atrophy

Idiopathic portal hypertension (IPH) is a rare clinical condition often misdiagnosed as cirrhosis. The management of IPH focuses on preventing and treating complications related to portal hypertension, such as bleeding from esophagogastric fundal varices. In contrast, the management of cirrhosis focuses on symptomatic treatment based on etiology, protecting hepatocyte function, and inhibiting hepatic inflammation and fibrosis. Therefore, it is crucial to correctly recognize both diseases and take appropriate therapeutic measures.

The aim of this study was to summarize and analyze the imaging, pathological, and serological features of idiopathic portal hypertension and cirrhosis to reduce misdiagnosis in clinical practice. Patients and

Pathological, radiological parameters [computed tomography (CT)/magnetic resonance imaging (MRI)], and serological examinations were retrospectively evaluated for 14 patients with IPH and 30 patients with cirrhosis. We analyzed and compared their imaging manifestations in terms of spleen thickness and length, liver morphology, hepatic lobe atrophy, hyperplasia, portal vein thrombosis, arteriovenous phase liver perfusion, regenerative nodules, focal nodular hyperplasia-like lesions of the liver, portal vein morphology, splenorenal shunt, and hepatorenal shunt. The aim was to investigate the correlation between the imaging manifestations and the pathological manifestations.

There were significant differences between the IPH and cirrhosis groups in individual indicators of liver function, routine blood tests, and coagulation function (P < 0.05). Significant differences in spleen thickness and length were also observed between the IPH and cirrhosis groups (P < 0.05). Atrophy and hyperplasia of the hepatic lobe differed between the two groups. Changes in liver morphology and parenchyma were observed in both the IPH and cirrhosis groups, with diffuse regenerative nodules and focal nodular hyperplasia-like lesions being significant for distinguishing between IPH and cirrhosis. Focal nodular hyperplasia-like lesions were more common in patients with idiopathic portal hypertension, whereas diffuse regenerative nodules were more common in patients with cirrhosis. All 14 IPH patients had abnormalities in the portal vein system, including main portal vein dilation, stiffness, straightening, and distal branch vein stenosis or occlusion, while 9 cirrhosis patients had portal vein abnormalities, primarily thinning of the portal vein. Pathology revealed that patients in the cirrhosis group had varying degrees of cell necrosis and edema, and pseudolobule formation was observed in all patients. Patients with IPH showed varying degrees of fibrosis in the portal and confluent areas, but lobular inflammation was not evident. Some IPH patients experienced portal vein occlusion and stenosis.

Idiopathic portal hypertension is relatively rare in clinical practice and is characterized by mostly normal liver function and hypersplenism, which may lead to a decrease in platelets, red blood cells, and white blood cells. If a giant spleen is found on imaging and the liver surface is smooth, IPH should be considered. Additionally, fibrosis, stenosis, and occlusion of the portal venous system, as well as focal nodular hyperplasia-like lesions, are suggestive of idiopathic portal hypertension. In contrast, diffuse regenerative nodules and pseudolobule formation are often indicative of cirrhosis. Furthermore, atrophy and hyperplasia of the liver are significant in differentiating the two diseases.

Multiple sclerosis (MS) is one of the most common and debilitating neurological diseases. Brain magnetic resonance imaging (MRI) is critical to determine the prognosis of MS. Using simple and accessible techniques is one of the researchers' concerns. So far, limited studies have been conducted on evaluating the relationship between the Bi-caudate ratio (BCR) and white matter atrophy in brain MRI of patients with MS. Therefore, in this study, we decided to evaluate this relationship.

In this cross-sectional study, which was conducted to determine the relationship between BCR and white matter atrophy in brain MRI patients with MS, patients with MS who were evaluated by MRI at Imam Hossein Hospital (Tehran-Iran) in 2022 were assessed. BCR is determined by dividing the shortest distance between two caudate nuclei by the length of the brain at the imaging. The symbol digit modalities test (SDMT) was used to check the cognitive function of patients, and the relationship between BCR and MS-related parameters was evaluated. Expanded disability status score (EDSS) was also evaluated. A significance level was considered less than 0.05.

