Group Of Lesions Research Articles

Clinical Presentations and Treatment Approaches in a Retrospective Analysis of 128 Intracranial Arteriovenous Malformation Cases

Background: Intracranial AVMs are a highly heterogeneous group of lesions that, while not very common, can pose significant risks. The therapeutic management of AVMs is complicated by ambiguous guidelines, particularly regarding which Spetzler–Martin grades should dictate specific treatment options. This study analyzed the clinical presentations and treatment approaches of 128 brain AVM cases managed between 2014 and 2022 at the National Institute of Neurology and Neurovascular Diseases in Bucharest, Romania. Methods: A retrospective analysis was conducted on patient demographics, clinical symptoms, Spetzler–Martin categorization, nidus localization, therapeutic management, and outcomes. Statistical analysis was performed using Python 3.10. Results: In our cohort of patients, the median age was 45 years, with a slight male predominance (67 males, 61 females). At admission, 51.5% presented with elevated blood pressure. The majority of patients had a Spetzler–Martin score of 2 (37.5%), followed by scores of 3 (31.3%) and 1 (20.3%). Treatment strategies included microsurgical resection in 32% of cases, conservative management in 31.2%, Gamma Knife radiosurgery in 22.6%, and endovascular embolization in 13.3%. Notably, open surgery was predominantly chosen for Grade II AVMs. The functional outcomes were favorable, with 69.5% achieving a good recovery score on the Glasgow Outcome Scale. Only four in-hospital deaths occurred, all in patients who underwent open surgery, and no deaths were recorded during the two-year follow-up. Conclusions: AVMs within the same Spetzler–Martin grade display considerable complexity, necessitating personalized treatment strategies. Our findings highlight the limitations of open surgery for Grade I cases but affirm its effectiveness for Grade II AVMs.

RADT-39. CENTRAL NERVOUS SYSTEM BRIDGING RADIOTHERAPY (CNS-BRT) ACHIEVES RAPID CYTOREDUCTION PRIOR TO CAR T-CELL THERAPY FOR AGGRESSIVE B-CELL LYMPHOMAS

Abstract BACKGROUND CAR T-cell therapy (CART) for central nervous system lymphoma (CNSL) is a promising strategy, yet responses are frequently not durable. Bridging radiotherapy (BRT) is used for extra-cranial lymphoma to improve CART outcomes through cytoreduction of high-risk lesions. We hypothesized that CNS-BRT would achieve similar, significant cytoreduction prior to CART for CNSL. METHODS We analyzed CNSL patients with non-Hodgkin B-cell lymphomas who received CNS-BRT prior to commercial CART. Best CNS response post-CART was evaluated using the International Primary CNS Lymphoma Collaborative Group (IPCG) or RANO for parenchymal or leptomeningeal lesions, respectively. Cytoreduction from CNS-BRT was calculated as change in lesion size prior to CART. RESULTS Twelve patients received CNS-BRT, with median follow up of 11.8m (IQR: 8.5–21.9). Ten had CNSL (9 secondary, 1 primary) and 2 patients had epidural disease (evaluable for toxicity). All ten CNSL patients had progressive disease at the time of CNS-BRT. RT targets included whole brain (n=3), involved site (partial) brain (n=4), involved site spine (n=4), and orbits (n=1) with median dose 24Gy (range: 15-33). 1/12 patients experienced grade ≥3 cytokine release syndrome (CRS), and 3/12 patients experienced grade ≥3 immune effector cell-associated neurotoxicity syndrome (ICANS). CNS-BRT achieved a 74.0% (95%CI: 62.0–86.0) mean reduction in lesion size from baseline (p=0.014) at a median of only 12d from BRT completion and pre-CART infusion. Best CNS response included 8 complete responses (CR), 1 partial response (PR), and 1 progressive disease (PD). Three patients experienced CNS relapse outside the BRT field for a 12-month estimated risk of CNS progression post-CART of 20.0% (95%CI: 3–49). CONCLUSIONS Early data suggest CNS-BRT achieves rapid cytoreduction and favorable CNS response. The rates of severe CRS/ICANS were similar to comparison series of CNSL patients treated with CART without BRT suggesting an acceptable safety profile. Our data support further study of BRT as a bridging strategy for CNSL-directed CART.

