Search Results (335)

Background/Objectives: Pituitary tumors account for over 90% of all sellar region masses. However, a spectrum of rare neoplastic, inflammatory, infectious, and vascular lesions—benign and malignant—can arise in the intra- and parasellar compartments and clinically and radiologically mimic PitNETs. We report a cohort of 47 such rare and cystic midline intracranial lesions, emphasizing their distinctive morphological, clinical, and imaging features and the personalized treatment strategies applied. Methods: In this retrospective single-center study, we reviewed all patients treated for suspected PitNETs via transsphenoidal approach between 2015 and 2024. Of 529 surgical cases, we excluded confirmed PitNETs, meningiomas, and classical intradural craniopharyngiomas. Collected data encompassed patient demographics, tumor characteristics, presenting symptoms, extent of resection or medical therapy, endocrine outcomes, and follow-up information. Results: Among all 529 patients who underwent surgical treatment for sellar lesions from 2015 to 2024, 47 cases (8.9%) were identified as rare or cystic masses. Forty-six underwent transsphenoidal resection; one patient with hypophysitis received corticosteroid therapy alone. Presenting symptoms included headache (n = 16), dizziness (n = 5), oculomotor disturbances (n = 2), and visual impairment (n = 17). Endocrine dysfunction was found in 30 patients, 27 of whom required hydrocortisone replacement. Histopathological diagnoses were led by colloid cysts (n = 14) and Rathke’s cleft cysts (n = 11). The remaining 22 cases comprised plasmacytoma, germinoma, lymphoma, pituicytoma, inverted papilloma, metastatic carcinoma, chordoma, nasopharyngeal carcinoma, chloroma, and other rare entities. Preoperative imaging diagnosis proved incorrect in 38% (18/47) of cases, with several lesions initially misidentified as PitNETs. Conclusions: Nearly 9% of presumed PitNETs were rare, often benign or inflammatory lesions requiring distinct management. Most could be safely resected and demonstrated excellent long-term outcomes. Yet, despite advanced imaging techniques, accurate preoperative differentiation remains challenging, with over one-third misdiagnosed. Clinical red flags—such as early hormone deficits, rapid progression or atypical imaging findings—should prompt early interdisciplinary evaluation and, when indicated, image-guided biopsy to avoid unnecessary surgery and ensure tailored therapy. Full article

Background: Pulsed field ablation (PFA) is a novel non-thermal modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF), offering myocardial selectivity through irreversible electroporation while sparing surrounding structures. However, concerns have emerged regarding potential subclinical hemolysis, reflected by alterations in biochemical markers such as lactate dehydrogenase (LDH). Methods: We conducted a retrospective, single-center study involving 249 patients undergoing PVI: 121 treated with PFA (PulseSelect or FARAPULSE) and 128 with radiofrequency (RF) ablation (PVAC catheter). Laboratory parameters were assessed at baseline, post-procedure, and at discharge, including hemoglobin, hematocrit, red blood cell (RBC) count, platelet count, creatinine, and LDH. The primary endpoint was the variation in blood cell indices; the secondary endpoint was the evaluation of LDH and hematocrit changes. Statistical analysis included t-tests and chi-square tests. Results: Baseline characteristics and pre-procedural labs did not differ significantly between groups. No significant changes in hemoglobin, hematocrit, RBC count, platelet count, or creatinine were observed post-ablation or at discharge. However, LDH levels significantly increased in the PFA group both post-procedurally and at discharge (p < 0.001), without concurrent changes in other blood cell parameters. Conclusions: PFA and RF ablation yield comparable hematological profiles after PVI, with no significant impact on key blood cell parameters. Nonetheless, the consistent rise in LDH levels in the PFA group suggests mild, subclinical hemolysis or tissue injury due to more extensive lesions. While supporting the hematologic safety of PFA, these findings underscore the need for further studies to assess the clinical significance of these biochemical alterations, particularly in high-risk patients or extensive ablation settings. Full article

