bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of pathological response to neoadjuvant chemotherapy in locally advanced cervical cancer
Authors: Wei Li-Jun , Fu Jia , Yang Hai-Xia , Yang Xia , Liang Hao-Yu , Luo Rong-Zhen , Liu Li-Li
Published: July 2024

Neoadjuvant chemotherapy (NACT) is a viable therapeutic option for women diagnosed locally advanced cervical cancer (LACC). However, the factors influencing pathological response are still controversial. We collected pair specimens of 185 LACC patients before and after receiving NACT and conducted histological evaluation. 8 fresh tissues pre-treatment were selected from the entire cohort to conducted immune gene expression profiling. A novel pathological grading system was established by comprehensively assessing the percentages of viable tumor, inflammatory stroma, fibrotic stroma, and necrosis in the tumor bed. Then, 185 patients were categorized into either the good pathological response (GPR) group or the poor pathological response (PPR) group post-NACT, with 134 patients (72.4%, 134/185) achieving GPR. Increasing tumor-infiltrating lymphocytes (TILs) and tumor-infiltrating lymphocytes volume (TILV) pre-treatment were correlated with GPR, with TILV emerging as an independent predictive factor for GPR. Additionally, CIBERSORT analysis revealed noteworthy differences in the expression of immune makers between cPR and non-cPR group. Furthermore, a significantly heightened density of CD8 + T cells and a reduced density of FOXP3 + T cells were observed in GPR than PPR. Importantly, patients exhibiting GPR or inflammatory type demonstrated improved overall survival and disease-free survival. Notably, stromal type was an independent prognostic factor in multivariate analysis. Our study indicates the elevated TILV in pre-treatment specimens may predict a favorable response to NACT, while identifying stromal type in post-treatment specimens as an independent prognostic factor. Moreover, we proposed this pathological grading system in NACT patients, which may offer a more comprehensive understanding of treatment response and prognosis.
Systemic interindividual DNA methylation variants in cattle share major hallmarks with those in humans
Authors: Chang Wen-Jou , Baker Maria S. , Laritsky Eleonora , Gunasekara Chathura J. , Maduranga Uditha , Galliou Justine C. , McFadden Joseph W. , Waltemyer Jessica R. , Berggren-Thomas Bruce , Tate Brianna N. , Zhang Hanxue , Rosen Benjamin D. , Van Tassell Curtis P. , Liu George E. , Coarfa Cristian , Ren Yi Athena , Waterland Robert A.
Published: July 2024

Background

We recently identified ~ 10,000 correlated regions of systemic interindividual epigenetic variation (CoRSIVs) in the human genome. These methylation variants are amenable to population studies, as DNA methylation measurements in blood provide information on epigenetic regulation throughout the body. Moreover, establishment of DNA methylation at human CoRSIVs is labile to periconceptional influences such as nutrition. Here, we analyze publicly available whole-genome bisulfite sequencing data on multiple tissues of each of two Holstein cows to determine whether CoRSIVs exist in cattle.

Results

Focusing on genomic blocks with ≥ 5 CpGs and a systemic interindividual variation index of at least 20, our approach identifies 217 cattle CoRSIVs, a subset of which we independently validate by bisulfite pyrosequencing. Similar to human CoRSIVs, those in cattle are strongly associated with genetic variation. Also as in humans, we show that establishment of DNA methylation at cattle CoRSIVs is particularly sensitive to early embryonic environment, in the context of embryo culture during assisted reproduction.

Conclusions

Our data indicate that CoRSIVs exist in cattle, as in humans, suggesting these systemic epigenetic variants may be common to mammals in general. To the extent that individual epigenetic variation at cattle CoRSIVs affects phenotypic outcomes, assessment of CoRSIV methylation at birth may become an important tool for optimizing agriculturally important traits. Moreover, adjusting embryo culture conditions during assisted reproduction may provide opportunities to tailor agricultural outcomes by engineering CoRSIV methylation profiles.
Intracranial dissemination of Klebsiella pneumoniae originating from pulmonary infection: a case report
Authors: Jamalipoursufi Ghazaleh , Hajihashemi Ali , Sadeghizade Shokouh , Geravandi Mahsa
Published: July 2024

Background

Metastatic brain abscesses caused by Klebsiella pneumoniae are extremely rare but life-threatening conditions. To depict a unique case of the middle-aged hypertensive man with an unusual presentation of metastatic brain abscesses originating from a pleural abscess caused by Klebsiella pneumoniae and subsequently leading to loss of consciousness (LOC).

Case report

A 52-year-old Iranian man with a history of hypertension presented to the emergency department with a five-day history of worsening cough, high-grade fever, shortness of breath, chest pain, fatigue, and a productive cough. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and respiratory alkalosis. A chest computed tomography scan confirmed pneumonia, and a brain scan revealed multiple hypodense lesions. Despite antibiotic therapy, the patient's condition worsened, leading to confusion, disorientation, and loss of consciousness. Magnetic resonance imaging revealed multiple ring-enhancing lesions, suggesting an abscess formation. Bronchial washings and BAL samples confirmed a lower respiratory tract infection. Cultures from the bronchial washings grew Klebsiella pneumoniae.

