Glands Of Patients Research Articles

Clinical, Radiological and Histopathological Features of Patients With Lacrimal Gland Enlargement.

The purpose of this study was to describe the radiologic and histopathologic features of lacrimal gland in patients presenting with lacrimal gland enlargement. We retrospectively retrieved the data of patients with lacrimal gland enlargement in Farabi Eye Hospital between 2012 and 2017. These data included demographics, the patients' facial photographs, orbital CT-scans, and histopathological findings of lacrimal gland biopsies. Forty-seven patients (15 men and 32 women) were enrolled in this study with a median age of 37.9 years (range, 15-79 years). Histopathologic diagnoses were chronic dacryoadenitis in 26 cases (55.32%), IgG4-related disease in 6 patients (12.77%), two cases of acute dacryoadenitis, two cases of non-necrotizing granulomatous inflammation, two cases of Non-Hodgkin's B-cell lymphoma, two cases of adenoid cystic carcinoma and two cases of mixed tumor (4.26% each), as well as one case of conjunctival epithelial cyst, and one case of benign lymphoid tissue and fibrofatty tissue (2.13%). In two samples (4.26%), biopsy revealed normal lacrimal glands. Interestingly, in two cases with relapsing lacrimal gland enlargement, different histopathologic diagnoses were found in biopsies taken from each lacrimal gland at different times. The average size of enlarged lacrimal glands was 19.67 mm × 7.06 mm on axial CT scan and 19.44 mm × 6.20 mm on coronal CT scan. Tissue biopsy is needed for diagnosis of lacrimal gland enlargement because it is difficult to distinguish the type of the lacrimal gland pathology based solely on clinical or radiological presentation.

Alterations in meibomian glands in patients treated with intensity-modulated radiotherapy for head and neck cancer

Patients undergoing intensity-modulated radiotherapy (IMRT) for head and neck cancer may have increased incidence of dry eye disease and the exact mechanism is unclear. The present study aims to assess tear film and meibomian gland (MG) features in patients who received IMRT for head and neck cancer not involving the orbital area. Twenty-seven patients (64.7 ± 9.8 years) and 30 age-matched controls (61.4 ± 11.0 years) underwent a comprehensive dry eye work-up. Compared to the control group, the patients had more lid margin abnormalities, and worse meibum quality. The MG loss, calculated as (tarsal area-MG area)/tarsal area, was higher in the patient group in both the upper (53.0 ± 12.0% vs. 35.1 ± 10.3%, p < 0.001) and lower lids (69.5 ± 12.6% vs. 48.5 ± 12.5%, p < 0.001). In the patient group, more MG loss in the lower lids correlated with worse meibum quality (r = 0.445, p = 0.029). In contrast, there was no significant difference in aqueous tear production level, measured with Schirmer test. Patients treated with IMRT for head and neck cancer seemed to have comparable lacrimal gland function to the controls despite more dry eye symptoms. However, the patients had MG functional and morphological changes, which may present a higher risk for developing dry eye disease.

Magnetic resonance picture of changes in the prostate gland in patients with localized prostate cancer after radical external beam radiotherapy

Introduction. Magnetic resonance imaging (MRI) is a highly informative imaging technique, but now days is not recommended for detecting prostate cancer revealing after external beam radiation therapy (EBRT) at localized prostate cancer.Purpose of the study. To study the magnetic resonance imaging of changes in the prostate gland in patients with localized prostate cancer after radical EBRT. Materials and methods. Studied and compared the data of clinical and histological studies of a series of MRI in nine patients with prostate cancer before and after EBRT. Standard sequences (T2-weighted images, diffusion-weighted images, dynamic con trast enhancement) were used for MRI. Results. After irradiation, in a delayed period, atrophy and fibrotic changes occur in the structure of the prostate gland, which leads to a decrease in its size, uneven contours, and the impossibility of differentiating the zonal anatomy on T2-VI. After RT, the intensity of the MR signal from the tumor on DWI with a high b-factor decreases, the difference in the ADC of the peripheral, transient zones and the tumor is practically leveled. After RT, the hypervascularity of the tumor progressively decreases, there fore, in the delayed period, in most cases, type 3 of the contrast curve is observed in DCE. In general, MRI gives results consistent with the dynamics of serum PSA levels. However, one patient after EBRT showed signs of local progression on MRI without signs of biochemical progression.Conclusion. MRI can be used as a method for early diagnosis of local recurrence of prostate cancer after EBRT, however, its clinical significance requires further study.

