In vivo最新文献

Background/aim: Metal artefacts from medical implants significantly impair computed tomography (CT) image quality, necessitating their reduction. Photon counting technology helps to reduce artefacts through spectral information and monoenergetic reconstructions, but its use in children is limited due to radiation dose concerns. The aim of this study was to evaluate photon-counting-based metal artefact reduction (MAR) techniques for their applicability and diagnostic utility under dose-adapted conditions in pediatric patients.

Materials and methods: A 10-year-old phantom with femoral nail osteosynthesis was studied on a photon-counting CT (NAEOTOM Alpha, Siemens Healthineers) using a pediatric reference protocol (70 kVp) without iterative metal artefact reduction (MAR), a 100Sn protocol with iterative MAR, Quantum-Plus (120 kVp) after dose adjustment (Computed Tomography Dose Index volume (CTDIvol) average: 1.30 mGy), and virtual monoenergetic reconstructions (VMI) from 60 to 190 keV. Image datasets were compared based on noise and artefact index (AIx) in different regions of interest (ROI).

Results: MAR techniques reduced noise. Near osteosynthesis (ROI 1), noise reduction was 49.40% for the 100Sn protocol and 46.76% for the Quantum-Plus protocol. The artefact index was highest for the 70 kVp protocol at 58.73 and nearly halved for dose-adapted protocols with iterative MAR (100Sn: 32.90; Quantum-Plus: 29.83). Image noise decreased by 40.46% from 60 to 110 keV, with the greatest reduction near osteosynthesis (59.12). Artefact index was highest at 60 keV (18.54), decreased to 5.88 at 100 keV, and then increased to 7.58 at 190 keV.

Conclusion: All MAR techniques improved CT number accuracy and significantly reduced image noise, especially near the prothesis. Using the full spectral information protocol in pediatric imaging is reasonable after dose adjustment to pediatric reference values.

Background/aim: This study aimed to characterize gut microbiota alterations and intestinal barrier markers in patients with functional abdominal bloating (FAB) to explore its underlying biological mechanisms.

Materials and methods: Stool samples from 42 adults diagnosed with FAB per Rome IV criteria were analyzed using the intergenic spacer profiling, which profiles the 16S-23S ribosomal DNA intergenic spacer region to enhance species-level resolution. Targeted real-time polymerase chain reaction quantified key bacterial taxa. Microbial diversity, Firmicutes/Bacteroidetes (F/B) ratio, enterotype distribution, and levels of beneficial and pathogenic bacteria were assessed. Gastrointestinal immune and permeability markers (calprotectin, secretory IgA, zonulin, α1-antitrypsin, bile acids, pancreatic elastase) were measured by enzyme-linked immunosorbent assay.

Results: A dysbiosis index ≥15 was observed in 90.5% of patients, indicating significant microbial imbalance. Most showed a low mean F/B ratio (<1.5) and microbial diversity index (<5), reflecting reduced microbiota resilience. Enterotype 1 (Bacteroides-dominant) was predominant (67%), with no detection of Enterotype 3 (Ruminococcus-dominant). Levels of beneficial bacteria, including Faecalibacterium prausnitzii, Akkermansia muciniphila, Bacteroides spp., and Bifidobacterium spp., were markedly decreased in over 80% of individuals. Conversely, Proteobacteria such as Sutterella wadsworthensis and Klebsiella spp. were at elevated levels. Calprotectin and sIgA were increased in >59.5% of cases; zonulin and α1-antitrypsin were elevated in 19% and 16.7%, respectively, suggesting mucosal immune activation and possible barrier dysfunction.

Conclusion: This study demonstrates that FAB is accompanied by profound alterations in gut microbiota composition and mucosal immune responses, indicating that its pathophysiology extends beyond functional disturbances to include measurable biological changes. These findings support the growing clinical relevance of microbiota-informed evaluation and open new avenues for targeted therapeutic strategies.

