Balkan Medical Journal最新文献

{"title":"An Important Feature of Gastric Adenocarcinoma: Heterogeneous Microsatellite Status.","authors":"Mirac Ajredini, Arda Ulaş Mutlu, Sibel Erdamar Çetin, Rümeysa Atabey, Erman Aytaç, Leyla Özer","doi":"10.4274/balkanmedj.galenos.2025.2025-7-281","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-7-281","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"168-170"},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overexpression of Soluble Fibrinogen-like Protein 2 in MSCs Ameliorates Renal Ischemia-Reperfusion Injury in Mice by Modulating Neutrophils.","authors":"Guo-Shan Chen, Wen-Hao Xiong, Dan-Zhou Li, Peng-Hui Zhang, Yi-Ting Wang, Yong-Chao Zhang, Feng Qi","doi":"10.4274/balkanmedj.galenos.2026.2025-12-101","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-12-101","url":null,"abstract":"<p><strong>Background: </strong>Renal ischemia-reperfusion (I/R) injury is a major cause of graft dysfunction and failure, driving inflammation and tissue damage. Mesenchymal stem cells (MSCs) possess therapeutic potential due to their immunomodulatory properties. Notably, neutrophils express the inhibitory receptor CD32b, which is a specific target of the immunosuppressive molecule soluble fibrinogen-like protein 2 (sFgl2).</p><p><strong>Aims: </strong>To investigate the therapeutic efficacy and underlying mechanisms of genetically engineered MSCs expressing sFgl2 (sFgl2-MSCs) in treating renal I/R injury, with a focus on neutrophil regulation.</p><p><strong>Study design: </strong>An <i>in vivo</i> renal I/R injury mouse model.</p><p><strong>Methods: </strong>Following imaging to localize MSCs, mice were randomly allocated into four treatment groups. Treatments were administered according to group assignments. Renal function was assessed using serum creatinine and blood urea nitrogen levels, while systemic inflammation was evaluated by measuring serum interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), and IL-10 via enzyme-linked immunosorbent assay (ELISA). Neutrophil proportions in the blood and kidney were analyzed by flow cytometry. At 24 h, surface expression of CD95 and CD206 was assessed; CD206 was used to define neutrophils with N2-like (CD206<sup>+</sup>) and N1-like (CD95<sup>+</sup>) phenotypic features. Histopathological scoring of renal tissue was performed at 24 h. Infiltration of Ly6G<sup>+</sup> neutrophils and citrullinated histone H3 (CitH3) as well as myeloperoxidase/CitH3 co-localization (an indicator of neutrophil extracellular traps, NETs) were detected by immunohistochemistry and immunofluorescence. Circulating free DNA (cf-DNA) in plasma was quantified using PicoGreen dye. Furthermore, the impact of sFgl2-MSCs on bone marrow-derived neutrophil polarization and function was evaluated <i>in vivo</i> using flow cytometry, ELISA, and a co-culture system.</p><p><strong>Results: </strong>While unmodified MSCs exhibited a moderate therapeutic effect, sFgl2-MSCs treatment was significantly more effective. sFgl2-MSCs markedly improved renal function, reduced histopathological damage (e.g., tubular necrosis), and modulated systemic cytokine levels by decreasing pro-inflammatory (IL-1β, IL-6, TNF-α) and increasing anti-inflammatory (IL-10) cytokines. Crucially, sFgl2-MSCs regulated neutrophil responses in the kidney: they increased the proportion of N2-like neutrophils and decreased N1-like neutrophils, concurrently reducing NET-related markers, as evidenced by decreased CitH3 and cf-DNA. Mechanistically, sFgl2-MSCs enhanced neutrophil immunoregulatory function via the TGFβ-Smad2/3 signaling pathway.</p><p><strong>Conclusion: </strong>Genetically modified sFgl2-MSCs alleviate renal I/R injury. This protective effect is associated with engagement of neutrophil CD32b receptors, activation of the TGFβ-Smad2/3 pathway","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"136-150"},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Childhood Interstitial Lung Disease.","authors":"Zhong-Qiang Li, Xue-Jun Wu","doi":"10.4274/balkanmedj.galenos.2025.2025-11-274","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-11-274","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"161-162"},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Cell