Benefits of intraoral stents for sparing normal tissue in radiotherapy of nasopharyngeal carcinoma: a radiobiological model-based quantitative analysis.

BackgroundTo determine the value of individualized intraoral stent for normal tissue sparing in radiotherapy of nasopharyngeal carcinoma (NPC) using quantitative analysis of radiobiological model.MethodsSixteen patients with NPC who used intraoral stent and 17 patients without intraoral stent were enrolled in this study. All patients underwent Helical Tomotherapy (HT) in our center. Based on the patient’s dose volume histogram (DVH), the modified Webb-Nahum model was used to predict tumor control probability (TCP), and the parallel architecture model and Lyman-Kutcher-Burman (LKB) model were used to estimate the normal tissue complications probability (NTCP). The differences of TCP, NTCP and dosimetric parameters between the two groups were compared and analyzed.ResultsThe mean dose metrics of oral cavity, mandible, left and right parotid gland in patients with intraoral stent was significantly decreased by 11.6%, 12.2%, 15.4%, and 8.7% on average, respectively (P<0.05), while the conformity index (CI, P=0.056) and homogeneity index (HI, P=0.676) of the tumor target showed no statistically different. Quantitative assessment of radiobiological model revealed that the NTCP of oral cavity and parotid glands were both significantly lower in patients with intraoral stent than those without intraoral stent (P<0.001), without compromising TCP of the tumor target (P=0.056). For example, patients using intraoral stent significantly reduced oral mucositis and xerostomia complication probability by 2.52% and 10.11% on average compared to unused ones, respectively.ConclusionsThe custom-made intraoral stents showed promising value at sparing normal tissue during radiotherapy for NPC without affecting target dose coverage or tumor control.

Treatment of Sjögren's Syndrome with Mesenchymal Stem Cells: A Systematic Review.

Mesenchymal stem cells (MSCs) are ubiquitous in the human body. Mesenchymal stem cells were initially isolated from bone marrow and later from other organs such as fatty tissues, umbilical cords, and gingiva. Their secretory capacities give them interesting immunomodulatory properties in cell therapy. Some studies have explored the use of MSCs to treat Sjögren’s syndrome (SS), a chronic inflammatory autoimmune disease that mainly affects exocrine glands, including salivary and lacrimal glands, although current treatments are only palliative. This systematic review summarizes the current data about the application of MSCs in SS. Reports show improvements in salivary secretions and a decrease in lymphocytic infiltration in salivary glands in patients and mice with SS after intravenous or infra-peritoneal injections of MSCs. MSC injections led to a decrease in inflammatory cytokines and an increase in anti-inflammatory cytokines. However, the intrinsic mechanism of action of these MSCs currently remains unknown.

Clinicopathological variables that correlate with sestamibi positivity in uniglandular parathyroid disease: a retrospective analysis of 378 parathyroid adenomas.

Technetium-99m sestamibi parathyroid scintigraphy (MIBI scan) has been used to localize abnormal glands in patients with primary hyperparathyroidism to guide parathyroidectomy. This series aimed to identify the biochemical and histopathological correlates of MIBI scan findings in patients with parathyroid adenoma. A total of 378 patients with histologically and biochemically proven parathyroid adenoma were included. The results of MIBI scan, histopathological (gland volume and weight, oxyphil cell ratio), biochemical (blood and 24h urine calcium, creatinine, glomerular filtration rate, parathormone, alkaline phosphate, and vitamin D3) variables were recorded. A positive uptake on the MIBI scan referred to a localized adenoma. Among histological variables, a cutoff of 30% was applied to define parathyroid adenomas with low (≤ 30%) and high (> 30%) oxyphil cell content. Statistical analyses were performed to assess the relationship among variables. MIBI scan localized the adenoma in 306 patients. Parathyroid gland volume and weight, and oxyphil ratio were significantly higher in the MIBI scan-positive group. Among the biochemical variables, only PTH was found to be significantly increased in the MIBI scan-positive group. Binary logistic regression models identified statistically significant cutoffs for the gland volume (1700mm3), gland weight (1.3g) and PTH levels (170pg/mL) that can be used to predict the MIBI scan positivity. In addition to PTH levels, this series underscored the impact of cellular composition along with the parathyroid gland volume and weight, both of which correlate with sestamibi positivity in patients with benign uniglandular parathyroid disease.

