bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute myeloid leukemia with new complex t(8;21;22) induced hemophagocytic lymphohistiocytosis
Authors: Wu Yuling , Xu Juan , Shen Kai , Ji Jie , Yang Chenlu , Liu Ting , Xiang Bing
Published: October 2018

Rationale:

The balanced translocation t(8;21;22)(q22;q22;q11.2) is not reported previously, although t(8;21)(q22;q22) is seen in approximately 7% of adults and most frequent abnormality in children with newly diagnosed acute myeloid leukemia (AML). AML-associated hemophagocytic lymphohistiocytosis (HLH) is a rare event, reported only of limited numbers. The present study reports a very rare case of t(8;21;22)(q22;q22;q11.2) with AML, not reported previously, and developed HLH at the same time.

Patient concerns and diagnosis:

A 15-year-old girl presented with a history of bleeding gums and high fever, leukocytosis, anemia, and thrombocytopenia. While waiting the result of bone marrow aspirate, the HLH-associated examinations were abnormal. Bone marrow aspirate showed a hypercellular marrow with 1% myeloblasts. The cytogenetic and molecular studies revealed the presence of abnormal karyotype-46, XX, t(8;21;22)(q22;q22;q11.2) and RUNX1–RUNX1T1 fusion gene. Genetic detections of HLH showed heterozygous genetic variants in lysosomal trafficking regulator (LYST). Hence, she was diagnosed with AML with t(8;21;22)(q22;q22;q11.2) and HLH.

Interventions and outcomes:

All HLH clinical symptoms disappeared after the 4 weeks treatment of HLH. Then the patient received standard AML induction chemotherapy and the leukemia relapsed after 2 cycles of high-dosed consolidation therapy. Eventually, the patient received emergent paternal haploidentical hematopoietic stem cell transplantation based on the complex variant translocation, leukemia replased state and HLH with compound heterozygotes mutation, and achieved sustained remission with RUNX1–RUNX1T1 negative for more than 1 year.

Lessons:

Patients with some specific recurrent cytogenetic abnormalities should be diagnosed with AML regardless of the blast count, for example t(8;21). We should improve the understanding of complex variant translocations. HLH-related genetic mutations were not only found in primary HLH, but also in second HLH.
A stress management intervention for adults living with HIV in Nigerian community settings
Authors: Nwobi Uju A. , Eseadi Chiedu , Obetta Kenneth Chukwuemeka , Ekwealor Nwakaego , Ogbonnaya Kingsley Asogu , Oboegbulem Angie I. , Chinweuba Ngozi H. , Mbagwu Felicia , Agundu Uche-Vita , Okpoko Chinwe , Ololo Kennedy Okechukwu , Ohia Nkiru Christian , Nwankwor Paulinus P. , Osilike Chioma , Okechukwu Ebere , Umoke Prince C.I.
Published: October 2018

Background:

This study evaluated the effectiveness of a group-based cognitive-behavioral stress management intervention among community-dwelling adults living with HIV in Southeastern Nigeria.

Method:

A total of 28 HIV-positive adults meeting the criteria for high perceived stress, anxiety, and depression were randomized into 1 of 2 groups: treatment group (n = 14); and no-treatment control group (n = 14). Stress level was measured using the 10-item Perceived Stress Scale (PSS-10). Depression and anxiety symptoms were assessed using Hospital Anxiety and Depression Scale (HADS). Secondary outcome measure was Satisfaction with Life Scale (SWLS). The intervention was delivered over the course of 10 weeks, using an evidence-based cognitive-behavioral stress management manual. We employed repeated-measures between and within-subjects analysis of variance (ANOVA) and Eta squared in the analyses and interpretation of data collected from the study participants at 3 time points.

Results:

Our results showed that, after benefitting from the cognitive behavioral stress management intervention, the PSS-10 and HADS scores were lowered significantly in the treatment group participants than those in the no-treatment control group during evaluations of post-treatment and 3 months follow-up outcomes. Significant improvements were also recorded in the treatment group participants’ SWLS scores at post-treatment and follow-up compared with participants in the no-treatment group.

Conclusion:

The present results suggest the need for further implementation of group-based cognitive-behavioral stress management interventions for people living with HIV. Cognitive-behavioral stress management clinicians should make efforts toward identifying HIV-positive adults experiencing psychological distress and design cognitive-behavioral stress management interventions in order to better assist them.
Detection of a metallic foreign body in the Wharton duct
Authors: Li Peng , Zhu HuiCong , Huang DaHong
Published: October 2018

Rationale:

Foreign bodies are rarely found in the submandibular gland and the Wharton duct, due to their physiological and anatomical features.

Patient concerns:

A 23-year-old man was referred to Foshan Stomatology Hospital in July 2016, with pain and intermittent swelling in the right submandibular area.

Diagnoses:

Physical examination revealed enlarged, indurated, and painful swelling in the right submandibular area, with a normal oral cavity. No abscess or fistula was detected. Radiography and computed tomography (CT) indicated a 1.7 cm radiopaque mass in the Wharton duct, close to the submandibular gland.

Interventions:

Submandibular sialadenectomy was performed under general anesthesia. Upon exploration of the fully dissected submandibular gland, a 2.0 cm long barb-like metallic body was found in the Wharton duct.

Outcomes:

The patient had an uneventful recovery during a 6-months follow-up.

