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Flow cytometry of intestinal lymphocytes is discussed to be a stronger predictor of enteropathy-associated T-cell lymphoma development in refractory celiac disease than T-cell clonality analysis. To investigate possible associations between clinical characteristics of refractory celiac disease patients and aberrant intraepithelial lymphocytes and to evaluate the accuracy of immunophenotyping for the identification of high-risk refractory celiac disease. Flow cytometry of isolated lymphocytes from duodenal biopsies of controls and celiac disease patients was performed and results were compared to clinical data. Flow cytometry analysis was performed on 42 controls, 37 non-complicated celiac disease and 30 refractory celiac disease cases with or without T-cell receptor clonality. Elevated aberrant intraepithelial lymphocyte counts were significantly associated with severe malabsorption. A 15% cut-off (aberrant lymphocytes among all lymphocytes) had the best discriminatory ability to identify high-risk patients. However, this technique failed to identify some high-risk cases (sensitivity 63%, specificity 100%). The severity of malabsorption was added to the criteria for high-risk refractory celiac disease, improving the correct patients' allocation (sensitivity 100%, specificity 96%). Immunophenotyping of aberrant intraepithelial lymphocytes is a good predictor for high-risk refractory celiac disease. Furthermore, adding the evaluation of malabsorption to the diagnostic assessment of refractory celiac disease optimizes accuracy. [ABSTRACT FROM AUTHOR]

Aberrant subclavian artery (aSCA) is a rare anatomic variant whose association with other aortic branch variations and aortic pathology has yet to be established. Knowledge of such an association could be relevant to recommendations for screening and awareness as associated variations are important for operative planning. We describe the incidence of aSCA variations, its association with aortic pathology, and a proposed classification system. The thoracic cross-sectional imaging database at Keck Hospital of the University of Southern California from 2006 to 2018 was queried for presence of aSCA. Studies were evaluated for aSCA laterality, variant anatomy, and aortic and branch vessel disease. Medical records were reviewed for associated symptoms and diagnoses. The primary outcome was association of aSCA with aortic pathology (aneurysm or dissection). Secondary outcomes were comparison of right and left aSCA, comparison between the sexes, and creation of a proposed classification system. Of 98,580 axial imaging studies, 810 studies (0.82%) were identified with aSCA in 312 unique patients. Right aSCA made up the majority of cases (90.1%). All aSCAs had a retroesophageal course. Kommerell's diverticulum (KD) was present in 184 (59%) with an average diameter of 1.67 cm (range, 1.2-3.3 cm). KD was more frequent (84% vs 56%; P =.0003) and larger (2.05 cm vs 1.61 cm; P <.0001) in left aSCA patients. When present, KD was more often symptomatic in left aSCA compared with right aSCA (77.4% vs 49.1%; P =.005). Dysphagia, chest pain, reflux, and asthma were all more common in left aSCA patients. KD was also more common in men (73.3% vs 50%; P <.0001) and larger in men (1.81 cm vs 1.54 cm; P <.0001) but with no difference in symptoms between sexes. Our proposed classification system based on aortic arch branching is as follows: type 1, left arch with right aSCA (59.9%); type 2, left arch with common carotid trunk and right aSCA (30.1%); type 3, right arch with left aSCA (9.6%); and type 4, right arch with common carotid trunk and left aSCA (0.3%). Subtypes describe the right vertebral artery (RVA) and left vertebral artery (LVA) origin: subclavian (s, RVA 90.1%, LVA 96.8%), carotid (c, RVA 9.6%, LVA 0.3%), or arch (a, RVA 0.3%, LVA 2.9%). Overall, 9.9% (31/312) had associated aortic pathology, although the study was underpowered to detect a difference between right aSCA and left aSCA (9.3% vs 16.1%; P =.213). Type 3 and type 4 arches more often have associated aortic pathology, KD, and symptoms. aSCAs are frequently symptomatic and commonly associated with aortic dissection and aneurysm. Our proposed classification scheme depicts all four aSCA arch variants and accounts for vertebral artery origin variation. These variants are common, and vertebral anatomy can differ greatly. Knowledge of these anatomic variations is critical to planning for endovascular and open repair of aortic arch pathology. [ABSTRACT FROM AUTHOR]

