Symmetrical bronchial pattern with normal atrial morphology

An infant with trisomy 21 and tracheostenosis is described. Postmortem findings included symmetrical bronchi, normal atrial arrangement (“situs”) and anomalous thoracic vessels. The lack of concordance between the bronchial morphology and atrial arrangement supports the premise that atrial morphology is a more accurate predictor of the presence or absence of the isomerism syndromes.     

颅顶骨萎缩症的影像诊断

患者，女，57岁。双侧顶骨凹陷多年，凹陷渐深，为排除恶性病变摄头颅正侧位片检查。体检：局部皮肤毛发正常，双侧顶骨区凹陷变形，局部无压痛。神经系统检查无异常。X线所见：头颅前后位片（图1）双侧顶骨对称性碟状凹陷长约6cm，部在距中线向两侧约2.5cm处开始。     

蛋白质甲基转移酶的结合蛋白在肺癌组织中的表达

目的探讨蛋白质甲基转移酶的结合蛋白在肺癌组织中的表达。方法采用蛋白质免疫杂交（Westernblot）方法,利用H4R3sme2抗体检测11例肺癌病人组织样品当中的组蛋白H4R3对称性双甲基化（H4R3sme2）水平。结果发现11例肺癌患者组织样品中,组蛋白H4R3对称性双甲基化（H4R3sme2）水平癌组织都比癌旁组织有显著提高。结论发现在所有肺癌组织中H4R3sme2修饰水平都有显著提高,表明PRMT5在调控肺癌发生中是通过促进组蛋白H4R3sme2的表观遗传修饰,抑制肺癌细胞中抑癌基因的表达,诱导肺癌发生。     

Symmetrical Pouch Dilatation After Laparoscopic Adjustable Gastric Banding: Incidence and Management

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) has commonly been complicated by the problem of band slippage or prolapse. Since popularization of the pars flaccida approach and improved anterior fixation, it is our impression that the problem of symmetrical dilatation of the proximal gastric pouch has become more important. METHODS: We have reviewed the results of a series of 425 LAGB all performed by the pars flaccida approach from June 2003 to October 2007 to analyze the incidence and implications of this new pattern. RESULTS: There were no posterior prolapses, 2 anterior prolapses, and 17 cases of symmetrical pouch dilatation (SPD) (revision rate 4.4%). Teenage patients had a 22% revision rate for SPD. All revisions were completed laparoscopically with no mortality, no significant complications, and a median hospital stay of 1 day. The median weight loss following revisional surgery was not significantly different from the background cohort. CONCLUSION: SPD is the most common reason for revision of LAGB in this series. We postulate that SPD is caused by excessive pressure in the proximal gastric pouch. This may be generated either by eating too quickly or too large a volume or excessive tightening of the band. The radial forces in the pouch may ultimately cause pressure on the phrenoesophageal ligament and a secondary hiatal hernia.     

COVID-19 associated symmetrical peripheral gangrene: A case series

Background and aimsThe novel coronavirus disease (COVID-19) caused by SARS-CoV-2 has turned the world topsy-turvy since its onset in 2019. The thromboinflammatory complications of this disease are common in critically ill patients and associated with poor prognosis. Symmetrical peripheral gangrene (SPG) is characterized by symmetrical distal gangrene in absence of any large vessel occlusion or vasculitis and it is usually associated with critical illness. Our aim was to report the clinical profile and outcome of patients diagnosed with SPG associated with COVID-19. To the best of our knowledge, no such similar cases have been reported till date.MethodsIn this case series, we have discussed the clinical presentation, laboratory parameters and outcome in a series of two patients of SPG associated with COVID-19 and also compared those findings. Due to paucity of data, we also reviewed the literature on this under-diagnosed and rarely reported condition and association.ResultsTwo consecutive patients (both males, age range: 37–42 years, mean: 39.5 years) were admitted with the diagnosis of COVID-19 associated SPG. Both patients had clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Leucopenia was noted in both patients. Despite vigorous therapy, both patients succumbed to their illness within a fortnight of admission.ConclusionSPG in the background of COVID-19 portends a fatal outcome. Physicians should be aware of its grim prognosis.     

Mechanism of the antialcohol effect of gamma-hydroxybutyric acid

Treatment with gamma-hydroxybutyric acid has been reported to effectively decrease alcohol craving and consumption as well as alcohol withdrawal symptoms in alcoholics. We describe the results of animal studies demonstrating the ability of gamma-hydroxybutyric acid to reduce (1) the severity of ethanol withdrawal signs in rats rendered physically dependent on ethanol and (2) voluntary ethanol intake in selectively bred Sardinian alcohol-preferring rats. Furthermore, we review experimental data suggesting that gamma-hydroxybutyric acid and ethanol have several pharmacological effects in common. Relevant similarities are: (1) stimulation of firing rate of dopaminergic neurons and dopamine release in specific rat brain areas; (2) development of cross-tolerance to the motor-impairing effects after repeated administration in rats; 3) abuse potential, as indicated by self-administration of pharmacologically relevant doses of gamma-hydroxybutyric acid in rats and mice; (4) induction of anxiolytic effects in rats; and (5) induction of similar discriminative stimulus effects, as evidenced by symmetrical generalization in a drug discrimination study in rats. These lines of evidence are discussed in relation to gamma-hydroxybutyric acid exerting its antialcohol effects by a substitution mechanism.     

Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) syndrome in an elderly Spanish patient: Ruling-out polymyalgia rheumatica and management

BackgroundThe Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) syndrome is a rare rheumatological disorder of the elderly with pitting edema and tenosynovitis of the hands as notable features.Aim of the workThis case report presents an elderly male patient with RS3PE without arthritis after ruling out polymylagia rheumatica (PMR) or any associated malignancy.Case presentationA 73-year-old white man presented to the Hospital of Navarra, Spain with pain and weakness in both upper extremities, predominantly in wrists, associated with symmetrical swelling of dorsum of both hands of two months duration. The patient was febrile (37.5 °C) had pitting edema in both hands, with no signs of arthritis, associated with shoulder girdle muscles weakness without pelvic involvement. The lower limbs and feet were not involved. The differential diagnosis of PMR was raised adding to the clinical diagnostic dilemma. Erythrocyte sedimentation rate was 66 mm/1st hour and C-reactive protein 126.4 mg/L. Extended diagnostic work showed negative autoimmune biomarkers with normal complement. No joint erosion was found on plain x-ray radiography of the affected joints. Thoracic and abdominal CT scan was performed with no evidence of a neoplastic disease. The patient was finally diagnosed with RS3PE showing a rapid response to low doses of prednisone (20 mg/day) and without any further flares on follow up.ConclusionRS3PE could be diagnosed even without polyarthritis and successfully treated by low dose steroids after excluding any related malignancy. Excluding PMR is important to avoid exposing the patient to unwanted higher steroid doses.     

Mesomorphic Behavior of Symmetrical and Unsymmetrical Azomethines with Two Imine Groups

Seven symmetrical azomethines with two imine groups (HC=N) were synthesized by condensation of the benzene-1,4-dicarboxaldehyde with five amines (first group: A1-A5) and of the 2,5-thiophenedicarboxaldehyde with two amines (second group: AT1-AT2). Additionally, two unsymmetrical azomethines were obtained by a two step condensation of benzene-1,4-dicarboxaldehyde with pyren-1-amine (1^st step) (abbreviated hereinafter as AP1) and then AP1 was reacted with 4-dodecylaniline or 4-hexadecylaniline (2^nd step) (third group: AP1A-AP1B). Liquid crystalline properties of the azomethines were studied by differential scanning calorimetry (DSC), polarizing optical microscopy (POM) and UV-vis spectroscopy in the function of temperature [UV-vis(T)]. The Wide-Angle X-ray Diffraction (WAXD) technique was used to probe the structural properties of the azomethines. Mesomorphic behavior was observed for symmetrical and unsymmetrical azomethines, obtained from the benzene-1,4-dicarboxaldehyde and symmetrical ones prepared from 2,5-thiophenedicarboxaldehyde and different amines having aliphatic chains. Based on the POM and DSC measurements the following mesophases were detected: nematic, smectic A, smectic C, smectic F (I), smectic G (J).     

下颌第三磨牙阻生类型同体两侧对称性研究

目的研究下颌第三磨牙阻生类型同体左、右对称性。方法收集186例下颌第三磨牙拔除病例数据。所有患者进行临床检查并拍摄曲面断层片。按照Pell—Gregory升支分类、Pell—Gregory牙争平面分类和Winter分类对左、右两侧下颌第三磨牙阻生类型分别进行分类。对两侧下颌第三磨牙阻生类型进行描述性统计分析和Speaman相关分析。结果三种阻生类型两侧完全对称者95例，占51．1％；任意两种阻生类型两侧均对称，另一种不对称者占19．9％；三种阻生类型中仅一种两侧对称，另两种不对称者占14．5％；三种阻生类型两侧均不对称者占14．5％。两侧下颌第三磨牙Pell—Gregory升支分类（r=0．51，P=0．01）、Pell—Gregory铪平面分类（r=0．41，P=0．01）和Winter分类（r=0．48，P=0．01）均有显著相关性，将每侧下颌第三磨牙三种阻生类型合并，两侧也具有显著相关性r=0．67，P=0．01）。结论同体两侧下颌第三磨牙阻生类型具有对称性，一侧下颌第三磨牙的阻生类型、临床病理以及治疗方案对另一侧具有指导意义。