ABSTRACT
As is the case for most solid tumours, chemotherapy remains the backbone in the management of metastatic disease. However, the occurrence of chemotherapy resistance is a cause to worry, especially in bladder cancer. Extensive evidence indicates molecular changes in bladder cancer cells to be the underlying cause of chemotherapy resistance, including the reduced expression of farnesyl-diphosphate farnesyltransferase 1 (FDFT1) - a gene involved in cholesterol biosynthesis. This can likely be a hallmark in examining the resistance and sensitivity of chemotherapy drugs. This work performs spectroscopic analysis and metabolite characterization on resistant, sensitive, stable-disease and healthy bladder tissues. Raman spectroscopy has detected peaks at around 1003 cm-1 (squalene), 1178 cm-1 (cholesterol), 1258 cm-1 (cholesteryl ester), 1343 cm-1 (collagen), 1525 cm-1 (carotenoid), 1575 cm-1 (DNA bases) and 1608 cm-1 (cytosine). The peak parameters were examined, and statistical analysis was performed on the peak features, attaining significant differences between the sample groups. Small-angle x-ray scattering (SAXS) measurements observed the triglyceride peak together with 6th, 7th and 8th - order collagen peaks; peak parameters were also determined. Neutron activation analysis (NAA) detected seven trace elements. Carbon (Ca), magnesium (Mg), chlorine (Cl) and sodium (Na) have been found to have the greatest concentration in the sample groups, suggestive of a role as a biomarker for cisplatin resistance studies. Results from the present research are suggested to provide an important insight into understanding the development of drug resistance in bladder cancer, opening up the possibility of novel avenues for treatment through personalised interventions.
Subject(s)
Cisplatin , Drug Resistance, Neoplasm , Spectrum Analysis, Raman , Urinary Bladder Neoplasms , Humans , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Cisplatin/pharmacology , Cisplatin/therapeutic use , Farnesyltranstransferase/metabolism , Spectrum Analysis, Raman/methods , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/metabolism , Urinary Bladder Neoplasms/pathology , X-Ray Diffraction , Farnesyl-Diphosphate Farnesyltransferase/metabolismABSTRACT
Complex regional pain syndrome (CRPS) is a chronic neurologic painful disorder usually present after a traumatic insult. It is divided into two subtypes based on the absence of a significant nerve injury: type 1 or dystrophy and type 2 or causalgia. The exact mechanism still needs to be fully understood. The management of CRPS requires a multidisciplinary team approach with a rehabilitation program and physical and occupational therapies. We present a case report of a 22-year-old Saudi female with no medical or surgical history who presented to the clinic with severe pain, swelling, and discoloration in the left lower limb associated with unusual symptoms of non-epileptic convulsion attack and short-term memory loss for three years that increased in intensity. There was marked swelling and discoloration of the left lower limb, which was more significant at the foot, and the limb was tender and warm to the touch and allodynia. A slight touch to the limb led to a whole-body non-epileptic convulsion lasting for less than 30 seconds and loss of short-term memory and consciousness following the convulsion attack. A multidisciplinary team primarily managed the patient. In this case, the rarity and refractory to medical management emphasize the importance of understanding the different therapeutic modalities in managing this syndrome. However, more studies are warranted to understand the exact cause, pathogenesis, and available treatment options.
