bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotic reconstruction of necrosed ileal ureter: Technical challenges, intra-operative difficulty, and learning points
Authors: Aggarwal Deepanshu , Kalra Sidhartha , Dorairajan Lalgudi Narayanan , Sreerag K S , Thakor Poojan 
Published: April 2024

ABSTRACT
This video explores the challenges faced during a re-do robotic intra-corporeal ileal ureter reconstruction in a previously operated case. A 24-year-old woman presented with a 12-cm long stricture after robotic ileal ureter replacement surgery. A proper preoperative evaluation in the form of ureteroscopy and a nephrostogram is essential and the key steps include adhesiolysis, identification of the necrotic ileal ureter, and meticulous dissection. A 13-cm long segment of the ileum was isolated and was anastomosed to the renal pelvis and the bladder. The surgery lasted for 420 min with 300 ml of blood loss. Post-operatively, the patient recovered well and had a normal drainage with no complications at 1-year of follow-up. The factors such as a broad mesentery, a tension-free anastomosis, and avoiding the twisting of the pedicle are crucial for success of robotic ileal ureter replacement surgery.
Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case
Authors: Hage Lory , O’Donnell Michael A , Abou Chakra Mohamad , Kime Amel , Sibony Mathilde , Peyromaure Michaël , Duquesne Igor 
Published: April 2024

ABSTRACT

Introduction:
Inflammatory myofibroblastic tumors (IMTs) are intermediate-grade lesions that frequently recur and rarely metastasize. There are currently no guidelines on the management of bladder IMTs. This systematic review aims to describe the clinical presentation and compare the management options for bladder IMTs.

Methods:
A PubMed/Medline search was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the following Mesh terms: (“inflammatory myofibroblastic”) AND (“tumor”) OR (“tumor”) AND (“bladder”) AND (“case report”). A total of 75 case reports were included in the analysis.

Results:
The mean age of the patients was 36 years. 65% of the cases initially presented with hematuria. 68% of the tumors stained positive for anaplastic lymphoma kinase, and 20% invaded the muscularis. Patients underwent either transurethral resection of the bladder tumor (TURBT) only (34%), TURBT followed by complementary partial cystectomy (16%), or TURBT followed by radical cystectomy (4%). 36% and 9% of the cases underwent partial and radical cystectomy after the initial diagnosis, respectively. Cystectomies were performed using an open (74%), laparoscopic (14%), robotic-assisted (10%), or unknown (2%) approach. At a mean follow-up of 14 months, the recurrence and metastasis rates were about 9% and 4%, respectively. In addition, we present the case of a 49-year-old woman with a bladder IMT who underwent TURBT followed by laparoscopic partial cystectomy. The patient remains tumor free postoperatively (follow-up period of 12 months).

Conclusion:
A complete surgical excision of the bladder IMT is crucial for the optimal management of these cases. Proper differentiation of this tumor from sarcoma or leiomyosarcoma leads to the best outcomes.
Accuracy of Transthoracic Echocardiography in Detecting Persistent Left Superior Vena Cava against the Cardiac Computed Tomography Scan
Authors: Rakholia Dishant , Kanpariya Arpita , Ganjiwale Jaishree , Patel Viral , Trivedi Bhadra 
Published: April 2024

Abstract

Introduction:
Detection of the persistent left superior vena cava (LSVC) is essential to diagnosing pediatric congenital heart diseases (CHDs). Transthoracic echocardiography is the most commonly used diagnostic tool for CHDs. This study compares transthoracic echocardiography and cardiac computed tomography (CT) to detect LSVC.

Methods:
Retrospective review of 49 pediatrics patients with CHDs who underwent echocardiography and cardiac CT.

Results:
Forty-nine pediatric patients with CHDs who underwent CT scans were included. In acyanotic CHD patients, CT identified four with bilateral superior vena cava (SVC), while echocardiography picked up three and missed one. In the remaining 16 patients with acyanotic CHDs, CT found single right-sided SVC; however, two of these were misidentified as having bilateral SVC during echocardiography. In the cyanotic CHD group, four patients had bilateral SVC. All four were picked up by echocardiography as well. However, echocardiography diagnosed one additional patient as having bilateral SVC, while the patient actually had a single SVC on CT scan.

