A Case of Acquired Idiopathic Pterygium Inversum Unguis

Pterygium inversum unguis (PIU) is a rare nail abnormality in which the distal nail bed adheres to the ventral surface of the nail plate, with obliteration of the distal groove. Because of the rarity of this condition, its exact origin is unknown. This disorder can be either congenital or acquired, with or without a family history. The acquired forms may be idiopathic or secondary to systemic connective tissue diseases or other causes such as stroke, neurofibromatosis, leprosy, or the use of nail fortifiers. We present an unusual case of acquired idiopathic PIU of the 10 fingernails in a 22-year-old man.     

“Symptom-Specific or Holistic”: Menopausal Symptom Management

Our purpose in this study was to identify differences in menopausal symptom management among four major ethnic groups in the United States. This was a secondary analysis of the qualitative data from a larger Internet-based study. We analyzed data from 90 middle-aged women in the United States using thematic analysis. We extracted four themes during the data analysis process: (a) “seeking formal or informal advice,” (b) “medication as the first or final choice,” (c) “symptom-specific or holistic,” and (d) “avoiding or pursuing specific foods.” Health care providers need to develop menopausal symptom management programs while considering ethnic differences in menopausal symptom management.     

Measurement of alcohol craving

Despite considerable research activity and application in treatment, the construct of craving remains poorly understood. We propose that cravings and urges are cognitive–emotional events in time, characterised by frequency, duration, intensity and salience. Commonly used measures of alcohol craving are reviewed, and their strengths and weaknesses identified. Most measures confound craving with behaviours, or with separable cognitive phenomena such as expectancies, intentions, or perceived behavioural control. These confounds have limited our advances in understanding the determinants and consequences of craving. Based on the criteria applied in this review, among the better performing multi-item measures are the Penn Alcohol Craving Scale and Obsessive subscale of the Obsessive–Compulsive Drinking Scale. Optimal assessment strategies are likely to involve daily assessments of peak intensity of cravings, desires or urges and of the frequency and duration of craving episodes. Of particular interest are measures of intensity at times when individuals are at risk of drinking or of other functional impacts from craving.     

Brain Stem Hypoplasia Associated with Cri-du-Chat Syndrome

Cri-du-Chat syndrome, also called the 5p-syndrome, is a rare genetic abnormality, and only few cases have been reported on its brain MRI findings. We describe the magnetic resonance imaging findings of a 1-year-old girl with Cri-du-Chat syndrome who showed brain stem hypoplasia, particularly in the pons, with normal cerebellum and diffuse hypoplasia of the cerebral hemispheres. We suggest that Cri-du-Chat syndrome chould be suspected in children with brain stem hypoplasia, particularly for those with high-pitched cries.     

Clinical Utility of Real-Time MR-Navigated Ultrasound with Supine Breast MRI for Suspicious Enhancing Lesions Not Identified on Second-Look Ultrasound

This study evaluated the usefulness of magnetic resonance (MR)-navigated ultrasound (US) for evaluation of magnetic resonance imaging (MRI)-detected lesions not visible on second-look US and analyzed differences in lesion-to-nipple distance between supine and prone positions. Of the 831 consecutive patients who were diagnosed with breast cancer and examined with breast MRI from June 2013 to September 2015, 40 lesions in 37 patients who underwent MR-navigated US for MRI-detected lesions that were not visible on second-look US were included. First, MRI was performed in a prone position using a 1.5-T imager, and second, MRI was performed in a supine position for MR-navigated US. Of 40 lesions, 31 (78%) were identified with MR-navigated US, whereas 5 (13%) lesions disappeared on supine MRI and 4 (10%) exhibited no correlation on MR-navigated US. Of 31 lesions with pathologic confirmation, 7 (23%) were malignant, 2 (6%) were high-risk lesions and 22 (71%) were benign lesions. Comparison of the US findings of benign and malignant lesions revealed that orientation of the lesion differed significantly (p = 0.045), whereas lesion shape, margin and echo pattern did not significantly differ between the two groups (p = 0.088, p = 0.094 and p = 0.412, respectively). Median difference in lesion-to-nipple distance on supine and prone MRI was 8 mm (0–34 mm) in the horizontal direction and 5 mm (0–39.5 mm) in the vertical direction. Thirteen lesions exhibited a >1-cm difference in both horizontal and vertical directions. In conclusion, MR-navigated US was useful for the evaluation of MRI-detected lesions that were not visible on second-look US in breast cancer patients.     

Detection of Problem Gambler Subgroups Using Recursive Partitioning

The multivariate socio-demographic risk factors for problem gambling have been well documented. While this body of research is valuable in determining risk factors aggregated across various populations, the majority of studies tend not to specifically identify particular subgroups of problem gamblers based on the interaction between variables. The identification of problem gambling subgroups offers the potential for improved harm-reduction initiatives in particular geographic contexts. We introduce an analytical approach termed recursive partitioning, commonly used in the health sciences but infrequently employed in gambling research, to identify specific gambler subgroups based on the interaction of a range of predictor variables. Recursive partitioning creates groups of cases (e.g. gamblers) with similar outcomes by repeatedly splitting each group into smaller and more homogenous subgroups. We employ it to define problem gambler subgroups within a diverse population context (i.e. northern Australia) and compare the results with a multivariate analysis of the same dataset using a generalized linear regression model. We assess the advantages and disadvantages of each approach, and argue that recursive partitioning is an easily-interpretable approach that may be useful both in identifying problem gambling subgroups and in developing targeted harm-minimisation strategies.     

GalNAc-T14 promotes metastasis through Wnt dependent HOXB9 expression in lung adenocarcinoma

While metastasis, the main cause of lung cancer-related death, has been extensively studied, the underlying molecular mechanism remains unclear. A previous clinicogenomic study revealed that expression of N-acetylgalactosaminyltransferase (GalNAc-T14), is highly inversely correlated with recurrence-free survival in those with non-small cell lung cancer (NSCLC). However, the underlying molecular mechanism(s) has not been determined. Here, we showed that GalNAc-T14 expression was positively associated with the invasive phenotype. Microarray and biochemical analyses revealed that HOXB9, the expression of which was increased in a GalNAc-T14-dependent manner, played an important role in metastasis. GalNAc-T14 increased the sensitivity of the WNT response and increased the stability of the β-catenin protein, leading to induced expression of HOXB9 and acquisition of an invasive phenotype. Pharmacological inhibition of β-catenin in GalNAc-T14-expressing cancer cells suppressed HOXB9 expression and invasion. A meta-analysis of clinical genomics data revealed that expression of GalNAc-T14 or HOXB9 was strongly correlated with reduced recurrence-free survival and increased hazard risk, suggesting that targeting β-catenin within the GalNAc-T14/WNT/HOXB9 axis may be a novel therapeutic approach to inhibit metastasis in NSCLC.