Search Results (79)

Background and Clinical Significance: Non-palpable migrated contraceptive implants pose significant challenges for removal and are associated with neurovascular complications. Traditional open surgery near nerves is associated with postoperative morbidity. Migrated or deeply embedded implants near critical structures can result in severe complications, such as neuropathy, and their removal typically requires open surgical intervention. Case Presentation: We report a novel, minimally invasive, ultrasound (US)-guided technique for removing a migrated etonogestrel Implanon^® implant that caused ulnar neuropathy. A 38-year-old woman presented with severe neuropathic pain and paresthesia (NPRS 10/10; QuickDASH 55) along her left ulnar nerve following multiple failed removal attempts that induced deep migration. US confirmed the proximity of the implant to the ulnar nerve. Initial US-guided removal exacerbated her symptoms. Hydrodissection (HD) with 50 mL of 5% dextrose in water (D5W) without local anesthetic (LA) was performed to reduce inflammation and achieve separation. The implant migrated proximally during extraction. An additional HD with 50 mL of D5W without LA distally repositioned the implant. Percutaneous stabilization using a 25-gauge needle enabled secure removal. The intact 4 cm implant was extracted under real-time US guidance without open surgery. The patient experienced immediate symptom relief (NPRS 2/10; QuickDASH 4.5 at one month) and full resolution (NPRS 0/10; QuickDASH 0) with no motor deficits at one year. Conclusions: This case represents the first documented percutaneous removal of a nerve-adherent implant using combined US-guided D5W HD and needle stabilization, marking a paradigm shift in the management of such cases. This approach confirms the safety of US-guided foreign body removal using HD for nerve-adjacent implants and demonstrates the efficacy of combining D5W HD with needle stabilization. Surgical morbidity was avoided, while excellent long-term outcomes were achieved. Full article

The aim of this work is to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) against oral MDR (multi-drug-resistant) Candida spp. infections related to orthodontic treatment with palatal expanders through in vitro study. Methods: PDT protocol: Curcumin + H₂O₂ was used as a photosensitizer activated by a 460 nm diode LED lamp, with an 8 mm blunt tip for 2 min in each spot of interest. In vitro simulation: A palatal expander sterile device was inserted into a custom-designed orthodontic bioreactor, realized with 10 mL of Sabouraud dextrose broth plus 10% human saliva and infected with an MDR C. albicans clinical isolate CA95 strain to reproduce an oral palatal expander infection. After 48 h of incubation at 37 °C, the device was treated with the PDT protocol. Two samples before and 5 min after the PDT process were taken and used to contaminate a Petri dish with a Sabouraud field to evaluate Candida spp. CFUs (colony-forming units). Results: A nearly 99% reduction in C. albicans colonies in the palatal expander biofilm was found after PDT. Conclusion: The data showed the effectiveness of using aPDT to treat palatal infection; however, specific patient oral micro-environment reproduction (Ph values, salivary flow, mucosal adhesion of photosensitizer) must be further analyzed. Full article

Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability and affecting ipsilateral upper limb movement and quality of life. Current diagnosis relies on exclusion and physical examination, with limited treatment options beyond conservative approaches. This case report presents a novel approach to chronic SAMPS, successfully diagnosed using Sonoguided Digital Palpation (SDP) and treated with ultrasound-guided hydrodissection of the LTN using 5% dextrose in water (D5W) without local anesthetic (LA), in a patient where conventional treatments had failed. Case Presentation: A 72-year-old male presented with a three-year history of persistent left chest pain radiating to the upper back, exacerbated by activity and mimicking cardiac pain. His medical history included two percutaneous coronary interventions. Physical examination revealed tenderness along the anterior axillary line and a positive hyperirritable spot at the mid axillary line at the 5th rib level. SDP was used to visualize the serratus anterior fascia (SAF) and LTN, and to reproduce the patient’s concordant pain by palpating the LTN. Ultrasound-guided hydrodissection of the LTN was then performed using 20–30cc of D5W without LA to separate the nerve from the surrounding tissues, employing a “fascial unzipping” technique. The patient reported immediate pain relief post-procedure, with the pain reducing from 9/10 to 1/10 on the Numeric Rating Scale (NRS), and sustained relief and functional improvement at the 12-month follow-up. Conclusions: Sonoguided Digital Palpation (SDP) of the LTN can serve as a valuable diagnostic adjunct for visualizing and diagnosing SAMPS. Ultrasound-guided hydrodissection of the LTN with D5W without LA may provide a promising and safe treatment option for patients with chronic SAMPS refractory to conservative management, resulting in rapid and sustained pain relief. Further research, including controlled trials, is warranted to evaluate the long-term efficacy and generalizability of these findings and to compare D5W to other injectates. Full article

