Acute appendicitis after colorectal endoscopic mucosal resection: a case report

Endoscopic mucosal resection (EMR) was originally described in 1973 and is currently a popular practice used in treating polyps, small adenomas, and early cancers. Although the safety of EMR has been proven in numerous studies, complications occur occasionally. We report a case in which the patient complained of severe upper abdominal pain and who was diagnosed with acute appendicitis after colorectal EMR. The patient recovered well after surgery. Cautious observation is necessary when resuming oral intake in patients who undergo colorectal EMR and who complain of postoperative abdominal pain. Observation is especially important for patients with a fecalith that may have originally existed in the appendix or in the colon near the appendix.     

L-Serine Treatment is Associated with Improvements in Behavior,EEG, and Seizure Frequency in Individuals with GRIN-Related Disorders Due to Null Variants

Pathogenic missense variants in GRIN2A and GRIN2B may result in gain or loss of function (GoF/LoF) of the N-methyl-D-aspartate receptor (NMDAR). This observation gave rise to the hypothesis of successfully treating GRIN-related disorders due to LoF variants with co-agonists of the NMDAR. In this respect, we describe a retrospectively collected series of ten individuals with GRIN2A- or GRIN2B-related disorders who were treated with L-serine, each within an independent n-of-1 trial. Our cohort comprises one individual with a LoF missense variant with clinical improvements confirming the above hypothesis and replicating a previous n-of-1 trial. A second individual with a GoF missense variant was erroneously treated with L-serine and experienced immediate temporary behavioral deterioration further supporting the supposed functional pathomechanism. Eight additional individuals with null variants (that had been interpreted as loss-of-function variants despite not being missense) again showed clinical improvements. Among all nine individuals with LoF missense or null variants, L-serine treatment was associated with improvements in behavior in eight (89%), in development in four (44%), and/or in EEG or seizure frequency in four (44%). None of these nine individuals experienced side effects or adverse findings in the context of L-serine treatment. In summary, we describe the first evidence that L-serine treatment may not only be associated with clinical improvements in GRIN-related disorders due to LoF missense but particularly also null variants.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-021-01173-9.     

Free‐wall perforation of the left ventricle after acute myocardial infarction complicated with pericardial tamponade that mimicked ascending aortic dissection: A case report

Life‐threatening cardiac events may be misdiagnosed as acute aortic dissection because of notable symptom mimicry. We report the case of a 72‐year‐old male patient with presentations presumed to be of aortic origin. However, surgery revealed posterior free‐wall perforation in the left ventricle caused by the occlusion of an obtuse marginal branch.     

Follicular dendritic cell sarcoma of the nasopharynx: a case report and literature review

Follicular dendritic cell sarcoma (FDCS) of the nasopharynx is a rare malignant tumor that has been described in only a few case reports, and its differential diagnoses include diverse clinicopathologic entities. FDCS is often initially misdiagnosed, especially when examining small biopsy specimens. We herein report a case of FDCS arising in the nasopharynx that was initially misdiagnosed as a nerve sheath tumor. A 44-year-old woman presented with persistent obstruction of the left nasal cavity and underwent an excisional biopsy. The specimen demonstrated morphologic and immunohistochemical features of FDCS. In situ hybridization for Epstein–Barr virus-encoded RNA was negative. The patient was treated with chemotherapy and radiotherapy. The sarcoma recurred near the original site more than 3 years after the initial treatment and was completely resected. At the time of this writing, the patient had remained disease-free for 1 year after resection. This case is being reported to improve the clinical recognition of FDCS.     

Study on Hot Deformation Behavior of an Antibacterial 50Cr15MoVCu Tool Steel

Hot deformation behaviors of an antibacterial 50Cr15MoVCu tool steel were studied. The flow stress curves presented three typical characteristics: (i) a single peak dynamic recrystallization curve, (ii) a monotone incremental work-hardening curve, and (iii) the equilibrium dynamic recovery curve. The flow stress increased with the increase of the deformation rate at each deformation temperature and decreased with the increase of the deformation temperature at the same deformation rate. The thermal activation energy and material constants were Q of 461.6574 kJ/mol, A of 3.42 × 10¹⁷, and α of 0.00681 MPa⁻¹, respectively. The high temperature constitutive equation was: Z=ε˙expQ/RT=3.42×1017sinh0.0068×σ5.6807. Based on the processing maps and microstructure evolution, the best hot working process was a deformation temperature of 1050 °C and deformation rate of 0.001 s⁻¹.     

