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BACKGROUND: Malignancies involving the pelvic ring present numerous challenges, especially in the periacetabular area. Extensive resection of the pelvic region without reconstruction can lead to severe functional impairment. Numerous reconstructive options exist, but all have drawbacks. Extracorporeally irradiated autografts are one option for reconstruction after periacetabular resections; they offer the potential advantages of eliminating the risk of allogeneic reactions associated with allografts and preserving local anatomy. However, little is known about the durability and risks of this approach in pelvic reconstruction. QUESTIONS/PURPOSES: (1) What are the survival rates of the autograft used, and if there is graft loss, what is the extent of this loss? (2) What are the functional outcomes after the implementation of this method? (3) What is the rate and nature of complications associated with this approach? METHODS: This is a retrospective case series from one subspecialty tumor unit that evaluated patients treated between January 2005 to January 2022. During that time, three surgeons treated 48 patients with Type II resections (defined as resection of periacetabular area). Patients treated with isolated Type II resections were eligible, as were those treated either with Type I+II resections, Type II+III resections, Type I+II+III resections, and Type I+II+III+IV resections. Of those, 21% (10 of 48) were treated primarily with a cone prosthesis, 13% (6 of 48) were treated without femoral reconstruction, 10% (5 of 48) were treated with resection without reconstruction, and 6% (3 of 48) had a THA on the sacrum, leaving 50% (24 of 48) of patients who were treated with femoral and acetabular reconstruction using extracorporeally irradiated autograft and total hip replacement; those patients were potentially eligible for this study. During that time span, we used this approach in all Type II pelvic resection procedures, when a part of the hemipelvis could be preserved without resection (other than Type I+II+III+IV) and where we predicted that there would be sufficient bone stock after tumor removal. Of those, 21% (5 of 24) were lost to follow-up before 2 years, and 13% (3 of 24) died within 2 years with the reconstruction intact and without any reoperation or graft loss, leaving 67% (16 of 24) for analysis here. Demographic characteristics, type of tumor, tumor origin site, type of applied resection, and extent of applied surgical procedure were noted. Of 16 patients, 12 were male, with a mean age of 38 ± 21 years. Tumor types included chondrosarcoma in eight patients, malignant mesenchymal tumor in four patients, osteosarcoma in two patients, and Ewing sarcoma in two patients. Among these, 10 patients had tumors originating from the pelvis, whereas six patients had tumors originating from the proximal femur. We used a Kaplan-Meier estimator to calculate survivorship free from total or partial graft removal at 72 months. To measure functional results, the Musculoskeletal Tumor Society (MSTS) scoring system was utilized at most recent follow-up so as to be able to evaluate the impact of complications (if any) on the ultimate result. The MSTS score ranges from a minimum of 0 points to a maximum of 30 points, where a higher score reflects lower pain and higher functional and emotional capacity. Related complications, time of complications, secondary interventions, and mortality rates were also ascertained from chart review. RESULTS: Graft survival rate at 72 months after initial reconstruction, free from partial or total graft removal, was 50% (95% CI 26% to 75%). Kaplan-Meier analyses revealed estimated mean time of graft removal as 43 months (95% CI 28 to 58). The graft was protected in eight patients on their final follow-up radiographs. The median (range) MSTS score was 18 (6 to 25) of 30 points at most-recent follow-up (these scores include patients who have had their grafts removed). In all, 15 of 16 patients had 17 complications; 16 were major complications (defined as those substantial enough to result in further surgery or a life- or limb-threatening event). A total of 14 of those 15 patients underwent one or more secondary procedures (a total of 21 unplanned additional procedures were performed in those patients). Deep infection was the most common complication, occurring in eight patients. Prosthesis dislocation occurred in four patients. Three patients developed aseptic acetabular component loosening, two had graft fractures, and one patient developed heterotopic ossification. CONCLUSION: Composite reconstruction with extracorporeal irradiated autografts plus total hip replacement is a feasible reconstruction technique after Type II pelvic resections, although complications and reoperations were common. Although no reconstruction technique has been proven superior to other alternatives, the high risk of complications and reoperations associated with this technique should be considered when selecting from among possible alternative reconstruction methods. LEVEL OF EVIDENCE: Level IV, therapeutic study.