Impact of Size on Endoluminal Approaches to Submucosal Tumors of the Stomach

Gastric subepithelial lesions (SELs) represent a heterogenous group of mass lesions that arise from the gastric mucosa. Several endoscopic techniques can be used to manage gastric SELs once the decision is made to pursue resection, including endoscopic submucosal resection, endoscopic submucosal dissection, submucosal tunnel endoscopic resection, and endoscopic full-thickness resection. In addition to other clinical and anatomic factors, lesion size has important implications on the ability to obtain a complete resection while minimizing risk of adverse events. This article reviews technical considerations and available data regarding how size may impact the endoscopic approach to gastric SEL resection.

Evaluation and Comparison of the Efficacy and Safety of Cryotherapy and Electrosurgery in the Treatment of Sebaceous Hyperplasia, Seborrheic Keratosis, Cherry Angioma, and Skin Tag: A Blinded Randomized Clinical Trial Study.

Cryotherapy and electrosurgery are two commonly used methods to remove sebaceous hyperplasia, seborrheic keratosis, cherry angioma, and skin tags, which can be bothersome and uncomfortable. We compare the effectiveness and adverse effects of cryotherapy and electrosurgery in treating these skin conditions. The study was conducted as an assessor-blind trial. The 32 lesions in each lesion group were divided into two treatment groups, cryotherapy and electrosurgery, using sealed envelopes. We collected baseline information, which included age, gender, lesion location, and consent, from the patients. Follow-up visits were scheduled at 2 weeks, 1 month, and 3 months after the initial treatment session to evaluate the response rate of the lesions. Based on before-after clinical images, this evaluation encompassed patient and physician satisfaction (no change, little, somewhat, good, and excellent), and any potential complications. The mean age of cryotherapy group was 52.04 ± 11.59 years, while the mean age in the electrosurgery group was 50.48 ± 10.70 years (p > 0.05). Regarding gender, 15 (23.4%) in the cryotherapy and 24 (37.5%) in the electrosurgery were female (p > 0.05). Physician and patient satisfaction increased significantly over time in the cryotherapy and electrosurgery groups (p < 0.001). For sebaceous hyperplasia, cherry angioma and skin tags, the degree of satisfaction of patients and physicians was significantly higher for electrosurgery than cryotherapy during follow-up (p < 0.05). However, seborrheic keratosis responded better to cryotherapy. Hypopigmentation and depigmentation occurred in 2 (3.1%) and 4 (6.3%) of the cryotherapy cases, respectively. Hypopigmentation and atrophic scars also occurred in 4 (6.3%) and 2 (3.1%) of the cases in the electrosurgical group in different sessions. It appears that electrosurgery is more effective in the treatment of sebaceous hyperplasia, cherry angioma and skin tags, while cryotherapy is more effective in the treatment of seborrheic keratosis.

Influence of vitamin D supplementation and the vaginal microenvironment on human papillomavirus infection

This was a retrospective study, mainly explored the mediating role of vaginal microenvironment and the influence of vitamin D addition on human papillomavirus (HPV) infection. Five hundred and twelve participants were chosen in this study, followed by dividing into HPV positive (212 cases) and negative groups (300 cases) based on HPV 23 typing results. The high-risk human papillomavirus (HR-HPV) positive group showed higher abnormal rates of lactobacillus, catalase, cleanliness, sialidosidase, and proline aminopeptidase than the HPV negative group. No significant differences were found in pH value, leukocyte esterase, and Acetylglucosaminidase abnormality between 2 groups. The HR-HPV positive group presented a higher percentage of patients with cleanliness III and IV. Relative to low-grade squamous intraepithelial lesion (LSIL) group, HSIL group presented a higher HPV positive infection rate. Mould infection, Gardnerella infection, and catalase were identified as independent risk elements for HR-HPV infection. Vitamin D supplementation was found to potentially reduce HR-HPV infection persistence post-Loop Electrosurgical Excision Procedure (LEEP), improve nutritional health, reduce insulin, insulin resistance (HOMA-IR) and triglyceride levels, as well as reduce high-sensitivity C-reactive protein (hs-CRP) along with malondialdehyde (MDA) levels. Our results indicate that HR-HPV infection is intimately associated with the condition of the vaginal microenvironment, and vitamin D addition potentially reduces the persistence of HR-HPV infection post-LEEP, improves nutritional and metabolic health, reduces inflammation, and be well-tolerated.