Conclusions

Metastatic brain abscesses caused by Klebsiella pneumoniae are exceedingly rare but life-threatening conditions. Timely diagnosis and effective antimicrobial treatment are critical for patient outcomes. This case underscores the significance of recognizing atypical presentations of bacterial infections, as early detection and appropriate management can significantly impact patient outcomes.
Integrated use of the CA–Markov model and the Trends.Earth module to enhance the assessment of land cover degradation
Authors: Zimba Henry M. , Banda Kawawa E. , Mbewe Stephen , Nyambe Imasiku A.
Published: July 2024

This study aims to demonstrate the potential of assessing future land cover degradation status by combining the forecasting capabilities of the Cellular-Automata and Markov chain (CA-Markov) models in Idris Selva with the land cover degradation (LCD) model in the Trends.Earth module. The study focuses on the upper Zambezi Basin (UZB) in southern Africa, which is one of the regions with high rates of land degradation globally. Landsat satellite imagery is utilised to generate historical (1993–2023) land cover and land use (LCLU) maps for the UZB, while the global European Space Agency Climate Change Initiative (ESA CCI) LCLU maps are obtained from the Trends.Earth module. The CA-Markov chain model is employed to predict future LCLU changes between 2023 and 2043. The LCD model in the Trends.Earth module in QGIS 3.32.3 is then used to assess the historical and forecasted land cover degradation status. The findings reveal that land cover degradation maps produced from local LCLU classifications provide more detailed information compared to those produced from the global ESA CCI LCLU product. Between 2023 and 2043, the UZB is predicted to experience a net reduction of approximately 3.2 million hectares of forest cover, with an average annual reduction rate of − 0.13%. In terms of land cover degradation, the UZB is forecasted to remain generally stable, with 87% and 96% of the total land cover area expected to be stable during the periods 2023–2033 and 2033–2043, respectively, relative to the base years 2023 and 2033. Reduction in forest cover due to the expansion of grassland, human settlements, and cropland is projected to drive land cover degradation, while improvements in forest cover are anticipated through the conversion of grassland and cropland into forested areas. It appears that using locally produced LCLU with high-resolution images provides better assessments of land degradation in the Trends.Earth module than using global LCLU products. By leveraging the opportunities offered by models with capacity to predict LCLU such as the CA–Markov model and the capabilities of the LCD model, as evidenced in this study, valuable forecasted information can be effectively obtained for monitoring land cover degradation. This information can then be used to implement targeted interventions that align with the objective of realising the United Nations' land degradation neutral world target by 2030.
Text summarization based on semantic graphs: an abstract meaning representation graph-to-text deep learning approach
Authors: Kouris Panagiotis , Alexandridis Georgios , Stafylopatis Andreas
Published: July 2024

Nowadays, due to the constantly growing amount of textual information, automatic text summarization constitutes an important research area in natural language processing. In this work, we present a novel framework that combines semantic graph representations along with deep learning predictions to generate abstractive summaries of single documents, in an effort to utilize a semantic representation of the unstructured textual content in a machine-readable, structured, and concise manner. The overall framework is based on a well defined methodology for performing semantic graph parsing, graph construction, graph transformations for machine learning models and deep learning predictions. The employed semantic graph representation focuses on using the model of abstract meaning representation. Several combinations of graph construction and graph transformation methods are investigated to specify the most efficient of them for the machine learning models. Additionally, a range of deep learning architectures is examined, including a sequence-to-sequence attentive network, reinforcement learning, transformer-based architectures, and pre-trained neural language models. In this direction, a semantic graph representation of an original text is extracted, and then the present framework formulates the problem as a graph-to-summary learning problem to predict a summary of an original text. To the best of our knowledge, this formulation of graph-to-summary predictions in abstractive text summarization, without other intermediate steps in the machine learning phase, has not been presented in the relevant literature. Another important contribution is an introduction of a measure for assessing the factual consistency of the generated summaries in an effort to provide a qualitative evaluation. To assess the framework, an extensive experimental procedure is presented that uses popular datasets to evaluate key aspects of the proposed approach. The obtained results exhibit promising performance, validating the robustness of the proposed framework.
FDG altered biodistribution in white adipose tissue, a rare entity: case report and review of the literature
Authors: Raynor William Y. , Sozio Stephen J. , Kempf Jeffrey S.
Published: July 2024

Purpose

Altered 18F-fluorodeoxyglucose (FDG) biodistribution due to patient factors such as exercise and inadequate fasting are well established causes of limited diagnostic efficacy. In addition, medications such as G-CSF are known to affect uptake of FDG by bone marrow and spleen. In this study, we present a case of increased white adipose uptake in a pediatric lymphoma patient who recently received high dose dexamethasone and review the relevant literature regarding this rare and poorly understood pattern of altered FDG biodistribution.

