Objective: RNA modification of 5-methylcytosine (m5C) has been discovered in diverse kinds of RNA and plays a vital role in gene regulation and cellular functions; however, how m5C regulates oral squamous cell carcinoma (OSCC) progression remains unclear. Design: Bioinformatics analysis and validation Setting: Stomatological Hospital Subjects: Transcriptome and clinical data of OSCC samples (including 201 tumors and 18 normal samples) were downloaded from The Cancer Genome Atlas. Interventions: Not applicable Main Outcome Measures: Subjected to analyze m5C regulators expression and prognostic value. GSEA and immune infiltration analysis were conducted. Finally, NSUN2 expression in OSCC cell lines was validated by western blot. Results: Of the 21 m5C regulators, 15 were significantly up-regulated (including NSUN2) in tumor tissue and only two were down-regulated, compared to normal tissue. Furthermore, among the 17 m5C regulators, univariate and multivariate cox regression analyses revealed that only NSUN2 was an independent prognostic risk factor for OSCC. GSEA revealed that pathways associated with immune response were enriched in the NSUN2-low expression group and pro-tumor pathways were enriched in the NSUN2-high expression group. Moreover, NSUN2 negatively correlated with active immune cell type, including CD8+T cells, B cells, NK cells, monocyte and gamma delta T cells, but positively correlated with myeloid-derived suppressor cells. NSUN2 expression was up-regulated in seven OSCC cell lines relative to normal cells. Conclusion: In conclusion, m5C modification was active in OSCC tumor tissues and NSUN2 was a prognostic marker of OSCC, possibly by inhibiting immune reaction against tumor.
Saddle pulmonary embolism (PE), which is a rare form of acute PE, can cause sudden hemodynamic deterioration and death. In this case, we present a female patient who presented to the emergency department with complaints of back pain and was found to have sinus bradycardia on electrocardiogram, ultimately diagnosed with saddle PE. A chest computed tomography was ordered to evaluate for a possible lung infection. Although no evidence of pneumonia was found, the imaging showed an enlarged diameter of the pulmonary artery measuring 3.22 cm. Saddle PE is a condition that should be considered in the diagnosis in the Emergency Department as it can lead to serious mortality and morbidity, and may not always present with typical symptoms. In cases with atypical presentation where PE is not initially suspected, the high diameter of the main pulmonary artery detected on chest CT scans should be associated with diseases with right ventricular overloading such as PE.
Achalasia is esophageal motor dysfunction caused by impaired relaxation of the lower esophageal sphincter. A 77-year-old female patient was brought to the emergency department with complaints of nausea, vomiting and chest pain. Thorax computed tomography (CT) imaging was performed because there was no abnormality in troponin and electrocardiogram (ECG) follow-ups; approximately 7 cm diameter megaesophagus was detected. Endoscopy was performed for advanced diagnosis and treatment. Diagnosis of achalasia was confirmed by endoscopy. The distal end of the esophagus was widened by dilatation. The patient was discharged after 24 hours of service follow-up. Although it is a rare condition in elderly patients presenting to the emergency department, it should be noted that achalasia will constitute a non-cardiac chest pain clinic.
Objective: This study aimed to determine the value of netrin-1 in epithelial ovarian cancer (EOC), which has high morbidity and mortality. Design: This research is a cross-sectional type descriptive study. Setting: The study was carried out at the Gynecological Oncology Department of Sakarya University Training and Research Hospital. Subjects: Female patients with a diagnosis of adnexal mass Interventions: Serum netrin 1 levels of patients with benign (n=43) and malignant (n=40) histopathology operated in our clinic with the diagnosis of suspected adnexal mass were evaluated. The netrin 1 levels of both groups were compared and the receiver operating characteristic analysis was carried out. Main outcome measures: Serum netrin-1 levels in patients with a diagnosis of ovarian cancer. Results: While netrin-1 level was found to be higher in patients with EOC, the cut-off value was found to be 325 pg/mL. AUC=0.690, p=0.003 (95%CI:0.571-0.809) was determined to be able to differentiate between malignant and benign adnexal masses by means of the netrin 1 level. The sensitivity of the netrin-1 level for the diagnosis of EOC is 60%, and the specificity is 83.7%. Conclusion: Serum netrin-1 may be a potential biomarker in patients with EOC.
Background: No cases have been reported in which the contralateral breast was treated with conventional whole-breast irradiation (WBI) while the ipsilateral breast was treated with hypofractionated WBI and a hypofractionated boost. Case report: A 58-year-old woman with breast cancer underwent WBI and a boost to the tumor bed. She had a history of early-stage breast cancer on the contralateral side, for which she received conventional WBI with a total dose of 50 Gy in 25 fractions. She received a total of 39 Gy in 13 fractions and a boost with a dose of 9 Gy in 3 fractions. Mild dermatitis occurred during treatment, and mild hyperpigmentation developed 3 months after boost irradiation, which worsened over time and was considered a grade 2 late adverse event. Six years later, no recurrence or additional adverse events occurred. Conclusion: Hypofractionated boost irradiation after hypofractionated WBI carries a risk of hyperpigmentation and should be treated with caution, even if conventional WBI did not cause late skin damage.