Анализ ипсилатеральной адренальной патологии у пациентов с почечно-клеточным раком

The purpose of the study was the analysis of the structure of the pathology of the ipsilateral adrenal gland after radical nephrectomy or partial nephrectomy in patients with renal cell cancer. Materials and methods. To study the structure of adrenal pathology in a sample of 2,084 patients who were treated for renal cell cancer, a retrospective study of the pathological findings and case reports of 108 patients, in whom surgical treatment included adrenalectomy or adrenal resection, was performed. Results and discussion. In 10 (83.3%) of 12 patients with adrenal gland resection, mass lesions of this organ served as an indication for adrenal surgery, while in 2 (16.7%) patients intraoperative adrenal trauma was noted. In this group, there were no situations of preservation of the adrenal gland with a direct generalization of the renal tumor to it. Among 98 patients who underwent adrenalectomy, the main indications for removal of the adrenal gland were its mass lesions in 65 (66.3%) cases, while direct tumor generalization to the ipsilateral adrenal gland took place in 8 (8.2%) cases. In other 7 (7.1%) situations, a tumor thrombus penetrated through the lumen of the renal or inferior vena cava into the lumen of the adrenal vein. In 16 (16.7%) patients, adrenalectomy was performed due to massive trauma to the adrenal gland during the removal of massive renal tumors localized in the upper pole of the kidney. Among all 75 patients with mass ipsilateral lesions of the adrenal glands, metastases of renal cell cancer were detected in 12 (16%) cases. In 59 (78.7%) cases benign adrenal adenomas were found, in 2 (2.7%) cases – myelolipomas, in 1 (1.3%) – adrenal hyperplasia, in another 1 (1.3%) – pheochromocytoma. The proportion of synchronous malignant pathology of the ipsilateral adrenal gland in patients with renal cell cancer and with indications for adrenalectomy was 25% (27 out of 108 observations). In relation to all 2,084 operated patients, this indicator did not exceed 1.3%. In the group of organ-preserving surgery, it was significantly lower – 0.2% (2 out of 968 patients), while in the group of radical or cytoreductive nephrectomy it reached 2.2% (25 out of 1116 cases). The total amount of cases of the ipsilateral adrenal gland lesions with renal cell cancer was also studied: 12 (0.6%) – metastases, 8 (0.4%) – direct tumor generalization and 7 (0.3%) – tumor invasion into the adrenal vein, which was determined in 27 (1.3%) patients. Conclusion. The need for ipsilateral adrenalectomy or adrenal resection is extremely rare in the large modern cohort of patients. At the same time, a significant part of the synchronous formations of the ipsilateral adrenal glands is benign tumors. In this regard, further study of the feasibility and safety of adrenal organ-preserving surgeries is necessary

Клиническая оценка нарушений мелатонинобразующей функции эпифиза и анемии у больных с хронической болезнью почек 5-й стадии, которые лечатся гемодиализом

