Expression analysis of hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, and hsa_circ_0006990 in renal cell carcinoma

Renal cell carcinoma (RCC) is a prevalent heterogeneous kidney cancer. So far, different genes have been reported for RCC development. However, its particular molecular mechanism remains unclear. Circular RNAs (circRNAs), a class of non-coding RNAs, are involved in numerous biological processes in different malignancies such as RCC. This study aims to assess the expression and underlying mechanism of four circRNAs (hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, hsa_circ_0006990) with possible new roles in RCC. In the experimental step, we investigated the expression of these four circRNAs in our RCC samples using quantitative real-time polymerase chain reaction. In the bioinformatics step, the differential expressed mRNAs (DEmRNAs), and miRNAs (DEmiRNAs) were obtained from the GEO datasets using the GEO2R tool. A protein-protein interaction network was constructed using the STRING database, and hub genes were identified by Cytoscape. Molecular pathways associated with hub genes were detected using KEGG pathway enrichment analysis. Then, we utilized the ToppGene database to detect the relationships between DEmiRNAs and hub genes. Furthermore, interactions between circRNAs and DEmiRNAs were predicted by the StarBase and circinteractome databases. Finally, a circRNA-DEmiRNA-hub gene triple network was constructed. Our results revealed that the expression of hsa_circ_0020397, hsa_circ_0005986, and hsa_circ_0006990 was downregulated in RCC tissues. Moreover, these circRNAs had a significantly lower expression in patients with a history of kidney disease. Furthermore, hsa_circ_0003028 and hsa_circ_0006990 showed higher expression in the tumor of participants with Lymphovascular/perineural invasion and oncocytoma type, respectively. Based on bioinformatic results, 15 circRNA-DEmiRNA-hub gene ceRNA regulatory axes were predicted, which included three hub genes, five miRNAs, and four selected circRNAs. In conclusion, the current work is the first to emphasize the expression of the hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, and hsa_circ_0006990 in RCC patients presents a novel perspective on the molecular processes underlying the pathogenic mechanisms of RCC.

Concordance between Gleason score of prostate biopsies and radical prostatectomy specimens and its predictive factors

Objective:

The Gleason score is an essential factor for making decisions about prostate cancer management and its prognosis. Thus, we conducted this research to discover the histologic-grading accuracy of needle biopsy specimens, and to identify preoperative clinical and pathological factors that predict upgrading and downgrading from biopsy to radical prostatectomy specimen.

Patients and methods:

This study was performed on 570 patients who were referred to the medical centers affiliated with Shiraz University of Medical Sciences and underwent radical prostatectomy from 2013 to 2017. Concordance was evaluated between the Gleason score of needle biopsy and radical prostatectomy specimens. Predictors of upgrades and downgrades were assessed in univariate and multivariate logistic regression analyses.

Results:

Scores were the same in 50% of cases, downgraded in 26%, and upgraded in 24%. The variables predicting a Gleason score upgrade were higher Prostate specific antigen level, larger tumors, and older age. Lower tumor volume, lower Prostate specific antigen, and low maximum percentage of cancer in cores were predictors of downgrading from Gleason score>6 to ⩽6. Also, Body mass index>30, smaller tumor size, and negative lymph nodes were predictors of downgrading from Gleason score>7 to 7.

Conclusion:

The correlation between biopsy and Radical prostatectomy Gleason scores was only 50%. After dividing them into the new grading groups, this coordination increased by only 5.6%. Physicians need to consider possible limitations of the Gleason score of biopsy and factors that can be predictive of upgrading to high-risk prostate cancer before making treatment decisions.

Comparison of Male and Female Sexual Dysfunction between Hemodialysis and Peritoneal Dialysis in Patients with End-Stage Renal Disease: An Analytical Cross-Sectional Study

BACKGROUND

Maintenance dialysis is the most common treatment for end-stage renal disease (ESRD) patients. One of the most ignored but important health issue among dialysis patients is sexual dysfunction, which interferes with quality of life (QoL). Studies showed that the side effects of the two conventional methods of dialysis (hemodialysis (HD) and peritoneal dialysis (PD)) are different on a patient's health. Therefore, we sought to compare the sexual dysfunction score, both male and female, between patients undergoing HD and PD.

