In vivo最新文献

Background/aim: Although it has been reported that different molecules are effective in preventing ischemia-reperfusion (I/R) injury, the most effective treatment is still unknown.

Materials and methods: The rats were divided into four groups of eight rats each. Group C: 1 ml intraperitoneal (IP) isotonic + laparotomy + IP 2 ml isotonic +I/R. Group D: 100 μg kg^-1/1 ml IP dexmedetomidine + laparotomy + IP 2 ml isotonic +I/R. Group L: 1 ml IP isotonic + laparotomy + IP levobupivacaine (2.5 mg kg^-1/2 ml) +I/R. Group DL: 100 μg kg^-1/1 ml IP dexmedetomidine + laparotomy + IP levobupivacaine (2.5 mg kg^-1/2 ml) +I/R. Brain, heart, lung, and liver tissue samples were collected for histopathological examination. Biochemically, levels of aspartate amino transaminase, alanine amino transaminase, serum glucose, total antioxidant status (TAS), total oxidant status, ischemia modified albumin, and malondialdehyde were measured in blood samples.

Results: Group D mean blood TAS levels were found to be statistically significantly higher than those in Group C and Group L (p=0.037, p=0.048 respectively). Group DL oxidative stress index (OSI) value was found to be statistically significantly lower than that of Group C (p=0.010).

Conclusion: Both dexmedetomidine and levobupivacaine demonstrated protective effects in I/R injury. When used in combination, the effects of these treatments were further enhanced, reaching statistical significance. As our literature review found no studies on the combined use of dexmedetomidine and levobupivacaine in I/R injury, it is anticipated that supporting these results with clinical studies may significantly contribute to clinical practice.

Background/aim: Sarcopenia is diagnosed based on grip strength and skeletal muscle mass. Although decreased skeletal muscle mass has been reported to be associated with poor outcomes after hepatectomy, a few studies have included data on grip strength in hepatectomy candidates. This multicenter study investigated the clinical factors and postoperative complications associated with sarcopenia by assessing the grip strength and skeletal muscle mass in patients undergoing hepatectomy for hepatocellular carcinoma (HCC).

Patients and methods: Data from patients who underwent hepatectomy for HCC between January 2020 and March 2022 were retrospectively collected from multi-institutional databases. Sarcopenia was defined as reduced grip strength and skeletal muscle mass. The patients were categorized into the sarcopenia and non-sarcopenia groups, and baseline characteristics and short term outcomes were compared between the two groups.

Results: Overall, 253 patients were included, among which 36 (14.2%) had sarcopenia. The sarcopenia group was significantly associated with older age, low body mass index, comorbid heart or chronic pulmonary disease, cerebrovascular accident history, and overall and major postoperative complications compared to the non-sarcopenia group. Among major postoperative complications [Clavien-Dindo classification (CDC) ≥III], the incidence of bile leakage and intra-abdominal abscess were higher in the sarcopenia group than in the non-sarcopenia group. Multivariate analysis revealed that sarcopenia was an independent risk factor for overall and major postoperative complications (CDC ≥III).

Conclusion: Sarcopenia, defined by grip strength and skeletal muscle mass, is a predictor of overall and major complications after hepatectomy for HCC.

Background/aim: Adenoid cystic carcinoma (AdCC) is a rare malignant tumor that primarily affects the salivary glands but can also occur in other organs. Low incidence and unpredictable clinical behavior make AdCC one of the most difficult head and neck tumors to treat.

Case report: We present the case of a 54-year-old woman with AdCC localized at the base of the tongue, following radical surgical and oncological therapy. Due to advances in palliative oncological treatment, there is a more than five-year survival period before the progression of metastatic disease. Considering the rare occurrence of this disease, a literature search was also conducted, and therapy options are discussed. Ensuring a sufficient extent of the surgical procedure is still a challenge, and most specialists agree that subsequent postoperative radiotherapy reduces the risk of local recurrence. The effective dose of radiotherapy to the area of the primary tumor and lymph nodes is not clearly defined.

Conclusion: The distinct biological behavior of AdCC results in varying sensitivity to chemotherapy or radiotherapy compared to treatments commonly used for head and neck squamous cell carcinomas. Treatment recommendations for these rarer tumors are based mainly on case reports and small clinical trials. The acquired therapeutic experience can contribute to prolonging the survival period of patients and improving their prognosis and quality of life.

Background/aim: We hypothesized that adding bevacizumab to platinum-based neoadjuvant chemotherapy - whose efficacy for patients with recurrent or metastatic cervical cancer has already been proven - could optimize the therapy regimen, leading to improved response rates and survival outcomes.

Patients and methods: Forty patients with histologically confirmed cervical cancer with FIGO stage IB3-IVA who received platinum-based neoadjuvant treatment between March 2008 and January 2019 in the Department of Obstetrics and Gynecology of University Hospital Cologne were analyzed. Twenty patients were treated with additional bevacizumab. The comparative cohort consisted of 18 patients treated with neoadjuvant chemotherapy alone. The response rates and clinical outcomes, including progression-free survival and overall survival, were evaluated.