Analysis, Spatial Transcriptomics and Molecular Docking Unveil Potential Therapeutic Targets for Carotid Atherosclerosis.","authors":"Rongxing Qin, Hongyu Xu, Qingchun Qin, Wei Xu, Xinyu Lai, Li Chen","doi":"10.4274/balkanmedj.galenos.2025.2025-8-151","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-8-151","url":null,"abstract":"<p><strong>Background: </strong>Carotid atherosclerosis (CAS) is a key cause of ischemic stroke that is strongly associated with increased risks of cardiovascular disease and vascular death, hence the urgent need to develop therapeutic strategies targeting carotid atherosclerotic plaques that would reduce the overall risk of cerebrovascular events.</p><p><strong>Aims: </strong>This study performs single-cell sequencing to dissect the cellular subpopulations in CAS. Molecular docking is used to uncover the potential therapeutic targets, consequently providing a theoretical basis for the CAS treatment strategies.</p><p><strong>Study design: </strong>Integrated single-cell, spatial transcriptomic and molecular docking analysis.</p><p><strong>Methods: </strong>The single-cell sequencing data were retrieved from the Gene Expression Omnibus. Enrichment analyses were performed to characterize the cellular subpopulation functions. Accordingly, cell-cell communication networks were mapped to uncover the inter-subgroup interactions. Molecular docking was also employed to identify the potential therapeutic targets.</p><p><strong>Results: </strong>In this study, we identified the multiple cellular subpopulations that are associated with CAS. These CAS-related subpopulations engage in intercellular communication via distinct signaling pathways. Cannabidiol exhibits strong binding affinities for the macrophage, endothelial, and vascular smooth muscle cell markers. Spatial transcriptomics revealed that <i>ACTC1, AKR1C2</i>, and <i>FABP4</i> exhibit region-specific expression patterns within the plaque.</p><p><strong>Conclusion: </strong>Dissecting the diverse cellular subpopulations in CAS and elucidating their functions and mechanisms, this study integrates single-cell sequencing, molecular docking, and spatial transcriptomics to offer fresh insights into CAS therapy.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"69-82"},"PeriodicalIF":3.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Metastatic Ameloblastoma: A Hidden Cause of Pulmonary Nodules.","authors":"İrem Karaman, Barış Hekimoğlu, Mürüvvet Akçay Çelik, Dilek Erdem, Şevket Özkaya","doi":"10.4274/balkanmedj.galenos.2025.2025-8-6","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-8-6","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"109-110"},"PeriodicalIF":3.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Ultrasound: From Diagnosis to Rehabilitation.","authors":"Deniz Palamar","doi":"10.4274/balkanmedj.galenos.2026.2026.060126","DOIUrl":"10.4274/balkanmedj.galenos.2026.2026.060126","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 2","pages":"58-60"},"PeriodicalIF":3.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secukinumab-Induced Interstitial Pneumonia in a Patient with Psoriasis.","authors":"Siqi Li, Ru Dai, Qunye Xu","doi":"10.4274/balkanmedj.galenos.2025.2025-8-43","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-8-43","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"107-108"},"PeriodicalIF":3.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Wiedemann-Steiner Syndrome: Novel <i>KMT2A</i> Variants and Broadened Clinical Spectrum.","authors":"Zehra Manav Yiğit, Aydan Mengübaş Erbaş, Ayberk Türkyılmaz, İsmihan Merve Tekin, Elif Yılmaz Güleç, Gülsüm Kayhan, Aydeniz Aydın Gümüş, Esra Arslan Ateş, Eyyüp Üçtepe, Kübra Ateş, Elvin Kazancıoğlu, Bülent Uyanık, Sena Çetin, Sahra Acır, Elif Sobu, İbrahim Kamer, Ahmet Yeşilyurt, Alperhan Çebi, Ahmet Anık, Müge Ayanoğlu, Gül Ünsel Bolat, Gökay Bozkurt, Hilmi Bolat","doi":"10.4274/balkanmedj.galenos.2025.2025-9-81","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-9-81","url":null,"abstract":"<p><strong>Background: </strong>Wiedemann-Steiner syndrome (WDSTS) is a rare autosomal dominant neurodevelopmental disorder caused by heterozygous pathogenic variants in <i>KMT2A</i>. Although several large international cohorts have helped define its broad clinical spectrum, data from underrepresented populations remain limited.