Hilar cholangiocarcinoma with extensive immunoglobulin G4 reaction

xlomafota13 shared this article with you from Inoreader Hilar cholangiocarcinoma with extensive immunoglobulin G4 reaction Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):987-992. eCollection 2021. ABSTRACT Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a systemic fibroinflammatory disorder that can involve multiple organs. It is often challenging to distinguish IgG4-related sclerosing cholangitis (IgG4-SC) from cholangiocarcinoma because of overlap in their clinical findings. A 75-year-old man presented to a hospital for a detailed examination of the elevation of some biliary enzymes. Radiographic examination revealed segmental bile duct with wall thickening of the common hepatic bile duct, and dilation of the peripheral branches. Transampullary biopsy showed a non-specific inflammatory reaction with several IgG4-positive cell infiltrations. There were no signs of malignancy. The liver biopsy showed bile duct injury accompanied by IgG4-positive cell infiltration. We then performed bile duct biopsy and finally diagnosed the patient with cholangiocarcinoma. We should remember that the IgG4 reaction is neither completely sensitive nor specific for IgG4-RD and avoid resting solely on the IgG4 reaction to precisely distinguish IgG4-SC from cholangiocarcinoma. PMID:34646417 | PMC:PMC8493266 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autochthonous male urothelial carcinoma immune competent model: from induction to BCG transurethral treatment

xlomafota13 shared this article with you from Inoreader Autochthonous male urothelial carcinoma immune competent model: from induction to BCG transurethral treatment Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):980-986. eCollection 2021. ABSTRACT To describe a new animal model of autochthonous urothelial cancer (UC) accessible by transurethral catheter in males, from induction to treatment. Seven-week-old male Fischer 344 rats were used. The first 10 animals were used to overcome and standardize the technical challenges of safe transurethral catheterization of male rats. The remaining 14 animals underwent intravesical N-Methyl-Nitrosourea (MNU) instillation for UC induction, of which six were randomized to undergo intravesical BCG treatment. The stretched male rat urethra travels 35 mm in a tortuous "S" shaped trajectory with a 180° angle behind the pubic bone, safely traversed by a 20G 36" 0.8 mm epidural catheter in a stretched, straightened urethra inserted after anterior dilation of the penile urethra with a 24G IV catheter. Histopathologic analysis of the urinary bladder demonstrated Stage pT1, p Ta, and pTis lesions in the 8 controls, all with increased cell proliferation by Ki-67 expression and no pT1 or pTis in the animals 6 treated with BCG. This pioneering study describes an autochthonous, effective, and accessible transurethral animal model of immune-competent UC in males, and may help with understanding of the biology, immunology, and treatment of UC, which predominates in males. PMID:34646416 | PMC:PMC8493267 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Malignant uterine perivascular epithelioid cell tumor: histopathologic and immunohistochemical characterization of a rare tumor in a post-menopausal woman

xlomafota13 shared this article with you from Inoreader Malignant uterine perivascular epithelioid cell tumor: histopathologic and immunohistochemical characterization of a rare tumor in a post-menopausal woman Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):993-999. eCollection 2021. ABSTRACT BACKGROUND: Perivascular epithelioid cell tumors (PEComas) are rare, mesenchymal neoplasms composed of epithelioid cells exhibiting myogenic and melanocytic differentiation. The uterus is an infrequent site of involvement. The most common histopathologic mimics include leiomyosarcoma, endometrial stromal sarcoma, undifferentiated uterine sarcoma, and malignant melanoma. Rendering an accurate histopathologic diagnosis is essential, owing to the prognostic and therapeutic implications. CASE: A 65-years-old post-menopausal woman presented with post-menopausal bleeding, abdominal pain, and heaviness for the last four months. Ultrasound abdomen revealed a large uterine mass replacing the endometrial cavity. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. RESULT: Microscopically, a circumscribed tumor with tumor cells a rranged in sheets and interlacing fascicles, with interspersed fine capillary network, was seen. The individual tumor cells were epithelioid to spindle with moderate pleomorphism, round nuclei, vesicular chromatin, prominent macronucleoli, and moderate cytoplasm. Mitosis was 2-3/50 HPFs. On immunohistochemistry, tumor cells were positive for HMB-45, Melan-A, and smooth muscle actin and were negative for h-caldesmon, TFE3, S-100, CD10, and pan-cytokeratin. Based on the histopathologic and immunohistochemical features, a final diagnosis of malignant uterine PEComa was rendered. CONCLUSIONS: This index report describes the characteristic histopathologic and immunohistochemical features of malignant uterine PEComa and highlights the salient features that distinguish it from other commonly encountered histopathologic mimics. PMID:34646418 | PMC:PMC8493258 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