METHODS

One hundred seventy adults (85 HD and 85 PD) subject with end-stage renal disease (ESRD) on dialysis for at least 2 months were included. For male subjects, the erectile function (EF) domain of the International Index of Erectile Function (IIEF) questionnaire was calculated. Moreover, the Female Sexual Function Index (FSFI) questionnaire was calculated for females. Data were analyzed via SPSS software. Two independent sample t-test with two-sided significance level of 5% was used for comparing the sexual dysfunction score between HD and PD patients.

RESULTS

Out of 170 patients with mean age of 49.34 ± 11.7 years, 52.9% were female. Better sexual function scores were obtained in the HD group's females for desire, orgasm, and satisfaction domains, as well as the total score (P = 0.03, 0.016, 0.02, and 0.039, respectively). The erectile function was significantly better in the PD group's males (P).

CONCLUSION

We found better sexual life in the HD group's females and PD group's males. Considering dialysis as a life-long treatment of CKD patients, this part of a patient's life must be taken seriously by the healthcare providers to choose the most suitable method for patients based on their personalized conditions.

An Investigation of the Pathology Report of Bladder Cancer Patients with Radical Cystectomy in Southern Iran, 2013-2018: A Cross-Sectional Study

Background: The oncological outcomes of bladder cancer are directly associated with disease pathology and surgical technique. Therefore, we investigated the pathologic factors of radical cystectomy (RC) specimens. Methods: In this retrospective study, 365 patients who underwent RC between March 2013 to March 2018 in hospitals affiliated to Shiraz University were enrolled. The patients' clinicopathological parameters, such as tumor type, tumor grade, carcinoma in situ, lymph node (LN) involvement, lymphovascular invasion (LVI), perineural invasion (PNI), and age, were recorded from their pathology reports. For comparison of variables, an independent t test was used. P < 0.05 was regarded as significant. The statistical software SPSS version 22 was used to examine the data. Results: The participants' mean age was 64.52 ± 11.54 years, and 320 (87.7%) patients were men and 45 (12.3%) were women. The mean dissected LN was 9.69 ± 8.70 nodes and 1.06 ±3.49 of the dissected LNs were involved by tumor. PNI and perivesical invasion were presented in 148 (40.5%) and 96 (26.3%) patients, respectively. Ureteral, urethral, and prostate involvements were seen in 23 (6.3%), 50 (13.7%), and 66 (18.1%) patients. Most patients had pathologic tumor stage 2 (36.4%). Factors such as LVI, PNI, perivesical invasion, and prostate involvement, were strongly correlated with positive LN (P ≤ 0.05). Conclusion: The examination of the RC specimen is critical for patient care, outcome, and justification of adjuvant therapy. Factors such as LVI, perineural invasion, perivesical invasion, and prostate involvement were strongly correlated with positive LN.

Genital exam, a missed piece of the puzzle in medical diagnosis, can be lifesaving in men: A lesson from a case of a state of shock due to duodenal metastasis of testicular choriocarcinoma

Here we reported a case of a 17-year-old man with a history of weakness, vertigo, nausea, vomiting and dark stool within the last three months prior to admission. He was taken to the Emergency Room in a state of shock. After resuscitation, vital signs became stable, but due to low hemoglobin (HB = 5 g/dl), to find the source of bleeding, endoscopy was performed and a mass in the duodenum was detected. The pathology report was metastatic germ cell tumor. On genital physical exam (PE) there was a mass in the right testis; thus, the patient underwent radical orchiectomy and choriocarcinoma was diagnosed. The patient then received chemotherapy for six months, and he responded well to the treatment. This case report confirmed that genital PE should be part of a patients visit, even when we cannot find logical relation between clinical presentation and genital PE.

Scrotal leiomyoma a rare benign intra-scrotal mass could lead to unnecessary orchiectomy

Leiomyoma is a benign tumor originating from smooth muscle cell, Mostly from uterus. However, in men is a very rare entity. Scrotal leiomyoma is a very rare tumor. Here we presented a case of scrotal leiomyoma in a 71-year-old man. He presented with a slowly growing, painless mass and heaviness in the left testis for 10 years. Due to huge size, testicular attachment and preoperational diagnosis of atypical leiomyoma/leiomyosarcoma, orchiectomy was performed. Pathology report diagnosed leiomyoma. We suggest frozen section diagnosis as a useful tool, to prevent unnecessary procedure.

