Expression analysis of necroptosis related genes and lncRNAs in patients with pituitary neuroendocrine tumors.

Necroptosis can either be the cause of tumorigenesis or it can impede its process. Recently, it has been proved that long non-coding RNAs (lncRNAs) have different crucial roles at cellular level, especially on cell death. Regarding the important role of necroptosis and lncRNAs in the pathogenesis of different cancers, especially pituitary adenomas (PAs), we assessed expression levels of two necroptosis related genes, namely TRADD and BIRC2, in addition to three related lncRNAs, namely FLVCR1-DT, MAGI2-AS3, and NEAT1 in PAs compared with adjacent normal tissues (ANTs). TRADD had no significant difference between two groups; however, BIRC2, FLVCR1-DT, MAGI2-AS3, and NEAT1 were upregulated in PAs compared to ANTs (Expression ratios [95% CI] = 2.3 [1.47-3.6], 2.13 [1.02-4.44], 3.01 [1.76-5.16] and 2.47 [1.37-4.45], respectively). When taking into account different types of PAs, significant upregulation of BIRC2, MAGI2-AS3 and NEAT1 was recorded in non-functioning PAs compared with corresponding ANTs (Expression ratios [95% CI] =1.9 [1.04-3.43], 2.69 [1.26-5.72] and 2.22 [0.98-5.01], respectively). Additionally, higher levels of BIRC2 were associated with higher flow of CSF (P value=0.048). Moreover, higher Knosp classified tumors had lower levels of BIRC2 (P value=0.001). Finally, lower levels of MAGI2-AS3 were associated with larger tumor size (P value=0.006). NEAT1 expression was correlated with FLVCR1-DT and TRADD. TRADD expression was correlated with FLVCR1-DT. Additional correlation was observed between expression of BIRC2 and MAGI2-AS3. In sum, this study provides evidence that dysregulated levels of studied genes could contribute to the pathogenesis of pituitary tumors.

Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study.

BACKGROUND: Urinary tract stones is one of the most frequent medical emergencies which leads to life-threatening complications, namely obstructive uropathy as well as renal failure in some situations. Previously, bilateral stones were treated with either open surgery or percutaneous nephrolithotomy (PCNL). However, these treatment options were associated with lengthy operation time, need for more anesthesia, further bleeding, and long hospitalization. Therefore, much effort has been made to treat both sides simultaneously. OBJECTIVE: The aim of this study was an attempt to prospectively review cases undergoing simultaneous bilateral PCNL in terms of the therapy outcomes, complications, and consequences. METHODS: In this prospective cohort study, 39 adult patients with bilateral renal stones were randomly recruited at Imam Reza hospital in Mashhad, Iran between January 2016 and January 2017. Adult patients with bilateral renal stones were included in this study. Exclusion criteria were as follows: Patients with severe heart or lung disease, patients with coagulation disorders, pregnant women, and cases with any contraindications for general anesthesia. After insertion of bilateral ureteral catheters, all patients underwent simultaneous bilateral PCNL in prone position. Transureteral lithotripsy was performed for patients with ureteral stones. The surgery was initially carried out on the symptomatic side and then iterated on the remaining kidney. Major complications including bleeding, fever, pain, urine leakage, and residual stones were recorded. SPSS software was used for data analysis. Data were expressed as percentage and mean ± SD. P value less than 0.05 was considered significant. RESULTS: A total of 39 patients (27 males with mean age of 37.6 years and 12 females with mean age of 45.7 years) were studied. As many as 15 (38%) patients received a unilateral nephrostomy. Three underwent totally tubeless surgery. Bleeding (41.0%) was the most common complication, followed by residual stones (20.5%) and fever (20.5%), urine leakage (15.3%), pain (12.8%), blood transfusion (2.5%) and colon perforation (2.5%). CONCLUSIONS: It was concluded that simultaneous bilateral PCNL was not associated with higher morbidity than the unilateral method.

The Effect of l-Arginine on Dural Healing After Experimentally Induced Dural Defect in a Rat Model.

BACKGROUND: Incomplete repair of the dura mater may result in numerous complications such as cerebrospinal fluid leakage and meningitis. For this reason, accurate repair of the dura mater is essential. In this study, the effect of systemic and local supplementation of l-arginine on dural healing was evaluated. METHODS: Thirty male Wistar rats were used and divided into control, local, and systemic l-arginine groups, with 10 rats in each. In each group, a 5-mm experimental incision was made at the lumbar segment of the dura mater and cerebrospinal fluid leakage was induced. Each group was divided into 2 subgroups and at the end of the first and sixth weeks, the rats were killed and the damaged segments of the dura were separated, histologically evaluated and the dural healing indicators including cell types, granulation tissue formation, collagen deposit, and vascularization were compared between groups. RESULTS: The systematic supplementation of l-arginine showed a significant effect in dural healing compared with the control group. After the first week, granulation formation increased considerably (P < 0.031), and after 6 weeks, collagen deposition and neovascularization were significantly different compared with the control group (P < 0.030; P < 0.009). In comparison between different groups at the end of the first and sixth weeks, maximum changes in healing indicators were observed in the systemic group and the least variations were related to the control group. CONCLUSIONS: The systemic supplementation of l-arginine may accelerate dural healing by increasing the level of granulation tissue formation, collagen deposition, and vascularization.