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PURPOSE: To assess oncological outcomes of patients receiving neoadjuvant radiochemotherapy (RCT) for soft tissue sarcoma (STS) of the extremities. METHODS: Patients who were treated with preoperative radiotherapy and concomitant chemotherapy-3 cycles of mitomycin/doxorubicin/cisplatin (MAP) or 2-4 cycles of doxorubicin/cisplatin (AP)-followed by surgery were analyzed retrospectively. Survival rates were estimated, and prognostic factors were identified. RESULTS: Between 1994 and 2017, a total of 108 patients were included. Median ages were 43 years and 51 years for patients receiving MAP and AP, respectively. The 5year local relapse-free survival (LRFS), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) were 94.1, 63.6, 75.3, and 71.9%, respectively. In the multivariate analysis, significant predictors were identified as follows: de novo or R1/R2 resected tumor on admission before RCT (pâ¯= 0.017; hazard ratio [HR] 0.112, 95% confidence interval [CI] 0.019-0.675) and R0 resection after RCT (pâ¯= 0.010; HR 0.121, 95% CI 0.024-0.598) for LRFS; female gender (pâ¯= 0.042; HR 0.569, 95% CI 0.330-0.979) and liposarcoma histology (pâ¯= 0.014; HR 0.436, 95% CI 0.224-0.845) for DFS; liposarcoma histology (pâ¯= 0.003; HR 0.114, 95% CI 0.027-0.478) and AP regimen (pâ¯= 0.017; HR 0.371, 95% CI 0.165-0.836) for DSS; ageâ¯≤ 45 years (pâ¯= 0.043; HR 0.537, 95% CI 0.294-0.980) and liposarcoma histology (pâ¯= 0.006; HR 0.318, 95% CI 0.141-0.716) for OS, respectively. CONCLUSION: An increased risk for local failure seems to exist for patients with relapsed tumor on admission and having positive surgical margins after neoadjuvant RCT. Intensity of chemotherapy influenced DSS but not OS, which could be due to younger patients receiving MAP.
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Lipossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Cisplatino , Recidiva Local de Neoplasia/patologia , Sarcoma/terapia , Sarcoma/patologia , Extremidades/patologia , Neoplasias de Tecidos Moles/cirurgia , Doxorrubicina , Lipossarcoma/tratamento farmacológico , Lipossarcoma/patologia , Terapia Neoadjuvante , Quimiorradioterapia , Estudos RetrospectivosRESUMO
BACKGROUND: The study's objective is to evaluate if Molsidomine (MOL), an anti-oxidant, anti-inflammatory, and anti-apoptotic drug, is effective in treating hyperoxic lung injury (HLI). METHODS: The study consisted of four groups of neonatal rats characterized as the Control, Control+MOL, HLI, HLI + MOL groups. Near the end of the study, the lung tissue of the rats were evaluated with respect to apoptosis, histopathological damage, anti-oxidant and oxidant capacity as well as degree of inflammation. RESULTS: Compared to the HLI group, malondialdehyde and total oxidant status levels in lung tissue were notably reduced in the HLI + MOL group. Furthermore, mean superoxide dismutase, glutathione peroxidase, and glutathione activities/levels in lung tissue were significantly higher in the HLI + MOL group as compared to the HLI group. Tumor necrosis factor-α and interleukin-1ß elevations associated with hyperoxia were significantly reduced following MOL treatment. Median histopathological damage and mean alveolar macrophage numbers were found to be higher in the HLI and HLI + MOL groups when compared to the Control and Control+MOL groups. Both values were increased in the HLI group when compared to the HLI + MOL group. CONCLUSIONS: Our research is the first to demonstrate that bronchopulmonary dysplasia may be prevented through the protective characteristics of MOL, an anti-inflammatory, anti-oxidant, and anti-apoptotic drug. IMPACT: Molsidomine prophylaxis significantly decreased the level of oxidative stress markers. Molsidomine administration restored the activities of antioxidant enzymes. Molsidomine prophylaxis significantly reduced the levels of inflammatory cytokines. Molsidomine may provide a new and promising therapy for BPD in the future. Molsidomine prophylaxis decreased lung damage and macrophage infiltration in the tissue.
