Thioacetamide (TAA)-induced liver fibrosis, triggered by inflammation and oxidative stress, is prompted by hepatic stellate cells (HSCs) activation via several pathways. This study explores the hepatoprotective effect of aloe vera gel (AVG) extract and bone marrow mesenchymal stem cells (BM-MSCs) transplantation on regulating long intergenic noncoding RNA (lincRNA-p21) and microRNA (miR-17-5p) expressions and their impact on TGF-β1/Smad-3 and Wnt-10a/ β-Catenin cascades in TAA-induced liver damage. The study involved 48 adult male albino rats divided into four groups:control, TAA, TAA treated with BM-MSCs, and TAA treated with BM-MSCs+AVG extract. After 8 weeks, liver enzymes and hepatic oxidative parameters were evaluated alongside lincRNA-p21, miR-17-5p, TGF-β1, Smad-3, Wnt-10a, and β-Catenin expressions. Liver tissue sections were examined by light and electron microscopes and analyzed morphometrically. Group II showed increased aspartate aminotransferase, alanine aminotransferase, malondialdehyde, reduced glutathione levels, and deteriorated hepatocytes with distorted mitochondria and dilated rough endoplasmic reticulum. Group IV restored lincRNA-p21 expression, which downregulated miR-17-5p and suppressed activated HSCs by inhibiting TGF-β1/Smad-3 and Wnt-10a/β-Catenin pathways, and improved hepatic tissue architecture. Additionally, immunohistochemically, alpha-smooth muscle actin and cyclin D1 expressions were markedly decreased in group IV compared to group II. We concluded that AVG suppresses fibrotic pathways, boosts BM-MSCs differentiation, and reduces HSCs activation in liver fibrosis caused by TAA.

Purpose: This study aimed to determine whether the benefits of robotic surgery can be applied to the treatment of colon cancer by evaluating short-term outcomes of robotic versus laparoscopic colonic resection. Methods: This interim analysis of an interventional multicenter randomized trial was conducted to compare outcomes of robotic and laparoscopic colorectal surgery performed between January 2017 and December 2019. The study specifically assessed short-term outcomes in patients undergoing laparoscopic or robotic right or left colectomy for cancer. In addition, all short-term outcomes were evaluated in separate subgroups of right and left colonic resections through prespecified subgroup analyses. Results: A total of 323 patients were analyzed, of whom 142 underwent robotic-assisted surgery and 181 underwent laparoscopic surgery. Overall, 109 complications (33.7%) occurred in the short-term period, 41 (28.9%) in the robotic group and 68 (37.6%) in the laparoscopic group, with no differences between groups in intraoperative or postoperative complications. However, grade III complications were significantly more frequent in the laparoscopic group, with 17 cases (9.4%) compared to 5 cases (3.5%) in the robotic group. Oncological radicality was similar between groups. Functional recovery after surgery was superior in the robotic group, as reflected by a shorter time to mobilization (17.5±10.2 hours vs. 21.1±11.5 hours). In the right colectomy subgroup, rates of grade III complications (1.9% vs. 11.7%) and lymph nodes retrieved (20.3±10.3 vs. 20.2±6.4) favored robotic surgery. In the left colon cancer subgroup, functional recovery was also improved with robotic surgery (44.3±22.2 hours vs. 61.1±31.1 hours, as measured by the composite recovery outcome). Conclusion Robotic surgery is associated with fewer severe complications and improved postoperative recovery following colonic resections. Trial registration: ClinicalTrials.gov identifier: NCT02871960

Background: s/Aims: Postoperative pancreatic fistula (POPF) remains a significant complication following pancreatoduodenectomy (PD). It has been hypothesized that single loop (SL) reconstruction may increase the risk of POPF, leading to the proposal of double-loop (DL) reconstruction. In this approach, the pancreatic duct is connected to an isolated loop of bowel in a Roux-en-Y configuration. Methods: We conducted a retrospective multicenter study to compare various types of reconstruction after PD, analyzing data from 1,502 patients who underwent open, laparoscopic, or robotic PD across 28 centers worldwide. Propensity score matching (PSM) was applied to enhance comparability. Results: The overall rate of POPF was 34.89%, with a grade C POPF rate of 4.26%. The type of reconstruction (SL vs. DL) did not significantly impact the rates of POPF or grade C POPF, both before and after PSM. The rate of delayed gastric emptying (DGE) was 20.71%, and patients with DL reconstruction had a lower incidence of DGE both before and after PSM. Conclusions Our study found no significant differences in the risk of POPF between SL and DL reconstruction. However, DL reconstruction is associated with a reduced risk of DGE, suggesting it may be a preferable option following open PD.

