BACKGROUND

Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.

OBJECTIVES

The study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).

METHODS

A cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.

RESULTS

A total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION

Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.

Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment

BACKGROUND AND OBJECTIVES

Orthodontic tooth movement is driven by bone remodeling influenced by systemic factors, including caffeine and ethanol. This study aimed to investigate the effects of caffeine and ethanol on the expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG), key bone remodeling biomarkers, during orthodontic tooth movement.

METHODS

A laboratory experimental study was conducted on 30 male Wistar rats divided into three groups: K1 (orthodontic force only), K2 (force + caffeine), and K3 (force + ethanol). Orthodontic force was applied using Ni-Ti coil springs. Caffeine and ethanol were administered orally daily. On days 7 and 14, maxillary tissues were collected and analyzed via immunohistochemistry for RANK and OPG expression. Data were analyzed using One-Way ANOVA and Independent Sample T-tests with significance at pRESULTS

Caffeine and ethanol administration increased RANK and OPG expression compared to controls; however, only the ethanol group showed a significant increase in RANK expression on day 14 (p = 0.044). OPG expression was significantly higher in treatment groups at both time points (pCONCLUSION

Caffeine and ethanol modulate bone remodeling marker expression during orthodontic force application, with ethanol significantly increasing RANK expression at later stages. Further studies are needed to clarify the clinical implications for orthodontic treatment.

Animals ; Tooth Movement Techniques ; Tooth Movement ; Osteoprotegerin ; Role ; Movement ; Ethanol ; Bone Remodeling ; Caffeine ; Immunohistochemistry

BACKGROUND

Early-stage endometrial cancer often presents with favorable survival rates, but high-risk factors, including TP53 mutations and high-grade serous pathology, can lead to recurrence and poor prognosis. The standard primary treatment for endometrial cancer is surgical staging, and lymph node metastases significantly impact adjuvant therapy decisions. The subgroup of p53-abnormal (p53abn) indicates the worst prognosis and potential benefits from adjuvant chemotherapy. Molecular classification, while recommended, faces practical challenges due to resource constraints.

OBJECTIVES

The study aimed to assess the incidence of p53 abnormal expression in clinical stage 1 endometrial cancer cases that underwent surgery at a government tertiary hospital, and assess its relationship with clinicopathologic factors and pelvic and paraaortic lymph node metastasis (LNM).

METHODS

A cross-sectional retrospective analysis was conducted on clinical early-stage endometrial cancer cases that underwent surgical primary treatment between January 2018 and December 2022. Patient records were reviewed to gather demographics, surgical information, and pathological evaluations. Preoperative clinical staging was determined through imaging, and surgical staging involved comprehensive lymphadenectomy. Immunohistochemistry studies for p53 were carried out on formalin-fixed paraffin-embedded tissue samples.

RESULTS

A total of 233 endometrial cancer cases were included. The mean age at diagnosis was 53.7 years. Common comorbidities included hypertension (47.2%) and dyslipidemia (20.6%). Most cases were endometrioid histology (82.8%) and low-grade tumors (85.8%). Tumor grade (p=0.010), myometrial invasion (pCONCLUSION

Tumor grade, myometrial invasion, and LVSI were all significantly associated with lymph node involvement. While p53 immunohistochemical stains show promise in predicting metastasis and has been associated with tumor aggressiveness, this should still be correlated with clinicopathological parameters to carry out a more accurate risk stratification of early-stage patients.

Therapeutics ; Survival Rate ; Risk Factors ; Recurrence ; Prognosis ; Pathology ; Endometrial Neoplasms ; Immunohistochemistry ; Tumor Suppressor Protein P53 ; Lymph Node Excision ; Risk Assessment

BACKGROUND AND OBJECTIVES

Orthodontic tooth movement is driven by bone remodeling influenced by systemic factors, including caffeine and ethanol. This study aimed to investigate the effects of caffeine and ethanol on the expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG), key bone remodeling biomarkers, during orthodontic tooth movement.

METHODS

A laboratory experimental study was conducted on 30 male Wistar rats divided into three groups: K1 (orthodontic force only), K2 (force + caffeine), and K3 (force + ethanol). Orthodontic force was applied using Ni-Ti coil springs. Caffeine and ethanol were administered orally daily. On days 7 and 14, maxillary tissues were collected and analyzed via immunohistochemistry for RANK and OPG expression. Data were analyzed using One-Way ANOVA and Independent Sample T-tests with significance at pRESULTS

Caffeine and ethanol administration increased RANK and OPG expression compared to controls; however, only the ethanol group showed a significant increase in RANK expression on day 14 (p = 0.044). OPG expression was significantly higher in treatment groups at both time points (pCONCLUSION

Caffeine and ethanol modulate bone remodeling marker expression during orthodontic force application, with ethanol significantly increasing RANK expression at later stages. Further studies are needed to clarify the clinical implications for orthodontic treatment.

