Invading of intrauterine contraceptive device into the sigmoid colon through uterine perforation caused by a blunt trauma

Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks. Uterus perforation is rare and would be fatal. A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented. Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed. Imaging is required when the patients with IUCD present abdominal pain, particularly with a history of trauma.     

The Effect of Gingival Retraction Procedures on Periodontal Indices and Crevicular Fluid Cytokine Levels: A Pilot Study

PURPOSE: The purpose of this study was to examine the effects of placement of retraction cord subgingivally upon periodontal indices including plaque index (PI), gingival index (GI), pocket depth (PD), bleeding on probing (BOP), and attachment level (AL), as well as gingival crevicular fluid (GCF) and TNF-alpha levels. METHODS: Ten teeth in 6 patients who were periodontally healthy were selected. These teeth had pocket depths of 3 mm or less, no evidence of significant loss of attachment, BOP, or plaque accumulation. The patients each received an oral prophylaxis. The following week, baseline measurements of periodontal indices and TNF-alpha were taken and the retraction cord was placed for 15 minutes. Following removal, the patients were dismissed. The periodontal indices measured included PI, GI, PD, BOP, and AL. In addition, the levels of TNF-alpha in GCF, were investigated. These measurements were made before gingival retraction as a baseline and on the 1st, 3rd, 7th, 14th, and 28th days post retraction. RESULTS: A repeated measures ANOVA showed that TNF-alpha levels in GCF were significantly increased at all five intervals after gingival retraction compared to the baseline. The mean TNF-alpha level peaked at Day 1 (0.90 +/- 0.62), then declined at Days 3 (0.53 +/- 0.16), 7 (0.43 +/- 0.08), 14 (0.47 +/- 0.10), and 28 (0.43 +/- 0.08) but was still elevated 54% above baseline at Day 28, p < 0.01. The GI was significantly elevated at Day 1 (0.9 +/- 0.49), p < 0.01; Day 3 (0.53 +/- 0.32); and Day 7 (0.33 +/- 0.33), p < 0.05. Unlike TNF-alpha, GI recovered to the baseline by day 14. Other periodontal parameters, PI, PD, BOP, and AL were not significantly altered by the gingival retraction procedure. CONCLUSION: This pilot study supports the previous research that gingival retraction causes an acute injury that heals clinically in 2 weeks as is indicated by the GI. It also provides the first evidence that gingival retraction results in an elevation of the proinflammatory cytokine, TNF-alpha, in GCF.     

Impact of serum soluble programed death ligand 1 on end of treatment metabolic response of diffuse large B cell lymphoma patients

Programmed death ligand-1 (PD-L1) plays an important role in the immune evasion of cancer cells and, in turn, can influence the outcome of many malignancies. The serum soluble PD-L1 (sPD-L1) levels were measured in diffuse large B cell lymphoma (DLBCL) patients at diagnosis and at end of treatment. Their impact on end of treatment metabolic response was analyzed. Serum sPD-L1 level was significantly elevated in DLBCL patients at diagnosis than in controls (P?<?0.001). Also, serum sPD-L1 level at diagnosis was significantly higher than that at end of treatment (P?<?0.001). Patients who achieved partial response (PR) had significantly higher serum sPD-L1 level at end of treatment than controls (P?<?0.001). In contrast, all patients especially those who achieved complete response (CR) had insignificantly different serum sPD-L1 level at end of treatment than controls (P?=?0.354 and P?=?0.090, respectively). There was a significant difference between serum sPD-L1 level at diagnosis and that at end of treatment in patients who achieved PR and CR (P?=?0.023 and P?<?0.001, respectively). On univariate analysis, presence of comorbidities, Ann Arbor stage IV, high serum sPD-L1 level at diagnosis and high serum sPD-L1 level at end of treatment were significantly associated with achievement of PR (P?=?0.018 and P?=?0.043, P?=?0.045 and P?<?0.001, respectively). On multivariate analysis, serum sPD-L1 levels at diagnosis and at end of treatment were still influencing metabolic response significantly (P?=?0.014 and P?=?0.007, respectively). Serum sPD-L1 is a predictor for metabolic response to immunochemotherapy in DLBCL patients.     

