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Purpose: To evaluate the feasibility and safety of percutaneous image-guided cryoablation of abdominal wall endometriosis (AWE). Materials and methods: A retrospective review of percutaneous cryoablation (CT or MR) of AWE was performed from January 2018 to December 2020. Eighteen patients were identified from an internal percutaneous ablation database. Technical success, complications, and outcomes were analyzed according to standard nomenclature. Results: Patients comprised 18 females (mean age 36.9 years) who underwent 18 cryoablation procedures to treat 23 AWE deposits. Three of the 18 cases were performed under MR guidance, while the remaining 15 employed CT guidance. Technical success was achieved in all 18 cases (100%). Fifteen of 18 patients (83%) had biopsy proven AWE deposits prior to treatment. Hydrodisplacement was used to displace adjacent bowel, bladder, or neurovascular structures in 13/18 cases (72%). The mean number of probes used per case was 3. Sixteen of 23 (70%) of AWE deposits had imaging follow-up (median 85 days). Of the 16 lesions with imaging follow-up, 15 (94%) demonstrated no residual enhancement or T1 hyperintensity at the treatment site and 1 lesion (6%) demonstrated residual/progressive disease. At clinical follow-up, 13 of 14 (93%) patients reported improvement in AWE-related symptoms. Eleven patients had clinically documented pain scores before and after ablation and all demonstrated substantial symptomatic improvement. No society of interventional radiology (SIR) major complications were observed. Conclusions: Percutaneous cryoablation of AWE is feasible with a favorable safety profile. Further longitudinal studies are needed to document durable response over time. [ABSTRACT FROM AUTHOR]

Eosinophilic angiocentric fibrosis (EAF) has been postulated to lie on the spectrum of IgG4‐related disease (IgG4‐RD) in a study reported in 2011. However, the aetiology of EAF remains controversial, despite increasing literature reporting IgG4‐RD targeted investigations in those studies. This review aims to formally evaluate the relationship between EAF and IgG4‐RD using the latest 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification scheme for IgG4‐RD. A literature search was performed on the PubMed database for all studies describing patients diagnosed with EAF. Additionally, two EAF cases were retrospectively identified from our institution and presented. The demographics, clinical presentation, histological and serological data of each patient were analysed. A total of 20 cases were evaluated, including 18 patients from 14 articles in the English literature and two cases from our institution. Six of 20 (30%) patients with EAF met the criteria for IgG4‐RD with the 2019 ACR/EULAR classification scheme. This represents the first attempt at formally evaluating the relationship between EAF and IgG4‐RD using a validated set of classification criteria. Using the currently available data, a small proportion of patients with EAF met the criteria for IgG4‐RD. However, various limitations of this study suggest that further efforts at disease characterization of EAF may be required. [ABSTRACT FROM AUTHOR]

Eosinophilic myocarditis is a human condition that has been rarely documented in animals. We now report two unrelated porcine cases of idiopathic eosinophilic granulomatous myocarditis that resembled the human disease and which were associated with sudden death. The most relevant gross finding in both cases was marked cardiomegaly, accompanied by raised, multifocal to coalescent small white nodules (1–2 mm) and poorly demarcated multifocal pale areas in the epicardium. Histologically, there were multifocal to coalescent areas of cardiomyocyte loss with replacement by an intense inflammatory infiltrate of eosinophils and epithelioid macrophages, and proliferation of fibrous connective tissue. Immunohistochemistry for porcine circovirus type 2 (PCV2) and Toxoplasma gondii , in-situ hybridization and quantitative polymerase chain reaction tests for PCV2 and porcine circovirus type 3 and aerobic bacterial culture on myocardium samples were negative. [Display omitted] [ABSTRACT FROM AUTHOR]

Vertebral disorders have significant health and economic impacts, and due to aging and current lifestyle habits, there is a trend toward their increase. Obesity and the alignment of vertebral curvatures can be associated with back pain. Objective: This study aims to analyze whether general and abdominal obesity are associated with cervical, dorsal, and lumbar vertebral pain as well as increased or decreased values of cervical, dorsal, and lumbar vertebral curvatures. Methodology: Body composition, degree of vertebral curvature, and the perception of cervical, dorsal, and lumbar pain were evaluated in a study population of 301 people (>18 years old). Linear and logistic regression analyses were performed to evaluate the influence of several variables of body composition on vertebral angles and cervical, dorsal, and lumbar pain. Results: Lumbar pain was the most prevalent (66.1%), mainly affecting women (70.9%). They were also shown to have greater lumbar angles (p < 0.001). The degrees of lumbar curvature increased, as did the BMI, waist circumference, and waist-to-height ratio. Cervical and dorsal curvatures were increased by all the variables of adiposity and abdominal adiposity. It was found that people with abdominal obesity carried twice the risk of lower back pain than those without abdominal obesity (OR = 2.172, p < 0.05). In addition, an increased lumbar angle was related to an increased risk of low back pain (OR = 1.031, p < 0.05). Cervical pain, on the other hand, was associated with the waist-height index (OR = 0.948, p <0.01). Conclusions: This study shows that increased lumbar curvature and abdominal obesity may be risk factors for lower back pain. In addition, it shows an association between the amount of body and abdominal fat in relation to the degree of curvature of the spine in the sagittal plane. Investigating the effect of obesity on vertebral morphology and musculoskeletal disorders makes it possible to prescribe interventions and therapeutic strategies. [ABSTRACT FROM AUTHOR]

The article presents the case study of 14-year-old Morgan–Quarter Horse crossbred with chief complaint of tail rubbing and inability to move his tail. Topics include decreasing gluteal muscle and anal tone, absent tail tone, absent sensation around perineum and prepuce, and absent perineal reflex; and examination identified severely distended urinary bladder and accumulation of fecal material in the rectum.

Langerhans cell histiocytosis (LCH) is a rare enigmatic disease that pre-dominantly affects children under 5 years of age. We report an interesting case of a 5 month old female diagnosed with multisystem LCH. Her disease process included osseous, pulmonary, gastrointestinal, cutaneous, hematopoietic and neurologic involvement. This case highlights the varying clinical symptoms, risk factors, pathogenesis, and management of multisystem LCH. This case also emphasizes the role of diagnostic imaging in this multifaceted disease.