Animals ; Tooth Movement Techniques ; Tooth Movement ; Osteoprotegerin ; Role ; Movement ; Ethanol ; Bone Remodeling ; Caffeine ; Immunohistochemistry

Hyalinizing clear cell carcinoma of the salivary gland is a rare neoplasm, accounting for only less than 1% of malignancies arising from the salivary gland. It is molecularly defined by the expression of the EWSR-ATF1 fusion oncogene. To date, there has been no previous studies published yet in the Philippines regarding the existence of this tumor. In this paper, we present a case of a 70-year-old elderly female who had a 10-year history of a gradually enlarging left lateral neck mass. Histopathologic examination showed a tumor arranged of cords, nests, and trabeculae of monomorphic round cells with abundant clear to lightly eosinophilic cytoplasm surrounded by thick hyalinized collagen bundles. Immunohistochemistry and molecular studies were done which revealed a positive p63 staining, negative SMA and S100, and an EWSR1 rearrangement in Fluorescence in situ hybridization (FISH), thus, confirming the diagnosis.

Human ; Female ; Aged: 65-79 Yrs Old ; Carcinoma ; Immunohistochemistry

BACKGROUND

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Classification of DLBCL is often based on the cell of origin (COO), distinguishing between germinal center B-cell (GCB) and non-GCB subtypes. Although not yet recognized as a distinct entity by the World Health Organization (WHO), double expressor lymphoma (DEL), characterized by the co-expression of c-MYC and BCL2, carries an unfavorable prognosis for a subgroup of DLBCL patients. Another entity is the so-called high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-hit/triple-hit lymphomas) diagnosed through fluorescent in-situ hybridization (FISH) analysis.

OBJECTIVE

This study aimed to determine the clinicopathologic profile and survival outcomes of Filipino DLBCL patients at the Philippine General Hospital (2016-2021), comparing double-hit versus non-double-hit and doubleexpressor versus non-double-expressor lymphomas, and assessing concordance between FISH-measured double-hit and IHC-measured double-expressor statuses.

METHODS

This is a single-arm, retrospective cohort study involving all surgical pathology cases signed out, with the aid of immunohistochemistry (IHC) studies, as NHL DLBCL, GCB, or non-GCB subtype, from 2016 to 2021. A second panel of IHC studies and FISH analysis using tissue microarray was subsequently done. Most cases exhibited a nonGCB subtype and were classified as DEL on second IHC panel. Five out of eleven DEL cases were reclassified as double hit lymphoma (DHL).

RESULTS

Clinically, most patients with these lymphomas present at age 60 years and below, exhibit B symptoms, with elevated serum lactate dehydrogenase (LDH) levels, at least stage III-IV disease at diagnosis, and possess a high International Prognostic Index (IPI) score, collectively indicating a poor prognosis.

CONCLUSION

Survival outcomes for patients with DLBCL ranges from three to 37 months. All cases of mortality were associated with DEL, contrasting with DHL cases which had variable outcomes. Due to limited sampling, statistical significance of the results cannot be determined. A comprehensive evaluation is essential to the diagnosis of DLBCL and DHL to include a complete immunohistochemistry panel and molecular testing, notably with FISH studies.

Human ; Lymphoma ; Lymphoma, Large B-cell, Diffuse ; Immunohistochemistry ; Cytogenetics

BACKGROUND AND OBJECTIVE

Anatomical education utilizes mainly cadaver dissection, but it also depends on innovations such as novel preservation techniques, simulation models, and virtual dissection apps. There is no review on anatomical patents. This study aimed to review the worldwide landscape of existing patents on anatomical education to identify gaps and opportunities for utilization and further innovations.

METHODS

We conducted a scoping review for inventions, utility models, and industrial design applications on anatomical education. We searched the following databases as of December 31, 2022 (WIPO Patentscope, Espacenet, and Derwent). We deduplicated the records, screened them for eligibility, and extracted information on characteristics of the patent application and applicant. We computed frequency and percentage according to country, type of applicant, number of inventors, type of patent, scope of patent, purpose of patent, organ system, status of patent, and time to patent granting.

RESULTS

Out of 667 merged records from the initial search, we removed 312 duplicates, excluded 97 records, and included 258 reports in the review. The median number of patent applications per year was 58 (range, 32, 61). Majority of the applications were from China and USA (36.0 and 34.9%, respectively), national in scope (62.8%), industry as applicant (49.6%), inventions (77.5%), usable beyond anatomy (70.9%), physical models (53.1%) and with pending status (63.6%). The median time to granting for 65 patents was 316 days (range, 40 to 1568).

CONCLUSION

For the period 2018-2022, there were 258 patent applications related to anatomical education, both as a basic science and in clinical applications, were mostly inventions, applied for by industry, contributed by US and China, only national in scope, physical 3D models (mostly musculoskeletal, head/neck and sensory organs, and whole body), and usable beyond basic anatomy. The majority of patent applications are still pending with only 65 granted patents. Plastinated specimens, and the urinary, reproductive, and pulmonary organ system models were least represented.

