Malignant mixed Müllerian tumor (MMMT) or carcinosarcoma of the female genital tract is a rare but highly aggressive malignancy.

We report a unique case of primary ovarian MMMT with poorly differentiated angiosarcoma as its homologous sarcomatous component in a 53-year-old woman with a known germline BRCA1 mutation who presented with a pelvic mass. She underwent staging cytoreduction surgery including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymph node dissections. The removed right ovarian tumor formed a 2.5 cm nodular to cystic mass replacing the entire organ. Microscopic examination revealed two distinct tumor components: high-grade serous carcinoma and poorly differentiated angiosarcoma. The proliferating sarcomatous cells were diffusely positive for CD31 and Factor VIII, but were negative for 100, SOX10 and cytokeratin. Both the serous carcinoma and angiosarcoma components demonstrated aberrant strong and diffuse p53 nuclear positivity. KRAS mutation analysis revealed guanine-adenine-thymine point mutation at codon 12 in both tumor components. Metastatic tumor was found involving the contralateral left ovary with the cellular composition of pure angiosarcomatous component.

This is the first report of an ovarian MMMT with angiosarcoma as its homologous sarcoma component. The presence of aberrant p53 expression and identical KRAS mutation in both the serous carcinoma and angiosarcoma components supports the theory of malignant mesenchymal transition/metaplasia in the development of MMMT.

The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has been escalating annually, positioning it as the leading cause of chronic liver disease worldwide. Ursolic acid has demonstrated promising therapeutic efficacy in managing MASLD, thereby justifying the need for an in-depth exploration of its pharmacological mechanisms. This study aimed to investigate elucidate the therapeutic mechanisms by which ursolic acid modulates estrogen conversion in the treatment of MASLD.

Building upon prior studies that have highlighted the potent anti-inflammatory effects of ursolic acid and its specific targeting of 17β-hydroxysteroid dehydrogenase 14 (HSD17B14), this investigation employed a western diet to induce MASLD in murine models with varying severities over different time intervals.

The protein expression of HSD17B14 initially increased, followed by a subsequent decrease. This trend was accompanied by corresponding changes in 17β-estradiol (E2) and estrone (E1) levels. Intervention with ursolic acid resulted in a reduction in HSD17B14 and E1 levels during the phase of high HSD17B14 expression, while simultaneously elevating E2 levels. In steatotic hepatocytes, E1 promoted cellular inflammation, whereas E2 exhibited anti-inflammatory effects. However, the alleviated effects of E2 were antagonized by HSD17B14. As expected, ursolic acid modulated HSD17B14, thereby mitigating the inflammatory response in steatotic hepatocytes.

HSD17B14, a crucial enzyme regulating the balance between E1 and E2, catalyzes the conversion of estrogen E2 into E1, thereby exacerbating tissue inflammation induced by metabolic stress. Ursolic acid, by modulating HSD17B14-mediated estrogen conversion, appears to ameliorate immune-related inflammation in MASLD.

Brain metastases from ovarian cancer (BMFOC) are rare but associated with poor prognosis. This study aimed to evaluate the efficacy and safety of Gamma Knife stereotactic radiosurgery (GKSRS) in managing patients with BMFOC.

A retrospective analysis was conducted on 22 patients with BMFOC who were treated with GKSRS between January 2015 and May 2019. The median age at the start of treatment was 57.7 years (range, 46–72 years). A total of 70 brain metastases were treated, with each patient having between one and nine metastatic tumors. The mean tumor volume was 3.6 cm3 (range, 0.1–22.7 cm3). The mean peripheral dose was 16 Gy (range, 7–20 Gy), and the mean isodose curve was 54.6% (range, 45–80%).

At 12 months post-GKSRS, 68 metastatic tumors were assessed: 32 (47.1%) showed complete response, 20 (29.4%) had partial response, 14 (20.6%) remained stable, and two (2.9%) progressed, leading to a tumor control rate of 97.1%. No acute or chronic toxicity was observed.

GKSRS appears to be an effective and well-tolerated treatment for BMFOC, offering high tumor control rates and prolonged survival in selected patients.

Ischemic colitis has been previously associated with the use of certain medications; however, no cases have been reported in connection with zolmitriptan. This study aimed to describe a case of ischemic colitis associated with zolmitriptan use. A 56-year-old female patient taking zolmitriptan presented to the hospital with complaints of abdominal pain, bloody diarrhea, and emesis. Colonoscopy and abdominal imaging with computed tomography revealed findings consistent with ischemic colitis. After recognizing the association between ischemic colitis and zolmitriptan use, the medication was discontinued, and the patient recovered with supportive therapy. This is the first reported case of ischemic colitis associated with zolmitriptan.

