bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rectal adenocarcinoma coexisting with incidentally found microscopic gastrointestinal stromal tumor
Authors: Xue Wangsheng , Li Yongbo , Wang Shuang , Yu Ke , Yu Jiaqi , Zhao Zeyun , Jiang Dan , Zhang Mingwei , Liu Tongjun , Wang Min 
Published: August 2019

Abstract

Rationale:
Adenocarcinoma coexists with adjacent microscopic gastrointestinal stromal tumor (micro-GIST) is rare, especially in the rectum, where the gastrointestinal stromal tumors (GISTs) have the lower incidence rate. It is easy to ignore the concurrent micro-GIST due to the untypical symptoms.

Patient concerns:
A 77-year-old male patient suffered from lower abdominal pain for 20 days and presented with per rectal bleeding for 10 days. He had the medical history of hypertension and diabetes for more than 25 years.

Diagnoses:
Endoscopy revealed that the patient had rectum adenocarcinoma and multiple rectum polyps. Besides, the gastrointestinal stromal tumor was diagnosed by the pathologist.

Interventions:
The patient underwent surgery of laparoscopic rectum resection and prophylactic ileostomy and took 6 courses of Capecitabine tablets orally.

Outcomes:
One year after surgery, the patient had no local relapse by the CT scan. However, not long after the CT examination, he died of cardiovascular disease.

Lessons:
Although micro-GIST may be noninvasive and asymptomatic, it may have the potential for transforming to malignancies. More attention should be paid to the patients diagnosed with gastrointestinal malignancy coexisting with micro-GIST.
Fetal giant right cervical cyst causing severe tracheal compression
Authors: Kang Yanming , Ma Yushan , Jiang Xiaoqin , Lin Xuemei , Zhao Fumin 
Published: August 2019

Abstract

Rationale:
Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth.

Patient concerns:
We present a rare case of FGCC, which extended from the right neck into the superior mediastinum, and resulted in severe tracheal compression.

Diagnoses:
An FGCC was observed by ultrasonography and magnetic resonance imaging (MRI) at 27+4 weeks’ gestation (WG). Fetal MRI at 35+1 WG showed that the FGCC was 3.3 × 8.2 × 7.5 cm and extended from the right neck into the superior mediastinum. Severe tracheal compression was observed and the inside diameter of the narrowest section of tracheostenosis appeared thread-like and measured only 0.1 cm.

Interventions:
Cervical cyst reduction was performed prenatally under ultrasound guidance to alleviate the tracheal compression and maximize the chance of fetal survival 2 days before birth. At 36+3 WG, cesarean section was performed, and a female neonate was immediately delivered and intubated (3.5-mm tube) by an experienced anesthesiologist. Neonatal intralesional sclerotherapy and cystic component aspiration as guided by digital subtraction angiography were performed under general anesthesia. Anesthesia was maintained only with sevoflurane 3% in 2 L/min oxygen. Extubation was performed soon after surgery.

Outcome:
The neonate recovered uneventfully and was discharged 2 days postoperatively. After 140 days of follow-up, the neonate had recovered completely.

Lessons:
If an FGCC is suspected by abdominal ultrasound, a fetal MRI is recommended to assess the severity of tracheal compression before birth, if feasible. An anesthesiologist should assess the risk of intubation failure at birth according to those results. If fetal severe tracheal compression is detected and it may result in inability of intubation at birth, prenatal cervical cyst reduction under ultrasound guidance may be effective for alleviating tracheal compression at birth, if feasible. This could maximize the chance of fetal survival. Improvement of fetal short- and long-term outcomes is important.
A case report on an incidental discovery of congenital portosystemic shunt
Authors: Păcurar Daniela , Dijmărescu Irina , Dijmărescu Adrian Dumitru , Romaşcanu Mihai , Becheanu Cristina Adriana 
Published: August 2019

Abstract

Rationale:
Congenital portosystemic shunt (Abernethy malformation) is a rare entity causing the portal blood to drain directly into the systemic circulation, eluding the liver. These shunts arise through disturbances in the embryonic development.