Background/aim: Pleural metastasis and malignant pleural effusion (MPE) are common complications of lung adenocarcinoma. Patients with MPE have poor outcomes, with overall survival ranging from 5 to 11.4 months. The lack of established cell lines and stable animal models of pleural metastasis has limited studies on the underlying mechanisms of MPE development. In this study, we aimed to develop a murine lung adenocarcinoma cell line with high thoracic pleural metastatic potential.

Materials and methods: Luciferase-tagged Lewis lung carcinoma (LLC) cells were implanted into the pleural cavity of C57bl/6 mice, with five rounds of subsequent extraction from pleural foci and reinjection into the pleural cavity. The metastatic properties of the established cell line were verified in vivo by evaluating the metastatic burden and MPE volume (n=5). In vitro, the metastatic ability of cell lines was assessed by scratch assay, transwell migration assay, cell-matrix adhesion assay and cell-cell adhesion assay (3-5 replicates). The transcription profile was characterized by mRNA sequencing. Differential analysis and KEGG enrichment were performed to show their distinctions. Differential genes were verified by quantitative real-time PCR (qPCR).

Results: An LLC subpopulation with high thoracic pleural metastatic potential was generated and named LLC-PLM. In vivo, compared with parental LLC (LLC-P), LLC-PLM demonstrated a greater incidence of MPE and greater MPE volumes. In vitro, LLC-PLM demonstrated increased metastatic capacity and augmented adhesion capacities, compared to LLC-P. Transcriptomic analysis revealed that pathways related to adhesion, migration, and membrane signaling were notably enriched and activated in LLC-PLM cells. Relative genes were obviously activated, including Lamc2, Col4a3, Col6a3, Col1a1, Itga2 and Itga1.

Conclusion: We successfully established a murine cell line LLC-PLM that can serve as a valuable tool for studying pleural metastasis and MPE.

Background/aim: Endometriosis is characterized by the accumulation of immune cells in endometrial lesions and the peritoneal cavity. Macrophages contribute to the growth and neovascularization of endometriotic lesions. Vascular endothelial growth factor receptor-1 (VEGFR1) is involved in neovascularization, while peritoneal macrophages (PMs) play a critical role in endometriosis development and establishment. We examined the role of VEGFR1 signaling in PMs during endometriosis development using a murine model of ectopic endometrial transplantation.

Materials and methods: Endometrial fragments from female wild-type (WT) or VEGFR1 tyrosine kinase-deficient (TK^-/-) donor mice were implanted into the peritoneal walls of recipient mice, either in a WT→WT or TK^-/-→TK^-/- combination. On day 14 after endometrial transplantation, the implant size, neovascular growth-promoting factors, macrophage accumulation in the implants and peritoneal cavity, and cytokine production were assessed. PMs from WT or TK^-/- mice were transferred into the peritoneal cavity of WT→WT mice and their effects were assessed.

Results: Compared to WT→WT mice, TK^-/-→TK^-/- mice exhibited smaller implant sizes and reduced neovascularization, including angiogenesis and lymphangiogenesis. This was correlated with an increase in pro-inflammatory (M1) and a decrease in alternative (M2) large peritoneal macrophages (LPMs) within the peritoneal cavity. Transfer of TK^-/--PMs into the peritoneal cavity of WT→WT mice reduced endometriosis development and macrophage accumulation. This led to increased expression of M1 macrophage genes and decreased expression of M2 phenotype genes, compared to WT-PMs transfer. PMs from TK^-/- mice exhibited increased M1-related and decreased M2-related gene expression.

Conclusion: Deletion of VEGFR1 TK signaling in PMs suppressed endometriosis progression and neovascularization by increasing M1 LPMs. Specific inactivation of VEGFR1 TK signaling may represent a potential therapeutic target for the management of endometriosis.

Background/aim: Primary cardiac tumors, particularly sarcomas, are exceptionally rare, with limited literature available on their diagnosis and management. Patients are typically asymptomatic in the early stages of the disease, and present later with non-specific and varied symptoms.

Case report: This case describes a 59-year-old patient who presented with a cardiac mass and exhibited signs of superior vena cava syndrome, including odynophagia, dysphagia, hoarseness, and constitutional symptoms. Subsequent investigations revealed a primary malignant spindle cell sarcoma originating from the pericardium.