Background: Wound healing in diabetic individuals is a prolonged process, often complicated by infections and impaired tissue regeneration. Innovative strategies combining natural bioactive compounds are needed to enhance repair. Methods: This study reports the development and characterization of natural latex-based biomembranes (NLBs) incorporated with liposome-encapsulated curcumin and papain. The therapeutic efficacy of these composite dressings, in combination with red light-emitting diode (LED) phototherapy, was evaluated in a diabetic rat model. NLBs were produced by blending natural latex with multilamellar liposomes containing either curcumin, papain, or both. In vivo wound healing was assessed by applying the biomembranes to the dorsal lesions and administering red LED irradiation (650 ± 20 nm, 10 min every 48 h) over 11 days. Results: Fourier transform infrared spectroscopy (FTIR) confirmed that the integration of liposomes did not induce significant chemical alterations to the latex matrix. The treated diabetic rats exhibited enhanced wound contraction, with the curcumin and papain groups demonstrating up to 99% and 95% healing, respectively. Plasma fructosamine levels were significantly reduced (p < 0.05), indicating improved glycemic control. Conclusions: Combining NLBs with bioactive-loaded liposomes and phototherapy accelerated wound healing in diabetic rats. This multifunctional platform shows promise for the treatment of chronic wounds in diabetic patients. Full article

Background/Objectives: Red bone marrow irradiation is a major concern for patients with advanced prostate cancer undergoing [¹⁷⁷Lu]Lu-PSMA therapy. However, low uptake in the red bone marrow and the presence of bone lesions complicate image-based red bone marrow dosimetry. This study aimed to investigate the general feasibility of image-based red bone marrow activity estimation for [¹⁷⁷Lu]Lu-PSMA treatment and to develop a fully automated workflow for clinical implementation. Methods: In the first part of the study, 175 virtual patient phantoms with realistic ¹⁷⁷Lu activity distributions were generated based on 639 pre-therapeutic [¹⁸F]F-PSMA-1007 PET/CT scans. The SIMIND Monte Carlo tool was used to simulate the ¹⁷⁷Lu SPECT acquisitions (24 h post-injection (p.i.)), which were used to assess the uncertainty of red bone marrow activity estimation. In the second part, red bone marrow self- and cross-absorbed doses were estimated for four therapy cycles of 20 patients. Results: The simulation study shows a significant overestimation of activity in skeletal sites with bone lesions, with median recovery coefficients (RCs) across all phantoms yielding a median of 225% (range: 106–1015%). In contrast, the median RCs were markedly lower in skeletal sites neighboring or distant to lesion-carrying sites (105% [72–163%] and 107% [77–130%], respectively). The median total absorbed dose to the red bone marrow was 20.8 mGy/GBq (range: 5.6–297.9 mGy/GBq). Median blood levels decreased with an increasing median cumulative total absorbed dose. Conclusions: Reliable estimation of activity concentration in skeletal sites without bone lesion infiltration has been shown to be feasible. Based on this finding, an automated workflow for routine image-based red bone marrow dosimetry was developed. Full article