Primary amelanotic melanoma of the male urethra: A rare entity and diagnostic challenge

Malignant melanoma (melanoma) is a tumor of melanocytes that usually presents as cutaneous lesions. While melanoma can infrequently appear as a primary tumor elsewhere in the body, it is extremely rare in the urethra and even rarer as amelanotic malignant melanoma. We report the case of a 66-year-old male who presented with painless gross hematuria and lower urinary tract obstructive symptoms in the recent 2 weeks prior to his visit to our clinic. History and physical examination, including external genital examination, abdominopelvic sonography, and urine culture, were not conclusive. Cystourethroscopy revealed a creamy pink fragile mass located in the anterior proximal urethra that extended to the mid portion. Pathological examination of this lesion confirmed the diagnosis of amelanotic malignant melanoma using immunohistochemistry. Radical cystourethrectomy with ileal conduit was subsequently conducted. Although this tumor is extremely rare, urologists and pathologists should consider malignant melanoma as a diagnosis in patients with urethral tumor because of the likelihood of early metastasis and, consequently, poor prognosis. Complete surgical removal of the tumor and use of effective therapies can improve outcomes in these patients.

The prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): A systematic review and meta-analysis

BACKGROUND

Previous studies of diabetes in Eastern Mediterranean Region (EMRO) did not assess the prevalence of either unknown diabetes or prediabetes. We conducted a systematic review and meta-analysis to estimate the prevalence of undiagnosed type 2 diabetes and prediabetes as well as variations by region in EMRO, using the relevant publications since 2000.

METHODS

We carried out a comprehensive electronic search on electronic databases from January 1, 2000 to March 1, 2018. We selected cross-sectional and cohort studies reporting the prevalence of undiagnosed type 2 diabetes, prediabetes, or both. Two independent reviewers initially screened the eligible articles; then, synthesized the target data from full papers. Random- or fixed-effect models, subgroup analysis on Human Development Index (HDI), and publication year and sensitivity analysis to minimize the plausible effect of outliers were used.

RESULTS

Amongst 849 identified citations, 55 articles were entered into meta-analysis, involving 567,025 individuals. The forest plots estimated 5.46% (confidence intervals [CI]: 4.77-6.14) undiagnosed diabetic and 12.19% (CI: 10.13-14.24) prediabetics in EMRO. Low HDI countries and high HDI countries had the highest (7.25%; CI: 4.59-9.92) and the lowest (3.98%; CI: 3.11-4.85) undiagnosed diabetes prevalence, respectively. Very high HDI countries and low HDI countries had the highest (13.50%; CI: 8.43-18.57) and the lowest (7.45%; 1.20-13.71) prediabetes prevalence, respectively. In addition, meta-regression analysis showed a statistically significant association between publication year and prevalence of prediabetes (Reg Coef = 0.059, P = 0.014). But such finding was not observed for undiagnosed diabetes and publication year (Reg Coef = 0.034, P = 0.124), prediabetes and HDI (Reg Coef = 0.128, P = 0.31) and undiagnosed diabetes and HDI (Reg Coef = - 0.04, P = 0.96).

CONCLUSION

The prevalence of undiagnosed diabetes and prediabetes was high and increasing. The notion of universal health coverage is a priority; that is the integration of the primary, secondary and tertiary health levels, as well as employing the available action plans. Therefore, future studies, using identical screening tool and diagnostic criteria, are warranted to make an accurate picture of diabetes in EMRO.

Detection of Y Chromosome Microdeletions and Hormonal Profile Analysis of Infertile Men undergoing Assisted Reproductive Technologies

Background

Y chromosome deletions (YCDs) in azoospermia factor (AZF) region are associated with ab- normal spermatogenesis and may lead to azoospermia or severe oligozoospermia. Assisted reproductive tech- nologies (ART) by intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) are com- monly required for infertility management of patients carrying YCDs. The aim of this study was to estimate the frequency of YCDs, to find the most frequent variant in infertile men candidate for ART and to compare YCD distribution with a control fertile group. The semen parameters, hormonal profiles and ART outcomes of the infertile group were studied.