Background and Clinical Significance: Radial nerve palsy typically presents as wrist drop due to nerve compression, with conventional management often yielding prolonged recovery. We report a case where ultrasound-guided hydrodissection (HD) with 5% dextrose in water (D5W) achieved immediate functional restoration, suggesting neurapraxia as the underlying pathology. Case Presentation: A 54-year-old diabetic female presented with acute left wrist drop without trauma. Examination confirmed radial nerve palsy (MRC grade 0 wrist extension), while radiographs ruled out structural causes. Ultrasound revealed fascicular swelling at the spiral groove. Under real-time guidance, 50 mL D5W (no local anesthetic) was injected to hydrodissect the radial nerve. Immediate post-procedure assessment showed restored wrist extension (medical research council (MRC) grade 4+). At one- and three-month follow-ups, the patient maintained complete resolution of symptoms and normal function. Conclusions: This case highlights two key findings: (1) HD with D5W can serve as both a diagnostic tool (confirming reversible neurapraxia through immediate response) and therapeutic intervention, and (2) early HD may circumvent prolonged disability associated with conservative management. The absence of electrodiagnostic studies limits objective severity assessment, though ultrasound localized the lesion. While promising, these observations require validation through controlled trials comparing HD to standard care, particularly in diabetic patients with heightened compression susceptibility. Technical considerations—including optimal injectate volume and the role of adjuvant therapies—warrant further investigation. US-guided HD with D5W emerges as a minimally invasive, surgery-sparing option for acute compressive radial neuropathies, with potential to redefine treatment paradigms when applied at symptom onset. Full article

Background and Objectives: This study aimed to compare the effects of HIPEC procedures using oxaliplatin and mitomycin C on serum electrolyte, glucose, and lactate levels, with a specific focus on the carrier solutions employed. Materials and Methods: A retrospective analysis was performed on 82 patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases. Patients were assigned to one of two groups based on the chemotherapeutic agent used: oxaliplatin (n = 63) or mitomycin C (MMC, n = 19). The oxaliplatin group was further subdivided based on the carrier solution used: 5% dextrose (D5W, n = 29) or peritoneal dialysate (n = 34). The assignment of regimens was based on institutional protocols and surgeon preference. Pre- and post-HIPEC serum levels of sodium, potassium, bicarbonate, glucose, and lactate were compared. Results: Significant biochemical changes were observed across groups, depending on both the chemotherapeutic agent and carrier solution. In the MMC group (peritoneal dialysate), only lactate increased significantly post-HIPEC (p = 0.001). In the oxaliplatin–peritoneal dialysate group, significant changes were observed in bicarbonate (p = 0.009), glucose (p = 0.001), and lactate (p < 0.001), whereas sodium and potassium remained stable. The oxaliplatin–D5W group showed significant changes in all parameters: sodium (p = 0.001), potassium (p = 0.001), bicarbonate (p = 0.001), glucose (p < 0.001), and lactate (2.4 → 7.6 mmol/L, p < 0.001). Between-group comparisons revealed significant differences in sodium, potassium, glucose, and lactate changes (p < 0.05), but not in bicarbonate (p = 0.099). Demographic and clinical characteristics—including age, sex, primary disease, ICU stay, and 90-day mortality were similar across groups. Conclusions: The use of dextrose-containing solutions with oxaliplatin was associated with marked metabolic disturbances, including clinically meaningful hyponatremia, hypokalemia, and hyperglycemia in the early postoperative period. These findings suggest that the choice of carrier solution is as important as the chemotherapeutic agent in terms of perioperative safety. Closer postoperative electrolyte monitoring is recommended when using dextrose-based regimens. The retrospective design and sample size imbalance between groups are acknowledged limitations. Nonetheless, this study offers clinically relevant insights and lays the groundwork for future prospective research. Full article

