Search Results (1,935)

Background/Objectives: Hemangioblastomas are rare, benign, highly vascular tumors of the central nervous system, frequently associated with von Hippel–Lindau (vHL) disease. Case Presentation: We report a 16-year-old female with vHL presenting with recurrent headaches, abdominal distension, and ocular discomfort. Imaging revealed hemangioblastomas in the fourth ventricle and retrobulbar space, alongside multiple pancreatic cysts. The patient underwent three sessions of Gamma Knife Surgery (GKS) with initial tumor regression and symptom relief. However, long-term follow-up demonstrated progressive disease, with new lesions in the cerebellum, spinal cord, and orbit, including cystic transformation. Histopathology confirmed the reticular variant of hemangioblastoma. Despite further radiosurgical and surgical recommendations, the patient and family opted for conservative management, with lesions remaining radiographically stable over nine years. Conclusions: This case demonstrates that Gamma Knife Surgery may provide temporary local disease control for selected solid hemangioblastomas in von Hippel–Lindau disease but does not alter the underlying disease course. Long-term radiographic stability should be interpreted cautiously, as hemangioblastomas exhibit saltatory growth patterns that make it difficult to distinguish treatment effect from natural tumor quiescence. These findings emphasize that radiosurgery should be regarded as a disease-control strategy rather than curative therapy, underscoring the importance of individualized management, multidisciplinary decision-making, and prolonged surveillance. Full article

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by progressive kidney enlargement by cyst formation. Endothelial dysfunction significantly contributes to chronic kidney disease (CKD). The Mediterranean diet (Med-diet) may reduce endothelial dysfunction in ADPKD patients, but its effect was not investigated in these patients. Our aim was to assess the relationship between Med-diet adherence and endothelial function biomarkers such as nitric oxide (NO) and endothelin-1 (ET-1). We enrolled ADPKD patients aged 18–70 years with CKD stages G2–G4. Adherence to the Med-diet was evaluated using the PREDIMED questionnaire. NO and ET-1 were evaluated at enrolment. Correlations and associations between these markers and Med-diet adherence were analysed. We enrolled 63 patients with ADPKD (mean age was 50.0 ± 11.8 years, 66.7% were female). A low/intermediate adherence to Med-Diet was assessed in 47 (74.6%) patients. When comparing patients with low/intermediate and high adherence, we found a higher NO and lower ET-1 serum concentration (p < 0.001 and p = 0.014, respectively) in patients with high adherence compared with low/intermediate ones. We found a significant correlation between Med-Diet adherence and NO (Spearman’s rs = 0.696, p < 0.001, 95%CI 0.542 to 0.805) and ET-1 serum concentrations (rs = −0.387, p = 0.002, 95%CI −0.579 to −0.154). For the univariable and multivariable linear regression analyses, we found an association between Med-Diet and NO (B: 0.547, 95%CI 0.050 to 0.121, p < 0.001) between Med-Diet and ET-1 (B: −0.327, 95%CI −0.157 to −0.020, p = 0.012). In conclusion, higher Med-Diet adherence seems to be associated with more favourable endothelial function in ADPKD patients. Full article

Background: Subchondral cysts at the ulnar corner of the lunate are frequently encountered in patients with distal radius fractures. We hypothesized that the presence of these lunate subchondral cysts may be associatedwith decreased cortical bone density due to limited load translation. Consequently, this could lead to lunate fossa collapse and increased ulnar variance following fracture fixation. Methods: A retrospective analysis was performed on 176 patients who underwent open reduction and internal fixation using the Double-tiered Subchondral Support (DSS) procedure between May 2014 and June 2017. Twenty-eight patients identified with lunate subchondral cysts on preoperative CT scans were selected as the study group. A control group of 28 patients without cysts was selected using matched-pair analysis, controlling for gender, age, fracture classification, and follow-up period. Results: The mean change (delta) in ulnar variance was 0.191 mm in the cyst group, which was less than the 0.233 mm observed in the control group; however, this difference was not statistically significant (p = 0.557). Regarding ulnolunate distance, the cyst group showed a mean change (delta) of 0.991 mm, while the control group showed a change of 1.123 mm. This difference was also not statistically significant (p = 0.681). Conclusions: Although it was hypothesized that lunate subchondral cysts might limit load translation to the radius and compromise cortical bone density—potentially affecting fracture healing and the maintenance of reduction—our statistical analysis did not support this hypothesis. The presence of lunate subchondral cysts did not significantly increase the risk of lunate fossa collapse or ulnar variance progression compared to the control group. Full article