Intellectual Property ; Patent ; Inventions ; Review ; Anatomy ; Education ; Training

BACKGROUND

The COVID-19 pandemic resulted in the lack of traditional cadaveric dissection among first year medical students in Anatomy courses in the University of the Philippines College of Medicine. The Learning Enhancement in Anatomy Program (LEAP) was implemented as a bridging program to enhance knowledge and understanding of gross anatomy and histology. As part of this program, a novel multi-strategy teaching method was conducted for the Integumentary and Musculoskeletal Anatomy Module.

OBJECTIVE

This case study described a novel multi-strategy teaching method on Integumentary and Musculoskeletal anatomy for first year medical students which was done after the COVID-19 pandemic wherein there was a shortage of cadavers. By describing this multi-strategy teaching method, this case study aims to present a potential alternative teaching method in a situation where there is an unexpected shortage of human cadavers.

METHODS

A retrospective review of documents related to this teaching method among first year medical students at the University of the Philippines College of Medicine was conducted from November 15, 2023, to January 15, 2024. The novel teaching method for the Integumentary and Musculoskeletal station was taught using five different methods: proctor demonstration, a prosected lower extremity with a self-directed manual, dissection education videos viewed on a large screen, skeletons for osteology, and individual light microscopes with a self-directed laboratory histology manual. We described the data and analyzed according to strengths and limitations, and formulated recommendations to improve the module.

RESULTS

The Integumentary and Musculoskeletal Module of the LEAP provided an interactive, hands-on experience in anatomy education. The five-pronged method facilitated a multifaceted approach to learning through cadaveric prosections, self-directed manuals, dissection videos, osteology exercises, and microscopic study. There was active engagement, overall positive student feedback, and increased post-test scores. However, certain limitations, such as the lack of direct cadaveric dissection, potential underutilization of histology components, and reliance on faculty guidance, highlight areas for improvement.

CONCLUSION

The Integumentary and Musculoskeletal Module of the LEAP has demonstrated significant strengths in enhancing anatomical education through a multimodal approach that fosters active learning, improves knowledge retention, and provides a structured curriculum adaptable to various resource constraints. Student feedback and test performance support the effectiveness of the module, particularly in gross anatomy. Addressing challenges in future iterations will be crucial in refining the program and expanding its applicability to different educational contexts. By building on its strengths and mitigating its weaknesses, this five-pronged method can continue to serve as a model for innovative and effective anatomy education. 

Human ; Education, Medical ; Histology

Gliomatosis peritonei (GP) is a condition characterized by the dissemination of mature glial tissues throughout the peritoneal cavity. It is usually associated with immature ovarian teratoma but presents with mature cystic teratoma (MCT) in 1% of cases. GP, associated with MCT, is a benign disorder. The majority of cases remain asymptomatic and rarely recur. Here, we present a case of a 22-year-old woman with a history of abdominal enlargement and severe abdominal pain who underwent exploratory laparotomy, peritoneal fluid cytology, bilateral salpingo-oophorectomy, appendectomy, omental biopsy, and Jackson-Pratt drain insertion with histopathologic result of GP with MCT. A month later, the patient had a recurrence of abdominal enlargement, necessitating a second surgery. Immunohistochemistry for histopathologic evaluation and diagnostic imaging are crucial in confirming the diagnosis and guiding the treatment strategy. A multidisciplinary team approach in monitoring and comprehensive support is significant in optimizing outcomes for patients with aggressive GPs associated with MCT. Further research and clinical experience are essential to establish a standardized guideline to improve the management and clinical outcome of this condition.

Human ; Female ; Young Adult: 19-24 Yrs Old ; Salpingo-oophorectomy ; Peritoneal Cavity ; Appendectomy ; Abdominal Pain ; Ascitic Fluid ; Immunohistochemistry

This study explored how the human cortical folding pattern composed of convex gyri and concave sulci affected single-subject morphological brain networks, which are becoming an important method for studying the human brain connectome. We found that gyri-gyri networks exhibited higher morphological similarity, lower small-world parameters, and lower long-term test-retest reliability than sulci-sulci networks for cortical thickness- and gyrification index-based networks, while opposite patterns were observed for fractal dimension-based networks. Further behavioral association analysis revealed that gyri-gyri networks and connections between gyral and sulcal regions significantly explained inter-individual variance in Cognition and Motor domains for fractal dimension- and sulcal depth-based networks. Finally, the clinical application showed that only sulci-sulci networks exhibited morphological similarity reductions in major depressive disorder for cortical thickness-, fractal dimension-, and gyrification index-based networks. Taken together, these findings provide novel insights into the constraint of the cortical folding pattern to the network organization of the human brain.
Humans ; Cerebral Cortex/anatomy & histology* ; Male ; Female ; Magnetic Resonance Imaging ; Adult ; Connectome/methods* ; Young Adult ; Nerve Net/anatomy & histology* ; Neural Pathways ; Depressive Disorder, Major/diagnostic imaging*