Conclusion:
Transthoracic echocardiography can reasonably detect persistent LSVC in pediatric CHD patients.
Pragmatic algorithm for management of common bile duct calculi in resource-limited settings in India
Authors: Mehendale Vinay Gangadhar , Kamdar Manoj S. , Shenoy Sharad Narayan 
Published: April 2024

Abstract

Introduction:
Endoscopic retrograde cholangiopancreatography (ERCP) facilitates the removal of common bile duct (CBD) calculi by endoscopy. When ERCP fails, exploration of CBD is required for the clearance of CBD calculi. The optimum way for the exploration of CBD is by choledochoscopy. Dedicated flexible or rigid choledochoscopes are expensive and available only in few places in India. Since 1991, we subjected patients with suspected CBD calculi to ERCP, followed by laparoscopic cholecystectomy (LC). Patients in whom ERCP failed to clear CBD were subjected to open exploration of CBD using any easily available, suitable, straight rigid scope for choledochoscopy.

Patients and Methods:
Since March 1991, out of 8866 patients with cholelithiasis, 862 underwent ERCP. Ninety-six patients in whom ERCP failed to clear CBD underwent open exploration of CBD. In each case of exploration of CBD, choledochoscopy was performed using a straight rigid scope, either a cystoscope, paediatric cystoscope, hysteroscope or 5-mm laparoscopy telescope with a 5-mm cannula.

Results:
The CBD clearance was complete in 95 patients, and one patient had an impacted calculus at the ampulla. CBD explorations were followed by choledochoduodenostomy, T-tube placement or suturing of choledochotomy. No residual calculi were observed after such exploration.

Conclusion:
From our results, we advocate the following algorithm for CBD calculi in resource-limited settings. Subject patients with CBD calculi to ERCP followed by LC. In case of failed ERCP, open exploration of CBD with choledochoscopy using any suitable rigid scope. Dedicated flexible or rigid choledochoscope is not essential. This approach is cost-effective and successful.
Assessing the educational value of laparoscopic radical nephrectomy videos on YouTube®: A comparative analysis of short versus long videos
Authors: Baturu Muharrem , Öztürk Mehmet , Bayrak Ömer , Erturhan Sakıp , Seckiner Ilker 
Published: April 2024

Abstract

Introduction:
To evaluate the quality of laparoscopic radical nephrectomy videos and determine the extent to which they are informative and educational for healthcare professionals.

Patients and Methods:
We used the YouTube® search engine to search for the term ‘laparoscopic radical nephrectomy’ with time filters of 4–20 min (Group 1) and >20 min (Group 2) and then sorted the results uploaded chronologically before January 2023. One hundred videos were analysed for each group. The reliability of the videos was assessed using the Journal of American Medical Association (JAMA) Benchmark Criteria and DISCERN questionnaire scores (DISCERN). Educational quality was assessed using the Global Quality Score (GQS) and a 20-item objective scoring system (OSS) for laparoscopic nephrectomy. The popularity of the videos was evaluated using the video power index (VPI).

Results:
The mean video duration was 8.9 ± 4.3 min in Group 1 and 52.02 ± 31.09 min in Group 2 (P < 0.001). The mean JAMA (2.49 ± 0.61) and OSS scores (60 ± 12.3) were higher in Group 2 than in Group 1, while no significant difference was observed in the mean GQS (2.53 ± 0.7, 2.39 ± 0.88, respectively) between the groups (P < 0.001, P = 0.039, P = 0.131, respectively).

Conclusion:
While the standardisation of surgical videos published on YouTube® and the establishment of auditing mechanisms do not seem plausible, high total OSS, periprocedural OSS, and VPI scores, and high OSS, JAMAS, GQS and DISCERN scores in long videos indicate that such videos offer a greater contribution to education.
The effect of upper transabdominal plane block on diaphragm thickness in adult patients after laparoscopic cholecystectomy operation
Authors: Uyar Sami , Tire Yasin , Kozanhan Betul 
Published: April 2024

Abstract

Introduction:
In this prospective and observational study, our objective was to examine the impact of subcostal transversus abdominis plane (SubTAP) block, along with intravenous analgesia techniques, on diaphragm thickness and post-operative pain following laparoscopic cholecystectomy.

Patients and Methods:
This study examined laparoscopic cholecystectomy patients aged 18–60 years with an American Society of Anesthesiologist score of 1–2. This study divided patients into Group 1 for SubTAP block and Group 2 for intravenous analgesia. This study had 67 patients, at least 30 from each group. Thus, diaphragm thicknesses and Visual Analogue Scale (VAS) values were compared between regional anaesthesia and intravenous analgesia groups.

