Heterotopic ossification (HO) is the formation of mature bone tissues in non-skeletal tissues and has been reported in various types of neoplasms. The presence of HO in pancreatic tumors is rare, with only 16 cases reported in the English literature, and the mechanism of HO formation remains unclear. In the present study, the 17th to 19th cases of HO in pancreatic neoplasms were described and the literature on HO in pancreatic neoplasms was reviewed. Three Japanese women with pancreatic masses on imaging underwent laparoscopic distal pancreatectomy. The three pancreatic masses were histopathologically diagnosed as a pancreatic neuroendocrine tumor (NET), mucinous cystic neoplasm (MCN), and intraductal papillary mucinous neoplasm, and HO was found in all of them. Neither pancreatic NET with HO nor MCN with HO has yet been reported in the English-language literature, and to our knowledge, these are the first such reports. Although rare, the knowledge that various types of pancreatic tumors, including NETs and MCNs, are associated with HO may be useful in daily practice, and the significance of tumor-associated HO is discussed.

Doxofylline, a xanthine derivative introduced in 1987, was developed as an alternative to theophylline for the treatment of chronic respiratory disease, including chronic obstructive pulmonary disease and bronchial asthma, but also a promising agent with therapeutic potential, unique pharmacological profile, improved safety and tolerability, potential to decrease corticosteroid dependence and applicability in diverse healthcare settings, including resource-limited environments. The present review examines the utility of doxofylline as an effective bronchodilator, highlighting its improved tolerability profile, minimal drug interactions and distinct pharmacological activities, including its roles as a phosphodiesterase inhibitor, adenosine receptor antagonist and β-adrenergic receptor agonist, alongside its bronchodilator, antitussive and anti-inflammatory properties. The present review performed a comprehensive analysis of literature and a comparative evaluation of relevant clinical trials. By contrast with theophylline, whose clinical use has diminished due to its narrow therapeutic window and notable side effects, doxofylline demonstrates a more favorable safety profile and wider therapeutic range. Doxofylline not only enhances spirometric values and reduces the need for salbutamol administration but also exhibits fewer adverse effects, contributing to improved patient tolerance and adherence to treatment. Clinical findings further suggest significant improvements in lung function, exercise capacity and quality of life among patients treated with doxofylline. These results underscore its potential as a viable long-term therapeutic option, particularly in resource-limited settings, where it may reduce corticosteroid dependency and provide an effective, affordable and safer alternative to theophylline.

Porcine liver decomposition product (PLDP) is a functional food that enhances delayed memory recall and frontal lobe function in humans and exerts antidepressant and anxiolytic effects. In the present study, the previously unexplored anti-inflammatory effects of PLDP were investigated both in vitro and in vivo. The effects of PLDP on interleukin (IL)-1β production were examined in lipopolysaccharide (LPS)-stimulated Raw 264.7 cells and on their transition to an M1 or M2 phenotype. The effects of PLDP administered 30 min before the initiation of a formalin-induced inflammation-related behavior were also evaluated. Furthermore, the effects of PLDP on LPS-induced inflammation related to cytokine production and behavior in vivo were examined. PLDP was orally administered for five consecutive days and 24 h after LPS administration the mice were evaluated in an open field test and plasma cytokine production was measured. PLDP and its lipid fraction, PLDP extracted lipids (PEL) suppressed LPS-induced IL-1β production. Flow cytometry revealed that PEL shifted Raw 264.7 cells to the M2 phenotype. Moreover, PEL reduced phase 2 inflammation-related behavior in formalin-induced inflammation. In the LPS-induced inflammation model, PLDP improved the LPS-attenuated locomotor activity and exploratory behavior and reduced the increased plasma interferon-γ levels. These results suggest that PLDP exerts anti-inflammatory effects and shifts macrophages to the M2 phenotype. Furthermore, our results indicate that the lipid components in PLDP, especially phospholipids, could exert considerable central neuroprotective effects.

