Alveolar soft part sarcoma of the retroperitoneum: A case report

Alveolar soft part sarcoma is a rare soft tissue tumor with uncertain histogenesis. It is a slow growing tumor with a high rate of metastasis. The tumor is not easily identified as clinical symptoms are not pronounced. The retroperitoneum is a rare location of tumor, with a few cases published in literature. Surgical excision is the mainstay of treatment. Here we describe a rare case of a large retroperitoneal Alveolar soft part sarcoma in a young female with radiological and histopathological findings.     

Nutritional Status of Indian Children with Cerebral Palsy: A Cross-sectional Study

Indian Journal of Pediatrics -     

A radiographic investigation to determine the safety of suture anchor systems for pediatric modified Broström ankle ligament reconstruction

BACKGROUND: The modified Brostr?m ligament reconstruction using anchor sutures has been performed in adults with clinical success; however, the safety parameters for the use of suture anchors in adolescent lateral ankle ligament reconstruction have not been established. PURPOSE: To perform a radiographic analysis comparing the depth of penetration of suture anchors in adult ankle ligament reconstruction with the average distance of the physis from the tip of the fibula in adolescents. STUDY DESIGN: Cross-sectional study, Level of evidence, 4. METHODS: Forty postoperative ankle radiographs of adult patients who had a modified Brostr?m procedure were compared with 40 normal adolescent ankle radiographs. In the adult group, the distance of the suture anchor penetration from the distal tip of the fibula was measured; in the adolescent group, the distance of the physis from the distal tip of the fibula was measured. RESULTS: The mean depth of the suture anchors was 17 mm (range, 14-21 mm) from the tip of the fibula in the adult group, and the mean distance of the growth plate was 23 mm (range, 18-29 mm) in the adolescent group. Eight radiographs from the adolescent group (20%) had a physis measurement of <22 mm on the anteroposterior or mortise view. CONCLUSIONS: Using careful preoperative planning and intraoperative technique, it is possible to safely perform lateral ankle ligament repair in the skeletally immature patient using suture anchors.     

Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients

Background

The impact of gender on the staging and prognosis of urothelial carcinoma of the bladder (UCB) is insufficiently understood.

Objective

To assess gender-specific differences in pathologic factors and survival of UCB patients treated with radical cystectomy (RC).

Design, setting, and participants

Data from 8102 patients treated with RC (6497 men [80%] and 1605 women [20%]) for UCB between 1971 and 2012 were analyzed.

Outcome measurements and statistical analysis

Multivariable competing-risk regression analyses were performed to evaluate the relationship of gender on disease recurrence (DR) and cancer-specific mortality (CSM). We also tested the interaction of gender and tumor stage, nodal status, and lymphovascular invasion (LVI).

Results and limitations

Female patients were older at the time of RC (p = 0.033) and had higher rates of pathologic stage T3/T4 disease (p < 0.001). In univariable, but not in multivariable analysis, female gender was associated with a higher risk of DR (p = 0.022 and p = 0.11, respectively). Female gender was an independent predictor for CSM (p = 0.004). We did not find a significant interaction between gender and stage, nodal metastasis, or LVI (all p values >0.05).

Conclusions

We found female gender to be associated with a higher risk of CSM following RC. However, these findings do not appear to be explained by gender differences in pathologic stage, nodal status, or LVI. This gender disparity may be due to differences in care and/or the biology of UCB.     

Moderation of prekallkrein–factor XII interactions in surface activation of coagulation by protein-adsorption competition

Traditional biochemistry of contact activation of blood coagulation suggesting that anionic hydrophilic surfaces are specific activators of the cascade is inconsistent with known trends in protein adsorption. To investigate contact activation reactions, a chromogenic assay was used to measure prekallkrein (PK) hydrolysis to kallikrein (Kal) by activated factor XII (FXIIa) at test hydrophilic (clean glass) and hydrophobic (silanized glass) surfaces in the presence of bovine serum albumin (BSA). Hydrolysis of PK by FXIIa is detected after contact of the zymogen FXII with a test hydrophobic surface only if putatively-adsorbed FXIIa is competitively displaced by BSA. By contrast, FXIIa activity is detected spontaneously following FXII activation by a hydrophilic surface and requires no adsorption displacement. These results (i) show that an anionic hydrophilic surface is not a necessary cofactor for FXIIa-mediated hydrolysis of PK, (ii) indicate that PK hydrolysis does not need to occur by an activation complex assembled directly on an anionic, activating surface, (iii) confirms that contact activation of FXII (autoactivation) is not specific to anionic hydrophilic surfaces, and (iv) demonstrates that protein-adsorption competition is an essential feature that must be included in any comprehensive mechanism of surface-induced blood coagulation.     

Pharmacophore-based predictive model generation for potent antimalarials targeting haem detoxification pathway

Pharmacophore hypotheses were developed for molecules having antimalarial activities targeting the haem detoxification pathway of the malaria parasite. A training set consisting of 23 compounds was selected to generate these hypotheses, and their activities were evaluated for haem polymerization inhibition and against chloroquine-sensitive (3D7) as well as chloroquine-resistant (K1) strains of p. falciparum. The models were cross-validated by Fischer’s randomization test at a 95% confidence level. The model developed against chloroquine-resistant malaria parasites was found to yield the best predictions among the three models.     

Cyclodialysis cleft diagnosed by conventional ultrasonography

This case report describes the diagnosis and management of a traumatic cyclodialysis cleft, in the absence of newer investigating modalities like ultrasonic biomicroscopy (UBM). This entity is frequently difficult to recognize clinically owing to the extreme hypotony and media haze that these patients usually present with, which makes gonioscopy particularly taxing. Adding to the diagnostic dilemma is the difficulty in delineating the lesion ultrasonically due to the extreme anterior location of the cleft. In these situations, high frequency ultrasound has been found to be extremely helpful, but the availability of such sophistication is difficult. Presented here is demonstration of the cleft with a microconvex ultrasound probe of 9 MHz frequency. The patient was successfully managed conservatively. This modality could prove to be a valuable adjunct to the diagnosis of such cases even in the situations of nonavailability of high frequency ultrasonography.