealed a strong hypointense signal; the contrast effect on the septum was satisfactory. On the T2WI taken 2 years previously, the tumor was a 4.5 × 3.5 cm polypoid mass protruding from the posterior endocervical wall. Contrastingly, the current T2WI showed that the stem was no longer identifiable because of tumor growth. Because previous imaging showed that the tumor was a stalked tumor protruding from the posterior endocervical wall, the imaging diagnosis was uterine adenomyoma of the endocervical type. A biopsy suggested the possibility of a minimal deviation adenocarcinoma (MDA). Hence, a total hysterectomy was performed. The final diagnosis confirmed the uterine adenomyoma of endocervical type. Uterine adenomyoma of the endocervical type might be difficult to differentiate from MDA in small biopsy specimens; therefore, evaluation of morphology by MRI is considered important in preoperative diagnosis.
PubMed: 38812595
DOI: 10.1016/j.radcr.2024.04.084 -
World Journal of Clinical Cases May 2024Esophageal cysts are relatively rare in clinical practice, with most of the literature comprising case reports. Esophageal cysts protruding into the thyroid gland are...
BACKGROUND
Esophageal cysts are relatively rare in clinical practice, with most of the literature comprising case reports. Esophageal cysts protruding into the thyroid gland are easily misdiagnosed as thyroid tumors. No such cases have been reported so far.
CASE SUMMARY
This article reports the case of a 31-year-old adult male diagnosed with thyroid nodules before admission. The patient underwent left thyroidectomy and isthmusectomy. During the surgery, esophageal cysts were identified in the esophageal muscle and thyroid glands. The pathology results confirmed a nodular goiter combined with esophageal cysts. Postoperatively, the patient developed a neck infection and underwent another operation and broad-spectrum antibiotic treatment for recovery.
CONCLUSION
We report the first clinical case of an esophageal cyst located within the thyroid gland that was successfully treated surgically. Esophageal cyst located within the thyroid gland cause difficulties in diagnosis. In the present study, the contents of the esophageal cysts were calcified foci, and a small amount of fluid mixture, which were easily misdiagnosed as thyroid nodules and misled the surgical methods.
PubMed: 38808349
DOI: 10.12998/wjcc.v12.i13.2231 -
International Journal of Analytical... 2024MiR-378 is abnormally expressed in various cancers, such as hepatocellular carcinoma, renal cell carcinoma, and nonsmall cell lung cancer. Here, we developed a label-...
MiR-378 is abnormally expressed in various cancers, such as hepatocellular carcinoma, renal cell carcinoma, and nonsmall cell lung cancer. Here, we developed a label- and immobilization-free ratiometric homogeneous electrochemical strategy based on exonuclease III (Exo III) for the facile and rapid determination of miR-378. Two 3'-protruding hairpin DNA probes (HPs) are designed in this strategy. Doxorubicin (DOX) and potassium ferrocyanide (Fe) were used as label-free probes to produce a response signal (I) and a reference signal (I) in the solution phase. When no target was present in the solution, the HP was stable, most of the DOX was intercalated in the stem of the HP, and the diffusion rate of DOX was significantly reduced, resulting in reduced electrochemical signal response. When miR-378 was present, double-cycle signal amplification triggered by Exo III cleavage was initiated, ultimately disrupting the hairpin structures of HP1 and HP2 and releasing a large amount of DOX into the solution, yielding a stronger electrochemical signal, which was low to 50 pM. This detection possesses excellent selectivity, demonstrating high application potential in biological systems, and offers simple and low-cost electrochemical detection for miR-378.
PubMed: 38807657
DOI: 10.1155/2024/8368987 -
ELife May 2024Human H3N2 influenza viruses are subject to rapid antigenic evolution which translates into frequent updates of the composition of seasonal influenza vaccines. Despite...
