Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant compared to preoperative values. The average span of silicon oil tamponade was 162 +/− 23 days. Conclusions: Silicon oil tamponade during 23-gauge rhegmatogenous retinal detachment surgery leads to a transitory reduction of central macular thickness, central macular volume cube and average macular thickness cube in eyes that underwent retinal surgery. After silicon oil removal, macular parameters returned to preoperative values in most of the patients. Full article

Background and Objective: Non-functioning pituitary neuroendocrine tumors (NF-PitNETs) represent a heterogeneous tumor type that lacks effective medical treatment. MDM2, the main negative regulator of p53, binds to and forms a stable complex with p53 to regulate its activity. In this study, we measured the expression levels and role of MDM2 in non-functioning PitNET patients’ combined clinical features and investigated the effect of etoposide on the cell bioactivity of the GT1-1 cell line in vivo and in vitro. Methods: RT-PCR and immunochemistry measured the expression levels and role of MDM2 in 103 NF-PitNET patients’ combined clinical features. Cell proliferation, migration, colony and apoptosis experiments measured the effect of etoposide on the GT1-1 cell line in vivo and in vitro. Results: There was more invasive behavior (p = 0.013) in patients with high MDM2, who were also younger (p = 0.007), were more frequently female (p = 0.049) and had larger tumor sizes (p = 0.018) compared with patients with low MDM2. Patients with high p53 were younger (p = 0.017) and had larger tumor sizes (p = 0.034) compared with patients with low p53. Univariate (p = 0.018) and multivariate (p = 0.023) Cox regression analysis showed that MDM2 was the independent factor for invasive behavior in NF-PitNET patients. Log-rank analysis showed that the average progression-free survival (PFS) time in the low MDM2 patients was longer than that in the high MDM2 patients (p = 0.044). Functional studies indicated that etoposide inhibited cell proliferation and cell migration and induced apoptosis in p53 independence in GT1-1 cells. Furthermore, etoposide significantly inhibited the growth of GT1-1-xenograft in BALB/c nude mice. The tumor growth inhibition rate of etoposide was 67.4 ± 4.6% after 14 d of treatment, which suggested the anti-tumor activity of etoposide. Conclusions: MDM2 played the role of tumorigenesis of NF-PitNET in a p53 independence manner, and an MDM2 inhibitor could be a potential choice for the treatment of NF-PitNET patients. Full article

Background and Objectives: Left atrial hypertension is one of the pathophysiologies of heart failure with preserved ejection fraction. We hypothesized that left atrial pressure response (LAPR) to incremental pacing is higher in patients with atrial fibrillation (AF) and can predict left ventricular diastolic dysfunction. Materials and Methods: Patients requiring left atrial access as a part of a therapeutic procedure for AF (n = 204, AF group) or supraventricular tachycardia (n = 34, control group) were analyzed (male n = 183, 54 ± 12 years old). LAPR was measured during incremental pacing. Results: Baseline left atrial pressure and LAPR at all pacing rates were not different between the AF and control groups. They were higher in patients with a high E/e’ (≥ 8) than in those with a low E/e’ (<8). LAPR at a pacing interval of 400 ms and E/e’ were positively correlated (r = 0.373, p < 0.001). Body mass index and a high E/e’ were independent predictors of pacing-induced left atrial hypertension. Conclusions: LAPR to incremental pacing was constant regardless of AF. The non-invasive echocardiographic marker E/e’ reflected pacing-induced left atrial hypertension. Full article

Background and Objectives: The inflammatory cells released after intracranial hemorrhage, such as monocytes, macrophages, and neutrophils, activate the inflammatory system. These parameters can be used to evaluate the clinical course of diseases. This study aims to evaluate these parameters as possible predictors for evaluating the development of brain death. Materials and Methods: Patients with a Glasgow coma scale score below 7 were assigned to Group BD (patients with brain death) and Group ICH (intracranial hemorrhage). The neutrophil, lymphocyte, platelet, monocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-neutrophil ratio (PNR) were measured at admission. Results: A high WBC count, neutrophil count, NLR, and PLR and a low lymphocyte count, LMR, and PNR were found to be significant for determining brain death. The area under the curve (AUC) values of NLR, PNR, PLR, and LMR to discriminate brain death were 0.63, 0.61, 0.56, and 0.61, respectively. Conclusion: NLR, PNR, PLR, and LMR are easily accessible and reliable parameters that can be used to predict the development of brain death and can be estimated by a simple complete blood count test. Full article

Combined cases of hypertrophic obstructive cardiomyopathy (HOCM) and pulmonary arterial hypertension (PAH) are rare and have a management dilemma. Although preload is crucial in the management of HOCM, anti-PAH agents dramatically change the preload, leading to improving or worsening heart failure in patients with HOCM. We had a 74-year-old woman with Sjogren-syndrome-associated PAH. Her heart failure worsened following the initiation of anti-PAH agents due to an incremental preload on the left ventricle, whereas HOCM clinically developed following the termination of anti-PAH agents and progressing anorexia due to the progression of the left ventricular outflow obstruction. Careful monitoring of the left ventricular outflow obstruction during initiation/termination of anti-PAH agents and medical intervention to the HOCM are highly recommended. Full article

Background: During mammography, a lead-acrylic protective screen is recommended to reduce radiation exposure to the unexposed breast. Objectives: This research study aimed to construct an Indium-(III)-oxide-rich tellurite-glass screen (TZI8) and compare its performance to that of lead acrylic. Materials and Methods: A three-layer heterogeneous-breast phantom was developed, using the MCNPX (version 2.7.0) Monte Carlo code. An MCNPX-simulation geometry was designed and implemented, using the lead-acrylic and TZI8 shielding screens between the right and left breast. Next, the reliability of the phantom and the variations in absorption between the lead-acrylic and TZI8 glass were investigated. Results: The findings show that the TZI8-protective-glass screen offers significantly greater radioprotection than the lead-acrylic material. The quantity of total dose absorbed in the unexposed breast was much lower for TZI8 than for lead-based acrylic. The TZI8-glass screen gives about 60% more radioprotection than the lead-acrylic screen. Conclusion: Considering the toxic lead in the structure that may be hazardous to the human tissues, the TZI8-glass screen may be used in mammography examination to provide greater radioprotection than the lead-acrylic screen, in order to greatly reduce the dose to the unexposed breast. Full article

Together with the “law of entropy”, two of the main reasons for the risk of burnout among physicians who work in emergency departments around the world are the variety of clinical issues presented by patients and the absence of guidelines for managing most of them [...] Full article