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Background/aim: Chemotherapy-induced alopecia (CIA) is a significant concern for patients with breast cancer (BC). Although scalp-cooling therapy has shown efficacy in reducing scalp hair loss, its effects on eyebrow and eyelash preservation have been unclear.

Patients and methods: We conducted a prospective observational study of 154 patients with BC who received perioperative chemotherapy from 2016 to 2024. Seventeen of these patients underwent scalp cooling using the Paxman Scalp Cooling System (Paxman, Houston, TX, USA). Patient-reported outcomes were assessed via questionnaires evaluating the degree of hair loss at the scalp, eyebrows, eyelashes, and body hair.

Results: Scalp cooling significantly reduced the incidence of severe hair loss (score 4-5) at the scalp (p<0.001). Although the differences in eyebrow and eyelash hair loss were not significant (p=0.095 and p=0.199, respectively), a trend toward reduced severe alopecia was observed. No protective effect was observed for body hair (p=0.446).

Conclusion: Scalp-cooling therapy is effective for preventing severe scalp hair loss and may offer partial protection against eyebrow and eyelash alopecia. These findings support its broader application in BC care to enhance patients' quality of life.

Background/aim: Rectal dilatation strongly affects bowel function. However, the relationship between rectal dilatation and bowel function remains unclear. Since January 2024, we have attempted to evaluate this relationship by using sagittal computed tomography (CT) imaging.

Patients and methods: Sixty patients with colon cancer, excluding obstructive cancer, who underwent surgical procedures at our hospital were retrospectively registered in this study from January 2024 to March 2025. Rectal dilatations were evaluated by using axial and sagittal CT imaging. A rectal diameter greater than that of the fifth lumbar vertebral body diameter was considered long. The diameter of the upper rectum was measured at the inferior border of the second sacral vertebra, and that of the lower rectum was measured at the inferior border of the fourth sacral vertebra.

Results: Rectal dilatations were detected in 26 (43.3%) of the patients. Twenty-two (36.7%) patients were administered laxatives orally for constipation. In nineteen (86.4%) of the twenty-two patients, dilatation in both the upper and lower rectum was detected simultaneously, and the patients were administered laxatives. No patient experienced dilatation only in the upper rectum. Thirty-eight (63%) patients with no rectal dilatation above the inferior border of the third sacral vertebra were not treated with any laxative.

Conclusion: Sagittal CT imaging is very useful for evaluating anatomical changes in the rectum. The diameter of the rectum at the inferior border of the third sacral vertebra on sagittal CT images may be a clinical diagnostic criterion for patients with anorectal motility disorders.

Background/aim: Cachexia is a multifactorial syndrome that adversely affects the prognosis of patients with gastrointestinal cancer. Although anamorelin has been shown to improve appetite and body weight, the optimal timing of its initiation remains unclear. This study evaluated the effects of the timing of anamorelin initiation on nutritional recovery and clinical outcomes in patients with gastrointestinal cancer cachexia.

Patients and methods: We retrospectively reviewed 42 patients with gastric (n=17) or colorectal cancer (n=25) complicated by cachexia who received 100 mg of anamorelin once daily between August 2021 and December 2024. Changes in body weight, food intake, and nutritional status were assessed before and after anamorelin administration, and overall survival was analyzed according to the type of cancer.

Results: Initially, patients had experienced a mean body weight loss of 15.9±1.7% relative to the pre-diagnosis baseline. After four weeks, mean body weight increased by 2.9% (p<0.001), food intake improved significantly from 30.5%±0.3% to 57.1%±0.5% (p<0.001), and the Patient-Generated Subjective Global Assessment short form (PG-SGA SF) score decreased from 12.3±0.4 to 10.3±0.9 (p=0.003). The median overall survival was 17.9 months for gastric cancer and 36.8 months for colorectal cancer, with no significant difference between the two groups (p=0.089).

Conclusion: Anamorelin improved body weight, food intake, and nutritional status in patients with advanced gastrointestinal cancer cachexia. However, the modest degree of recovery suggests that earlier administration, before substantial weight and muscle loss, may maximize therapeutic benefits, support treatment continuity, and potentially improve survival outcomes. Therefore, early intervention should be considered in the clinical management of cancer cachexia.

Background/aim: Sunitinib, a second-line treatment for gastrointestinal stromal tumors (GIST), is commonly associated with adverse events (AEs) such as myelosuppression in older patients. However, an optimal dosing schedule has not been established. This study evaluated the therapeutic efficacy and toxicity management of sunitinib administration based on platelet count.