Patients with nephronophthisis caused by nephrocystin 3 (NPHP3) variants rapidly progress to end-stage kidney disease. However, existing Nphp3 mouse models fail to fully recapitulate the characteristics of this disease. We generated a renal tubule-specific Nphp3 knockout mouse model that more accurately mirrors the human disease course. The mouse model was first validated by confirming the loss of Nphp3 protein expression in renal tubules. Comprehensive phenotypic analyses were then performed to assess both renal and extrarenal manifestations. The origin of renal cysts was investigated, and the underlying mechanisms were further validated. We successfully generated a renal tubule-specific Nphp3 knockout mouse model (Cdh16-Cre; Nphp3^flox/flox). These mice exhibited a markedly shortened lifespan (5–8 weeks) and developed key features of infantile nephronophthisis, including early-onset renal cysts originating from distal tubules and collecting ducts, progressive interstitial fibrosis that was evident by postnatal week 2, a rapid decline in kidney function, and increased urinary protein levels. Importantly, treatment with the vasopressin V2 receptor antagonist tolvaptan or the mitogen-activated extracellular signal-regulated kinase (MEK) inhibitor 2-(2-chloro-4-iodoanilino)-N-(cyclopropylmethoxy)-3,4-difluorobenzamide (CI-1040) significantly attenuated cyst growth and improved kidney morphology, confirming shared pathogenic pathways with other Nphp3 models. We established a renal tubule-specific Nphp3 knockout mouse model that accurately recapitulates the aggressive infantile form of nephronophthisis characterized by early cystogenesis, progressive fibrosis, and a shortened lifespan, and is ideal for evaluating novel interventions against this currently untreatable ciliopathy. Full article

Parasitic infections in veterinary medicine are commonly diagnosed through microscopic examination of fecal samples, yet traditional manual methods are labor-intensive and subject to diagnostic variability. This study investigates YOLOv8 for automated identification of parasitic elements in fecal microscopy images. Six parasitic taxa were analyzed at 1000×, 2500×, and 10,000× magnifications: Spirometra eggs, Dipylidium egg packets, hookworm eggs, Ascaris eggs, Giardia cysts, and Trichomonas trophozoites. The dataset comprised 326 images with 3710 annotated objects, split at the sample level into training (70%), validation (15%), and testing (15%) sets. The YOLOv8n model achieved mean average precision (mAP@0.5) of 0.982 ± 0.015 across 5-fold cross-validation. Per-class AP exceeded 0.97 for five taxa, with Trichomonas achieving 0.952. Inference time averaged under 60 ms per image on a standard CPU. These results demonstrate that YOLOv8 provides accurate and efficient detection of diverse parasitic elements, supporting its potential as a clinical screening tool. Full article

Primary intracranial squamous cell carcinoma (SCC) arising from an epidermoid cyst is an exceptionally rare and aggressive malignancy with a dismal prognosis. Conventional management typically involves gross total resection followed by wide-field radiotherapy; however, this intensive approach is often unfeasible for elderly or frail patients. We present a case of primary intracranial SCC in a 75-year-old woman who presented with rapid cochleovestibular deterioration. Imaging revealed subtle enlargement of a long-standing cerebellopontine angle epidermoid cyst. Subtotal resection was performed to preserve critical neurovascular structures adherent to the infiltrative tumor. Given the patient’s poor performance status and the risk of toxicity from broad-field radiation, adjuvant Gamma Knife radiosurgery (GKS) was selected as a focal salvage modality. Despite the limited surgical margin, the patient has maintained a progression-free status with no radiographic evidence of disease progression for 18 months without neurological decline. This case highlights the diagnostic challenge of malignant transformation disguised by radiologic mimicry and demonstrates that GKS can serve as an effective and tolerable adjuvant strategy. We propose that for high-risk patients precluded from intensive multimodal therapy, focused stereotactic irradiation offers a viable alternative to secure local control while preserving quality of life and systemic immune integrity. Full article

