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

Abstract Embryonal rhabdomyosarcoma (ERMS) is a primitive and aggressive soft tissue tumor that arises from premature mesenchymal cells and accounts for less than 1% of prostate malignancies. We present the case of a 26-year-old Filipino male who initially sought consultation and work-up for acute urinary retention. Although his prostate-specific antigen (PSA) level was normal, a kidney-ureter-bladder (KUB) ultrasound revealed an incidental finding of an enlarged prostate gland. Subsequent imaging tests (MRI and CT) identified a large, partially exophytic mass on the prostate with intravesical extension. The patient underwent a biopsy via transurethral resection at another institution, which yielded findings of a poorly differentiated carcinoma, primarily suggesting prostatic adenocarcinoma with a Gleason score of 10 (5+5). A request for slide review was submitted to our institution, and subsequent immunohistochemistry (IHC) studies—highlighting the tumor's immunoreactivity to myogenin and desmin—confirmed the diagnosis of ERMS. In this report, we discuss the clinical features, pathogenesis, treatment, diagnosis, and prognosis of this rare prostate tumor.
Embryonal rhabdomyosarcoma ; Immunohistochemistry ; Prostate ; Young adult

OBJECTIVE: To investigate the anthropometric parameters that can accurately predict the diameter of the hamstring tendon graft, and to examine the correlation between disease etiology, duration, and graft diameter. METHODS: A retrospective analysis was conducted on data from 166 patients who underwent anterior cruciate ligament reconstruction using hamstring tendon autografts (semitendinosus and gracilis tendon) between January 2013 and December 2023. The cohort conprised 135 males and 31 females;the age ranged from 14 to 62 years old with an average of (28.87±10.46) years old. Pearson correlation coefficients, partial correlation coefficients, and stepwise multiple linear regression analysis were utilized to elucidate the relationship between the outcome variable (diameter of hamstring tendon grafts) and predictive variables (e.g., height). RESULTS: Correlation analysis revealed significant associations between the diameter of hamstring tendon grafts and height (r=0.379, P<0.001), weight (r=0.225, P=0.002), male gender (r=0.302, P<0.001), age(r=-0.218, P=0.002), and sports injury etiology (r=0.167, P=0.016). No significant correlations were found with surgical side, body mass index (BMI), or injury duration (P>0.05). Stepwise multiple linear regression analysis using a backward elimination method indicated that height was the sole significant predictive variable (R²=0.144, P<0.001), with the optimal predictive equation being:Graft size =2.636+0.029×Height (cm). Partial correlation analysis, after controlling for height, showed no significant association between age, gender, weight, and injury etiology with graft diameter. CONCLUSION Height is an effective predictive factor for the diameter of autologous hamstring tendon grafts. Factors such as gender, age, surgical side, body weight, and BMI are not influential to the diameter of the hamstring tendon grafts. Under the condition of the same height, there is no significant difference in the influence of these factors on the graft diameter. Preoperative physical activity level and the duration of injury do not significantly affect the diameter of the hamstring tendon grafts obtained during surgery. It is recommended to use the formula 'Graft Diameter=2.636 + 0.029 × Height (cm)' for preoperative prediction.
Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Adolescent ; Young Adult ; Transplantation, Autologous ; Anthropometry ; Anterior Cruciate Ligament Reconstruction ; Tendons/anatomy & histology* ; Autografts ; Hamstring Tendons/transplantation* ; Quadriceps Muscle/surgery*

PURPOSE: In surgical procedures commonly employed for the management of scaphoid and distal radial fractures, the incision and dissection of the pronator quadratus muscle play a pivotal role. Nevertheless, comprehensive investigations into the anatomical intricacies of the pronator quadratus muscle have been relatively scarce within the clinical community. In light of this, our study endeavors to make a substantive contribution to the medical literature by conducting a meticulous examination of the morphology and morphometry of this muscle. METHODS: This study is a cross-sectional observational study conducted on 22 cadaveric upper extremities (44 sides) preserved between January 2005 and December 2018 at Istanbul University. The study included specimens with intact dissection areas and no prior surgical intervention. Observations focused on the morphometry of the pronator quadratus muscle and related anatomical structures. Statistical analysis was performed using SPSS v23.0, employing Student's t-test and paired t-test, with significance set at p < 0.05. RESULTS: Significant differences were found in the morphometric measurements of the pronator quadratus muscle between the right and left upper extremities, particularly in the vertical distance between the proximal and distal attachment points of the pronator quadratus to the radius (p = 0.008). Additionally, significant differences were observed between male and female samples for radius length (p < 0.001), ulna length (p < 0.001), pronator quadratus width (p < 0.001), and the vertical distance between pronator quadratus attachment points on both the radius (p = 0.001) and ulna (p = 0.001). Furthermore, significant correlations were identified between radius length and parameters such as the vertical distance between pronator quadratus attachment points on both the radius (p = 0.002) and pronator quadratus width (p = 0.030), and between ulna length and parameters including the vertical distances on the radius (p = 0.001) and ulna (p = 0.024). CONCLUSION In light of our comprehensive analysis, which encompasses not only the anatomical features of the pronator quadratus muscle but also its vascular supply and the organization of its neurovascular structures, we posit that our study holds significant implications for the field of orthopedic surgery. We anticipate that this research will furnish valuable insights that can inform and enhance orthopedic procedures.
Humans ; Female ; Male ; Cross-Sectional Studies ; Muscle, Skeletal/anatomy & histology* ; Cadaver ; Aged ; Middle Aged

