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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

World Journal of transplantation 2024年第1期14卷 154-163页

作者： Ameet Kumar Jesrani Syed M Faiq Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan Muhammed Mubarak department of Radiology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Pathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of transplantation Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Urology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term *** and novel ultrasound-based investigations are being increasingly used for this purpose with variable *** To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological *** This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the departments of transplantation and Radiology,Sindh Institute of Urology and transplantation,Karachi,Pakistan,from August 2022 to February *** consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this *** and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic *** The mean age of all patients was 35.32±11.08 *** these,126(81.8%)were males and 28(18.2%)were *** mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 *** allograft biopsy results showed chronic changes in 55(37.66%)*** sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft *** can be of great help during the routine follow-up of kidney transplant recipients for screening a

关键词： Shear wave Sonoelastography Resistive index Chronic allograft changes Biopsy Histopathology

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Reinforcing the management of type 1 gastric esophageal varices

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World Journal of Gastroenterology 2024年第19期30卷 2615-2617页

作者： Zain Majid Ghazi Abrar department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan

Variceal bleed represents an important complication of cirrhosis,with its presence reflecting the severity of liver *** varices,though less frequently seen than esophageal varices,present a distinct clinical challenge due to its higher intensity of bleeding and associated *** upon the Sarin classification,GOV1 is the most common subtype of gastric varices seen in clinical practice.

关键词： Gastric varices Sarin classification Gastroesophageal varices Cyanoacrylate Endoscopic variceal ligation Trans jugular intrahepatic portosystemic shunt

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Chronic active and atrophic gastritis as significant contributing factor to the development of gastric cystica profunda

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World Journal of Gastroenterology 2024年第17期30卷 2308-2310页

作者： Veronika Papp Pál Miheller department of Surgery Transplantation and GastroenterologySemmelweis UniversityBudapest 1082Hungary

Gastric cystica profunda(GCP)is an uncommon but underestimated gastric *** precancerous potential determines its *** addition to previous mucosa injury due to operations,biopsy or polypectomy,chronic active and atrophic gastritis may also lead to the development of *** carefully examining the stomach and taking biopsy samples from the susceptible regions,the stage of atrophy can be *** atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs *** frequently occur close to early gastric cancers(EGCs)or EGC can arise from the cystic *** resection is an effective and minimally invasive treat-ment in GCP.

关键词： Gastric cystica profunda Chronic active gastritis Atrophic gastritis Operative Link for Gastritis Assessment staging Early gastric cancer Endoscopic resection

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TPOL triggers apoptosis with mitochondrial injury through activating a ROS-dependent p53/p21/p27/Rb/Bax/Cyto C/caspase-mediated signaling

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中国病理生理杂志 2024年第8期40卷 1488-1496页

作者： CHENG Zongwei ZENG Boning XING Feiyue department of Immunobiology Institute of Tissue Transplantation and ImmunologyJinan UniversityGuangzhou 510632China

AIM:To explore the influence of ethyl(2,4,6-trimethylbenzoyl)phenylphosphinate(TPOL)on cell apoptosis and its potential ***:HEK293T cells sensitive to TPOL were treated with different concentrations of TPOL with or without exposure to light radiation,before treatment with various inhibitors,N-acetyl-Lcysteine(NAC),pifithrin-αand *** viability was measured by CCK-8 *** V/propidium iodide staining was used to count the number of apoptotic ***-DA staining was used to detect reactive oxygen species(ROS)levels,and JC-1 staining was used to assess mitochondrial membrane potential by flow *** expression of apoptosis-related proteins and cell cycle-regulated molecules was measured by Western ***:TPOL enhanced the apoptosis of HEK293T cells in a dose-dependent manner(P<0.05),with a decrease in Bcl-2 and increases in Bax and cytochrome C(Cyto C),followed by up-regulation of activated caspase-9 and caspase-3,and the cleavage of PARP(P<0.05).The TPOL-enhanced cleavage of caspase-3 and PARP was rescued by Z-DVED-FMK(P<0.01).TPOL also led to a rapid increase in ROS,a reduction in mitochondrial membrane potential,and the release of Cyto C(P<0.01),all of which could be reversed by the ROS scavenger ***,the TPOL-caused alterations in p21,p27,Rb,and CDK2 were also recovered by the p53 inhibitor pifithrin-α(P<0.05).The TPOL-induced changes in Bax,Bcl-2,cleaved caspase-9,activated caspase-3,and cleaved PARP were subsequently rescued by pretreatment with pifithrin-α(P<0.05).CONCLUSION:TPOL can induce cellular apoptosis with ROS-mediated mitochondrial membrane damage through the activation of a ROS-dependent p53/p21/p27/Rb/Bax/Cyto C/caspase-mediated signal axis.