In this study, pigment-producing yeast (Rhodotorula alborubescens) was isolated from the soil sample, demonstrating the potential for carotenoid biosynthesis. Physiological, morphological, biochemical, and molecular characterization confirmed the identity of the isolate. Optimization of the physical parameters for carotenoid production was achieved through batch shake flask experiments. The optimal conditions were determined to be 84 h of incubation at pH 6.0 and 28 °C under white light irradiation, utilizing the Yeast Peptone Dextrose (YPD) medium composed of 10 g/L yeast extract, 5 g/L of peptone, and 5 g/L dextrose, resulting in maximum carotenoid content. Further, the presence of β-carotene was confirmed using High-Performance Liquid Chromatography and Fourier Transform Infrared Spectroscopy. These findings highlight the potential of the isolated soil yeast (R. alborubescens) as a potential source of carotenoids, offering natural alternatives for various industrial applications. Full article

Antifungal composite beads were prepared using a methylcellulose, alginate, and ethanol solution with the ionic gelation method and ethanol beads (E). A total of 1.0 mL of clove essential oil (CEO) and 1.0 g of vanillin were added to provide an antifungal effect against Aspergillus flavus and Rhizopus stolonifera. Four bead formulations were prepared: ethanol beads (E), ethanol beads containing CEO (EC), ethanol beads containing vanillin (EV), and ethanol beads containing vanillin and CEO (EVC). Ethanol beads were transparent and spherical, whereas those containing CEO or vanillin were spherical and opaque, with diameters ranging from 2.1 to 2.4 mm. The surface and pores in the polymer matrix were investigated in relation to the encapsulation and release of antifungal agents. The bursting release of ethanol and CEO occurred on the first day. Antifungal assays on potato dextrose agar against Aspergillus flavus and Rhizopus stolonifera showed that beads containing CEO (EC and EVC) provided superior inhibition, particularly at a dosage of 1.0 g. In butter cake preservation tests, packaging the butter cake with a sachet containing 1.0 g of EC or EVC beads can extend the shelf life by two days, delaying visible mold growth from day 5 to day 7 compared to the control. Full article

Background: The use of an elastomeric diffuser is favored to administer outpatient antibiotic therapy. A study published in 2022 highlighted the instability of several antibiotics in elastomeric devices at 37 °C. The objective was to evaluate the stability of nine time-dependent antibiotics that are unstable at 37 °C at lower concentrations and a reduced storage temperature of 32 °C. Methods: Chemical stability was assessed by pH measurement and high-performance liquid chromatography. Physical stability was evaluated by visual and subvisual inspection. The solutions were considered stable if the remaining drug percentage was ≥90%, the maximum variation in pH was less than 1, the particle count was within acceptable limits and the visual aspect remained unchanged after storage. Results: Solutions showing stability for 24 h are composed of 12.5 mg/mL cefiderocol in NS (normal saline) and 50–133 mg/mL piperacillin in NS-D5W (5% dextrose). Additionally, 12.5 mg/mL amoxicillin in NS; 12.5 mg/mL cefepime in NS-D5W; 12.5 mg/mL cefiderocol in D5W; 25 mg/mL cefiderocol in NS-D5W; 12.5 mg/mL cefotaxime in NS-D5W; 12.5 mg/mL cefoxitin in NS-D5W; 12.5 mg/mL ceftazidime in NS-D5W; 25 mg/mL ceftazidime in NS; 25 mg/mL cloxacillin in NS-D5W; and 25–50 mg/mL oxacillin in NS were shown to be stable for 12 h. Notably, 25 mg/mL amoxicillin in NS, 50 mg/mL cloxacillin in NS and 25 mg/mL oxacillin in D5W were shown to be stable for 8 h. Conclusions: These 12–24 h stability data indicate that these antibiotics can be administered by continuous infusion using only one–two elastomeric devices per day, facilitating outpatient parenteral antimicrobial therapy (OPAT). Full article