Patient concerns:
A 9-year-old male patient was referred to our department for further evaluation of a vascular malformation which was diagnosed in another facility when the patient was 2 years old, following a routine abdominal ultrasound. The patient had no complaints and the physical examination was normal at all times.

Diagnosis:
Laboratory tests and esogastroduodenoscopy were normal. The abdominal ultrasound showed a side-to-side shunt between a short portal trunk and the inferior vena cava. A hepatic mass suggestive for focal noduar hyperplasia was seen in the left liver lobe. Abdominal angio-computed tomography (angio-CT) was performed and the ultrasonographic anomalies were confirmed. Multiple other vascular malformations were diagnosed—hepatic artery emerging from the superior mesenteric artery, with early division; hepatic veins forming a short common trunk before draining into the inferior vena cava; supranumerary right renal artery emerging from the aorta, tributary for the upper renal pole. Ecocardiography showed left superior vena cava persistence. The final diagnosis was Abernathy malformation type IB. In the meantime the patient was diagnosed with allergic asthma.

Interventions:
No surgical cure was pursued because the malformation was an incidental discovery.

Outcomes:
The patient was followed-up closely from the final diagnosis (when he was 9 years old) to present (he is currently 10 years old) with no change in his status—he remained asymptomatic.

Lessons:
Angio-CT should be the performed whenever a vascular malformation is suspected in order to establish a correct diagnosis, because portosystemic shunts carry a high risk of severe complications. Knowing that patients with portosystemic shunts may have pulmonary hypertension, respiratory complaints should be carefully evaluated—in this particular case, even though the most probable cause for the respiratory symptoms was pulmonary hypertension, it was ruled out by cardiac ultrasonography and further investigations confirmed the diagnosis of allergic asthma.
Association of C8orf4 expression with its methylation status, aberrant β-catenin expression, and the development of cervical squamous cell carcinoma
Authors: Lan Chong , Huan Da-Wei , Nie Xiao-Cui , Niu Ju-Min , Sun Jian-Hua , Huang Wen-Jing , Li Zhi-Han , Xu Hong-Tao 
Published: August 2019

Abstract
Chromosome 8 open reading frame 4 (C8orf4) is an activator of Wnt signaling pathway, and participates in the tumorigenesis and progression of many tumors. The expression levels of C8orf4 and β-catenin were assessed via immunohistochemical staining in 100 cervical squamous cell carcinoma (CSCC) tissues, 50 high-grade squamous intraepithelial lesions (HSILs), 50 low-grade squamous intraepithelial lesions (LSILs), and 50 normal cervical tissues. Bisulfite sequencing polymerase chain reaction analysis was used to examine the methylation status of the C8orf4 locus in CSCC and normal cervical tissues. The expression rates of C8orf4 and β-catenin were significantly higher in CSCCs or HSILs than in LSILs or normal cervical tissues (P < .05). C8orf4 expression was positively correlated with the poor differentiation of CSCCs (P = .009), and with aberrant expression of β-catenin in CSCCs (P = .002) and squamous intraepithelial lesions (P < .001). The methylation rate of C8orf4 in CSCCs was significantly lower than that in normal cervical tissues (P = .001). The Cancer Genome Atlas genomics data also confirmed that the mRNA expression of C8orf4 was positively associated with the copy number alteration of C8orf4 (correlation coefficient = 0.213, P < .001), and negatively correlated with the methylation level of C8orf4 (correlation coefficient = −0.408, P < .001). In conclusion, the expressions of C8orf4 and β-catenin were synergistically increased in CSCCs and HSILs and higher than those in LSILs and normal cervical tissues. The methylation level of C8orf4 is decreased in CSCCs and is responsible for the increased expression of C8orf4.
Control of Nasal Tip Position: Quantitative Assessment of Columellar Strut versus Caudal Septal Extension Graft
Authors: Sawh-Martinez Rajendra , Perkins Kevin , Madari Sarika , Steinbacher Derek M. 
Published: August 2019

Background:
Control and maintenance of nasal tip position are critical in rhinoplasty. Two frequent methods of exerting tip control are columellar strut and caudal septal extension graft. However, no quantitative data exist comparing the two methods over time. The purpose of this study was to analyze maintenance of tip projection and rotation following either columellar strut or septal extension graft.