Evaluation of non-target lesions in femoropopliteal disease using near-infrared spectroscopy intravascular ultrasound imaging

Abstract Aim This study aims to assess the plaque morphology of non-target lesions, especially lipid-core-containing plaque (LCP), and compare it to target lesions using near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) in patients with femoropopliteal disease. Methods We conducted a single-center prospective observational study on 14 patients who underwent endovascular therapy for femoropopliteal disease between July 2022 and November 2023. NIRS-IVUS assessment was performed on the whole femoropopliteal arterial segment. Forty-one LCP lesions &amp;gt; maximum lipid-core burden index in any 4-mm region (max LCBI4mm) 100 were detected by NIRS-IVUS. We evaluated patient and lesion characteristics. In addition, the LCP lesions were divided into two groups, the target lesion group (n=18) and the non-target lesion group (n=23), and compared. Results Patient characteristics were notable for advanced age (76.8±6.6 years), high incidence of male (78.7%), hypertension (100%), dyslipidemia (78.6%), diabetes (64.3%), statin use (71.4%). Lipid profiles were as follows: LDL-cholesterol 85.9±26.7 mg/dl, HDL-cholesterol 48.9±12.7 mg/dl, triglyceride 138.9±80.3 mg/dl, lipoprotein(a) 19.6±16.3 mg/dl. Ten participants had LCPs in the non-target lesion (71.4%). For IVUS findings, the target lesion group had significantly longer lesion length (34.6±11.9 mm vs. 22.6±8.7 mm, p=0.001), smaller minimum lumen area (7.0±2.8 mm2 vs. 14.8±5.4 mm2, p&amp;lt;0.001), and larger plaque burden (78.0±5.0 % vs. 53.0±12.0 %, p&amp;lt;0.001) than those in the non-target lesion group. No significant differences were observed in the prevalence of calcification (target lesion group vs. non-target lesion group: 83.3 % vs. 91.3 %, p=0.64) and the extent of calcification (p=0.76). For NIRS findings, the target lesion group contained a significantly smaller proportion of LCP in the lesion length (25.9±15.7 % vs. 50.6±29.2 %, p=0.002) than the non-target lesion group. On the other hand, there were no significant differences in the value of max LCBI4mm (284.4±153.4 vs. 289.5±113.1, p=0.90) and the length of LCP lesion (9.8±9.7 mm vs. 10.7±6.9 mm, p=0.74) and distribution of LCP (p=0.08) between both groups. In addition, the number of LCPs in the target femoropopliteal artery was positively correlated with max LCBI4mm in the target femoropopliteal artery (r=0.671, p=0.008) Conclusion NIRS-IVUS findings in this study demonstrated that the non-target lesions contained LCPs to the same degree as the target lesions.

Association between J-scores and ostial lesions: quantifying the effects of ostial lesions in chronic total occlusion percutaneous interventions