Results:
Pre-operative data showed no statistically significant changes between the groups, although post-extubation inspiratory thickness was closer to baseline in Group 1 patients who received regional block. The groups had different outcomes after extubation and at the post-operative 30th min (P = 0.028 and P = 0.001, respectively). There was also a significant difference in post-operative oxygen saturation and VAS scores (P = 0.001). Our receiver operating characteristic analysis determined that the threshold values for VAS parameters of 2 or 3 were 0.28 cm in inspiration, 0.18 cm in expiration and 1.29 as i/e ratio. Significant discomfort was defined as diaphragm parameter values below these limits.

Conclusions:
We found that the earlier return of diaphragmatic functions to baseline was associated with diaphragm thickness. According to the measurements made in the post-operative care unit, the regional block group effectively prevented the loss of diaphragm function.
In vitro and in vivo assessment of indomethacin-induced genotoxicity: protection by curcumin
Authors: Zamani Ehsan , Klour Reza Alipour , Shekarsarayi Amirreza Gholami , Ghazizadeh Foad , Evazalipour Mehdi 
Published: April 2024

Background and purpose:
Indomethacin is one of the most widely used non-steroidal anti-inflammatory drugs. This study aimed to investigate the protective effects of curcumin against indomethacin-induced genotoxicity.

Experimental approach:
For in vitro studies, human peripheral blood lymphocytes were obtained from a healthy volunteer and treated for 24 h as follows: vehicle control, indomethacin at 100 and 200 μΜ, indomethacin (100 μM and 200 μM) plus curcumin (27 μM). For in vivo experiments, mice received a single i.p dose of curcumin (100 mg/kg) and after 30 min genotoxicity induction was carried out by a single i.p injection of indomethacin at 10, 20, and 40 mg/kg. After 24 h, bone marrow cells were obtained from mice femurs. Genotoxicity was evaluated using a micronucleus assay. Oxidative damage was also inspected both in vitro and in vivo.

Findings/Results:

In-vitro studies indicated that co-treatment with curcumin caused a significant decrease in the average micronuclei percentage and MDA level, and a significant increase in GSH concentration compared to the groups treated only with indomethacin. In-vivo findings revealed that pretreatment with curcumin induced a significant increase in the average ratio of polychromatic erythrocyte/normochromic erythrocyte, GSH concentration and caused a significant decrease in the average percentage of micronuclei and MDA level, in comparison with the group treated only with indomethacin.

Conclusion and implications:
Curcumin attenuated indomethacin-induced genotoxicity both in vitro and in vivo. These effects might be partially exerted by decreasing oxidative stress. Further studies are required to elucidate the exact genoprotective mechanism of curcumin against indomethacin.
Carbon nanotubes induce cytotoxicity and apoptosis through increasing protein levels of Bax and ROS in mouse skin fibroblasts
Authors: Nazeri Zahra , Zarezade Vahid , Jamalan Mostafa , Cheraghzadeh Maryam , Azizidoost Shirin , Kheirollah Alireza 
Published: April 2024

Background and purpose:
Carbon nanotubes (CNTs) are a significant discovery in nanotechnology, with widespread applications in modern technology. However, there are concerns about their potential toxicity, particularly in skin cells. This study aimed to investigate the mechanisms by which CNTs induced cytotoxicity and apoptosis in mouse skin fibroblasts.

Experimental approach:
The mice skin fibroblasts were isolated and exposed to two types of CNTs at various concentrations and then analyzed for changes in viability, reactive oxygen species (ROS) production, the levels of Bcl-2-associated X protein (Bax), and lactate production.

Findings/Results:
The results demonstrated that CNTs reduced cell viability and increased ROS production in a dose-dependent manner. Additionally, the current study found that CNTs increased the protein levels of Bax, a pro-apoptotic protein, in mouse skin fibroblasts. Furthermore, it was observed a significant decrease in lactate production in cells exposed to CNTs.