Methods

A 14-year-old male patient diagnosed with B-cell lymphoblastic lymphoma underwent FDG-PET/CT for restaging shortly after completing an induction chemotherapy regimen. Images revealed diffuse FDG uptake localizing to white adipose tissue, attributed to the 29-day course of dexamethasone which was completed two days prior. A diagnostically adequate study with relative normalization of FDG biodistribution was obtained seven days later.

Results

In our review of the literature, diffuse FDG uptake by white fat is a rare occurrence and has only been reported by a few case reports and early observational studies. In addition to patients receiving corticosteroids, other cases of medication-induced adipose remodeling such as patients receiving highly active antiretroviral therapy have been documented with similar patterns of increased white adipose tissue activity.

Conclusion

Corticosteroid-induced white fat uptake of FDG is a rare phenomenon that can limit diagnostic accuracy of FDG-PET/CT and necessitate repeat imaging. Current evidence suggests that a wait period of at least one week after discontinuation of corticosteroids is sufficient to allow for decreased white fat uptake and increased diagnostic accuracy.
Comparative analysis of addiction severity and renal functions in patients with synthetic cannabinoid use disorder versus cannabis use disorder
Authors: Hamimy Rana Walid , Wahab Momtaz Mohamed Abd El , Mohamed Rania Mamdouh
Published: July 2024

Background

The use of synthetic cannabinoids (SC) has become a concerning public health issue due to their potential adverse effects on both physical and mental health. Understanding the effect of cannabis and synthetic cannabinoids use on kidney functions and creatinine phosphokinase-total (CPK) levels is essential for targeted intervention and patient care.

Methods

This cross-sectional study aimed to assess addiction severity using the Addiction Severity Index (ASI) and kidney functions in 45 patients with SC use disorder and compare them to 45 patients with cannabis use disorder (CUD). Participants were recruited from the addiction outpatient clinics and inpatient ward of the addiction psychiatry unit at “Kasr Al Aini Hospital,” Cairo University.

Results

There was a statistically significant difference between the 2 groups regarding the Addiction Severity Index domains, where patients with SC use disorder had higher scores in all domains of the ASI.

Regarding kidney functions and CPK-total levels, there was a significant difference in the serum CPK-total level (p < 0.05) between the 2 groups; however, there was no significant difference regarding the other kidney function tests (serum creatinine, urea, blood urea nitrogen, and estimated glomerular filtration rate).

As for the correlative analysis, there was a significant correlation between some domains of the ASI and the kidney function tests in both patient groups.

Conclusion

Our results strongly suggest that SC may have a more hazardous and detrimental impact on individuals, encompassing various aspects of addiction severity such as physical health, psychological well-being, social functioning, and overall quality of life. Our findings also highlight the potential risk of elevated CPK-total levels in patients with SC use disorder; therefore, regular monitoring of kidney function in patients with synthetic cannabinoid use disorder is crucial for guiding appropriate treatment interventions and mitigating adverse health outcomes.
A comprehensive review of iatrogenic withdrawal syndrome in critically ill children
Authors: Al-Harbi Samah
Published: July 2024

Background

Benzodiazepines and opioids are commonly administered to severely ill children in the pediatric intensive care unit (PICU) for analgesia and sedation. Long-term opioid medication often results in iatrogenic withdrawal syndrome (IWS) as well as tolerance when the dosage of benzodiazepines and opioids are gradually lowered or entirely stopped.

Objectives

This review aimed to review and summarize existing knowledge and information on IWS in pediatrics.

Conclusion

IWS in critically ill children is difficult to diagnose and manage. However, detecting and successfully managing IWS is critical to minimizing potentially negative effects during a patient’s ICU stay and after discharge. Further research is required to ascertain the exact and reliable prevalence of IWS among pediatric patients, as well as the benefits and drawbacks of existing assessment tools and treatments.
Inexpensive and colorimetric RNA detection at ambient temperature with a cell-free protein synthesis platform
Authors: Toparlak Ö. Duhan , Notarangelo Michela , Quattrone Alessandro , Pizzato Massimo , Mansy Sheref S.
Published: July 2024

While many proposals of paper-based diagnostics utilize cell-free gene expression systems, these assays oftentimes suffer from the need for temperature cycling and high operational costs, particularly for developing countries. Here, we explore and report the experimental conditions for the colorimetric detection of viral RNA with an in vitro transcription/translation assay that uses crude E. coli extracts at room temperature where the signal amplification is aided by body heat. Clinically-relevant concentrations of RNA (ca. 600 copies/test) were detected from synthetic RNA samples. The activation of cell-free gene expression was achieved using toehold-switch-mediated riboregulatory elements that are specific to RNA sequences. The colorimetric output was generated by the α-complementation of β-galactosidase ω-fragment (LacZω) with cell-free expressed LacZα, using an X-gal analogue as a substrate. The estimated cost of a single reaction is as low as ~ 0.26 euro/test, which may help to facilitate the accessibility of the diagnostic kit in developing countries. With future optimizations and bacterial strain engineering, production costs can be even further brought down, and the test times can be shortened.