Objective. Comparison of the clinical and radiological effects of precise unilateral puncture pathway prepared by preoperative CT data and traditional unilateral puncture pathway in PVP administration for the treatment of osteoporotic vertebral compression fractures. Summary of background data. PVP is a commonly used vertebral augmentation operation for the treatment of painful spinal compression fractures. A percutaneous unilateral approach is routinely used to get access to the vertebral body. PVP has had positive clinical results in a number of prior investigations. Numerous difficulties and issues, including puncture difficulty, radiation exposure, cement leakage, spinal cord or nerve damage, and intraspinal hematoma, have been described in contrast. Methods. This prospective study included 300 patients with single-level lumbar osteoporotic vertebral compression fractures, 180 females and 120 males, with an average age of 71.5 years. PVP was performed on randomized subjects using two distinct puncture procedures. The patients were separated into two groups: Preoperative planning, in which a precise unilateral puncture path was established using preoperative CT data, and Conventional planning, in which multiple puncture procedures were used. The participants were followed up on after surgery and mostly assessed on clinical and radiological results. The visual analogue scale for pain and the 36-item Short Form Health Survey (SF-36) questionnaire for health status were used to assess clinical outcomes. Radiation dosage, bone cement distribution, vertebral body height, and kyphotic angle were used to evaluate radiological results. Results. Participants remained monitored for 12 to 28 months on average. 151 individuals were treated with accurate unilateral puncture paths planned by preoperative CT data percutaneous vertebroplasty and 149 patients were treated with conventional unilateral paths percutaneous vertebroplasty. The Preoperative planning group's operation time and radiation dose were significantly lower than the Conventional group's; nevertheless, the volume of injected cement was significantly higher in the Preoperative steering committee than in the Conventional group. All patients in both groups had much less pain after the operations when compared to their preoperative suffering. There were no statistically significant variations between groups when the visual analogue scale and the 36-Item Short Form Health Survey were compared. Neither group showed a substantial decrease in the kyphotic angle during the follow-ups. In the Preoperative planning group, the kyphotic angle improved much more than in the Conventional group. At 1 month postoperatively, 16 patients in the Conventional group experienced apparent discomfort in the puncture sites because to facet joint violation. At the latest follow-up, all of the patients' discomfort had vanished after receiving local block therapy. Conclusion. Both preoperatively designed precise unilateral puncture pathways and traditional unilateral puncture procedures PVP are reasonably safe and effective for individuals with painful osteoporotic spinal compression fractures. Unilateral puncture courses planned via preoperative PVP, on the other hand, absorbed less radiation and operation time, as well as a good level of deformity correction and amount of injected cement, and caused less complications than traditional unilateral PVP. [ABSTRACT FROM AUTHOR]

Background Human papillomavirus (HPV) E6/E7 mRNA tests determine the oncogenic activity of the virus and represent a good clinical biomarker for predicting the risk of cervical cancer. So, the present study was conducted to know the role of HPV E6/E7 mRNA as a predictive biomarker for cervical carcinoma. Methodology The present study was conducted on 55 clinical samples of cervical scrapings and biopsy from the clinically suspected cases (based on signs and symptoms) of cervical cancer having abnormal PAP smear. The samples were processed in three steps—(1) HPV DNA detection, (2) HPV E6/E7 mRNA detection, and (3) histopathological analysis. Results Out of a total of 55 patients, 16 (29.09%) were positive for both HPV E6/E7 mRNA and HPV DNA and six were positive for only HPV DNA. So, a total of 22 (40%) patients were positive for HPV DNA. Out of these 22 samples, 10 (45.5%) were of HPV-16, six (27.3%) were of HPV-18, four (18.2%) were of HPV-31, and two (9.1%) were of HPV-45. Out of total 16 patients positive for HPV E6/E7 mRNA, 10 (62.5%) were of genotype 16 and six (37.5%) were of genotype 18. The patients who were found positive for HPV 31 and 45 genotypes did not have E6/E7 mRNA expression. On colposcopic-guided biopsy, among these 16 samples, eight (50%) were diagnosed with invasive squamous cell carcinoma, six (37.5%) with cervical intraepithelial neoplasia grade 3 (CIN3), and two (12.5%) with CIN2. Out of those six patients in whom only HPV DNA was positive, five had normal biopsy findings and one had CIN1. Conclusion The present study suggests that HPV E6/E7 mRNA detection could be more reliable than DNA testing for predicting the risk of progression of HPV-induced cervical lesions to cervical carcinoma and it can be used as a non-invasive tool for triage and patient follow-up. [ABSTRACT FROM AUTHOR]

Background: Sarcoidosis features non-necrotizing granulomas consisting mainly of activated CD4-lymphocytes. T-cell activation is regulated by immune checkpoint (IC) molecules. The present study aimed to compare IC expression on CD4, CD8 and NK cells from peripheral, alveolar and lung‐draining lymph node (LLN) samples of sarcoidosis patients. Methods: Flow-cytometry analysis was performed to detect IC molecules and a regression decision tree model was constructed to investigate potential binary classifiers for sarcoidosis diagnosis as well as for the IC distribution. Results: Fourteen patients (7 females) were consecutively recruited in the study; all enrolled patients showed hilo-mediastinal lymph node enlargement and lung parenchyma involvement with chest X-rays and high resolution computed tomography. CD4+PD1+ and CD8+PD1+ were higher in bronchoalveolar lavage (BAL) than in LLN (p = 0.0159 and p = 0.0439, respectively). CD4+ T-cell immunoglobulin and ITIM domain (TIGIT)+ were higher in BAL than in peripheral blood mononuclear cells (PBMCs) (p = 0.0239), while CD8+TIGIT+ were higher in PBMC than in BAL (p = 0.0386). CD56+TIGIT+ were higher in LLN than in PBMC (p = 0.0126). The decision-tree model showed the best clustering cells of PBMC, BAL and LLN: CD56, CD4/CD8 and CD4+TIGIT+ cells. Considering patients and controls, the best subset was CD4+CTLA-4+. Conclusion: High expression of PD1 and TIGIT on T cells in BAL, as well as CTLA-4 and TIGIT on T cells in LLN, suggest that inhibition of these molecules could be a therapeutic strategy for avoiding the development of chronic inflammation and tissue damage in sarcoidosis patients. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective study aimed to describe the B‐mode lung ultrasound (B‐LUS) and contrast‐enhanced ultrasound (CEUS) follow‐up patterns of peripheral pulmonary lesions (PPLs) in patients with confirmed pulmonary embolism (PE). Patients and Methods: Data from 27 patients with a confirmed diagnosis of PE and PPLs over 5 mm from October 2009 to November 2018 were included retrospectively in the study. The inclusion criteria were performance of a baseline CEUS examination, a short‐term B‐LUS and CEUS follow‐up, and a long‐term B‐LUS follow‐up of PPLs. The homogeneity of enhancement of PPLs (homogeneous/inhomogeneous/absent) on CEUS and the presence and size of PPLs on B‐LUS were evaluated. Results: A total of n = 25/27 (92.6%) lesions showed absent or inhomogeneous enhancement during baseline examination or short‐term follow‐up, indicating impaired perfusion. On short‐term CEUS follow‐up, 9/27 cases (33.3%) showed a pattern shift. On B‐LUS long‐term follow‐up, 26/27 lesions (96.3%) were detectable for an average of 10 weeks (range 3–32 weeks). The size of reference lesions was significantly reduced at the time of the final follow‐up examination (P <.05). Conclusion: B‐LUS follow‐up showed that, in patients with confirmed PE, PPLs had a delayed regression. On CEUS follow‐up examination, various perfusion patterns of PPLs were observed, indicating the different ages and the variable reparative processes of pulmonary infarction. In PPLs independent of the underlying signs and symptoms, follow‐up B‐LUS and CEUS examinations may be helpful for a possible retrospective diagnosis of peripheral pulmonary infarction suggestive of PE. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontológica Colombiana is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rationale: Patients with asthma who have neutrophilic bronchitis may have an underlying cause leading to increased susceptibility to airway infections. Methods: Retrospective review of patients with asthma who had a previous history of recurrent exacerbations that had been associated with airway or sinus infections referred to a tertiary asthma center between 2005 and 2020. Demographics, clinical features, and airway inflammation type determined by sputum cytometry were compared between CFTR carriers and non-carriers. Multiple linear regression was used to identify clinical predictors of CFTR carrier status. Response to nebulized hypertonic saline was assessed by comparing the number of infective exacerbations before and after its initiation. Results: 75 patients underwent CFTR mutation testing. Of these, 13 (17%) were CFTR carriers. The most common mutation was Δ F508. CFTR carriers were older (adjusted odds ratio 1.06 (CI 95% 1.01, 1.13)) and had more frequent flares requiring hospitalization (4.19 (1.34, 24.74)). Neutrophilic airway inflammation was the most common inflammatory subtype in CFTR carriers, though 8/13 also had eosinophilic bronchitis. Nebulized hypertonic saline was well tolerated by most and reduced the frequency of infective exacerbations. Conclusions: The prevalence of CFTR heterozygosity in this cohort with recurrent neutrophilic bronchitis is higher than in the general population. Respiratory disease in CFTR carriers is associated with older age and may cause significant morbidity. Airway neutrophilia is the most common inflammatory subtype, but > 50% had eosinophilic bronchitis requiring treatment. Hypertonic saline appears to be well tolerated and effective in reducing the number of infective exacerbations. [ABSTRACT FROM AUTHOR]