Актуальность. Результаты ряда исследований доказали наличие взаимосвязи между функциональным состоянием эпифиза и функцией почек. Однако нарушение мелатонинобразующей функции эпифиза (МФЭ) у больных хронической болезнью почек (ХБП), находящихся на гемодиализе (ГД), и его связь с развитием анемии у данной популяции пациентов являются малоизученным вопросом. Цель: провести клиническую оценку анемии у больных ХБП 5-й стадии, которые лечатся ГД, в зависимости от клинико-демографических показателей и определить ее связь с нарушением МФЭ. Материалы и методы. Обследованы 130 пациентов (50 % мужчин) с ХБП 5-й стадии, находящихся на лечении гемодиализом. С учетом уровня мелатонина (МТ) в слюне больных, которые лечатся ГД, разделили на две группы: группа I — 110 больных с нарушенной МФЭ, группа II — 20 пациентов с нормальной МФЭ. Контрольную группу составили 20 здоровых лиц, сопоставимых по возрасту и полу. Всем больным проведены клинико-лабораторные исследования: общий и биохимический анализы крови с определением всех показателей обмена железа крови, липидного профиля, измерение артериального давления, расчет индекса массы тела, определение концентрации мелатонина в слюне в разные периоды суток и паратгормона. Результаты. Обнаружена значительная распространенность нарушения МФЭ у больных ХБП 5-й стадии, которые лечатся ГД, и его связь с развитием анемии. Анализ циркадных уровней МТ в зависимости от степени тяжести анемии продемонстрировал глубокие их нарушения у пациентов со средней степенью тяжести анемии, при котором достоверная разница определялась по уровню МТ в ночное время (р = 0,004). Анализ корреляционных связей показал слабую отрицательную корреляционною связь между уровнем гемоглобина (Нb) и продолжительностью лечения ГД (r = –0,217; р &lt; 0,05), что может свидетельствовать о прогрессировании анемии при увеличении стажа почечно-заместительной терапии (ПЗТ). Установлены положительные корреляции между Нb и уровнем дневного МТ (r = 0,193; р &lt; 0,05) и более тесные — с уровнем ночного МТ (r = 0,278; р &lt; 0,05), что отражает взаимосвязь между нарушением МФЭ и синтезом Нb. Продемонстрирована отрицательная корреляционная связь ферритина с Нb (r = –0,31; р &lt; 0,05), с уровнем сывороточного железа (r = –0,202; р &lt; 0,05) и уровнем трансферрина (r = –0,234 р &lt; 0,05). Отрицательная корреляционная связь определяется между уровнем ферритина и дневным уровнем МТ в слюне (r = –0,202; р &lt; 0,05), связь средней силы — с ночным уровнем МТ (r = –0,396; р &lt; 0,05). При анализе уровня трансферрина определялись положительные корреляционные связи последнего с дневным уровнем МТ (r = –0,332; р &lt; 0,05) и средние корреляционные связи — с ночным (r = 0,447; р &lt; 0,05). Определялась обратная слабая корреляционная связь трансферрина со стажем ГД (r = –0,191; р &lt; 0,05). Выводы. Продемонстрирована высокая частота нарушения МФЭ (84,6 %), что ассоциируется со значительной распространенностью анемии и дефицита железа у больных ХБП 5-й стадии, находящихся на лечении ГД. У больных на ПЗТ установлена взаимосвязь между степенью дисфункции эпифиза и тяжестью анемии, при этом она усиливается с увеличением срока лечения ГД, продолжительности АГ. У больных на ГД концентрация ферритина отражает активность воспаления, возрастает при нарушении МФЭ. Дисфункция эпифиза и анемия имеют возрастзависимый характер: наиболее выражены в пожилом возрасте.

Molecular Mechanism of Sphingosine-1-Phosphate Receptor 1 Regulating CD4+ Tissue Memory in situ T Cells in Primary Sjogren's Syndrome.

ObjectiveAlthough extensive research has been carried out on CD4+T cells infiltrating the labial glands in patients with primary Sjögren’s Syndrome (pSS), it is still unclear how CD4+T cells remain in the labial gland tissue and develop into tissue resident cells. The aim of this study was to investigate the molecular mechanism by which CD4+T reside in labial glandular tissue of pSS patients.MethodsLymphocyte infiltration in labial salivary glands (LSG) of pSS patients was detected by H&E staining. Expression of sphingosine-1-phosphate receptor 1 (S1PR1) in LSG was examined by Immunohistochemistry. Immunofluorescence analyses were utilized to detect the co-expression of CD4, CD69 and S1PR1 in T cells of LSG of pSS patients. Expression of gene S1pr1 in peripheral blood CD4+T cells of healthy controls and pSS patients was detected by quantitative real-time PCR (QPCR). QPCR was used to examine the expression of gene S1pr1, Klf2, and Cd69 in the CD4+T cells that were co-cultured in vitro with cytokines TNF-α, TGF-β, and IL-33.ResultsS1PR1 was expressed in the infiltrating monocytes in LSG of pSS patients, and S1PR1 was weakly or even not expressed in cytoplasm of CD4+CD69+TRM cells of LSG in patients with pSS. Expression of gene S1pr1 in peripheral blood CD4+T cells of pSS patients was about three-fifths of that of healthy controls (P < 0.05). Expression of genes S1pr1 (P < 0.001) and Klf-2 (P < 0.001) was significantly decreased, and the expression of gene Cd69 (P < 0.05) was significantly increased in peripheral blood CD4+T cells of pSS patients co-cultured in vitro with cytokines TNF-α, TGF-β, and IL-33.ConclusionOur study suggests that the decrease of S1pr1 gene expression may provide a molecular basis for promoting the tissue retention and development of CD4+CD69+TRM cells.