Graphical Abstract
Effect of fluid patch clustering on the P-wave velocity-saturation relation: A critical saturation model
Authors: Liu Qiang , Müller Tobias M. , Rezaee Reza , Liu Yanli , Cao Danping
Published: July 2024

Quantitative analysis of the relationship between seismic wave velocities and fluid saturation in porous media is of great significance for any fluid injection and extraction operation in subsurface rock formations. However, seismic velocities are not only dependent on the amount of saturation but also on the distribution of fluid patches and their size. The patch-size variation during changes in saturation is often ignored in modeling studies even though it is natural to assume that with increasing saturation, fluid patches will form larger and, at some critical saturation, percolating clusters. To capture the evolution of patch size with saturation implied in the velocity-saturation relations (VSRs), we are inspired by percolation theory. By incorporating the connectivity of water-filled patches in a continuous random medium model, we develop a critical saturation model (CSM). We apply this CSM to examine recently reported experimental measurements, specifically analyzing the patch-size changes. For measurements of drainage or imbibition processes in four sandstone samples, we indeed find a clear indication of growing patch size with water saturation. The predictions of the CSM are in reasonable agreement with observations. Our approach improves the accuracy of the interpretation of the VSR in partially saturated rocks and forms a basis for exploring its underlying mechanisms.
Robust unsupervised 5D seismic data reconstruction on regular and irregular grids
Authors: Li Ji , Liu Dawei , Trad Daniel , Sacchi Mauricio D.
Published: July 2024

Seismic data reconstruction has become a central focus in seismic data processing, addressing challenges posed by sparse sampling due to physical and budgetary constraints. The advent of 5D acquisition methodologies marks a significant advancement in the quality and completeness of seismic data sets. Most traditional 5D reconstruction methods commonly use the fast Fourier transform (FFT), requiring regular grids and preliminary 4D binning before 5D interpolation. Discrete Fourier transform and nonequidistant FFT can honor the original irregular coordinates. However, when using exact locations, these methods become computationally expensive. We introduce an unsupervised deep-learning methodology to learn a continuous function across the sampling points in seismic data, facilitating reconstruction on regular and irregular grids. The network comprises a multilayer perceptron with linear layers and element-wise periodic activation functions. It excels at mapping the input coordinates to the corresponding seismic data amplitudes without relying on external training sets. The network’s intrinsic low-frequency bias is crucial in prioritizing acquiring self-similar features over high-frequency and incoherent ones during training. This characteristic mitigates incoherent noise in seismic data, such as random and erratic components. To assess the robustness of the unsupervised reconstruction technique, we conduct comprehensive evaluations using synthetic data examples sampled regularly and irregularly, as well as field-data examples with and without binning. The findings demonstrate the efficacy of our deep-learning framework in achieving resilient and accurate seismic data reconstruction across diverse sampling scenarios.
Review of 3D electromagnetic modeling and inversion for mineral exploration
Authors: Zhang Bo , Qu Kelin , Yin Changchun , Wang Yinfeng , Liu Yunhe , Ren Xiuyan , Su Yang
Published: July 2024

Many mineral deposits have low resistivity. This property makes the electromagnetic (EM) method a very useful tool for mineral exploration. In the past few decades, the application of EM exploration technologies has been reviewed by many researchers. However, most reviews focused on EM exploration methods, the development of equipment, or their applications. Three-dimensional forward modeling and inversions are high-accuracy EM interpretation techniques in which great progress has been made in recent years in mineral exploration. We review the development of EM technology for mineral exploration with a focus on 3D EM forward modeling, inversion technology, and its applications. We first briefly introduce the EM methods for mineral exploration. Next, we give a comprehensive review of 3D EM forward modeling, inversion, and data interpretation, with special attention paid to the development of EM theory and applications in mineral exploration. We hope this review can promote the application of 3D EM numerical simulation and inversion in mineral exploration.
Insights Into Central Congenital Hypothyroidism: A Multicenter Retrospective Analysis
Authors: German Alina , Almashanu Shlomo , de Vries Liat , Gil Margolis Merav , Halloun Rana , Haim Alon , Eyal Ori , Levy-Khademi Floris , Pivko-Levy Dikla , Nir Judith , Pinhas-Hamiel Orit , Tenenbaum-Rakover Yardena
Published: July 2024

Context

Central congenital hypothyroidism (CCH) is a thyroid hormone deficiency at birth caused by inadequate pituitary stimulation of the thyroid gland. Although primary congenital hypothyroidism has been studied extensively, studies on CCH are sparse.

Objective

To assess the prevalence of CCH in Israel and describe its clinical features, neonatal screening results, and outcomes.

