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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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Impact of low-intensity extracorporeal shockwave therapy on vascular parameters and sexual function in patients with arteriogenic erectile dysfunction

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Asian Journal of Andrology 2024年第4期26卷 344-348页

作者： Matteo Rubino Anna Ricapito Marco Finati Ugo G Falagario Pasquale Annese Vito Mancini Gian Maria Busetto Luigi Cormio Giuseppe Carrieri Carlo Bettocchi Andrology Unit Department of Urology and Renal TransplantationUniversity of FoggiaFoggia 71122Italy department of Molecular Medicine and Surgery Karolinska InstitutetStockholm 17177Sweden department of urology Bonomo Teaching HospitalUniversity of FoggiaAndria 76123Italy.

Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy(Li-ESWT).However,the clinical significance of these findings remains unclear,and definitive selection criteria for Li-ESWT based on preexisting comorbidities have yet to be *** was an observational study of 113 patients with ED,evaluated between January 2019 and December 2021 in Andrology Unit at the department of urology and renal transplantation,University of Foggia(Foggia,Italy).Penile dynamic Doppler was performed to evaluate vascular parameters and 5-item version of the International Index of Erectile Dysfunction(IIEF-5)questionnaire was administered to assess the severity of *** was repeated 1 month after *** with a peak systolic velocity(PSV)30 cm s−1 at posttherapeutic penile dynamic Doppler.A clinically significant IIEF-5 score improvement was observed in 7 patients,21 patients,and 2 patients with mild-to-moderate,moderate,and severe pretreatment ED,*** different outcomes were assessed based on smoking habits,previous pelvic surgery,or use of oral phosphodiesterase-5 inhibitor(PDE5i).On the other side,only 1(6.7%)in 15 patients with diabetes mellitus showed an IIEF-5 score improvement after *** treatment determined a significant increase in PSV and correlated IIEF-5 improvement in ED *** advantage seemed particularly evident for moderate ED and was not affected by smoking habits,previous pelvic surgery,and use of ***,diabetic patients did not benefit from the treatment.

关键词： arteriogenic erectile dysfunction International Index of Erectile Function low-intensity extracorporeal shockwave therapy peak systolic velocity

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Early prediction of growth patterns after pediatric kidney transplantation based on height-related single-nucleotide polymorphisms

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Chinese Medical Journal 2024年第10期137卷 1199-1206页

作者： Yi Feng Yonghua Feng Mingyao Hu Hongen Xu Zhigang Wang Shicheng Xu Yongchuang Yan Chenghao Feng Zhou Li Guiwen Feng Wenjun Shang department of renal transplantation The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Precision Medicine center Academy of Medical ScienceZhengzhou UniversityZhengzhouHenan 450052China

Background:Growth retardation is a common complication of chronic kidney disease in children,which can be partially relieved after renal *** study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease(ESRD)after kidney transplantation using machine learning algorithms based on genomic and clinical ***:A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing(WES),and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external *** on previous studies,we comprehensively collected 729 height-related single-nucleotide polymorphisms(SNPs)in exon *** machine learning algorithms and 10-fold cross-validation analysis were employed for model ***:The 110 children were divided into two groups according to change in height-for-age *** univariate analysis,age and 19 SNPs were incorporated into the model and *** random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve(AUC)of 0.924,and also performed well in the external validation cohort(accuracy,0.7949;AUC,0.796).Conclusions:A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning *** model is expected to guide clinicians in the management of children after renal transplantation,including the use of growth hormone,glucocorticoid withdrawal,and nutritional supplementation,to alleviate growth retardation in children with ESRD.

关键词： Growth Machine learning Pediatric kidney transplantation Single-nucleotide polymorphism

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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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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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Curcumin Interferes with TGF-β1-Induced Fibrosis in NRK-49F Cells by Reversing ADAMTS18 Gene Methylation

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Chinese Journal of Integrative Medicine 2024年第7期30卷 600-607页

作者： XU Ben ZHANG Jia-en YE Lin YUAN Chang-wei department of urology Peking University First Hospital and Institute of UrologyPeking UniversityNational Urological Cancer CenterBeijing100034China

