To determine the distinction of primary ovarian carcinoma from metastatic ovariancarcinoma, the author studied total 40 cases of malignant tumors(13 primary ovarian carcinomas:7 serous, 4 mucinous, and 2 endometrioid, 7 metastatic ovarian adenocarcinomas,10 gastric adenocarcinomas and 10 colonic adenocarcinomas) using primary antibody to CEA,CK7, CK20 and CK18. The results were summerised as follows: The expression of CK7was demonstrated in all(7) serous and 3 out of 4 mucinous adenocarcinoma, and 1 out of10 each gastric and colonic adenocarcinoma. The CK20 positivity was seen in 4 out of 10cases of colonic adenocarcinoma and 3 out of 7 cases of metastatic adenocarcinoma. Allprimary ovarian carcinoma and gastric adenocarcinoma were negative for CK20 except forfocal positivity in only 1 ovarian mucinous adenocarcinoma. All types of serous andendometrioid adenocarcinoma were negative for CEA. But, the vast majority of mucinousadenocarcinoma, metastatic adenocarcinoma, gastric and colonic adenocarcinoma were positivefor CEA. The CK18 may not be helpful to differentiate the primay or metastatic carcinomabecause all cases examined were positive for CK18 except for 1 ovarian mucinous carcinoma.Immunostainning for CK7 may be helpful on differential diagnosis of primary andmetastatic ovarian carcinoma, especially mucinous adenocarcinoma and metastatic gastric andcolonic adenocarcinoma. The CK20 may be a useful marker for differential diagosis inprimary and metastatic ovarian carcinomas. The CEA may be of value on differential diagnosisof mucinous and nonmucinous(serous and endomerioid) ovarian carcinomas, and metastaticcolonic adenocarcinoma and endometrioid carcinoma.In conclusion, immunohistochemical study for CEA, CK7, and CK20 may be helpful indifferential diagnosis between primary and metastatic ovarian carcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colon ; Diagnosis ; Diagnosis, Differential* ; Female ; Immunohistochemistry ; Mucins ; Neoplasm Metastasis ; Ovary

BACKGROUND: The skin consists of tightly connected keratinocytes, and prevents extensive water loss while simultaneously protecting against the entry of microbial pathogens. Excessive cellular levels of reactive oxygen species can induce cell apoptosis and also damage skin integrity. Propofol (2,6-diisopropylphenol) has antioxidant properties. In this study, we investigated how propofol influences intracellular autophagy and apoptotic cell death induced by oxidative stress in human keratinocytes. METHOD: The following groups were used for experimentation: control, cells were incubated under normoxia (5% CO₂, 21% O₂, and 74% N₂) without propofol; hydrogen peroxide (H₂O₂), cells were exposed to H₂O₂ (300 µM) for 2 h; propofol preconditioning (PPC)/H₂O₂, cells pretreated with propofol (100 µM) for 2 h were exposed to H₂O₂; and 3-methyladenine (3-MA)/PPC/H₂O₂, cells pretreated with 3-MA (1 mM) for 1 h and propofol were exposed to H₂O₂. Cell viability, apoptosis, and migration capability were evaluated. Relation to autophagy was detected by western blot analysis. RESULTS: Cell viability decreased significantly in the H₂O₂ group compared to that in the control group and was improved by propofol preconditioning. Propofol preconditioning effectively decreased H₂O₂-induced cell apoptosis and increased cell migration. However, pretreatment with 3-MA inhibited the protective effect of propofol on cell apoptosis. Autophagy was activated in the PPC/H₂O₂ group compared to that in the H₂O₂ group as demonstrated by western blot analysis and autophagosome staining. CONCLUSION: The results suggest that propofol preconditioning induces an endogenous cellular protective effect in human keratinocytes against oxidative stress through the activation of signaling pathways related to autophagy.
Apoptosis ; Autophagy* ; Blotting, Western ; Cell Death ; Cell Movement ; Cell Survival ; Humans* ; Hydrogen Peroxide ; Keratinocytes* ; Methods ; Oxidative Stress* ; Propofol* ; Reactive Oxygen Species ; Skin ; Water

Anti-inflammatory effects of Houttuynia cordata supercritical extract (HSE) were investigated in a carrageenan-air pouch model. HSE (200 mg/kg, oral) suppressed exudation and albumin leakage, as well as inflammatory cell infiltration. Dexamethasone (2 mg/kg, i.p.) only decreased exudation and cell infiltration, while indomethacin (2 mg/kg, i.p.) reduced exudate volume and albumin content. HSE lowered tumor-necrosis factor (TNF)-alpha and nitric oxide (NO), as well as prostaglandin E2 (PGE2). Dexamethasone only reduced TNF-alpha and NO, while indomethacin decreased TNF-alpha and PGE2. The suppressive activity of HSE on NO and PGE2 production was confirmed in RAW 264.7. These results demonstrate that HSE exerts anti-inflammatory effects by inhibiting both TNF-alpha-NO and cyclooxygenase II-PGE2 pathways.
Analysis of Variance ; Animals ; Anti-Inflammatory Agents/*pharmacology ; Carrageenan ; Cell Line, Tumor ; Dexamethasone/pharmacology ; Dinoprostone/metabolism ; Drugs, Chinese Herbal/*pharmacology ; Immunoenzyme Techniques ; Indomethacin/pharmacology ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/metabolism ; Signal Transduction/*drug effects ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha/metabolism

BACKGROUND: The structure and function of bone tissue is maintained through a constant remodeling process, which is maintained by the balance between osteoblasts and osteoclasts. The failure of bone remodeling can lead to pathological conditions of bone structure and function. Remifentanil is currently used as a narcotic analgesic agent in general anesthesia and sedation. However, the effect of remifentanil on osteoclasts has not been studied. Therefore, we investigated the effect of remifentanil on pre-osteoclast (pre-OCs) differentiation and the mechanism of osteoclast differentiation in the absence of specific stimulus. METHODS: Pre-OCs were obtained by culturing bone marrow-derived macrophages (BMMs) in osteoclastogenic medium for 2 days and then treated with various concentration of remifentanil. The mRNA expression of NFATc1 and c-fos was examined by using real-time PCR. We also examined the effect of remifentanil on the osteoclast-specific genes TRAP, cathepsin K, calcitonin receptor, and DC-STAMP. Finally, we examined the influence of remifentanil on the migration of pre-OCs by using the Boyden chamber assay. RESULTS: Remifentanil increased pre-OC differentiation and osteoclast size, but did not affect the mRNA expression of NFATc1 and c-fos or significantly affect the expression of TRAP, cathepsin K, calcitonin receptor, and DC-STAMP. However, remifentanil increased the migration of pre-OCs. CONCLUSIONS: This study suggested that remifentanil promotes the differentiation of pre-OCs and induces maturation, such as increasing osteoclast size. In addition, the increase in osteoclast size was mediated by the enhancement of pre-OC migration and cell fusion.
Anesthesia, General ; Bone and Bones ; Bone Remodeling ; Cathepsin K ; Cell Differentiation ; Cell Fusion ; Cell Movement ; In Vitro Techniques ; Macrophages ; Osteoblasts ; Osteoclasts ; Real-Time Polymerase Chain Reaction ; Receptors, Calcitonin ; RNA, Messenger

The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.