Lessons:

Foreign bodies in the Wharton's duct can be detected by imaging techniques, such as radiography and CT, and successfully treated by submandibular sialadenectomy.
Successful second allogeneic stem-cell transplantation from the same sibling donor for a patient with recurrent hepatosplenic gamma-delta (γ/δ) T-cell lymphoma
Authors: Pan Hui , Huang Jing , Li Jun-Nan , Yang Li , Wang Jian-Yu , Wang Xin , Liu Lin , Yang Ze-Song , Wang Li
Published: October 2018

Rationale:

Hepatosplenic T-cell lymphoma (HSTCL) is a rare but aggressive type of peripheral T-cell lymphoma (PTCL). There is an urgent need for effective treatment due to the poor prognosis of HSTCL. Here, for the 1st time we describe the rare successful case of HSTCL who relapsed after a previous allogeneic stem-cell transplantation (allo-SCT), achieved remission with the second allo-SCT from the same donor.

Patient concerns:

A 24-year-old male, presented with a 2-week history of fever, drenching night sweats and nonquantified weight loss.

Diagnoses:

Laboratory studies, flow cytometry of immunophenotyped, and physical examination results strongly suggested hepatosplenic γ/δ T-cell lymphoma, stage IVB.

Interventions:

We proceeded to an allo-SCT with a human leukocyte antigen (HLA) identical sibling donor. The bone marrow examination and fluorescent in situ hybridization were observed for complete donor chimerism of bone marrow cells on day 34. On day 157 after the initial allo-SCT, the bone marrow examination revealed the relapse of the sinusoidal infiltration with lymphoma cells. Considering the disease persistence, we conducted the second allo-SCT from the same HLA-identical sibling donor immediately.

Outcomes:

Bone marrow examination indicated hematologic recovery without residual lymphoma cells.

Lessons:

Our encouraging outcome suggests that the latter allo-SCT needs to be considered early for patients with disease recurrence, and it also demonstrates that graft-vs-lymphoma conferred by allo-SCT may play an essential role on HSTCL treatment. Furthermore, detecting related genes at diagnosis may have prognostic implications and guidance value for personal chemotherapy program.
Reconstruction of complex nail matrix defect using the homodigital reverse fasciocutaneous flap
Authors: Liu Yang , Li Xiucun , Li Ruijun , Zhang Jiayi , Lu Laijin
Published: October 2018

Reconstruction of complex and severe nail matrix defects with the exposure of bone, tendon or joint continues to be challenging for the surgeon. We present our experience using the homodigital reverse laterodorsal fasciocutaneous flap in the reconstruction of complex nail matrix defects.

Six patients (7 fingers) of complex nail matrix defects with the exposure of bone, tendon or joint were treated with the homodigital reverse laterodorsal fasciocutaneous flap based on the dorsal branches of the proper digital artery. In this study, the composite tissue defect size ranged from 1.0 × 1.5 cm2 to 1.3 × 2.5 cm2. All 6 patients participated in follow-up.

All flaps survived well, and no complications were found postoperatively. The mean size of the flaps was 1.4 × 2.4 cm2 (range, 1.2 × 2.0–1.5 × 3.0 cm2); the mean follow-up period was 8 months (range, 4–15 months); patients’ average time to get back to their former jobs was 4.3 weeks (range, 3–6 weeks) postoperatively. All patients were satisfied with the appearance and functional outcomes of the fingers.

The homodigital reverse laterodorsal fasciocutaneous flap based on the dorsal branches of the proper digital artery is an ideal surgical method to reconstruct the complex and severe nail matrix defect.
A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult
Authors: Xiao-Ming Ai , Jin-Jing Lu , Li-Chen Ho , Lu-Lu Han , Xiong Yue , Hong-Hai Zhang , Nian-Yin Yang
Published: October 2018

Rationale:

Intestinal or enteric duplication (ED) does exit as a rare congenital malformation of the gastrointestinal system clinically. It is a separate entity, but can be communicated with the gastrointestinal tract. It is characterized by a well-developed muscular wall and lumen endowed with ectopic mucosa, simulating a portion of normal bowel. A completely isolated duplication cyst (CIDC) refers to an extremely uncommon variant of ED, which is secluded from the alimentary tract and possesses its own exclusive blood supply. Surgical procedure is the treatment of choice, because most often, a definitive diagnosis can only be confirmed intraoperatively.

Patient concerns:

A 20-year-old male patient presented with a 10-day history of intermittent episodes of abdominal pain. The pain evolved from dull into progressive and intolerable, accompanied by vomiting, nausea, and abdominal distention.

Diagnoses:

Closed-loop small-bowel obstruction with volvulus.

Interventions:

The patient underwent an emergency exploratory laparotomy.

Outcomes:

A huge CIDC was observed upon operation, which was affixed to the mesentery with only a narrow base, just like a pedicle; 720° counterclockwise twisting around its base was definitely noted, provoking the compromised blood supply. Complete excision of the cyst was performed along its base safely without violating the intestinal tract. Furthermore, the ectopic mucosa of the cyst exhibited 3 different epithelial lining components histopathologically.