Results: Neoadjuvant chemotherapy combined with bevacizumab significantly improved the response rate (p=0.046). The survival analysis showed that patients treated without bevacizumab had better progression-free survival up to FIGO stage IVA than patients treated with bevacizumab. However, overall survival was similar for both cohorts. For patients with advanced tumor stage, including FIGO IVB, progression-free survival and overall survival improved with the addition of bevacizumab. Pathological complete remission was a statistically significant prognostic factor for progression-free survival (p=0.039) but did not significantly affect overall survival (p=0.098).

Conclusion: While bevacizumab did not demonstrate a significant improvement in overall survival rates, it was associated with a notable reduction in tumor size and showed a trend towards improved clinical response rates. These findings suggest that bevacizumab may have potential in optimizing the neoadjuvant treatment approach.

Background/aim: Hypertension does not always improve after adrenalectomy for primary aldosteronism (PA), and antihypertensive medications cannot always be discontinued. This study aimed to identify the prognostic predictors of hypertension following adrenalectomy for PA.

Patients and methods: This retrospective cohort study included patients undergoing adrenalectomy for PA between 2008 and 2022 at a tertiary hospital, grouping them based on whether they had normal blood pressure without antihypertensive medications or still required medications postoperatively. Age, sex, body mass index (BMI), biochemical data, hypertension duration, pre- and post-operative defined daily dose (DDD) of antihypertensive drugs, presence of metabolic syndrome (MetS)-related diseases, and visceral fat area and volume (recorded using preoperative abdominal computed tomography) were the outcome measures.

Results: A total of 71 (clinical success, n=21) (nonclinical success, n=50) patients were included. A high BMI (p=0.038), DDD (p=0.008), and visceral fat volume (p=0.048); long hypertension duration (p=0.034); and the presence of MetS-related diseases (p=0.014) were associated with a low clinical success rate on univariate analyses. After adjusting for age and sex, hypertension duration (p=0.047), MetS-related diseases (p=0.021), and DDD (p=0.011) were potential prognostic predictors.

Conclusion: Hypertension duration, MetS-related diseases, and DDD are potential prognostic predictors of hypertension following surgery for PA.

Background/aim: Breast cancer remains a major global health concern. This study aimed to develop a deep-learning-based artificial intelligence (AI) model that predicts the malignancy of mammographic lesions and reduces unnecessary biopsies in patients with breast cancer.

Patients and methods: In this retrospective study, we used deep-learning-based AI to predict whether lesions in mammographic images are malignant. The AI model learned the malignancy as well as margins and shapes of mass lesions through multi-label training, similar to the diagnostic process of a radiologist. We used the Curated Breast Imaging Subset of Digital Database for Screening Mammography. This dataset includes annotations for mass lesions, and we developed an algorithm to determine the exact location of the lesions for accurate classification. A multi-label classification approach enabled the model to recognize malignancy and lesion attributes.

Results: Our multi-label classification model, trained on both lesion shape and margin, demonstrated superior performance compared with models trained solely on malignancy. Gradient-weighted class activation mapping analysis revealed that by considering the margin and shape, the model assigned higher importance to border areas and analyzed pixels more uniformly when classifying malignant lesions. This approach improved diagnostic accuracy, particularly in challenging cases, such as American College of Radiology Breast Imaging-Reporting and Data System categories 3 and 4, where the breast density exceeded 50%.

Conclusion: This study highlights the potential of AI in improving the diagnosis of breast cancer. By integrating advanced techniques and modern neural network designs, we developed an AI model with enhanced accuracy for mammographic image analysis.

Background/aim: The dynamic interplay between cancer cells and the microenvironment involves a wide range of intricate relationships that evolve during different stages of tumor progression. Recent attention has focused on high endothelial venules (HEVs), specialized endothelial cells in tumors with a unique cuboidal shape similar to those in lymph nodes. Previous animal studies have shown that normalization of tumor angiogenesis through anti-VEGFR2 therapy promotes HEV formation. However, few reports exist regarding the relationship between HEVs and preexisting blood vessels or interstitial fibers. In this study, we histologically examined whether tumor vascular structure correlates with HEV neogenesis.

Patients and methods: A total of 109 patients with pathological stage I lung adenocarcinoma who had undergone curative lung resection at our Institute between 2012 and 2016 were included. HEVs were identified by anti-peripheral node addressin (PNAd) staining. Immunostaining and Elastica-Masson-Goldner staining were performed on tumor sections and quantified.

Results: PNAd-positive cells were identified in 102 (93.6%) patients. Nearly all PNAd-positive cells were located within or near immune cell clusters. We investigated the correlation between microvessel structures or interstitial fibers and the number/density of PNAd-positive vessels, but no significant correlation was found. Since PNAd-positive cells were concentrated in immune cell aggregates, we focused our analysis specifically on these regions. Immune cell aggregates with abundant PNAd-positive vessels had a greater microvessel density along with by rich collagen fiber production, and displayed a more mature morphological phenotype of HEVs.

Conclusion: The generation of PNAd-positive cells in tumors is governed by an angiogenetic mechanism distinct from that of broader tumor microenvironment. Furthermore, the accumulation of immune cells is associated with increased HEV maturation.

