Corona mortis, aberrant obturator vessels, accessory obturator vessels: clinical applications in gynaecology

Corona mortis (CMOR) is a heterogeneous and often dubious term that causes much confusion in medical literature, especially in regard to its modern day significance in pelvic surgery. Some authors define CMOR as any abnormal anastomotic vessel between the external iliac and obturator vessels, whereas others define it as any vessel coursing over the superior pubic branch, regardless whether it is a vascular anastomosis, an accessory obturator vessels, an obturator vessel related to the external iliac system or a terminal small vessel. There is no standard classification of CMOR and obturator vessels variations, although there are multitudes of classifications describing the diverse variations in the obturator foramen region. We define accessory obturator, aberrant obturator vessels and CMOR as different structures, as CMOR is an anatomical term that reflects a clinical situation rather than an anatomical structure. A new clinical classification for aberrant, accessory obturator vessels and CMOR is proposed regarding the anatomical variations, and the location of vessels to the deep femoral ring. The clinical significance of accessory obturator, aberrant vessels and CMOR is delineated in oncogynaecological and urogynaecological surgery

Cimpact-now updates and the 2021 who classification of central nervous system tumors: Where does it leave underdeveloped neuropathology centers and how to report diffuse gliomas

The classification of central nervous system tumors, first introduced by Bailey and Cushing in 1926, has been constantly updated by the World Health Organization. The latest fifth edition, introduced in 2021, although the bluebook was officially published in the first weeks of 2022, is the first classification to officially introduce histological and molecular grading criteria for the differ-ent nosological units based on mutation-oriented, evidence-based patient prognosis. So far, these changes have had no impact on patient treatment, despite the stratified patient risk and prognosis. As such, there has been little initiative for underfunded and underdeveloped neuropathological centers to introduce molecular diagnostic modalities, especially as they are of little use to other tumor groups. This has disadvantaged neuropathologists in such centers, especially when reporting the most common of these tumor groups – diffuse (high-grade) gliomas, as mutational status is key in these nosological units. Herein we review the changes in the classification system and suggest an integrated descriptive manner of reporting such tumors, allowing for the oncologist to initiate treatment, suggesting the necessary mutations to be evaluated and not misleading the patient that he was misdiagnosed upon consultation at a referral center

Cardio- and nephroprotective effects of fractions isolated from Lycium barbarum (goji berry) in models of cardio- and nephrotoxicity in rats

AbstractThe aim of the present study was to identify agents that reduce the anthracyclines-induced cardiovascular and renal damage and have the potential to enhance their therapeutic effects. Three fractions of Lycium barbarum (Goji berry), pectin-free, polysaccharide and a combination of the two (1:1, w/w), were tested on rat models of doxorubicin (DOX)-induced cardio- and nephrotoxicity. They were administered p.o. as doses of 2 mg/kg. DOX was applied at a cumulative dose of 20 mg/kg (i.p.). Different biomarkers for cardiotoxicity (creatine kinase, creatine kinase-MB fraction, aspartate aminotransferase, lactate dehydrogenase), nephrotoxicity (creatinine, blood urea nitrogen, uric acid) and the serum potassium levels were evaluated. Histological analysis of hearts and kidneys was performed. The male Wistar rats treated only with DOX showed a drastic increase in all biomarkers for toxicity. Meanwhile, in all cohorts receiving simultaneously any of the plant fractions, the biomarkers for heart and kidney tissue damage were significantly reduced (p < 0.001 for uric acid; p < 0.01 for other parameters). Intriguingly, the pectin-free fraction and the combined one showed the most pronounced decrease in the indicators for toxicity. Histological findings also confirmed these observations, suggesting that the fractions in question need to be investigated as potential enhancers of anthracyclines’ pharmacodynamic effects

Protective Effect of Methylxanthine Fractions Isolated from Bancha Tea Leaves against Doxorubicin-Induced Cardio- and Nephrotoxicities in Rats

Doxorubicin is an anthracycline antibiotic that is used for the treatment of various types of cancer. However, its clinical usage is limited due to its potential life-threatening adverse effects, such as cardio- and nephrotoxicities. Nonetheless, simultaneous administration of doxorubicin and antioxidants, such as those found in green tea leaves, could reduce cardiac and renal tissue damage caused by oxidative stress. The methylxanthine fraction isolated from Bancha tea leaves were tested in vitro for its antioxidant activity and in vivo for its organoprotective properties against doxorubicin-induced cardio- and nephrotoxicities in a rat model. The in vivo study was conducted on male Wistar rats divided into 6 groups. Methylxanthines were administered at high (5 mg/kg body weight) and low (1 mg/kg body weight) doses, while doxorubicin was administered at a cumulative dose of 20 mg/kg body weight. Serum creatinine, uric acid, and urea concentrations, as well as serum enzyme levels (creatinine kinase (CK), creatinine kinase MB fraction (CK-MB), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH)) and electrolytes (Na+, K+, and Cl-), were analysed. In addition, histological analysis was performed to assess cardiac and renal tissue damage. The concomitant administration of Bancha methylxanthines and doxorubicin showed a dose-dependent reduction in the serum biochemical parameters, indicating a decrease in the cardiac and renal tissue damage caused by the antibiotic. Histological analysis showed that pretreatment with methylxanthines at the dose of 5 mg/kg resulted in an almost normal myocardial structure and a significant decrease in the morphological kidney changes caused by doxorubicin exposure compared with the group that received doxorubicin alone. The putative mechanism is most likely related to a reduction in the oxidative stress caused by doxorubicin