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ancer patients.The renin-angiotensin system (RAS) is a major regulator of body fluid hemostasis and blood pressure. Angiotensin type 1 receptors (AT1R) are one of the major components of this system and are widely expressed in different organs, including the gastrointestinal (GI) system. selleck products Very little known about the physiological roles of AT1R in GI tract but evidence has reported that local AT1Rs are upregulated in pathological conditions like GI malignancies and play role in stimulation of signaling pathways associated with GI cancers progression. AT1Rs axes signaling in tumor microenvironments stimulate inflammation and facilitate vascularization around the tumor cell to display invasive behavior. AT1Rs in stroma cells promote tumor-associated angiogenesis by upregulated of vessel endothelial growth factor (VEGF). Also, AT1Rs by the activation of molecular mechanisms such as PI3/Akt/NF-κB pathways increase the invasion of tumor cells. Experimental and clinical studies have reported that AT1R antagonists have beneficial influences by increasing the survival of patients with GI malignancies and reduction in the proliferation of GI cancer cell lines in vitro, and the growth and metastasis of tumors in vivo, therefore, AT1Rs antagonist have the potential for future anticancer strategies. This review focuses on the pathological roles of AT1Rs in GI malignancies.

Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to develop and validate a random survival forest (RSF) to identify important risk factors on mortality in colorectal patients based on their demographic and clinical-related variables.

In this retrospective cohort study, the information of 317 patients with colorectal cancer who were referred to Imam Khomeini Clinic of Hamadan during the years of 2002 to 2017 were examined. Patient survival was calculated from the time of diagnosis to death. In the present study, the RSF model was used to identify factors affecting patient survival. Also, the results of the RSF model were compared with the Cox model. The data were analyzed using R software (version 3.6.1) and survival packages.

One-, 2-, 3-, 4-, 5-, and 10-year survival rates of included patients were 81.4%, 63%, 57%, 52%, 45%, and 34%, respectively, and the median survival was obtained to be 53 months. The number of 150 patients was died at this time period. The four most important predictors of survival included metastasis to other organs, WBC count, disease stage, and number of lymphomas involved. RSF method predicted survival better than the conventional Cox proportional hazard model.

We found that metastasis to other organs, WBC count, disease stage, and number of lymphomas involved were the most four most important predictors of low survival for colorectal cancer patients.

We found that metastasis to other organs, WBC count, disease stage, and number of lymphomas involved were the most four most important predictors of low survival for colorectal cancer patients.

Therapeutic effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD) may in parts be attributed to the stimulation of white matter near the targeted structure. The dentato-rubro-thalamic (DRT) tract supposed to improve tremor control in patients with essential tremor could be one candidate structure. The aim of this study was to investigate the effect of stimulation proximity to the DRT on tremor control in PD patients treated with STN-DBS.

For this retrospective analysis, we included 36 consecutive patients (median age 65.5years) treated with STN-DBS for disabling motor symptoms including tremor. Stereotactic implantation of DBS electrodes into the motor area of the STN was performed using direct MRI-based targeting and intraoperative microelectrode recording. Tremor severity was assessed preoperatively and at regular intervals postoperatively (Unified Parkinson's Disease Rating Scale III). The DRT was visualized in 60 hemispheres after probabilistic fiber tracctography may optimize both individually DBS targeting and postoperative adjustment of stimulation parameters.

This retrospective analysis suggests that in STN-DBS, better tremor control in PD patients correlates with the distance of active electrode contacts to the DRT. Tractography may optimize both individually DBS targeting and postoperative adjustment of stimulation parameters.

Precise placement of electrodes in deep brain stimulation (DBS) may be influenced by brain shift caused by cerebrospinal fluid leaking or air inflow. We compared accuracy and treatment outcomes between a standard technique and one aiming at reducing brain shift.

We retrospectively reviewed 46 patients (92 targets) treated with bilateral subthalamic-DBS for Parkinson's disease. The patients were divided into two groups group A surgery was performed in supine position with standard burr hole, dural opening, fibrin glue and gelfoam plugging. Group B patients were operated in a semi-sitting position with direct dural puncture to reduce CSF loss. We analysed target deviation on head CT performed immediately after surgery and at 1 month merged with preoperative MRI planning. We recorded pneumocephalus volume, brain atrophy and target correction by intraoperative neurophysiology (ION).

In group A, the mean pneumocephalus volume was 10.55 cm

, mean brain volume 1116 cm

, mean target deviation 1.09 mm and ION corrected 70% of targets. In group B, mean pneumocephalus was 7.60 cm

(p = 0.3048), mean brain volume 1132 cm

(p = 0.6526), mean target deviation 0.64 mm (p = 0.0074) and ION corrected 50% of targets (p = 0.4886). Most leads' deviations realigned to the planned target after pneumocephalus reabsorbtion suggesting a deviation caused by displacement of anatomical structures due to brain shift. Definitive lead position was always decided with ION.

The modified DBS technique significantly reduced errors of electrode placement, though such difference was clinically irrelevant. ION corrected a high amount of trajectories in both groups (70% vs 50%). The choice of either strategy is acceptable.

The modified DBS technique significantly reduced errors of electrode placement, though such difference was clinically irrelevant. ION corrected a high amount of trajectories in both groups (70% vs 50%). The choice of either strategy is acceptable.