Background/aim: The global obesity epidemic has seen a dramatic increase in prevalence since 1975, posing significant health and economic challenges worldwide. Robotic-assisted single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a promising surgical intervention for morbid obesity, offering potential advantages over traditional laparoscopic approaches in terms of precision, safety, and recovery outcomes. This study aimed to evaluate the efficacy and safety of robotic-assisted SADI-S, focusing on perioperative and postoperative outcomes including intraoperative complications, operative time, conversion rates, mortality, length of hospital stay, weight loss, and postoperative complications.

Materials and methods: A comprehensive literature search was conducted on PubMed, Scopus, and Cochrane Library, adhering to inclusion and exclusion criteria focused on obese adult humans undergoing robotic SADI-S. Seven studies, published between 2015 and 2024, involving 204 patients, were ultimately included for analysis.

Results: The analysis revealed a low rate of intraoperative complications (0.49%), no mortality, and varied operative times (138 to 205.7 min). The median hospital stay ranged from 2 to 6.7 days, with minimal readmission rates. Postoperative complications occurred in 6.37% of patients, but no late complications (>30 days) were reported. Notably, significant weight loss outcomes were documented, with mean excess weight loss (EWL) up to 113.74% at 24 months follow-up.

Conclusion: Robotic-assisted SADI-S demonstrates a favourable safety profile with promising weight loss outcomes, highlighting its potential as a primary or revisional treatment for morbid obesity. Further research, including randomized controlled trials, is needed to establish its long-term efficacy and cost-effectiveness compared to traditional laparoscopic methods.

Background/aim: As prostaglandin E2 (PGE2) and its receptors (EP2) are over-expressed on tumor cells and microenvironment, radiolabeled cyclodextrins targeting such biomolecules are valuable vector candidates in molecular cancer diagnostics. Using experimental melanoma models, we evaluated the in vivo imaging behavior of novel Manganese-52-labeled (⁵²Mn) randomly methylated beta-cyclodextrin ([⁵²Mn]Mn-DOTAGA-RAMEB) and compared it with the following well-established tumor-specific probes: melanocortin-1 receptor (MC1-R)-affine [⁶⁸Ga]Ga-DOTA-NAPamide and PGE2 selective [⁶⁸Ga]Ga-DOTAGA-RAMEB cyclodextrin.

Materials and methods: Post-injection of [⁶⁸Ga]Ga-DOTA-NAPamide, [⁶⁸Ga]Ga-DOTAGA-RAMEB, and [⁵²Mn]Mn-DOTAGA-RAMEB into MC1-R positive B16F10 melanoma-bearing mice, tumor radio-pharmaceutical uptake was quantified in vivo and ex vivo using preclinical positron emission tomography (PET) and high-performance gamma counter.

Results: Although all tracers performed well in tumor identification, the highest standardized uptake values were detected in the [⁶⁸Ga]Ga-DOTA-NAPamide scans. Corresponding to the ex vivo data, meaningful [⁵²Mn]Mn-DOTAGA-RAMEB accumulation 1 h post-injection confirmed the tumor-targeting potential of the tracer. Temporal changes in PGE2/EP2 expression of the neoplasms may explain the significant differences observed between the tumor uptake of the two cyclodextrin probes and that of the ⁵²Mn-labelled compound measured 1 h, 4 h, and 3 days post-injection (p≤0.01, p≤0.05).

Conclusion: Although further pharmacokinetical optimization may be required, ⁵²Mn-labelled cyclodextrin holds potential in melanoma diagnostics and the PET-based longitudinal assessment of tumor-associated PGE2/EP2 expression.

Background/aim: Pleomorphic high-grade squamous intraepithelial lesions (PHSILs) of the uterine cervix are characterized by strikingly pleomorphic and enlarged nuclei with brisk mitotic activity. The aim of this study was to analyze the clinical outcomes of patients with PHSIL.

Patients and methods: Clinical data were collected from the electronic medical records of 44 patients with PHSIL.

Results: The patients' mean age was 52.1 years. The initial cytological diagnosis was HSIL in 43.2% of patients. High-risk human papillomavirus was detected in 89.5% of patients. The human papillomavirus type was not predominated by one specific type. The patients were treated with conization alone or with conization with subsequent hysterectomy. Two cases of squamous cell carcinoma coexisting with PHSIL, and one case of adenoid basal carcinoma were detected among the surgical specimens. Follow-up cytology revealed negative results for intraepithelial lesions in all patients, except for one patient who experienced recurrent PHSIL 41 months after hysterectomy and underwent laser ablation.

Conclusion: The incidence rates of concurrent squamous cell carcinoma (4.5%) and recurrence (2.3%) in our PHSIL cohort were lower than those previously reported in patients with conventional HSIL. Our findings suggest that pleomorphic nuclear change alone in PHSIL was not associated with worse clinical outcomes than conventional HSIL and support the notion that PHSIL does not require more aggressive clinical management than conventional HSIL. However, close follow-up with cytological examination may be necessary to determine the potential risk of recurrence.