Endoscopic Surgery for Third Ventricular Colloid Cysts in the Absence of Hydrocephalus- a feasibility study

Purpose: The aim of this study was to investigate the feasibility and effectiveness of endoscopic neurosurgery for patients with third ventricular colloid cysts without ventriculomegaly.Methods: Seventy-one patients with third ventricular colloid cysts were identified and recruited to this study. Eighteen of these patients did not have concomitant hydrocephalus and underwent primary endoscopic surgery for cyst resection. The surgical technique, the success rate, and patients’ outcome were assessed and compared with 53 hydrocephalic patients who underwent similar procedures.Results: The ventricular compartments were successfully cannulated and gross total resectin of the colloid cysts was achieved in all patients. There were no operative complications related to the endoscopic procedure. Two patients required subsequent intervention for hydrocephalus. The success rate for endoscopic surgery in non-hydrocephalic patients was similar to its value in patients with hydrocephalus.Conclusion: Endoscopic resection of third ventricular colloid cyst in patients without hydrocephalus seems to be feasible, effective and not contraindicated

DLX6-AS1: A long non-coding RNA with oncogenic features

Long non-coding RNAs (lncRNAs) are a heterogeneous group of ncRNAs with characteristic size of more than 200 nucleotides. An increasing number of lncRNAs have been found to be dysregulated in many human diseases particularly cancer. However, their role in carcinogenesis is not precisely understood. DLX6-AS1 is an lncRNAs which has been unveiled to be up-regulated in various number of cancers. In different cell studies, DLX6-AS1 has shown oncogenic role via promoting oncogenic phenotype of cancer cell lines. Increase in tumor cell proliferation, migration, invasion, and EMT while suppressing apoptosis in cancer cells are the effects of DLX6-AS1 in development and progression of cancer. In the majority of cell experiment, mediator miRNAs have been identified which are sponged and negatively regulated by DLX6-AS1, and they in turn regulate expression of a number of transcription factors, eventually affecting signaling pathways involved in carcinogenesis. These pathways form axes through which DLX6-AS1 promotes carcinogenicity of cancer cells. Xenograft animal studies, also have confirmed enhancing effect of DLX6-AS1 on tumor growth and metastasis. Clinical evaluations in cancerous patients have also shown increased expression of DLX6-AS1 in tumor tissues compared to healthy tissues. High DLX6-AS1 expression has shown positive association with advanced clinicopathological features in cancerous patients. Survival analyses have demonstrated correlation between high DLX6-AS1 expression and shorter survival. In cox regression analysis, DLX6-AS1 has been found as an independent prognostic factor for patients with various types of cancer

he Determiners of Temporal Lobe Epilepsy Surgery Outcome in a Developing Country

Background: Epilepsy surgery has become a successful treatment option for patients with drug-resistant epilepsies. Objectives: This study aimed to assess temporal lobe epilepsy (TLE) surgery outcome and its association with epilepsy duration, the presence of pre-surgical generalized tonic-clonic seizure (GTCS), and brain MRI findings. Materials & Methods: This retrospective study was performed from 2016 to 2020 at Loghman-Hakim Hospital, Tehran, Iran. The patients’ demographic data, epilepsy type, duration, frequency, brain image findings, the selected surgical approaches, and histopathological findings were collected. The post-operative seizure outcome was expressed one year according to the proposed International League Against Epilepsy (ILAE) classification system. The independent sample t-test, chi-square, and one-way analysis of variance were applied to analyze the differences between variables in terms of quantitative and categorical data. Results: A total number of 69 TLE surgeries were enrolled in our study. No differences were found in the surgical outcome base on the ILAE classification system of patients with lesional vs non-lesional MRIs (P=0.834). In patients with mesial temporal sclerosis, no correlation was found between the surgical approaches including selective amygdalohippocampectomy, anterior temporal lobectomy, and post-operative seizure outcome (P=0.142). Seven patients (10.1%) developed post-operative functional seizures. Conclusion: In our study, the epilepsy duration and the presence of GTCSs before surgery had no effect on the surgery outcome. In patients with mesial temporal sclerosis, amygdalohippocampectomy, and anterior temporal lobectomy did not confer different surgical outcomes. TLE patients with normal MRI showed similar surgical outcomes as lesional patients. A significantly high proportion of our patients developed functional seizures, postoperatively

Prevalence of Cerebrospinal Fluid Rhinorrhea Following Trans-Sphenoidal Surgery for Pituitary Adenoma in Patients Referred to Loghman Hakim Hospital from 2016 to 2020