Anti-neutrophil cytoplasmic antibody-associated vasculitides (AAV) are rare autoimmune disorders typically involving the lungs and kidneys. A few case reports have described an association with hematopoietic stem cell transplant (HSCT). We present a case of myeloperoxidase-positive AAV with predominant renal involvement in a 49-year-old male with a history of acute myeloid leukemia treated with allogenic HSCT and complicated by chronic graft-versus-host disease (GVHD). He presented with rapidly progressive glomerulonephritis, and kidney biopsy revealed pauci-immune necrotizing crescentic glomerulonephritis. Treatment with methylprednisolone pulses followed by oral prednisolone, rituximab, and plasmapheresis led to improved kidney function and a tailored rituximab maintenance regimen was followed. However, a renal-limited relapse occurred at 15 months, requiring repeat induction therapy. Dialysis was avoided, but renal function only partially recovered. This case suggests that AAV can develop after HSCT and GVHD and highlights the importance of long-term follow-up and further research into underlying mechanisms.

Purpose: To investigate the recent prescription patterns among South Korean pediatric ophthalmologists to control myopia progression. Methods: An online survey was distributed to the members of the Korean Association of Pediatric Ophthalmology and Strabismus (KAPOS) between August 22 and 31, 2023. Respondents selected treatment modalities that they prescribed to slow myopia progression. Multiple responses were allowed, and prescribing patterns were analyzed by respondents’ characteristics, including years since board certification, practice type, practice location, and average number of pediatric myopia patients seen per week. Results: Of 167 active members, 119 (71.3%) completed the survey, and 118 provided full responses. Most respondents practiced in Seoul or metropolitan areas (75.4%), worked in hospitals (73.7%), had >10 years of clinical experience (68.9%), and treated >20 pediatric myopia patients weekly (62.2%). With multiple responses allowed, 0.125% atropine eye drops (75.6%) were most commonly prescribed, followed by orthokeratology lenses (57.1%). When grouped into mutually exclusive categories (topical atropine only, optical interventions only, both and neither), the largest proportion of respondents (63.0%) selected both pharmacological and optical treatments. Treatment patterns did not differ by experience or location, but significant differences were observed by practice type and weekly pediatric myopia patient volume. Private practitioners more often prescribed orthokeratology, dual-focus soft contact lenses, and selected both pharmacologic and optical treatments, whereas hospital practitioners more commonly selected topical atropine alone. Those treating a higher volume of pediatric myopia patients showed a greater tendency to select both pharmacologic and optical treatments. Conclusions In this survey of KAPOS members, topical atropine, particularly the 0.125% commercial formulation, was the most commonly prescribed single modality for myopia control. Topical atropine and optical interventions emerged as the most common treatment strategies, particularly in private clinics. These findings indicate a trend towards more proactive and multimodal approaches to myopia control compared with earlier practice patterns in South Korea.

Conventional size-based criteria have limitations in accurately assessing neoadjuvant therapy (NAT) response in soft tissue sarcomas (STS). This systematic review evaluated the association between dynamic contrast-enhanced MRI (DCE-MRI) parameters and histopathology-based response to NAT in STS and summarized which DCE-MRI parameters show the most consistent associations across diverse clinical contexts. Following Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines, a comprehensive search was conducted to identify studies evaluating treatment response to NAT in STS using DCE-MRI. Thirteen studies comprising 234 patients were included. Quantitative DCE-MRI parameters, particularly Ktrans , showed a strong predictive performance for treatment response and demonstrated high discriminatory ability in several cohorts during both early and late post-treatment phases. Related measures such as ΔKtrans , Kep, and Ve also correlated significantly with histopathologic necrosis. Semi-quantitative markers, including the integrated area under the curve in the first 60 seconds after injection (iAUC60), wash-in rate, and time-to-peak, showed consistent associations with tumor perfusion and hypoxia. Qualitative features, including time–intensity curve patterns, effectively differentiated responders from non-responders, with type II curves most strongly associated with favorable outcomes. In conclusion, DCE-MRI, particularly quantitative pharmacokinetic parameters such as Ktrans , shows promise for assessing treatment response in STS and demonstrates generally concordant associations with histopathology-based response. However, protocol and endpoint heterogeneity and small cohort sizes limit the ability to establish definitive cutoffs and reduce generalizability, highlighting the need for standardized prospective validation.