Eighty-five patients with a mean age of 40.73 ± 8.45 years and female gender was more prevalent (65.9%). The mean EDSS in all participants was 2.64 ± 2.49, and the mean BCR was 0.11 ± 0.03. EDSS score, age of the disease onset, SDMT score, and BCR were significantly different between different MS types (secondary progressive MS, primary progressive MS, and relapsing-remitting MS) (P-values<0.05). There was a statistically significant relationship between age, disease duration, EDSS score, onset age of the disease, and SDMT score with BCR (P<0.05). There was a statistically significant difference in the amount of BCR between sexes (P<0.045).

BCR is a valuable method for evaluating the condition of multiple sclerosis, and it can be used as a simple and accessible technique for evaluating MS conditions.

Overweight and obesity increase the risk of cardiovascular diseases. Obesity is also known to contribute to heart muscle atrophy. This study investigates the effects of aerobic exercise and royal jelly (RJ) supplementation on indices of heart tissue atrophy and hypertrophy in rats fed a high-fat diet.  Forty-five male Wistar rats were randomly divided into five groups (n=9 per group): normal diet (ND), high-fat diet (HFD), high-fat diet with training (HFDT), high-fat diet with royal jelly (HFDRJ), and high-fat diet with both training and royal jelly (HFDTRJ). The supplement groups received 100 mg of royal jelly per kg of body weight orally every day. The exercise program involved running on a treadmill at an intensity of 50-60% of VO2max, performed five days a week for eight weeks. Data were analyzed using one-way ANOVA and Tukey's post hoc test with a significance level of p<0.05.  In the HFD group, the expression of FoxO3a and MAFbx was significantly increased, while AMPK expression was decreased compared to the ND group (P=0.000). There was a significant decrease in FoxO3a and MAFbx expression in the HFDT (P=0.033 and P=0.027), HFDRJ (P=0.049 and P=0.041), and HFDTRJ (P=0.000 and P=0.000) groups compared to the HFD group. Additionally, the HFDTRJ group showed significant reductions in FoxO3a and MAFbx compared to the HFDT (P=0.045 and P=0.041) and HFDRJ (P=0.030 and P=0.027) groups. A significant increase in AMPK expression was observed in the HFDT (P=0.002), HFDRJ (P=0.007), and HFDTRJ (P=0.000) groups compared to the HFD group. Furthermore, the HFDTRJ group exhibited higher AMPK expression compared to the HFDT (P=0.048) and HFDRJ (P=0.015) groups.  Aerobic training, with or without the intake of royal jelly, leads to a reduction in the expression of FoxO3a and MAFbx and an increase in AMPK. These changes may result in decreased atrophy indices and enhanced hypertrophy of cardiomyocytes in rats fed a high-fat diet.

Cervical cancer has seen a significant decline in death rates due to early diagnosis and treatment. The Pap test remains valuable but exhibits limitations, such as false positives and false negatives, with the former associated with atrophy-related changes. This article aims to bring attention to cervical carcinoma screening, focusing on the interpretation of atrophy-related changes in Pap smears and minimizing intervention.

This retrospective study, conducted at a tertiary care center, evaluated cases with intra-epithelial abnormalities or malignancies in Pap smears.

A total of 11,680 cervical cytology smears received in the Department of Pathology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, over 7.5 years (From January 1, 2016, to June 30, 2023), were reviewed. Of these, 56 cases exhibited epithelial abnormalities and were categorized as follows: 1. Atypical squamous cells of undetermined significance, 2. Low-grade squamous intraepithelial lesion, 3. High-grade squamous intraepithelial lesion, and 4. Malignancy. Among the 56 smears, 40 (71%) showed co-existent atrophy. Biopsies were available for 22 smears, and atrophy with epithelial abnormalities co-existed in 16 (28%) of these cases. Of these 16 cases, only eight (50%) were found to have abnormalities greater than Cervical Intraepithelial Neoplasia II dysplasia. This results in the positive predictive value of cervical cytology smears detecting epithelial abnormalities in cases with co-existing atrophy-related changes being only 50%.

The article emphasizes the importance of cautious interpretation of Pap smears in the presence of atrophy.

