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This study aimed to explore the correlation of Golgi phosphoprotein 3 (GOLPH3) levels in papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) with clinicopathologic features. GOLPH3 expression was determined by western blotting in solid tumors and the adjacent normal thyroid tissues. Mammalian target of rapamycin (mTOR) and Ki-67 were examined by immunohistochemical staining. Significantly higher levels of GOLPH3 protein were observed in PTC and PTMC compared with the adjacent normal thyroid tissues ( P <0.001). GOLPH3 level was positively associated with lymph node metastasis and clinical stage in PTC ( P <0.05) and utterly related to the clinical stage in PTMC ( P =0.012). No correlation was observed between GOLPH3 level and other clinicopathologic parameters such as sex, local invasion, tumor number, and tumor size. The expression level of GOLPH3 protein in mTOR-positive PTC was significantly higher than in mTOR-negative PTC ( P =0.002 in PTC, P =0.022 in PTMC) and positively correlated with Ki-67 proliferation index in PTC via Pearson correlation analysis ( r =0.353, P =0.007 in PTC; r =0.583, P <0.001 in PTMC). In conclusion, the relative expression level of GOLPH3 protein was significantly higher in PTC and PTMC than in normal thyroid tissues and increased with cancer severity. It may provide adjunctive information for diagnosing and predicting prognosis in patients with PTC or PTMC., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Purpose- Intracranial artery calcification detected by computed tomography is associated with ischemic stroke as an indicator of intracranial atherosclerosis. However, little is known about its histopathology. This study aimed to explore the intracranial calcification patterns and their associations with atherosclerotic plaques. Methods- We recruited 32 adult autopsy cases to assess the calcification patterns and distributions in the middle cerebral artery, vertebral artery, and basilar artery. The relationships of calcification patterns with plaque phenotype and luminal stenosis were evaluated. The calcification patterns on computed tomography were correlated with that on histology. Results- Visible calcifications were detected within 37 (39%) segments, including 25 segments with intimal calcification, 6 segments with internal elastic lamina calcification, 3 segments with adventitial calcification, and 3 segments with concurrent calcification. Calcification occurred more often in the vertebral artery (51%), followed by the middle cerebral artery (35%) and basilar artery (14%; P<0.01 for vertebral artery versus basilar artery). Internal elastic lamina calcification was predominantly detected in the vertebral artery (7/8, 88%). All of the 27 (100%) intimal calcifications were present in the progressive atherosclerotic lesions ( P<0.001), whereas only 3/8 (38%) internal elastic lamina calcifications and 4/6 (67%) adventitial calcifications were associated with progressive plaques. Arteries with intimal calcification had more severe luminal stenosis than those without (46% versus 21%; P<0.001). Conclusions- Our histological findings indicate that the presence of intracranial artery calcification has 3 patterns, including intimal, internal elastic lamina, and adventitial calcifications. But only intimal calcification is related with progressive atherosclerotic lesions, indicative of a proxy for intracranial atherosclerosis.

The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index). Besides these, we gathered the general information such as age, gender, smoking history, and use of steroids. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters. Variations like gender (odds ratio [OR] = 1.269, 95% confidence interval [CI] [0.609-2.646]), smoking history (OR = 2.902, 95% CI [1.564-5.385]), AIS grade (grade A) (OR = 6.439, 95% CI [3.334-12.434]), neurological level (C1-C4) (OR = 2.714, 95% CI [1.458-5.066]), and steroid use (OR = 2.983, 95% CI [1.276-6.969]) have a facilitated effect on RC. When we estimated surgery-related affection, only the time of surgery and anterior approach compared with posterior has significant difference in RC (P < .05). Between death and survival group, the aspect of age, non-surgical, CPIS, AIS grade, and BMI have statistically significant difference. Survival analysis reveals significant difference in aforementioned groups. In patients suffering from acute TCSCI, those who are old, have long smoking history, complete spinal cord injury, C1-C4, high CPIS, and fat have high incidence of RC and mortality.

