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2021 ◽  
Vol 15 (1) ◽  
Yojiro Ishikawa ◽  
Rei Umezawa ◽  
Takaya Yamamoto ◽  
Noriyoshi Takahashi ◽  
Kazuya Takeda ◽  

Abstract Background Desmoid-type fibromatosis is a rare disease that can result in hydronephrosis. Hydronephrosis associated with desmoid-type fibromatosis often requires surgery or ureteral stent insertion. Although radiation therapy is recommended for inoperable cases of desmoid-type fibromatosis, there has been no report of treatment for hydronephrosis associated with desmoid-type fibromatosis by radiation therapy alone. We herein report a case of successful treatment for inoperable recurrence of desmoid-type fibromatosis with unilateral hydronephrosis by radiation therapy alone. Case presentation A 43-year-old Japanese female underwent resection of desmoid-type fibromatosis in the right inguinal region and combined resection of the right external iliac vein 5 years before. Other treatment was not performed because of her pregnancy. Four years after surgery, desmoid-type fibromatosis recurred in the right pelvic wall. Cyclooxygenase-2 selective inhibitor treatment was given for 1 year, but her desmoid-type fibromatosis enlarged to more than 10 cm, and she had swelling of her right leg and hydronephrosis of her right kidney. The patient received 50.4 Gy in 28 fractions of prophylactic irradiation using 10 MV X-ray and 9 Gy in five fractions of a sequential boost for the recurrent desmoid-type fibromatosis. Although there was temporary tumor progression at 1 month after radiation therapy, slow regression of the tumor was seen. At 5 years after radiation therapy, there was no disease progression or severe complications. Conclusion We experienced successful treatment for an inoperable case of desmoid-type fibromatosis with hydronephrosis. Moderate-dose radiation therapy alone is an effective and feasible approach for the management of hydronephrosis associated with desmoid-type fibromatosis.

2021 ◽  
Vol 16 (4) ◽  
pp. 649-660
Barbara Gnidovec Stražišar

2022 ◽  
Vol 174 ◽  
pp. 106468
Walmer Bruno Rocha Martins ◽  
Julia Isabella de Matos Rodrigues ◽  
Victor Pereira de Oliveira ◽  
Sabrina Santos Ribeiro ◽  
Welton dos Santos Barros ◽  

2021 ◽  
Laurence Jones ◽  
Marco Boeri ◽  
Mike Christie ◽  
Isabelle Durance ◽  
Karl L. Evans ◽  

2021 ◽  
Paulina Lyskawa ◽  
Rodrigo Ranero

Abstract We investigate optional predicate agreement in Santiago Tz’utujil (Mayan). Several generalizations emerge: (i) inanimate arguments base-generated as complements control agreement optionally; (ii) some animate arguments base-generated as complements control agreement optionally; (iii) all arguments base-generated as specifiers control full agreement obligatorily. We propose that two conditions must be met for the operation Agree to succeed, resulting in the exponence of all the features of the agreement controller. First, a goal must be visible (bear the right feature). Second, a goal must be accessible (be in the right structural position). If one or both conditions are not met, Agree fails, but the derivation converges and 3sg agreement is exponed. While Agree is deterministic, surface optionality arises when the operation fails. We use optional agreement to diagnose the syntactic structure of understudied constructions in Mayan (nominalizations, Agent Focus). We discuss microvariation, highlighting methodological considerations that arise when assuming an I-language approach.

2021 ◽  
pp. 1-21
Tomas Ros ◽  
Abele Michela ◽  
Anaïs Mayer ◽  
Anne Bellmann ◽  
Philippe Vuadens ◽  

Abstract Stroke frequently produces attentional dysfunctions including symptoms of hemispatial neglect, which is characterized by a breakdown of awareness for the contralesional hemispace. Recent studies with functional MRI (fMRI) suggest that hemineglect patients display abnormal intra- and interhemispheric functional connectivity. However, since stroke is a vascular disorder and fMRI signals remain sensitive to nonneuronal (i.e., vascular) coupling, more direct demonstrations of neural network dysfunction in hemispatial neglect are warranted. Here, we utilize electroencephalogram (EEG) source imaging to uncover differences in resting-state network organization between patients with right hemispheric stroke (N = 15) and age-matched, healthy controls (N = 27), and determine the relationship between hemineglect symptoms and brain network organization. We estimated intra- and interregional differences in cortical communication by calculating the spectral power and amplitude envelope correlations of narrow-band EEG oscillations. We first observed focal frequency-slowing within the right posterior cortical regions, reflected in relative delta/theta power increases and alpha/beta/gamma decreases. Secondly, nodes within the right temporal and parietal cortex consistently displayed anomalous intra- and interhemispheric coupling, stronger in delta and gamma bands, and weaker in theta, alpha, and beta bands. Finally, a significant association was observed between the severity of left-hemispace search deficits (e.g., cancellation test omissions) and reduced functional connectivity within the alpha and beta bands. In sum, our novel results validate the hypothesis of large-scale cortical network disruption following stroke and reinforce the proposal that abnormal brain oscillations may be intimately involved in the pathophysiology of visuospatial neglect.

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Shinya Ishizuka ◽  
Akinori Kobayakawa ◽  
Hideki Hiraiwa ◽  
Hiroki Oba ◽  
Takefumi Sakaguchi ◽  

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.

2021 ◽  
Vol 21 (1) ◽  
Makiko Ueda ◽  
Kuniaki Ota ◽  
Toshifumi Takahashi ◽  
Satoshi Suzuki ◽  
Daisuke Suzuki ◽  

Abstract Background Pregnancy in a rudimentary horn is an extremely rare type of ectopic pregnancy. A rudimentary uterine horn pregnancy is associated with a risk of spontaneous rupture and bleeding during surgery due to the increased uterine blood flow. Recent advances in imaging modalities have enabled laparoscopic surgery to be performed in cases without rupture in the early stages of pregnancy. However, there are few reports of successful pregnancies and deliveries after treatment of rudimentary horn pregnancies. We report the successful management of a case of non-communicating rudimentary horn pregnancy by local injection of methotrexate followed by complete laparoscopic excision along with a review of the literature. Case presentation The patient was a 29-year-old Japanese woman, gravida 2, nullipara. She was diagnosed with a left unicornuate uterus with a right non-communicating rudimentary horn on hysterosalpingography and magnetic resonance imaging. A gestational sac with a heartbeat was observed in the right rudimentary uterine horn at 6 weeks of gestation. A diagnosis of ectopic pregnancy in a non-communicating rudimentary horn was made. Color Doppler detected multiple blood flow signals around the gestational sac, which were clearly increased compared to the left unicornuate uterus. Her serum human chorionic gonadotropin level was 104,619 mIU/ml. A 100 mg methotrexate injection into the gestational sac was administered, and laparoscopic surgery was performed on day 48 after the methotrexate treatment. The right rudimentary horn and fallopian tube were successfully excised with minimal bleeding. A spontaneous normal pregnancy was established 6 months after the surgery. The pregnancy was uneventful, and a baby girl was born by elective cesarean section at 38w0d. Conclusion Combined local methotrexate injection and laparoscopic surgery are safe treatment options for patients with a unicornuate uterus with a non-communicating rudimentary horn pregnancy.

2021 ◽  
Vol Publish Ahead of Print ◽  
Mark D. Sullivan ◽  
Jane C. Ballantyne

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