Muscle atrophy due to immobility is a common complication of many diseases and a consequence of therapeutic processes. Immobility and inactivity have been shown to be associated with increased inflammation. The aim of this study was to investigate the therapeutic potential of Wild Bitter Melon (WBM) (Momordica charantia Linn) on muscle atrophy due to immobility in a mouse model. This study was performed in two phases of atrophy and recovery on male BALB/c mice which were divided into 3 groups: control, immobilized, and experimental. The treatment period with WBM at a dose of 400 mg/kg daily by gavage was 17 days, including 7 days of being immobilized and 10 days of recovery. At the end of each phase, half of the mice from each group were examined regarding the four limb grip strength, and then histological and biochemical analyses were done. The tissue level of malondialdehyde (MDA) oxidative stress index in the atrophy phase in the atrophy group (5.4567±0.522) nmol/g compared to the control group (3.455±0.065) nmol significantly (p 0.001) <) increased. Also, the tissue level of MDA in the WBM group (3.87±0.035) showed a significant decrease compared to the atrophy group (p<0.01). The strength percentage of four limbs in the mice of the treatment group (-23.46±2.45) was significantly higher than that of the atrophy group (-30.60±3.15) at the end of the atrophy phase. The results suggest that the use of WBM reduces the degree of inflammation, oxidative stress and muscle damage, as well as muscle atrophy, which may improve the muscle atrophy in mice.

Vulvovaginal atrophy (VVA) is a common condition and a silent epidemic affectingmany postmenopausal women who suffer from it in silence. This study aimed to evaluate the effect ofCitrus aurantium vaginal cream on vaginal atrophy in postmenopausal women. This single-group pretest-posttest quasi-experimental study was conducted on 30postmenopausal women who were referred to the Gynecology Clinic of Imam Khomeini Hospital in thecity of Noor, Iran, from June to November 2020. Citrus aurantium vaginal cream was administered towomen diagnosed with vaginal atrophy (based on subjective symptoms of atrophy, descriptive evaluationof the vagina, vaginal pH measurement, and degree of vaginal maturation determined by vaginal smear)every night in the first two weeks and every other night for the second two weeks. Data were collectedusing the scale of subjective symptoms of vaginal atrophy; descriptive evaluation checklist of vaginalmucosa; laboratory results registration form (vaginal maturation index, vaginal maturation value, andvaginal pH) before the intervention and two and four weeks after the intervention. Data were analyzedusing SPSS software (version 24) through the analysis of variance with repeated measurements, andLSD post-hoc test. A P value less than 0.05 (P<0.05) was considered statistically significant. Citrus aurantium vaginal cream improved subjective symptoms of vaginal atrophy (P<0.001),reduced the score of descriptive evaluation of vaginal mucosa (P<0.001), decreased vaginal pH(P<0.001), and increased vaginal maturity (P<0.001). The results showed that citrus aurantium vaginal cream could improve the symptoms ofvaginal atrophy without causing serious complications. However, further studies with a control groupare suggested to confirm the findings of this study.Trial Registration Number: IRCT20200215046494N1

In this case report, we employed an admix material to record the neutral zone in a patient presenting with a palatal fistula and an atrophic mandibular ridge.

Case report:

 In this case report, we present a 67-year-old edentulous female with a history of oropharyngeal carcinoma affecting the soft palate. A circular palatal fistula, measuring approximately 8mm×8mm, was identified at the junction of the hard and soft palate. The mandibular residual ridge displayed significant atrophy. The neutral zone was recorded using admix material, comprising three parts by weight of impression compound and seven parts by weight of tracing compound. The fabricated dentures yielded favorable outcomes in terms of denture stability, and patient comfort. The patient reported the absence of nasal regurgitation and a notable improvement in speech production due to the obturator prosthesis.

The neutral zone impression technique with admix impression material provided successful results in constructing both a mandibular complete denture and a maxillary denture with an obturator.  The retention and stability of the complete denture were desirable and the patient was satisfied with the outcome.

Vulvovaginal atrophy (VVA) usually occurs during and after menopause due to low estrogen levels and can cause frustrating symptoms. Existing treatments such as estrogen compounds have undesired side effects.