Materials and Methods

This case-control study consisted of 97 oligozoospermic or non-obstructive azoospermic (NOA) infertile men, who had undergone ART, as the case group and 100 fertile men as the control group. DNA samples were extracted from blood samples taken from all 197 participants and YCDs were identified by multiplex polymerase chain reaction (PCR) of eight known sequence-tagged sites. The chi-square test was used to compare the mean values of hormone and sperm parameters between the two groups. P<0.05 was considered statistically significant.

Results

No YCD was detected in the control group. However, 20 out of 97 (20.6%) infertile men had a YCD. AZFc, AZFbc and AZFabc deletions were detected in 15 (75%), four (20%) and one (5%) YCD-positive patients. No fer- tilization or clinical pregnancy was seen following ICSI in this sub-group with YCD. The mean level of FSH was significantly higher in the group with YCD (28.45 ± 22.2 vs. 4.8 ± 3.17 and 10.83 ± 7.23 in YCD-negative patients with and without clinical pregnancy respectively).

Conclusion

YCD is frequent among NOA men and YCD screening before ART and patient counseling is thus strongly recommended.

The Effect of Core and Veneering Design on the Optical Properties of Polyether Ether Ketone

This study aimed to evaluate the effect of core shade and core and veneering thickness on color parameters and translucency of polyether ether ketone (PEEK). Sixty PEEK discs (0.5 and 1 mm in thickness) with white and dentine shades were veneered with A2 shade indirect composite resin with 0.5, 1 and 1.5 mm thickness (n=5). Cores without the veneering material served as controls for translucency evaluation. Color parameters were measured by a spectroradiometer. Color difference (ΔE₀₀) and translucency parameters (TP) were computed. Data were analyzed using one-way ANOVA and Tukey's test (for veneering thickness) and independent t-test (for core shade and thickness) via SPSS 20.0 (p⟨0.05). Regarding the veneering thickness, white cores of 0.5 mm thickness showed significant differences in all color parameters. In white cores of 1 mm thickness and dentine cores of 0.5 and 1 mm thickness, there were statistically significant differences only in L∗, a∗ and h∗. The mean TP was significantly higher in all white cores of 1 mm thickness than dentine cores of 1 mm. Considering ΔE₀₀=3.7 as clinically unacceptable, only three groups had higher mean ΔE₀₀ values. Core shade, core thickness, and the veneering thickness affected the color and translucency of PEEK restorations.

CD8+ T Lymphocyte Subsets in Bladder Tumor Draining Lymph Nodes

BACKGROUND

Cytotoxic CD8+ T cells, as essential parts of the adaptive immune system, play pivotal roles in anti-tumor immune responses. It is well documented that cytokine expression profiles and activation status of these cells during anti-tumor immune responses affect the outcome of host-tumor interaction.

OBJECTIVE

To investigate the percentages of CD8+ lymphocytes and their subsets in tumor draining lymph nodes of patients with bladder cancer.

METHODS

Forty-five patients with bladder cancer, candidate for radical cystectomy, were recruited. Mononuclear cells were isolated from draining lymph nodes using Ficoll-Hypaque gradient centrifugation, and were activated by PMA/Ionomycin in the presence of Golgi inhibitors. The cells were then permeabilized and stained with appropriate flourochrome conjugated antibodies against CD3, CD8, IFN-γ, IL-17 and IL-4 molecules. Data were collected on a four-color flow cytometer and analyzed by CellQuestPro software.

RESULTS

Despite no difference in the frequency of IL-17 producing CD8+ (Tc17) lymphocytes, the mean expression of IL-17 in this subset was significantly elevated in high-grade patients (p=0.011). The percentage of double positive IFN-γ/IL-17 CD8+ lymphocytes was also significantly increased in node positive patients compared to node negative ones (p=0.046). Our results also demonstrated that the percentage of IFN-γ producing CD8+ (Tc1) lymphocytes was significantly increased in the patients with higher histological grade compared to those with lower ones (p=0.038).