Background: Photodynamic therapy (PDT) utilizing nano-based photosensitizers (PSs) offers promising cancer treatment potential but requires rigorous safety evaluation. Conjugated polymer nanoparticles (CPNs) doped with porphyrins, such as platinum porphyrin–doped poly(9,9-dioctylfluorene-alt-benzothiadiazole) (F8BT), exhibit enhanced photodynamic efficiency but lack comprehensive preclinical toxicity data. This study aimed to evaluate the biocompatibility, biodistribution, and acute/subacute toxicity of these CPNs to establish their safety profile for clinical translation. Methods: CPNs were synthesized via nanoprecipitation using amphiphilic stabilizers (PSMA or PS-PEG-COOH) and characterized for colloidal stability in parenteral solutions. Hemolysis assays were used to assess blood compatibility. Single-dose (0.3 and 1 mg/kg, intravenous) and repeated-dose (0.1–1 mg/kg, intraperitoneal, every 48 h for 28 days) toxicity studies were conducted in BALB/c mice. Hematological, biochemical, histopathological, and biodistribution analyses (via ICP-MS) were performed to evaluate systemic and organ-specific effects. Results: CPNs demonstrated excellent colloidal stability in 5% dextrose, with minimal aggregation. No hemolytic activity was observed at concentrations up to 50 mg/L. Single and repeated administrations revealed no significant changes in body/organ weights, hematological parameters (except transient fibrinogen elevation), or liver/kidney function markers (ALT, AST, BUN, Cr). Histopathology showed preserved tissue architecture in major organs, with mild hepatocyte vacuolation at 30 days. Biodistribution indicated hepatic/splenic accumulation and rapid blood clearance, suggesting hepatobiliary elimination. Conclusions: Platinum porphyrin–doped F8BT CPNs exhibited minimal acute and subacute toxicity, favorable biocompatibility, and no systemic adverse effects in murine models. These findings support their potential as safe PS candidates for PDT. However, chronic toxicity studies are warranted to address long-term organ accumulation and metabolic impacts. This preclinical evaluation provides a critical foundation for advancing CPNs toward clinical applications in oncology. Full article

Heavy metal contamination in water resources presents a significant environmental and public health challenge, with lead being particularly concerning due to its toxicity and persistence. This study reports the green synthesis of Fe-Ti mixed oxide nanoparticles (NPs) using dextrose as a green source and investigates their effectiveness in lead removal from aqueous solutions. The synthesized NPs were characterized using XRD, FTIR, XPS, SEM-EDS, and BET analysis, revealing an amorphous structure with a high surface area (292.89 m² g⁻¹) and mesoporous characteristics. XPS analysis confirmed the presence of mixed Fe³⁺/Fe²⁺ valence states in a Ti⁴⁺-rich framework, creating diverse binding sites for lead adsorption. The material exhibited optimal lead removal at pH 5, with adsorption following pseudo-second-order kinetics (R² > 0.99) and a Langmuir isotherm model (R² > 0.98). Maximum adsorption capacity reached 25.10 mg g⁻¹ at 40 °C, showing endothermic behavior. The low point of zero charge (PZC, 0.22) and surface hydroxyl groups enabled efficient lead binding possibly through multiple mechanisms. Dose optimization studies established 6 g L⁻¹ as the optimal adsorbent concentration. The synergistic combination of iron’s affinity for heavy metals and titanium’s structural stability, coupled with environmentally friendly synthesis, resulted in a promising material for sustainable water treatment applications. Full article