Abstract Aims We aimed to evaluate the influence of ostial lesions on the predicted probability of success in patients undergoing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). Methods 245 patients underwent CTO PCIs at our center, Germany. Of these patients, 197 (80.4%) without an ostial lesion and 48 (19.6%) with an ostial lesion were evaluated. Logistic regression models were used to estimate the interaction effect between the presence of ostial lesions and J-score. Results The ostial lesion group exhibited significantly higher pro-B-type natriuretic peptide levels (1644 pg/ml vs. 963 pg/ml, p=0.034) than the non-ostial lesion group. The final success rate was lower in the ostial lesion group than in the non-ostial lesion group (64.6% vs. 81.7%, p=0.018). The ostial lesion group had higher J-scores than the non-ostial lesion group, indicating more complex lesions (median: 2.5 vs. 2.0, p=0.005). Technical details revealed less antegrade (68.8% vs. 89.8%, p=0.001) and more retrograde access (33.3% vs. 7.6%, p&amp;lt;0.001) in the ostial lesion group than in the non-ostial lesion group. An ordered logistic regression with J-score as an outcome showed a statistically significant association between higher J-scores and ostial lesions (OR, 2.4; p=0.003). Investigating the association between ostial lesion and J-score categories (&amp;lt;3 and ≥3) revealed that ostial lesions were associated with lower success rates, especially in cases with higher J-scores (≥3), although the interaction effect was not statistically significant (p=0.506). Conclusion The presence of ostial CTO is associated with higher lesion complexity and lower technical and procedural success rates. Further studies, based on our retrospective and the previous studies, require the inclusion of the presence of ostial CTO as a factor in the currently used CTO scores to predict the difficulty of CTO procedure.Interaction EffectPredicted Probability

Low-Field Magnetic Resonance Imaging for the Detection of Medial Meniscal Lesions in Cranial Cruciate-Deficient Stifle Joints in Dogs

Background: The aim of this study was to substantiate the ability of noninvasive low-field magnetic resonance imaging (lfMRI) to accurately depict meniscal lesions, thereby establishing lfMRI as a viable option for the diagnosis of meniscal pathology. Study Design: This was a prospective, controlled study. Materials and Methods: In each of 57 stifle joints, 5 predefined lfMRI sequences using a 0.25 T lfMRI were used. The scans were evaluated by an experienced surgeon (DECVS) and through external assessment by a radiologist (DECVDI). The patients were divided into two groups depending on their meniscal status after lfMRI. Dogs (Group 1; n = 33) without lfMRI evidence of medial meniscal pathology underwent TPLO, whereas concurrent craniomedial mini-arthrotomy was performed in patients with suspected meniscal lesions (Group 2; n = 24). Gait assessment was performed 6 weeks later and 6 months postoperatively. Results: Cohen’s kappa value of 0.8571 corresponds to a high level of agreement between the observers. A significant correlation was found between preoperative lameness severity and intraoperative meniscal damage (p &lt; 0.04). The results showed a highly significant correlation between meniscal injuries on MRI and intraoperative findings (p &lt; 0.0001). Conclusions: LfMRI appears to be a noninvasive, reliable imaging tool for the detection of medial meniscal lesions in cranial cruciate-deficient stifle joints, aiming to avoid (minimally) invasive diagnostics in healthy menisci.

Coronary heart disease evaluation using PCAT radiomics model based on coronary CT angiography and pericoronary adipose tissue.

To explore the clinical application value of radiomics model based on pericoronary adipose tissue (PCAT) in predicting coronary heart disease. A retrospective analysis was performed for inpatients who had undergone coronary computed tomography angiography from January to December 2023, and 164 cases of coronary artery lesions were screened as the lesion group and 190 cases of normal coronary artery samples were selected as the control group. The clinical data and imaging data of all patients were collected, the radiomics features were extracted by relevant software, and the "region of interest" of pericoronary fat was delineated, and the selection operator and multivariate logistic regression were used to screen the radiomic features of pericoronary fat. A coronary heart disease evaluation model was constructed by the best radiomics features. Area under the curve values of the PCAT radiomics scoring model for predicting the receiver operating characteristic curve of coronary heart disease were 0.863 and 0.851 in training and test sets, respectively. After calibration curve analysis, PCAT radiomics scoring model has a high consistency between the predictive evaluation results and the actual results of coronary heart disease events. In addition, in the training set, the PCAT radiomics scoring model has a net benefit on all threshold probabilities. In the test set, the model has a negative net return with only a small number of threshold probabilities. After combining the clinical characteristics model, the evaluation accuracy of the model for coronary heart disease can reach 0.896. PCAT radiomics model based on coronary computed tomography angiography can effectively predict and evaluate coronary heart disease, which is of great value for the clinical diagnosis of coronary artery disease.