Background: Endoscopic endonasal transsphenoidal surgery is commonly used to remove pituitary adenomas. However, it can lead to cerebrospinal fluid (CSF) leakage, with an incidence of around 5% in sphenoid transnasal procedures and up to 20% in extended endonasal approaches. A retrospective study was conducted on 160 pituitary adenoma patients admitted to Loghman Hakim Hospital from 2016 to 2020 to evaluate the factors influencing CSF leak. Aim: The aim of this study was evaluating the occurrence of cerebrospinal fluid leakage and analyzing the factors involved. Methods: This is a retrospective analysis of patients diagnosed with pituitary adenoma at Loghman-Hakim hospital over a four-year period. Demographic information, tumor characteristics, surgical procedures, and complications were collected. All patients gave their consent, and the study was approved by the ethics committee. Surgical procedures were conducted using a direct endonasal trans-sphenoidal approach under general anesthesia, and antibiotics were given. Statistical analysis was conducted using SPSS to evaluate the relation between measured variables and the occurrence of CSF leak. Results: The study found that 19.4% of the patients developed CSF leak during their hospital stay. Age and body mass index (BMI) of patients with CSF leak significantly differed from those without. The size of the tumor did not differ significantly between patients with and without CSF leak. The only variable associated with CSF leak was sphenoid sinus anatomy. Conclusion: The study concluded that older patients with a lower BMI and a larger defect size are more prone to CSF leak, but no significant difference was found in tumor size between the groups with and without CSF leak. Sphenoid sinus anatomy correlated with CSF leak, while other factors did not show any correlation with the incidence of CSF leak

Seroprevalence of Hepatitis a in Hemodialysis Patient Candidate for Kidney Transplant Younger Than Forty Years

Background: Hepatitis A is a common infection during childhood, especially in developing countries. It can cause severe complications in immunocompromised patients. Due to the increasing number of kidney transplants in the country and epidemiologic shift of HAV which was observed in previous studies, we're going to evaluate the seroprevalence of hepatitis A in hemodialysis patients less than forty years serving kidney transplant candidates to follow vaccination policy for them.Materials and Methods: In a cross sectional study during 2014-2015 hepatitis A antibody levels in hemodialysis patients less than forty years in kidney transplant candidates examined in 12 hospitals in Tehran, Iran. Their serums were tested for anti HAV IgM and IgG by ELISA kits.Results: Hepatitis A virus antibody was positive in 66 (72.5%) of 91 patients. The prevalence of HAV was 0% at the range of younger than 20 and 45% in under 25 years age group. This significantly increased prevalence by increasing the age, and there was according to epidemiological shifts which were shown in other studies.Conclusion: Due to the availability of vaccine and hepatitis severe complications in immunocompromised individuals, as well as a low prevalence of positive serology in individuals under 25 years, it seems the check of antibodies in patients undergoing kidney transplantation and vaccination in seronegative persons is a logical

A Case Report of Calcifying Pseudoneoplasm of the Neuraxis: An Incidental Finding After a Car Accident

Calcifying pseudoneoplasms of the neuraxis are rare, poorly understood lesions that can occur anywhere in the central nervous system without any age or sex predilection. Their pathogenesis is still controversial. Patients can present with various symptoms due to lesion location and only few cases have been discovered incidentally. We present a 25-year-old male referred to our hospital after a car accident. Computed tomography scan and magnetic resonance imaging was done because of the patient's head trauma and a calcified intracranial lesion was found and excised surgically. Pathologic evaluation of the specimen was consistent with the diagnosis of calcifying pseudoneoplasm of the neuraxis

Quality of Life in Acromegaly Disease Among Iranian Population:One Longitudinal Before-After Study

Background: The current study aimed to determine the quality of life (QoL) scores before and after treatment in patients with acromegaly.Methods: In this longitudinal before-after study, the acromegaly quality of life (AcroQoL) questionnaire was used to assess the QoL. Demographics, clinical manifestations and co-morbidity data, pituitary axis involvement, biochemical and hormonal component tests, and health-related quality of life (HRQoL) before and after treatment (endoscopic transsphenoidal surgery, medication, radiotherapy) were evaluated in patients over 18 years of age. To compare the mean of continuous data, the independent t and Mann–Whitney tests were used. To compare the mean QOL score before and after the study, the paired-t and Wilcoxon tests were performed. The significance level was set at p<0.05.Results: Among 80 patients with acromegaly who underwent trans-sphenoid surgery with or without radiotherapy or medication therapy with somatostatin analogs, 52 (65%) entered the remission phase within 6 months. Associations were found between the remission phase and female gender (p=0.004) and lower growth hormone (GH) (p=0.04) but not between remission and lower insulin-like growth factor-I (IGF1) after surgery (p=0.02) or gonadal axis disorder after treatment (p<0.001) statistically. Moreover, a significant association was found between not being in the remission phase and gonadal axis disorder before treatment (p=0.04). The QoL score in all dimensions of the AcroQoL questionnaire increased 6 months after treatment (p<0.001). Total AcroQoL score was higher after treatment in the remission group (p=0.03). The psychological scale had a significantly higher score both on the total scale (p<0.001) and on the two subscales of appearance (p<0.001) and personal relationship (p=0.003).Conclusion: Because of the importance of QoL in acromegaly patients, further studies in this field are recommended