Conclusion: Despite treatment with chemotherapy, radiotherapy, and surgical tumor resection, the prognosis of primary cardiac spindle cell sarcoma remains poor.

Background/aim: To evaluate alterations in total antioxidant capacity (TAC) and ascorbic acid (AA) levels in femtosecond laser-assisted cataract surgery (FLACS) compared with conventional cataract surgery.

Patients and methods: A prospective non-randomized study was conducted wherein 18 and 36 patients undergoing FLACS and conventional cataract surgery, respectively, with the same phacoemulsification and femtosecond laser devices were enrolled. Samples of aqueous humor were obtained via paracentesis before and 1 day after the cataract surgery, and TAC and AA concentrations were determined. The generalized linear mixed model was adopted to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) of changes in TAC and AA between groups.

Results: The TAC and AA levels significantly decreased postoperatively in both groups (p=0.05). In the multivariate analysis, the trend in decline in TAC (aOR=0.352, 95% CI=0.218-0.527, p=0.0177) and AA (aOR=0.308, 95% CI=0.156-0.488, p=0.0204) was significantly lower in the FLACS group. In the subgroup analyses, the correlation between FLACS and smaller TAC reduction was more significant in patients with high myopia, dense cataract, short anterior chamber depth, and greater axial length (p<0.05). In addition, the correlation between FLACS and smaller reduction in AA was more significant in patients with high myopia, dense cataract, greater axial length, and greater central corneal thickness (p<0.05).

Conclusion: Patients with high myopia and dense cataract may consider FLACS to reduce the possibility of oxidative stress-related postoperative complications.

Background/aim: Skin cancer, particularly non-melanocytic types like squamous and basal cell carcinoma, remains a growing concern. The tumor suppressor proteins p53 and p63 play key roles in skin carcinogenesis. This study aimed to assess the differential expression of p53 and p63 in various stages of chemically-induced skin cancer.

Materials and methods: FVB/N mice, aged 44 weeks, were randomly assigned into three groups: a control group (n=8) and two experimental groups (Group A: n=16, Group B: n=16). The study employed a two-stage carcinogenesis procedure, which involved an initial application of 97.4 nmol DMBA to shaved skin on the back, followed by applications of 32.4 nmol TPA after thirteen weeks for Group A and after twenty weeks for Group B. The control group did not receive any treatment. Skin lesions were monitored, and tissue samples were collected for histological and immunohistochemical analysis.

Results: p53 expression was significantly elevated in precancerous and benign tumors compared to normal histology (47.6% and 47.8% vs. 18.8%, respectively; p<0.05), but not in malignant tumors. Mean p53 expression was significantly higher in both experimental groups compared to controls (group A: 42.1%, group B: 47.1%; p<0.001). Conversely, p63 expression remained generally low across all stages, with slightly higher levels in malignant lesions. The difference in expression between p53 and p63 was significant in precancerous and benign lesions (p<0.001). No significant differences in expression were found between the two experimental groups.

Conclusion: Distinct expression patterns of p53 and p63 suggest stage-specific roles in skin carcinogenesis. Elevated p53 in early lesions supports its tumor-suppressive function, while p63 may contribute to tumor maintenance in advanced stages. These findings support the utility of p53 and p63 as biomarkers for diagnosis and prognosis in skin cancer, and potential targets for future therapies.

Background/aim: This study aimed to investigate the association between the perioperative usage of hyaluronic acid (HA)-containing artificial tears and the refractive accuracy of cataract surgery in patients with dry eye disease (DED).

Patients and methods: In this retrospective cohort study, patients with DED who underwent cataract surgery were categorized based on their use of HA-containing artificial tears. A total of 62 eyes were assigned to the non-HA group and 54 eyes to the HA group. The primary outcomes were the uncorrected distance visual acuity (UDVA), postoperative spherical equivalent (SE), and astigmatism assessed via vector analysis. The independent t test and the generalized linear regression were applied for the statistical analysis.