Neurodegenerative diseases (NDs) represent a major global health challenge in aging populations, with their incidence continuing to rise worldwide. Although substantial progress has been made in elucidating the clinical features and molecular underpinnings of these disorders, the precise mechanisms driving neurodegeneration remain incompletely understood. This review examines the increasing significance of the gut–brain–immune triad in the pathogenesis of NDs, with particular attention to Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and multiple sclerosis. It explores how disruptions in gut microbiota composition and function influence neuroinflammation, blood–brain barrier integrity, and immune modulation through microbial-derived metabolites, including short-chain fatty acids, lipopolysaccharides, and bacterial amyloids. In both Alzheimer’s and Parkinson’s diseases, a reduced abundance of short-chain fatty acid-producing bacterial taxa has been consistently associated with heightened pro-inflammatory signaling, thereby facilitating disease progression. Although detailed mechanistic understanding remains limited, experimental evidence—primarily from rodent models—indicates that microbial metabolites derived from a dysbiotic gut may initiate or aggravate central nervous system dysfunctions, such as neuroinflammation, synaptic dysregulation, neuronal degeneration, and disruptions in neurotransmitter signaling via vagal, humoral, and immune-mediated pathways. The review further highlights how gut microbiota alterations in amyotrophic lateral sclerosis and multiple sclerosis contribute to dysregulated T cell polarization, glial cell activation, and central nervous system inflammation, implicating microbial factors in disease pathophysiology. In addition to identifying critical knowledge gaps, the review emphasizes the need for sustained, multifactorial research efforts, including the development of physiologically relevant brain–gut organoid models and the implementation of standardized experimental protocols. A major limitation in the field remains the difficulty of establishing causality, as clinical manifestations often arise after extended preclinical phases—lasting years or decades—during which aging, dietary patterns, pharmacological exposures, environmental factors, and comorbidities collectively modulate the gut microbiome. Finally, the review discusses how microbial influences on host epigenetic regulation may offer innovative avenues for modulating neuroimmune dynamics, underscoring the therapeutic potential of targeted microbiome-based interventions in neurodegenerative diseases.

Chronic subdural hematoma (CSDH) is a common disease in neurosurgery, with epidemiological characteristics showing an overall annual incidence of 1.7–20.6 per 100,000 people and a higher prevalence in the elderly. However, despite the increased disease burden, there have been limited breakthroughs in treatment options over the past 20 years. A significant gap exists in our understanding of the exact pathophysiological mechanism of CSDH, leading to a lack of specific clinical treatment options based on a clear pathological mechanism. Current research suggests that the development of CSDH involves dual mechanisms of trauma and inflammation, and that these pathologic processes together promote pathological changes such as angiogenesis, inflammatory response, and neovascularization. Therapies for CSDH encompass both surgical (e.g., twist-drill drainage, burr-hole drainage, craniotomy) and non-surgical approaches (e.g., clinical observation, medication, intracranial pressure monitoring, anticoagulation). Meanwhile, middle meningeal artery embolization, as an emerging minimally invasive interventional technique, has shown good prospects for clinical application. This review aims to bridge the gap between current treatment options and the need for effective strategies by providing a comprehensive summary of the epidemiological trends, pathophysiological advances, and optimization of therapeutic strategies for CSDH.

Acupuncture treatment on the DU channel has shown therapeutic effects for Alzheimer’s disease (AD), but the underlying mechanisms are not yet clear. The purpose of this study was to comprehensively observe the protective effects of acupuncture on different brain regions in AD model mice, providing laboratory evidence for clinical acupuncture intervention in AD.

Eleven senescence-resistant strain 1 male mice were used as the normal control group. The senescence-accelerated prone strain 8 (SAMP8) male mice were used as AD model mice. Thirty-three SAMP8 mice were randomly divided into three groups: AD model group (group M), drug treatment group, and acupuncture treatment group (group A). The effect of acupuncture on learning and memory capabilities of SAMP8 mice was assessed by the Morris water maze test. Nissl staining was employed to provide a general view of the brain structure in AD model mice. Additionally, Western blot analysis was used to quantify Caspase-3 and tau protein levels.

In the spatial navigation test, the ratio of time mice spent in the goal quadrant in group M remained low, even lower than 25%. The ratio of time spent in the goal quadrant by mice in the acupuncture group on day 4 was higher than that on day 1 (P < 0.01). There was a trend indicating that the time ratio of mice in the acupuncture group during the probe trial was higher than in group M, though there was no statistically significant difference. Most traces of mice in group A were in the goal platform quadrant and across the platform in different, yet effective, ways. Compared to group M, most of the cells in the frontal cortex, hippocampus, and temporal cortex of mice in group A were round with clear stratification, regular arrangement, and increased Nissl bodies. The content of Caspase-3 in the frontal cortex and hippocampus of mice in the acupuncture group was lower than in group M (P < 0.01, P < 0.05). The content of tau in the hippocampus and temporal cortex of mice in group A was lower than in group M (P < 0.05; P < 0.01).

Acupuncture at the DU channel can improve learning and memory abilities to a certain degree by reducing apoptosis in the frontal cortex and hippocampus and decreasing tau deposition in the hippocampus and temporal cortex of AD model mice.

The development and progression of breast cancer may be influenced by thyroid hormone levels. In this study, we investigated thyroid function in pre- and postmenopausal women with breast cancer, with and without neoadjuvant chemotherapy (NCh).