Case report: An 83-year-old man receiving imatinib for rectal GISTs was switched to sunitinib (initially 50 mg/day) due to imatinib failure. After eight days, he developed grade 2 anorexia and nausea, prompting a dose reduction to 37.5 mg/day. These AEs persisted, and sunitinib was discontinued 15 days after treatment initiation and later resumed at 25 mg/day after the symptoms improved. Thereafter, the sunitinib withdrawal period was adjusted based on neutrophil and platelet counts. As a result, the only non-hematologic AE of grade 2 or higher was hypothyroidism, with no serious AEs. He achieved a partial response according to Choi criteria but was switched to regorafenib after five cycles of sunitinib due to disease progression. Changes in neutrophil and platelet counts during the withdrawal period of each cycle of sunitinib therapy were predicted using a quadratic regression model and validated using leave-one-out cross-validation. The coefficient of determination (R²) of the neutrophil count prediction model during the withdrawal period was 0.28, and the validated R² for each cycle ranged from -26.34 to -0.11. In contrast, the platelet count model yielded an R² value of 0.86, with validated R² values ranging from 0.42 to 0.88.

Conclusion: Low-dose sunitinib monotherapy, with dosing intervals based on platelet counts, may be an effective treatment option for managing toxicity in older patients with imatinib-resistant GIST.

Background/aim: Fetal growth restriction (FGR) is a major and common complication of pregnancy. As the placenta holds the key to fetal growth, the detection of biomarkers associated with FGR is essential. The aim of the present study was to compare the expression of O-linked N-acetylglucosamine (O-GlcNAc) epitope H in placental tissues of pregnancies complicated with FGR and gestations with normal growth.

Materials and methods: Postpartum samples from chorionic villi from pregnancies were used for the present study. An immunochemical pathology study was performed in order to study the expression of O-GlcNAc epitope H.

Results: In total, 30 pregnant women were included. When the expression of epitope H between the two groups was compared, the proportion of FGR pregnancies with high expression of epitope H in chorionic villi was statistically significant higher (p<0.001).

Conclusion: Although preliminary findings regarding the expression of O-GlcNAc epitope H in chorionic villi samples of pregnancies complicated by FGR are promising, further studies are expected to contribute to a better understanding of the role of O-GlcNacylation in FGR pathogenesis and its clinical significance.

Background/aim: Bacterial translocation (BT) is linked to increased postoperative infections in oncologic patients undergoing major abdominal surgery. This study evaluated the prognostic value of BT, serum endotoxin, and zonula occludens-1 (ZO-1) for postoperative infections in patients with colon cancer undergoing open or laparoscopic colectomy.

Patients and methods: Seventy-one patients (40 open, 31 laparoscopic colectomy) were analyzed. Mesenteric lymph nodes (MLNs) and liver tissue were cultured for BT detection. Serum endotoxin and ZO-1 were measured preoperatively and 24 h post-operation and compared with 12 healthy controls. Postoperative infections and hospital length of stay (HLOS) were recorded.

Results: Postoperative infection rates did not differ between groups (p=0.16); however, open surgery patients had longer HLOS (p<0.001). BT rates were similar between groups. Endotoxin levels increased on Day 1 in both open (p=0.03) and laparoscopic (p=0.04) groups vs. controls. Serum ZO-1 was significantly higher preoperatively (p<0.001) and remained elevated postoperatively, with no group differences. BT was the only independent risk factor for infection [OR 95% confidence interval (CI)=17.45 (2.65-36.8), p=0.01], while endotoxin and ZO-1 showed low prognostic accuracy. Open surgery and infections were independent predictors of prolonged HLOS (p<0.001).

Conclusion: Open and laparoscopic colectomy show similar infection rates. Serum ZO-1 and endotoxin are not reliable infection predictors. BT, detected via MLN and liver cultures, is an independent infection risk factor and may aid in identifying high-risk patients for enhanced postoperative surveillance and early intervention.

Cancer stem cells (CSCs) are a highly tumorigenic cell population present in many malignancies and cancer cell lines, frequently exhibiting resistance to conventional chemotherapeutic agents. In this brief review, we discuss the ability CSCs to transdifferentiate into endothelial cells by expressing markers of the vascular endothelium. We highlight the similarities between mechanisms found in embryonic and tumor development, emphasizing mechanisms that enable CSCs to adopt an endothelial phenotype. Correlations with cellular and molecular mechanisms favoring CSC-to-endothelial transition, but also the impact on vasculogenic mimicry and antiangiogenic/antivascular drug resistance are also debated.

Background/aim: Positron emission tomography/computed tomography with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG PET/CT) is frequently used to differentiate schwannomas from malignant peripheral nerve sheath tumors. Schwannomas exhibit pathological heterogeneity, with highly cellular (Antoni A) and hypocellular (Antoni B) areas, but current PET/CT methods do not adequately reflect this heterogeneity. This study aimed to compare imaging characteristics of schwannomas in the trunk versus the extremities, with emphasis on metabolic heterogeneity.