Lessons:

Clinicians should be aware of the possibility of the existence of a duplication and raise a high index of suspicion in case of equivocal diagnosis, particularly in adult population. A low threshold for surgical management should be recommended in order to prevent lethal outcomes.
Correlation between tripartite motif-containing protein 44 protein expression and the prognosis of postoperative patients exhibiting skin squamous cell carcinoma
Authors: Wu Jian , Guo Nai-Zhou , Cui Lei-lei , Wang Wei , Xiong Cun-quan , Zhang Xue-yan
Published: October 2018

Tripartite motif-containing protein 44 (TRIM44) plays an important role in the development and progression of some human cancers; however, its role in skin squamous cell carcinoma (SCC) remains unknown. The aim of the present study was to investigate TRIM44 expression and clinicopathological significance of TRIM44 in SCC.

Immunohistochemistry (IHC) technique, reverse transcriptase-polymerase chain reaction (RT-PCR) and western blot were performed to evaluate differences in TRIM44 protein expression in SCC and normal skin tissues.

IHC showed that the positive rate of TRIM44 staining in SCC tissues 26.00% (9/30), while the positive rate of normal control group was 83.33% (25/30). The positive rate of TRIM44 staining in SCC tissues is significantly lower than normal skin tissue (P <.01). RT-PCR showed that the positive rates of TRIM44 mRNA expression in SCC tissues were 16.67% (5/30), but the positive rate of normal control group was 86.67% (26/30). TRIM44 mRNA expression in SCC group was significantly lower than that in the normal group (P <.01). Kaplan–Meier survival analysis showed that low expression was associated with poor overall survival in SCC patients (P =.004). Multi-factor survival analysis indicated that both low TRIM44 expression and tumor stage were independent factors affecting the overall survival of patients with SCC (P =.038 and P =.001, respectively). Low expression of TRIM44 in SCC was associated with staging (P =.009 and P =.008, respectively) and metastasis (P =.003 and P =.004, respectively).

The levels of TRIM44 protein and TRIM44 mRNA in SCC are both lowly expressed which is strongly associated with tumor staging, metastasis, and poor survival. And it also is an independent factor affecting the overall survival of patients with SCC.
Thrombotic thrombocytopenic purpura and hemophagocytic lymphohistiocytosis in an elderly man
Authors: Aiempanakit Kumpol , Apinantriyo Benjawan
Published: October 2018

Rationale:

Thrombotic thrombocytopenic purpura (TTP) and hemophagocytic lymphohistiocytosis (HLH) are rare hematologic conditions and have high mortality. Both TTP and HLH result from deregulation of the immune system. There are no published reports of coexisting TTP and HLH in elderly patients.

Patient concerns:

A 67-year-old Asian male presented with altered consciousness and fever for 2 days. Physical examination revealed markedly pale, mild icterus with petechiae and purpura. Initially, TTP was recognized in this patient. Bone marrow studies are suggested for evaluating elderly patients to assess specific causes, especially infection and neoplasm.

Diagnoses:

The TTP was diagnosed based on typical history-related symptoms and a specific laboratory result of very low ADAMTS13 level. The diagnosis of HLH was determined after detection of high levels of ferritin and lactase dehydrogenase, which were confirmed by the presence of hemophagocytosis in the bone marrow.

Interventions:

Systemic corticosteroids and plasma exchange were initiated as specific treatment of the patient.

Outcomes:

The patient died in 3 weeks from ventilator-associated pneumonia.

Lessons:

The HLH should be tested using bone marrow studies and specific laboratory tests in patients with TTP.
The impact of prophylactic cranial irradiation for post-operative patients with limited stage small cell lung cancer
Authors: Chen Meng-yuan , Hu Xiao , Xu Yu-jin , Chen Ming
Published: October 2018

To evaluate the impact of prophylactic cranial irradiation (PCI) on the prognosis of patients who received definitive surgery for surgically resected small cell lung cancer (SCLC).

A retrospective analysis was performed on post-operative SCLC patients treated in Zhejiang Cancer Hospital from January 2003 to December 2015. According to the treatment modality, patients were allocated to PCI group and non-PCI group. Univariate survival analysis was performed by the Kaplan–Meier method. Multivariate survival analysis was performed by a Cox proportional hazards model.

A total of 52 patients were included for analysis, among which, 19 patients were in PCI group and 33 were in non-PCI group. Multivariate analysis revealed that PCI (HR = .330; P = .041) was an independently favorable prognostic factor for the overall survival. The median overall survival (OS) time was 32.9 months in PCI group, and 20.4 months in non-PCI group. The 2-year OS rates were 78.0% and 38.0% in PCI and non-PCI group respectively (P = .023). The brain metastasis-free survival (BMFS) rate at 2-year in PCI group was significantly higher than those of non-PCI group (89.0% vs 53.0%, respectively, P = .026).

In conclusion, PCI might be suggested for limited SCLC patients who received definitive surgery.
Management of postoperative ileus after robot-assisted laparoscopic prostatectomy
Authors: Park Jee Soo , Kim Jongchan , Jang Won Sik , Heo Ji Eun , Elghiaty Ahmed , Rha Koon Ho , Choi Young Deuk , Ham Won Sik
Published: October 2018

To compare different postoperative management methods on the recovery of bowel function after robot-assisted laparoscopic prostatectomy (RALP).

This is a prospective study of 716 patients who underwent RALP at Severance Hospital in Seoul, South Korea, between March 2017 and February 2018. Instructions for the different postoperative management methods (mobilization, abdominal massage, hot pack therapy, and gum chewing) were presented to patients, who subsequently reported when these activities were performed as well as the time to first flatus on a designated form.

