Cauda equina neuroendocrine tumors (CENETs) are neoplasms of uncertain histogenesis with overlapping features between those of paragangliomas (PGs) and visceral neuroendocrine tumors (NETs). We have explored their biological relationship to both subsets of neuroendocrine neoplasms. The clinical and radiological features of a cohort of 23 CENETs were analyzed. A total of 21 cases were included in tissue microarrays, along with a control group of 38 PGs and 83 NETs. An extensive panel of antibodies was used to assess epithelial phenotype (cytokeratins, E-cadherin, EpCAM, Claudin-4, EMA, CD138), neuronal and neuroendocrine features (synaptophysin, chromogranin A, INSM1, neurofilaments, NeuN, internexin-α, calretinin), chromaffin differentiation (GATA3, Phox2b, tyrosine hydroxylase), and possible histogenesis (Sox2, T-brachyury, Oct3/4, Sox10). The cohort included 5 women (22%) and 18 men (78%). The average age at the time of surgery was 48.3 years (range from 21 to 80 years). The average diameter of the tumors was 39.27 mm, and invasion of surrounding structures was observed in 6/21 (29%) tumors. Follow-up was available in 16 patients (median 46.5 months). One tumor recurred after 19 months. No metastatic behavior and no endocrine activity were observed. Compared to control groups, CENETs lacked expression of epithelial adhesion molecules (EpCAM, CD138, E-cadherin, Claudin-4), and at the same time, they lacked features of chromaffin differentiation (GATA3, Phox2b, tyrosine hydroxylase). We observed no loss of SDHB. Cytokeratin expression was present in all CENETs. All the CENETs showed variable cytoplasmic expression of T-brachyury and limited nuclear expression of Sox2. These findings support the unique nature of the neoplasm with respect to NETs and PGs.
- MeSH
- adhezní molekula epiteliálních buněk MeSH
- cauda equina * metabolismus patologie chirurgie MeSH
- claudin-4 MeSH
- lidé MeSH
- lokální recidiva nádoru patologie MeSH
- nádory centrálního nervového systému * patologie MeSH
- neuroendokrinní nádory * patologie MeSH
- paragangliom * MeSH
- represorové proteiny MeSH
- transkripční faktory MeSH
- tyrosin-3-monooxygenasa MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Hyaluronic acid (HA), an extracellular biopolymer found throughout the human body, holds promise as a biocompatible and biodegradable scaffold material. High molecular weight (HMW) HA degrades, generating low molecular weight (LMW) fragments with distinct properties. These fragments can influence the behaviour of cells, including human dental pulp stem cells (hDPSCs) incorporated into HA-containing hydrogels or scaffolds. Therefore, a comprehensive examination of the impact of a range of HA molecular weights on hDPSCs is essential before designing HA-based scaffolds for these cells. hDPSC lines were cultured with LMW HA (800 Da, 1600 Da, 15 kDa), medium molecular weight HA (237 kDa), or HMW HA (1500 kDa) over six passages. The various molecular weights had negligible effects on hDPSCs viability, morphology, adhesion, or relative telomere length. Furthermore, the expression of key surface stemness markers (CD29, CD44, CD73, CD90) remained unaltered. HA did not induce osteogenic, chondrogenic, or adipogenic differentiation. Moreover, the potential for chondrogenic and osteogenic differentiation was not adversely affected by LMW or HMW HA. Various molecular weights of HA seem safe, biocompatible and therefore suitable components for hDPSCs-containing scaffolds. These findings affirm that the hDPCSs will not be negatively affected by HA fragments resulting from scaffold degradation.
- MeSH
- analgetika terapeutické užití MeSH
- ankylózující spondylitida * diagnóza farmakoterapie terapie MeSH
- antirevmatika terapeutické užití MeSH
- biologická terapie klasifikace MeSH
- cytokiny antagonisté a inhibitory MeSH
- inhibitory Janus kinas klasifikace terapeutické užití MeSH
- inhibitory TNF farmakologie terapeutické užití MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Lékař ošetřující potenciálního revmatologického pacienta často pracuje s omezeným počtem vstupních informací. Musí odhadnout rizika a správně nasměrovat pacienta k další péči do spádového zdravotnického zařízení nebo terciárního centra. V článku se proto zaměřujeme na typický klinický obraz vybraných urgentních stavů při systémových onemocněních pojiva a systémových vaskulitidách s cílem osvojit si přístup k nemocnému odpovídající této naléhavé situaci. Ve většině případů jde o zánětlivý stav spojený s postižením pohybového systému (zejm. artritidami), ale i jiných orgánů a systémů (srdce, plíce, ledviny, nervový systém a jiné), a/nebo teplotou. Většinu z nich spolehlivě diagnostikujeme kombinací běžných laboratorních, zobrazovacích a imunologických vyšetření, kdy je typický nález autoprotilátek většinou z okruhu ANA nebo ANCA. U jednotlivých systémových nemocí jsou rozebírány specifické naléhavé situace, jako je neurolupus, stavy asociované s trombotickou mikroangiopatií (sklerodermická renální krize, katastrofický antifosfolipidový syndrom), porucha polykání s rizikem aspirace, přední ischemická neuropatie optického nervu a syndrom difúzní alveolární hemoragie. Jejich naléhavost spočívá mimo jiné v tom, že se může jednat o vůbec první projev dosud nediagnostikovaného systémového onemocnění. Mají vysokou mortalitu a špatnou prognózu, nejsou-li diagnostikovány a léčeny dostatečně rychle. Zlatým standardem v terapii zůstávají vysokodávkované pulzy intravenózních glukokortikoidů. Je vždy obtížné, složité a zodpovědné být mezi prvními na cestě k poznání závažné naléhavé diagnózy. Snadněji se kráčí připraveným.
A physician treating a potential rheumatology patient often works with a limited amount of information. They must assess the risks and correctly refer the patient for further care to the regional healthcare facility or tertiary center. In this article, we therefore focus on the typical clinical picture of selected emergency conditions in connective tissue diseases and systemic vasculitis with the aim of adopting an approach to the patient corresponding to this urgent situation. In most cases, it is an inflammatory condition associated with the involvement of the locomotor system (especially arthritis), but also other organs and systems (heart, lungs, kidneys, nervous system and others), and/or fever. Most of them are reliably diagnosed by a combination of common laboratory, imaging and immunological examinations, where the typical finding of autoantibodies is mostly from the ANA or ANCA family. For individual systemic diseases, specific emergency situations are discussed, such as neurolupus, conditions associated with thrombotic microangiopathy (scleroderma renal crisis, catastrophic antiphospholipid syndrome), swallowing disorder with risk of aspiration, anterior ischemic optic neuropathy, and diffuse alveolar hemorrhage syndrome. Their urgency lies, among other things, in the fact that this may be the very first manifestation of a systemic disease that has not been diagnosed yet. They have a high mortality rate and a poor prognosis if not diagnosed and treated quickly enough. High-dose pulses of intravenous glucocorticoids remain the gold standard for treatment. It is always difficult, complex and responsible to be among the first on the way to knowing a serious emergency diagnosis. It is easier to walk prepared.
- MeSH
- ankylózující spondylitida * farmakoterapie MeSH
- biologická terapie metody MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakt z konference MeSH