Background and Clinical Significance: Kaposi sarcoma (KS) is a rare angio-proliferative mesenchymal tumor that predominantly affects the skin and mucous membranes but may involve lymph nodes and visceral organs. Clinically, it manifests as red-purple-brown papules, nodules, or plaques, either painless or painful, often with disfiguring potential. The diagnosis is traditionally based on clinical and histopathological evaluation, although non-invasive imaging techniques are increasingly used to support diagnosis and treatment monitoring. We report a case of HHV-8-negative Kaposi sarcoma evaluated with multiple non-invasive imaging modalities to highlight their diagnostic utility. Case Presentation: An 83-year-old man presented with multiple painful, violaceous papulo-nodular lesions, some ulcerated, on the lateral aspect of his left foot. Dermoscopy revealed the characteristic rainbow pattern. Dynamic Optical Coherence Tomography (D-OCT) allowed real-time visualization of microvascular abnormalities, identifying large serpentine and branching vessels with clearly delineated capsules. Line-field Optical Coherence Tomography (LC-OCT) showed irregular dermal collagen, vascular lacunae, and the presence of spindle cells and slit-like vessels. Histological analysis confirmed the diagnosis of Kaposi sarcoma, revealing a proliferation of spindle-shaped endothelial cells forming angulated vascular spaces, with red blood cell extravasation and a mixed inflammatory infiltrate. Conclusions: Non-invasive imaging tools, including dermoscopy, D-OCT, and LC-OCT, have emerged as valuable adjuncts in the diagnosis and monitoring of KS. These techniques enable in vivo assessment of vascular architecture and tissue morphology, enhancing clinical decision-making while reducing the need for immediate biopsy. Dermoscopy reveals polychromatic vascular features, such as the rainbow pattern, while D-OCT and LC-OCT provide high-resolution insights into vascular proliferation, tissue heterogeneity, and cellular morphology. Dermoscopy, dynamic OCT, and LC-OCT represent promising non-invasive diagnostic tools for the assessment of Kaposi sarcoma. These technologies provide detailed morphological and vascular information, enabling earlier diagnosis and more personalized management. While histopathology remains the gold standard, non-invasive imaging offers a valuable complementary approach for diagnosis and follow-up, particularly in complex or atypical presentations. Ongoing research and technological refinement are essential to improve accessibility and clinical applicability. Full article

Dictyocaulosis is a parasitic disease that affects ungulate species, including red deer (Cervus elaphus). The genus Dictyocaulus comprises eighteen species, but only four have been reported to infect red deer. The disease is characterized by respiratory tract infection, particularly in the lungs, bronchi, and bronchioles, leading to inflammatory and hemorrhagic microscopic lesions, as well as emphysema and edema. The biological cycle involves a female ovipositing larvated eggs in the bronchi and trachea, which are expelled to the exterior through coughing or feces, releasing L1 into the environment. In this study, 106 adult red deer were collected from seven locations in Extremadura (Spain). Eight positive lungs were initially assessed by morphological identification, revealing a mean intensity of 13.3 adult worms per infected lung, with a global decrease to an average of 1.8 adult worms per sampled lung. The presence of adult worms in the upper and middle respiratory tract was confirmed through anatomopathological analysis. Molecular identification was performed by sequencing the COI gene. The results indicated the presence of three genetic groups, supported by significant subdivision using the ɸ_ST measure. D. cervi and D. viviparus exhibited their respective matrilineal ancestry, while D. eckerti and D. cervi demonstrated matrilineal sharing. Consequently, the possibility of introgression between these two species was suggested. Although D. viviparus had previously been identified in the same Spanish region based on morphological characteristics, D. cervi and D. eckerti were reported for the first time in the explored geographic area. Full article

Background/Objectives: Actinic keratosis (AK) occurs on sun-damaged skin and is considered a precursor to squamous cell carcinoma (SCC). Photodynamic therapy (PDT), using 5-aminolevulinic acid (ALA) and red light, is a common treatment for AK. However, its clinical efficacy for invasive tumors such as SCC is limited by the poor penetration and distribution of the photosensitizer. Cold atmospheric plasma (CAP), a partially ionized gas, increases skin permeability and exhibits anti-cancer properties through the generation of reactive oxygen species (ROS). In a previous study, CAP showed promising synergistic effects when combined with ALA-PDT for the treatment of SCC cells in vitro. The present study investigated the effects of combining CAP with ALA-PDT on cutaneous AK and SCC induced by ultraviolet B (UV-B) irradiation in SKH1 hairless mice. Methods: We compared various application sequences (CAP-ALA–red light, ALA–red light–CAP, and ALA-CAP–red light) against conventional ALA-PDT using visual, histological, and molecular assessments of the affected skin. Results: The results demonstrated that combined treatments strongly inhibited the growth of UV-B-induced skin lesions. TUNEL staining revealed increased apoptosis following both single and combined therapies, while Ki-67 staining indicated reduced keratinocyte proliferation and diminished DNA damage in treated areas. mRNA expression analysis showed the upregulation of apoptosis-related genes (p16^INK4a, p21^CIP1) alongside enhanced anti-tumor immune responses (IL-6, IL-8) in the affected tissue samples. Notably, the combined treatment enhances the therapeutic effect, whereas the sequence of application does not seem to be relevant for therapeutic efficacy in vivo. Conclusions: Overall, these results suggest that CAP may enhance the anti-tumor effect of conventional ALA-PDT, supporting previous findings on SCC cells. Full article