Conclusion and implications:
The findings concluded that CNTs have the potential to be toxic substances for skin fibroblasts, which serve as the body's first line of defense. This is evidenced by their ability to increase the production of ROS and the protein levels of Bax, as well as reduce lactic acid levels. As lactic acid has been reported to have beneficial effects on skin collagen production, further studies are needed to fully understand the impact of carbon nanotube exposure on human skin health.
The protective effect of Thai rice bran on N-acetyl-ρ-aminophen-induced hepatotoxicity in mice
Authors: Wanyo Pitchaporn , So-In Charinya 
Published: April 2024

Background and purpose:
N-acetyl-ρ-aminophen (APAP) is a widely used medication with analgesic and antipyretic characteristics. High paracetamol doses can damage the liver. Thai-pigmented rice may treat numerous liver disorders due to its antioxidant, anti-inflammatory, and glutathione-restoring capabilities. This study aimed to evaluate the phenolic components in three Thai rice bran extracts and their antioxidant and hepatoprotective activities in an animal model.

Experimental approach:
Fifty male mice were randomly assigned to the control and APAP studies. Each study was divided into 5 groups (n = 5) treated with distilled water, Hom Mali, Hang-Ngok, and Hom Nil (HN) rice compared with N-acetylcysteine with/without 60 mg/kg/day of APAP orally once a day for two weeks. Blood and liver sampling were collected for analysis.

Findings/Results:
HN rice bran exhibited higher contents of total phenolic, total flavonoid, total anthocyanin, ferric-reducing antioxidant, and 1,1-diphenyl-2-picrylhydrazyl radical scavenging activities than Hom Mali and Hang-Ngok. Anthocyanin was merely detected in HN. Following APAP administration, mice exhibited significant increases in hepatic enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), pro-inflammatory cytokines (tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)), and malondialdehyde (MDA), but lower levels of antioxidant enzymes and glutathione profiles. Amongst the three cultivars, HN rice was the only compound that decreased MDA, ALT, AST, TNF-α, and IL-6 while increasing antioxidant enzyme activity such as superoxide dismutase, catalase, and glutathione peroxidase that was very close to that of N-acetylcysteine groups.

Conclusion and implications:
Given the hepatoprotective and antioxidant properties, HN has the potential to be used as a health supplement.
Effects of extracts and manna of Echinops cephalotes on impaired cognitive function induced by scopolamine in mice
Authors: Sadeghi Giti , Dinani Masoud Sadeghi , Rabbani Mohammad 
Published: April 2024

Background and purpose:Alzheimer’s disease (AD) is a neurodegenerative disease specified by chronic and irreversible destruction of neurons. This study aimed to evaluate the effects of different extracts (aqueous, hydroalcoholic, hexane, and ethyl acetate) and manna ofEchinops cephalotes(EC) on impaired cognitive function induced by scopolamine in mice. EC is shown to have anti-cholinesterase-butyrylcholinesterase activities.Experimental approach:In this study, aqueous and hydroalcoholic extracts, hexane and ethyl acetate fractions of EC (25, 50, 100 mg/kg, i.p.), and the manna (25, 50, 100 mg/kg, gavage) were administered for 14 days alongside scopolamine (0.7 mg/kg, i.p.). Rivastigmine (reference drug) was administered for 2 weeks i.p. Mice were tested for their memory function using two behavioral models, object recognition test (ORT) and passive avoidance test (PAT).Findings/Results:Administration of scopolamine significantly impaired memory function in both behavioral models. In the PAT model, all extracts at 50 and 100 mg/kg significantly reversed the effect of memory destruction caused by scopolamine. At a lower dose of 25 mg/kg, however, none of the extracts were able to significantly change the step-through latency time. In the ORT model, however, administration of all extracts at 50 and 100 mg/kg, significantly increased the recognition index. Only the manna and the aqueous extract at 25 mg/kg were able to reverse scopolamine-induced memory impairment.Conclusions and implications:These results suggest that all forms of EC extracts improve memory impairment induced by scopolamine comparably to rivastigmine. Whether the effects are sustained over a longer period remains to be tested in future work.
The effect of redox bacteria on the programmed cell death-1 cancer immunotherapy
Authors: Nejati Majid , Soheili Masoud , Salami Mahmoud , Khedri Mostafa 
Published: April 2024

Background and purpose:
Extracellular electron transferring (EET) or redox bacteria employ a shuttle of flavins to transfer electrons to the oxygen in the intestinal mucosa. Although clinical studies suggest that the gut microbiome modulates the efficiency of immune checkpoint therapy in patients with cancer, the modulation mechanisms have not been well-characterized yet.