On the Significance of Systolic Flow Waveform on Aortic Valve Energy Loss

This study aims to quantitatively and qualitatively assess energy dissipation in the aortic valve as a function of systolic aortic flow waveform representing pathologies where flow time-to-peak is delayed. A bioprosthetic valve was tested in the aortic position of a left-heart simulator under physiological pressure and flow conditions. The flow loop piston pump was programmed to generate three different flow waveforms each with a different peak time annotated as early peak (EP) with a rapid acceleration, mid peak (MP) and late peak (LP) with a rapid deceleration. Energy dissipation was calculated from flow and pressure measurements while sinus vorticity dynamics were evaluated using time-resolved planar particle image velocimetry. Average pressure gradients during systole are found 30.2?±?0.19, 30.7?±?0.25 and 32.9?±?0.29 mmHg and average dissipation over systole is found 0.95?±?0.026, 1.05?±?0.034 and 1.25?±?0.043 W for EP, MP and LP respectively. As systole’s acceleration phase is slower, sinus vortices are more likely to form, necessitating more energy exchange from shear layers inducing more viscous dissipation. EP found in healthy individuals is superior in terms of reducing energy dissipation and increasing aortic valve efficiency. In the context of possible left ventricular dysfunction and aortic stenosis, this means that delayed time-to-peak in the aortic flow waveform seen is not compensatory.     

Graphene supports in vitro proliferation and osteogenic differentiation of goat adult mesenchymal stem cells: potential for bone tissue engineering

Current treatments for bone loss injuries involve autologous and allogenic bone grafts, metal alloys and ceramics. Although these therapies have proved useful, they suffer from inherent challenges, and hence, an adequate bone replacement therapy has not yet been found. We hypothesize that graphene may be a useful nanoscaffold for mesenchymal stem cells and will promote proliferation and differentiation into bone progenitor cells. In this study, we evaluate graphene, a biocompatible inert nanomaterial, for its effect on in vitro growth and differentiation of goat adult mesenchymal stem cells. Cell proliferation and differentiation are compared between polystyrene‐coated tissue culture plates and graphene‐coated plates. Graphitic materials are cytocompatible and support cell adhesion and proliferation. Importantly, cells seeded on to oxidized graphene films undergo osteogenic differentiation in fetal bovine serum‐containing medium without the addition of any glucocorticoid or specific growth factors. These findings support graphene's potential to act as an osteoinducer and a vehicle to deliver mesenchymal stem cells, and suggest that the combination of graphene and goat mesenchymal stem cells provides a promising construct for bone tissue engineering. Copyright © 2014 John Wiley & Sons, Ltd.     

High grade endometrial stromal sarcoma on thinprep

High grade endometrial stromal sarcoma (HGESS) is an uncommon malignancy recently re‐defined in the new WHO classification of endometrial stromal tumors. In this article, we discuss the differential diagnoses of metastatic HGESS in a fine needle aspiration (FNA) of a lymph node and compare the cytomorphology of HGESS in ThinPrep [(TP), Hologic Inc., Boxborough, MA] to conventional smears (CS). The patient had a history of stage I HGESS, status‐post supracervical hysterectomy without regional lymph node metastases. Her post‐operative course was complicated by pelvic fluid collections and enlarging para‐aortic lymph nodes. Diff‐Quik (DQ)‐stained and Papanicolaou (Pap)‐stained smears from a para‐aortic lymph node FNA demonstrated a cellular specimen with monomorphic population of plump to oval cells with scant, wispy cytoplasm in aggregates and as single cells. The nuclei showed fine chromatin and small inconspicuous nucleoli. Compared to the CS, HGESS cells in the TP showed similar cytological features, with the exception that the nuclei were slightly smaller, hyperchromatic, and the chromatin pattern was attenuated. In the absence of prior clinical history, the cytomorphology of metastatic HGESS in a lymph node can be difficult to differentiate from a lymphoma, a variety of metastatic spindle cell tumors or metastatic carcinoma. Immunohistochemical analysis and comparison with the primary tumor can be useful in proving the nature of the malignant cells. The cytomorphology of HGESS on TP correlated well in both single cells and aggregates when compared to CS. The differences noted were decreased nuclear size, nuclear hyperchromasia, and slightly attenuated nuclear detail on TP. Diagn. Cytopathol. 2015;43:756–762. © 2015 Wiley Periodicals, Inc.