Background: Proteomics and genomics studies have contributed to understanding the pathogenesis of chronic obstructive pulmonary disease (COPD), but previous studies have limitations. Here, using a machine learning (ML) algorithm, we attempted to identify pathways in cultured bronchial epithelial cells of COPD patients that were significantly affected when the cells were exposed to a cigarette smoke extract (CSE). Methods: Small airway epithelial cells were collected from patients with COPD and those without COPD who underwent bronchoscopy. After expansion through primary cell culture, the cells were treated with or without CSEs, and the proteomics of the cells were analyzed by mass spectrometry. ML-based feature selection was used to determine the most distinctive patterns in the proteomes of COPD and non-COPD cells after exposure to smoke extract.Publicly available single-cell RNA sequencing data from patients with COPD (GSE136831) were used to analyze and validate our findings. Results: Five patients with COPD and five without COPD were enrolled, and 7,953 proteins were detected. Ferroptosis was enriched in both COPD and non-COPD epithelial cells after their exposure to smoke extract. However, the ML-based analysis identified ferroptosis as the most dramatically different response between COPD and non-COPD epithelial cells, adjusted P value = 4.172 × 10−6 , showing that epithelial cells from COPD patients are particularly vulnerable to the effects of smoke. Single-cell RNA sequencing data showed that in cells from COPD patients, ferroptosis is enriched in basal, goblet, and club cells in COPD but not in other cell types. Conclusion Our ML-based feature selection from proteomic data reveals ferroptosis to be the most distinctive feature of cultured COPD epithelial cells compared to non-COPD epithelial cells upon exposure to smoke extract.

Sebaceous carcinoma is a malignant neoplasm frequently classified as periocular or extraocular. Extraocular sebaceous carcinoma is a relatively rare tumor commonly appearing in the head and neck region. Furthermore, extraocular sebaceous carcinoma limited to the epithelium, which is called ‘extraocular sebaceous carcinoma in situ’ is extremely rare with less than 10 cases reported in the literature. Herein, we present the case of a 93-year-old female who diagnosed as extraocular sebaceous carcinoma in situ occurring concurrently with actinic keratosis. In the present case, extraocular sebaceous carcinoma in situ as identified without any connection to an adnexal component but concurrent with actinic keratosis. This case is evidence that extraocular sebaceous carcinoma can arise from the epidermis and the tumor cells of intraepidermal squamous neoplasia can differentiate toward malignant sebocytes.

Sebaceous carcinoma is a malignant neoplasm frequently classified as periocular or extraocular. Extraocular sebaceous carcinoma is a relatively rare tumor commonly appearing in the head and neck region. Furthermore, extraocular sebaceous carcinoma limited to the epithelium, which is called ‘extraocular sebaceous carcinoma in situ’ is extremely rare with less than 10 cases reported in the literature. Herein, we present the case of a 93-year-old female who diagnosed as extraocular sebaceous carcinoma in situ occurring concurrently with actinic keratosis. In the present case, extraocular sebaceous carcinoma in situ as identified without any connection to an adnexal component but concurrent with actinic keratosis. This case is evidence that extraocular sebaceous carcinoma can arise from the epidermis and the tumor cells of intraepidermal squamous neoplasia can differentiate toward malignant sebocytes.

Paradoxical reactions in patients treated with tumor necrosis factor-alpha inhibitors (TNFis) have an estimated prevalence of 1.5% to 5%. Such reactions usually present as psoriasiform eruptions on the trunk and extremities along with palmar and flexural involvement. When affecting the scalp, new-onset psoriasis induced by TNFi can result in non-scarring or scarring alopecia. Although the paradoxical reaction was first reported in 2003, this TNFi-associated psoriatic alopecia (TiAPA) has been recently reported with increasing frequency. This condition is characteristically reversible and requires clinical and histopathological identification from other diseases for proper treatment. The cessation of TNFi therapy may not be mandatory, and decision to continue TNFi therapy depends on the severity of TiAPA and the riskbenefit ratio of treatment modification on the underlying disease. Herein, we report a case of TiAPA in a patient with inflammatory bowel disease whose alopecia improved following suspension of TNFi. We also describe the clinical and histopathological diagnostic criteria based on review of the literature.