Methods:
A retrospective cohort study of patients undergoing rhinoplasty was reviewed. Three-dimensional photogrammetric evaluation of patients with either columellar strut or septal extension graft to increase tip projection was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, the Goode ratio, and tip rotation. Results were stratified based on technique and compared statistically.

Results:
One hundred six patients were included. Overall, 66 percent were female, with an average age of 34.5 years. A columellar strut was used in 42 percent of cases (n = 45), and a septal extension graft was used in 57 percent (n = 61). Analysis showed greater maintenance of tip rotation over time with the septal extension graft compared with the columellar strut [−1.01 percent change (p = not significant versus −5.08 percent change (p = 0.009)]. Tip projection, nasal length, and the Goode ratio decreased over time for both groups, but the differences were not statistically different.

Conclusions:
Nasal tip projection and rotation appear to decrease from the immediate postoperative position. In this study, both septal extension graft and columellar strut exhibit similar changes in tip projection with time; however, septal extension graft is better able to preserve tip rotation compared with the columellar strut.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Significant Radiation Dose Reduction Using a Novel Angiography Platform in Patients Undergoing Cryoballoon Pulmonary Vein Isolation
Authors: Schmidt Martin , Tesche Christian , Hapfelmeier Alexander , Finsterer Sebastian , Valassis Gregorius , Ebersberger Ullrich , Schlüter Mathis , Ziegler Martin , Kraemer Bjoern F. 
Published: August 2019

Objectives:
Cryoballoon pulmonary vein isolation (cPVI) in patients with atrial fibrillation requires fluoroscopic guidance, causing a relevant amount of radiation exposure. Strategies to reduce radiation exposure in electrophysiologic procedures and specifically cPVI are of great importance. The aim of this study was to evaluate a possible reduction of radiation dose using the novel Azurion 7 F12 x-ray system compared with its predecessor Allura FD10.

Methods:
In February 2017, the Philips Azurion angiography system was introduced, combining the Allura Clarity radiation dose reduction technology with a more powerful generator, improved image resolution, and a large screen display. In 173 patients undergoing cPVI by a single experienced operator in our institution between December 2016 and April 2018, dose area products (cGy×cm2) and image quality were compared using Azurion 7 F12 or Allura FD10 angiography system.

Results:
A significant reduction in total radiation dose expressed as a dose area products of 524 (332; 821) cGy×cm2 on the Allura system compared with 309 (224; 432) cGy×cm2 on the Azurion system was observed (P<0.001). The number of imaging scenes recorded were 14.7 versus 13.9, and mean overall imaging quality scores (grading 4.85±0.4 with Azurion vs. 4.80±0.4 with Allura, P=0.38) and scores based on specific quality parameters were similar in both groups.

Conclusion:
Use of the new Azurion 7 F12 angiography system substantially reduced radiation doses compared with the previous generation reference system, Allura Clarity, without compromising imaging quality in patients undergoing cryoballoon pulmonary vein isolation.
LSD1-mediated enhancer silencing enables endocrine cell development through attenuation of retinoic acid signalling
Authors: Vinckier Nicholas K. , Patel Nisha A. , Wang Allen , Wang Jinzhao , Shih Hung-Ping , Wang Jianxun , Jhala Ulupi S. , Rosenfeld Michael G. , Benner Christopher W. , Sander Maike 
Published: August 2019