This study was conducted to assess the effectiveness of a chicken tallow product for vaginal use on subjective symptoms of VVA in women with breast cancer.

Menopause induced by chemical drugs with subjective symptoms of VVA were selected from the Oncology-Radiotherapy Clinic of Shohadaye Tajrish Hospital between March and July 2020. Informed consent was obtained. Patients were instructed to apply 5g cream every other night before bedtime for 2 weeks, and 2 nights a week for the next 2 weeks and stop themedication. Patients were assessed at the time of initiation of medication, and 2, 4, 6, and 8 weeks after initiation of the trial, and VVA subjective symptoms were assessed. VVA subjective symptom score (VVA-SSS) form was used to assess itching, burning, dryness, and dyspareunia, using a 5-point Likert scale. Data were, then, analyzed.

Fifty women were included in the study (age above 18 years). All 5 monitored indices (itching, burning, dryness, dyspareunia, and VVA subjective symptoms score) diminished after initiation of intervention and reached a minimum level after 4 weeks of intervention (1.10 ± 1.16 baseline to 0.04 ± 0.20 at 4 weeks for itching, 1.42 ± 1.09 to 0.04 ± 0.20 for burning, 2.68 ± 0.91 to 0.30 ± 0.54 for dryness, 2.96± 0.88 to 0.50 ± 0.61 for dyspareunia, and 8.12 ± 2.70 to 0.86 ± 1.07 for VVA-SSS). During the 4 weeks following discontinuation of treatment, the symptoms slightly increased but remained significantly lower than the baseline (P-value < 0.001 for all 5 indices at all monitored time points).

The proposed treatment, rooted in Persian traditional medicine, may offer a safe and effective treatment for VVA symptoms in BCS.

on the one hand, very limited studies were performed on identifying the active regions during swallowing among healthy individuals and those with dementia. On the other hand, to the best of our knowledge, no research has yet compared the injured areas in the brain of patients with dementia with and without dysphagia, such that damage to specific regions in dementia causes dysphagia may be found using this approach. The present study was performed to evaluate the atrophic changes in the internal temporal lobe (hippocampus), frontal (anterior cingulate cortex), and parietal (posterior cingulate cortex), and insula cortex in these patients. the present study is a retrospective cross-sectional study. 54 patients with dementia were investigated. The data were collected using a checklist, including information related to the dysphagia, and the brain MRI findings to determine atrophy. The extent of atrophic changes was recorded in the checklist using the median temporal lobe atrophy (MTA) score, Koedem score scale, and the global cortical atrophy (GCA) scale. To present the results, descriptive statistics, and data comparison, chi-square tests were used. The mean age of the examined patients was 72.01 with a standard deviation of 10.64 years, and range of 50-95 years. Out of them, 32 (59.3%) were male, and 22 (40.7%) were female. The degree atrophy of hippocampus (p=0.12), frontal lobe (P=0.46), parietal lobe (P=0.83), and insular cortex (P=0.91) in the patients with and without dysphagia did not show significant differences. The frequency distribution of the degree of atrophy based on the site of the development of atrophy was significant in the patients with dysphagia (P=0.033). In general, the findings showed that individuals with dementia who had dysphagia had more hippocampal and frontal lobe (and anterior cingulate) atrophy than dementia patients who did not have this impairment.

Muscle loss occurs in some conditions such as aging, sarcopenia, and cancer. The interaction between protein synthesis and degradation signaling components induced by high-intensity interval training (HIIT) is not well studied.

The purpose of the present study was to simultaneously examine the effect of eight-week HIIT on the gene expression of both signaling components.

Sixteen male Wistar rats were randomly assigned to HIIT and non-exercise control groups. The HIIT group ran on a treadmill, five days/week for eight weeks, with 0º slope, including five interval sets of high and low intensity. Forty-eight hours after the last exercise session, dissected soleus muscles were stored at -80°C for later analyses.

The gene expression of Akt1, mTORC1, and S6K1 were increased in the HIIT group compared with the control group (All P ≤ 0.031) concomitant with the suppression of eIF4EBP1. The results of the S6K1 and eIF4EBP1 mRNA were also confirmed by the Western blotting. According to the inhibitory effect of Akt1, the gene expressions of FoxO3a and, consequently, MuRF1 and LC3A were significantly inhibited (All P ≤ 0.003). Western blot analysis did not confirm the LC3A protein expression, which may underline the role of LC3A in autophagy to promote cell survival.