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Hiperóxia , Lesão Pulmonar , Ratos , Animais , Lesão Pulmonar/tratamento farmacológico , Lesão Pulmonar/etiologia , Lesão Pulmonar/prevenção & controle , Antioxidantes/metabolismo , Molsidomina/farmacologia , Molsidomina/uso terapêutico , Animais Recém-Nascidos , Ratos Wistar , Hiperóxia/patologia , Pulmão , Estresse Oxidativo , Oxidantes/farmacologia , Anti-Inflamatórios/farmacologiaRESUMO
OBJECTIVE: We aimed to evaluate the efficacy of combined (ibuprofen+paracetamol) medical therapy in cases of persistent haemodynamically significant patent ductus arteriosus that are resistant to standard medical monotherapy (ibuprofen and/or paracetamol) in this retrospective multi-centre study. METHODS: The combined therapy included the administration of 15mg/kg/dose of paracetamol every 6 h for 3 days and ibuprofen at an initial dose of 10mg/kg/dose followed by 5 mg/kg/dose every 24 h. After 2 days following the administration of the last dose, the researchers evaluated the efficacy of combined treatment by conducting an echocardiographic examination. RESULTS: Of all 42 patients who received combined therapy, 37 (88.1%) patients exhibited closure of the haemodynamically significant patent ductus arteriosus without requiring surgical ligation. Patients who did not respond to combined therapy had a higher mean birth weight and gestational age compared to those who responded (p < 0.05). CONCLUSION: The researchers believe the success of ibuprofen and paracetamol in haemodynamically significant patent ductus arteriosus treatment may be due to their synergistic efficacy and inhibition of the prostaglandin synthesis pathway through different enzymes. The results of our retrospective trial suggest that combination therapy with paracetamol and ibuprofen can be attempted when monotherapy is unsuccessful in treating haemodynamically significant patent ductus arteriosus, especially in centres without a surgical department.
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Acetaminofen , Permeabilidade do Canal Arterial , Ibuprofeno , Feminino , Humanos , Recém-Nascido , Masculino , Acetaminofen/uso terapêutico , Quimioterapia Combinada , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/tratamento farmacológico , Ibuprofeno/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , EcocardiografiaRESUMO
Photothermal atomic force microscopy coupled with infrared spectroscopy (AFM-IR) brings significant value as a spatially resolved surface analysis technique for disordered oxide materials such as glasses, but additional development and fundamental understanding of governing principles is needed to interpret AFM-IR spectra, since the existing theory described for organic materials does not work for materials with high extinction coefficients for infrared (IR) absorption. This paper describes theoretical calculation of a transient temperature profile inside the IR-absorbing material considering IR refraction at the interface as well as IR adsorption and heat transfer inside the sample. This calculation explains the differences in peak positions and amplitudes of AFM-IR spectra from those of specular reflectance and extinction coefficient spectra. It also addresses the information depth of the AFM-IR characterization of bulk materials. AFM-IR applied to silica and silicate glass surfaces has demonstrated novel capability of characterizing subsurface structural changes and surface heterogeneity due to mechanical stresses from physical contacts, as well as chemical alterations manifested in surface layers through aqueous corrosion.
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Surface-tethered macromolecules (polymer brushes) are a potent means to modify surfaces with stimuli-responsive properties while avoiding delamination problems. This vibrational sum frequency generation spectroscopy study describes how the conformation of hydrophilic polymer brushes changes in response to environmental conditions, that is, changes in humidity (in air) and upon exposure to liquid water. Three hydrophilic brushes were prepared on silicon oxide surfaces by surface-initiated reversible deactivation radical polymerization of cationic (quaternary ammonium), anionic (sulfonate), and zwitterionic (containing both) monomers. The average tilt angle of methyl groups was analyzed and used to deduce the chain conformations of the polymer brushes. In air, the brush films absorb water and swell with increasing humidity. This is accompanied by the rotation of interfacial polymer chains. The degree of water uptake and chain conformation vary with the nature of the charged hydrophilic moieties. The hydrophilic polymer brush surfaces appear to remain relatively dry except in near-condensation conditions. In water, the quaternary ammonium groups of cationic and zwitterionic brushes are aligned nearly parallel to the surface. The anionic brush chains appear to assume nearly random conformations in water.