Toxoplasmosis is a zoonotic disease with limited therapeutic options, which are further hampered by significant toxicity and suboptimal efficacy. Effective interventions for chronic infection remain insufficient, and thus, natural product-derived drug screening remains a key focus in anti-Toxoplasma research. Licochalcone A (Lico A), a major bioactive compound isolated from Glycyrrhiza uralensis, exhibits potent activity against Toxoplasma tachyzoites. However, systematic studies of its targets, pharmacokinetics, and efficacy are lacking, hindering its development as an anti-Toxoplasma candidate drug. In this study, we used SPR-MS to identify 33 high-affinity target proteins (affinity score > 1000). Furthermore, an AI-driven multidimensional analysis identified a cluster of five proteins (TgMORN1, D3XD37, ABCB2, MIC15, and IDH), with TgMORN1 yielding the highest composite score. RNAi experiments confirmed TgMORN1 as a key target, as its silencing attenuated the anti-proliferative effect of Lico A. Western blotting, NanoDSF, and SPR supported direct binding between Lico A and TgMORN1, suggesting that Lico A modulates TgMORN1 thermal stability through residues S168 and D203, with high species specificity. Pharmacokinetic evaluation revealed that Lico A had favorable absorption and blood–brain barrier permeability, supporting its potential utility in treating brain disease. In vitro assays showed that Lico A effectively inhibited Toxoplasma gondii brain cyst formation. Collectively, these findings support Lico A as a promising candidate for the treatment of toxoplasmosis. Full article

Background and Clinical Significance: Currently, the only effective treatment for cataracts is surgery. The most commonly employed method is phacoemulsification, a well-established procedure that uses ultrasound energy to fragment the lens, allowing for easier removal. Potential postoperative complications range from mild to severe corneal edema (pseudophakic bullous keratopathy), which may be caused by intraoperative endothelial cell damage, to the rare formation of iris cysts. Case Presentation: In this paper, we report the case of a patient who underwent cataract surgery in both eyes, where iris incarceration occurred during the surgical procedure, resulting in corneal edema and an iris cyst, both in the left eye. Secondary iris cysts are uncommon following phacoemulsification, with only a few cases reported in the recent literature. The cyst’s impact on corneal edema was unexpected, making this case particularly noteworthy and emphasizing the complexity of cataract surgery and its postoperative complications. Conclusions: This case illustrates the unique interaction between two infrequent complications of cataract surgery. Full article

Isolated pelvic nodal metastasis from carcinoma of unknown primary origin (CUP) is rare. Evaluation should prioritize gynecological and anorectal sites based on pelvic lymphatic drainage. Although spontaneous regression of these primary lesions is exceptional, regressed lesions can present as CUP, necessitating diagnostic caution. Here, we report the case of a 40-year-old woman with a solitary, intensely fluorodeoxyglucose F-18 avid left obturator lymph node and a subtle endocervical abnormality on pelvic magnetic resonance imaging. Loop electrosurgical excision revealed a Nabothian cyst only. Excisional nodal biopsy by polymerase chain reaction revealed metastatic squamous cell carcinoma with diffuse block-type p16 and human papillomavirus (HPV) 16. Considering the potential for a primary cervical tumor along the obturator drainage pathway, the patient underwent hysterectomy with pelvic lymph node dissection. No residual invasive carcinoma was found; however, HPV16 was detected in the cervix with a low-grade squamous intraepithelial lesion, supporting a regressed cervical focus. She received adjuvant cisplatin-based chemoradiotherapy and has remained disease-free for 56 months. This case highlights the diagnostic value of integrating lymphatic anatomy with the molecular profile of HPV. Cervical squamous cell carcinoma rarely regresses and presents solely as an isolated nodal disease. Full article

Background: Hydatid disease poses unique management challenges in pediatric populations due to developing anatomy and growth considerations. This systematic review evaluates the efficacy and safety of medical, surgical, and combination therapies for pediatric hydatid liver disease. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Library from inception to January 2025 identified studies investigating treatment outcomes in pediatric hydatid liver disease. Data was synthesized through qualitative analysis of treatment effectiveness, complications, and patient outcomes. Results: Fifteen studies were included, comprising controlled trials, cohort studies, and cross-sectional studies. Treatment efficacy correlated significantly with cyst size: small cysts (<5 cm) responded well to albendazole monotherapy (88.3–97.6% success at 6–12 months); medium-sized cysts (5–6 cm) benefited from percutaneous interventions (PAIR) with 97.1% technical success; large cysts (>6 cm) required surgical management. Laparoscopic approaches demonstrated advantages over open surgery, including shorter hospitalization (5.6 ± 2.2 vs. 12.1 ± 1.5 days) and reduced analgesic requirements. Omentoplasty emerged as superior for residual cavity management with fewer complications than tube drainage approaches. Conclusions: This review supports personalized treatment algorithms based primarily on cyst characteristics. The findings recommend standardized protocols incorporating cyst size, location, and complexity as key decision points, with expanded access to minimally invasive techniques. Future research should focus on prospective comparative studies with standardized outcome measures. Full article