</p><p><strong>Aims: </strong>To characterize the molecular and phenotypic spectrum of Turkish patients with WDSTS and compare these findings with previously published cohorts.</p><p><strong>Study design: </strong>Multicenter retrospective cohort study.</p><p><strong>Methods: </strong>Sixteen individuals from 15 unrelated families were recruited across Türkiye. Clinical information was obtained through medical records and systematic phenotyping. Molecular analyses included next-generation sequencing or targeted variant testing, and the variants were classified according to the American College of Medical Genetics and Genomics guidelines.</p><p><strong>Results: </strong>Fifteen distinct <i>KMT2A</i> variants were identified, including nine novel alleles. Most variants were predicted to result in loss of function; only one was a missense substitution. Neurodevelopmental involvement was prominent, with developmental and speech delays, intellectual disability, and behavioral comorbidities such as autism spectrum disorder and attention-deficit/hyperactivity disorder. Endocrine evaluation revealed growth hormone deficiency in approximately half of the tested patients. Ophthalmologic, cardiac, and dental abnormalities, including delayed tooth eruption, further expanded the known phenotype. Additional systemic features included skeletal, genitourinary, and immunological findings. Comparison with previously reported cohorts displayed no statistically significant genotype-phenotype correlations, although truncating variants appeared to be associated with more pronounced neurodevelopmental and behavioral manifestations.</p><p><strong>Conclusion: </strong>This report presents the largest Turkish WDSTS cohort to date, expands the known <i>KMT2A</i> variant spectrum with nine novel alleles, and highlights several underreported clinical features. Beyond its immediate clinical relevance, the study further supports <i>KMT2A</i> as a key chromatin regulator and an \"umbrella gene\" within the chromatinopathy spectrum. Growing recognition of these disorders underscores the need for systematic, multidisciplinary surveillance and contributes to the expanding global understanding of their shared pathogenic mechanisms.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"92-102"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transabdominal Surgical Management for Pouch Failure.","authors":"Mirac Ajredini, Arman Erkan, Amishi Desai, David Schwartzberg, Mehmet Gülmez, Feza H Remzi","doi":"10.4274/balkanmedj.galenos.2026.2025-11-230","DOIUrl":"10.4274/balkanmedj.galenos.2026.2025-11-230","url":null,"abstract":"<p><p>Restorative proctocolectomy with ileal pouch-anal anastomosis restores intestinal continuity and generally provides excellent long-term functional outcomes. However, 5-15% of patients experience pouch failure, most commonly due to septic, mechanical, or inflammatory complications. Surgical management of pouch failure is technically demanding and requires a multidisciplinary approach in high-volume, specialized centers. This narrative review synthesizes contemporary evidence on the transabdominal surgical management of pouch failure, with an emphasis on standardized preoperative evaluation, nomenclature. Key topics include predictors of failure, differentiation of Crohn's-like disease from mechanical etiologies, and technical considerations for pouch reconstruction. The review also emphasizes the importance of a unified team for revisional pouch surgery, involving specialized colorectal surgeons, gastroenterologists, radiologists, physician assistants, dietitians, IBD-specialized psychologists, wound-ostomy nurses, and patient support personnel.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":"43 2","pages":"61-68"},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Manual Carotid Compression for Cavernous Sinus Fistula.","authors":"Xiaoxin Ji, Wei Su, Shancheng Si","doi":"10.4274/balkanmedj.galenos.2025.2025-5-157","DOIUrl":"10.4274/balkanmedj.galenos.2025.2025-5-157","url":null,"abstract":"","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"103-104"},"PeriodicalIF":3.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}