Trans-oral robotic surgery for Hilo-parenchymal submandibular stones

Sialolithiasis represents a common benign disease of the major salivary glands. Conventional therapeutic approaches include trans-oral sialendoscopy removal of the stones, duct incision and marsupialization, and trans-cervical sialadenectomy. However, the recent technological innovations of endoscopic and robot-assisted surgery provide unique opportunities to treat submandibular salivary gland stones. During the last decade, surgical robots have been utilized to remove submandibular glands in patients with sialolithiasis. In addition, they have used surgical access methods such as trans-hairline and facelift incisions for superior cosmesis. Most salivary stones involve the submandibular gland (80%–90%), and the most frequent locations are the distal tract of the duct, the hilum, and the hilo-parenchymal area. Trans-oral robotic surgery (TORS) has been proposed for the removal of hilo-parenchymal submandibular stones. TORS appears to be a viable option specifically in cases of deep and nonpalpable stones, multiple and recurrent intraparenchymal stones as well as iatrogenic duct stenoses. In this article, we review and discuss The role of TORS in the treatment of hilo-parenchymal submandibular stones.

Wnt signaling pathway activities may be altered in primary Sjogren’s syndrome

Background/aimSjögren’s syndrome (SS) is an autoimmune disease and its pathogenesis is still not completely clear. The wingless (Wnt)/β-catenin pathway has recently been shown to play an important role in inflammation. This study aims to determine the serum and saliva levels of Dickkopf (DKK)1 and sclerostin and to evaluate Wnt-1 and Wnt-3a expression in the salivary gland in patients with primary SS.Materials and methods This study included 30 patients diagnosed with SS, 30 patients diagnosed with systemic lupus erythematosus (SLE), and 29 healthy controls. Serum and saliva levels of DKK1 and sclerostin were measured and the expressions of Wnt1 and Wnt3a in the salivary gland were measured immunohistochemically. ResultsSerum DKK1 and sclerostin levels were lower in the SS and SLE groups compared to the control group (both p < 0.001). Saliva DKK1 levels were higher in the SS group compared to the control and SLE groups (p = 0.004 and p = 0.009, respectively). Wnt1 and Wnt3a expression were found in salivary gland tissue samples in 71.4% of primary SS patients and relatively frequent than control group.ConclusionsSerum DKK1 and sclerostin levels in primary SS and SLE were decreased. Moreover, levels of Wnt1 and Wnt3a expression in the salivary gland were also elevated in primary SS. Therefore, it can be concluded that the Wnt/β-catenin pathway activities may be altered in case of glandular inflammation.

Sonographic findings of immunoglobulin G4-related sialadenitis and differences from Sjögren’s syndrome

Objective To evaluate ultrasonic features of the major salivary glands in patients with immunoglobulin G4-related sialadenitis (IgG4-RS) and to explore the differences between IgG4-RS and Sjögren’s syndrome (SS). Method We conducted the study in 150 patients with IgG4-RS and 100 patients with SS. Ultrasonographic variables of the static images of major salivary glands were analysed. An experienced radiologist scored the confidence rating regarding the presence of the characteristic imaging findings using a five-grade rating system. Ultrasonography scores between IgG4-RS and SS were compared. Results The major salivary glands were significantly larger in patients with IgG4-RS than in the SS group. The main features of ultrasonography of the salivary glands in IgG4-RS were various hypoechoic lesions and increased colour Doppler signalling. In contrast, the major salivary glands in SS exhibited hyperechoic lines and/or spots and obscuration of the gland configuration. The scores of the summarized sonographic characteristics also showed statistically significant differences between the IgG4-RS and SS groups. Conclusion This study revealed different ultrasonic features of the major salivary glands in patients with IgG4-RS and SS. The scored sonographic features were helpful in differentiating IgG4-RS from SS. Consequently, we suggest that ultrasonography of major salivary glands could be a useful imaging procedure in the evaluation of patients suspected of having IgG4-RS.