Cutaneous lymphoma is rare in cats. An 11-year-old spayed female Persian cat presented with crust, ulceration, and multiple nodules on the shoulder and forelimb for 2 months. Computed tomography revealed a diffuse, irregularly margined lesion in the dorsal cutis extending from cervical to thoracic vertebrae. Cytological evaluation predominantly revealed large round cells with multilobulated nuclei and basophilic cytoplasm. Histopathological examination confirmed round CD3+/PAX5- cells packed in the dermis. Thus, the diagnosis of non-epitheliotropic cutaneous lymphoma with a diffuse large T-cell type was made. The disease progressed rapidly for the next 2 weeks, and the owner elected humane euthanasia. [ABSTRACT FROM AUTHOR]

The pathogenesis of allergic asthma is complex, it is usually caused by immune system imbalance. Th1, Th2, regulatory T cells (Treg) and T helper 17 (Th17) cells have an important role in the pathogenesis of eosinophilic asthma. Yet, the exact role of Th1, Th2, Treg and Th17 cells in eosinophilic asthmatic disease is not fully understood. This study used an untargeted plasma metabolomics combine 16S rDNA technology to identify new biomarkers of plasma metabolites and gut microbiota in ovalbumin-induced eosinophilic allergic asthma in BALB/c mice to further explore the biomarkers in regulating the immune balance or the immune response. We discovered that malate, l-dihydroorotate were associated with Th1/Th2 and Treg/Th17 cells balance, imidazoleacetic acid was associated with Th1/Th2 cell balance, 1,5-anhydro-d-sorbitol was associated with Treg/Th17 cell balance. The results also found that genus Candidatus Arthromitus of gut microbiota were associated with Th1/2, Treg/Th17 balance, genus Ruminiclostridium 6 , they were all associated with Th1/2 and Treg/Th17 cell balance, while the gut microbiota were not associated with penh value which reflect airway hyperresponsiveness (AHR) in the eosinophilic asthma mice model. Interestingly, the plasma metabolite biomarkers of malate, l-dihydroorotate are associated with genus Ruminiclostridium 6, they were all associated with Th1/2 and Treg/Th17 cell balance, while imidazoleacetic acid is associated with genus Ruminiclostridium 6 which is associated with Th1/2 balance. Among the differential plasma metabolites, 1,5-anhydro-d-sorbitol is associated with genus Ruminiclostridium 6 and genus Candidatus Arthromitus. Among them, malate participate in the T cell activation, T cell differentiation and activation may be a new research direction in eosinophilic allergic asthma. We firstly study the gut microbiota and plasma metabolites markers of immune balance in eosinophilic asthma in mice model, laying a foundation for drug treatment in eosinophilic allergic asthma. [ABSTRACT FROM AUTHOR]

Asthma is a heterogeneous disease usually characterized by chronic airway inflammation, in which several phenotypes have been described, related to the age of onset, symptoms, inflammatory characteristics and treatment response. The identification of the inflammatory phenotype in asthma is very useful, since it allows for both the recognition of the asthmatic triggering factor as well as the optimization of treatment The paucigranulocytic phenotype of asthma (PGA) is characterized by sputum eosinophil levels <1–3% and sputum neutrophil levels < 60%. The precise characteristics and the pathobiology of PGA are not fully understood, and, in some cases, it seems to represent a previous eosinophilic phenotype with a good response to anti-inflammatory treatment. However, many patients with PGA remain uncontrolled and experience asthmatic symptoms and exacerbations, irrespective of the low grade of airway inflammation. This observation leads to the hypothesis that PGA might also be either a special phenotype driven by different kinds of cells, such as macrophages or mast cells, or a non-inflammatory phenotype with a low grade of eosinophilic inflammation. In this review, we aim to describe the special characteristics of PGA and the potential therapeutic interventions that could be offered to these patients. [ABSTRACT FROM AUTHOR]

The eosinophilic granuloma is defined by dense cellular infiltration of eosinophils, macrophages, and mast cells, in addition to collagenolysis foci. Canine eosinophilic granuloma is a rare inflammatory skin disease that affects the oral mucosa. However, the cutaneous eosinophilic granuloma is more evident and can be found in the scrotum, testicles, perineum, and flanks. The etiology of eosinophilic granuloma in dogs is unclear but allergic processes can originate in granulomatous nodules or plaques. Affected dogs may experience itching, swelling, and, occasionally, pain. The histopathological analysis is necessary for a definitive diagnosis. The present case report described a 12-year-old male dog, Poodle, with a history of swelling, itching, and pain in the scrotum. Complete clinical staging was performed through blood count, biochemistry analysis, thoracic radiographs, abdominal ultrasound, and electrocardiogram. The dog was submitted for surgical removal followed by histopathologic evaluation. Eosinophilic granuloma should be included in the differential diagnosis of solitary masses in the scrotal region. [ABSTRACT FROM AUTHOR]

In‐stent restenosis is a common complication after percutaneous coronary intervention (PCI) for coronary heart disease requiring revascularization. We performed a retrospective analysis to assess the value of inflammatory biomarker albumin to globulin ratio (AGR) in clinical prognosis of PCI. In total, 992 patients with coronary heart disease who underwent the first drug‐eluting stent implantation and re‐examination angiography in our hospital were enrolled in this study. The AGR was measured. At mean follow‐up of 11.2 ± 4 months, the in‐stent restenosis (ISR) and revascularization events (including target lesion revascularization, target vessel revascularization, and revascularization of de novo lesions) occurred in 127 and 284 patients, respectively. Compared with the non‐ISR or non‐event group, AGR was significantly lower in the ISR group and the events group. Beyond that, albumin was significantly lower, whereas urea nitrogen, glucose, and Gensini score, as well as the proportions of a history of diabetes and peripheral vascular diseases were significantly higher in the ISR group and the events group. Age, heart rate, white blood cell, neutrophils, lymphocyte, monocyte, and incidence of ischemic stroke were significantly higher in the events group. Multivariate Cox regression analysis showed that AGR was independently associated with ISR (p = 0.032) and events (p = 0.024). Besides, Kaplan‐Meier analysis indicated that the higher quartile of AGR had a lower rate of ISR (p = 0.038) and events (p ≤ 0.001). Finally, the receiver operating characteristic curve for AGR in diagnosing ISR and events indicated that the area under the curve were 0.56 and 0.57, respectively. Therefore, AGR is one of the most important factors that independently associate with the ISR and revascularization events after PCI. [ABSTRACT FROM AUTHOR]