Juvenile Xanthogranuloma: A Case Report and Literature Review of an Underdiagnosed Benign Entity

Abstract Juvenile xanthogranuloma (JXG) is an uncommon non-Langerhans cell histiocytic lesion group that usually occurs at an early age group and is asymptomatic. It is usually a self-limiting disorder, and predilection sites are the head and neck, extremities, and trunk. We report a 3-year-old male child who presented to the hospital with asymptomatic swelling in the right upper eyelid region. Excision biopsy was done, and histopathology along with immunohistochemistry was reported as JXG. It is essential to differentiate this condition from childhood malignancy.

Comparison of Frozen and Final Pathology Results in Patients Operated for Endometrial Hyperplasia

OBJECTIVE: Our study aimed to determine the frequency of endometrial cancer in patients undergoing surgery with a diagnosis of endometrial hyperplasia and to evaluate the concordance between preoperative diagnosis, frozen section examination, and final pathology results. STUDY DESIGN: The clinical findings, imaging results, and all pathology reports of patients who underwent total abdominal hysterectomy for endometrial hyperplasia (atypical or non-atypical) between January 2020 and January 2023 at our hospital were retrospectively evaluated. Demographic and clinical characteristics (age, menopausal status, parity, body mass index, presence of diabetes and hypertension) and pathology results were recorded from patient records. RESULTS: 144 patients diagnosed with endometrial hyperplasia were included in the study. The frozen section and final pathology results of all patients diagnosed with non-atypical endometrial hyperplasia were reported as benign lesions. In the atypia group, the intraoperative frozen section results of 80.7% of the patients were classified as benign lesions, while the results of 19.3% were reported as malignant pathology. A statistically significant difference was found between the benign and malignant lesion groups, which were classified based on the final pathology results, with respect to age, menopausal status, and average endometrial thickness before biopsy. CONCLUSION: In cases of endometrial hyperplasia with atypia, the possibility of cancer appearing in the final pathology results should be taken into consideration. In the preoperative evaluation of patients, characteristics such as endometrial thickness, age, and menopausal status may suggest the likelihood of encountering endometrial cancer during surgery in this patient group.

Development and validation of a prediction model for gastric cancer: a single-center prospective study.

This study aimed to develop and validate a novel nomogram for diagnosing gastric cancer (GC). In this prospective analysis, 146 patients of Wenzhou Central Hospital were recruited for a GC group and a benign lesion group and were divided into a training set and an internal validation set in a ratio of 7:3. Clinical and analytical characteristics were collected and analyzed by logistic regression analysis. The performance of the predictive model was evaluated using the receiver operating characteristic curve, calibration curve, and decision curve analysis. There were 5 variables, namely albumin, carcinoembryonic antigen, carbohydrate antigen 125, creatinine, and small proline-rich protein 2A, that were identified as the final parameters for the developed model. In the training and internal validation sets, the area under the curve of the model was 0.968 and 0.979, respectively, showing good diagnostic performance. This study developed and validated a new nomogram based on 5 parameters. This model shows good diagnostic performance in distinguishing GC from benign lesion groups and has certain significance in clinical application.