Transcriptome analysis discloses dysregulated genes in normal appearing tumor-adjacent thyroid tissues from patients with papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. The molecular characteristics of histologically normal appearing tissue adjacent to the tumor (NAT) from PTC patients are not well characterized. The aim of this study was to characterize the global gene expression profile of NAT and compare it with those of normal and tumor thyroid tissues. We performed total RNA sequencing with fresh frozen thyroid tissues from a cohort of three categories of samples including NAT, normal thyroid (N), and PTC tumor (T). Transcriptome analysis shows that NAT presents a unique gene expression profile, which was not associated with sex or the presence of lymphocytic thyroiditis. Among the differentially expressed genes (DEGs) of NAT vs N, 256 coding genes and 5 noncoding genes have been reported as cancer genes involved in cell proliferation, apoptosis, and/or tumorigenesis. Bioinformatics analysis with Ingenuity Pathway Analysis software revealed that “Cancer, Organismal Injury and Abnormalities, Cellular Response to Therapeutics, and Cellular Movement” were major dysregulated pathways in the NAT tissues. This study provides improved insight into the complexity of gene expression changes in the thyroid glands of patients with PTC.

18FDG positron emission tomography mining for metabolic imaging biomarkers of radiation-induced xerostomia in patients with oropharyngeal cancer

PurposeHead and neck cancers radiotherapy (RT) is associated with inevitable injury to parotid glands and subsequent xerostomia. We investigated the utility of SUV derived from 18FDG-PET to develop metabolic imaging biomarkers (MIBs) of RT-related parotid injury. MethodsData for oropharyngeal cancer (OPC) patients treated with RT at our institution between 2005 and 2015 with available planning computed tomography (CT), dose grid, pre- & first post-RT 18FDG-PET-CT scans, and physician-reported xerostomia assessment at 3–6 months post-RT (Xero 3–6 ms) per CTCAE, was retrieved, following an IRB approval. A CT-CT deformable image co-registration followed by voxel-by-voxel resampling of pre & post-RT 18FDG activity and dose grid were performed. Ipsilateral (Ipsi) and contralateral (contra) parotid glands were sub-segmented based on the received dose in 5 Gy increments, i.e. 0–5 Gy, 5–10 Gy sub-volumes, etc. Median and dose-weighted SUV were extracted from whole parotid volumes and sub-volumes on pre- & post-RT PET scans, using in-house code that runs on MATLAB. Wilcoxon signed-rank and Kruskal-Wallis tests were used to test differences pre- and post-RT. Results432 parotid glands, belonging to 108 OPC patients treated with RT, were sub-segmented & analyzed. Xero 3–6 ms was reported as: non-severe (78.7%) and severe (21.3%). SUV- median values were significantly reduced post-RT, irrespective of laterality (p = 0.02). A similar pattern was observed in parotid sub-volumes, especially ipsi parotid gland sub-volumes receiving doses 10–50 Gy (p < 0.05). Kruskal-Wallis test showed a significantly higher mean RT dose in the contra parotid in the patients with more severe Xero 3-6mo (p = 0.03). Multiple logistic regression showed a combined clinical-dosimetric-metabolic imaging model could predict the severity of Xero 3-6mo; AUC = 0.78 (95%CI: 0.66–0.85; p < 0.0001). ConclusionWe sought to quantify pre- and post-RT 18FDG-PET metrics of parotid glands in patients with OPC. Temporal dynamics of PET-derived metrics can potentially serve as MIBs of RT-related xerostomia in concert with clinical and dosimetric variables.

LASER TECHNOLOGIES IN SURGERY BENEFICIAL PROSTATE HYPERPLASIA

Benign prostatic hyperplasia is one of the most common diseases in urological practice. The classical method of surgical treatment of benign prostatic hyperplasia is transurethral resection of the prostate gland. However, this operation is accompanied by a fairly large number of postoperative complications and is not recommended for patients with a large prostate volume, with a high cardiovascular risk, and receiving anticoagulant therapy. In recent years, the medical community has been paying close attention to laser technologies. The article provides an overview of the literature on laser methods for the treatment of benign prostatic hyperplasia. Modern laser systems are considered: holmium, thulium, diode, «green» lasers. The advantages and disadvantages of each technique are described. The results of studies of the efficacy and safety of laser surgical methods for the treatment of benign prostatic hyperplasia and their influence on the indicators of urodynamics, symptoms of the disease, and the quality of life of patients are presented. Based on the analysis of scientific literature sources, it was concluded that laser methods of surgical treatment of benign prostatic hyperplasia are clinically effective and safe. Compared with transurethral resection of the prostate, laser technologies can shorten the period of hospitalization and catheterization of patients, have a low number of complications, provide good hemostasis, and can be used regardless of the volume of the gland in patients with concomitant diseases who are taking anticoagulants. Laser methods of surgical treatment of benign prostatic hyperplasia are currently a full-fledged worthy alternative to transurethral resection of the prostate gland. Among the disadvantages of using laser systems are the duration of the operation and the need to train specialists in the technique of surgical intervention.