Oral anticoagulants are widely used to prevent and treat thromboembolic disorders, but inappropriate use can increase adverse effects and reduce therapeutic efficacy. This study evaluated the utilization patterns, dosing appropriateness, and adverse effects of oral anticoagulants in a tertiary hospital in Iran. A retrospective cross-sectional study was conducted at Razi Educational Hospital, Birjand University of Medical Sciences, from April 2020 to September 2022. Data were collected from medical records and pharmacy databases for patients aged ≥18 years who received warfarin, rivaroxaban, or apixaban. Dosing appropriateness was assessed using 2021 European Heart Rhythm Association (EHRA) and UpToDate guidelines, while adverse effects were classified according to 2020 American College of Cardiology (ACC) criteria. Among 1,027 patients (mean age 64±16.4 years; 52.3% male), rivaroxaban was the most prescribed anticoagulant (43.5%), followed by warfarin (33.2%) and apixaban (23.3%).Warfarin was primarily used for valvular heart disease, whereas DOACs were mainly prescribed for non-valvular atrial fibrillation and venous thromboembolism. Adverse effects occurred in 12.1% of patients, mostly minor bleeding, with warfarin accounting for the majority. Guideline-based dosing was achieved in 61.9% of apixaban and 58.6% of rivaroxaban users; 46.9% of warfarin patients reached therapeutic INR (2-3). Correct renal dose adjustments were applied in 40.5% of apixaban and 33% of rivaroxaban users. Guideline adherence for oral anticoagulant dosing was suboptimal. Improved prescriber education, enhanced drug utilization evaluation, and routine renal monitoring may enhance patient safety and optimize anticoagulation outcomes.

Background: and Purpose In patients with ischemic stroke and isolated cervical internal carotid artery occlusion (c-ICA-O), endovascular therapy (EVT) can improve cerebral perfusion. To maintain vessel patency, EVT is frequently combined with carotid artery stenting (CAS). We assessed the efficacy and safety of emergent CAS during EVT for isolated c-ICA-O. Methods: This retrospective multinational cohort study (42 centers) included consecutive patients who underwent EVT for isolated c-ICA-O within 24 hours from the time last seen well. Patients who underwent emergent CAS were compared with those who did not. Co-primary outcomes were c-ICA vessel patency and symptomatic intracerebral hemorrhage (sICH) 24 hours post-EVT. Secondary outcomes included any intracerebral hemorrhage (ICH) at 24 hours and disability at 3 months (modified Rankin Scale [mRS] shift). Outcomes were adjusted using inverse probability of treatment weighting. Results: Of 317 patients (mean age, 68.6 years [standard deviation, 12.9]; median National Institutes of Health Stroke Scale 11 [interquartile range, 6–17]; 26.8% female), 219 (69.1%) underwent CAS, whereas 98 (30.9%) did not. At 24 hours, vessel patency was more common after CAS (83.5% vs. 40.7%; adjusted odds ratio [aOR], 9.45; 95% confidence interval [CI], 4.91–18.17); sICH rates did not differ (2.3% vs. 3.1%; aOR, 0.92; 95% CI, 0.18–4.73). Any ICH was more common after CAS (19.3% vs. 9.3%; aOR, 2.50; 95% CI, 1.12–5.60). CAS was not associated with mRS at 3 months (adjusted common odds ratio, 0.98; 95% CI, 0.62–1.56). Conclusions In patients undergoing EVT for isolated c-ICA-O, emergent CAS was technically effective and reasonably safe. More frequent vessel patency in patients who underwent CAS did not translate into improved functional outcome at 3 months.

Purpose: Prostatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is an exceptionally rare malignancy that often mimics benign prostatic conditions. Its nonspecific symptoms and the frequent absence of abnormalities on prostate-specific antigen (PSA) testing or digital rectal examination contribute to delayed or incidental diagnosis. This review summarizes the published literature on prostatic MALT lymphoma and integrates an illustrative case from our institution. Materials and Methods: A PubMed literature search was conducted on 29 November 2025 using predefined free-text terms related to prostatic MALT lymphoma. Human studies published in English were included. A total of 24 articles were screened, of which 10 met eligibility criteria. Given the rarity of the condition and heterogeneity across reported cases, a narrative synthesis was performed. One case from Hospital Professor Doutor Fernando Fonseca was analyzed separately and incorporated into the results. Results: A total of 25 patients were identified. Clinical presentation was dominated by lower urinary tract symptoms, and nearly half of reported PSA values were within the normal range. Histology consistently demonstrated centrocyte-like B-cell infiltrates with variable lymphoepithelial lesions and a characteristic CD20-positive/BCL2-positive immunophenotype. Most patients presented with localized Ann Arbor stage I disease. Local therapies, including transurethral resection of the prostate or radiotherapy, achieved durable complete remissions, whereas systemic chemotherapy was reserved for disseminated disease. The illustrative case showed typical features of localized prostatic MALT lymphoma and achieved complete remission after low-dose radiotherapy, remaining disease-free at 9 months. Conclusion Prostatic MALT lymphoma is an indolent but highly treatable malignancy when recognized early. Awareness of its nonspecific presentation and characteristic histopathologic profile is essential for timely diagnosis. Organ-preserving treatment strategies offer excellent outcomes in localized disease.