PURPOSE: End-stage knee osteoarthritis (OA) patients are the primary candidates for total knee arthroplasty (TKA). However, most morphological refinements of TKA prosthesis are based on anatomical data from the knees of healthy individuals. This study aimed to determine whether differences exist in key bony morphological characteristics of the distal femur and proximal tibia between osteoarthritic knees and healthy knees. METHODS: This was a retrospective cross-sectional observational study with a case-control design. Patients who were aged ≥ 50 years, had no history of trauma, fracture, or surgery in the studied knee, and had no obvious knee flexion contracture were included in this study by CT scans. Patients who met the American College of Rheumatology clinical criteria for knee OA were included in the study group. Kellgren-Lawrence grade III or IV knees were studied (for bilateral cases, the more severely affected knee was chosen). Patients who presented with unilateral knee pain or trauma were included in the control group, with CT scans from the opposite (asymptomatic) knee used for analyzing. The studied knee had a Kellgren-Lawrence grade of 0 or I and showed no abnormalities upon physical examination. Archived knee CT scans from 160 patients were divided into 2 groups: the study group (80 moderate-to-severe OA knees) and the control group (80 healthy knees). After 3-dimensional reconstruction and virtual cutting using a CT workstation, 13 morphological parameters of the distal femur and proximal tibia were compared between the 2 groups using independent-samples t-tests. RESULTS: No significant group differences in the femoral anteroposterior dimension (p = 0.797), height of the lateral femoral condyle (p = 0.268), posterior condylar angle (p = 0.240), tibial anteroposterior dimension (p = 0.536), or tibial lateral anteroposterior dimension (p = 0.702) were observed. However, the femoral mediolateral dimension (p = 0.002), distal femoral aspect ratio (femoral mediolateral dimension/femoral anteroposterior dimension) (p < 0.001), height of the femoral trochlear groove (p < 0.001), height of the medial femoral condyle (p < 0.001), tibial mediolateral dimension (p = 0.001), proximal tibial aspect ratio (tibial mediolateral dimension/tibial anteroposterior dimension) (p = 0.004), tibial medial anteroposterior dimension (p = 0.005), and tibial asymmetry ratio (tibial medial anteroposterior dimension/tibial lateral anteroposterior dimension) (p = 0.006) were all significantly greater in the study group. CONCLUSION Knees with moderate-to-severe OA are significantly wider than healthy knees, and OA is a risk factor for increased tibial platform asymmetry. When refining the morphological parameters of TKA prostheses, the specific bony morphological characteristics of OA knees should be taken into account to reduce the potential risk of femoral or tibial component underhang and facilitate optimal balance between tibial component fit and rotational alignment.
Humans ; Osteoarthritis, Knee/pathology* ; Male ; Female ; Cross-Sectional Studies ; Retrospective Studies ; Arthroplasty, Replacement, Knee ; Middle Aged ; Aged ; Case-Control Studies ; Prosthesis Design ; Knee Prosthesis ; Femur/anatomy & histology* ; Tibia/anatomy & histology* ; Tomography, X-Ray Computed ; Knee Joint/diagnostic imaging*