The management of Dollar spot, the fungal disease of turfgrasses, is complicated and, today, tends to include new eco-friendly approaches. The aim of this study is to evaluate the effect of UV-B and UV-C lamps against the infection of Clarireedia species in warm- and cool-season turfgrasses. In vitro tests were performed to evaluate the growth of C. jacksonii mycelium on Potato Dextrose Agar, irradiated with UV-B and UV-C at heights of 5 and 15 cm, 5 s per day for three consecutive days. The same treatments, prolonged for seven days, were applied on naturally infected potted Agrostis stolonifera and Cynodon dactylon × C. transvaalensis, for in vivo tests. Disease severity, antioxidant capacity, and pigment content were assessed at the end of the experiment. Only UV-C reduced the growth of C. jacksonii after 48 h at 5 cm (−36%) and 72 h at both distances (−15 and −27%). Agrostis stolonifera showed symptoms, reduced by UV-C at 5 cm, and fungal structures, except in UV-C exposed samples. Total antioxidant capacity increased after UV-B exposure at 5 cm (+10%). No variations in terms of photosynthetic pigments were observed. These results confirm the potential of UV-C lamps for the containment of Dollar spot. Full article

Objective: Fungal corneal infections are challenging to treat due to delayed diagnostic procedures, bacterial co-infections, and limited antifungal efficacy. This study investigates the therapeutic potential of ultraviolet C (UVC) light alone and combined with antifungal drugs. Methods: A subsurface infection model was developed in semi-solid agar droplets, with Candida albicans cells or Aspergillus brasiliensis spores inoculated into 0.75% w/v yeast peptone dextrose (YPD) agar in a 96-well microplate (5 µL per well). Two treatment groups were tested: (1) UVC exposure (265 nm, 1.93 mW/cm²) for durations of 0 s, 5 s, 10 s, 15 s, 30 s, 60 s, or 120 s, and (2) UVC combined with antifungal drugs (Amphotericin B and Natamycin) at their minimum inhibitory concentrations (MICs), determined in YPD broth. After treatment, agar droplets were homogenized, diluted, and plated for microbial enumeration. The most effective UVC doses were further tested in an ex vivo C. albicans porcine keratitis model, where the corneal epithelium was debrided, infected with C. albicans, and exposed to UVC. Corneas were then homogenized and plated to evaluate treatment efficacy. Results: UVC exposure of ≥15 s inhibited C. albicans, and ≥10 s inhibited A. brasiliensis (all p < 0.05). The broth MICs were 0.1875 µg/mL for Amphotericin B against C. albicans, 6.25 µg/mL against A. brasiliensis, and 0.78125 µg/mL for Natamycin against C. albicans, 7.8125 µg/mL against A. brasiliensis. The broth MIC did not eradicate fungi in the subsurface model. Combined treatments enhanced inhibition (all p < 0.05), with 30 s UVC + amphotericin B for C. albicans (p = 0.0218) and 30 s UVC + natamycin for A. brasiliensis (p = 0.0017). Ex vivo, 15 s and 30 s UVC inhibited growth (p = 0.0476), but no differences were seen between groups (all p > 0.05). Conclusion: UVC demonstrated strong antifungal efficacy, with supplementary benefits from combining UVC with low doses of antifungal drugs. Full article

