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Antiviral Drugs as Tools for Nanomedicine
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
Figure 12.3 depicts the various steps of cancer development (Witsch et al. 2011). In brief, cancer is instigated by a somatic mutation conferring considerable survival and growth advantages to the initiated cell (1). GFs like EGF and IGF1 help the resulting expansion of clones having mutations (2), this results in intra-luminal lesions (3), such as carcinoma at the site or neoplasia, which are surrounded by the basal membrane. (4) Next step is migration and penetration by cancer cells into neighbouring tissues called invasion. Loss of epithelial polarity, motility attainment, changing phenotype to mesenchymal-like, and secretion of enzymes like proteases. The various oncogenes and tumour suppressors, with the involvement of different growth factors, control the critical phase of tumour development. The extravasation of transformed cells - cancer cells from the site and intravasation into the lymphatic and blood vessels results in metastasis (5) to distant organs. Extra- and intravasation require the assistance of macrophages, platelets, and endothelial cells. At this stage of resulting micro-metastases, (6) the cells usually are sensitive to chemotherapy and radiotherapy. However, constant accumulation of mutation leads to the acquisition of further mutations and makes the cancer cells proficient to produce growth factors. This leads to autocrine loops that propel the development of resistant clones (7). Angiogenesis (8) is an indispensable factor for the establishment of secondary tumours. In the last phase, large metastases (9) move to a distinct set of target organs leading to metastases.
Hysteroscopic Myomectomy
Published in Botros R.M.B. Rizk, Yakoub Khalaf, Mostafa A. Borahay, Fibroids and Reproduction, 2020
Anja Frost, Mostafa A. Borahay
Cervical injection of vasopressin can be considered before the start of the case, which can reduce intravasation of fluid, reduce intraoperative blood loss, and improve visualization, although it has not been shown to reduce operation duration [24]. Paracervical/intracervical blockade has also been studied and can be considered with injection of local anesthetic (i.e., 1% lidocaine) prior to initiation of cervical dilation.
Metastasis
Published in John Melford, Pocket Guide to Cancer, 2017
Intravasation refers to the passing of cancer cells into the bloodstream or lymphatic system. To accomplish it, migrating cells need to traverse tissues between their primary tumor and carrier vessels, and squeeze through junctions between cells of blood vessels. Both intravasation and extravasation involve changes to the shape of a cancer cell and therefore, involve regulators that affect the cytoskeleton of cells. The blood system is considered to be the main route for metastasis, but there is increasing evidence it may be the lymphatic system. Whereas blood capillaries are covered by a basement membrane, lymphatic capillaries have thin walls with single layers of endothelial cells and junctions that are not as secure.
Pathology of breast cancer metastasis and a view of metastasis to the brain
Published in International Journal of Neuroscience, 2023
Md Sakibuzzaman, Shahriar Mahmud, Tanzina Afroze, Sawsan Fathma, Ummul Barakat Zakia, Sabrina Afroz, Farzina Zafar, Maksuda Hossain, Amit Barua, Sabiha Akter, Hasanul Islam Chowdhury, Eram Ahsan, Shayet Hossain Eshan, Tasnuva Tarannum Fariza
Intravasation regulates the number of tumor cells penetrating across the vascular endothelium. Perivascular localized macrophages release epidermal growth factor to attract BCCs toward the vessel endothelium. Thus, it facilitates margination and adhesion of the BCCs to the vascular endothelium. It also releases vascular endothelial growth factor (VEGF), which increases vascular permeability [49–52]. In paracellular and/or transcellular pathways, the adhesion interaction subsequently enables the BCCs to migrate through the vascular endothelium [53]. A single cell or a group of cells can migrate from the abluminal face to the luminal face of the vascular lining. As the development of metastasis depends on the number of migrating cells, group migration is more deleterious [3,54,55]. Intravasation is crucial for the BCCs to spread to the brain and most distant organs.
Minimally Invasive Myomectomy: An Overview on the Surgical Approaches and a Comparison with Mini-Laparotomy
Published in Journal of Investigative Surgery, 2021
Alejandro Marín-Buck, Erbil Karaman, Juan J. Amer-Cuenca, Juan F. Lisón, Péter Török, Onur Karaaslan, Gaetano Valenti, Gabriella Zito, Antonio Biondi, Benito Chiofalo
Office preparation of partially intramural leiomyomas (OPPIuM) technique is a safe and effective hysteroscopic procedure that allows surgeons to perform resectoscopic surgery more safely and quickly as dealing with prevalently intracavitary lesions [75,76]. The most frequently used electrode for the hysteroscopic myomectomy is the loop electrode. However, in G1 and G2 UFs cold loop technique has been described as an alternative technique to the electrical slicing. In these conditions, cold loop enucleation is considered safer because the mechanical enucleation comply with the anatomical and functional integrity of the surrounding myometrium (pseudocapsule) reducing the risk of perforation [77,78]. The most common complication of these procedures is perforation and secondarily pelvic organs damage (bowel and vessels) [79]. Other documented complications are bleeding, infection, Asherman’s syndrome, and intravasation [80,81].
Efficacy and safety of Tramadol as an analgesic in women undergoing vaginoscopic hysteroscopy: a randomized placebo-controlled trial
Published in Journal of Obstetrics and Gynaecology, 2020
Shree Bharathi, Dilip Kumar Maurya, Anish Keepanasseril, N. S. Kubera
Cochrane review suggested the use of analgesia to reduce significant reduction of pain score during and within 30 min of the procedure, however, they found the reduction to be significant for local anaesthesia use rather than with the use of NSAIDs or opioids (Ahmad et al. 2011). The injection of the local anaesthetics, especially in paracervical blocks or intracervical anaesthesia, may itself cause pain and there is a risk of accidental intravasation which can lead to major complications (Mercorio et al. 2002). Also bleeding from injection site can cause difficulty in visualisation. NSAIDs with its inhibition of the arachidonic pathway in the production of prostaglandin is either alone or in combination with paracetamol is used during hysteroscopy in various studies and most of them couldn’t demonstrate a significant reduction of pain score (Nagele et al. 1997; Mercorio et al. 2002; Teran-Alonso et al. 2014).