Diagnostic Approach to Mesenchymal and Spindle Cell Tumors of the Breast

Mesenchymal and spindle cell tumors of the breast represent a broad and heterogeneous group of lesions that may be sampled on core needle biopsy or surgical excision. Mesenchymal lesions unique to the breast are those that derive from the specialized breast myofibroblast, such as mammary myofibroblastoma and pseudoangiomatous stromal hyperplasia. However, any mesenchymal lesion arising in extramammary soft tissue may also arise in the breast, including fibroblastic, peripheral nerve sheath, adipocytic, and vascular lesions. The spindle cell lesions pose the greatest diagnostic challenge, due to the significant radiographic, morphologic, and immunophenotypic overlap within the category of mesenchymal lesions and more broadly with other nonmesenchymal breast lesions. The distinction is particularly challenging on the limited material of breast core needle biopsies, and caution should be taken before definitively classifying a breast spindle cell lesion on core needle biopsy to avoid unnecessary treatment if misdiagnosed. Consideration of a wide differential diagnosis, adequate sampling of a resection specimen, use of a targeted immunopanel, and selective use of molecular assays are essential steps for accurate classification of mesenchymal lesions in the breast. This review covers the clinical, histologic, and immunophenotypic features of mesenchymal tumors of the breast, with a special emphasis on the differential diagnoses unique to the breast and challenges encountered on breast core needle biopsy.

Multiomics-Based Outcome Prediction in Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy (PULSAR).

Objectives: This retrospective study aims to develop a multiomics approach that integrates radiomics, dosiomics, and delta features to predict treatment responses in brain metastasis (BM) patients undergoing PULSAR. Methods: A retrospective study encompassing 39 BM patients with 69 lesions treated with PULSAR was undertaken. Radiomics, dosiomics, and delta features were extracted from both pre-treatment and intra-treatment MRI scans alongside dose distributions. Six individual models, alongside an ensemble feature selection (EFS) model, were evaluated. The classification task focused on distinguishing between two lesion groups based on whether they exhibited a volume reduction of more than 20% at follow-up. Performance metrics, including sensitivity, specificity, accuracy, precision, F1 score, and the area under the receiver operating characteristic (ROC) curve (AUC), were assessed. Results: The EFS model integrated the features from pre-treatment radiomics, pre-treatment dosiomics, intra-treatment radiomics, and delta radiomics. It outperformed six individual models, achieving an AUC of 0.979, accuracy of 0.917, and F1 score of 0.821. Among the top nine features of the EFS model, six features came from post-wavelet transformation and three from original images. Conclusions: The study demonstrated the feasibility of employing a data-driven multiomics approach to predict treatment outcomes in BM patients receiving PULSAR treatment. Integrating multiomics with intra-treatment decision support in PULSAR shows promise for optimizing patient management and reducing the risks of under- or over-treatment.

Local calcium chloride infusion after pulsed field ablation enhances acute efficacy of cardiac electroporation.

Pulsed field ablation (PFA) has emerged as an innovative therapy for cardiac arrhythmias. Drawing parallels with PFA's application in solid tumors, calcium chloride (CaCl2) as an adjuvant therapy, known as calcium electroporation, may amplify PFA's apoptotic effects. We propose that PFA in the atrium could enhance calcium uptake through PFA-created pores, thereby increasing ablation efficacy even at reduced power levels by exploiting PFA's permeabilization effects. We conducted in vivo ablations on the atria of seven pigs using low PFA power (250 V, 20 μs for 50 pulses at 200 ms intervals). Post-PFA, we randomly administered an infusion of either 200 mg/2 ml CaCl2 (calcium group) or saline (control) directly to the ablation site via the catheter tip. We evaluated reduction in electrogram voltage amplitude, electrocardiography (ECG) parameters, ablation lesion parameters, and histology after PFA. Nineteen lesions from control and calcium groups were examined. Control lesions showed no voltage decrease post-PFA, whereas calcium-treated lesions exhibited a significant voltage reduction. Gross pathology indicated marked differences in maximum lesion surface diameter, depth, and volume between the lesion groups. Histologically, calcium group lesions were characterized by a more severe acute PFA response with contraction band necrosis, myocytolysis and nuclear pyknosis in adjacent myocardium, in addition to microhemorrhages. Infusing calcium chloride locally after PFA markedly improves the immediate efficacy of electroporation in porcine atria. This study suggests that calcium electroporation could bolster PFA outcomes without higher energy levels, potentially diminishing associated risks. These preliminary findings warrant further research into the long-term efficacy and potential clinical application of calcium electroporation in PFA.