Methods

This multicenter cross-sectional retrospective chart review covered 9 pediatric endocrine units throughout Israel; patients diagnosed with CCH in 1987–2021 were categorized into early (within 14 days of life) and late (after 14 days) diagnosis groups. Newborn screening (NBS) results were retrospectively retrieved from the national NBS program dataset.

Results

CCH prevalence in Israel was about 1:42 800 live births. Subjects were 94 patients (54 males), of these, 84% had multiple pituitary hormone deficiencies and 16% had isolated CCH. The median age at diagnosis was 50 days (range, 1-8760), with 66% having moderate to severe hypothyroidism. NBS detected only 3 infants. Early diagnosis occurred in 34% due to hypopituitarism, while 66% were diagnosed later due to growth and developmental delays. Neurodevelopmental sequelae included mental retardation (12%), learning difficulties (18%), delayed speech (27%), and motor clumsiness (19%), with no significant differences in outcomes between early and late diagnosis.

Conclusion

Despite high rates of neurodevelopmental sequelae, no differences were found between early and late diagnosis groups. Further research is needed to assess the impact of delayed diagnosis on neurological outcomes in newborns with CCH. Improved strategies for detecting CCH in newborns are also necessary.
In Vivo Formation of Adrenal Organoids in a Novel Porcine Model of Adrenocortical Cell Transplantation
Authors: Clarke Brigette Marie , Kireta Svjetlana , Johnston Julie , Christou Chris , Greenwood John Edward , Hurtado Plinio R , Manavis Jim , Coates Patrick Toby , Torpy David J
Published: July 2024

Recognizing the limitations of current therapies for Addison's disease, novel treatments that replicate dynamic physiologic corticosteroid secretion, under control of ACTH, are required. The aim of these experiments was to evaluate the feasibility of adrenocortical cell transplantation (ACT) in a large animal model, adapting methods successfully used for intracutaneous pancreatic islet cell transplantation, using a fully biodegradable temporizing matrix. Autologous porcine ACT was undertaken by bilateral adrenalectomy, cell isolation, culture, and intracutaneous injection into a skin site preprepared using a biodegradable temporizing matrix (BTM) foam. Hydrocortisone support was provided during adrenocortical cell engraftment and weaned as tolerated. Blood adrenocortical hormone concentrations were monitored, and the transplant site was examined at endpoint. Outcome measures included cellular histochemistry, systemic hormone production, and hydrocortisone independence. Transplanted adrenocortical cells showed a capability to survive and proliferate within the intracutaneous site and an ability to self-organize into discrete tissue organoids with features of the normal adrenal histologic architecture. Interpretation of systemic hormone levels was confounded by the identification of accessory adrenals and regenerative cortical tissue within the adrenal bed postmortem. Corticosteroids were unable to be completely ceased.

ACT in a large animal model has not previously been attempted, yet it is an important step toward clinical translation. These results demonstrate rhe potential for ACT based on the development of adrenal organoids at the BTM site. However, the inability to achieve clinically relevant systemic hormone production suggests insufficient function, likely attributable to insufficient cells through delivered dose and subsequent proliferation.
Beyond the Back: The Science of Lumbar Epidural Steroid Injections
Authors: Kale Sachin ,   Department of Orthopedics, D Y Patil Hospital and Medical College, Navi Mumbai, Maharashtra, India,, Vatkar Arvind ,   Department of Orthopedic Spine Surgeon, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.
Published: July 2024

Chronic low back pain causes significant morbidity and increases the global burden of disability. It has been shown to increase psychological, physical, and monetary load on the world population, In the USA alone, it causes an economic burden of 100 billion dollars/year [1]. Low back pain has been referred to as sciatica pain, lumbar radiculopathy, lumbar nerve entrapment, and neurogenic claudication. It is basically pain arising from the lower back region and radiating like a current to the lower limbs. The two prime causes of this low back pain with radiculopathy are intervertebral disc disease and facet joint arthritis [2]. The pathological aging changes happening in intervertebral disk cause disk herniation and other degenerative diseases such as lumbar canal stenosis and chronic instability. Lumbar radiculopathy or sciatica is mainly caused by compression of the nerve by protruded nucleus pulposus, which is the jelly like material of intervertebral disk [3,4]. Most of the patients with intervertebral disk disease and sciatica can be managed with conservative measures. These include anti-inflammatory analgesics, neuropathic medications such as pregabalin and gabapentin, regular exercises, and epidural steroid injections [5-7]. These measures help to prevent surgery. Significant compression of nerves with no relief from conservative measures qualifies to surgical intervention [2]. ESI, which has been used since 1952, is mainly used for lumbar and neck pain with radicular pain. It has shown excellent and quick results with minimal adverse effects. The ESI consists of injecting the steroids with or without local anesthetic medication in the epidural space to decrease the discogenic source of pain [8-11]. LSEI can be divided according to the needle route (interlaminar, transforaminal, or caudal). In this article, we will go over the various approaches for intralaminar (between the 2 adjacent laminae of lumbar vertebrae), transforaminal (through the intervertebral foramen), and caudal (through the sacral hiatus) epidural steroid injections [12-14].
Difficulty in Early Diagnosis of Bilateral Posterior Fracture-dislocation of the Shoulder Caused by an Electric Shock in a Walk-in Patient: A Case Report
Authors: Kato Sakurako ,   Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan,, Yasuma Sanshiro , Joyo Yuji , Shiraga Hiroo , Murakami Hideki , Waguri-Nagaya Yuko ,   Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan,,   Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan,,   Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan,,   Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan.,   Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan,
Published: July 2024