Experimental approach:
In the present study, the oral gavage administration of Shewanella oneidensis MR-1 as a prototypic EET bacteria was assayed in a mouse model of lung cancer to determine the effect of EET bacterium on the efficacy of the programmed cell death protein 1 (PD1)-immune checkpoint therapy.

Findings/Results:
It was indicated that in vitro EET from S. oneidensis was mediated by riboflavins that were supplied through extrinsic sources. Co-administration of S. oneidensis and anti-PD 1 antibodies represent better tumor remission compared to the single-administration of each one; however, no statistically significant change was observed in the tumor volume.

Conclusion and implications:
More detailed studies are needed to definitively confirm the therapeutic effects of electrogenic bacteria in patients with cancer. Given the findings of the present study, increasing flavin compounds or EET bacteria in the intestine may provide novel strategies for modulating cancer immunotherapy.
Curcuma longa extract inhibits migration by reducing MMP-9 and Rac-1 expression in highly metastatic breast cancer cells
Authors: Hermansyah Dedy , Paramita Desiree Anggia , Muhar Adi Muradi , Amalina Nur Dina 
Published: April 2024

Background and purpose:
Highly metastatic breast cancer is a population of cancer cells that has metastasized to other organs in the body leading to apoptosis resistance. It was reported that MDAMB-231 cells contain lower levels of reactive oxygen species associated with metastatic capability. Curcuma longa (CL) possesses cytotoxic effects in several cancer cells including metastatic breast cancer cells. This study aimed to investigate the effect of CL-inhibited cell migration in highly metastatic breast cancer MDAMB-231 cells.

Experimental approach:
CL was extracted under maceration with methanol. The cytotoxic effect on single and combination treatment of CL was assessed through the MTT assay. Migration analysis was evaluated using scratch wound healing assay, MMP-9 expression by gelatine zymography, Rac-1, and MMP-9 gene expression using Real-Time Quantitative Reverse transcription polymerase chain reaction (qRT-PCR). The apoptosis induction was analyzed through Bax gene expression and Bcl-2 protein expression.

Findings/Results:
We found that CL inhibits the growth of MDAMB-231 cells, induces Bax gene expression, and suppresses Bcl-2 expression in a dose-dependent manner. Moreover, cancer cell migration was suppressed by the presence of CL. qRT-PCR and gelatine zymography assay showed that CL downregulates Rac-1 and MMP-9 gene expression.

Conclusion and implications:
CL could inhibit the growth and migration of highly metastatic breast cancer cells by reducing the Rac-1 gene expression and regulating apoptosis protein expression.
Antioxidant and hepatoprotective activities of Juniperus excelsa M. Bieb against bile duct ligation-induced cholestasis
Authors: Akbari Ghaidafeh , Abasi Mohammad Reza , Gharaghani Maral , Nouripoor Sadegh , Shakerinasab Nasrin , Azizi Mahdokht , Salahi Marjan , Karimi Farzaneh , Eftekhari Mahdieh , Razmjoue Damoun , Doustimotlagh Amir Hossein 
Published: April 2024

Background and purpose:
Cholestasis is caused by a malfunction of the biliary liver system. Oxidative stress plays an essential role in the progression of cholestasis. This study aimed to investigate the antioxidant and hepatoprotective effects of ethanolic extract of Juniperus excelsa M. Bieb (JE) fruits on hepatic impairment induced by bile duct ligation (BDL) in rats.

Experimental approach:
Forty male Wistar rats were randomly divided into 4 groups; sham control + vehicle (SC), BDL + vehicle (BDL), BDL + JE extract (BDL + JE), and SC + extract (SC + JE). One day after surgery, the animals were treated with vehicle or ethanolic extract of JE (500 mg/kg/day) for 7 days. Finally, the blood was taken for biochemical and oxidative stress analysis. Furthermore, the liver tissue of rats was removed for histological examination.

Findings/Results:
Treatment with the extract of JE decreased the ALP level, whereas it enhanced total protein content compared to the BDL group. Also, JE increased the activity of SOD and GPx, as well as FRAP content compared to the BDL group; while it did not significantly affect the levels of MDA and inflammation markers. However, JE could not improve BDL-induced histopathological alterations in hepatic tissue.

Conclusion and implication:
This study demonstrated that JE may be useful as an adjuvant therapy by attenuating ALP activity, increasing serum total protein and FRAP content, as well as improving the antioxidant enzymes activity of SOD and GPx. However, further research is warranted to explore the other underlying mechanisms of action.