Human H3N2 influenza viruses are subject to rapid antigenic evolution which translates into frequent updates of the composition of seasonal influenza vaccines. Despite these updates, the effectiveness of influenza vaccines against H3N2-associated disease is suboptimal. Seasonal influenza vaccines primarily induce hemagglutinin-specific antibody responses. However, antibodies directed against influenza neuraminidase (NA) also contribute to protection. Here, we analysed the antigenic diversity of a panel of N2 NAs derived from human H3N2 viruses that circulated between 2009 and 2017. The antigenic breadth of these NAs was determined based on the NA inhibition (NAI) of a broad panel of ferret and mouse immune sera that were raised by infection and recombinant N2 NA immunisation. This assessment allowed us to distinguish at least four antigenic groups in the N2 NAs derived from human H3N2 viruses that circulated between 2009 and 2017. Computational analysis further revealed that the amino acid residues in N2 NA that have a major impact on susceptibility to NAI by immune sera are in proximity of the catalytic site. Finally, a machine learning method was developed that allowed to accurately predict the impact of mutations that are present in our N2 NA panel on NAI. These findings have important implications for the renewed interest to develop improved influenza vaccines based on the inclusion of a protective NA antigen formulation.
Topics: Neuraminidase; Influenza A Virus, H3N2 Subtype; Humans; Animals; Ferrets; Antigens, Viral; Mice; Influenza, Human; Antibodies, Viral; Influenza Vaccines; Antigenic Variation; Viral Proteins; Orthomyxoviridae Infections
PubMed: 38805550
DOI: 10.7554/eLife.90782 -
Clinical Case Reports Jun 2024This report emphasizes the significance of acknowledging infrequent yet severe complications such as bowel perforation and transanal protrusion post ventriculoperitoneal...
KEY CLINICAL MESSAGE
This report emphasizes the significance of acknowledging infrequent yet severe complications such as bowel perforation and transanal protrusion post ventriculoperitoneal shunt (VPS) surgery. VPS patients should be observed for atypical indicators and manifestations that could suggest the presence of such complications, even in the lack of traditional clinical signs of peritonitis or bowel perforation.
ABSTRACT
Placing an intracranial shunt, may be a reasonable approach to decrease the complications of hydrocephalus and it can be done either simultaneous to cranioplasty or not. Ventriculoperitoneal shunts were first proposed in 1905 and has been used since. Similar to any other procedure, there are different complications to this surgery. Abdominal complications, including peritoneal pseudocysts, intestinal volvulus, protruding in hernial sac or extrusion through vagina, scrotum, umbilicus or gastrointestinal tract, are rare but according to previous studies happen in 5%-47% of cases. Bowel perforation is a rare complication and can happen in 0.01%-0.07% of patients. It's also worth mentioning that only 25% of patients with bowel perforation experience the classic clinical symptoms of peritonitis or bowel perforation. This particular complication should not be overlooked since it can cause a high mortality rate of 15%. Here we present a case of transanal protrusion of ventriculoperitoneal shunt after an asymptomatic bowel perforation, in an adult who has undergone surgery after a traumatic brain injury. The patient has undergone surgery and lastly the shunt was manually removed from anus. He was monitored for 3 days and eventually discharged.
PubMed: 38803322
DOI: 10.1002/ccr3.8983 -
BioRxiv : the Preprint Server For... May 2024Inside the cell, proteins essential for signaling, morphogenesis, and migration navigate complex pathways, typically via vesicular trafficking or microtubule-driven...
Inside the cell, proteins essential for signaling, morphogenesis, and migration navigate complex pathways, typically via vesicular trafficking or microtubule-driven mechanisms . However, the process by which soluble cytoskeletal monomers maneuver through the cytoplasm's ever-changing environment to reach their destinations without using these pathways remains unknown. Here, we show that actin cytoskeletal treadmilling leads to the formation of a semi-permeable actin-myosin barrier, creating a specialized compartment separated from the rest of the cell body that directs proteins toward the cell edge by advection, diffusion facilitated by fluid flow. Contraction at this barrier generates a molecularly non-specific fluid flow that transports actin, actin-binding proteins, adhesion proteins, and even inert proteins forward. The local curvature of the barrier specifically targets these proteins toward protruding edges of the leading edge, sites of new filament growth, effectively coordinating protein distribution with cellular dynamics. Outside this compartment, diffusion remains the primary mode of protein transport, contrasting sharply with the directed advection within. This discovery reveals a novel protein transport mechanism that redefines the front of the cell as a pseudo-organelle, actively orchestrating protein mobilization for cellular front activities such as protrusion and adhesion. By elucidating a new model of protein dynamics at the cellular front, this work contributes a critical piece to the puzzle of how cells adapt their internal structures for targeted and rapid response to extracellular cues. The findings challenge the current understanding of intracellular transport, suggesting that cells possess highly specialized and previously unrecognized organizational strategies for managing protein distribution efficiently, providing a new framework for understanding the cellular architecture's role in rapid response and adaptation to environmental changes.