A schwannoma is a benign tumor that originates from the peripheral nerve sheath. Schwannomas occur most commonly in the head and neck region involving the brachial plexus and the spinal nerves. The lower limbs are less commonly affected. This paper presents a case of a patient with a schwannoma showing atypical localization at the digital nerve of the foot causing neurological symptoms.
Brachial Plexus ; Foot ; Head ; Humans ; Lower Extremity ; Neck ; Neurilemmoma* ; Peripheral Nerves ; Spinal Nerves ; Toes*

STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
Analgesia ; Analgesia, Patient-Controlled ; Decompression ; Humans ; Injections, Epidural ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Spinal Stenosis ; Vomiting

OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression.SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.

Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer, and gastric cancer. There is evidence that IL-1beta is associated with the development of gastric cancer. Therefore, downregulation of H. pylori-mediated IL-1beta production may be a way to prevent gastric cancer. Withaferin A (WA), a withanolide purified from Withania somnifera, is known to exert anti-inflammatory and anti-tumor effects. In the present study, we explored the inhibitory activity of WA on H. pylori-induced production of IL-1beta in murine bone marrow-derived dendritic cells (BMDCs) and the underlying cellular mechanism. Co-treatment with WA decreased IL-1beta production by H. pylori in BMDCs in a dose-dependent manner. H. pylori-induced gene expression of IL-1beta and NLRP3 (NOD-like receptor family, pyrin domain containing 3) were also suppressed by WA treatment. Moreover, IkappaB-alpha phosphorylation by H. pylori infection was suppressed by WA in BMDCs. Western blot analysis revealed that H. pylori induced cleavage of caspase-1 and IL-1beta, as well as increased procaspase-1 and pro IL-1beta protein levels, and that both were suppressed by co-treatment with WA. Finally, we determined whether WA can directly inhibit ac tivation of the NLRP3 inflammasome. NLRP3 activators induced IL-1beta secretion in LPS-primed macrophages, which was inhibited by WA in a dose-dependent manner, whereas IL-6 production was not affected by WA. Moreover, cleavage of IL-1beta and caspase-1 by NLRP3 activators was also dose-dependently inhibited by WA. These findings suggest that WA can inhibit IL-1beta production by H. pylori in dendritic cells and can be used as a new preventive and therapeutic agent for gastric cancer.
Blotting, Western ; Caspase 1 ; Dendritic Cells* ; Down-Regulation ; Gastritis ; Gene Expression ; Helicobacter pylori ; Helicobacter* ; Humans ; Interleukin-1beta ; Interleukin-6 ; Macrophages ; NF-kappa B* ; Peptic Ulcer ; Phosphorylation ; Stomach Neoplasms ; Withania

A 24-year-old man was admitted due to an incidentally detected mass in his left testis, which showed radiopaque calcification on plain X-ray film. Left orchiectomy was performed, and the resected testis contained a well-demarcated, hard mass measuring 1.1 cm. Histological analysis revealed that the tumor was composed of neoplastic cells, fibrotic stroma, and laminated or irregularly shaped calcific bodies. The individual cells had abundant eosinophilic or clear cytoplasm with round nuclei, each of which contained one or two conspicuous nucleoli. They were arranged in cords, trabeculae, clusters, and diffuse sheets. There were several foci of intra-tubular growth patterns, with thickening of the basal lamina. Immunohistochemically, the neoplastic cells were positive for S-100 protein and vimentin, focally positive for inhibin alpha, and negative for cytokeratin, CD10, and Melan-A. In addition to reporting this rare case, we also review the relevant literature regarding large cell calcifying Sertoli cell tumors.
Basement Membrane ; Cytoplasm ; Eosinophils ; Humans ; Immunohistochemistry ; Inhibins ; Keratins ; MART-1 Antigen ; Orchiectomy ; S100 Proteins ; Sertoli Cell Tumor* ; Testis* ; Vimentin ; X-Ray Film ; Young Adult