Phenylketonuria (PKU) is an autosomal recessive metabolic disorder caused by pathogenic variants in the phenylalanine hydroxylase (PAH) gene. PKU is considered as one of the most common autosomal recessive diseases in Jordan; however, the spectrum of gene variants is yet to be determined. The present study aimed to identify the PAH genetic variants in a cohort of Jordanian children diagnosed with PKU. A total of 77 affected patients from 50 families were enrolled in the present study. All exons as well as exon-intron boundaries of the PAH gene were analyzed by Sanger sequencing. Segregation analysis was performed on the available family members. A total of 23 distinct PAH variants were identified with a detection rate of 100%. All variants were either pathogenic or likely pathogenic. These variants included 9 missense (39.1%), 6 splice site (26.1%), 4 frameshift (17.4%), 2 nonsense (8.7%) and 2 in-frame deletion (8.7%) variants. Among these variants, one was novel [c.781del; p.(Arg261Glufs80)]. The present study highlighted the wide spectrum of disease-causing variants in the PAH gene among Jordanian patients. The findings also underscore the importance of establishing region-specific genetic screening. Early genetic diagnosis of PKU will facilitate timely treatment and management of affected patients, risk stratification and genetic counseling, thereby reducing the burden of PKU in Jordan.

Coronary artery disease (CAD) is a common disease and can be treated with coronary artery bypass grafting (CABG) in specific cases. Stem cell therapy has been shown to be effective in patients with CAD who underwent CABG in several settings but limited to those without heart failure. The aim of the present study was to evaluate whether stem cell therapy is effective in patients with CAD who underwent CABG and had no heart failure. The present systematic review investigated wether there was any improvement in cardiac function or reduction of mortality in patients with CAD who received CABG and did not have heart failure. The types of studies included in this systematic review were randomized controlled trials. In total, four databases were used for a systematic search: PubMed, CENTRAL database, Scopus, and CINAHL Plus. The results were reported as the mean difference of left ventricular ejection fraction (LVEF) and risk ratio of mortality rate between stem cell therapy vs. controls. There were 125 studies retrieved from a search in the four aforementioned databases; of those, seven studies met the study criteria. Regarding the outcome of cardiac function, the standardized mean difference of LVEF between the experimental and the control groups was 0.17 (95% CI: -0.09, 0.44). The risk ratio of mortality was also not statistically significant (1.59; 95% CI: 0.68, 3.73). Stem cell therapy did not exert significant improvement of the LVEF or the mortality rate compared with controls, in patients with CAD who underwent CABG and had no heart failure. Further studies are required to confirm the results of the present study.

The present systematic review evaluated the efficacy and safety of tacrolimus (TAC) and other immunosuppressants in the treatment of systemic lupus erythematosus (SLE), providing evidence-based recommendations for clinical practice. PubMed, Web of Science, Embase and Cochrane Library databases were searched for clinical studies comparing TAC with other immunosuppressive drugs. A total of 12 studies, including 10 randomized controlled trials and two cohort studies involving 1,217 patients, were identified. The results indicated that TAC was significantly superior to cyclophosphamide (CYC) in complete remission (CR) rates [odds ratio (OR)=1.83, 95% confidence interval (CI): 1.33-2.51], whereas no significant differences were found when compared with mycophenolate mofetil [(MMF); OR=0.93; 95% CI: 0.58-1.47] or azathioprine [(AZA); OR=0.95; 95% CI: 0.49-1.84]. Thus, significant differences were found in the partial remission rates between TAC and CYC, MMF, or AZA. TAC demonstrated improvements in the short-term SLE disease activity index scores and albumin levels, with long-term efficacy comparable to that of MMF and CYC. Furthermore, the infection rate with TAC was lower than that with MMF (OR=0.48; 95% CI: 0.31-0.75), but similar to those with CYC and AZA. TAC also showed a lower incidence of leukopenia than AZA (OR=0.13; 95% CI: 0.04-0.43). In conclusion, TAC is superior to CYC in achieving CR in patients with SLE, with comparable efficacy to MMF and AZA. TAC improves short-term disease activity and albumin levels, and its long-term efficacy is similar to those of MMF and CYC.