There were no significant differences in age, height, weight, body mass index, body surface area, prevalence of hypertension and diabetes mellitus, and in American Society of Anesthesiologists (ASA) scores with respect to early bowel recovery. Prolonged times of surgery and anesthesia significantly caused delays in bowel recovery. The total number and time of mobilization, total time of hot pack therapy, and number of gum chewing were significantly and positively associated with bowel recovery. A Kaplan–Meier analysis showed that all of the postoperative management methods were positively associated with the mean time to first flatus.

Methods of postoperative management (mobilization, abdominal massage, hot pack therapy, and gum chewing) have positive effect on bowel motility after RALP. Furthermore, reductions in the times of surgery and anesthesia could significantly decrease prolonged delays in bowel recovery.
Letrozole for patients with polycystic ovary syndrome
Authors: Guang Hui-juan , Li Feng , Shi Jun
Published: October 2018

This retrospective study investigated the efficacy and safety of letrozole for patients with polycystic ovary syndrome (PCOS).

Totally, 136 cases of infertility women with PCOS were analyzed. Of those, 68 patients received letrozole, and were assigned to Letrozole group. The other 68 cases received clomiphene, and were assigned to clomiphene group. Patients in both groups were treated up to 5 treatment cycles. The primary endpoint included infant outcomes. The secondary endpoints consisted of the number of women in conception, pregnancy, pregnancy loss, and ovulation. In addition, any kinds of adverse events were also recorded.

Cases in the Letrozole group did not show better outcomes neither in primary endpoint (live birth, P = .11; birth weight, P = .95; infant gender, P = .85), nor in secondary endpoints (the number of women in conception, P = .07; pregnancy, P = .12; pregnancy loss, P = .47; pregnancy loss in first trimester, P = .70; and ovulation, P = .09), compared with cases in the clomiphene group. Moreover, no adverse events differ significantly between 2 groups.

This study demonstrated that the efficacy of letrozole is not superior to the clomiphene in patients with PCOS.
The effect of Imaginary Working Qigong on the psychological well-being of college students
Authors: Guo Yu , Xu Mingmin , Ji Meiqi , Wei Zeren , Zhang Jialei , Hu Qingchuan , Yan Jian , Chen Yue , Lyu Jiaxuan , Shao Xiaoqian , Wang Ying , Guo Jiamei , Wei Yulong
Published: October 2018

Introduction:

College students are special populations that are particularly prone to have significantly high level of psychological distress than their community peers. Apparently, the best way to manage stress and mental state is through self-care. The characteristic of Qigong is self-directed and self-healing, which is a traditional Chinese mind-body exercise, which has the potential as a stress management intervention. Imaginary Working Qigong, as a kind of static Qigong, is more perception-oriented and can bring about benign sensations of mind and body so as to eliminate stress completely and induce physiological and mental relaxation. In this study protocol, we will systematically examine the feasibility and acceptability of Imaginary Working Qigong on psychological outcomes of the college students and deeply explore molecular biological mechanisms underlying the effects of mind adjustment induced Imaginary Working Qigong.

Methods/designs:

We will conduct a randomized, assessor and statistician-blinded, parallel-controlled trial exploring the beneficial mind adjustment of Imaginary Working Qigong in college students.

A total of 80 eligible college students from Beijing University of Chinese Medicine will be recruited and randomly allocated into Imaginary Working Qigong training or unaltered lifestyle control group according 1:1 allocation ratio with allocation concealment. Imaginary Working Qigong training will last 8 weeks. The study period is 12 weeks including a 4-week supervised training, 4-week independence training, and a 4-week follow-up. Relevant psychological outcomes measurement will take place at baseline, 5 weeks (at the end of supervised training), 9 weeks (at the end of independence training), and 13 weeks (after the 4-week follow-up period) by blinded independent outcome assessors.

Conclusion:

This is the first randomized controlled trial protocol from the perspective of Qigong connotation to systematically evaluate the effects and relevant molecular mechanism of Imaginary Working Qigong for the mental health of a college student population. If our study demonstrates a significant intervention effect, this would provide preliminary higher-quality evidence and establish a further guidance for the application of Imaginary Working Qigong program among a college student population.

Ethics and dissemination:

The study protocol and consent forms have been approved by the medical and animal experiment ethic committee of BUCM (approval number: BJZYYDX-LL2014005).
Efficacy and safety of electromagnetic acupuncture using an electromagnetic therapy stimulator (Whata153) for the treatment of chronic low back pain
Authors: Oh Seo Young , Kang Jae Hui
Published: October 2018

Background:

Chronic low back pain is one of the major conditions causing serious personal and social difficulties in modern society. There are several noninvasive therapies for chronic low back pain; however, the effects of electromagnetic acupuncture have not been studied. Here, we describe the protocol for a study that will investigate the efficacy and safety of electromagnetic acupuncture for patients with chronic low back pain.