Introduction: Bilateral posterior fracture-dislocation of the shoulder is a very rare injury that is commonly missed. Almost 70% of bilateral posterior dislocations are due to convulsive seizures, with electric shocks accounting for < 5% of bilateral posterior shoulder dislocations. Case Report: The case of a walk-in patient, a 52-year-old man, with bilateral posterior fracture-dislocation of the shoulder caused by an electric shock is reported. Although he was initially admitted to the emergency department for observation of the potential complications of an electric shock, such as fatal arrhythmia and rhabdomyolysis, he subsequently consulted an orthopedic surgeon 4 days after the event due to persistent bilateral shoulder pain and was diagnosed using X-ray and computed tomography with bilateral posterior fracture-dislocation of the shoulder. Following open reduction and internal fixation 7 days after the injury, the upper limbs were fixed with shoulder braces at a slightly flexed and abducted position with neutral rotation for 3 weeks postoperatively followed by range of motion exercises. Twelve months after surgery, he had a Constant shoulder score of 94, an American Shoulder and Elbow Surgeon score of 100, and no shoulder re-dislocation or humeral head necrosis. Conclusion: In this walk-in patient, the diagnosis of bilateral posterior fracture-dislocation of the shoulder caused by an electric shock was delayed. We believe that understanding the mechanism of this type of injury will facilitate its early diagnosis. Keywords: Bilateral, electric shock, posterior fracture-dislocation, shoulder.
From the Metaphor of the Lizard’s Tail to That of the Doughnut: A Case of Achilles Tendon Complete Regrowth
Authors: Bisciotti Andrea ,   [1] Kinemove Rehabilitation Centers Pontremoli-La Spezia, Pontremoli, 54027, Italy, [2] Orthopaedics of the Knee and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy,, Bisciotti Gian Nicola , Quaglia Alessandro , Carimati Giulia , Volpi Piero ,   Kinemove Rehabilitation Centers Pontremoli-La Spezia, Pontremoli, 54027, Italy,,   [2] Orthopaedics of the Knee and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy, [3] FC Internazionale Milano, Italy.,   [2] Orthopaedics of the Knee and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy, [3] FC Internazionale Milano, Italy.,   [2] Orthopaedics of the Knee and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy, [3] FC Internazionale Milano, Italy.
Published: July 2024

Introduction: Tendon tissue turnover is a very slow process. However, some tendons show very unique regeneration capabilities. The Achilles tendon regeneration and maturation process occurs uniformly and centripetally along the entire the length of the neo-tendon. Case Report: The present case report describes a complete regeneration of the Achilles tendon in a 54-year-old patient with a reinjury to the Achilles tendon following open tenorrhaphy surgery. The regenerative process had a positive outcome despite the patient suffering, at the time, from an infection caused by Cutibacterium acnes. Conclusion: This case report is a paradigmatic example of how the Achilles tendon is able to maintain its regenerative capacity even in extremely critical biological situations such as after an infection. However, the issue concerning the biological characteristics of the regenerated tendon remains open. Keywords: Achilles tendon, post-surgical infection, regenerative process, tendon histology, mechanical properties.
Persistent Challenges: A Recurrent Adamantinoma – Case Report
Authors: Farooque Khalil ,   Department of Orthopedics, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan., Farooq Muhammad Zoha , Rafi Ilyas ,   Department of Orthopedics, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan.,   Department of Orthopedics, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan.
Published: July 2024