The present study developed a novel injectable, biocompatible, and thermosensitive hydrogel system for ultrasound-triggered drug release, using a chitosan/sodium β-glycerophosphate/titanium dioxide nanoparticle (CS/β-GP/TiO2 NP) composite. The inclusion of TiO2 NPs aimed to enhance ultrasound sensitivity, enabling precise therapeutic release to targeted tissues. The hydrogels displayed excellent injectability (maximum injection force <6.5 N) and gelled effectively at body temperature. Biocompatibility was confirmed through Cell Counting Kit-8, LIVE/DEAD, and western blot assays. The present study demonstrated that hydrogels with TiO2 NPs significantly increased the release rates of sodium fluorescein and bovine serum albumin, affirming the role of TiO2 NPs as a sensitizer. This establishes the CS/β-GP/TiO2 NP hydrogel as a promising system for ultrasound-responsive drug delivery. Potential applications include drug delivery, tissue engineering, and wound healing, with the system offering controlled and targeted therapy under ultrasound stimulation. Future research will optimize hydrogel properties, assess in vivo performance, and evaluate long-term stability and effectiveness in clinical settings.

Embryonal tumor with medulloblastoma-like histopathology (ETMH) is an embryonic-type malignancy originating from remnants of primitive embryonic cells. It is rarer in adults, especially those over the age of 40. Adult ETMH occurring in the supratentorial region is extremely rare and has atypical radiology manifestations. The present study reported a case of adult supratentorial ETMH misdiagnosed as glioblastoma preoperatively. By summarizing its clinical features, radiological manifestations, differential diagnosis, and treatment and reviewing relevant literature, the present study aimed to improve the understanding of the diagnosis and treatment of adult supratentorial ETMH.

The SWitch/sucrose non-fermentable chromatin remodeling complex functions as a tumor suppressor by regulating gene expression and thus various cellular processes. Key subunits of this complex, including the AT-rich interactive domain (ARID)-containing proteins ARID1A, ARID1B and ARID2, are frequently mutated in cancer, including colorectal cancer (CRC). However, their protein expression and prognostic significance in CRC remain unclear. The present study investigated the ARID1A, ARID1B and ARID2 expression levels in CRC tissues and their relationship with the clinicopathological characteristics of patients. Bioinformatics analysis of The Cancer Genome Atlas-colon adenocarcinoma cohort revealed frequent mutations, positive mRNA correlations among the ARID genes and increased promoter methylation levels. Immunohistochemical analysis of 63 CRC tissue samples demonstrated significantly decreased ARID1A, ARID1B and ARID2 protein expression in cancerous areas compared with adjacent non-cancerous areas of the tissues. Low ARID1A and ARID1B expression levels were significantly associated with advanced clinicopathological characteristics in Thai patients with CRC. All three ARIDs showed a trend towards an association with the 5-year progression-free survival of Thai patients with CRC. Kaplan-Meier plotter database analysis further demonstrated that low expression of all three ARID genes was associated with a shorter overall survival time in patients with CRC; however, only ARID1A expression showed a statistically significant prognostic relevance. In conclusion, the ARID1A, ARID1B and ARID2 expression levels were shown to be positively correlated, and their reduced expression was associated with worse clinicopathological characteristics in patients with CRC. These findings suggest the potential of ARIDs as prognostic biomarkers, warranting further investigation to validate their clinical significance.

Recent advancements in diagnostic technologies have significantly transformed the landscape of respiratory medicine, aiming for early detection, improved specificity and personalized therapeutic strategies. Innovations in imaging such as multi-slice computed tomography (CT) scanners, high-resolution CT and magnetic resonance imaging (MRI) have revolutionized our ability to visualize and assess the structural and functional aspects of the respiratory system. These techniques are complemented by breakthroughs in molecular biology that have identified specific biomarkers and genetic determinants of respiratory diseases, enabling targeted diagnostic approaches. Additionally, functional tests including spirometry and exercise testing continue to provide valuable insights into pulmonary function and capacity. The integration of artificial intelligence is poised to further refine these diagnostic tools, enhancing their accuracy and efficiency. The present narrative review explores these developments and their impact on the management and outcomes of respiratory conditions, underscoring the ongoing shift towards more precise and less invasive diagnostic modalities in respiratory medicine.