Introduction: Inlet patch (IP) is a congenital anomaly characterized by gastric heterotopia in the cervical esophagus. While extensively described in adults, it remains poorl characterized in pediatric populations. Material and Methods: This retrospective, single-center study included all pediatric patients (0–14 years) diagnosed with IP between 2018 and 2025. Sociodemographic and clinical data were collected. A blinded pathologist assessed the presence and severity of inflammation within the IP. Results: Nine patients (median age, 12 years; range, 6–14 years) were included, with 78% beingmale. Cervical esophageal symptoms were identified in 67%, primarily dysphagia and gastroesophageal reflux disease-related complaints, although concomitant conditions such as eosinophilic esophagitis were frequently present. Three patients had symptoms potentially attributable to IP (33%). Endoscopic examination revealed characteristic well-demarcated salmon-red plaques in all patients, with multiple lesions observed in three cases. Histology confirmed gastric heterotopia with varying degrees of chronic inflammation in all cases. A potential association was observed between the severity of gastritis in the stomach, the severity of inflammation in the IP, and the presence of H. pylori, with 75% of patients with moderate-to-severe IP inflammation also exhibiting gastric H. pylori-associated gastritis. All patients except one received proton pump inhibitors, and symptoms improved in all cases. Conclusions: A thorough and targeted examination of the cervical esophagus significantly increased IP detection at our center, with most cases (89%) being diagnosed in the last 12 months. While mostly asymptomatic and incidental, IP can be symptomatic. In this case, series, we found a possible association between the severity of inflammation in the IP, the severity of gastritis, and the presence of H. pylori. Further studies are needed to define the clinical significance of pediatric IP and optimal management. Full article

Endometriosis is a chronic, hormone-dependent disorder characterized by an inflammatory response. The disease affects approximately 10% of the general female population, with prevalence rates reaching 30–40% in women with dysmenorrhea and 50–60% in those experiencing infertility. In addition to pelvic pain and reproductive issues, gastrointestinal symptoms, such as acute abdominal pain, constipation, diarrhea, or alternating bowel habits, are frequently reported and can be highly disabling. Emerging evidence indicates that dietary patterns may modulate the inflammatory environment associated with endometriosis, potentially influencing symptom severity by affecting oxidative stress, estrogen metabolism, and levels of sex hormone-binding globulin (SHBG). Diets rich in antioxidants, polyunsaturated fatty acids (PUFAs), and vitamins D, C, and E—alongside the avoidance of processed foods, red meat, and animal fats—may offer beneficial effects. This narrative review explores the relationship between nutrition and endometriosis, emphasizing the therapeutic potential of dietary interventions as a complementary strategy. Notably, dietary approaches may serve not only to alleviate pain and improve fertility outcomes but also to reduce lesion growth and recurrence, particularly in patients seeking pregnancy or those unable to undergo hormonal therapy due to contraindications. Furthermore, nutritional strategies may enhance postoperative recovery and act as a viable first-line therapy when conventional treatments are not applicable. A total of 250 studies were initially identified through PubMed and Scopus. After removing duplicates and non-relevant articles, 174 were included in this review. Our findings underscore the urgent need for further studies to develop evidence-based, personalized nutritional interventions for managing endometriosis-related symptoms. Full article