Introduction: Adamantinoma is a rare, locally aggressive bone tumor that primarily affects the long bones, with a predilection for the tibia. Although considered a low-grade malignancy, adamantinoma is notorious for its high propensity for recurrence, which poses significant clinical challenges in the management of affected individuals. This case report aims to explore the intricacies of recurrent adamantinoma of the tibia, shedding light on its clinical presentation, diagnostic modalities, treatment strategies, and prognostic factors. Objective: This case report aims to evaluate surgical and functional outcomes of post-excision and reconstruction in recurrent adamantinoma. Case Report: This retrospective case report includes the patient who presented in Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore with recurrent adamantinoma. Data were collected after patient’s written and informed consent, and a retrospective analysis of the patient’s demographics was done with the Statistical Package for the Social Sciences using the information in the Hospital Information System with a predesigned pro forma. Histology slides were collected from the Department of Pathology. Variables that were included are categorized into demographics, history and examination findings, site, and size of the primary tumor, radiological findings, histological type, stage, and resection margins. The patient underwent wide margin excision and reconstruction with free vascularized fibula graft and his functional outcome was evaluated using the musculoskeletal tumor society score which showed good functional outcome. Conclusion: Despite therapeutic challenges, wide excision of the tumor followed by free vascularized fibula grafting for reconstruction is a viable option to treat such patients where advanced prosthesis and allografts are not available. Keywords: Case report, adamantinoma, recurrence, vascularized free fibula graft.
A Rare Outcome of a Case of Medullary Osteosarcoma of the Femur in Ghana
Authors: Konadu-Yeboah Dominic ,   [1] Department of Orthopaedics and Trauma, Komfo Anokye Teaching Hospital, Kumasi, Ghana, [2] Department of Surgery School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,, Okrah Helena , Henneh Gillian , Konadu Peter , Kwasi Kusi , Anarfi Nicholas ,   Department of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.,   Department of Orthopaedics and Trauma, Komfo Anokye Teaching Hospital, Kumasi, Ghana,,   [1] Department of Orthopaedics and Trauma, Komfo Anokye Teaching Hospital, Kumasi, Ghana, [2] Department of Surgery School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,,   Department of Orthopaedics and Trauma, Komfo Anokye Teaching Hospital, Kumasi, Ghana,,   Department of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Published: July 2024

Introduction: Osteosarcoma is a malignant mesenchymal neoplasm in which the tumor cells produce defective and immature bone (osteoid). The risk factors for developing the disease include: Patients with hereditary retinoblastoma and germline mutations of the p53 tumor suppressor gene. Case Report: A 32-year old male presented with pain and swelling of the left thigh of 9 months duration. The pain was progressive, excruciating, worse at night, and unresponsive to paracetamol with moderate weight loss. He had sought treatment from a traditional bonesetter 6 months before presentation and had no improvement of the symptoms. Conclusion: In medullary osteosarcoma of the femur, where there is extracomparmental disease with no distant metastasis, clinically and radiologically, radical tumor resection with a free oncological margin increases survival of the patient up to 7 years. Keywords: Medullary osteosarcoma, malignant tumor, metastasis, extracompartmental
Multifocal Skeletal Tuberculosis – A Case Report
Authors: Unnikrishnan Ranjith ,   Department of Orthopaedics and Spine Surgery, KIMS Health, Trivandrum, India., Chacko Ankith , Jasim Muhammad , Chandran Nitheesh , Gowrishankar S ,   Department of Orthopaedics and Spine Surgery, KIMS Health, Trivandrum, India.,   Department of Orthopaedics and Spine Surgery, KIMS Health, Trivandrum, India.,   Department of Orthopaedics and Spine Surgery, KIMS Health, Trivandrum, India.,   Department of Orthopaedics and Spine Surgery, KIMS Health, Trivandrum, India.
Published: July 2024

Introduction: Tuberculosis (TB) remains a pervasive infectious disease, and extrapulmonary manifestations account for a significant proportion of cases. Skeletal involvement is observed in about 10% of extrapulmonary TB instances. While spinal TB is relatively common, sacroiliac (SI) joint TB is a rare occurrence, particularly in immunocompetent individuals. Case Report: This case report discusses an unusual presentation in a 19-year-old immunocompetent lady where the spine, acetabulum, and SI joint were concurrently affected. The patient, initially undergoing alternative medicine, exhibited severe pain, weight loss, and restricted mobility. Radiological evaluations, including X-rays and magnetic resonance imaging, revealed extensive vertebral and pelvic destruction with abscess formation. Surgical debridement and stabilization, alongside antitubercular treatment, led to significant improvement. Conclusion: This case emphasizes the challenges in diagnosing multifocal skeletal TB, highlights the importance of early intervention, and underscores the impact of alternative medicine on treatment delays. A multidisciplinary approach involving histopathological and microbiological examinations is crucial for optimal management. Keywords: Multifocal skeletal tuberculosis, surgical intervention, antitubercular treatment.
Integrated Nail and Plate Fixation with Allograft in the Management of Osteoporotic Intra-articular Distal Femur Fracture – A Case Report
Authors: Kale Sachin ,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India., Dhar Sanjay , Chaudhari Prasad , Mehta Nirupam , Das Sonali , Modi Ravi ,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India.,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India.,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India.,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India.,   Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Mumbai, Maharashtra, India.
Published: July 2024