Background: Resection of the parapharyngeal space is often challenging. This study aims to evaluate the outcome of the endoscopy-assisted transoral approach for resection of the parapharyngeal space tumors compared with the endoscopy-assisted transcervical approach., Methods: Twenty-three consecutive patients (15 males, 8 females) who underwent resection of large parapharyngeal space tumors via endoscopy-assisted transoral (ETO) approach or endoscopy-assisted transcervical minimal incision plus osteotomy of the vertical ramus outside the mandibular foramen (ETC + MO) approach were analyzed retrospectively., Results: The tumors in ETO group are benign; there are 2 patients with adenoid cystic carcinoma and 1 patient with recurrent pleomorphic adenoma in ETC + MO group. All of the tumors were removed completely and without rupture. No major complications developed in any patient. Temporary facial paresis occurred in 1 patient in the ETC + MO group, which resolved spontaneously within 8 weeks. The cosmetic effects of all patients in ETO groups and 10 patients in ETC + MO groups were excellent. Patients were followed up for 7 to 26 months, no recurrence was encountered., Conclusion: ETO and ETC + MO approach in resection of large parapharyngeal space tumors are feasible and safe technique that achieve excellent aesthetic and functional results. Endoscopy-assisted transoral approach can shorten hospitalized time and avoid the risk of marginal mandibular nerve injury and ETC + MO approach may be used in malignant or recurrent parapharyngeal space tumors.

Objective: To analyze the risk and benefit of aggressive hepatectomy for the curative treatment of bilobar bile duct cysts (BDCs) of type IV-A., Background: Conventional surgical treatment of bilobar BDCs of type IV-A is extrahepatic cyst excision, followed by biliodigestive anastomosis. The role of hepatectomy in the treatment of bilobar BDCs remains unclear., Methods: Between January 2006 and December 2011, a total of 28 patients with bilobar BDCs who underwent an aggressive hepatectomy were identified from a prospective database. Perioperative and long-term outcomes in these patients were compared with 18 patients with bilobar BDCs who received conventional surgical treatment., Results: Patient characteristics such as age, sex, and clinical presentation were similar in both groups. Cystic dilatation of bile ducts was curatively resected in all 28 patients undergoing aggressive hepatectomy. Postoperative morbidity (57.1% vs 22.2%, P = 0.020), but not mortality (3.6% vs 0%, P = 1.000), in patients who underwent aggressive hepatectomy was significantly increased when compared with those who received conventional surgical treatment. Clearance rate of intrahepatic stones was significantly higher after aggressive hepatectomy than that after conventional surgical treatment (100.0% vs 45.5%, P < 0.001). Twenty-seven of 28 patients (96.4%), except 1 patient who met in-hospital death, achieved a symptom-free status after aggressive hepatectomy during a mean follow-up of 31 months. In contrast, during a mean follow-up of 37 months, 7 patients (38.9%, 7/18) remained free of biliary symptoms after conventional surgical treatment. The long-term outcomes between aggressive hepatectomy and conventional surgical treatment were significantly different (P < 0.001). In addition, no malignant transformation occurred after aggressive hepatectomy. However, intrahepatic cholangiocarcinoma has developed in the remnant BDC in 2 of 18 patients (11.1%) receiving conventional surgical treatment during follow-up., Conclusions: Aggressive hepatectomy, a challenging procedure, provides an efficient treatment option for some selected patients with bilobar BDCs of type IV-A. The role of aggressive hepatectomy in the curative treatment of bilobar BDCs of type IV-A should be paid particular attention in the future.

Insulinlike growth factor II mRNA-binding protein 3 (IMP3) is a newly identified mRNA-binding protein that is involved in embryogenesis and carcinogenesis of some malignant tumors. The aim of this study was to investigate the clinicopathologic significance of this protein in tongue squamous cell carcinoma (SCC). The expression of IMP3 in 65 samples of tongue SCC and 27 cases of oral leukoplakia (OL) was evaluated by immunohistochemistry. These expression levels were correlated with clinical and pathologic features as well as death from tongue SCC. Weak immunohistochemical stain for IMP3 was identified in all 19 cases of OL with mild dysplasia, and no immunohistochemical reactivity was found in 8 cases of OL without dysplasia. Positive immunohistochemical stain for IMP3 was identified in 50 cases (77%) of SCC; among them, weak staining was identified in 33 cases (51%) and intermediate staining in 17 cases (26%). To compare the expression of IMP3 in tongue SCC and OL, stronger immunohistochemical reactivity was found in tongue SCC (P < 0.05). Stronger expression of IMP3 was found to be associated with lymphoid metastasis (P < 0.05) and patient poor outcome (median survival time of 40 months in the negative and weak expression group vs 10 months in the intermediate expression group; P < 0.05). This study suggests that the increase in IMP3 expression in tongue leukopathia and SCCs may play a role in the carcinogenesis and tumor metastasis of tongue SCCs. Insulinlike growth factor II mRNA-binding protein 3 could be a novel prognostic indicator for patients with tongue SCCs.