Objective To explore the molecular mechanism by which curcumin affects renal interstitial fibrosis(RIF)progression by regulating ADAM metallopeptidase with thrombospondin type 1 motif 18(ADAMTS18)*** NRK-49F cells RIF model were induced with transforming growth factorβ1(TGF-β1).Effects of different concentrations of curcumin(0,10,20,and 30μmol/L)on cell proliferation,cell cycle,cell apoptosis as well as cyclin D1 expression were analyzed by cell counting kit-8,flow cytometry and Western blot,***18 methylation levels were determined by methylation-specific polymerase chain ***18,fibronectin(FN),type I collagen(Col-I)and alpha-smooth muscle actin(α-SMA)mRNA and protein expressions were analyzed by real-time PCR(RT-PCR)and Western blot,***,cells were treated with 50 mmol/L 5-aza-2′-deoxycytidine(5-aza-dC,demethylation agent)for 72 *** of curcumin on extracellular matrix(ECM)deposition was evaluated by immunochemical staining and Western ***-49F cells were transfected with ADAMTS18 small interfering RNA and grouped into a normal control,ADAMTS18-knock-out(KO),and ADAMTS18-KO+30μmol/L curcumin groups,and whether curcumin can reverse the effect of ADAMTS18 knockdown on RIF was *** Compared with the control group,TGF-β1 significantly inhibited the proliferation of NRK-49F cells,blocked the G1/G0 phase,promoted cell apoptosis and inhibited cyclin D1 expression(P<0.01).Among the different concentrations of curcumin,30μmol/L curcumin significantly reversed these processes(P<0.01).Immunochemical staining and Western blot results showed that curcumin significantly inhibited the deposition of FN,Col-I andα-SMA(P<0.01).Curcumin and 5-zaz-dC had synergistic effects,promoting ADAMTS18 expression,removing ADAMTS18 methylation,and reducing ECM ***18 knockdown promoted ECM accumulation,and curcumin reversed this process(P<0.01).Conclusion TGF-β1-induced fibrosis in NRK-49F ***

关键词： renal fibrosis curcumin Chinese medicine ADAMTS18 methylation modification

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Antioxidant treatment for oligoasthenoteratozoospermia and varicocele:a DBPC trial to evaluate the impact of age and body mass index

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Asian Journal of Andrology 2024年第3期26卷 239-244页

作者： Gian Maria Busetto Bernarde F Rodrigues Ashraf Virmani Andrea Checchia Antonella Ninivaggi Anna Ricapito Giovanni Barbieri Piero Fischetti Ugo G Falagario Pasquale Annese Nicola d’Altilia Vito Mancini Matteo Ferro Felice Crocetto Angelo Porreca Carlo Bettocchi Luigi Cormio Ashok Agarwal Giuseppe Carrieri University of Foggia Foggia 71122Italy department of urology and renal transplantation Policlinico of FoggiaFoggia 71122Italy department of urology Human Reproduction SectionFederal University of Sao PauloSao Paulo 05403-000Brazil Alfasigma Healthscience Utrecht 3528 BGThe Netherlands urology Unit “G.Tatarella”HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IEO)IRCCSMilan 20142Italy University of Naples Federico II Naples80126Italy department of Oncological urology Veneto Institute of Oncology(IOV)IRCCSPadua 35039Italy urology Unit “L.Bonomo”HospitalAndria 70031Italy Global Andrology Forum Moreland HillsOH 44022USA

Oxidative stress is one of the main mechanisms responsible for male *** conditions such as varicocele,obesity,advanced age,and lifestyle can lead to an increase in reactive oxygen species,causing an oxidative imbalance in the *** are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizingthe *** reactive oxygen species can affect sperm metabolism,leading to immobility,impaired acrosome reaction,and celldeath,thereby impairing reproductive *** double-blind randomized study evaluated the effect of supplementation withL-carnitine,acetyl-L-carnitine,vitamins,and other nutrients on semen quality in 104 infertile patients with or without varicocele,while also investigating the impact of factors such as obesity and advanced age on *** concentration significantlyincreased in the supplemented group compared to the placebo group(P=0.0186).Total sperm count also significantly increasedin the supplemented group(P=0.0117),as did sperm motility(P=0.0120).The treatment had a positive effect on patients upto 35 years of age in terms of sperm concentration(P=0.0352),while a body mass index(BMI)above 25 kg m^(−2) had a negativeeffect on sperm concentration(P=0.0110).Results were not showing a net benefit in stratifying patients in accordance withtheir BMI since sperm quality increase was not affected by this *** conclusion,antioxidant supplementation may bebeneficial for infertile patients and has a more positive effect on younger patients with a normal weight.

关键词： aging antioxidants body mass index oligoasthenoteratozoospermia varicocele

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Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia Marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia Vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca Di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy department of urology and renal transplantation Policlinico of FoggiaFoggia 71122Italy urology Unit "G.Tatarlla"HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania department of Oncological urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male *** aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still *** of them are still under investigation and,to date,only a few options have been given as a recommendation for *** cannot be considered as standard of care and are not suitable for all *** and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

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Medical management of urolithiasis: Great efforts and limited progress

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Asian Journal of urology 2024年第2期11卷 149-155页

作者： Victoria Jahrreiss Christian Seitz Fahad Quhal department of urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria department of urology King Fahad Specialist HospitalDammamSaudi Arabia

Objective:To provide a comprehensive review on the existing literature on medical management of ***:A thorough literature review was performed using Medline,PubMed/PMC,Embase,and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of *** that assessed dietary and pharmacologic management of urolithiasis were reviewed;studies on medical expulsive therapy were not included in this ***:Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution *** most treatment concepts have been long established,large randomized controlled trials are *** modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis.A major limitation for medical management of urolithiasis is poor patient ***:Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing *** medical management can be effective in limiting stone recurrence,medical interventions often fail due to poor compliance.

关键词： Medicalmanagement Medical therapy Urolithiasis Kidneystonedisease

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