Background/Objectives: To review the problem of diagnostic delay in soft tissue sarcomas with the aim of identifying its causes and consequences, understanding how to clinically suspect and refer them, and evaluating the main limitations of the referral guidelines already in use. Methods: A systematic review of the available literature was performed, focusing on the theoretical framework, the elements and time intervals to be considered, causes and consequences, “red flag” symptoms/signs, the main referral guidelines in use, their results, and the methods used to avoid excessive referrals. Results: Diagnostic delay in soft tissue sarcomas is a frequent event that is poorly characterized and has important consequences, including prognostic, medico-legal and psycho-social effects. The common denominator is the lack of knowledge and awareness. Several referral guidelines have been described, and most of them are based on clinical data. Their results have been disappointing. Thus, it is necessary to implement new methods to improve their results and avoid the overload of pre-referral imaging systems, sarcoma diagnostic triage meetings, and telemedicine systems. Conclusions: Sarcoma units and health system leaders need to study this issue to determine the extent of the problem and its causes. Without this information, it is almost impossible to properly address the problem and take corrective actions. Early referral of suspected soft tissue sarcoma lesions, although desirable, is a complex issue due to the non-specificity of the symptoms. Existing clinical referral guidelines need to be modified to improve detection and conversion rates. Full article

Background: Dissolvable Microneedle Patches (DMP) have emerged as a promising approach for improved topical delivery of skincare agents with dermatological values (dermo-cosmetics), effectively addressing the various skin concerns. These patches enable minimally invasive penetration of the skin’s outer layer, facilitating efficient transdermal delivery of actives by overcoming skin barrier for successful outcomes. Objectives: The aim of this work was to assess the efficacy and safety of hyaluronic acid-based microneedle patches (HA-MNP) with agents for the managements of an inflammatory disorder of acne. A particular focus was on helping individuals with moderate inflammatory acne. Methods: A single-center clinical trial was conducted over a period of four weeks on acne patients. Measurable skin properties, including sebum content, redness, and severity of inflammation, were evaluated to gauge the overall usefulness of the MN patches. Results: The application of the patches resulted in a significant decrease in sebum content, with reductions of −4.9% and −36.8% observed after two and four weeks of use, respectively. The redness of localized acne lesions also showed a marked decline, with reductions of −47.2% and −65.5% observed after two and four weeks of use, respectively. Additionally, the severity of inflammatory signs in acne lesions showed significant improvements, with reductions of −68.8% and −83.3% observed for the application periods. The patches utilized in this investigation exhibited highly encouraging results, displaying a notable synergistic effect in the context of combating acne without adverse effects. Conclusions: The patches have the potential to be broadly applied as a modular and adaptable approach for therapeutic delivery of actives for various skin diseases and concerns. Full article

For centuries, the most prevalent antler abnormalities observed worldwide have been attributed to trauma. However, detailed pathological investigation of these cases has not yet been carried out. In free-living fallow deer (Dama dama), we identified a chronic osteomyelitis-like condition—Pedunculitis Chronica Deformans (PCD)—using pathological and radiological diagnostics. We propose that inflammation during post-casting wound healing and consequent scar formation can trigger the development of PCD. In this study, we characterize the pathomorphology of PCD and introduce a scoring system to describe its severity. Furthermore, we describe the histoanatomy of the junction between the pedicle and the surrounding skin—an area essential for the integrity of the integument—which, when compromised, may predispose cervids to PCD. Our findings suggest that the most common antler abnormality results from a pathological fracture associated with PCD, which can be further complicated by fatal meningoencephalitis and brain abscesses. PCD-related lesions, while less frequently observed, can also be identified in roe deer (Capreolus capreolus) and red deer (Cervus elaphus), with species-specific differences. These findings overlap with cases reported in other cervid species, suggesting a more general disorder of antler formation. Describing this condition provides a basis for assessing its epidemiology and understanding its relevance to wildlife health. Full article