AbstractDevelopmental progression depends on temporally defined changes in gene expression mediated by transient exposure of lineage intermediates to signals in the progenitor niche. To identify a possible contribution of cell-intrinsic epigenetic mechanisms to signal-induced transcriptional responses, we manipulated the signalling environment and activity of the histone demethylase LSD1 during stepwise differentiation of gut tube intermediates into pancreatic endocrine cells. Analysis of enhancer and transcriptome landscapes revealed that lineage progression and endocrine cell differentiation requires LSD1-mediated silencing of transiently active retinoic acid (RA)-induced enhancers. In the absence of LSD1, early RA-responsive enhancers remain partially active despite RA removal, resulting in perduring expression of RA-induced genes, and failure to progress in development. Our findings identify LSD1-mediated enhancer silencing as a cell-intrinsic epigenetic feedback mechanism by which the duration of the transcriptional response to a developmental signal is limited. Given LSD1’s requirement in numerous developmental contexts, the here-described mechanism would be broadly relevant.
Telomeric Double Strand Breaks Facilitate Formation of 5’ C-Rich Overhangs in G1 Human Cells
Authors: Nelson Christopher B , Al Turki Taghreed M , Taylor Lynn , Maranon David G , Muraki Keiko , Murnane John P. , Bailey Susan M 
Published: August 2019

AbstractTelomeres are repetitive nucleoprotein complexes that protect chromosomal termini and prevent them from activating an inappropriate DNA damage response (DDR). Here, we characterized the human cellular response to targeted telomeric DSBs in telomerase positive and telomerase-independent alternative lengthening of telomeres (ALT) cells, specifically in G1. Telomeric DSBs in G1 human cells elicited early signatures of a DDR, however, localization of 53BP1, an important regulator of resection at broken ends, was not observed at telomeric break sites. Consistent with this finding and previously reported repression of classical nonhomologous end-joining (c-NHEJ) at telomeres, evidence for c-NHEJ was also lacking. Likewise, no evidence of homologous recombination (HR)-dependent repair of telomeric DSBs in G1 was observed. Rather, and supportive of rapid truncation events, telomeric DSBs in G1 human cells facilitated formation of extensively resected tracks of 5’ C-rich telomeric single-stranded (ss)DNA, a previously proposed marker of the recombination dependent ALT pathway. Indeed, induction of telomeric DSBs in human ALT cells also resulted in significant increases in 5’ C-rich (ss)telomeric DNA in G1, which rather than RPA, were bound by the complementary telomeric RNA, TERRA. These results suggest that targeting TERRA-mediated protection at damaged telomeres may represent a promising therapeutic strategy, particularly against ALT-positive cancers.
Alpha oscillations in the human brain implement distractor suppression independent of target selection
Authors: Wöstmann Malte , Alavash Mohsen , Obleser Jonas 
Published: August 2019

AbstractIn principle, selective attention is the net result of target selection and distractor suppression. The way in which both mechanisms are implemented neurally has remained contested. Neural oscillatory power in the alpha frequency band (~10 Hz) has been implicated in the selection of to-be-attended targets, but there is lack of empirical evidence for its involvement in the suppression of to-be-ignored distractors. Here, we use electroencephalography (EEG) recordings of N = 33 human participants (males and females) to test the pre-registered hypothesis that alpha power directly relates to distractor suppression and thus operates independently from target selection. In an auditory spatial pitch discrimination task, we modulated the location (left vs right) of either a target or a distractor tone sequence, while fixing the other in the front. When the distractor was fixed in the front, alpha power relatively decreased contralaterally to the target and increased ipsilaterally. Most importantly, when the target was fixed in the front, alpha lateralization reversed in direction for the suppression of distractors on the left versus right. These data show that target-selection–independent alpha power modulation is involved in distractor suppression. While both lateralized alpha responses for selection and for suppression proved reliable, they were uncorrelated and distractor-related alpha power emerged from more anterior, frontal cortical regions. Lending functional significance to suppression-related alpha oscillations, alpha lateralization at the individual, single-trial level was predictive of behavioral accuracy. These results fuel a renewed look at neurobiological accounts of selection-independent suppressive filtering in attention.Significance statementAlthough well-established models of attention rest on the assumption that irrelevant sensory information is filtered out, the neural implementation of such a filter mechanism is unclear. Using an auditory attention task that decouples target selection from distractor suppression, we demonstrate that two sign-reversed lateralized alpha responses reflect target selection versus distractor suppression. Critically, these alpha responses are reliable, independent of each other, and generated in more anterior, frontal regions for suppression versus selection. Prediction of single-trial task performance from alpha modulation after stimulus onset agrees with the view that alpha modulation bears direct functional relevance as a neural implementation of attention. Results demonstrate that the neurobiological foundation of attention implies a selection-independent alpha oscillatory mechanism to suppress distraction.
Metabolic rate is negatively linked to adult survival but does not explain latitudinal differences in songbirds
Authors: Boyce Andy J. , Mouton James C. , Lloyd Penn , Wolf Blair O. , Martin Thomas E. 
Published: August 2019