Methods:

The study has been designed as a double-blind, single-center, parallel-arm, sham-controlled, randomized clinical trial. A total of 104 patients with chronic low back pain who meet the criteria for selection and exclusion will be enrolled in a 1:1 ratio in an electromagnetic acupuncture group or a sham group. Sterilized disposable needles will be inserted at 6 acupoints, following which stimulation via an electromagnetic (Whata153) or a placebo (sham) stimulator will be applied. The 2 groups will receive a total of 6 treatment sessions over 3 weeks, with 1 follow-up visit within 3 days after the final treatment. The primary outcome will be the change in the visual analog scale (VAS) score for pain from baseline (visit 1, first treatment session) to the follow-up visit (visit 7, after treatment completion). The secondary outcomes will be as follows: changes in the VAS score for pain from baseline (visit 1) to visits 3 (third session) and 5 (fifth session); changes in the VAS score for pain at all assessment points from baseline (visit 1) to the follow-up visit (visit 7); changes in the Oswestry Disability Index (ODI) from visit 1 to visits 3, 5, and 7; and the change in ODI at all assessment points from visit 1 to visit 7.

Discussion:

The results of this trial are expected to provide important clinical information on the efficacy and safety of electromagnetic acupuncture for patients with chronic low back pain.
Bone regeneration around immediate placed implant of molar teeth with autologous platelet-rich fibrin
Authors: Zhou Jing , Li Xue , Sun Xiaolin , Qi Manlin , Chi Minghan , Yin Lihua , Zhou Yanmin
Published: October 2018

Rationale:

There are some challenges concerning immediate implant placement in molar region. Platelet-rich fibrin (PRF), a second generation platelet concentrate, is an autologous fibrin matrix and contains platelets, growth factors, and leukocytes. It is used for tissue healing and regeneration in periodontal and oral-maxillofacial surgery. We report 2 cases of immediate placed implant of molar teeth with autologous PRF to improve and accelerate tissue healing.

Patient concerns:

Case 1 was a 38-year-old female patient with masticatory discomfort. Case 2 was a 43-year-old male patient with a demand for his left mandibular posterior tooth restoration.

Diagnoses:

Through the clinical and radiographic examination, the patient in case 1 was diagnosed with vertical root crown fracture of the maxillary right first molar. The patient in case 2 was diagnosed with residual root of the left mandibular first molar via cone-beam computer tomography and clinical examination.

Interventions:

The 2 patients underwent extraction of the molar teeth and immediate placed implant of molar teeth with autologous PRF was performed. In case 1, the gap between the implant surface and the socket walls of freshly extracted tooth was filled with PRF mixed with a commercial spongious bone substitute, followed by 2 PRF membranes coverage for protection. In case 2, PRF was used as a sole bone substitute material, placed between immediate implant and the socket wall of freshly extracted tooth.

Outcomes:

Follow-up of 2 cases revealed successful osseointegration and matured gingiva with optimal form and function.

Lessons:

The results suggested that PRF could solely serve as a bone scaffold in 4-wall bony defects, or can be combined with xenograft in 3-wall bony defects during immediately placed implants in molar regions, exhibiting excellent biocompatibility and good soft and hard tissue healing.
A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent
Authors: Lan Zhigang , Richard Seidu A. , Li Jin , Xu Jianguo , You Chao
Published: October 2018

Rationale:

Central nervous system (CNS) solid cavernous hemangiomas are rare extra-axial anomalies that may sometimes resemble meningiomas. Due to their complex vascular nature, accurate preoperative diagnosis is important to avoid disastrous hemorrhage during operation. To the best of our knowledge this is the first case in an adolescent since all middle cranial fossa hemangioma cases reported in literature are adults in their 40s or 50s and all the pediatric cases are cystic.

Patient concerns:

We present a case of a 14-year-old girl with headache and dizziness for 3 months. She occasionally experienced nausea and vomiting but denied visual disturbances and loss of smell.

Diagnoses:

MRI revealed a lesion that extends to the greater wing of the sphenoid bone as well as the pituitary fossa. Our initial diagnosis was a sphenoid wing meningioma but interestingly, histopathology revealed solid cavernous hemangioma.

Interventions:

The residual tumor was completely removed with 2 sessions of Gamma Knife radiotherapy after surgery.

Outcomes:

We were confronted with excessive bleeding during surgery so we attained subtotal resection. However, the patient recovered well with no recurrence of the tumor.

Lessons:

Our case shows that space occupying lesions involving the cavernous sinus and sphenoid ridged could be easily misdiagnosed as sphenoid wing meningiomas in children and adolescents and even adults therefore great care must be exercised when confronted with this kind of presentation.
Prevalence of monoclonal gammopathy of uncertain significance in chronic myeloid leukemia
Authors: Ouyang Wanyan , Zhao Xiaohong , Lu Shiyun , Wang Zhi
Published: October 2018

Rationale:

The abnormal cell types in chronic myeloid leukemia (CML) and monoclonal gammopathy of uncertain (MGUS) are quite different, being myeloid and plasma cells, respectively. The coexistence of CML and MGUS is an uncommon event, which is seldom reported in literature.

Patient concerns:

A 52-year-old female was diagnosed with CML in April 2001. From November 2006, the patient started on imatinib mesylate and kept a complete hematologic and cytogenetic response for nearly 11 years. During her follow-up on July 7, 2017, thrombocytopenia (35∗109/L) was found. Bone marrow aspiration revealed 6% plasma cell infiltration. Serum immunoelectrophoresis revealed 1.24 g/dL of serum monoclonal (M) protein of IgG-κ type.

Diagnosis:

MGUS was diagnosed because of absence of anemia, hypercalcemia, lytic bone lesions, or renal failure. Immune thrombocytopenia (ITP) was also diagnosed in this patient following the detection of antiplatelet autoantibodies. Complex karyotype and missense mutation in PRDM1 were identified.