Background: In many patients, low-dose computed tomography (CT) screening for lung cancer reveals asymptomatic pulmonary nodules. Lung resection surgery may be indicated in these patients; however, distinguishing malignancies from benign lesions preoperatively can be challenging.Methods: From 2013 to 2018, 4181 patients undergoing surgery for pulmonary nodules were reviewed at National Taiwan University Hospital, and 837 were diagnosed with benign pathologies. Only patients with pathological diagnosis as caseating granulomatous inflammation were included, sixty-nine patients were then analyzed for preoperative clinical and imaging characteristics, surgical methods and complications, pathogens, medical treatment and outcomes. Mycobacterial evidence was obtained from the culture of respiratory or surgical specimen.Results: Overall, 68% of the patients were asymptomatic before surgery. More than half of the nodules were in the upper lobes, and all patients underwent video-assisted thoracoscopic surgery (VATS). Some patients (14.5%) developed grade I complications, and the mean postoperative hospital stay was 4 days. The final pathology reports of 20% benign entities postoperatively, and caseating granulomatous inflammation accounted for a significant part. MTB and NTM were cultured from one-fourth of the patients respectively. All patients with confirmed MTB infection received antimycobacterial treatment, while the medical treatment in NTM-infected patients was decided by the infectious disease specialists. The mean follow-up period was 736 days, and no recurrence was found.Conclusion: Lung resection surgery is an aggressive but safe and feasible method for diagnosing MTB- or NTM-associated pulmonary nodules, and, potentially, an effective therapeutic tool for patients with undiagnosed MTB- or NTM-associated pulmonary nodules. [ABSTRACT FROM AUTHOR]

Many aggressive non-endodontic radiolucent lesions show very similar clinical and radiographical features to periapical lesions of endodontic origin. Since the treatments of endodontic and non-endodontic lesions differ markedly, a precise diagnosis is imperative. Thus, the present study aimed at presenting a clinical case on the diagnosis and management of a Langerhans cell histiocytosis (LCH) lesion mimicking a periapical lesion of endodontic origin. A 51-year-old male patient was referred to a private dental office due to slight pain from the region of tooth 36. Although no sign of prosthetic or endodontic failure was noted, radiographical examination revealed a radiolucent image with poorly defined borders associated with the periapical region of the tooth. Apicoectomy and bone curettage were then performed and, given the clinical and laboratory features, the definitive diagnosis of solitary eosinophilic granuloma was made. The surgical treatment was sufficient for the remission of the symptoms, and recurrence was not observed. Given the current case, dentists should be aware of LCH lesions as they may mimic endodontic periapical pathoses, leading to misdiagnosis and therapeutic complications. Moreover, alveolar bone lesions may be the first or only sign of LCH in many cases. [ABSTRACT FROM AUTHOR]

Copyright of Universidad Médica Pinareña is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Traumatic ulcerative granuloma with stromal eosinophilia is an uncommon condition of the oral mucosa with a chronic course, usually affecting the tongue. Case Report: Clinically it presents as a chronic ulcer, with raised and indurated borders, rarely presented as a tumor. Histologically it shows a diffuse mixed inflammatory infiltrate, rich in eosinophils. The etiology of this lesion is still unclear; however, chronic irritation from traumatic agents is considered a major initiating factor. In some cases, the presence of CD30+ mononuclear cells within the lesions suggest the possibility of a CD30+ lymphoproliferative disorder. This article presents a case of a traumatic ulcerative granuloma with stromal eosinophilia manifested in a 56-year-old female with a solitary ulcerated tumor inside the right cheek. Conclusion: It was diagnosed based on clinical data and histopathological features. In a brief literature review, the entity has been characterized, analyzing its etiology and nature.

This paper presents two clinical cases of eosinophilic granuloma of bone diagnosed by CT, MRI, and 18F-FDG PET/CT. In both cases the patients were admitted to the clinic with suspected primary malignant bone tumor and the diagnosis of a solitary eosinophilic granuloma was made based on the results of comprehensive radiological diagnostic examination and histological verification. Solitary eosinophilic granuloma of bone is an infrequent condition, occurring in less than 1% of cases of skeletal tumor masses. The most common eosinophilic granuloma is found in the parietal and frontal bones of the skull and is an osteolytic volumetric mass that gradually increases in size. Although most bone tumors can be detected by radiography, computed tomography is preferred, primarily because of its superior ability to detect cortical bone destruction. The diagnostic accuracy of computed tomography and magnetic resonance imaging may be different. The combined use of radiological and radionuclide methods allows us to narrow the spectrum of differential diagnosis. Unfortunately, relatively low specificity of existing radiological diagnostic studies in most cases does not allow to establish a precise diagnosis, and biopsy with subsequent pathological examination remains the method of choice. These clinical observations demonstrate the need to include eosinophilic granuloma in the differential diagnosis when a solitary osteolytic focus is detected.

Furthermore, since tendon sheath fluid was unfortunately not obtained for analysis in the current case report, it is unknown if eosinophils would be present within the digital flexor tendon sheath fluid or if the eosinophils would be strictly confined to within the well encapsulated granuloma. Tendon sheath masses - What are the differential diagnoses and what diagnostics are needed? Admittedly, none of our clinical cases with tendon masses had digital flexor tendon sheath fluid submitted for analyses, nor were the masses that were resected at surgery always submitted for histopathology. [Extracted from the article]

Langerhans cell histiocytosis (LCH) is a common disease in the pediatric population with a peak incidence between 5 and 10 years of age. Eosinophilic granuloma (EG) accounts for less than 1% of all primary bone tumors primarily affecting the skull, pelvis, ribs and metaphyses of long bones and is a benign localized form of LCH. It is extremely rare in adults, more so in the spine, with a predilection for the thoracic spine than the lumbar and cervical region. A 35-year-old gentleman presented with transitional mid back pain for two months radiating to the right flank which worsened at night. There was no history of fever or trauma. Physical examination revealed right dorsolumbar tenderness without any neurological deficit. Serological parameters were normal and C-reactive protein (CRP) was negative. X-ray showed radiolucency in the right D12 pedicle with CT scan showing a lytic lesion in D12 body extending into the right pedicle. Magnetic resonance imaging (MRI) showed a hypointense lesion on T1 and hyperintense lesion on T2. Transpedicular biopsy was done and histopathology revealed Langerhans cell with abundant basophilic cytoplasm and a centrally placed nucleus with a groove. On further confirmation with IHC, a diagnosis of LCH was made. He then received radiotherapy for 12 days. PET CT done one year after diagnosis revealed near-total metabolic response of the tumor after comparing the PET CT done prior to diagnosis. The patient has reported complete relief since 2 years with recent radiological evidence of no recurrence. A precise diagnosis of LCH largely relies on biopsy and histopathology and once definitive diagnosis is established, EG can be managed by chemotherapy and/or radiotherapy in patients with no neurological deficit. Despite its rarity, EG should be considered as an important differential for solitary osteolytic lesions at the thoracolumbar junction in the adult spine.