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BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is a condition that may cause multiple organ dysfunction and has a high rate of mortality and morbidity. Therapeutic hypothermia is the only proven treatment that decreases the sequel and mortality rate of neonates that are born after 36 weeks of pregnancy and have moderate-severe HIE. METHODS: Our study was a single-center, retrospective study that includes newborns (gestational age ≥ 36 weeks) who underwent therapeutic hypothermia due to hypoxic-ischemic encephalopathy between 2010 and 2020. We evaluated 125 patients who were diagnosed with moderate to severe HIE and received therapeutic hypothermia. Demographic and clinical data were obtained from electronic medical records and patient files. The patients were separated into two groups as exitus group (n = 39) and discharged group (n = 86). We aimed to evaluate factors affecting mortality. RESULTS: We determined that the median resuscitation times were longer in the delivery room [retrospectively, 10th minutes (0-30) vs. 1 min (0-20), p < 0.05], the tenth min APGAR scores were lower [respectively, 4 (0-7) vs. 6 (3-10), p < 0.05], and the median pH value in the first blood gas taken was lower [respectively, 6.87 (6.4-7.14) vs. 6.90 (6.58-7.12), p < 0.05] in the exitus group. We also determined that multiple organ dysfunction is seen more often in the exitus group. DISCUSSION: This study demonstrated that the depth of acidosis in the blood gas, multiple organ dysfunction, and the existence of early-onset seizures are the signs of poor prognosis. Therefore, physicians need to be aware of such prognostic factors to follow these patients more closely in terms of possible complications and to inform their parents.
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Hipotermia Induzida , Hipóxia-Isquemia Encefálica , Gravidez , Feminino , Humanos , Recém-Nascido , Lactente , Hipóxia-Isquemia Encefálica/terapia , Hipóxia-Isquemia Encefálica/diagnóstico , Estudos Retrospectivos , Insuficiência de Múltiplos Órgãos , Hipotermia Induzida/efeitos adversos , Índice de ApgarRESUMO
Fast methods for calculating two-body interactions have many applications, and for molecular science and cosmology, it is common to employ periodic boundary conditions. However, for the 1/r potential, the energy and forces are ill-defined. Adopted here is the model given by the classic Ewald sum. For the fast calculation of two-body forces, the most celebrated method is the fast multipole method and its tree-code predecessor. However, molecular simulations typically employ mesh-based approximations and the fast Fourier transform. Both types of methods have significant drawbacks, which, in most respects, are overcome by the less well-known multilevel summation method (MSM). Presented here is a realization of the MSM, which can be regarded as a multilevel extension of the (smoothed) particle mesh Ewald (PME) method, but with the Ewald softening replaced by one having a finite range. The two-level (single-grid) version of MSM requires fewer tuning parameters than PME and is marginally faster. Additionally, higher-level versions of MSM scale well to large numbers of processors, whereas PME and other two-level methods do not. Although higher-level versions of MSM are less efficient on a single processor than the two-level version, evidence suggests that they are more efficient than other methods that scale well, such as the fast multipole method and tree codes.
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PURPOSE: The primary aim was to evaluate the influence of the surgical modification on posterior tibial slope (PTS) and patellar height in open-wedge high tibial osteotomy (OWHTO). The secondary aim was to evaluate the influence of preoperative mechanical axis deviations (MA) on PTS METHODS: Between January 2014 and February 2016, patients with a diagnosis of medial-compartment osteoarthritis who had undergone OWHTO with posteromedial osteotomy technique with a minimum follow-up of 3 months were included in this retrospective study. Preoperative and postoperative PTS angles with 3 different methods and patellar heights with respect to the Insall-Salvati and Caton-Deschamps indices were measured on lateral radiographs by 2 observers. Patients were grouped according to preoperative MA (either <10° or ≥10°). PTS changes were compared between groups RESULTS: Thirty consecutive knees of 28 patients were evaluated. Preoperative mean PTS angles were 9.50° ± 4.47° (posterior tibial cortex referenced), 11.51° ± 4.50° (tibial anatomical axis referenced), and 10.80° ± 4.58° (posterior fibular cortex referenced); postoperative angles were 6.10° ± 4.23°, 8.78° ± 4.57°, and 8.11° ± 4.55°, respectively. PTS was significantly decreased postoperatively with respect to all 3 methods (P < .0001). Mean preoperative and postoperative Insall-Salvati indices were 1.04 ± 0.16 and 1.07 ± 0.17, respectively (P = .088). Mean preoperative and postoperative Caton-Deschamps indices were 0.87 ± 0.18 and 0.78 ± 0.18, respectively (P = .017). PTS changes were not statistically significant between groups with respect to MA (P values .861, .723, and .727, respectively) CONCLUSIONS: It is possible to preserve and even decrease PTS with an OWHTO performed posterior to MCL in a posteromedial to anterolateral direction. LEVEL OF EVIDENCE: Level IV, retrospective case series.