To systematically assess available information about all variations of obturator vessels and to present the most surgically relevant types, their prevalence and calibre in order to provide a comprehensive overview for both anatomists and clinicians. A total of 2689 studies were found via searching the online databases. After applying exclusion criteria 44 studies were assessed. The cadaveric studies, CT angiographies, and clinical studies were included. Number of hemipelves, prevalence of each variation and calibre of identified vessels were studied. Each variation was classified as aberrant obturator artery/vein, aberrant accessory obturator artery/vein or anastomosis. In included studies the average incidence of the variant obturator artery was 26% with the aberrant obturator artery being the most frequent type (with the mean calibre 2.10 mm, SD = 0.35 mm), while the overall incidence of the variant obturator vein was 55%. Presented venous structures had the mean calibre of 2.98 mm (SD = 0.56 mm). According to reviewed studies, variant obturator vessels are present in a great number of patients. Due to their possible calibre larger than 3 mm they represent a structure of high clinical importance. It is important to unify the terminology and to stress out the significance to all clinicians. • Systematic review of 6113 hemipelves concerning variability of obturator vessels. • Incidence of arterial variants of corona mortis incidence is 26.06%. • Incidence of arterial variants of corona mortis incidence is 54.57%. • The most common is the aberrant obturator artery but anastomotic venous arrangement. • The mean length between the corona mortis and the pubic symphysis is 55 mm. [ABSTRACT FROM AUTHOR]

Aberrant DNA methylation is one of the important molecular markers in acute lymphoblastic leukemia (ALL). To determine Aberrant DNA methylation profiles of the CDKN2A and CDKN2B genes in ALL samples from T1DM cases. Aberrant hypermethylation of CDKN2B gene and cytogenetic abnormalities were analyzed in >60% of subjected cases. Total cholesterol, triglycerides and low-density lipoprotein cholesterol were not significantly varied between experimental and control (p >0.05). Expression analysis of human peripheral blood mononuclear cells revealed decreased mRNA levels of CDKN2B. The decreased level of p21 and CDK4 expression in the T1DM cases than control. The number of monocytes, lymphocytes and neutrophils significantly varied in T1DM samples and control (p < 0.05). Aberrant methylation is one of the important mechanisms involved in the expression of CDKN2B genes and is an important prognostic marker for the early detection of ALL risks. [ABSTRACT FROM AUTHOR]

Aberrant insertions of the pectoralis minor tendon are quite rare. Most cases are incidental findings during cadaver dissections, on an MRI or during surgical procedures of the shoulder joint. Rarely the aberrant insertion points can be a source of pain or restriction of the shoulder joint. From the literature review, we found that there has been no mention regarding the frequency of occurrence of this variation with respect to unilateral or bilateral occurence, and only three cases have been reported, in which aberrant bilateral insertions have been documented of which two were noted during cadaveric dissection and one radiologically. We report a rare case of aberrant bilateral insertions of the pectoralis minor, which was found during an arthroscopic procedure, and we discuss its clinical and surgical implications. [ABSTRACT FROM AUTHOR]