Background: Langerhans cell histiocytosis (LCH) is a rare nonmalignant disease characterized by a clonal proliferation of mononuclear cells called Langerhans histiocytes and infiltrates surrounding tissues, mostly self-limiting and usually occurring in the first two decades of life. Vertebral involvement is rare, mostly seen in the thoracic region, and involves the anterior elements of the corpus. In the literature, several treatment options and surgical approaches have been reported concerning the treatment of this disease and surgery. Case Presentation: We report an 18-month-old male with thoracic LCH who underwent surgery due to progressive neurological deficit. Gross total removal of the tumor with one level corpectomy in this patient was achieved via a posterolateral approach with postoperative functional improvement. The surgical cavity was supported by corpectomy cage and unilateral screw-rod fixation system at the same stage. Conclusion: Gross total tumor removal, corpectomy, and 360° stabilization via posterolateral approach at a single stage are safe, effective, and definite neurosurgical methods in terms of providing neurological recovery, long-term tumor-free survival, and spinal stability.

We report the case of an otherwise healthy 17-year-old female who presented for surgical removal of an enlarging “atypical cyst” on her scalp. During subtotal excision, only friable serosanguinous translucent ribbons of tissue were found. A histopathologic diagnosis of Langerhans cell histiocytosis (LCH) was rendered and imaging studies revealed extradural invasion of the tumor. Within weeks, the patient also developed progressive lymphadenopathy with grossly elevated levels of Epstein-Barr virus viral capsid antigen antibody levels. This report aims to highlight a unique presentation of LCH with discussion of workup, management, and avoidance of potential surgical complications.

Objective To compare the diagnostic efficacy of 18F-PSMA-1007 and 18F-FDG PET/CT in primary and metastatic lesions of newly diagnosed prostate cancer. Methods From October 2019 to March 2021, 20 patients with pathologically confirmed prostate cancer underwent 18F-PSMA-1007 and 18F-FDG PET/CT before treatment. Receiver operating characteristic（ROC） curve analysis was used to compare the diagnostic threshold and diagnostic efficacy of SUVmaxbetween the two imaging methods. Pearson correlation analysis was used to evaluate correlation between the patient’s serum tPSA level, Gleason score, and SUVmax（prostate specific membrane antigen, PSMA） of the primary tumor. The weighted kappa test was used to analyze the consistency of the diagnostic results between the two groups. Results There were 51 lesions in 20 patients including 18 bone metastases in 4 patients and 13 lymph node metastases in5 patients. The area under the ROC curve（AUC） of SUVmaxon18F-PSMA-1007 scan was 0.870 with 90.2% sensitivity, 90% specificity,97.9% positive predictive value, 64.3% negative predictive value, and 90.2% accuracy compared to that of18F-FDG PET/CT（0.585,60.8%, 70%, 91.2%, 25.9%, 65.6%） for diagnosing prostate cancer. The difference in sensitivity between the two methods was statistically significant（P<0.05）. The detection rates of 18F-PSMA-1007 PET/CT for prostate cancer lesions and lymph node metastases were significantly higher than that of 18F-FDG PET/CT（P<0.05）. The serum tPSA value, Gleason score and the SUVmaxvalue（PSMA） of the primary lesions were all positively correlated（r=0.515, 0.765, both P<0.05）. There was better agreement in the diagnosis of 18FPSMA-1007 PET/CT between two nuclear medicine physicians（Kappa value=0.85, P<0.05）. Conclusion 18F-PSMA-1007 PET/CT is significantly better than 18F-FDG PET/CT in the diagnosis of primary prostate cancer lesions and lymph node metastasis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Percutaneous kyphoplasty is widely used in the treatment of stage I and II Kümmell disease, which can rapidly relieve pain, stabilize vertebral body and correct kyphosis; however, the treatment of stage III Kümmell disease is still controversial. OBJECTIVE: To evaluate the clinical outcome of kyphoplasty with high-viscosity bone cement for treatment of stage III Kümmell disease without neurologic symptoms. METHODS: Twenty-eight patients (11 males and 17 females, aged 57-82 years) with stage III Kümmell disease without neurologic symptoms were admitted to Jiangyin People’s Hospital from May 2016 to May 2019, in which T11 vertebral body in 6 cases and T12 vertebral body in 14 cases, L1 vertebral body in 5 cases and L2 vertebral body in 3 cases were treated by kyphoplasty with high viscosity bone cement. At 1 day after operation and 1 year after follow up, postoperative pain and improvement of life ability were evaluated by the Visual Analogue Scale and Oswestry Disability Index. The recovery of vertebral height and correction of kyphosis were measured with X-ray films. The study was approved by the Ethics Committee of Jiangyin People’s Hospital, approval No. [2017](021). RESULTS AND CONCLUSION: (1) Totally 28 patients were followed up for 12-22 months. No serious complications such as wound infection or pulmonary embolism were found during treatment. Asymptomatic cement leakage occurred in three patients. Adjacent vertebral fracture was encountered in 1 patient at 3 months after operation, and healed after kyphoplasty. (2) Visual Analogue Scale, Oswestry Disability Index, and kyphotic angle were lower at 1 day and 1 year after operation than those before operation in 28 patients (P < 0.05). The height of anterior, middle and posterior edges of vertebral body at 1 day and 1 year after operation was higher than that before operation (P < 0.05). (3) The results showed that kyphoplasty with high-viscosity bone cement can relieve back pain, improve viability, retain the vertebral body height, reduce kyphosis, and restore spinal alignment, and is an effective method for treatment of stage III Kümmell disease. [ABSTRACT FROM AUTHOR]

Background: Traditionally, Eosinophilic Granulomatosis with Polyangiitis (EGPA) has been treated with systemic corticosteroids and immunosuppressants. In recent years, therapeutic efforts have been directed towards targeting eosinophils which represent a major player in the pathogenesis of EGPA. In 2017 the Food and Drug Administration (FDA) approved mepolizumab, a humanized monoclonal antibody targeting interleukin 5 (IL-5) which reduces the production and survival of eosinophils, already used to treat severe eosinophilic asthma, for the management of EGPA. Benralizumab is a humanized monoclonal antibody that targets the IL-5 receptor and is indicated in the treatment of severe eosinophilic asthma. Case description: We describe the case of a young female with a positive history of severe eosinophilic asthma associated with EGPA, treated successfully with benralizumab. [ABSTRACT FROM AUTHOR]

Background & Objective: The existence of eosinophils in the gastric mucosal epithelium is unusual, while the term "eosinophilic gastritis" has become overused due to the increased numbers of eosinophils found in gastric specimens. Thus, we aimed to assess the number and distribution of eosinophils in gastric specimens in Shahid Beheshti University of Medical Sciences hospitals. Methods: This study was performed on 318 patients with gastric diseases who had undergone endoscopic biopsy or gastrectomy in the hospitals affiliated with Shahid Beheshti University from 2016 to 2018. By referring to the archives of pathology departments, patients' demographic and clinical information, endoscopic and histopathological findings were collected. The data was then statistically analyzed using SPSS software version 24 with a significance level of P-value< 0.05 in all tests. Results: The participants were 157 men and 161 women, with an average age of 51.21 years. There was no significant correlation between eosinophil distribution and age, gender, or primary gastric locations. However, there was a strong correlation between the count of eosinophils in the lamina propria and intestinal metaplasia. Mean eosinophil count per high power field (HPF) was 12, 23, and 14 in mild, moderate, and severe degrees of intestinal metaplasia, respectively. An increase in eosinophil count was seen along with lymphoplasma cells infiltration up to 8/HPF in mild cases, 13/HPF in moderate cases, and 14/HPF in severe cases. Conclusion: Eosinophil counts in the lamina propria layer show a significant positive relationship with the eosinophil sheet, presence of Heliobacter pylori microorganism, intestinal metaplasia, and lymphoplasma cells infiltration. [ABSTRACT FROM AUTHOR]