lncRNA TUG1 promotes atherosclerosis progression by targeting miR-382-5p

xlomafota13 shared this article with you from Inoreader lncRNA <em>TUG1</em> promotes atherosclerosis progression by targeting miR-382-5p Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):972-979. eCollection 2021. ABSTRACT OBJECTIVE: Atherosclerosis is a key risk factor for the initiation of cardiovascular disease, which results in high morbidity and mortality. lncRNA taurine upregulated gene 1 (TUG1) has been reported to participate in the development of atherosclerosis. Here, we aimed to investigate the interaction of TUG1 and miR-382-5p in regulating atherosclerosis progression. METHODS: The levels of TUG1 and miR-382-5p in atherosclerotic serum samples and a cell model were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Pearson correlation analysis was then applied to TUG1 and miR-382-5p expression. Moreover, the interaction between TUG1 and miR-382-5p was confirmed by luciferase assay. The biological interaction between TUG1 and miR-382-5p was also dissected by loss of function analyse s, including cell counting kit-8 (CCK-8) and Caspase-3 assays for cell proliferation and apoptosis, respectively, in oxidized low-density lipoprotein (ox-LDL)-treated human vascular smooth muscle cells (VSMCs). RESULTS: TUG1 and miR-382-5p expressions were significantly increased and decreased, respectively, in both atherosclerotic serum samples and a cell model. In addition, the expression of TUG1 was negatively correlated with the level of miR-382-5p in atherosclerotic serum samples. Moreover, silencing of TUG1 reduced cell growth and enhanced the apoptosis of ox-LDL-treated VSMCs. Notably, a miR-382-5p inhibitor significantly reversed the effect of TUG1 downregulation on ox-LDL-treated VSMCs, which aggravates the process of atherosclerosis. CONCLUSION: TUG1 can aggravate atherosclerosis progression by reducing the expression of miR-382-5p. This study provides an effective treatment target of atherosclerosis patients based on the TUG1 -miR-382-5p axis. PMID:34646415 | PMC:PMC8493262 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary pure large cell neuroendocrine carcinoma of the ovary: histopathologic and immunohistochemical analysis with review of the literature

xlomafota13 shared this article with you from Inoreader Primary pure large cell neuroendocrine carcinoma of the ovary: histopathologic and immunohistochemical analysis with review of the literature Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):1000-1009. eCollection 2021. ABSTRACT BACKGROUND: Primary ovarian large cell neuroendocrine carcinoma (POLNEC) is an extremely rare and highly aggressive malignancy. Establishing a definite diagnosis requires histopathologic examination with immunohistochemical demonstration of neuroendocrine differentiation in the tumor cells. The histopathology may overlap with a variety of other ovarian malignancies; however, rendering an accurate diagnosis is essential, owing to the therapeutic and prognostic implications. CASE: A 62-year-old, post-menopausal woman presented with complaints of abdominal fullness and dull-aching abdominal pain for the last three months. A pelvic ultrasound revealed the presence of a complex adnexal mass. Serum levels of tumor markers, CA125, carcinoembryonic antigen, alpha-fetoprotein, and beta-human chorionic gonadotropin, were within normal limits. Pelvic magnetic res onance imaging showed a heterogeneous lobulated right adnexal mass measuring 6.7×5.8×5.6 cm, which was T2-hyperintense and T1-hypointense. A provisional diagnosis of ovarian carcinoma was made, and a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. RESULTS: Histopathology showed an organoid and nesting pattern with a focal perivascular arrangement of the tumor cells with large, moderately pleomorphic, round to oval nuclei, granular chromatin, conspicuous nucleoli, and a moderate amount of pale-eosinophilic cytoplasm. Brisk mitosis and lymphovascular space involvement were noted. On immunohistochemistry, the tumor cells showed positivity for chromogranin, synaptophysin, and neuron-specific enolase and were negative for PAX8, WT1, vimentin, and epithelial membrane antigen. p53 showed wild-type, and SMARCB1/INI-1 showed retained nuclear expression. Based on the histopathologic and immunohistochemical features, a final diagnosis of POLNEC was rend ered. The patient received 4 cycles of adjuvant chemotherapy and is disease-free, 28 months post-treatment. CONCLUSIONS: The present report highlights the characteristic histopathologic and immunohistochemical features of POLCNEC to distinguish it from other clinicopathologic mimics and present a comprehensive review of the published literature of all such cases. PMID:34646419 | PMC:PMC8493259 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Organization of the fibrous connective tissue of the fallopian tubes in fertile and climacteric periods: a scanning electron microscopic and stereologic study