MicroRNAs as Biomarkers for Early Diagnosis, Prognosis, and Therapeutic Targeting of Ovarian Cancer

Ovarian cancer is the major cause of gynecologic cancer-related mortality. Regardless of outstanding advances, which have been made for improving the prognosis, diagnosis, and treatment of ovarian cancer, the majority of the patients will die of the disease. Late-stage diagnosis and the occurrence of recurrent cancer after treatment are the most important causes of the high mortality rate observed in ovarian cancer patients. Unraveling the molecular mechanisms involved in the pathogenesis of ovarian cancer may help find new biomarkers and therapeutic targets for ovarian cancer. MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression, mostly at the posttranscriptional stage, through binding to mRNA targets and inducing translational repression or degradation of target via the RNA-induced silencing complex. Over the last two decades, the role of miRNAs in the pathogenesis of various human cancers, including ovarian cancer, has been documented in multiple studies. Consequently, these small RNAs could be considered as reliable markers for prognosis and early diagnosis. Furthermore, given the function of miRNAs in various cellular pathways, including cell survival and differentiation, targeting miRNAs could be an interesting approach for the treatment of human cancers. Here, we review our current understanding of the most updated role of the important dysregulation of miRNAs and their roles in the progression and metastasis of ovarian cancer. Furthermore, we meticulously discuss the significance of miRNAs as prognostic and diagnostic markers. Lastly, we mention the opportunities and the efforts made for targeting ovarian cancer through inhibition and/or stimulation of the miRNAs

The physiological cost index of walking with a powered knee ankle foot orthosis in subjects with poliomyelitis : A pilot study

Background: A powered knee ankle foot orthosis (KAFO) was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait. Objectives: The purpose of this study was to determine its effect on the physiological cost index (PCI), walking speed and the distance walked in people with poliomyelitis compared to when walking with a KAFO with drop lock knee joints. Methods: Seven subjects with poliomyelitis volunteered for the study, and undertook gait analysis with both types of KAFO. Results: Walking with the powered KAFO significantly reduced walking speed (p=0.015) and the distance walked (p=0.004), and also it did not improve PCI values (p =0.009) compared to walking with the locked KAFO. Conclusion: Using a powered KAFO did not significantly improve any of the primary outcome measures during walking for poliomyelitis subjects

A Systematic Review of the Genotoxicity and Antigenotoxicity of Biologically Synthesized Metallic Nanomaterials: Are Green Nanoparticles Safe Enough for Clinical Marketing?

Abstract: Background and objectives: Although studies have elucidated the significant biomedical potential of biogenic metallic nanoparticles (MNPs), it is very important to explore the hazards associated with the use of biogenic MNPs. Evidence indicates that genetic toxicity causes mutation, carcinogenesis, and cell death. Materials and Methods: Therefore, we systematically review original studies that investigated the genotoxic effect of biologically synthesized MNPs via in vitro and in vivo models. Articles were systematically collected by screening the literature published online in the following databases; Cochrane, Web of Science, PubMed, Scopus, Science Direct, ProQuest, and EBSCO. Results: Most of the studies were carried out on the MCF-7 cancer cell line and phytosynthesis was the general approach to MNP preparation in all studies. Fungi were the second most predominant resource applied for MNP synthesis. A total of 80.57% of the studies synthesized biogenic MNPs with sizes below 50 nm. The genotoxicity of Ag, Au, ZnO, TiO2, Se, Cu, Pt, Zn, Ag-Au, CdS, Fe3O4, Tb2O3, and Si-Ag NPs was evaluated. AgNPs, prepared in 68.79% of studies, and AuNPs, prepared in 12.76%, were the two most predominant biogenic MNPs synthesized and evaluated in the included articles. Conclusions: Although several studies reported the antigenotoxic influence of biogenic MNPs, most of them reported biogenic MNP genotoxicity at specific concentrations and with a dose or time dependence. To the best of our knowledge, this is the first study to systematically evaluate the genotoxicity of biologically synthesized MNPs and provide a valuable summary of genotoxicity data. In conclusion, our study implied that the genotoxicity of biologically synthesized MNPs varies case-by-case and highly dependent on the synthesis parameters, biological source, applied assay, etc. The gathered data are required for the translation of these nanoproducts from research laboratories to the clinical market. Keywords: genotoxicity; biosynthesis; metal nanoparticles; systematic revie