PubMed: 38798549
DOI: 10.1101/2024.05.12.593794 -
Life (Basel, Switzerland) May 2024Fryns syndrome (FS) is a multiple congenital anomaly syndrome with different multisystemic malformations. These include congenital diaphragmatic hernia, pulmonary...
Fryns syndrome (FS) is a multiple congenital anomaly syndrome with different multisystemic malformations. These include congenital diaphragmatic hernia, pulmonary hypoplasia, and craniofacial dysmorphic features in combination with malformations of the central nervous system such as agenesis of the corpus callosum, cerebellar hypoplasia, and enlarged ventricles. We present a non-consanguineous northern European family with two recurrent cases of FS: a boy with multiple congenital malformations who died at the age of 2.5 months and a female fetus with a complex developmental disorder with similar features in a following pregnancy. Quad whole exome analysis revealed two likely splicing-affecting disease-causing mutations in the gene: a synonymous mutation c.2619G>A, p.(Leu873=) in the last nucleotide of exon 29 and a 30 bp-deletion c.996_1023+2del (NM_176787.5) protruding into intron 12, with both mutations in configuration in the affected patients. Exon skipping resulting from these two variants was confirmed via RNA sequencing. Our molecular and clinical findings identified compound heterozygosity for two novel splice-affecting variants as the underlying pathomechanism for the development of FS in two patients.
PubMed: 38792648
DOI: 10.3390/life14050628 -
Diagnostics (Basel, Switzerland) May 2024The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among...
The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among skeletal Class I (BM1), II (BM2) and III (BM3). Understanding these characteristics would be useful for incisor and lip diagnostics in different skeletal classifications. Fourteen linear and twelve angular variables of the incisors and lips were evaluated in 214 lateral cephalograms (BM1 = 91, BM2 = 84, BM3 = 39). ANOVA and Bonferroni tests compared the measurements. BM1 and BM3 exhibited a greater U1 position and U1 inclination than the norms, while BM2 presented only a greater U1 position than the norms but normal U1 inclination. BM1 and BM3 had a significantly greater U1 position than BM2. BM1 and BM2 demonstrated a greater L1 position and L1 inclination than the norms, whereas BM3 displayed only a greater L1 position than the norms but normal L1 inclination. BM2 had the most anterior L1 position, whereas BM3 had the least anterior position. Only BM2 had a longer anterior dental height (ADH) than the norms, while BM1 and BM3 had a normal ADH and the significantly shortest ADH, respectively. Only BM1 had a normal upper incisor display at rest (U1R), while BM2 and BM3 displayed an increased and decreased U1R, respectively, with significant differences among the three groups. The most significantly protruded upper and lower lips were presented in BM2, but these were exhibited the least in BM3. The most significant acute nasolabial angle (NLA) was found in BM3, whereas BM2 presented the least acute NLA. A normal lip-chin-throat angle (LCTA) was observed in BM1 and BM3, while only BM2 had a greater LCTA than the norms. The most significant obtuse LCTA was found in BM2, while BM3 had the least obtuse LCTA. Therefore, both U1 and L1 in all groups presented protrusion and proclination, except for U1 in BM2, while L1 in BM3 exhibited normal inclination. The ADH and U1R were increased in BM2 but decreased in BM3. The most acute NLA was found in BM3, whereas the least acute was found in BM2. The most obtuse LCTA was in BM2, while the least was in BM3.
PubMed: 38786330
DOI: 10.3390/diagnostics14101031 -
Cureus Apr 2024Research on complications necessitating reoperation following vertebroplasty related to hydroxyapatite (HA) blocks is limited. We present the case of a 25-year-old woman...
Research on complications necessitating reoperation following vertebroplasty related to hydroxyapatite (HA) blocks is limited. We present the case of a 25-year-old woman who underwent posterior fixation and vertebroplasty using HA blocks for a T12 burst fracture. Postoperative computed tomography revealed anterior protrusion of some blocks, with consequent compression of the descending aorta. We removed the protruded blocks viaa transthoracic approach and observed no aortic injuries. Although HA blocks are considered safe for vertebroplasty, surgeons should be aware of the risk of anterior protrusion and potential aortic injury.
PubMed: 38784331
DOI: 10.7759/cureus.58784