阿瑞匹坦三元超饱和固体分散体的制备及性能考察

目的：为了提高难溶性药物阿瑞匹坦(Aprepitant,APR)的溶解度,解决其酸中溶出、碱中结晶沉淀的问题,选择不同功能的聚合物载体,采用热熔挤出技术制备三元固体分散体,并对其进行性能考察;方法：采用溶剂-熔融法制备二元固体分散体,以溶出度和溶出速度为指标,筛选具有增溶功能的载体材料。通过介质转移法考察各聚合物在不同浓度的药物溶液中的抑晶性能,筛选出最佳的沉淀抑制剂。确定药载比,将APR、溶出促进剂及沉淀抑制剂以不同比例混合,采用热熔挤出技术制备三元固体分散体,以溶出度和抑晶时间为指标,优选出三元固体分散体处方。经XRD确认药物在载体中的存在状态,考察该三元固体分散体在模拟肠液中的动态溶解度和加速条件下的物理稳定性。结果：亲水性聚合物PVP K30制备的二元固体分散体溶出速度快,增溶效果佳,肠溶性聚合物HPMCAS显示出优越的抑晶作用,延长了APR的过饱和点,质量比为1:1:3(APR:PVP K30:HPMCAS)的三元固体分散体在酸中迅速完全释放(120min溶出95%),相对于原料药显著提高了溶出度和溶出速率,当介质pH转为6.8后,三元固体分散体完全释放并在6h内维持溶液处于高过饱和的稳定状态,药物以无定形形式存在于载体基质中,同时能在加速条件下保持至少三个月的无定形状态。结论：基于不同聚合物的理化特性,本研究制备的三元固体分散体通过协调溶出速率和结晶抑制效果,不仅显著提高APR的溶解度,并能解决APR在胃中溶出、肠中沉淀析晶的问题,具有良好的溶出特性。     

Birth outcomes of patients with isolated anorectal malformations: A population‐based case‐control study

In most patients affected by isolated anorectal malformation (IARM) the etiology is largely unknown. Thus, the aim of our project was to analyze possible risk factors for IARM. In the first step, birth outcomes of cases with IARM were analyzed on the basis of maternal socio‐demographic variables, and these data are presented in this paper. Gestational age at delivery, birthweight, preterm birth, low birthweight and small for gestational age of cases with IARM were evaluated in the function of maternal age, birth/pregnancy order, marital and employment status of mothers in the population‐based large dataset of the Hungarian Case‐Control Surveillance of Congenital Abnormalities, 1980–1996. The study samples included 231 live‐born cases with IARM, 361 matched and 38 151 population controls without any defect. IARMs are more frequent in males, twins and newborn infants with low birthweight and small‐for‐gestational‐age, the latter being the consequence of intrauterine growth restriction. In addition, mothers of cases were younger but with higher birth order, and had lower socio‐economic status. These maternal variables are characteristic for the gypsy population in Hungary. The higher proportion of gypsy women among the mothers of cases with IARM was confirmed during the home visits of the study. Male sex and intrauterine growth restriction of cases, in addition to low socioeconomic status and gypsy origin of mothers may have a role in the risk of IARMs.     

Analgesic and anticonvulsant activity of new derivatives of 2-substituted 4-hydroxybutanamides in mice

Earlier in vitro studies of the compounds marked as GT27, GT28, GT29 and BM128 revealed their inhibitory action towards murine γ-aminobutyric acid (GABA) transporters (mGAT1-mGAT4). In the present paper, the pharmacological activity of four γ-hydroxybutyric acid (GHB) amide derivatives was investigated. The following procedures were involved: locomotor activity, hot plate and electroconvulsive threshold tests. The compounds' influence on motor coordination was evaluated in the chimney test, as well. Intraperitoneal (i.p.) administration of the GHB derivatives decreased animals' locomotor activity (ED(50) values ranged between 23.79 and 26.37 mg/kg). At a dose of 25 mg/kg (i.p.) the compounds prolonged the nociceptive reaction time latency in the hot plate assay to various degree and GT28 and GT29 were the most potent ones in this respect. Their analgesic efficacy was particularly pronounced 30 min after their administration [percent of maximal possible effect (%MPE) = 16.93 and 22.72, respectively]. The investigated GHB derivatives, except for GT29 at 100 mg/kg, increased the electroconvulsive threshold by approximately 4-11 mA as compared to the vehicle-treated mice. In the chimney test they impaired the animals' motor coordination to various degree. We suggest further investigations of the compounds to estimate their biological activity.     

Aggressive prolactinomas responsive to temozolomide treatment: Report of two cases

Refractory aggressive prolactinomas are detected after the unresponsiveness to conventional therapies. We report two cases that underwent temozolomide treatment and have been in near‐complete remission ever since. We suggest the pathology techniques for earlier detection and, subsequently, treatment with temozolomide to reduce morbidities and better respond to therapy.     

Report of two cases of myxoinflammatory fibroblastic sarcomas with preceding hematolymphoid neoplasms: Is there any association?

Myxoinflammatory fibroblastic sarcoma (MIFS) is an uncommon soft tissue sarcoma. We present two cases of MIFS: A known case of Hodgkin‘s lymphoma presented with hand mass; a recurrence of MIFS with a history of chronic lymphocytic leukemia.