Notes

Protecting Connection between Curcumin upon Endothelium: A current Evaluate.
We identified six unique subsets of IL-13-producing immune cells in the inflamed stomach. Organoid cultures showed that IL-13 acts directly on gastric epithelium to induce a metaplastic phenotype. IL-4Rα-deficient mice did not progress to metaplasia. Single-cell RNA sequencing determined that gastric epithelial cells from IL-4Rα-deficient mice upregulated inflammatory genes but failed to upregulate metaplasia-associated transcripts. Neutralization of IL-13 significantly reduced and reversed metaplasia development in mice with gastritis.

IL-13 is made by a variety of immune cell subsets during chronic gastritis and promotes gastric cancer-associated metaplastic epithelial cell changes. Neutralization of IL-13 reduces metaplasia severity during chronic gastritis.
IL-13 is made by a variety of immune cell subsets during chronic gastritis and promotes gastric cancer-associated metaplastic epithelial cell changes. Neutralization of IL-13 reduces metaplasia severity during chronic gastritis.
Botulinum toxin (BT) injections may play a role in preventing Hirschsprung associated enterocolitis (HAEC) episodes related to internal anal sphincter (IAS dysfunction). Our aim was to determine the association of outpatient BT injections for early obstructive symptoms on the development of HAEC.

A retrospective review of children who underwent definitive surgery for Hirschsprung disease (HSCR) from July 2010 - July 2020 was performed. The timing from pull-through to first HAEC episode and to first BT injection was recorded. Primary analysis focused on the rate of HAEC episodes and timing between episodes in patients who did and did not receive BT injections.

Eighty patients were included. Sixty patients (75%) were male, 15 (19%) were diagnosed with trisomy 21, and 58 (72.5%) had short-segment disease. The median time to pull-through was 150 days (IQR 16, 132). Eight patients (10%) had neither an episode of HAEC or BT injections and were not included in further analysis. Forty-six patients (64%) experienced at least one episode of HAEC, while 64 patients (89%) had at least one outpatient BT injection. Compared to patients who never received BT injections (n=9) and those who developed HAEC prior to BT injections (n=35), significantly fewer patients who received BT injections first (n=28) developed enterocolitis (P < 0.001), with no patient developing more than one HAEC episode.

Outpatient BT is associated with decreased episodes of HAEC and increased interval between HAEC episodes requiring inpatient treatment. Scheduling outpatient BT injections to manage obstructive symptoms may be beneficial after pull-through for HSCR.
Outpatient BT is associated with decreased episodes of HAEC and increased interval between HAEC episodes requiring inpatient treatment. Scheduling outpatient BT injections to manage obstructive symptoms may be beneficial after pull-through for HSCR.
Nonfasting serum triglyceride (TG) level is attracting more and more attention as an atherosclerosis-promoting factor. However, no study has investigated the relationships between nonfasting TG levels and carotid restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS). This study was conducted to investigate if nonfasting TG levels can be used to assess a risk for carotid restenosis after CEA or CAS.

This was a single-center retrospective study. We reviewed 201 consecutive primary carotid artery revascularization procedures (39 CEAs and 162 CASs), which were performed from 2008 to 2018 for 179 patients (163 men and 16 women) with atherosclerotic carotid stenosis, and were followed up for at least 1 year. Clinical variables including nonfasting lipid profiles and findings of magnetic resonance plaque imaging were compared between groups with and without postprocedural carotid restenosis (≥50% stenosis on ultrasonography).

During a mean follow-up period of 1413 days, 24 of 201 carotid stenosis procedures (11.9%) suffered restenosis after successful revascularization procedures. Multivariate analyses demonstrated that nonfasting TG level was the only independent risk factor of postprocedural restenosis. The receiver operating characteristic curve analyses revealed that a cutoff value of nonfasting TG to discriminate postprocedural carotid restenosis was 127.5 mg/dL, which was much lower than the upper limit of normal.

This study showed that nonfasting TG level may be a useful marker to predict carotid restenosis after CEA or CAS, and could be a new therapeutic target to prevent carotid restenosis after revascularization procedures.
This study showed that nonfasting TG level may be a useful marker to predict carotid restenosis after CEA or CAS, and could be a new therapeutic target to prevent carotid restenosis after revascularization procedures.
The "Scalpel sign" is a radiological finding observed on sagittal MRI and CT myelographic images, corresponding to an indentation in the dorsal aspect of the spinal cord, resembling a surgical scalpel blade. It is said to be a pathognomonic imaging discovery linked to dorsal arachnoid webs (DAWs). However, other spine-related conditions may mimic DAWS on MRI such as arachnoid cysts (SAC) or ventral herniation (VSCH), inducing misdiagnosis.

We present a retrospective review of cases involving these three different diagnoses presented in our institution in the last 5 years that share in common the characteristic focal dorsal indentation of the spinal cord.

7 cases were identified, all but one treated and confirmed intraoperatively. All of them were located at the dorsal spinal cord. MRI was the study of choice for evaluation. Clinical manifestations included back pain and lower extremity numbness and weakness together with compressive myelopathy signs and urinary symptoms. Mean follow up was 16.8 months with satisfactory postoperative results.