Meibomian glands dropout in patients with inactive thyroid related orbitopathy.

PurposeTo evaluate the structure and function of meibomian glands in patients with thyroid related orbitopathy (TRO) compared with age- and sex-matched controls without TRO.MethodsThis cross-sectional study included 106 eyes of 53 patients with TRO and 106 eyes of 53 age- and sex-matched controls without TRO. Patients with TRO were assessed for thyroid hormone status, activity and severity of TRO. All participants completed OSDI questionnaires. Their meibomian glands’ structure and function were assessed, including the area of meibomian gland dropout, lipid layer thickness (LLT), meibum expressibility and quality scores, tear break-up time (TBUT), corneal and conjunctival staining scores. A generalized estimating equation (GEE) was used to compare between the two groups. The correlations between the area of meibomian gland dropout with symptoms and signs of TRO were evaluated using GEE and Spearman correlation.ResultsAll patients with TRO had inactive status. The mean area of meibomian gland dropout was higher in the TRO group (34.5±11.2%) compared with that of controls (30.1±10.7%, P = 0.03). Both mean meibum quality (TRO, 1.6±0.7; Controls, 2.0 ±0.5) and expressibility (TRO, 1.5 ±0.7; Controls, 1.7 ±0.6) scores were slightly better in the TRO group compared with those of controls (P = 0.01). There was no significant difference in OSDI, corneal and conjunctival staining, TBUT and LLT. The area of meibomian gland dropout in patients with TRO was correlated with euthyroid status (P<0.05) and lagophthalmos (P = 0.03).ConclusionsPatients with inactive TRO showed significantly higher meibomian gland dropout compared with that of age- and sex-matched controls without TRO.

In vitro effects of curcumin on proinflammatory cytokines and expression of their genes in minor salivary gland tissue of patients with Sjogren's syndrome.

Curcumin reduces disease severity and ameliorates lupus-like/Sjögren's Syndrome-like disease in mice model. The immunological basis of these effects is largelyunknown. This study examined the effects of curcumin on pro-inflammatory cytokines secreted by minor salivary glands in patients with primary Sjögren's syndrome (pSS). Minor salivary gland (MSG) tissue samples were collected from patients undergoing biopsy for suspected pSS. The tissues were treated with phytohemagglutinin (PHA) alone as well as PHA with curcumin (30μM) and cultured in RPMI 1640 medium for 48h at 37°C in CO2 incubator. After the incubation period, culture supernatant and tissues were stored in the freezer (-80°C). IL-6 levels were measured in supernatant by ELISA kit. Gene expressions of pro-inflammatory cytokines, namely IL-6, IL-8, TNF-α, IL-1β, IL-4, IL-10, IL-17, IL-21, and IFN-γ, were measured by qPCR. IL-6 secretion levels and gene expressions were compared statistically between groups by Student's t test. Forty-seven patients were screened. Eight patients satisfied ACR/EULAR criteria for pSS. Seven patients with absent glandular inflammation and negative serology constituted sicca controls. These 15 subjects were included in final analysis. In pSS group, but not in controls, median IL-6 levels in supernatant were less in curcumin-treated as compared to PHA-alone subset [5.5 (0.7-13.34) vs 18.3 (12-32)ng/ml; p=0.0156]. mRNA expression levels of IL-6 were also lower in curcumin-treated samples as compared to PHA alone, when cases and controls were analyzed together as well as in cases alone (p=0.0009 and p=0.0078, respectively); however, mRNA expression of IL-1β was lower in curcumin-treated samples as compared to PHA alone, only when cases and controls were analyzed together (p=0.0215). There was no difference in other cytokine gene expression levels between the subsets under the in-vitro experimental conditions. In conclusion, curcumin reduced mRNA expression as well as secretion of IL-6 levels by salivary gland tissue of patients with pSS. Curcumin also suppressed PHA-induced mRNA expression levels of IL-6 and IL-1β in MSG tissue of patients with pSS and controls when analyzed together as a combined group.