Background/Objectives: The treatment options for endometriosis vary depending on individual needs and clinical circumstances. To preserve ovarian reserve, ethanol catheter-directed sclerotherapy may be considered as a treatment option. We compared the efficacy of catheter-directed sclerotherapy with that of surgical removal for the treatment of large ovarian endometriomas. Methods: This retrospective, single-center study was conducted at a tertiary care center. Patients diagnosed with ovarian endometriomas of >10 cm between 1 January 2019 and 5 December 2024 were included. Fifteen patients underwent catheter-directed sclerotherapy, and 69 underwent laparoscopic ovarian cystectomy or oophorectomy. The changes in ovarian cyst size, anti-Müllerian hormone levels, and cancer antigen 125 levels after six months of treatment were determined. Results: Before matched comparison, anti-Müllerian hormone levels decreased from 2.48 ng/mL to 1.11 ng/mL 6 months after surgical treatment. In the catheter-directed sclerotherapy group, anti-Müllerian hormone levels decreased from 1.33 ng/mL to 1.19 ng/mL. In the 1:1 matched comparison between the catheter-directed sclerotherapy and surgical groups, the anti-Müllerian hormone levels decreased by approximately −0.13 and −0.59 in the catheter-directed sclerotherapy and surgical groups, respectively. The relative reduction in the anti-Müllerian hormone levels was approximately −0.25 and −0.78 in the unilateral and bilateral ovarian surgery groups, respectively. In the surgical group, cyst size decreased to 0 cm six months after treatment, whereas CA-125 levels decreased from 62.10 U/mL to 11.20 U/mL. In the CDS group, cyst size reduced to 3.30 cm, whereas CA-125 levels decreased from 74.20 U/mL to 17.60 U/mL. Conclusions: Catheter-directed sclerotherapy preserves ovarian reserve more effectively than surgical treatment, even in cases of large endometriomas. It may be a promising treatment option for individuals with low anti-Müllerian hormone levels who are planning to conceive. Full article

Soybean cyst nematode (SCN) is the most economically devastating pathogen of soybean in North America. Even at low to moderate infestation levels, SCN can cause 20–30% yield loss without producing any visible aboveground symptoms. In severely infested fields, yield reductions can reach 60–70% and, in extreme cases, exceed 80%. Prior research on identifying SCN infestations has primarily relied on traditional machine-learning methods applied to Unmanned Aerial System (UAS)-based multispectral imagery, with limited success. This study hypothesizes that deep-learning (DL) methods can more effectively capture the subtle spectral and spatial signatures in multispectral images of SCN stress. To address this gap, we evaluate the performance of advanced DL architectures, including Vision Transformer (ViT) and a customized Convolutional Neural Network (CNN), for detecting SCN infestation in soybean fields using multispectral UAS imagery. Spectral analysis of the multispectral imagery revealed that the near-infrared (NIR) band is a strong discriminator between non-detected and SCN-infested areas. The DL models trained and tested across multiple growth stages showed promising results. The four-timestamp ViT model (3 June, 29 July, 19 August, and 2 September) achieved an F1-score of 0.74, while the five-timestamp SCN–CNN model (3 June, 22 July, 29 July, 19 August, and 2 September) achieved an F1-score of 0.75. Although overall performance was comparable, ViT demonstrated more stable performance across varying training and test data distributions. These findings highlight the effectiveness of DL architectures to automatically extract subtle, complex plant features from multispectral imagery throughout the growing season. Compared with manual, time-consuming soil-sampling techniques, the proposed framework enables more precise spatial and temporal monitoring of SCN infestations across fields. Full article