Automated skin lesion classification using machine learning techniques is crucial for early and accurate skin cancer detection. This study proposes a hybrid method combining the Hermite, Radial Fourier–Mellin, and Hilbert transform to extract comprehensive features from skin lesion images. By separating the images into red, green, and blue (RGB) channels and grayscale, unique textural and structural information specific to each channel is analyzed. The Hermite transform captures localized spatial features, while the Radial Fourier–Mellin and Hilbert transforms ensure global invariance to scale, translation, and rotation. Texture information for each channel is also obtained based on the Local Binary Pattern (LBP) technique. The proposed hybrid transform-based feature extraction was applied to multiple lesion classes using the International Skin Imaging Collaboration (ISIC) 2019 dataset, preprocessed with data augmentation. Experimental results demonstrate that the proposed method improves classification accuracy and robustness, highlighting its potential as a non-invasive AI-based tool for dermatological diagnosis. Full article

Sarcoptic mange is a highly contagious and often lethal parasitic skin disease caused by the mite Sarcoptes scabiei, which is frequently reported in red foxes (Vulpes vulpes). However, there is a lack of documented cases and treatment strategies for sarcoptic mange in reintroduced red fox populations, particularly in South Korea. This study describes 27 cases of sarcoptic mange outbreaks in 26 red foxes reintroduced into South Korea between 2019 and 2024. Of these, 15 foxes were rescued alive, while 12 were found dead. Blood tests of the surviving animals (n = 15) showed significant leukocytosis, anemia, decreased albumin levels, increased globulin levels, elevated blood urea nitrogen levels, and decreased creatinine levels, indicative of a chronic wasting infection. Treatment with ivermectin or fluralaner resulted in complete recovery in 12 of 15 animals, while three animals died during treatment. Necropsy of the deceased animals (n = 12) revealed characteristic skin lesions, such as alopecia, hyperkeratosis, epidermal hyperplasia, and dermatitis. The study findings highlight the importance of long-term monitoring and active, continuous treatment of sarcoptic mange, a major threat, for the stable re-establishment of reintroduced foxes in South Korea. Full article

Background/Objectives: Studies have shown that Atractylenolide I (AT-I) can exert anti-inflammatory and anti-oxidative effects, protecting against the development of various kinds of cardiovascular diseases. However, whether AT-I prevents nicotine-induced atherogenesis is unknown. This study was designed to explore the effects of AT-I on nicotine-induced macrophage pyroptosis and the progression of atherosclerosis. Methods: RT-qPCR and Western blot were used to detect the mRNA and protein levels of TXNIP and pyroptosis-related factors in THP-1-derived macrophages. ELISA was used to detect the secretion of pro-inflammatory cytokines. Hoechst/PI double-staining assay was used to assess plasma membrane integrity. The ROS assay kit, LDH release assay kit, and caspase-1 activity assay kit were used to detect ROS production, LDH release, and caspase-1 activity. Oil Red O, HE, and Masson staining were used to evaluate lipid accumulation, lesion size, and plaque stability in HFD-fed apoE^−/− mice. Results: AT-I treatment significantly decreased pyroptosis-related factors expression, disrupted plasma membrane integrity, and down-regulated pro-inflammatory cytokines secretion, thereby inhibiting nicotine-induced pyroptosis of THP-1-derived macrophages. In addition, AT-I decreased ROS production and the expression of TLR4 and TXNIP. Lentivirus overexpression of TLR4 or TXNIP, or pre-treatment with ROS agonist, mainly reversed the anti-pyroptotic effects of AT-I in nicotine-treated THP-1-derived macrophages. Additionally, administering AT-I to HFD-fed apoE^−/− mice markedly decreased nicotine-induced up-regulation of pyroptosis-related proteins in the aortas. Enzymatic methods and ELISA assay suggested that AT-I improved dyslipidemia and inflammation in vivo. Oil Red O, HE, and Masson staining showed that AT-I alleviated lipid accumulation, decreased plaque size, and increased plaque stability. Conclusions: Taken together, AT-I can be regarded as a potential phytomedicine that protects against macrophage pyroptosis and atherosclerosis triggered by nicotine. Full article