The intensities and durations of the exercise training protocol are sufficient to increase protein synthesis signaling components and especially inhibit the atrophy-related gene expression, which may lead to attenuating muscle loss and increasing muscle mass. Accordingly, it may be considered for rehabilitation and/or prevention of some conditions such as sarcopenia and cachexia.

We assessed the presence of brain volume loss in the extratemporal structures in patients with temporal lobe epilepsy (TLE). The associations between brain volume loss in these structures and epilepsy duration, magnetic resonance imaging (MRI) findings, and occurrence of focal to bilateral tonic-clonic seizures (TCS) were assessed.

In this cross-sectional study, all adult patients with drug-resistant TLE, who were admitted to the epilepsy monitoring unit at Loghman-Hakim Hospital, Tehran, Iran, during 2016-2020, were included. For all the participants, brain MRI was performed and patients with TLE were divided into two subgroups of those with hippocampal sclerosis (TLE-HS) and patients with normal-appearing brain MRI findings (TLE-no). Independent sample t test was applied to compare quantitative variables in the study groups. Pearson correlation test examined the correlation between the clinical and volumetric features.

203 participants (81 patients with TLE and 122 healthy controls) were studied. Compared with healthy controls, patients with TLE showed a decrease in their midbrain (P = 0.02) and thalamus (P = 0.01) volume. The degree of thalamic atrophy was more significant in TLE-HS (P = 0.03). Moreover, the degree of midbrain volume loss was more significant (P = 0.07) in patients who had TCS in the past two years (N = 31) compared with those who did not (N = 50). The volume of the thalamus (r: -0.252, P = 0.02) and pallidum (r: -0.255, P = 0.02) had inverse correlations with the epilepsy duration.

Patients with TLE have lower midbrain and thalamus volume compared with the healthy controls, which may be attributed to the seizure-induced injury. Midbrain atrophy may theoretically increase the risk of sudden unexpected death in epilepsy (SUDEP) because of the enhanced autonomic dysfunction.

Posterior Cortical Atrophy (PCA) is a rare neuropsychiatric syndrome characterized by the dominancy of visuospatial impairments due to bilateral parieto-occipital divesting with the most common pathological changes presented in typical Alzheimer’s Disease (AD). We reported 3 cases with similar diagnoses and interesting manifestations in this study. Gradual onset and progression of visual deficits without underlying ophthalmologic disease accompanied by intact memory and fluent speech and also the presence of simultagnosia, optic ataxia, oculomotor apraxia, dyscalculia, finger agnosia, and environmental disorientation, and the absence of any history of related diseases; all of them strongly suggesting posterior cortical atrophy.

This study aimed to measure PGC-1α4 soleus muscle and to investigate the effect of endurance training pre-conditioning with different intensities on the atrophy response of the soleus muscle to a period of inactivity.

In this experimental study, 24 male Wistar rats were randomly divided into equal groups of control (C), control inactivity (CI), high-intensity endurance training group (HE) (treadmill speed 30 km/h), and low-intensity endurance training (LE) (treadmill’s speed: 10 km/h). After two weeks of familiarization, the endurance training group ran on a treadmill for two weeks (five sessions each week). The animal’s lower limbs were then immobilized for seven days. Then the soleus muscle was extracted, and after weighting, the expression of the PGC-1α4 gene was measured using the real-time polymerase chain reaction (realtime PCR) technique. Data were analyzed using SPSS software, version 24.

The expression of the PGC-1α4 gene was significantly higher in the HE group than the CI group. However, compared to the C group, all groups with inactivity intervention showed significantly lower PGC-1α4 gene levels. The ratio of muscle mass to body weight in the C group was significantly higher than the LE and CI groups, and higher in the HE group than the CI group.

Endurance training seems to be able to reduce the destructive effects of inactive atrophy. The higher intensity of these exercises was more effective, which was associated with increased expression of the PGC-1α4 gene.