Fumarate hydratase (FH)-deficient renal cell carcinoma (RCC) is a rare and clinically aggressive RCC subtype that is commonly associated with the hereditary leiomyomatosis and renal cell carcinoma syndrome. The diagnostic hallmark of FH-deficient RCC is a high-grade microscopic appearance with prominent inclusion-like eosinophilic nucleoli and perinucleolar halos. Herein we report a case of an FH-deficient RCC in a 30-year-old female that exhibited low-grade nuclei and abundant eosinophilic cytoplasm, reminiscent of the clinically more indolent succinate dehydrogenase-deficient RCC subtype and the newly described eintity, eosinophilic, solid and cystic RCC. This case illustrates that FH-deficient RCC can have a wide spectrum of microscopic appearances, including low-grade eosinophilic RCC. In addition, it highlights that a low threshold to perform the immunohistochemical stains for FH and S-(2-succino) cysteine is warranted in RCC cases with unusual and even low-grade eosinophilic morphology. [ABSTRACT FROM AUTHOR]

Purpose: Ophthalmic histiocytic lesions comprise a heterogeneous rare group of disorders that are characterized by an abnormal proliferation of histiocytes and may affect all age groups of both sexes. The aim of this study was to highlight the basic demographic, clinical, and histopathological characteristics of this rare group of diseases in ophthalmic practice, which has not been previously studied in this area. Only individual cases have been previously reported. Methods: This was a retrospective study of all biopsied ocular and periocular histiocytic lesions from two centers, King Khaled Eye Specialist Hospital (KKESH) and King Abdulaziz University Hospital (KAUH) in Riyadh, Saudi Arabia, from January 1993 to December 2018. The histopathological diagnosis was confirmed, and the cases were re-classified by reviewing all histopathological slides. The corresponding demographic and clinical data were analyzed. A relevant literature review was also carried out for comparison of our collected analyzed data to published data and to draw our own conclusions. Results: A total of 34 ocular/periocular histiocytic lesions in 28 patients who were mostly Saudis (92.9%) were included. The male-to-female ratio was 4:3. The median age at presentation was 6.4 years (range: 2.8–35 years). Twenty-two patients had unilateral involvement, and six patients had bilateral lesions. In patients with Langerhans cell histiocytosis (LCH; L group), the most common presenting findings were eyelid swelling (75%), periocular tenderness (37.5%), proptosis/globe displacement (37.5%) eyelid erythema (25%), and orbital pain (12.5%). In patients with Rosai Dorfman disease (RDD; R group), proptosis/globe displacement occurred in all patients and 80% had decreased vision. Patients in the C group (Cutaneous non-LCH histiocytoses) had variable clinical features because of the different locations of the histiocytic lesions, with the majority involving the eyelids (66.7%). Diagnosis was accurately reached clinically in 38.8%, 33.7%, and 46.7% of patients in the L, C, and R groups, respectively. Overall, the clinical diagnosis was in concordance with the histopathologic diagnosis in 14 out of 34 lesions (41.2%). Conclusions: Histiocytic disease is more likely to be overlooked clinically owing to its rarity. In the C group, juvenile xanthogranuloma (JXG) was the most commonly encountered histiocytic lesion and had a tendency to present at a later age with extremely rare intraocular involvement in contrast to previously published reports. The median age at presentation was higher in group R. All patients in group L had strictly unilateral disease, while RDD (group R) was most commonly bilateral. Future research on genetic aspects, management, and prognosis is necessary. [ABSTRACT FROM AUTHOR]

Two types of interleukin (IL)-5 antibody biologics, anti-IL-5 antibodies (mepolizumab) and anti-IL-5α receptor antibodies (benralizumab), are indicated for severe asthma. While high-dose mepolizumab is also indicated for EGPA, benralizumab is indicated only for severe asthma. Benralizumab is characterized by antibody-dependent cell-mediated cytotoxicity activity, giving them specific and rapid anti-IL-5α receptor binding abilities and the ability to target a high number of eosinophils in tissues as well as peripheral blood. Recently, reports on the efficacy of benralizumab as a treatment for EGPA have been published, along with reports on some cases that are difficult to treat with existing oral corticosteroids and mepolizumab. Therefore, we focus on the perspective of the efficacy and safety of benralizumab as a treatment for EGPA patients with steroid dependence in this review. A total of 41 patients with EGPA were treated with benralizumab. After the introduction of benralizumab, oral corticosteroids could be reduced to 10 mg/day or less in all cases and to less than 5 mg/day in 80% or more of the cases. Discontinuation of oral corticosteroids was achieved in more than 40% of patients with EGPA. Benralizumab was effective in patients with mepolizumab-refractory EGPA and intractable cardiac and neuropathy complications. Efficient elimination of eosinophils is expected to improve the remission rate of EGPA with benralizumab treatment. Although the total number of patients was small, benralizumab was safe and tolerable in a wide range of age groups, suggesting efficacy in severe cases with EGPA. [ABSTRACT FROM AUTHOR]

Myotonic Dystrophy Type 1 (DM1) is a multisystemic disease that affects gray and white matter (WM) tissues. WM changes in DM1 include increased hyperintensities and altered tract integrity distributed in a widespread manner. However, the precise temporal and spatial progression of the changes are yet undetermined. MRI data were acquired from 8 adult- and late-onset DM1 patients and 10 healthy controls (HC) at two different timepoints over 9.06 years. Fractional anisotropy (FA) and mean diffusivity (MD) variations were assessed with Tract-Based Spatial Statistics. Transversal and longitudinal intra- and intergroup analyses were conducted, along with correlation analyses with clinical and neuropsychological data. At baseline, reduced FA and increased MD values were found in patients in the uncinate, anterior-thalamic, fronto-occipital, and longitudinal tracts. At follow-up, the WM disconnection was shown to have spread from the frontal part to the rest of the tracts in the brain. Furthermore, WM lesion burden was negatively correlated with FA values, while visuo-construction and intellectual functioning were positively correlated with global and regional FA values at follow-up. DM1 patients showed a pronounced WM integrity loss over time compared to HC, with a neurodegeneration pattern that suggests a progressive anterior–posterior disconnection. The visuo-construction domain stands out as the most sensitive neuropsychological measure for WM microstructural impairment. [ABSTRACT FROM AUTHOR]

Background: Pityriasis lichenoides (PL) is a papulosquamous disease that affects both adults and children. Previous studies have shown a subset of this entity to have clonal T-cell populations via PCR-based assays. In this study, we sought to implement next-generation sequencing (NGS) as a more sensitive and specific test to examine for T-cell clonality within the pediatric population. Methods: We identified 18 biopsy specimens from 12 pediatric patients with clinical and histopathologic findings compatible with PL. Patient demographics, clinical features, management, and histopathologic findings were reviewed. All specimens were analyzed for clonality with NGS of T-cell receptor beta (TRB) and gamma (TRG) genes. Results: Of the 12 patients, 9 (75%) had complete resolution of lesions at the time of data collection (mean follow-up 31 months). The remaining three patients significantly improved with methotrexate (with or without acitretin). Interestingly, 7 of 12 patients (58%) and 9 of 17 biopsy specimens (53%) showed evidence of T-cell clonality. Two patients showed matching TRB clones from different anatomic sites. Conclusions: T-cell clonality is a common finding in PL, probably representing a "reactive clonality" rather than a true lymphoproliferative disorder. Clonality alone cannot be used as a means to distinguish PL from lymphomatoid papulosis or cutaneous lymphoma. [ABSTRACT FROM AUTHOR]