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Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Patela/cirurgia , Tíbia/cirurgia , Adulto , Idoso , Feminino , Fíbula/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Radiografia , Estudos RetrospectivosRESUMO
Purpose: To investigate the effect of Hypericum perforatum on corneal alkali burn. Methods: We studied 45 250 g weighing, 4 months old Wistar albino rats. Alkaline burns were performed in the corneas of all experimental animals with 2 mol/L NaOH after general anaesthesia. Rats were divided into five groups according to the subsequent process applied to them: group 1 was the topical Hypericum perforatum group, group 2 was the topical pure olive oil group, group 3 was the oral Hypericum perforatum group, group 4 was the oral pure olive oil group, and group 5 was the control untreated group. Rats were sacrificed under general anaesthesia on the 14 day. The rate of corneal inflammation, neovascularization, fibroblastic activity, and cluster of differentiation 31 (CD31) staining was investigated. Result: There were 45 rats at the beginning of the study. One rat in groups 1, 2, and 3 died during the study; therefore, 42 rats could be evaluated. There were 8 rats in group 1, 8 rats in group 2, 8 rats in group 3, and 9 rats in group 4. We found less corneal neovascularization (CNV), inflammation, and fibroblastic activity in group 1 and group 2 than in the other groups (p Ë 0.001 for all parameters). CNV, inflammation, fibroblastic activity, and CD31 staining rates were lower in group 1 than in group 2 (p Ë 0.001 for all parameters). There was no difference between groups 3, 4, and 5 (respectively, p = 0.436, 0.634, and 0.750). Conclusions: We found that both topical Hypericum perforatum oily extract and olive oil have anti-inflammatory, anti-angiogenic, and anti-fibroblastic effects when applied after corneal alkali burns in rat corneas. Further studies should be conducted in this field.
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Anti-Inflamatórios/uso terapêutico , Queimaduras Químicas/tratamento farmacológico , Neovascularização da Córnea/tratamento farmacológico , Queimaduras Oculares/tratamento farmacológico , Hypericum , Extratos Vegetais/uso terapêutico , Animais , Queimaduras Químicas/patologia , Neovascularização da Córnea/patologia , Queimaduras Oculares/induzido quimicamente , Queimaduras Oculares/patologia , Feminino , Fibroblastos/efeitos dos fármacos , Ratos WistarRESUMO
Genitourinary system tuberculosis (GUTB) is a chronic granulomatous infection in which tuberculous bacilli affect one or more organs in the genitourinary system. In this report, an unusual presentation of miliary tuberculosis was presented as GUTB. A 15-year-old girl presented with complaints of severe abdominal pain and dysuria. Abdominal examination showed tenderness and defense. Pyuria and microscopic hematuria were observed. Acute abdominal causes could not be excluded through abdominal ultrasound. On abdominal computed tomography, a necrotic lesion was detected in the right kidney. Acid-fast bacilli were detected in the urine. Quartet anti-tuberculosis therapy was started. After treatment, static renal scintigraphy with 99mTc-dimer captosuccinic acid and single-photon emission CT imaging showed parenchymal injury. In any suspected patient, voiding symptoms, abdominal or flank pain, sterile pyuria, and hematuria should be kept in mind as the presenting manifestations of GUTB in the differential diagnosis.
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Piúria/etiologia , Tuberculose Urogenital/diagnóstico , Infecções Urinárias/diagnóstico , Adolescente , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Mycobacterium tuberculosis/isolamento & purificação , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tuberculose Urogenital/tratamento farmacológico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Urina/microbiologiaRESUMO
OBJECTIVES: To evaluate the effects of topically and subconjunctivally administered sesamol on experimentally induced corneal neovascularization in rats. METHODS: Fifty-six right eyes of 56 Wistar Albino rats were chemically cauterized to induce corneal neovascularization in this experimental and comparative study. The subjects were divided into eight groups: topical sesamol (group 1), subconjunctival sesamol (group 2), topical bevacizumab (group 3), subconjunctival bevacizumab (group 4), topical bevacizumab+ sesamol (group 5), subconjunctival bevacizumab+ sesamol (group 6), topical Tween 80 (group 7), and control (group 8). The amount of subconjunctivally injected sesamol and bevacizumab was 1.25 mg each. Topical groups were administered 10 mg/mL drops twice daily. The control group was left untreated. To evaluate the degree of corneal neovascularization, digital photographs and corneal sections stained with hematoxylin-eosin and CD31 were used. RESULTS: When photographs of neovascularization areas were examined, all treatment groups showed statistically significant differences when compared with the control group (P<0.001). Topical sesamol was found to be more effective when compared with subconjunctival sesamol (P=0.003). Topical sesamol+ bevacizumab was found to be more effective when compared with topical bevacizumab (P=0.018). The numbers of new corneal vessels were as follows: 12.28±6.29 in group 1, 36.85±12.8 in group 2, 18.85±7.71 in group 3, 16.85±8.70 in group 4, 19.57±8.56 in group 5, 22.57±7.43 in group 6, 45.00±11.29 in group 7, and 51.16±5.91 in group 8 (P<0.001). CONCLUSIONS: The outcomes of this study suggest antiangiogenic effects of sesamol. The use of topical sesamol monotherapy or sesamol combined with bevacizumab may be options for the prevention of corneal neovascularization.