Tumor detection of 18F-PSMA-1007 in the prostate gland in patients with prostate cancer using prostatectomy specimens as reference method.

Prostate-specific membrane antigen (PSMA) radiopharmaceuticals used with positron emission tomography/computed tomography (PET-CT) are a promising tool for managing patients with prostate cancer. This study aimed to determine the accuracy of 18F-PSMA-1007 PET-CT for detecting tumors in the prostate gland using radical prostatectomy (RP) specimens as a reference method and to determine whether a correlation exists between 18F-PSMA-1007 uptake and the International Society of Urological Pathology (ISUP) grade and prostate specific antigen (PSA) levels at diagnosis. Methods: Thirty-nine patients referred for 18F-PSMA-1007 PET-CT for initial staging and who underwent RP within four months were retrospectively included. Uptake of 18F-PSMA-1007 indicative of cancer was assessed and maximum standardized uptake values (SUVmax) and total lesion uptake (TLU) were calculated for the index tumor. Histopathology was assessed from RP specimens. True positive, false negative, and false positive lesions were calculated. Results: In 94.9% of patients, the index tumor was correctly identified with PET. SUVmax was significantly higher in the tumors vs normal prostate tissue, but no significant differences were found between different ISUP grades and SUVmax There was a poor correlation between PSA at diagnosis and SUVmax (r=0.23) and moderate agreement between PSA at diagnosis and TLU (r=0.67). When all tumors (also non-index tumors) were considered, many small tumors (approx. 1-2 mm) were not detected with PET. Conclusion: 18F-PSMA-1007 PET-CT performs well in correctly identifying the index tumor in patients with intermediate to high-risk prostate cancer. Approximately 5% of the index tumors were missed by PET, which agrees with previous studies.

Breast Cancer in Patients with Gene Polymorphisms Associated with Metabolic Syndrome

Each tumor is a combination of several dozen to several hundred potentially highly functional somatic mutation variants, along with a much larger number of potentially highly functional germ mutation variants. The combined action of all gene variations leads to the development and clinical diversity of malignancies. Their changes can lead to violations of gene expression and regulation and the appearance of proteins with altered functional properties. Polymorphism at the phenotype level is explained by the simultaneous existence of both a wild-type allele and a series of mutant alleles in the same population. Mutations change the gene product, and as a result, the functions of the gene product are changed. This can lead to changes in the phenotype. Materials and methods: Markers are studied (single-nucleotide polymorphisms) in people with malignant neoplasms breast, associated with a metabolic syndrome, and also in representatives of test groups (malignant neoplasm without metabolic syndrome's), allowing predict association development of disease. The results are received thanks to examining of 250 patients. Results: The association of polymorphism's rs11868035 (p = 0.01481525) based on 5 inheritance models’ polymorphisms with a risk of development breast cancer glands in patients with a metabolic syndrome in Ka-zakh populations was identified.

Investigate the improvement of facial skin texture with the VISIA system after total thyroidectomy

BackgroundDuring clinical practice we have noticed that some patients with hyperthyroidism have finer skin with less wrinkles, pores, and spots after thyroidectomy, and the improvement can be observed within a few weeks after the operation. However, there is no evidence or study in the literature to proof this finding.Aim and objectiveThis study was designed to evaluate and quantify the skin characters of patients with hyperthyroidism before and after thyroidectomy.Material and methodsThis is a prospective study to include patients with hyperthyroidism who received total thyroidectomy between March 1st, 2018 and February 28th, 2019. The patients received blood test for T4 and TSH analysis and VISIA measurements for skin texture quantification, at the preoperative stage, three, and six months postoperatively. A total of 8 patients were included. Repeated measurement was used to determine the lab data and VISIA measurement changes before and after the operation. Mauchly’s sphericity test was performed to determine whether the violation of sphericity occurs, and the Greenhouse–Geisser correction was used when the violation of sphericity occurs.ResultsAll the patients were female and generally healthy without systemic medical disease except the hyperthyroidism. The T4 and TSH levels were not significantly different before and after the thyroidectomy. In terms of the skin character measurements, the wrinkles, texture, pores, UV spots, and brown spots were not improved after thyroidectomy. A trend of improvement in spots, red area, and porphyrin was noted, although not statistically significant.ConclusionsSurgical removal of the thyroid gland in patients with hyperthyroidism does not improve the skin quality and texture in examinations via the VISIA system.