The purpose of this study was to investigate the expression pattern of extracellular matrix metalloproteinase inducer (EMMPRIN) as well as the correlation between EMMPRIN and microvessel density (MVD) in salivary gland tumors. Extracellular matrix metalloproteinase inducer expression and MVD were examined immunohistochemically on paraffin-embedded tissue specimens from 95 patients with salivary gland tumors, who underwent surgical resection from 1998 to 2006. Reverse transcription-polymerase chain reaction was used to monitor EMMPRIN mRNA expression in frozen samples. Extracellular matrix metalloproteinase inducer expression in mucoepidermoid carcinomas and adenoid cystic carcinomas was significantly higher than in normal salivary gland tissues and pleomorphic adenomas (P < 0.05). The MVD of mucoepidermoid carcinomas and adenoid cystic carcinomas was significantly higher compared with pleomorphic adenomas (P < 0.05). The MVD of the EMMPRIN-positive expression group was significantly higher than the MVD of the EMMPRIN-negative expression group (P < 0.05). Extracellular matrix metalloproteinase inducer mRNA expression in malignant salivary gland tumors was higher than that in pleomorphic adenomas (P < 0.05). This study suggests that EMMPRIN expression is an important feature of malignant salivary gland tumors and can be used as a biologic marker to characterize salivary gland tumors. Extracellular matrix metalloproteinase inducer is also a positive angiogenic factor in salivary gland tumors.

This study assessed the reliability of using the reverse facial-submental artery deepithelialized submental island flap for reconstructing facial contour deformities. Reverse facial-submental artery deepithelialized submental island flaps were used for reconstructing facial contour deformities in 5 patients after benign tumor ablation. The patients, 4 women and 1 man, ranged in age from 29 to 36 years. Recurrent pleomorphic adenoma in the cheek and inferior temple was present in 3 patients, and recurrent basal cell adenoma was present in 1. Adequate reconstruction was achieved in all patients using reverse facial-submental artery deepithelialized submental island flaps, without flap failures or complications. Proper aesthetics and complete functionality were achieved, and no donor-site problems occurred. The patients were followed up for 20 to 24 months, and no recurrence was observed. Reverse facial-submental artery deepithelialized submental island flaps are safe, quick, and simple to elevate. The flap can be used reliably for facial contour reconstruction of middle and upper facial contour deformities after benign tumor ablation in the cheek and inferior temple.

This study evaluated the aesthetic and functional outcomes of vascularized fibular flaps used for pediatric mandibular reconstruction. Six pediatric patients ranging in age from 12 to 15 years underwent mandibular reconstruction using a vascularized fibula flap with a skin paddle, after benign tumor ablation. All of the flap transfers were successful, and there were no complications. Panorex radiographs showed good bone union in all patients. The flap conferred adequate support for dental rehabilitation. The mean follow-up was 24.2 months. The aesthetic and functional outcomes were normal. No patient had recurrence. A vascularized fibular flap is a very reliable method for reconstructing the pediatric mandible after benign tumor ablation.

The purposes of this study were to determine the correlation between the expression of inducible nitric oxide synthase (iNOS) and vascular endothelial growth factor (VEGF) in ameloblastoma and to examine the relationships of this expression to angiogenesis and the clinical and biological behaviors of the tumor. Immunohistochemical staining with streptavidin peroxidase was used to analyze iNOS and VEGF expression, and CD34 was used to evaluate microvascular density (MVD) in 35 ameloblastomas (24 primary tumors and 11 recurrences) and 5 malignant ameloblastomas. Ten odontogenic keratocysts (OKCs) served as controls. On relational analysis, positive and VEGF expression and MVD counts increased in this order: OKCs, primary ameloblastoma, recurrent ameloblastoma, and malignant ameloblastoma. Differences between the ameloblastomas and OKCs were significant (P < 0.05). Among ameloblastomas, MVD counts increased with increasing expression of iNOS and VEGF (P < 0.05), and iNOS expression and VEGF expression were positively correlated (r = 0.66, P < 0.05). Inducible nitric oxide synthase expression and VEGF expression may be closely related to the angiogenesis and invasive biological behavior of ameloblastomas.