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Antioxidantes/uso terapêutico , Benzodioxóis/uso terapêutico , Neovascularização da Córnea/tratamento farmacológico , Fenóis/uso terapêutico , Administração Tópica , Inibidores da Angiogênese/administração & dosagem , Animais , Antioxidantes/administração & dosagem , Benzodioxóis/administração & dosagem , Bevacizumab/administração & dosagem , Modelos Animais de Doenças , Quimioterapia Combinada , Injeções Intraoculares , Fenóis/administração & dosagem , Ratos , Ratos WistarRESUMO
Discriminative feature extraction technique is always required for the development of accurate and efficient prediction systems for protein subcellular localization so that effective drugs can be developed. In this work, we showed that Local Ternary Patterns (LTPs) effectively exploit small variations in pixel intensities; present in fluorescence microscopy based protein images of human and hamster cell lines. Further, Synthetic Minority Oversampling Technique is applied to balance the feature space for the classification stage. We observed that LTPs coupled with data balancing technique could enable a classifier, in this case support vector machine, to yield good performance. The proposed ensemble based prediction system, using 10-fold cross-validation, has yielded better performance compared to existing techniques in predicting various subcellular compartments for both 2D HeLa and CHO datasets. The proposed predictor is available online at: http://111.68.99.218/Protein_SubLoc/, which is freely accessible to the public.
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Microscopia de Fluorescência , Proteínas/química , Algoritmos , Animais , Área Sob a Curva , Inteligência Artificial , Células CHO , Biologia Computacional , Simulação por Computador , Cricetinae , Cricetulus , Células HeLa , Humanos , Modelos Estatísticos , Neoplasias/metabolismo , Análise de Componente Principal , Curva ROC , Reprodutibilidade dos Testes , Máquina de Vetores de SuporteRESUMO
BACKGROUND: Chondroblastoma (CB), a rare benign bone tumor that produces chondrocytes, often develops in the epiphysis or apophysis of children and young adults. The treatment of these rare tumors is complex. The standard treatment protocol involves curettage with local adjuvants and bone graft or cement application. The authors examined 38 CBs to determine risk factors for local recurrence, complications, and functional outcomes following epiphyseal curettage. METHODS: Twenty-two girls and sixteen boys aged 10 to 17 years with histologically confirmed chondroblastoma who arrived at our hospital between January 2000 and June 2021 were reviewed retrospectively. Clinical data, radiographic images, histological results, treatment, functional outcomes, and the local recurrence rate were examined-surgical treatment involved total tumor curettage, followed by bone grafting and adjuvant techniques. Local recurrences have also been reported. RESULTS: The most frequently affected site was the proximal femur. Sites of involvement included the proximal femur in 10 (26.3%) cases, the proximal tibia in 8 (20.8%), the humerus in 5 cases (13.2%), the distal tibia in 4 cases (10.5%), the distal femur in 3 cases (7.9%), the supracetabular region in 3 cases (7.9%), the talus in 1 case (2.6%), the calcaneus in 1 case (2.6%), the scapula in 1 case (2.6%), the lumbar spine in 1 case (2.6%), and the iliac bone in 1 (2.6%) patient. The mean follow-up was 144.2 months (24 to 276). The local recurrence rate was 7.9%. The mean Musculoskeletal Tumor Society (MSTS) score was 28.3 points (17 to 30). The mean duration of symptoms at presentation was 5.8 (range, 1 to 28) months. CONCLUSION: Aggressive curettage and bone grafting resulted in local control and good outcomes in most pediatric patients. In a relatively small proportion of cases, long-term complications and recurrence can occur due to growth plate damage and late diagnosis. In patients admitted to the pediatric clinic with pain, which is often accompanied by localized edema and joint effusion, early detection via advanced radiological scans (X-ray, CT, or MRI) may prevent delays in diagnosis.
