Cartilage damage is caused by degenerative process and also by trauma, microtrauma or as a consequence of avascular necrosis. The damage may be focal or diffuse over a larger area. Because of the limited healing potential, treatment of articular cartilage injuries is problematic. The choice of surgical treatment depends on several factors: the size, depth and location of the defect, the age of the patient, the desired activity, associated changes and the possibility of postoperative rehabilitation. Finding an appropriate method of treatment for chondral defects with a reliable long-term outcome is difficult. The most common, clinically proven and used surgical techniques include abrasive chondroplasty, marrow stimulating techniques, transplantation procedures or a combination of methods. The possibility of introducing new methods in the form of the application of cultured mesenchymal stem cells represents a significant advance in the field of regenerative medicine. Their use is safe and effective.

The objective of this study is to assess the expression levels of different immaturity CD markers in diverse subtypes of Acute Lymphoblastic Leukemia (ALL) among children and adults, and determine any statistically significant variations in marker expression between these two groups. This dataset included CD marker expressions (CD34, HLA-DR, TdT, and CD38) for 130 ALL patients (51 pediatric B-ALL, 16 pediatric T-ALL, 44 adult B-ALL, and 19 adult T-ALL patients). The Shapiro-Wilk test analysis was conducted to check for normality distribution in all data points before proceeding with the statistical analysis test. As a result for each marker within these subtypes, descriptive statistics were calculated. Independent samples t-tests were initially conducted to compare mean expression levels of CD markers between groups. Moreover, since non-normal distributions are likely to occur, Mann-Whitney U tests were used for Pediatric T-ALL and Adult T-ALL. Descriptive analysis indicated variability in CD marker expression levels among the different subtypes of ALL. Both t-tests and Mann-Whitney U tests revealed statistically significant differences (p < 0.05) in the expression levels of CD markers between pediatric and adult groups, or between B-ALL and T-ALL groups. Significant differences have been identified using different analysis methods across the studied groups. The investigation analyzes the expression levels of CD34, HLA-DR CD38, and TdT within pediatric B-ALL patients and pediatric T-ALL patients along with adult B-ALL patients and adult T-ALL patients. The patterns need appreciation because they might reveal biological differences at their base which influence disease development and both treatment results and patient survival outcomes.

This case report aims to showcase the successful application of electron hypofractionated radiotherapy in the treatment of eyelid basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Two cases are presented involving a 91-year-old Greek female with nodular BCC and an 88-year-old Greek male with ulcerative SCC. Both cases were treated with electron 10MeV irradiation using an ELEKTA 5-15MV linear accelerator. In the first case, a patient with advanced dementia presented with left-upper-eyelid nodular BCC. Following confirmation through biopsy and imaging, hypofractionated electron-beam radiotherapy was chosen, leading to gradual recession of the lesion and no recurrence at the one-year follow-up. In the second case, an elderly male with comorbidities had right-upper-eyelid ulcerative SCC. After systemic evaluation ruled out metastasis, the patient underwent hypofractionated radiotherapy, resulting in unexpected lesion shrinkage, resolution, and absence of recurrence at the 6-month and one-year follow-ups. Hypofractionated electron-beam radiotherapy emerges as an effective and well-tolerated alternative for eyelid tumors, particularly in cases where surgical excision is challenging or contraindicated.

Anomalous extensor indicis proprius (EIP) tendons are rare anatomical variations that can cause wrist pain and dysfunction due to tendon compression and inflammation. These variations, though often asymptomatic, are implicated in conditions such as fourth extensor compartment peritendinitis, requiring accurate diagnosis and tailored treatment. We report the case of a 56-year-old man with chronic right wrist pain lasting eight months, primarily aggravated by finger extension. Physical examination revealed a tender nodule on the dorsum of the wrist and pain elicited by the Spinner test, indicating involvement of the fourth dorsal compartment. Magnetic resonance imaging (MRI) showed an anomalous, thickened EIP tendon with peritendinitis. The patient opted for conservative management, including nonsteroidal anti-inflammatory drugs (NSAIDs) and activity modification, which led to complete symptom resolution within two weeks. This case highlights the clinical relevance of EIP tendon anomalies, which can mimic other wrist pathologies. The Spinner test and imaging modalities such as MRI are essential for diagnosis. While conservative treatment is often sufficient, surgical decompression may be necessary in refractory cases. Awareness of these rare anatomical variations is crucial for accurate diagnosis and effective management, ensuring better outcomes for patients with wrist pain.