The arterial morphology in patients with aberrant subclavian artery (ASA) and its association with type B aortic dissection are important for treatment and prevention. In the present study, we examined the arterial morphology of ASA patients with type B dissection and evaluated its association with type B dissection in vivo. Patients with aortic dissection who had undergone computed tomography angiography were screened for the presence of ASA and type B dissection from January 2011 to May 2021. The angles of ascending aorta, aortic arch, and aortic deviation and the diameters of the ascending aorta, aortic arch, ASA ostium, and middle ASA segment were measured on the computed tomography angiography scans of the ASA patients with type B dissection (group 1; n = 16), clinically matched counterparts without type B dissection (group 2; n = 32), and patients with clinically matched type B dissection without ASA (group 3, n = 32). The correlation between ASA morphology and type B dissection was analyzed using variance analysis or the Wallis H test. Compared with group 2, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 148.1° ± 7.8°; P =.001), a larger aortic deviation angle in plane 2 (28.2° ± 6.0° vs 22.1° ±7.2°; P =.005) and plane 3 (26.4° ±7.3° vs 21.8° ± 6.3°; P =.028). Similarly, group 1 had a greater diameter in the ascending aorta and aortic arch and the ostium and middle of the ASA (38.3 ± 4.1 mm vs 33.6 ± 4.5 mm [ P =.001]; 34.0 ± 9.3 mm vs 26.2 ± 2.9 mm [ P =.004]; 20.3 ± 9.3 mm vs 14.0 ± 3.2 mm [ P =.018]; 10.8 ± 2.3 mm vs 9.0 ± 1.5 mm [ P =.002], respectively), without a significant difference in the aortic arch angle. Compared with group 3, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 142.5° ± 11.7°; P =.026) and smaller aortic deviation angle in plane 1 (21.7° ± 6.2° vs 28.9° ± 6.2°; P =.04) and plane 3 (26.4° ± 7.3° vs 21.8° ± 6.3°; P =.007), although with no significant differences in the aortic arch angle, aortic deviation angle in plane 2, and ascending aortic diameter. The diameters of the ostium and middle segment of the ASA and ascending aorta and the angles of the ascending aorta and aortic deviation are potential risk factors for type B dissection in patients with ASA, which could provide new insights into the mechanism of type B dissection in patients with ASA. [ABSTRACT FROM AUTHOR]

Describimos dos aberraciones cromáticas de plumaje no documentadas previamente en individuos de Aegolius acadicus capturados para anillamiento en los Estados Unidos y Canadá, entre 2007 y 2012. Ocho individuos exhibieron una 'dilución pastel' con una intensidad reducida de los pigmentos negro y marrón, consistente con una reducción de ∼50% en los niveles de eumelanina y feomelanina. Los individuos de A. acadicus presentaron pico y garras pálidos pero pigmentados e iris normalmente pigmentado. Cuatro de los ocho individuos capturados fueron clasificados como adultos basados en la muda del ala (dos individuos de dos años y dos individuos de más de dos años), lo que sugiere que la aberración no es un impedimento para la supervivencia. También describimos un individuo de A. acadicus de menos de un año de edad con leucismo parcial, en el cual estuvieron ausentes las barras verticales anchas y de color ferruginoso que normalmente se encuentran en el pecho y en la parte superior del pecho. Ambas aberraciones parecen ser extremadamente raras, ocurriendo sólo ocho veces y una vez, respectivamente, de entre >30 000 individuos capturados para anillado. [ABSTRACT FROM AUTHOR]

Epigenetic regulation is known to affect gene expression, and recent research shows that aberrant DNA methylation patterning may play a role in leukemogenesis. All leukemias display aberrant distribution of cytosine methylation, which is most notably distributed in specific and distinct signatures in acute myeloid leukemia (AML). These signatures reflect leukemic mechanisms and have clinical and prognostic significance. Compared with genetic lesions in AML, epigenetic lesions appear to be more frequent and recurrent. [ABSTRACT FROM AUTHOR]

Abstract: We present the case of a patient who exhibited continued flow in the distal internal carotid artery (ICA) despite complete occlusion at the carotid bifurcation. Patency was maintained by the presence of an aberrant branch distal to the occlusion. [Copyright &y& Elsevier]

Abstract: An aberrant common carotid artery is a rare anatomical anomaly. We report a case of an aberrant carotid artery running across the trachea in a patient undergoing total thyroidectomy. This rare anomaly may make a tracheostomy, a particularly hazardous procedure. [Copyright &y& Elsevier]

This report describes an incidental finding of an aberrant branch of the radial digital nerve in the index finger of a 39-year-old woman who cut herself with a knife. [Copyright &y& Elsevier]