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

OBJECTIVE: This study aimed to evaluate the relationships of white blood cell (WBC) count, platelet (PLT) count, and PLT-to-WBC ratio (PWR) with muscle mass in Chinese older adults. METHODS: This cross-sectional analysis involved 4,033 Chinese older adults aged ≥ 65 years from the Healthy Ageing and Biomarkers Cohort Study. Muscle mass and total skeletal muscle mass index (TSMI) were measured by bioelectric impedance analysis. WBC, PLT, and PWR were measured using standard methods. Multivariate linear regression was used to examine the associations of WBC count, PLT count, and PWR with TSMI. RESULTS: High WBC count, PLT count, and PWR were associated with low TSMI, with coefficients of -0.0091 (95% confidence interval [ CI]: -0.0142 to -0.0041), -0.0119 (95% CI: -0.0170 to -0.0068), and -0.0051 (95% CI: -0.0102 to -0.0001). The associations between the three inflammatory indices and TSMI were linear. Stratified analyses indicated that the relationship between inflammatory markers and TSMI was more evident in male participants and in individuals aged < 80 years than in their counterparts. CONCLUSION Elevated WBC count, PLT count, and PWR correlated with muscle mass loss. This study highlights the importance of regular monitoring of inflammatory markers as a potential strategy for the screening and management of sarcopenia in older adults.
Humans ; Aged ; Male ; Female ; China ; Leukocyte Count ; Cross-Sectional Studies ; Platelet Count ; Aged, 80 and over ; Muscle, Skeletal/anatomy & histology* ; Independent Living ; Blood Platelets ; Leukocytes ; Sarcopenia

The current low quality of fixed restoration margins is highly correlated with the high incidence of margin-related complications. It is also related to the unclear spatiotemporal geometric position relationship among the consensus definitions of the gingival margin (G), preparation margin (P), and restoration margin (R). This paper discusses the existing problem of the existing term "gingival margin" as a surface anatomical landmark; proposes the term "free gingival margin line" that conforms to geometry and measurement and has importance as a surface anatomical landmark; and clarifies the participants that exist in the marginal area. These participants include the P, R, and G; cementation (adhesive) layer; and gingival sulcus. Moreover, this paper discusses the various iatrogenic damages induced by entering the gingival sulcus via the P, R, and cementing (adhesive) layer. Through the discussion of the design deficiencies of the subgingival and biologically oriented preparation technique, the physiological and clinical importance of the concept of gingival sulcus/gingival sulcus fluid + supercrestal tissue attachment (biological width) = first periodontal protective barrier was analyzed. The value of preserving the physiological role of the gingival sulcus is emphasized. Furthermore, the newly defined RPG distance represents the distance between the successive P or R line and free G line and can be measured in the clinical procedure of tooth preparation. The optimal solution is 0-200 µm, that is, RPG200: the P and R are located on the free G line and the distance between these margins is less than 200 µm. This distance not only has the aesthetic effect of invisibility to the naked eye, it also has a minimal effect on the G and gingival sulcus and is convenient for doctors and patients to clean. Furthermore, in accordance with the positional relationship between the three margins and cementation (adhesive) layer, a new classification of marginal positions is proposed. This classification overcomes the problems of incomplete inclusion objects and uncontrolled risk factors in the previous classification. It also has the advantages of strong practicability, good efficiency of main control geometric quantity, and clear risk control points. The new design scheme and classification of the margi-nal position of RPG200 proposed in this paper provide a new understanding for margin design and complication prevention in the future.
Humans ; Gingiva/anatomy & histology* ; Cementation ; Dental Restoration, Permanent/methods*

OBJECTIVES: Digitally collect data on the preparation space of the molar occlusal surface for full crown restoration and analyze the minimum preparation spaces and areas prone to insufficient preparation. METHODS: A total of 846 molars (excluding third molars) designated for repair with zirconium dioxide crowns were selected. All molars were prepared by using the fixed-depth groove method under visual guidance. A digital impression was collected, and the occlusal surface of the preparation was divided into regions: mesiobuccal area, mesiolingual area, distobuccal area, distolingual area, mesial marginal ridge, and distal marginal ridge. Image measurement software (3Shape Unite) was employed to record the smallest preparation space on the molar occlusal surface, and a space of <1 mm was defined as insufficient preparation. The chi-square test was utilized for the statistical analysis of data. RESULTS: Significant differences were observed in the areas with the smallest preparation space on the occlusal surface of molars across different quadrants (P<0.05). Notably, the area with the smallest preparation space on the occlusal surface of the maxillary first molar was most frequently found in the mesiobuccal area, whereas the smallest preparation spaces on other molars were predominantly located in the distolingual area. The insufficient preparation of the occlusal surface occurred in 41.0% (347 cases) of teeth. The distribution of prone areas corresponded with the distribution of the smallest spatial areas. CONCLUSIONS Although the fixed-depth groove method is employed, the preparation space on the molar surface unavoidably remains uneven under visual guidance. The identification of the areas prone to minimum preparation spaces can serve as a valuable guide for clinicians to prevent insufficient preparation.
Humans ; Molar/anatomy & histology* ; Crowns ; Zirconium