关键词： ethyl(2,4,6-trimethylbenzoyl)phenylphosphinate reactive oxygen species mitochondria apoptosis

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Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus Francisco Tustumi Alexandre Chagas Santana Rafael Soares Nunes Pinheiro Daniel Reis Waisberg Liliana Ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino Luiz Augusto Carneiro D’Albuquerque department of Gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phCCC)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,Cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phCCC;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phCCC is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： Liver transplantation Cholangiocarcinoma Liver neoplasms

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Artificial kidney: Challenges and opportunities

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World Journal of transplantation 2024年第1期14卷 42-47页

作者： Filippos F Karageorgos Stavros Neiros Konstantina-Eleni Karakasi Stella Vasileiadou Georgios Katsanos Nikolaos Antoniadis Georgios Tsoulfas department of transplantation Surgery Center for Research and Innovation in Solid Organ TransplantationAristotle University School of MedicineThessaloniki 54642Greece

This review aims to present the developments occurring in the field of artificial organs and particularly focuses on the presentation of developments in artificial *** challenges for biomedical engineering involved in overcoming the potential difficulties are showcased,as well as the importance of interdisciplinary collaboration in this marriage of medicine and *** this review,modern artificial kidneys and the research efforts trying to provide and promise artificial kidneys are *** what are the problems faced by each technology and to what extent is the effort enough to date?

关键词： Artificial kidney Implantable kidney Hemodialysis Peritoneal dialysis Endstage kidney disease

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Liver transplantation as an alternative for the treatment of neuroendocrine liver metastasis: Appraisal of the current evidence

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 146-153页

作者： Philip C.Muller Matthias Pfister Dilmurodjon Eshmuminov Kuno Lehmann department of Surgery and transplantation University Hospital ZurichRämistrasse 100Zurich CH-8091Switzerland

Background:Liver transplantation(LT)for neuroendocrine liver metastases(NELM)is still in *** comparing LT with liver resection(LR)for NELM are scarce,as patient selection is heterogeneous and experience is *** goal of this review was to provide a critical analysis of the evidence on LT versus LR in the treatment of *** sources:A scoping literature search on LT and LR for NELM was performed with PubMed,including English articles up to March ***:International guidelines recommend LR for NELM in resectable,well-differentiated tumors in the absence of extrahepatic metastatic disease with superior results of LR compared to systemic or liver-directed *** liver surgery has extended resectability criteria whilst entailing increased perioperative risk and short disease-free *** highly selected patients(based on the Milan criteria)with unresectable NELM,oncologic results of LT are *** factors include tumor biology(G1/G2)and burden,waiting time for LT,patient age and extrahepatic *** on low-level evi-dence,LT for low-grade NELM within the Milan criteria resulted in improved disease-free survival and overall survival compared to *** benefits of LT were lost in patients beyond the Milan ***:With adherence to strict selection criteria especially tumor biology,LT for NELM is becoming a valuable option providing oncologic benefits compared to *** evidence suggests even stricter selection criteria with regard to tumor biology.

关键词： Liver transplantation Neuroendocrine liver metastases Liver resection Selection criteria Tumor biology

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Pleural empyema with endobronchial mass due to Rhodococcus equi infection after renal transplantation: A case report and review of literature

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World Journal of Clinical Cases 2024年第1期12卷 224-231页

作者： Guo-Fu Liang Sheng Chao Zhou Sun Ke-Jing Zhu Qian Chen Lei Jia Yu-Lin Niu department of Organ transplantation School of Clinical MedicineGuizhou Medical UniversityGuiyang 550025Guizhou ProvinceChina department of Organ transplantation The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550000Guizhou ProvinceChina

BACKGROUND Kidney transplantation is the best option for patients with end-stage renal ***,the need for lifelong immunosuppression results in renal transplant recipients being susceptible to various *** equi(***)is a rare opportunistic pathogen in humans,and there are limited reports of infection with *** in post-renal transplant recipients and no uniform standard of *** article reports on the diagnosis and treatment of a renal transplant recipient infected with *** 21 mo postoperatively and summarizes the charac-teristics of infection with *** after renal transplantation,along with a detailed review of the ***,we present the case of a 25-year-old man who was infected with *** 21 mo after renal *** the clinical features at the time of presentation were not specific,chest computed tomography(CT)showed a large volume of pus in the right thoracic cavity and right middle lung atelectasis,and fiberoptic bronchoscopy showed an endobronchial mass in the right middle and lower lobe *** culture and metagenomic next-generation sequen-cing sequencing of the pus were suggestive of *** *** immunosup-pressive drugs were immediately suspended and intravenous vancomycin and azithromycin were administered,along with adequate drainage of the *** endobronchial mass was then *** the patient’s clinical symptoms and chest CT presentation resolved,he was switched to intravenous ciprofloxacin and azithromycin,followed by oral ciprofloxacin and *** patient was re-hospitalized 2 wk after discharge for recurrence of *** *** recovered after another round of adequate abscess drainage and intravenous ciprofloxacin and *** Infection with *** in renal transplant recipients is rare and complex,and the clinical presentation lacks *** antibiotic therapy is required,and adequate abscess drainage and s

关键词： Kidney transplantation Rhodococcus equi Pleural empyema Pulmonary atelectasis Immunosuppression Case report

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Tumor deposits in axillary adipose tissue in patients with breast cancer:Do they matter?