The study included 198 women diagnosed with infiltrating ductal carcinoma: 83 did not receive NCh (39 premenopausal and 44 postmenopausal), while 115 underwent NCh before surgery (63 premenopausal and 52 postmenopausal). Additionally, 78 healthy volunteers, aged 28 to 69 years, served as the control group. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) were quantified using chemiluminescent immunoassays.

We observed a significant increase in serum TSH and fT4 levels in both pre- and postmenopausal women with breast cancer, regardless of NCh treatment, compared to control subjects. However, postmenopausal women with breast cancer who received NCh showed lower fT4 levels than their untreated counterparts. Notably, fT3 levels increased only in premenopausal women with breast cancer who underwent NCh, compared to both the premenopausal control group and untreated premenopausal breast cancer patients.

Altered thyroid function was observed in both pre- and postmenopausal women with breast cancer, characterized by increased TSH and fT4 levels. Neoadjuvant chemotherapy appeared to attenuate the rise in fT4 levels in postmenopausal women while elevating fT3 levels in premenopausal women. These findings highlight the importance of monitoring thyroid hormone profiles in women with breast cancer, considering menopausal status, given their potential influence on tumor progression and chemotherapy effectiveness.

The refusal of blood transfusions and blood derivatives compels surgeons to face clinical and ethical challenges. We reviewed our perioperative and long-term outcomes of Jehovah’s Witnesses undergoing colon cancer surgery to evaluate the feasibility of bloodless procedures.

We retrospectively analyzed data from patients with colon cancer and Jehovah’s Witnesses who underwent surgery between January 2014 and December 2023. A protocol was systematically followed to optimize hemoglobin levels and other parameters according to the Enhanced Recovery After Surgery guidelines.

Sixteen patients underwent colon surgery, with a median age of 69 years and an equal gender distribution. Thirty-seven and a half percent had preoperative anemia and were managed by a hematologist. All procedures were performed in accordance with oncological standards. Postoperative treatment included low molecular weight heparin, and hemoglobin levels temporarily decreased postoperatively. No blood transfusions were needed during hospitalization. Two patients required surgical intervention due to postoperative hemorrhage. Complications included anastomotic dehiscence and perforation, with an overall morbidity rate of 25% and no 90-day mortality.

This study highlights the challenges in managing patients who reject blood products during colon cancer surgeries; however, the outcomes show results comparable to those of the general population with appropriate protocols. Preoperative optimization is crucial to reduce blood loss. Treatment of postoperative hemorrhage requires a lower threshold for intervention due to limited alternatives to blood products. Despite the limitations of the study, the findings advocate for careful monitoring and intervention. Larger studies are needed to validate these findings and improve care for this group of patients.

Histopathology is the gold standard in cancer diagnosis. However, attenuated total reflectance (ATR)-Fourier transform infrared (FTIR) spectroscopy has shown diagnostic potential in other settings. Therefore, this study aimed to investigate the sensitivity and specificity of the ATR-FTIR spectroscopy in evaluating breast lesions.

This study was conducted on formalin-fixed, paraffin-embedded biopsy blocks received at Ladoke Akintola University of Technology Teaching Hospital between 2022 and 2023. The blocks were categorized into 10 normal (from benign breast tissue), 15 benign, and 31 malignant samples. Tissue sections of 15 µm were obtained during block trimming and floated onto FTIR slides. An additional 4 µm tissue sections were stained with hematoxylin and eosin for tumor diagnosis and to identify suitable areas on the FTIR slide. Spectrometer readings were taken within the range of 4,000–600 cm−1, 32 scans, and 16 cm−1 resolution, using the average of 10 preprocessed spectra per slide. Biomarkers were calculated by ratioing peak intensities for A1632/A1543, A1632/A2922, A1632/A1080, A1080/A1543, A1237/A1080, and A1043/A1543, which represent protein, diagnostic marker, cytoplasm-nucleus ratio, carcinogenesis marker, phosphate, and glycogen, respectively. The receiver operating characteristic curve was used to determine sensitivity, specificity, and the area under the curve (AUC).

The AUC analysis showed that cytoplasm-nucleus ratio values of 0.99 and 0.95 effectively distinguished normal from malignant tissue, and benign from malignant tissue, respectively (p < 0.0001). Additionally, protein marker (AUC = 0.73), diagnostic marker (AUC = 0.85), and cytoplasm-nucleus ratio marker (AUC = 0.94) were able to discriminate normal from benign tissue. Overall, the receiver operating characteristic analysis showed 100% sensitivity and specificity ranging from 54% to 87%. Glycogen (AUC = 1.00) exhibited 100% sensitivity in discriminating fibroadenoma from fibrocystic changes.

ATR-FTIR spectroscopy demonstrates high diagnostic accuracy in differentiating normal, benign, and malignant breast tissues using specific spectral biomarkers. Among these, the cytoplasm-nucleus ratio marker showed strong potential as a reliable spectral indicator for distinguishing various types of breast tumors. The cytoplasm-nucleus ratio marker demonstrated strong potential as a reliable spectral indicator for distinguishing various types of breast tumors.