Buchwaldoboletus xylophilus is an edible bolete species belonging to the family Boletaceae and the genus Buchwaldoboletus. It is found in tropical and subtropical regions, which are known for their rare wild resources. In this study, wild B. xylophilus was isolated and cultured, and its biological characteristics and artificial cultivation techniques were studied. The results show that the optimal carbon source, nitrogen source, and inorganic salt for the mycelium growth of B. xylophilus were maltose, ammonium tartrate, and magnesium sulfate, respectively. The most appropriate temperature was 28 °C, and the pH value was between 5 and 6. The most effective combination was determined via orthogonal experimentation, as follows: dextrose, ammonium nitrate, potassium dihydrogen phosphate, and 28 °C. The results of artificial cultivation in mushroom houses show that the mycelium of B. xylophilus was strong and grew well on the culture medium. The mycelial growth rate was 4.54 mm/d, and the fungus bags were filled about 50 days after inoculation. The primordia formed 9 to 14 days after covering with soil and the fruiting body matured in 6~8 days. The average yield of fresh mushrooms reached 131.07 ± 29.38 g/bag, and the average biological efficiency reached 28.48 ± 6.39%. In this study, artificial cultivation technology in respect of B. xylophilus in mushroom houses is reported for the first time. The fruiting bodies obtained through cultivation were identified using morphological and molecular biological methods. This technology offers benefits such as affordability, a brief cultivation cycle, substantial yields, and superior quality, making it ideal for industrial-scale and extensive cultivation. Full article

Mulberry is an important economic crop in China that is widely planted and has important edible and medicinal value. Anthracnose, a critical leaf disease, severely compromises the yield and quality of mulberry trees. However, there are many kinds of pathogens causing mulberry anthracnose and it is difficult to control. This study was undertaken to elucidate the biological characteristics of Colletotrichum fructicola, the pathogen responsible for mulberry leaf spot in Zhejiang Province, and to screen out effective fungicides for its management. The biological characteristics of the pathogen were studied using the cross method and spore counting method, while the sensitivity of the pathogen to seven different fungicides was determined using the growth rate method. The findings indicated that potato dextrose agar (PDA) is the optimal growth medium for the pathogen. The pathogen was capable of growing across a temperature range of 5 to 40 °C, with optimum growth observed at 25 °C. Exposure to a 56 °C water bath for 10 min resulted in the death of the pathogen. It was also found to grow and sporulate within a pH range of 4 to 12, with an optimum pH of 7. Under alternating 12 h light and dark cycles, the colonies grew rapidly and produced abundant spores. Among the fungicides tested, 97% carbendazim WP exhibited the best inhibitory effect, with an EC₅₀ (concentration for 50% of maximal effect) value of 0.0242 μg/mL. This was followed by 35% propiconazole SC, which had an EC₅₀ of 0.4180 μg/mL. The fungicidal effect of 25 g/L fludioxonil SSCC was relatively poor, with an EC₅₀ value of 103.0170 μg/mL. This study clarifies the optimal conditions for the growth and sporulation of the mulberry anthracnose pathogen and identifies fungicides with effective inhibitory properties. These findings will provide valuable guidance for field applications and disease management in controlling mulberry anthracnose. Full article

Background: Creating a model for acute liver failure in animal models is essential for research on liver regeneration and cancer. Current surgical techniques allow for a maximum of 80% partial hepatectomy in rats, with low survival rates due to poor inflow control. The common resection technique involves ligation at the liver lobe neck, causing peri-operative blood loss and postoperative blood loss. Methods: A 90% partial hepatectomy was performed on 5 rats using a bile duct-saving portal ligation technique, involving two hilum dissections for bile duct preservation. The first dissection controlled the blood supply to the median and left lateral lobes, and the second to the right inferior and superior lobes. Before closing, all rats were given 5 mL of 10% dextrose intraperitoneally and had access to ClearH₂O DietGel Recovery and 20% dextrose. Weight and behavior were closely monitored for seven days post-operatively. Results: This method resulted in 100% survival, with a 3.1% increase in liver mass and 12.3% increase in liver-to-body mass ratio. Conclusions: This technique is the first bile duct-saving portal ligation for rodent models of acute liver failure, with long-term survival and complete hepatic regeneration. Our procedure offers a viable 90% hepatectomy model for research with improved survival and regeneration outcomes. Full article