Attentional processing in the rat dorsal posterior parietal cortex

The human posterior parietal cortex (PPC) is known to support sustained attention. Specifically, top-down attention is generally processed in dorsal regions while bottom-up regulation occurs more ventrally. In rodent models, however, it is still unclear whether the PPC is required for sustained attention, or whether there is a similar functional dissociation between anatomical regions. Consequently, the aim of this study was to investigate the contribution of the rodent dorsal PPC (dPPC) in sustained attention. We used the five-choice serial reaction time task (5CSRTT) and compared rats with neurotoxic dPPC lesions to sham operated rats. We found that rats with dPPC lesions were less accurate and took longer to make correct choices, indicating impaired attention and reduced processing speed. This effect, however, was limited to the first few days of post-operative testing. After an apparent recovery, omissions became elevated in the lesion group, which, in the absence of reduced motivation and mobility, can also be interpreted as impaired attention. In subsequent challenge probes, the lesion group displayed globally elevated latency to make a correct response, indicating reduced processing speed. No differences in premature responses or perseverative responses were observed at any time, demonstrating that dPPC lesions did not affect impulsivity and compulsivity. This pattern of behavior suggests that while intact dPPC supports goal-driven (top-down) modulation of attention, it likely does not play a central role in processing stimulus-driven (bottom-up) attention. Furthermore, compensatory mechanisms can support sustained attention in the absence of a fully functioning dPPC, although this occurs at the expense of processing speed. Our results inform the literature by confirming that rodent PPC is involved in regulating sustained attention and providing preliminary evidence for a functional dissociation between top-down and bottom-up attentional processing.

Transcriptomic analysis of genes associated with vitamin D receptor signalling reveals differences between skin cancers.

Vitamin D activates the vitamin D receptor (VDR), which dimerizes preferentially with the retinoid X receptor-α (RXRα). This heterodimer connects with genetic elements responsive to vitamin D, inhibiting or stimulating gene activity. We performed Nanostring® analysis of VDR/RXRα to compare the mRNA expression of this heterodimer and their correlated transcriptomes in non-melanoma skin cancer (basal cell carcinomas (BCC) and squamous cell carcinomas (SCC)) and melanocytic lesions (intradermal nevi (IN), and melanomas (MM)) with control skin. To evaluate VDR, RXRα and other 22 correlated genes in BCC, SCC, IN and MM, paraffin samples had their transcriptomes analysed using Nanostring®, a platform that allows multiple mRNA analyses. There were 46 samples, including 11 BCC, 10 SCC, 10 IN, 12 MM and 3 pools of control skins. Most mRNAs differed between the lesion groups and the control group. BCC and SCC NCOR2 were upregulated; in MM and IN, RXRγ was higher than in the control group. TP53, FOXO3 and MED1 showed a significant difference when we compared the BCC group to the SCC group. Melanoma and intradermal nevi differed only in AhR. VDR and RXRα were lower than the control in all groups. The panel shows a clear difference between the non-melanocytic cancers and, on the other hand, a slight difference between the melanocytic lesions. The study of vitamin D's influence through its receptor and RXRα is an exciting issue for understanding the importance of this pathway, and the present study can impact the prevention and treatment strategies, mainly in non-melanocytic tumours.

Fusobacterium in oral bacterial flora relates with asymptomatic brain lesions

BackgroundSpecific bacterial species in the oral cavity contribute to cerebral hemorrhage and microbleeds. The relationship between oral bacterial flora and asymptomatic brain lesions (ABL) remains unclear. This study aimed to investigate this relationship in a healthy Japanese cohort. MethodsThis cross-sectional study included participants who underwent health examinations at our Brain Dock facility between October 2020 and March 2021. The oral microbiomes of participants with and without ABL were compared using magnetic resonance imaging. To extensively assess the oral bacterial flora, the differences in genes and species compositions between the ABL and noBL (without brain lesions) groups were statistically evaluated via extensive analysis using 16S rRNA gene-based cloning. ResultsAmong 143 patients, 48.3 % had ABL. In the univariate analyses, Fusobacterium and Leptotrichia were associated with ABL (P = 0.017 and P < 0.001, respectively). In the adjusted models, Fusobacterium was associated with ABL (P = 0.006). In an intergroup comparison of seven Fusobacterium species, F. nucleatum, F. naviforme, and F. canifelinum were associated with ABL (P < 0.001, P = 0.002, P < 0.001). ConclusionsThe elevation of Fusobacterium in the ABL indicates the importance of the microbiome in the oral cavity as a factor in inducing cerebral small-vessel disease in healthy individuals, whose preventive approach might have an impact on therapeutic applications.