CONCLUSION

IFN-γ and IL-17 producing CD8+ T cells may increase in advanced stages of bladder cancer, but their correlation with tumor prognosis remains to be investigated.

Effect of iron containing supplements on rats' dental caries progression

OBJECTIVE

Iron deficiency is the most common form of malnutrition in developing countries. Iron containing supplements have been used effectively to solve this problem. In children, because of teeth staining after taking iron drops, parents have the idea that iron drops are the cause of tooth decay; therefore, they limit this vital supplement in their children's diet. Hereby, we evaluate the histologic effect of iron containing supplements on tooth caries in rice rats with cariogenic or non-cariogenic diet.

MATERIALS AND METHODS

Twelve rats were selected and divided into four groups for this interventional experimental study. Four different types of dietary regimens were used for four months; group A, cariogenic diet with iron containing supplements; group B, cariogenic diet without iron containing supplements; group C, non-cariogenic diet with iron containing supplements; group D, non-cariogenic diet without iron containing supplements. After sacrificing the rats, 20-micron histological sections of their posterior teeth were prepared using the Ground Section method, then they were studied under polarized light microscopy. In order to compare the progression of caries in different samples, the depth of the lesions in the enamel was measured as three grades I, II and III.

RESULTS

The mean grade value of A, B, C and D groups were 1.61, 2.61, 1.37 and 1.80, respectively. Statistical analysis revealed that significantly fewer caries were seen in the group which had received iron containing supplements and cariogenic diet compared with cariogenic diet without iron supplements (p<0.05).

CONCLUSION

Ferrous sulfate reduces the progression of dental caries in the cariogenic dietary regimen.

Prostate-specific antigen doubling time as a predictor of Gleason grade in prostate cancer

INTRODUCTION

Our aim was to evaluate the value of serum prostate-specific antigen doubling time (PSADT) to identify patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer.

MATERIALS AND METHODS

Of 460 patients with extended 12-core transrectal ultrasonography-guided biopsy of the prostate, 59 with confirmed prostate cancer were selected. They had not received any previous treatment for prostate cancer and had at least 2 consecutive serum PSA tests with a rising trend. The PSADT was calculated in patients with 2 serum PSA levels measured with an interval more than 3 months.

RESULTS

Of 59 patients with prostate cancer, 35 (59.3%) had low-grade and 24 (40.7%) had high-grade tumors. There was no difference in age between the two groups. The median PSADT in patients with high-grade and low-grade tumors were 12.70 months (range, 0.7 to 44.8 months) and 25.00 months (range, 1.65 to 41.2 months; P = .001). A total of 21 patients with high-grade tumors (87.5%) had a PSADT less than 12 months, while only 9 of those with low-grade tumors (25.7%) had a PSADT less than 12 months. A PSADT cutoff of 12 months provided a sensitivity of 74% and a specificity of 87% for differentiation of high-grade from low-grade cancers.

CONCLUSION

We showed that men with a short PSADT (< 12 months) were at a higher risk of harboring a high-grade prostate cancer. Our data suggests PSADT to identify patients with high-grade tumors who require more aggressive therapy.

New software: comparison between three software programs for root canal length measurement

OBJECTIVES

The purpose of this study was to design a software program to estimate the curved root canal working length by using curved line software and comparing its accuracy with Trophy and Cygnus software programs.

METHODS

120 simulated curved canals were divided into 12 groups based on the radius and the angle of the curvature. The true canal length was measured from the orifice to the terminus. Canals were filled with urographin and were imaged by a digital radiographic system. Canal length was measured with newly developed software that uses a curved line, as well as with Cygnus and Trophy software, both of which use a sequence of straight lines, and their accuracies were compared.

RESULTS

The proposed software was significantly more accurate than other software with respect to the gold standard (P < 0.001). However, the error was less than 0.5 mm in over 99% of the cases with all software with three clicks, and over 96% of the cases with six clicks in Trophy, which was not statistically significant (P = 0.99).

CONCLUSIONS

The studied software programs were not significantly different and their statistically significant difference compared with the gold standard is not clinically significant. The suggested software has to be studied more regarding its capabilities in the utilization of curved lines in measuring curved canals and calibration of the measurements.