Endoscopic ultrasound guided fine needle aspiration cytology (EUS-FNAC) with the employment of cell block preparations and intraoperative squash smear cytology upgrade the interpretation accuracy and typing of common malignant lesions. Yet, their capacity in the diagnostic workup of less familiar neoplastic entities is not clearly determined and this analysis was designed towards this direction. We describe four cases of patients with uncommon malignancies and evaluate EUS-FNA cell block cytology and intraoperative squash smear cytology as a necessary (important) step in rendering the diagnosis. All cases enhance the diagnostic role of cytology in a wide variety of neoplastic disorders including lymphoproliferative conditions and rare carcinomas.

Breast cancer is the second leading cause of cancer-related death and the most common type of cancer in women. Recent studies have shown that the development of carcinogenesis is influenced by impaired XRCC1 expression. Therefore, research on the relationship between the XRCC1 Arg399Gln polymorphism and the luminal subtype of breast cancer is important so that it can be used as a reference for further research development. This study lasted for 12 months at the Integrated Biomedical Laboratory and Biochemistry Laboratory, Faculty of Medicine, Udayana University. The samples consisted of 30 samples of stored biological material from previous studies with a case-control study design. The status of the XRCC1 Arg399Gln polymorphism was determined by performing PCR on blood samples. Furthermore, the samples were analyzed with SPSS version 25.0. The number of samples in this study was 15 cases and 15 controls with the majority aged > 50 years. The results of the analysis showed that differences in age groups, menstrual status, and cancer grade were significantly associated with breast cancer subtypes (p < 0.05). Based on the results of sequencing and bivariate analysis, the XRCC1 Arg399Gln polymorphism acted as a protective risk factor for the development of luminal subtype breast cancer (OR = 0.182; p = 0.028). XRCC1 Arg399Gln polymorphism is associated with the risk of luminal subtype breast cancer in Bali.

To evaluate whether baseline serum creatinine is associated with survival outcomes in patients with advanced high-grade serous ovarian carcinoma undergoing neoadjuvant chemotherapy. We retrospectively analyzed 77 patients treated between 2009 and 2018. Patients were stratified by baseline serum creatinine levels (<84 vs. ≥84 µmol/L), and survival outcomes were assessed using Kaplan-Meier analysis. No statistically significant differences in progression-free or overall survival were observed between groups. A trend toward shorter OS in the elevated creatinine group did not reach significance. Baseline serum creatinine was not found to be a statistically significant prognostic marker in this cohort. These results highlight the need for adjusted analyses incorporating established prognostic factors in future research.