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Vitreous hemorrhage (VH) is one of the main causes of vision loss in diabetic retinopathy (DRP). Early surgery increases the visibility of the retina, allowing early recognition of DRP complications and additional treatments. One of the most important reasons affecting success after surgery is recurrent vitreous hemorrhage (RVH). We aimed to investigate the risk factors for RVH after early 25G vitrectomy in diabetic VH. Eighty eyes of eighty patients who underwent early 25G PPV surgery with a diagnosis of VH due to proliferative diabetic retinopathy (PDR) were included in this retrospective study. Vision acuity changes and intraocular pressure (IOP) changes were compared. The effect of arterial hypertension (HT), coronary artery disease (CAD), preoperative antiglaucomatous usage, and anticoagulant usage on RVH was investigated. A value of Pâ <â .05 was accepted as statistically significant. Postoperative RVH was observed in 18 (22.5%) patients. There was no correlation between the age of the patients and the development of postoperative RVH (râ =â -0.197, Pâ =â .08). The rate of HT and the mean HbA1C levels were found to be higher in the patients who developed RVH than in those who did not (Pâ =â .04 andâ <â 0.001, respectively). The presence of CAD, preoperative glaucoma disease, and the use of anticoagulants did not have any effect on RVH (Pâ =â .229, 0.843, 0.932, respectively). HT and increased HbA1c were found to be risk factors for RVH in VH patients who underwent 25G vitrectomy in the early period in our study.
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Diabetes Mellitus , Retinopatia Diabética , Humanos , Hemorragia Vítrea/etiologia , Hemorragia Vítrea/cirurgia , Vitrectomia/efeitos adversos , Retinopatia Diabética/complicações , Retinopatia Diabética/cirurgia , Retinopatia Diabética/diagnóstico , Estudos Retrospectivos , Hemoglobinas Glicadas , Retina , Fatores de Risco , Diabetes Mellitus/etiologiaRESUMO
Objectives: Triazolopyrimidinones are compounds used in medicinal chemistry. In this study, three novel triazolopyrimidinone derivatives were synthesized as drug candidates: (5-(chloromethyl)-2-(4-methoxyphenyl)-[1,2,4]triazolo[1,5-a]pyrimidin-7(3H)-one) (S1-TP), 2-(4-methoxyphenyl)-5-(piperidinomethyl)-[1,2,4]triazolo[1,5-a]pyrimidin-7(3H)-one) (S2-TP), and 2-(4-methoxyphenyl)-5-(morpholinomethyl)-[1,2,4]triazolo[1,5-a] pyrimidin-7(3H)-one) (S3-TP). Their electrochemical properties were investigated for the first time using voltammetric techniques on carbon graphite electrodes. Moreover, stability tests for each drug candidate were performed on different days. After revealing the electrochemical properties of the drug candidates, their effect on double-stranded (ds) DNA was examined by measuring the oxidation currents of the guanine of dsDNA before and after the interaction. Materials and Methods: An electrochemical setup that included a pencil graphite electrode as the working electrode, an Ag/AgCl reference electrode, and a platinum wire as the auxiliary electrode was used in this study. Experiments for optimum pH, scan rate, and concentration of drug candidates were conducted. The interaction between Ss-TP and dsDNA was evaluated using differential pulse voltammetry. The stability of each drug candidate was tested on various days. Results: A comprehensive characterization of the S1-TP, S2-TP, and S3-TP compounds was performed for the first time. This study showed that the electrochemical oxidation of S1-TP and S2-TP was irreversible and diffusion-controlled. In addition, the transfer of electrons in S3-TP was controlled by adsorption. The interaction between Ss-TP and dsDNA resulted in notable changes in the peak potentialof dsDNA. The dsDNA peak potential shifted negatively after interaction with S1-TP, S2-TP, and S3-TP. Under optimum conditions, the detection limits for S1-TP, S2-TP, and S3-TP were 1.5 µg/mL, 1.0 µg/mL, and 2.0 µg/mL, respectively. Conclusion: From our experimental data, we concluded that these molecules can be used as drug molecules because of their remarkable effects on DNA.
