MicroRNAs as biomarkers for early diagnosis, targeting and prognosis of prostate cancer.

Globally, prostate cancer (PC) is leading cause of cancer-related mortality in men worldwide. Despite significant advances in the treatment and management of this disease, the cure rates for PC remains low, largely due to late detection. PC detection is mostly reliant on prostate-specific antigen (PSA) and digital rectal examination (DRE); however, due to the low positive predictive value of current diagnostics, there is an urgent need to identify new accurate biomarkers. Recent studies support the biological role of microRNAs (miRNAs) in the initiation and progression of PC, as well as their potential as novel biomarkers for patients' diagnosis, prognosis, and disease relapse. In the advanced stages, cancer-cell-derived small extracellular vesicles (SEVs) may constitute a significant part of circulating vesicles and cause detectable changes in the plasma vesicular miRNA profile. Recent computational model for the identification of miRNA biomarkers discussed. In addition, accumulating evidence indicates that miRNAs can be utilized to target PC cells. In this article, the current understanding of the role of microRNAs and exosomes in the pathogenesis and their significance in PC prognosis, early diagnosis, chemoresistance, and treatment are reviewed.

Necrotizing Sarcoid Granulomatosis with Pneumothorax.

Necrotizing sarcoid granulomatosis (NSG) is a rare granulomatous pneumonitis which is composed of a background of sarcoidosis-like granulomas, granulomatous vasculitis, and variable amount of necrosis. We reported a case of a 38-year-old nonsmoking woman presented with left-sided chest pain and dyspnea for three days. Chest CT scan exhibited collapse consolidation of the left lower lobe with the presence of two separated small-sized cystic lesions within the collapsed segment. Lung lesion resection was performed, and histological examination confirmed the diagnosis by excluding other causes of granulomatous diseases. The prognosis of NSG is favorable, and medical treatment is usually not necessary, as well as in our case. NSG is a rare disease with nonspecific symptoms and good prognosis which is frequently confused with Wegener's granulomatosis, sarcoidosis, and Churg-Strauss syndrome. This entity should also be considered as differential diagnosis of necrotizing granulomatous diseases.

Mycobacterium haemophilum: A report of cutaneous Infection in a Patient with end-stage renal disease.

INTRODUCTION: Mycobacterium haemophilum is a slow-growing nontuberculous mycobacterium (NTM) that can cause ulcerating cutaneous or subcutaneous nodular skin lesions in immunocompromised and immunocompetent patients. Acid-fast staining cannot distinguish NTM from M. tuberculosis; culturing at two temperatures with iron-supplemented media and polymerase chain reaction (PCR) are needed for optimal detection of M. haemophilum. CASE PRESENTATION: A 32-year-old man with end-stage renal disease, undergoing hemodialysis twice a week, presented with multiple, painless, nonpruritic nodular lesions. A formalin-fixed paraffin-embedded tissue block from his finger lesion was sent to the Department of Pathology, Masih Daneshvari Hospital for consultation. The lesions were primarily diagnosed to be dermatofibroma by another pathologist. On microscopic examination, vague granuloma with areas of necrosis was observed. The diagnosis was established by positive acid-fast staining, negative PCR results for M. tuberculosis complex, and positive nested PCR results for M. haemophilum. CONCLUSION: Cutaneous lesions in immunocompromised patients with positive results in acid-fast staining and negative results for M. tuberculosis should be further assessed using skin culture and molecular techniques to identify rare, atypical mycobacterial species like M. haemophilum.

Preemptive low-dose of ketamine does not effective on anesthetic consumption, perioperative analgesic requirement and postoperative pain, nausea and vomiting in painful ophthalmic surgery.

BACKGROUND: Ketamine, a non-competitive NMDA (N-Methyl-D-Aspartate) receptor antagonist, is recognized as an intraoperative anesthetic agent. Increasing interest in the use of low-dose ketamine for postoperative analgesia has developed in part because of its NMDA-antagonistic properties, which may be important in attenuating central sensitization and opioid tolerance. Despite of many trial evaluations which have been done on the effect of low-dose ketamine in postoperative pain, the role of ketamine, as a component of perioperative analgesia, remains unclear. We evaluated the analgesic effect of low-dose ketamine during anesthesia induction in painful ophthalmic surgery. MATERIALS AND METHODS: After institutional approval and written informed consent, 88 patients undergoing retinal detachment, strabismus, and keratoplasty surgery aged 18-80 years old were randomly divided intoequal case and control groups. Anesthesia was induced with sodium thiopental, fentanyl, atracurium, and liducaine, and maintained with N2O, O2, and propofol. Ketamine 0.5 mg/kg was administered intravenously to patients in the case group during anesthetic induction. Mean blood pressure and pulse rate were listed in questionnaire every 5 minutes. The consumption of anesthetic, perioperative additional analgesic, extubation time, postoperative pain and nausea scores (based on Visual Analog Scale), vomiting frequency, and the recovery time were recorded. RESULTS: There were no differences in the recovery time (17.3 ± 3.4 in the case group vs. 16.3 ± 3 in the control group, P < 0.05), postoperative pain scores (5 ± 1 in the case group vs. 5.6 ± 2 in the control group, P < 0.05), the consumption of anesthetic (9376.9 ± 1245.8 in the case group vs. 9012.9 ± 1620 in the control group, P < 0.05), the analgesic requirements (1000 in the case group vs. 940.9 ± 135.6 in the control group, P < 0.05), and perioperative additional analgesic (63.4 ± 26.5 in the case group vs. 69.4 ± 25.6 in the control group, P < 0.05) between two groups. The extubation time in the case group (13.59 ± 4.83) was significantly shorter than in the control group (15.9 ± 3.6) (P = 0.01). CONCLUSION: This study demonstrates that a low dose administration of ketamine during anesthesia induction in retinal detachment, strabismus, and keratoplasty surgery improves the extubation time but have no effect on postoperative pain, nausea and vomiting, and perioperative additional analgesic requirements.