Acanthamoeba castellanii, an opportunistic free-living amoeba, causes severe infections including Acanthamoeba keratitis. This exploratory study evaluated whether three non-steroidal anti-inflammatory drugs (NSAIDs)—acetylsalicylic acid, ibuprofen, and diclofenac (100 µM)—modulate pathogenicity-related processes in A. castellanii and explored the involvement of a gp63-like protein during encystment and adhesion. Trophozoites were continuously exposed to each drug and analyzed for adhesion, migration on host-derived discontinuous brain micropatterns, encystment efficiency, and parasite-induced cytoskeletal remodeling in MDCK epithelial cells. In silico docking was performed to assess potential drug–protein interactions. Drug exposure reduced adhesion with maximal inhibition at 60 min. After 1 h, migration decreased by 49%, 64%, and 38%, and encystment was reduced by 50%, 85%, and up to 90%, respectively, in cultures treated with acetylsalicylic acid, ibuprofen, and diclofenac. Co-incubation with untreated trophozoites lowered actin fluorescence to approximately 50%, whereas drug-treated co-cultures preserved fluorescence near control levels. Colocalization analysis showed increased spatial overlap between gp63-like protein and F-actin in cysts (~40%) and migrating trophozoites (~20%) compared with non-stimulated forms (~3.8%). Collectively, these findings suggest that NSAID-sensitive pathways influence host interaction, migration, and encystment in A. castellanii and allow for the proposal of gp63-like protein as a putative molecular component of the NSAIDs sensitive pathways. Full article

Background: To assess longitudinal changes in the in vivo confocal microscopy (IVCM) features during Acanthamoeba keratitis (AK) treatment and develop a prognostic model. Methods: This retrospective study included 59 AK patients who underwent IVCM at baseline and 1 and 3 months. Fourteen morphological features covering pathogen-related characteristics, cyst arrangement patterns, and inflammatory markers were compared between good and poor prognosis groups, which were defined based on clinical outcomes including corneal perforation, the need for therapeutic keratoplasty, or final best-corrected visual acuity (BCVA) ≤ 0.05. Prognostic modeling was performed exclusively using baseline IVCM features and applied univariable and Firth-corrected multivariable logistic regression with collinearity assessment and clinical filtering, followed by 5-fold cross-validation. Results: Among 59 AK patients, 45 (76.3%) had a good prognosis and 14 (23.7%) had a poor prognosis. Poor prognosis eyes showed a higher prevalence of double-walled cysts, trophozoites, and clustered cysts, along with higher cyst density and deeper stromal invasion. In contrast, good-prognosis eyes had more target-like cysts, immature dendritic cells, and mature dendritic cells. Clustered cysts independently predicted poor prognosis (OR = 2.98), whereas target-like cysts (OR = 0.26) and mature dendritic cells (OR = 0.37) were protective (AUC = 0.883; all p < 0.05). Conclusions: IVCM provides a quantitative tool for early outcome prediction and individualized management. Higher cyst burden, clustered cysts, and persistent stromal involvement indicated poorer prognosis, whereas target-like cysts and mature dendritic cells indicated better prognosis. Full article

Background/Objectives: An Aneurysmal Bone Cyst (ABC) is a rare benign osteolytic bone lesion with locally destroying growth. It occurs mostly in the first two decades of life, rarely in older patients, and commonly affects the metaphysis. Clinical presentation includes pain and pathologic fractures. While most ABCs occur as primary lesions, there is an entity of secondary (reactive) ABC following osseous lesions such as fractures. We report a rare case of a secondary aneurysmal bone cyst of the distal radius following a distal radius fracture 4 years prior, with subsequent treatment and reconstruction. Methods: A 67-year-old female patient presented with a pathologic distal forearm fracture with radiologically expansive lytic bone lesion of the metaphysis of the distal radius, suspicious of an ABC. A biopsy and primary fracture management with an external fixator were performed due to the unclear dignity of the lesion. The diagnosis of an ABC was confirmed in the biopsy. The tumor resection and reconstruction were performed with a vascularized free fibula graft (ipsilateral, double barrel), using patient-specific 3D-printed osteotomy templates. Results: Follow-up radiographs showed excellent bone union with progressive remodeling. The functional outcome was very good with almost the same range of motion and grip strength as the contralateral side. No limitation in everyday life and no donor site morbidity was reported. Conclusions: ABC is a rare benign bone tumor the treatment of which consists of complete resection and reconstruction. Reconstruction of the distal radius can be achieved with a fibula graft. In our case, an excellent result was achieved with patient-specific osteotomy templates. Only a few cases of ABC in the distal radius and at this age have been reported; nevertheless, it should be considered as a differential diagnosis for osteolytic bone lesions Full article