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Background and purpose: In this study, we present an electrochemical sensor for the detection of oxypeucedanin (Oxyp) and prantschimgin (Pra), two natural furanocoumarin derivatives. The determination of the effects of these molecules on DNA is important to be potential drug candidates. Our research focused on exploring the electrochemical behaviour of these compounds and their interaction with DNA. Experimental approach: The electrochemical properties of Oxyp and Pra were systematically analyzed by evaluating their oxidation currents. Changes in the oxidation currents and peak potentials of guanine bases were monitored before and after interaction in the solution phase and at the electrode surface. Key results: The limit of detection (LOD) and limit of quantitation (LOQ) for Oxyp were determined to be 1.3 and 4.3 µg/mL, respectively. For Pra, the LOD and LOQ were found to be 20 and 68 µg/mL, respectively. Stability studies demonstrated that the Oxyp solution retained its oxidation capacity for over a month, whereas the Pra solution retained its oxidation capacity for nearly 120 min. Our findings suggest that Oxyp interacts with dsDNA, potentially through electrostatic interactions, showing promise as a potential drug candidate targeting DNA. On the other hand, the interaction of Pra with dsDNA requires further exploration to fully understand its mode of action. Conclusion: The electrochemical sensor developed in this study provides a reliable and efficient method for detecting and analysing the interaction of these natural compounds with dsDNA. Our research contributes to advancing the understanding of the interaction between natural furanocoumarins and dsDNA, laying the groundwork for the design and development of novel and effective DNA-targeted drugs.
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Objectives: This study aimed to evaluate choroidal thickness (CT) in patients with rheumatoid arthritis (RA) and healthy controls and to determine its relationship with RA-associated interstitial lung disease (RA-ILD). Patients and methods: A total of 63 patients with RA and 36 age- and sex-matched healthy controls were recruited in the cross-sectional study. Serological findings, Disease Activity Score-28, disease duration, and medical treatment of patients were recorded. Patients with RA were subdivided into two groups: patients with RA-ILD (Group 1) and patients with RA but without ILD (RA-noILD; Group 2). CTs were measured using enhanced depth imaging optical coherence tomography. CT was measured at five points: the subfoveal region, 750 µm nasal and temporal to the fovea, 1500 µm nasal and temporal to the fovea. Patients with RA-ILD were evaluated with delta high-resolution computed tomography (ΔHRCT) and pulmonary function test to determine the severity of interstitial lung disease. Results: Four of 63 RA patients were excluded due to comorbidities. Thus, 59 RA patients, 20 in the RA-ILD group and 39 in the RA-noILD group, were included in the analyses. The RA groups were similar in terms of clinical characteristics and laboratory findings. There were statistically significant differences between Group 1, Group 2 and healthy controls (Group 3) compared to all CT values (p<0.05). The mean CT measured at 750 µm and 1500 µm nasal to the fovea was lowest in the RA-ILD group, followed by the RA-noILD and healthy groups (p<0.05). CT measurements did not correlate with the pulmonary function test and ΔHRCT. Conclusion: RA-ILD patients had a thinner CT measured at nasal points. However, there was no association between CT measurements and the severity of ILD.
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INTRODUCTION: While long bone fractures are commonly seen in individuals with Osteogenesis Imperfecta (OI), femoral neck fractures (FNF) are exceedingly rare. There is a lack of comprehensive data regarding the etiology of FNFs, their characteristics, and the treatment protocols. Our aim was to determine the characteristics of femoral neck fractures in children with OI. MATERIALS AND METHODS: This study was conducted as retrospective series covering period of January 2011-December 2022. Total of 14 femoral neck fractures in 12 patients were included into final analysis. Age, gender, fracture location, ambulation level, injury mechanism, Sillence type, pre-fracture collo-diaphyseal angle, presence of previous implants and applied treatments were noted. RESULTS: The mean age was 9.3 (range: 3-16), 8 out of 12 patients were males. Sillence type 3 OI was most common (50 %) type. Among 12 patients, 2 (16.6 %) were restricted ambulatory while 5 (41.6 %) were non-ambulatory. Seven patients had prior femoral implants. Six fractures were managed non-operatively, while others underwent surgery, with cannulated screws (42.8 %) or plate osteosynthesis (7.1 %). All eight cases (100 %) with minor trauma or unknown origin were Sillence type 3-4, displaying varus deformity. FNFs that occured in mobile patients required higher-energy traumas. CONCLUSION: Femoral neck fractures in OI showed differing trauma mechanisms in ambulatory vs. non-ambulatory patients. Non-surgical treatment may be considered with in patients with high-risk anesthesia concerns, requiring higher level clinical studies.