Interventions:

Because of her obvious decrease of platelets, she started treatment with thalidomide and prednisone.

Outcomes:

Three months later, bone marrow aspirate showed disappearance of plasma cells. There developed an abrupt decrease in IgG and the absence of M-spike in serum immunoelectrophoresis. The platelet count kept normal during 1 year follow-up.

Lessons:

Karyotypic event and gene mutation found in this case may be the initiation of disease transformation. Administration of thalidomide and prednisone proved effective in this patient.
Desmoid fibromatosis in the foot
Authors: Liu Qinqin , Fang Lu , Li Bo
Published: October 2018

Rationale:

Desmoid fibromatosis is a rare benign neoplasm arising from musculoaponeurotic structures with the potential to infiltrate local tissues and recur locally. While the commonly affected regions are the shoulder, chest wall and back, thigh, head and neck, localization in the foot is rare and only a few cases have been reported. Deep-seated lesions of foot tend to spread along the fascia and nerve or tendon sheaths.

Patient concerns:

We present a case of a 41-year-old female with a 3 years history of a slowly enlarging painful mass in the right foot.

Diagnoses:

Desmoid fibromatosis was diagnosed based on clinical manifestations, imaging findings and pathological examinations.

Interventions:

The patient was treated by local incomplete resection.

Outcomes:

The patient recovered well postoperatively and was well followed up at our outpatient department with no evidence of recurrence during 16 months of follow-up after local excision.

Lessons:

Surgical excision is recommended for symptomatic lesions located in the foot. However, it is difficult to excise thoroughly and periodic follow-up is needed to monitor for recurrence. Further study is warranted to determine whether patients benefit more from function preservation instead of complete resection.
Short article: Hepatitis C and G virus coinfection in Punjab, Pakistan: incidence and its correlation analysis with clinical data
Authors: Shahid Muhammad , Idrees Muhammad , Butt Azeem M. , Raza Syed M. , Amin Iram , Rasul Afza , Afzal Samia , Zahid Sadia , Nawaz Rabia
Published: October 2018

Introduction

Hepatitis G virus (HGV) infection appears to be common in patients with chronic hepatitis C virus (HCV) infection. The aim of this study was to investigate the prevalence of HCV/HGV in patients with chronic hepatitis C (CHC) in Pakistan and to look for possible associations with various clinical and histopathological changes in HCV/HGV coinfection and HCV infection.

Patients and methods

The present study included 136 patients. Clinical, biochemical, virological and histological findings were compared between patients coinfected with HCV/HGV and patients with HCV alone.

Results

Of the 136 patients with CHC, 16 (11.76%) were coinfected with HCV/HGV. The mean age of coinfected patients was lower than in patients with HCV alone. HCV/HGV coinfected patients did not show significant differences in sex, clinical presentation, biochemical markers, and liver fibrosis as compared to those with HCV infection. Only the mean values of platelets count, mean corpuscular hemoglobin (MCH), and MCH concentration markers were significantly different in HCV/HGV coinfected patients as compare to patients with HCV alone.

Conclusion

It was found that 11.76% of patients with CHC in Pakistan were associated with HCV/HGV coinfection. No significant differences were observed in clinical and histological features except for platelets count, MCH, and MCH concentration markers between HCV and HGV coinfected patients in comparison with HCV-infected patients.
Vertebral artery fusiform aneurysm geometry in predicting rupture risk
Authors: Zhao Xiukun , Gold Nathan , Fang Yibin , Xu Shixin , Zhang Yongxin , Liu Jianmin , Gupta Arvind , Huang Huaxiong
Published: October 2018

Cerebral aneurysms affect a significant portion of the adult population worldwide. Despite significant progress, the development of robust techniques to evaluate the risk of aneurysm rupture remains a critical challenge. We hypothesize that vertebral artery fusiform aneurysm (VAFA) morphology may be predictive of rupture risk and can serve as a deciding factor in clinical management. To investigate the VAFA morphology, we use a combination of image analysis and machine learning techniques to study a geometric feature set computed from a depository of 37 (12 ruptured and 25 un-ruptured) aneurysm images. Of the 571 unique features we compute, we distinguish five features for use by our machine learning classification algorithm by an analysis of statistical significance. These machine learning methods achieve state-of-the-art classification performance (81.43 ± 13.08%) for the VAFA morphology, and identify five features (cross-sectional area change of aneurysm, maximum diameter of nearby distal vessel, solidity of aneurysm, maximum curvature of nearby distal vessel, and ratio of curvature between aneurysm and its nearby proximal vessel) as effective predictors of VAFA rupture risk. These results suggest that the geometric features of VAFA morphology may serve as useful non-invasive indicators for the prediction of aneurysm rupture risk in surgical settings.
A two-step method for fabricating large-area textile-embedded elastomers for tunable friction
Authors: Ohzono Takuya , Teraoka Kay
Published: October 2018