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World Journal of Clinical Cases 2024年第6期12卷 1045-1049页

作者： Muhammed Mubarak Rahma Rashid Shaheera Shakeel department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

Tumor deposits(TDs)are defined as discrete,irregular clusters of tumor cells lying in the soft tissue adjacent to but separate from the primary tumor,and are usually found in the lymphatic drainage area of the primary *** definition,no residual lymph node structure should be identified in these tumor *** present,TDs are mainly reported in colorectal cancer,with a few reports in gastric *** are very few reports on breast cancer(BC).For TDs,current dominant theories suggest that these are the result of lymph node metastasis of the tumor with complete destruction of the lymph nodes by the tumor *** some pathologists classify a TD as two lymph node metastases for *** pathologists also believe that TDs belong to the category of disseminated ***,regardless of the origin,TDs are an indicator of poor ***,for BC,sentinel lymph node biopsy is generally used at *** radical axillary lymph node dissection should be adopted for BC with TDs in axillary lymph nodes is still *** present commentary of this clinical issue has certain guiding *** is aimed to increase the awareness of the scientific community towards this under-recognized problem in BC pathology.

关键词： Breast cancer Tumor deposits Lymph node metastasis Staging

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Homoharringtonine promotes heart allograft acceptance by enhancing regulatory T cells induction in a mouse model

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Chinese Medical Journal 2024年第12期137卷 1453-1464页

作者： Xia Qiu Hedong Zhang Zhouqi Tang Yuxi Fan Wenjia Yuan Chen Feng Chao Chen Pengcheng Cui Yan Cui Zhongquan Qi Tengfang Li Yuexing Zhu Liming Xie Fenghua Peng Tuo Deng Xin Jiang Longkai Peng Helong Dai Medical College Guangxi UniversityNanningGuangxi 530004China department of Kidney transplantation Center of Organ TransplantationThe Second Xiangya Hospital of Central South UniversityChangshaHunan 410011China National Clinical Research Center for Metabolic Diseases and Department of Metabolism and EndocrinologyThe Second Xiangya Hospital of Central South UniversityChangshaHunan 410011China department of Organ transplantation The Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People’s Hospital)ZhengzhouHenan 450000China

Background:Homoharringtonine(HHT)is an effective anti-inflammatory,anti-viral,and anti-tumor protein synthesis inhibitor that has been applied ***,we explored the therapeutic effects of HHT in a mouse heart transplant ***:Healthy C57BL/6 mice were used to observe the toxicity of HHT in the liver,kidney,and hematology.A mouse heart transplantation model was constructed,and the potential mechanism of HHT prolonging allograft survival was evaluated using Kaplan-Meier analysis,immunostaining,and bulk RNA sequencing *** HHT-T cell crosstalk was modeled ex vivo to further verify the molecular mechanism of HHT-induced regulatory T cells(Tregs)***:HHT inhibited the activation and proliferation of T cells and promoted their apoptosis ex *** of 0.5 mg/kg HHT for 10 days significantly prolonged the mean graft survival time of the allografts from 7 days to 48 days(P<0.001)without non-immune *** allografts had long-term survival after continuous HHT treatment for 28 *** significantly reduced lymphocyte infiltration in the graft,and interferon-γ-secreting CD4^(+)and CD8^(+)T cells in the spleen(P<0.01).HHT significantly increased the number of peripheral Tregs(about 20%,P<0.001)and serum interleukin(IL)-10 *** downregulated the expression of T cell receptor(TCR)signaling pathway-related genes(CD4,H2-Eb1,TRAT1,and CD74)and upregulated the expression of IL-10 and transforming growth factor(TGF)-βpathway-related genes and Treg signature genes(CTLA4,Foxp3,CD74,and ICOS).HHT increased CD4^(+)Foxp3^(+)cells and Foxp3 expression ex vivo,and it enhanced the inhibitory function of inducible ***:HHT promotes Treg cell differentiation and enhances Treg suppressive function by attenuating the TCR signaling pathway and upregulating the expression of Treg signature genes and IL-10 levels,thereby promoting mouse heart allograft *** findings may have therapeutic implications for organ tr

关键词： Heart transplantation Homoharringtonine Immunosuppressive agents T-lymphocytes,Regulatory Graft acceptance

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