Results: Three months postoperatively, the UDVA in the HA group was significantly better than that in the non-HA group (p<0.001). At the same time, the residual SE was significantly higher in the non-HA group than in the HA group (p =0.001). In addition, the HA group showed a higher surgery-induced astigmatism (SIA), lower difference vector (DV), lower magnitude of error (ME), and higher correction index (CoI) compared to the non-HA group (all p>0.05). The high axial length (AXL) significantly correlated to the higher residual SE in the HA group (p=0.001), while the low preoperative tear break-up time, high corneal astigmatism and high AXL correlated to the higher residual SE in the non-HA group (all p<0.05).

Conclusion: Perioperative use of HA-containing artificial tears is associated with improved refractive accuracy following cataract surgery in patients with DED.

Background/aim: Hypertension is a vascular condition associated with an increased risk of cerebrovascular accidents (CVAs). Insomnia has also been linked to various neurological disorders, including CVA. Therefore, this study aimed to investigate the potential association between insomnia and subsequent CVA development in a hypertensive population.

Patients and methods: A retrospective cohort study was conducted, enrolling patients with hypertension who were then categorized into groups based on the presence or absence of insomnia. Each group comprised 244,397 patients. The primary outcomes were the occurrences of CVAs, including both ischemic and hemorrhagic strokes. Cox proportional hazards regression analysis was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for these outcomes to compare the insomnia and non-insomnia groups.

Results: There were 22,608 ischemic strokes and 3,390 hemorrhagic strokes in the non-insomnia group, compared to 22,669 ischemic strokes and 3,484 hemorrhagic strokes in the insomnia group. The incidence of ischemic stroke (aHR=1.063; 95%CI=1.041-1.085; p<0.001) and hemorrhagic stroke (aHR=1.154; 95%CI=1.093-1.218; p<0.001) was significantly higher in the insomnia group. Kaplan-Meier analysis showed that the cumulative probability of both ischemic and hemorrhagic stroke was significantly greater in the insomnia group (p<0.001 for both). Sensitivity analyses revealed that the increased risk of ischemic stroke in the Asian population and the increased risk of hemorrhagic stroke among African individuals, patients aged 20-44 years, and those with low HDL levels were not statistically significant.

Conclusion: In individuals with hypertension, the presence of insomnia is associated with a significantly higher risk of both ischemic and hemorrhagic stroke.

Background/aim: Colorectal cancer (CRC) presents a significant challenge in oldest-old patients (≥85 years), where surgical intervention carries substantial perioperative risks. Nutritional status is a crucial determinant of outcomes, and the Geriatric Nutritional Risk Index (GNRI) has shown promise. This prospective study aimed to validate the GNRI as a key indicator of perioperative outcomes in oldest-old patients undergoing CRC surgery, and to establish its utility in preoperative risk stratification.

Patients and methods: This prospective study enrolled patients aged ≥85 years undergoing elective surgery for CRC. Preoperative GNRI was calculated using the formula: GNRI=14.89×serum albumin (g/dl)+41.7×[actual body weight/ideal body weight (corresponding to body mass index 22)]. Patients were stratified into two groups: GNRI >98 and GNRI ≤98. Baseline demographics, clinical characteristics, geriatric assessments (including Geriatric-8 and EuroQol 5 dimension), and postoperative complication rates were analyzed.

Results: Twenty-four patients (median age 88 years, interquartile range=86-91) were included: 11 in the GNRI >98 group and 13 in the GNRI ≤98 group. The patients with GNRI >98 demonstrated significantly better G8 scores (median 12 vs. 11, p<0.01) and EQ-5D index values (median 88 vs. 75.0, p<0.01). The postoperative complication rate was significantly higher in the GNRI ≤98 group (p=0.02).

Conclusion: Preoperative GNRI effectively identifies oldest-old patients with CRC at increased risk for postoperative complications. A GNRI ≤98 correlates with poorer nutritional status and impaired geriatric functional parameters. These findings highlight GNRI's utility as a simple, valuable tool for preoperative risk stratification, potentially guiding interventions to optimize outcomes in this vulnerable population.