Recently, shape-tunable wrinkles formed on an elastomeric sheet with a textile finely embedded in proximity to the surface have been developed for
in situ
control of friction depending on various situations. For their actual uses, sheets with a large area are desired. A key challenge on their fabrication is to overcome the non-uniformity of the vertical position of the textile embedded within the elastomeric sheet, which causes substantial reduction in the tunable range of friction. The defect originates from the increased difficulty, as the sheet area is scaled up, of squeezing a viscoelastic precursor liquid due to the use of a deformable elastomeric surface. Here, we report a new two-step method for a textile-embedded elastomeric sheet that avoids using the soft elastomeric surface on the squeezing process and requires post-joining to an elastomeric base sheet. The obtained sheet with a large area (180 × 180 mm), was uniform and showed a large change of friction on its strain-induced transformation between flat and wrinkled states. The relationship between the experimentally controllable parameters and the squeeze film hydrodynamics is theoretically discussed, which is generally applicable to precise embedding micro-objects at the elastomer surface.
Indications for solar influence on radon and thoron in the atmosphere, Arad, Romania
Authors: Steinitz Gideon , Flore Nelida , Piatibratova Oksana
Published: October 2018

Radon (Rn-222; Rn) and Thoron (Rn-220; Tn) from the lowermost atmosphere in Arad, Romania, were investigated from 1993 to 2015. Daytime and night-time measurements exhibit (i) systematic differences; (ii) large annual variations; (iii) semi-annual and possibly ternary annual periodicities; (iv) amplitudes of the annual and semi-annual periodicities differ between daytime and night-time measurements. The day of year of the summer peak time (SPT) of the annual variation of composite Rn and Tn data depict smoothly covarying SPT patterns separated around 50 days. SPT patterns of daytime and night-time of Rn and Tn depict additional separations of gradually varying multi-year patterns. For both radionuclides, the night-time SPT precedes the daytime SPT—by around 105 days for Tn and around 60 days for Rn. In the case of temperature, the SPT of daytime and night-time measurements overlap at around day 195. Thus, for Rn and Tn, daytime and night-time differences depend on the time of measurement within the 24 h cycle. This implies that Rn and Tn measurements are influenced by the rotation of the Earth around its axis. It is suggested that these relations, observed in coexisting Rn and Tn, are a further indication for a solar (extraterrestrial) influence on nuclear radiation, previously suggested for radon.
Efficient finite-difference method for computing sensitivities of biochemical reactions
Authors: Thanh Vo Hong , Zunino Roberto , Priami Corrado
Published: October 2018

Sensitivity analysis of biochemical reactions aims at quantifying the dependence of the reaction dynamics on the reaction rates. The computation of the parameter sensitivities, however, poses many computational challenges when taking stochastic noise into account. This paper proposes a new finite-difference method for efficiently computing sensitivities of biochemical reactions. We employ propensity bounds of reactions to couple the simulation of the nominal and perturbed processes. The exactness of the simulation is preserved by applying the rejection-based mechanism. For each simulation step, the nominal and perturbed processes under our coupling strategy are synchronized and often jump together, increasing their positive correlation and hence reducing the variance of the estimator. The distinctive feature of our approach in comparison with existing coupling approaches is that it only needs to maintain a single data structure storing propensity bounds of reactions during the simulation of the nominal and perturbed processes. Our approach allows to compute sensitivities of many reaction rates simultaneously. Moreover, the data structure does not require to be updated frequently, hence improving the computational cost. This feature is especially useful when applied to large reaction networks. We benchmark our method on biological reaction models to prove its applicability and efficiency.
Simulating the interaction between a descending super-quadric solid object and a soap film
Authors: Davies I. T.
Published: October 2018

We investigate the interaction that occurs between a light solid object and a horizontal soap film of a ‘bamboo’ foam contained in a cylindrical tube. We vary the shape of the descending object from a sphere to a cube by changing a single shape parameter. We investigate in detail how the soap film deforms and determine the forces that the film exerts on the object, depending on the radius of the cylindrical tube, and the shape, orientation and position of the object. We show that a cubic particle in a particular orientation experiences the largest drag force, and that this orientation is also the most likely outcome of dropping a cube from an arbitrary orientation through a bamboo foam.
Reciprocal mimicry: kin selection can drive defended prey to resemble their Batesian mimics
Authors: Holen Øistein Haugsten , Johnstone Rufus A.
Published: October 2018

Established mimicry theory predicts that Batesian mimics are selected to resemble their defended models, while models are selected to become dissimilar from their mimics. However, this theory has mainly considered individual selection acting on solitary organisms such as adult butterflies. Although Batesian mimicry of social insects is common, the few existing applications of kin selection theory to mimicry have emphasized relatedness among mimics rather than among models. Here, we present a signal detection model of Batesian mimicry in which the population of defended model prey is kin structured. Our analysis shows for most of parameter space that increased average dissimilarity from mimics has a twofold group-level cost for the model prey: it attracts more predators and these adopt more aggressive attack strategies. When mimetic resemblance and local relatedness are sufficiently high, such costs acting in the local neighbourhood may outweigh the individual benefits of dissimilarity, causing kin selection to drive the models to resemble their mimics. This requires model prey to be more common than mimics and/or well-defended, the conditions under which Batesian mimicry is thought most successful. Local relatedness makes defended prey easier targets for Batesian mimicry and is likely to stabilize the mimetic relationship over time.
Nocturnal giants: evolution of the sensory ecology in elephant birds and other palaeognaths inferred from digital brain reconstructions
Authors: Torres Christopher R. , Clarke Julia A.
Published: October 2018