Isolated radiological presentation of the scalpel sign is not sufficient to distinguish between dorsal arachnoid webs, arachnoid cysts and ventral herniation of the spine. However, awareness of its importance is relevant for accurate curative surgical planning.
Isolated radiological presentation of the scalpel sign is not sufficient to distinguish between dorsal arachnoid webs, arachnoid cysts and ventral herniation of the spine. However, awareness of its importance is relevant for accurate curative surgical planning.
The vagus ("wandering") nerve is the longest cranial nerve with the largest territory of innervation in the human body. Injury during various operative procedures involving the anterior or lateral neck may lead to serious complications. Per "textbook" descriptions, the cervical vagus nerve (CVN) commonly locates within the carotid sheath, in-between the common carotid artery (CCA) and internal jugular vein (IJV). However, anatomic variations in its positioning may occur more often than expected and intraoperative identification may anticipate potential surgical pitfalls.

A literature review was conducted per PRISMA guidelines for all studies describing positional variations of the CVN within the carotid sheath. A rare and potentially dangerous variation, occurring in only 0.7% of all reported cases, is illustrated with a cadaveric case.

Overall, 10 anatomic CVN variations have been described across 971 specimens. The non-textbook variations (26.5%) consist of lateral (4.7%), anterolateral (8.7%), posteromedial (0.2%), posterior (5.8%), anterior (3.1%), medial (0.7%), and anteromedial (0.4%) to the CCA, as well as posterolateral (0.3%) and posterior (2.6%) to IJV. The "textbook" anatomic location is posterolateral to CCA (73.5%). Moreover, an increase in variability is reported on the left side (17.1%) compared to the right (11.3%). Our cadaveric dissection revealed a right-sided CVN directly medial to the CCA.

Positional variations of the CVN occur in over 26% of patients and may add difficulty to an array of surgical procedures. see more Knowledge of these variations and their prevalence may aid the surgeon in conducting a more precise dissection possibly preventing significant potential adverse sequelae.
Positional variations of the CVN occur in over 26% of patients and may add difficulty to an array of surgical procedures. Knowledge of these variations and their prevalence may aid the surgeon in conducting a more precise dissection possibly preventing significant potential adverse sequelae.
Vestibular schwannoma (VS) is the third most common benign intracranial tumor that can occur sporadically (SVS) or be associated with neurofibromatosis type 2 (NF2-VS). The aim of this study is to provide a comprehensive bioinformatic analysis of methylated differentially expressed genes (MDEGs) in NF2-VS.

Transcriptional sequencing datasets (GSE141801, GSE108524) and gene methylation microarrays (GSE56598) from the Gene Expression Omnibus (GEO) database were employed to identify and analyze MDEGs in NF2-VS. A protein-protein interaction (PPI) network was built and the hub genes and modules were identified. Finally, potential pharmacotherapy targeting MDEGs were extracted for NF2-VS.

A total of 57 hypermethylation-low expression genes and 88 hypomethylation-high expression genes were identified. Pathways associated with aberrantly MDEGs included P13K-AKT, MAPK pathway and Ras, which were also involved in NF2-VS. Six hub genes namely, EGFR, CCND1, CD53, CSF1R, PLAU, and FGFR1 were identified from the PPI network. Modification of the above mentioned genes altered cell-to-cell communication, response to stimulus, cellular regulation and membrane and protein bindings. Thirty drugs targeting these pathways were selected based on the hub genes.

Analysis of MDEGs may enrich the understanding of the molecular mechanisms of NF2-VS pathogenesis and lay the groundwork for potential biomarkers and therapeutic targets for NF2-VS.
Analysis of MDEGs may enrich the understanding of the molecular mechanisms of NF2-VS pathogenesis and lay the groundwork for potential biomarkers and therapeutic targets for NF2-VS.
This meta-analysis aimed to evaluate the prognostic performance of third ventricular floor bowing (TVFB) as a marker for surgical success in patients undergoing endoscopic third ventriculostomy (ETV).

We performed a comprehensive literature search for studies comparing ETV success in patients with TVFB compared to those without using PubMed, SCOPUS, Embase, and EuropePMC. TVFB was defined as inferior bowing or bulging deformation or convex third ventricular floor. Surgical success was defined as resolution of symptoms post-surgery and requires no further intervention for hydrocephalus. The outcome was surgical success in patients with TVFB compared to those without TVFB, the effect estimate was reported as odds ratio (OR).

Five studies comprising of 439 patients were included in this meta-analysis. The prevalence of overall surgical success was 42%. The prevalence of surgical success was 85% in patients with TVFB. TVFB was associated with increased success rate (OR 5.94 [95%CI 3.07, 11.5], p<0.001; I
26.04%, p=0.248). TVFB was associated with sensitivity 0.83, specificity 0.54, positive likelihood ratio 1.8, negative likelihood ratio 0.32, diagnostic odds ratio 6, and area under curve 0.81 [0.77 - 0.84] for surgical success. Presence of TVFB confers to 56% rate of surgical success and no TVFB confers to rate of 19% surgical success. The association between TVFB and surgical success was not affected by age (coefficient -0.03, p=0.474) and aqueductal stenosis (p=-0.05, p=0.237).

This meta-analysis showed that the presence of TVFB was associated with increased ETV success.
This meta-analysis showed that the presence of TVFB was associated with increased ETV success.
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