ABSTRACTSurvival rates vary dramatically among species and predictably across latitudes, but causes of this variation are unclear. The rate of living hypothesis posits that physiological damage from metabolism causes species with faster metabolic rates to exhibit lower survival rates. However, whether increased survival commonly observed in tropical and south temperate latitudes is associated with slower metabolic rate remains unclear. We compared metabolic rates and annual survival rates across 46 species that we measured, and 147 species from literature data across northern, southern, and tropical latitudes. High metabolic rates were associated with lower survival but latitude had substantial direct effects on survival independent of metabolism. The inability of metabolic rate to explain latitudinal variation in survival suggests 1) that species may evolve physiological mechanisms that mitigate physiological damage from cellular metabolism, and 2) a larger role of extrinsic environmental, rather than intrinsic metabolic, causes of latitudinal differences in mortality.
A Mac2-positive progenitor-like microglial population survives independent of CSF1R signaling in adult mouse brain
Authors: Zhan Lihong , Sohn Peter Dongmin , Zhou Yungui , Li Yaqiao , Gan Li 
Published: August 2019

ABSTRACTMicroglia are the resident myeloid cells in the central nervous system (CNS). The majority of microglial population relies on Csf1r signaling for survival and maintenance. However, a small subset of microglia in the murine brain can survive without Csf1r signaling, and reestablishes homeostasis after Csf1r signaling returns. Using single-cell RNA-seq, we characterized the heterogeneous microglial populations under Csf1r inhibition, including microglia lacking homeostatic markers and populations with elevated markers of monocytes, granulocytes and dendritic cells. Importantly, Mac2 is distinctively expressed in a subset of Csf1r-independent microglia cells, which were highly proliferative and shared striking similarities with those of microglial progenitors in yolk sac and early embryos. Lineage-tracing revealed that the Mac2+ population is of microglial origin and does not come from periphery monocytes. In non-treated mouse brains, Mac2+ microglia exhibited progenitor transcriptomic signature indistinguishable from those survived csf1r inhibition, supporting Mac2+ progenitor-like cells are present among homeostatic microglia.
Non-apoptotic caspase activation sustains ovarian somatic stem cell functions by modulating Hedgehog-signalling and autophagy
Authors: Galasso Alessia , Iakovleva Daria , Baena-Lopez Luis Alberto 
Published: August 2019

ABSTRACTThere is increasing evidence associating the activity of caspases with the regulation of basic cellular functions beyond apoptosis. Accordingly, the dysregulation of these novel non-apoptotic functions often sits at the origin of neurological disorders, metabolic defects, autoimmunity, and cancer. However, the molecular interplay between caspases and the signalling networks active in non-apoptotic cellular scenarios remains largely unknown. Our work show that non-apoptotic caspase activation is critical to modulate Hedgehog-signalling and autophagy in ovarian somatic cells from bothDrosophilaand humans under moderate stress. We also demonstrate that these novel caspase functions are key to sustain stem cell proliferation and differentiation without inducing apoptosis. Finally, we molecularly link these caspase-dependent effects to the fine-tuning of the Hedgehog-receptor, Patched. Together, these findings confer a pro-survival role to the caspases, as opposed to the widely held apoptotic function assigned to these enzymes.