NTRK-rearranged mesenchymal tumour with epithelioid features: expanding the morphological spectrum of NTRK-fused neoplasms Thus, we aim to report a case with such features, hoping to raise awareness of the possible morphological variations of I NTRK i -rearranged mesenchymal neoplasms and, ultimately, broaden treatment opportunities for patients with locally advanced and unresectable or metastatic sarcomas. Neurotrophic tropomyosin receptor kinase ( I NTRK i ) fusion positive neoplasms were first identified in colorectal carcinoma almost 40 years ago.1 The availability of tyrosine kinase inhibitors specifically targeting receptors encoded by I NTRK i genes (Trk receptors), together with a considerable clinical response and favourable safety profile has sparked interest in improving the detection of such fusions in the clinical setting, including in sarcomas with unresectable/metastatic disease.2 In this context, the identification of morphological patterns that should lead to prompt assessment of I NTRK i rearrangements may aid the pathologist to improve detection of patients who might benefit from targeted therapy. Despite being most frequently found in spindle cell neoplasms pathologists must be aware that the histopathological features of such lesions may be broader than expected, so pan-Trk immunohistochemistry and/or I NTRK i molecular testing should be performed in all metastatic or locally advanced tumours irrespective of morphologic appearance in order to identify I NTRK i rearrangements not previously suspected. [Extracted from the article]

Background: Females of the gammaridean amphipod Ampelisca eschrichtii with signs of regenerating, previously atrophied ovaries were recovered from the northeastern shelf of Sakhalin Island (Okhotsk Sea, Russia). Ovarian regeneration was previously unknown for any amphipod species. A. eschrichtii have a predominantly 2-year life cycle (from embryo to adult death) and reproduce once between late winter or early spring at the age of 2 years. Occasionally, females survive to a third year. An adaptive value of extended survival among these females is likely to require that they are also reproductive. Methods: Histological sections from a second-year female with ovarian atrophy, a female with normal ovaries, a third-year female with ovarian regeneration, as well as testes of an immature and a sexually mature male were compared to determine the sources of cells of the germinal and somatic lines necessary for ovarian regeneration. Results: Ovarian regeneration in the third-year female began with the formation of a new germinal zone from germ cells preserved in the atrophied ovaries and eosinophilic cells of the previously starving second-year female. Eosinophilic cells form the mesodermal component of the germinal zone. A mass of these cells appeared in the second-year female that had atrophied ovaries and in large numbers on the intestine wall of the third-year female with regenerating ovaries. These eosinophilic cells appear to migrate into the regenerating ovaries. Conclusions: All germ cells of the second-year female are not lost during ovarian atrophy and can be involved in subsequent ovarian regeneration. Eosinophilic cells involved in ovarian regeneration are of mesodermal origin. The eosinophilic cell morphologies are similar to those of quiescence cells (cells in a reversible state that do not divide but retain the ability to re-enter cell division and participate in regeneration). These histological data thus indicate that eosinophilic and germ cells of third-year females can participate in the regeneration of the ovaries to reproduce a second brood. The precursors of these third-year females (a small number the second-year females with an asynchronous [summer] breeding period and ovaries that have atrophied due to seasonal starvation) appear to possess sources of somatic and germ cells that are sufficient for ovarian regeneration and that may be adaptations to starvation stress. [ABSTRACT FROM AUTHOR]

Objective. To investigate the changes in vertebral function after minimally invasive surgery in patients with thoracolumbar spinal fractures and investigate the impact of percutaneous minimally invasive surgery on patients' quality of life by following up the patients in the long term. Methods. A retrospective analysis was performed to select 80 patients with thoracolumbar spinal fractures treated in our hospital from April 2013 to October 2018, and the patients were divided into a study group and a control group according to the difference in their choice of procedure. The two groups were compared in terms of perioperative wound pain, serum creatine kinase (CK) activity, and C-reactive protein (CRP) levels, and the two groups were followed up for 2 years to compare the changes in anterior vertebral body height and Cobb's angle during the follow-up period and to compare the differences in quality of life between the two groups. Results. (1) The pain level of patients in the study group was significantly lower than that of the control group at the 1st and 3rd postoperative days (p < 0.05). (2) The CK activity and CPR level of patients in the study group were significantly lower than that of the control group at the 1st and 3rd postoperative days (p < 0.05). (3) Compared with the preoperative period, the height of the anterior border of the vertebral body and the Cobb's angle in both groups showed significant changes at 7 d, 6 months, one year, and two years after surgery (p < 0.05), suggesting that both procedures can significantly restore the height of the injured vertebra and improve the function of the vertebral body. (4) The somatic, physical, and psychological functions of patients in the study group were significantly greater than those in the control group at 6 months postoperatively (p > 0.05). Conclusion. Compared to traditional open surgery, minimally invasive percutaneous surgery for thoracolumbar fractures can significantly reduce perioperative pain and improve perioperative stress in patients, while achieving better surgical outcomes and a significantly improved quality of life in patients at long-term follow-up. [ABSTRACT FROM AUTHOR]

Mechanisms underlying variability in transmission of Mycobacterium tuberculosis strains remain undefined. By characterizing high and low transmission strains of M.tuberculosis in mice, we show here that high transmission M.tuberculosis strain induce rapid IL-1R-dependent alveolar macrophage migration from the alveolar space into the interstitium and that this action is key to subsequent temporal events of early dissemination of bacteria to the lymph nodes, Th1 priming, granulomatous response and bacterial control. In contrast, IL-1R-dependent alveolar macrophage migration and early dissemination of bacteria to lymph nodes is significantly impeded in infection with low transmission M.tuberculosis strain; these events promote the development of Th17 immunity, fostering neutrophilic inflammation and increased bacterial replication. Our results suggest that by inducing granulomas with the potential to develop into cavitary lesions that aids bacterial escape into the airways, high transmission M.tuberculosis strain is poised for greater transmissibility. These findings implicate bacterial heterogeneity as an important modifier of TB disease manifestations and transmission. Halting tuberculosis transmission is crucial to TB elimination. Here the authors implicate IL-1R dependent T cell priming as the underlying mechanism determining variability in transmission of Mycobacterium tuberculosis strains. [ABSTRACT FROM AUTHOR]