Patients and methods: This retrospective study included patients with solitary schwannomas who underwent MRI and ¹⁸F-FDG PET/CT before surgical excision (June 2013-September 2023). Exclusion criteria were plexiform, multiple, biopsy-only lesions, and tumors originating from internal organs. Tumors were classified as trunk or extremity lesions. MRI was used to determine size and volume, while PET/CT measured SUV_max, SUV_mean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Heterogeneity was assessed using three indices: MTV-to-volume ratio (MTV/volume), SUV-based heterogeneity index (HI_SUV), and metabolic region-adjusted SUV-based heterogeneity index (MRA-HI_SUV).

Results: Fifty-six patients were included. Trunk schwannomas were larger than extremity tumors in diameter (4.33 cm vs. 2.77 cm; p<0.05) and volume (27.71 cm³ vs. 6.25 cm³; p<0.05). SUV_max (4.09 vs. 3.71) and SUV_mean (2.47 vs. 2.22) did not differ significantly. MTV (18.43 cm³ vs. 6.19 cm³, p<0.05) and TLG (58.41 vs. 14.40, p<0.05) were higher in trunk tumors. MTV/volume ratio was lower (0.77 vs. 1.12, p<0.05), while HI_SUV and MRA-HI_SUV were higher in trunk schwannomas (1.79 vs. 1.65 and 2.36 vs. 1.49, p<0.05).

Conclusion: Trunk schwannomas were larger and exhibited higher metabolic activity and heterogeneity. Novel parameters such as MTV/volume and MRA-HI_SUV may enhance the characterization of schwannoma heterogeneity.

Background/aim: The waveform patterns of nocturnal oxygen saturation (SpO₂) in patients with chronic obstructive pulmonary disease can be classified into three types on the basis of morphological characteristics: intermittent desaturation, sustained desaturation, and periodic desaturation. The aim of this study was to clarify the clinical significance of these waveform patterns in patients with chronic obstructive pulmonary disease by using polysomnography data.

Patients and methods: A total of 88 patients who underwent polysomnography were analyzed and classified into two groups: those with an intermittent desaturation pattern (n=76) and those without this pattern (n=12). We retrospectively analyzed polysomnography data from patients with suspected sleep apnea syndrome and evaluated the relationships between the waveform patterns of nocturnal SpO₂ and clinical characteristics.

Results: The mean apnea-hypopnea index (AHI) of the 88 patients was 39.9 (range=4.4-114.8) events/h, and 87 patients were diagnosed with sleep apnea syndrome. The mean AHI for the group with intermittent pattern was 43.6 (interquartile range=7.0-114.8) events/h, which was significantly greater than the mean AHI for the group with nonintermittent pattern, which was 30.4 (interquartile range=4.4-78.4) events/h. In addition, patients with the intermittent pattern were more likely to have moderate or severe obstructive sleep apnea (p=0.031).

Conclusion: Analysis of the waveform patterns of nocturnal SpO₂ enhanced the identification of patients eligible for continuous positive airway pressure therapy, suggesting a potentially efficient approach for treatment selection.

Background/aim: Pterygium is a common ocular surface disorder characterized by abnormal fibrovascular growth and extracellular matrix remodeling, yet its precise molecular etiology remains unclear. Matrix metalloproteinases (MMPs) have been implicated in pterygium pathogenesis. However, the genetic contribution of MMP13 remains unexplored.

Materials and methods: This case-control study evaluated the association between MMP13 promoter rs2252070 and intronic rs478927 with pterygium susceptibility, in a cohort comprising 160 patients and 320 age- and sex-matched controls by genotyping via polymerase chain reaction-restriction fragment length polymorphism methodology. The interaction between MMP13 genotype and age or sex were accessed by stratified analysis.

Results: The genotypic distributions of MMP13 rs2252070 showed no significant differences between cases (AA: 33.1%, AG: 42.5%, GG: 24.4%) and controls (AA: 28.4%, AG: 45.6%, GG: 26.0%; p for trend=0.5720). Compared to the AA genotype, the odds ratios (ORs) for pterygium in association with AG and GG were 0.80 (95% CI=0.51-1.25, p=0.3829) and 0.81 (95% CI=0.48-1.34, p=0.4856), respectively. Under dominant and recessive models, no significant associations were observed (dominant: OR=0.80, 95% CI=0.53-1.21, p=0.3417; recessive: OR=0.92, 95% CI=0.59-1.43, p=0.7953). Similarly, rs478927 showed no significant genotypic or allelic associations with pterygium risk (all p>0.05). Stratified analyses indicated no effect modification by age or sex.

Conclusion: These findings suggest that MMP13 genetic variants rs2252070 and rs478927 do not significantly contribute to pterygium susceptibility. Given the known involvement of other MMPs, future studies should focus on alternative genetic markers to better understand pterygium pathogenesis and improve early detection strategies.