Preliminary Evaluation of the Value of a Small-Molecule Probe Targeting DNMT1 in Detecting the Methylation of PAX1 in Cervical Cancer.

To investigate the screening value of a small-molecule probe to assess the methylation of PAX1 in cervical cancer. The diagnostic threshold of the grayscale values for cervical lesions was assessed by plotting the Receiver Operating Characteristic (ROC) curve of subjects. Grayscale values were significantly different among the four groups (p<0.05). Compared with the LSIL and cervicitis groups, a considerably higher grayscale value was found in the CA and high-grade squamous intraepithelial lesion (HSIL) groups (both p<0.05). The differential ROC curves of the grayscale values showed that the diagnostic Area Under Curve of the probe for cervicitis and low-grade squamous intraepithelial lesion (LSIL) was 0.8724 (95% CI=0.7762-0.9685, p<0.0001), for cervicitis and CA was 1.0000 (p<0.0001), for the LSIL and HSIL was 0.5484 (95% CI = 0.3826-0.7142, p=0.5755), and for the LSIL and CA was 0.7724 (95% CI = 0.6016-0.9432, p = 0.0138). The small molecular probe has certain application value in differentiating the type of cervical lesions and has better efficacy in distinguishing cervical inflammatory and precancerous lesions from carcinogenesis, but less efficacy in determining the type of precancerous lesions.

Analysis of therapeutic effect of fibrocystic degeneration of vocal folds

Objective:To explore the differences in clinical presentation and therapeutic outcomes between vocal fold fibrocystic degeneration and other common benign lesions, such as vocal fold polyp and cyst. Methods:Vocal function was assessed before and after surgery in 10 cases of vocal fold fibrocystoids, 30 cases of vocal fold polyps and 10 cases of vocal fold cysts at Department of Voice Medicine, Xiamen University Zhongshan Hospital. The voice Assessments included GRBAS（G-scale）, VHI-10 scale, Reflux Symptom Index（RSI） scale, stroboscope, acoustic objective analysis, and aerodynamics measurements. The acoustice analysis parameters included fundamental frequency（F0）, fundamental frequency perturbation（Jitter）, amplitude perturbation（Shimmer） and voice disturbance severity index（DSI）, while the maximum phonation time（MPT） was assessed for aerodynamics. Stroboscopic parameters included vocal fold straightness, vocal fold color, glottic closure and mucosal wave. All three groups underwent phonomicrosurgery and a follow-up review was conducted one month later. Pre-and post-operative function assessment parameters were compared across the three groups. Results:Significant differences were founded in the G grade, Jitter, Shimmer, DSI, glottic closure and mucosal wave between the vocal fold fibrocystic degeneration group and the vocal fold polyp and vocal fold cyst group（P<0.05）. Most voice function parameters in all three groups showed significant improvement after surgery（P<0.05）. The improvement of VHI（10）, RSI and mucosal wave scores in the vocal fold fibrocystic lesion group was significantly different from that of the vocal fold polyp group（P<0.05）. Conclusion:Vocal fold fibrocystic degeneration is a more severe than that of vocal fold polyps and cysts, which are two common benign vocal fold lesions. Phonomicrosurgery is an effective treatment for vocal fold fibrocystic degeneration, but its curative effect are less favorable compared to those for vocal fold polyps and vocal fold cysts. Therefore, a detailed preoperative evaluation is essential for predicting surgical outcomes.