Background: Microwave ablation (MWA) is a popular therapy for liver malignant tumor in recent years. Few studies have been conducted on its use in the treatment of hepatic alveolar echinococcosis (HAE). The study aims to evaluate the efficacy and safety of MWA in the treatment of HAE. Methods: This study analyzed the data of 45 patients (mean age, 38 ± 2 years; 24 males) diagnosed with HAE and underwent MWA treatment between June 2014 to December 2019. The patients after MWA were examined by CT or MRI [follow-up: 32 months (IQR 23–48.5)] to determine whether the lesions were relapsed and to evaluate the therapeutic effect of MWA. The safety of MWA was evaluated by monitoring postoperative complications. Clinical data, such as patient demographics, imaging features of the lesions, relevant findings of laboratory tests before and after ablation, and information related to ablation, were collected and analyzed. Paired-sample t tests and paired-sample Wilcoxon signed-rank tests were used to compare relevant laboratory indicators before and after MWA. Results: MWA was applied to 57 HAE lesions in 45 patients. The median size of lesions was 3.42 cm (IQR2.85–4.41). The rate of complete ablation was 100% (57/57). The median follow-up time was 32 months (IQR 23–48.5). The recurrence rate was 13% (6/45), and the median time of recurrence was 22 months. The rate of minor complications was 11.1% (5/45), and there were no major complications and deaths. Compared to preoperative, ALB, RBC, HBG, and PLT were decreased (p < 0.001); ALT, TB, DB, and WBC were increased (p < 0.001); and no statistically difference in PT, APTT, and INR (p > 0.05). Conclusions: MWA might be a safe and effective way to cure HAE. Meanwhile, it provides a new option and a new way of thinking about treatment for patients with HAE. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare imaging features between COVID-19 and mycoplasma pneumonia (MP). Materials and methods: The data of patients with mild COVID-19 and MP who underwent chest computed tomography (CT) examination from February 1, 2020 to April 17, 2020 were retrospectively analyzed. The Pneumonia-CT-LKM-PP model based on a deep learning algorithm was used to automatically quantify the number, volume, and involved lobes of pulmonary lesions, and longitudinal changes in quantitative parameters were assessed in three CT follow-ups. Results: A total of 10 patients with mild COVID-19 and 13 patients with MP were included in this study. There was no difference in lymphocyte counts at baseline between the two groups (1.43 ± 0.45 vs. 1.44 ± 0.50, p = 0.279). C-reactive protein levels were significantly higher in MP group than in COVID-19 group (p < 0.05). The number, volume, and involved lobes of pulmonary lesions reached a peak in 7–14 days in the COVID-19 group, but there was no peak or declining trend over time in the MP group (p < 0.05). Conclusion: Based on the longitudinal changes of quantitative CT, pulmonary lesions peaked at 7–14 days in patients with COVID-19, and this may be useful to distinguish COVID-19 from MP and evaluate curative effects and prognosis. [ABSTRACT FROM AUTHOR]

A middle meningeal artery (MMA) aneurysm is a type of intracranial aneurysm that has been rarely documented and is not completely understood in clinical medicine and especially in pediatrics, because juvenile cases have been extremely uncommon. Vascular conditions have occasionally been diagnosed in osteoarchaeological remains, providing evidence of their occurrence in previous eras. In the present report, we have described a lesion that was highly consistent with a case of an MMA aneurysm observed in an Etruscan child, whose remains had been exhumed during archaeological excavations in the necropolis of Pontecagnano (Salerno, southern Italy). The remains date back to the seventh to sixth century BC. Macroscopic and radiological examinations revealed an oval depression in the endocranial area corresponding to the parietal branch of the right MMA. The localized thinning of the bone and the absence of a bone reaction were compatible with a long-lasting compression of vascular origin highly consistent with an MMA aneurysm. Primary malignant bone tumors, bone metastasis, benign neoplastic conditions, and other non-neoplastic conditions, including calvarial venous malformations, eosinophilic granuloma, and sarcoidosis, could be excluded from the differential diagnosis, although the occurrence of other pathologies, such as dural arteriovenous fistulas, could not be rejected. Although it was not possible to definitely establish whether the MMA aneurysm was symptomatic, it could not be ruled out that rupture and subsequent extradural hemorrhage and/or intracranial hemorrhage could have caused the death of the child. From a paleopathological viewpoint, the case illustrated provides an interesting historical perspective on a rare neurovascular disorder that continues to be debated in modern clinical research. [ABSTRACT FROM AUTHOR]

When the peripheral eosinophilia increases to 20% of the total leukocyte count, the eosinophils begin to infiltrate into the myocardium.10 Thus, we assume that defining the eosinophil range >25% may help predict cardiac involvement in EGPA. Serial biopsies revealed eosinophil infiltration in the acute phase, myocytolysis and interstitial fibrosis in the subacute phase and endocardial thickening in the chronic phase. Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, is a rare disease with necrotising vasculitis, occurring exclusively among patients with asthma and eosinophilia. [Extracted from the article]

To assess the effectiveness of whole-body MRI (WB-MRI) in early diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) and the prediction of clinical response through quantitative MRI features. 20 children (mean age, 10.3 years; range, 5–14 years) with CRMO underwent WB-MRI and were assessed with a clinical score (Jansson) at baseline (median time after first encounter, 8 months) and follow-up (median time after baseline, 11.5 months). Baseline WB-MRI scans were classified as early (within 6 months after first encounter) and late. Clinical responders and non-responders were compared regarding number and localization of bone lesions, lesion volume and T2 signal intensity (SI) ratio (lesion to muscle). Diagnosis of CRMO was made promptly in the early WB-MRI group (n = 10; median, 3 months) compared to the late WB-MRI group (n = 10; 18 months; p = 0.006). Bone lesions were mainly located in the lower extremities (n = 119/223; 53%). No significant difference was detected regarding the number of bone lesions and lesion volume in the subgroups of clinical responders (n = 10) and non-responders (n = 10). Responders showed a higher volume reduction of bone lesions at follow-up compared to non-responders (p = 0.03). Baseline and follow-up SI ratios were lower in responders (5.6 and 5.8 vs 6.1 and 7.2; p = 0.047 and p = 0.005). The use of WB-MRI within 6 months of disease suspicion may serve as a benchmark to support early diagnosis of CRMO. T2 SI ratios and the reduction of lesions' volume correlate with clinical outcome. WB-MRI at an early stage of suspected CRMO plays a key role for early diagnosis. This is the first study showing that quantitative MRI features are suitable for response assessment and can be used as prognostic markers for the prediction of clinical response. [ABSTRACT FROM AUTHOR]

Abstract Background Acetabular roof lesions (ARLs) in children are uncommon and may involve a variety of diseases. The acetabular roof is the main weight-bearing area of the hip joint, and lesions affecting the acetabular roof lead to fluid accumulation in the hip joint, causing hip pain and claudication. Methods for diagnosing and treating ARLs and the prognosis after treatment are rarely reported. We present our experience in a group of children and teenagers with ARLs to retrospectively explore the clinical and imaging features and histopathological diagnosis and report the treatment methods and follow-up observations. Methods Patients with ARLs admitted to the Children’s Hospital of Chongqing Medical University from April 2011 to September 2018 were selected retrospectively. We collected the basic information of patients (name, sex, age), main symptoms and signs, results of various laboratory tests, treatment methods, and intraoperative observations through the hospital medical record system. We collected X-ray, computed tomography (CT), magnetic resonance imaging (MRI) and pathological examination data through the Picture Archiving and Communications System. Follow-up data were collected through an outpatient medical record system, telephone, and chat software (such as WeChat). We used descriptive methods to analyze the lesion structure and destruction mode based on the imaging findings and histopathological diagnosis. Results There were 14 ARL patients, including 6 with eosinophilic granuloma (EG), 5 with chronic osteomyelitis, 2 with bone cyst, and 1 with tuberculosis. One patient underwent percutaneous needle biopsy, 2 underwent open biopsy, and 11 underwent curettage; among them, 5 patients also underwent bone grafting. These lesions had no characteristic imaging findings, and the diagnosis was mainly based on histopathological examination. Most patients showed complete symptom resolution and good hip function at the 1-year follow-up. Conclusion ARLs are not common in children. The types of lesions are diverse and mostly benign, with EG being most common. Malignant tumors may also occur, such as Ewing’s sarcoma, non-Hodgkin’s lymphoma, metastases and neuroblastoma. CT and MRI can be helpful in diagnosing certain cases, but incisional biopsy is required in most cases.