xlomafota13 shared this article with you from Inoreader Organization of the fibrous connective tissue of the fallopian tubes in fertile and climacteric periods: a scanning electron microscopic and stereologic study Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Sep 15;14(9):956-963. eCollection 2021. ABSTRACT The extracellular matrix (ECM) of the fallopian tubes is subject to several changes due to hormonal influences and aging. However, there is a lack of studies regarding its arrangement in older women. We aimed to analyze the organization of ECMcomponents, including collagen and elastic fibers, in the fallopian tube's ampulla from young and old women by means of scanning electron microscopical and stereological methods. Twenty-one samples were analyzed: 12 from female cadavers in a fertile age (G1) and 9 from the climacteric period (G2). Masson's trichrome stain was used to observe collagen and smooth muscle, while Weigert's Fuchsin-Resorcin was employed to observe elastic fibers. Statistical analysis was performed by the Wilcoxon-Mann-Whitney test with the aid ofthe R© software. The tissue was also fixed for scanning electron microscopic analysis in a modified Karnovsky solution and the three-dimensional organization of fibrous connective tissue was observed and compared. Statistically significant differences (P < 0.01) were found in all stereologic comparisons of the extracellular matrix between the groups, which revealed a higher volumetric density of the fibrous tissue in the climacteric group. Scanning electron microscopy showed degenerative alterations of extracellular matrix. According to our results, aging caused significant changes to the elements of the extracellular matrix and the smooth muscle of the fallopian tubes. PMID:34646413 | PMC:PMC8493265 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The application of orthodontic bone stretching for correcting malpositioned dental implants

xlomafota13 shared this article with you from Inoreader The application of orthodontic bone stretching for correcting malpositioned dental implants Via Head & Face Medicine Dental implants are sometimes initially placed in a wrong position leading to esthetic damage, which is difficult to solve with prosthetics. Moreover, implants placed in the anterior sector, like ankylosed tee... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The changing face of Irish head and neck cancer epidemiology: 20 years of data

xlomafota13 shared this article with you from Inoreader The changing face of Irish head and neck cancer epidemiology: 20 years of data Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Oct 13. doi: 10.1007/s00405-021-07118-4. Online ahead of print. ABSTRACT BACKGROUND: Head and neck cancer (HNC) is associated with significant morbidity and mortality, especially when high stage disease is present. The epidemiology and prognosis of HNC has changed considerably over the last 20 years. AIMS: This study aimed to examine the epidemiological trends in HNC patients over a prolonged period in Ireland. METHODS: We conducted a retrospective cohort study using 20 years of cancer registry data provided by the National Cancer Registry of Ireland. Baseline characteristics and survival statistics were thereby generated. RESULTS: 10,148 patients were identified. There is a growing population of young (< 50 years) and very old (> 85 years) HNC patients; 48.15% of the population was elderly (> 65 years). Oral cavity (29.8%) and laryngeal cancer (28.1%) remain the most prevalent subsites, though oral cavity cancer prevalence declined from 35.9% in 1994 to 27.5% in 2014. Oropharyngeal cancer prevalence increased from 13.6 to 22.2% over the same period. Overall 5-year survival has improved significantly to 56.8% in 2010 but there remains a disparity between the elderly and adult cohorts (42.0% vs 60.7%). 5-year survival for hypopharyngeal and oropharyngeal cancers has improved from 11.8% and 33.3% to 22.2% and 44.8%, respectively, while laryngeal and oral cavity cancer survival remains approximately stable at 58.7% and 61.5%, respectively. CONCLUSION: HNC survival in Ireland has improved in line with increasing recognition of the value of multidisciplinary assessment, subspecialisation in cancer care, and targeted therapies based on tumour subsites. Survival in the elderly cohort remains poor despite increasing recognition of the challenges such cases pose. PMID:34647138 | DOI:10.1007/s00405-021-07118-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The comprehensive audiological evaluation in young violinists: the medial olivocochlear system, high frequency thresholds, and the auditory figure ground test