Colonic perforation during percutaneous nephrolithotomy: An 18-year experience.

INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large, extracorporeal lithotripsy failure stones and those in the inferior calyx. Despite the development of new techniques and the increasing experience in recent decades, complications may still occur. Colonic perforation is one of the most dangerous and rare complications of PCNL, which may lead to peritonitis and sepsis. We present our 18-year experience on the diagnosis and management of colonic perforation during PCNL. METHODS: We retrospectively reviewed the data of 5260 PCNL procedures performed between May1995 and August 2013. Preoperative and operative factors, such as age, sex, history of previous ipsilateral stone intervention, stone side, stone location, site of skin puncture and punctured calyx, were reviewed in patients with colonic injury. RESULTS: Colonic perforation was found in 11 patients (5 males and 6 females) and the mean age was 40.4 ± 22.2 years (range: 4 to 71). All injuries were retroperitoneal. The left side was affected in 5 patients and the right side was injured in 6 cases. Conservative management was the treatment planned for all patients. It included withdrawal of the nephrostomy tube outside the kidney to the colon as a percutaneous colostomy, insertion of a double-J ureteral stent, intravenous broad-spectrum antibiotics, bowel rest and total parenteral nutrition. Under this conservative management, complete healing of the colon was achieved in all patients. CONCLUSION: Early diagnosis and conservative management of colonic perforation can minimize patient morbidity and mortality and result in excellent healing of the fistulous tract without any serious complications.

The effect of a group exercise program on muscular function among fall-prone elderly women / Efecto de un programa de ejercicios grupales sobre la función muscular entre mujeres de edad avanzada propensas a caídas

In a sampled population of fall-prone elderly women, an exercise protocol was performed for 12 weeks on experimental group and at the end of exercise period, the strength and endurance of muscles and SF-6 Health Surveys were analyzed. Results showed that endurance and strength of muscles and also physical activity were improved in experimental group (P<0.05). Group exercise program causes improvement in both strength and endurance of muscles in fall-prone elderly women. The effect of group exercise program on women may be related to differences in central nervous system of this gender in comparison with men.

En una población de mujeres de edad avanzada propensas a las caídas, se realizó un protocolo de ejercicios durante 12 semanas. Al final del período de ejercicios, se analizó la fuerza y resistencia muscular junto a la encuestas de salud SF-6. Los resultados mostraron que tanto la resistencia y la fuerza muscular, así como la actividad física mejoraron en el grupo experimental (p <0,05). El programa de ejercicio grupal mejoró la fuerza y la resistencia de los músculos en las mujeres de edad avanzada propensas a las caídas. El efecto del programa ejercicio grupal en las mujeres puede estar relacionada con diferencias en el sistema nervioso central de este sexo en comparación con los hombres.

The effects of ethanol and strontium on growth and development of two-cell arrested mouse embryos.

BACKGROUND: Arresting at a certain stage of development like the two-cell stage could be one of the causes of infertility. The aim of this study is to evaluate the effects of ethanol and strontium on growth and development of mice embryos arrested at the two-cell stage. MATERIALS AND METHODS: In this experimental study, female mice were coupled with a male following superovulation. Positive vaginal plug mice were sacrificed 48 hours after human chorionic gonadotropin (hCG) injection. Two-cell embryos were transferred to M16 medium and divided to four groups. The first control group was incubated without any exposure to low temperatures. Groups 2, 3 and 4 were exposed to 4°C for 24 hours. The second control group was incubated immediately, while the third and fourth groups were exposed to 10 mM strontium for five minutes and 0.1% ethanol for a further five minutes. Growth rate and developmental parameters of embryos were analyzed by one- way ANOVA. The significant difference between the groups was determined by Post Hoc. RESULTS: The data shows that developmental rate is decreased significantly by 4°C exposure. The mean percentage of degenerated embryo was significantly different between groups but the mean cleavage rate was not significantly different. The mean percent of morula, blastocyst and hatched blastocyst formation were significantly different between groups during a 120 hours study post hCG injection. CONCLUSION: The effect of strontium and ethanol on arrested two-cell embryos had no significant effect on the mean percentage of morula, but ethanol treatment significantly increased the percentage of blastocyst and hatched blastocyst formation compared to strontium.