The aim of this study was to evaluate the use of a pedicled mandibular osteomuscular flap for zygoma reconstruction through a modified Weber-Ferguson incision. The study included 3 male patients and 2 female patients with an average age of 46 years. Zygomatic ameloblastoma was present in 2 cases. Vascular malformation was present in 2 cases, and chondromyxoid fibroma was present in 1 case. In all 5 patients, surgery consisted of a wide excision of the lesions with margins of at least 5 mm to ensure complete removal. The defects that were created measured between 3 x 3 and 4 x 4 cm. Primary reconstruction of the zygoma was carried out by a pedicled mandibular osteomuscular flap. No flap failures occurred. Proper aesthetics and complete functionality were obtained, and there were no donor-site problems. The patients were followed up for 12 to 24 months, with an average period of 18.6 months, and recurrence was never encountered.

Owing to its cardiovascular therapeutical effects, icariin, a flavonoid isolated from Epimedii herba, is considered to be the major active constituent of Epimedii herba. The aim of this study is to investigate the effect of icariin on precontracted coronary artery isolated from canine. Coronary artery segments were isolated from normal anesthetized Beagle dogs and cut into 5-mm rings. The rings were mounted in an organ chamber and contracted by either 40 mM KCl or 10 microM PGF2alpha, and vasorelaxant tone to icariin was measured. Treatment of icariin could significantly produce a relaxation of precontracted coronary arterial rings with intact endothelium in a concentration-dependent manner. Comparatively, the vasorelaxation disappeared in denuded-endothelium rings. Furthermore, the vasorelaxant effect of icariin was blocked by Nomega-Nitro- L-arginine Methyl Ester (L-NAME), 1H-[1, 2, 4]-oxadiazolo [4, 3-a] quinoxalin-1-one (ODQ) but not by indomethacin and glibenclamide, respectively. Tetraethylammonium (TEA) could partly antagonize the vasorelaxant effect triggered by icariin. There was no significant gene expression difference of the endothelial nitric oxide synthase (eNOS) gene in coronary arterial rings among the different concentrations of icariin by RT-PCR, but the activity of eNOS was increased in a concentration-dependent manner after icariin exposure. These results suggest that icariin produces NO-dependent relaxation in the isolated canine coronary artery, and the possible mechanism is involved in the activation of eNOS protein and NO-cGMP pathway.

A major challenge in clinical transplantation today is to design a practical and effective protocol for tolerance induction compatible with cadaver organ transplantation. A preclinical rhesus monkey kidney allograft model using immediate peritransplant anti-CD3 immunotoxin (anti-CD3-IT) and donor bone marrow (DBM) is shown here to induce operational tolerance with prolonged graft survival in the absence of chronic immunosuppressive drugs. Bone marrow harvested from the kidney donor was depleted of mature alloantigen-presenting cells and T cells by removing DR(bright) cells and CD3(bright) cells, respectively. In outbred, major histocompatibility complex-incompatible donor-recipient pairs with high pretransplant mixed lymphocyte response and cytotoxic T lymphocyte precursor activity, four of six allografts survived for periods of 120 days to >1.5 years. Graft acceptance after peritransplant treatment followed robust elimination of both peripheral blood T cells and lymph node T cells. In most recipients given anti-CD3-IT and DBM infusion, anti-donor immunoglobulin G responses were completely inhibited. Microchimerism was observed in all recipients studied, including those not given DBM, but levels of microchimerism did not correlate with graft survival. Anti-CD3-IT induction in combination with modified DBM protocols such as the depletion of mature T cells and DR(bright) antigen-presenting cells may offer new opportunities to improve clinical tolerance protocols beyond those attempted in the clinic to date. Overall, these results with anti-CD3-IT show promise for development of cadaver transplant tolerance induction.