xlomafota13 shared this article with you from Inoreader The comprehensive audiological evaluation in young violinists: the medial olivocochlear system, high frequency thresholds, and the auditory figure ground test Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Oct 14. doi: 10.1007/s00405-021-07122-8. Online ahead of print. ABSTRACT PURPOSE: The aim of this study was to examine whether the medial olivocochlear hearing system functions, the high frequency hearing thresholds and speech discrimination in noise performance can guide us in assessing the risk of hearing loss among violinists. It is aimed to investigate possible hearing damage that is not reflected in pure tone hearing thresholds in violinists. METHODS: The participants (n = 50) who have normal hearing and the ages of 18-30 were included in this study in two groups: violinists and controls who are unrelated to music. High frequency audiometer, auditory figure ground test (AFG) for speech discrimination in noise performance, Distortion Product Otoacoustic Emission (DPOAE) and contralateral suppression on DPOAE for medial olivocochlear system function tests were applied to all participants as well as routine audiological tests. RESULTS: The high frequency hearing thresholds were obtained higher in violinists compared to the controls. In violinists, the AFG test scores and the suppression amount at 1 kHz were lower than the controls. In addition, DPOAE responses at 4-6 kHz were obtained lower in violinists (p < 0.05). CONCLUSION: The reason for high frequency hearing loss, decreased DPOAE response amplitudes, and poor medial olivocochlear function in violinists can be explained by the long-term exposure to high-level noise caused by the violin, one of the closest musical instruments. Routine and comprehensive audiological follow-up is crucial for musicians. PMID:34648049 | DOI:10.1007/s00405-021-07122-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Oct 14. doi: 10.1007/s00405-021-07109-5. Online ahead of print. ABSTRACT PURPOSE: This study aimed to construct nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) for patients with locally advanced hypopharyngeal squamous cell carcinoma (HSCC). METHODS: 864 patients with locally advanced HSCC during 2010-2015 from the surveillance, epidemiology and end results (SEER) database were selected. After classifying continuous data by risk, Cox regression analyses were applied to detect significant independent prognostic factors, with which nomograms were established. To evaluate the value of nomograms, concordance index (C-index), area under the receiver-operating characteristic (ROC) curve (AUC), calibration curves, and decision curve analysis (DCA), Kaplan-Meier analysis was adopted. The efficacy of surgery in different risk groups was also studied to figure out people who can benefit from surgery. RESULTS: A total of 864 locally advanced HSCC patients were randomized into the training cohort (n = 608) and the validation cohort (n = 256). Age, race, tumor size, T stage, N stage, primary site, radiotherapy, and chemotherapy were independent prognostic factors for OS and CSS (except race) and formed the nomograms. The nomograms revealed satisfied performance in C-index, AUC, DCA, and calibration curves, and prevailed over American Joint Committee on Cancer (AJCC) TNM staging system in predicting OS and CSS. After risk stratification, patients of low-risk group resulted in the best outcomes. Patients in moderate-risk may benefit from surgery. CONCLUSIONS: Convenient and well-calibrated nomograms to predict OS and CSS for III/IVA/IVB-stage HSCC patients were set up and assessed and may do a favor to make clinical decisions. PMID:34648051 | DOI:10.1007/s00405-021-07109-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Disease-free time stratification in locally recurrent head and neck carcinoma after definitive radiotherapy or chemoradiotherapy

xlomafota13 shared this article with you from Inoreader Disease-free time stratification in locally recurrent head and neck carcinoma after definitive radiotherapy or chemoradiotherapy Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Oct 14. doi: 10.1007/s00405-021-07116-6. Online ahead of print. ABSTRACT PURPOSE: There is no standard definition of disease-free interval before local recurrence after treatment in head and neck carcinoma (HNSCC). We evaluated an easy-to-use stratification and its association with survival in a large cohort of patients. METHODS: We performed a retrospective cohort analysis of prognostic variables in 325 HNSCC patients with a local recurrence after definitive radiotherapy or concurrent chemoradiotherapy. Endpoints were overall survival (OS) and post-recurrence survival (PRS). RESULTS: Variables associated with the survival were the patient age (OS p < 0.0001, PRS p < 0.0001), the initial disease stage (OS p = 0.24, PRS p = 0.0358), localization (OS p = 0.012, PRS p = 0.0002), a complete initial response to treatment (OS p < 0.0001, PRS p = 0.019), synchronous regional or distant meta static disease (OS p = 0.0094, PRS p < 0.0001), a salvage surgery (OS p < 0.0001, PRS p < 0.0001) and time to recurrence (OS p = 0.0002, PRS p = 0.0029). Time to recurrence could be stratified between specific prognostic time categories that comprised disease persistence, early recurrence (< 12 months), standard recurrence (12 months-5 years) and late recurrence (> 5 years). CONCLUSION: In HNSCC patients, time to local recurrence is a prognostic variable that can be defined using an easy-to-use stratification. PMID:34648050 | DOI:10.1007/s00405-021-07116-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.