The etiology of rotator cuff tear (RCT) is multifactorial and includes extrinsic and intrinsic factors. Alterations of the peripheral microcirculation represent a main intrinsic etiological factor; recent evidence demonstrates that at the level of the rotator cuff tendons there is significant reduction in capillary density and microvascular blood flow. On the basis of the alterations of the microcirculation present at the level of the rotator cuff (RC) tendons, the aim of our study was to evaluate the possible presence of alterations of the peripheral nail microcirculation, through capillaroscopic examination, in a consecutive series of patients with RCT, comparing them with an adequate control group. The hypothesis of our study is that the alteration of the local microcirculation is accompanied in patients with RCT by an alteration of the peripheral microcirculation that may represent a systemic predisposing factor for tendon degeneration. A case-control study was conducted. The Case Group consisted of 82 patients (mean age 61 years ± 8) with RCT, the size of which was assessed intraoperatively and classified into small, large and massive according to Snyder; the control group was represented by 43 healthy subjects (mean age 63 years ± 9). All control subjects underwent ultrasound examination to objectively exclude rotator cuff tears. All participants underwent a nail capillaroscopic examination of the hands to evaluate morphological and dynamic parameters. The data was subsequently analyzed. In the Case Group, 34 patients had a small RC lesion, 23 had a large lesion, and 25 had a massive lesion. The main capillaroscopic differences between cases and controls were found in the morphology of the capillary loops and in the flow. In the group of cases, 50% have normal loops, 47.56% have tortuous loops and 2.44% have branched loops; in the control group 62.79% had normal loops, 34.88% had tortuous loops and 2.33% had branched loops. The capillary flow was normal in 46.34% of the cases group, granular in 48.78% and slowed in 2.44%. 95.35% of the control group had normal flow and 2.33% grainy flow. Regarding the severity of the lesion, no significant differences were found between patients with small, large and massive lesion (small lesion: 50% normal loops, 41.2% normal flow; large lesion: 52% normal loops, 47.8% normal flow; massive lesion: 48% normal loops, 48% normal flow). The prevalence of capillaroscopic alterations was higher in patients with rotator cuff tears: the capillary loops are more tortuous and present ectasias more frequently than in the control group. Additionally, capillary flow in patients with RCT is grainier and slowed. However, the compromise of the capillary picture is not proportional to the severity of the tendon lesion, limiting the direct clinical applicability of this finding. The results support the hypothesis that peripheral microcirculation disorders constitute an etiological factor predisposing to tendon degeneration and, therefore, rupture. Further longitudinal studies are needed to assess whether these alterations can predict healing outcomes and risk of re-tear after surgical repair.

Oxidized cellulose-based haemostatic agents are widely used for managing bleeding in various surgical procedures. This study evaluates the efficacy and safety of oxidized cellulose powder and an endoscopic applicator across a broad spectrum of surgical settings. This was a prospective, multicentre study involving 99 evaluable patients undergoing surgeries with varying bleeding severities and surgical approaches (open, laparoscopic, or thoracoscopic). The primary endpoint was achieving haemostasis within 3 minutes and avoiding revision surgery within 12 hours. The time to haemostasis (TTH) and complications were recorded, and statistical comparisons were made using a paired and unpaired t-test, with a significance threshold of P < 0.05. Data from this study were compared to historical results from fibrillar haemostats. Haemostasis was achieved within 3 minutes in 61.6% (95% CI [52.0, 71.2]) of patients and within 5 minutes in 99.0% (95% CI [97.0, 100.0]) of patients. The overall mean TTH was 153.8 seconds (95% CI: 141.5-166.1), with shorter TTH observed in minimally invasive procedures using the endoscopic applicator. Subgroup analysis revealed higher success rates for patients with mild bleeding (78%) compared to moderate bleeding (50%). Oxidized cellulose powder demonstrates reliable haemostatic performance across diverse surgical applications. The endoscopic applicator enhances precision and applicability, particularly in minimally invasive settings, making it a valuable tool in modern surgical practice.

Arteriovenous fistulas (AVFs) are widely accepted as the gold standard for vascular access in chronic hemodialysis patients due to their superior long-term patency and low complication rates. However, up to half of all created AVFs fail to mature adequately, and many develop late complications such as stenosis, thrombosis, or aneurysmal degeneration. This review provides an overview of the AVF development process, focusing on the biomechanical forces that drive vascular remodeling and contribute to maturation and pathological changes. We summarize the role of endothelial mechanotransduction and insights from recent studies that reveal how wall shear stress (WSS) patterns and oscillatory flow relate to the genesis of neointimal hyperplasia and later stenosis. Understanding these mechanobiological processes has led to novel surgical techniques, anastomosis design optimization, and better cannulation strategies. Although the knowledge of hemodynamic-biological interactions remain limited, further research can offer directions for better AVF performance.