The recently extinct Malagasy elephant birds (Palaeognathae, Aepyornithiformes) included the largest birds that ever lived. Elephant bird neuroanatomy is understudied but can shed light on the lifestyle of these enigmatic birds. Palaeoneurological studies can provide clues to the ecologies and behaviours of extinct birds because avian brain shape is correlated with neurological function. We digitally reconstruct endocasts of two elephant bird species,Aepyornis maximusandA. hildebrandti, and compare them with representatives of all major extant and recently extinct palaeognath lineages. Among palaeognaths, we find large olfactory bulbs in taxa generally occupying forested environments where visual cues used in foraging are likely to be limited. We detected variation in olfactory bulb size among elephant bird species, possibly indicating interspecific variation in habitat. Elephant birds exhibited extremely reduced optic lobes, a condition also observed in the nocturnal kiwi. Kiwi, the sister taxon of elephant birds, have effectively replaced their visual systems with hyperdeveloped olfactory, somatosensory and auditory systems useful for foraging. We interpret these results as evidence for nocturnality among elephant birds. Vision was likely deemphasized in the ancestor of elephant birds and kiwi. These results show a previously unreported trend towards decreased visual capacity apparently exclusive to flightless, nocturnal taxa endemic to predator-depauperate islands.
The functional role of serial dependence
Authors: Cicchini Guido Marco , Mikellidou Kyriaki , Burr David C.
Published: October 2018

The world tends to be stable from moment to moment, leading to strong serial correlations in natural scenes. As similar stimuli usually require similar behavioural responses, it is highly likely that the brain has developed strategies to leverage these regularities. A good deal of recent psychophysical evidence is beginning to show that the brain is sensitive to serial correlations, causing strong drifts in observer responses towards previously seen stimuli. However, it is still not clear that this tendency leads to a functional advantage. Here, we test a formal model of optimal serial dependence and show that as predicted, serial dependence in an orientation reproduction task is dependent on current stimulus reliability, with less precise stimuli, such as low spatial frequency oblique Gabors, exhibiting the strongest effects. We also show that serial dependence depends on the similarity between two successive stimuli, again consistent with the behaviour of an ideal observer aiming at minimizing reproduction errors. Lastly, we show that serial dependence leads to faster response times, indicating that the benefits of serial integration go beyond reproduction error. Overall our data show that serial dependence has a beneficial role at various levels of perception, consistent with the idea that the brain exploits the temporal redundancy of the visual scene as an optimization strategy.
Niche conservatism and elevated diversification shape species diversity in drylands: evidence from Zygophyllaceae
Authors: Wang Qinggang , Wu Shengdan , Su Xiangyan , Zhang Linjing , Xu Xiaoting , Lyu Lisha , Cai Hongyu , Shrestha Nawal , Liu Yunpeng , Wang Wei , Wang Zhiheng
Published: October 2018

The integrated contributions of climate and macroevolutionary processes to global patterns of species diversity are still controversial in spite of a long history of studies. The niche conservatism hypothesis and the net diversification rate hypothesis have gained wide attention in recent literature. Many studies have tested these two hypotheses for woody species in humid forests; however, the determinants of species diversity patterns for arid-adapted plants remain largely ignored. Here, using a molecular phylogeny and the global distributions of Zygophyllaceae, a typical arid-adapted plant family, we assessed the effects of contemporary climate and net diversification rates on species diversity patterns in drylands. We found the variables representing water availability to be the best predictors for Zygophyllaceae diversity. Specifically, Zygophyllaceae species diversity significantly decreased with the increase in water availability, probably owing to phylogenetic conservatism of water-related niches. The net diversification rates of Zygophyllaceae accelerated sharply in the recent 10 Myr, coinciding roughly with the period of global aridification. The species diversity of Zygophyllaceae significantly increased with the increase in mean net diversification rates per geographical unit, especially in the Old World, supporting the net diversification rate hypothesis. Our study provides a case exploring climatic and evolutionary mechanisms of dryland species diversity patterns, and suggests that the conservatism in water-related niches and elevated net diversification rates in drylands may have jointly determined the global patterns of dryland species diversity.
Temperature-mediated inhibition of a bumblebee parasite by an intestinal symbiont
Authors: Palmer-Young Evan C. , Raffel Thomas R. , McFrederick Quinn S.
Published: October 2018

Competition between organisms is often mediated by environmental factors, including temperature. In animal intestines, nonpathogenic symbionts compete physically and chemically against pathogens, with consequences for host infection. We used metabolic theory-based models to characterize differential responses to temperature of a bacterial symbiont and a co-occurring trypanosomatid parasite of bumblebees, which regulate body temperature during flight and incubation. We hypothesized that inhibition of parasites by bacterial symbionts would increase with temperature, due to symbionts having higher optimal growth temperatures than parasites. We found that a temperature increase over the range measured in bumblebee colonies would favour symbionts over parasites. As predicted by our hypothesis, symbionts reduced the optimal growth temperature for parasites, both in direct competition and when parasites were exposed to symbiont spent medium. Inhibitory effects of the symbiont increased with temperature, reflecting accelerated growth and acid production by symbionts. Our results indicate that high temperatures, whether due to host endothermy or environmental factors, can enhance the inhibitory effects of symbionts on parasites. Temperature-modulated manipulation of microbiota could be one explanation for fever- and heat-induced reductions of infection in animals, with consequences for diseases of medical and conservation concern.