Introduction: Securing stable internal fixation for fractures in the osteoporotic intra-articular distal femur proves to be a demanding task due to thin cortices, a wide medullary canal, diminished bone stock, and fracture comminution. No singular therapeutic approach has successfully tackled all facets of this injury. Consequently, we now introduce a pioneering fixation method in our report, aiming to offer a holistic solution to the intricate challenges associated with this scenario. Case Report: A 60-year-old female presented with an intra-articular distal femur fracture, and underwent a combination fixation of distal femur plate and intramedullary interlocking nailing. The patient was rehabilitated with active knee range of motion on post-operative day 7 and has now attained full knee range of motion. Conclusion: The utilization of anatomical plates with locking mechanisms, in tandem with intramedullary interlocking nailing, holds promise for the secure stabilization and fixation of osteoporotic distal femur fractures, potentially leading to an expedited recovery process. Keywords: Distal femur fracture, intra-articular fracture, distal femur plating, intramedullary nailing.
Anterior Congenital Radial Head Dislocation in an Adult with Associated Posterior Interosseous Nerve Palsy
Authors: U Ong Rachelle Jasmine ,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan., Muramatsu Keiichi , Yamashita Yosuke , Corpus-Zuñiga Fidelis Marie , Gonzales Mary Rose Casas , Tani Yasuhiro ,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan.,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan.,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan.,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan.,   Department of Orthopedic Surgery, Nagato General Hospital, Yamaguchi, Japan.
Published: July 2024

Introduction: Anterior congenital radial head dislocation (CRHD) is a rare abnormality that is less commonly seen in the adult population. Most of the time, adult-onset symptoms are due to the prolonged dislocation of the radiocapitellar joint that has been present since birth. One of the possible complications of having a prolonged radial head dislocation is the presence of neuropathies such as posterior interosseous nerve (PIN) palsy. There has been, however, no literature published regarding the relationship of CRHD with PIN palsy. Case Report: We here report a 66-year-old male incidentally diagnosed with anterior CRHD with concomitant PIN palsy after acquiring a fracture of the lateral humeral condyle. Open reduction internal fixation of the lateral condyle was done along with decompression of the said nerve. PIN palsy was completely recovered 2 months after surgery. Conclusion: Surgeons must be aware that PIN palsies can occur in the presence of a chronic radial head dislocation, even if asymptomatic. Prompt nerve decompression as well as removal of the mechanical block is pertinent to avoid the perilous effects of an irreversible PIN palsy. Keywords: Congenital radial head dislocation, posterior interosseous nerve palsy, neurolysis, fracture.
A Unique “Galeazzi-Like” Fracture through a Vacated External-Fixator Pin Track: A Case Report
Authors: Meyer Peyton ,   Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Kadiyala Manasa L , Egol Kenneth A ,   Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.,   Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Published: July 2024

Introduction: Galeazzi fractures are fractures of the radial shaft accompanied by distal radioulnar joint (DRUJ) instability. They usually occur due to a mechanical fall or direct trauma to the wrist or forearm. Management of this serious injury varies from non-operative treatment with closed reduction and splinting to operative fixation using an external fixator (ex-fix) or open reduction internal fixation with plate and screws. Case Report: We present a 76-year-old female who presented with a right distal radius fracture after a ground-level fall. Due to fracture displacement after initial conservative management, she was placed in an external fixator for stabilization. After removal of the ex-fix, she sustained a midshaft radius fracture with DRUJ malalignment, consistent with a “Galeazzi-like” fracture. Conclusion: “Galeazzi-like” fractures with associated DRUJ malalignment can occur from previous external fixator pin sites and are adequately treated with standard operative fixation. Keywords: Galeazzi-like fracture, ex-fix, distal radioulnar joint instability, nonunion.
Chronic Recurrent Osteomyelitis of Ribs Due to Bamboo Stick Injury in an Adult Man: A Case Report
Authors: Altaf Warid ,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India., Jajoo Shashank Omprakashji , Kothari Abhishek , Sodhai Vivek , Murari Ashok Kumar Shyam , Sancheti Parag ,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
Published: July 2024

Introduction: Chronic osteomyelitis of the ribs in adolescents and adults is a rare condition. Current understanding of its diagnosis and management is primarily derived from case reports and small series studies. Here, we present a case of chronic rib osteomyelitis initially managed conservatively with antibiotics, followed by debridement, sequestrectomy, and continued antibiotic therapy. However, due to recurrence, rib excision was ultimately chosen as the definitive management approach. Case Report: A 18-year-old male presents with a discharging sinus from the chest persisting for 6 months, with no history of fever, shivering, or weight loss. He sustained a blunt injury to the chest with a bamboo stick 9 months ago. Initially, the patient was treated with antibiotics, but there was no relief. He was later operated on with debridement, sequestrectomy, and antibiotics. Six weeks later, he again presented to us with a discharging sinus. Due to recurrence, he underwent re-operation with partial resection of the 6th rib. At the 1-year follow-up after rib excision, the patient is doing well, with all blood parameters within the normal range and without any systemic or local complications. Conclusion: Rib osteomyelitis is a rare complication of blunt chest trauma. Surgical management is indicated in cases of persistent infection. Sequestrectomy and antibiotics, though standard procedures in chronic osteomyelitis, may encounter failure due to various factors. Moreover, due to limited literature on chronic osteomyelitis of ribs, the standard approach to its management is not available. Partial excision of the rib with appropriate antibiotics in our case provided complete cure for the patient. Keywords: Recurrent osteomyelitis, ribs, bamboo stick injury, blunt trauma, rib excision.