Case Report: Management of Primary Tracheobronchial Light Chain Amyloidosis in a Patient With Biclonal Gammopathy Using a Systemic Bortezomib-Based Regimen

Primary tracheobronchial light chain (AL) amyloidosis is a rare and heterogeneous disease characterized by the buildup of amyloid deposits in the airway mucosa. Although its treatment remains challenging, the current view is that the localized form can be treated conservatively due to its slow progression. While radiotherapy has proven effective in treating localized form of the disease, some patients do not respond to local treatment and continue to experience poor quality of life, highlighting the need to explore additional treatment strategies. In this report, we discuss a case of primary tracheobronchial AL amyloidosis with biclonal gammopathy (IgA κ and IgG κ) in a 46-year-old man who was transferred to our hospital due to dyspnea progression over the preceding 3 years. Chest computed tomography revealed irregular tracheobronchial stenosis with wall thickening, and histological examination of the bronchial biopsies confirmed the diagnosis of endobronchial AL amyloidosis. Owing to the poor effect of radiation therapy and treatments for improving airway patency, he was treated with a systemic chemotherapy regimen [cyclophosphamide-bortezomib-dexamethasone (CyBorD)]. We observed substantial improvements in his dyspnea, highlighting the potential of systemic therapy to improve quality of life of patients with tracheobronchial AL amyloidosis. However, the long-term pathological changes associated with local bronchial lesions require further investigation.

Characterization of Chlorhexidine-Impregnated Cellulose-Based Hydrogel Films Intended for the Treatment of Periodontitis

Periodontitis comprises a chronic inflammation that is initiated by microbiota biofilm. If left untreated, periodontitis may lead to permanent tooth loss. Herein, we propose to design and improve a localized form of therapy comprising a chlorhexidine-impregnated hydrogel. Hydrogel films were prepared by varying the ratio between cellulose (MCC) and carboxymethylcellulose sodium (CMC) using the crosslinker epichlorohydrin (ECH). The hydrogel was loaded with chlorhexidine. Increasing the CMC ratio led to a reduction in the number of pores, an increase in their size, lower glass transition temperature ( T g ), decreased Young’s modulus, and increased film stretching and affected the time of release. Bacterial and fungal zones of inhibition showed similar activity and were not affected by the CMC and MCC ratio. Hydrogels loaded with chlorhexidine prevented the growth of S. oralis and C. albicans microorganisms and may provide a promising local delivery system for treating periodontitis.

Paint brush hair: a case report

<p class="abstract">Trichorrhexis nodosa (TN) is an hair shaft disorder presenting with whitish nodes all over the hair (diffuse form) or localized to an area (localized form) and could be either congenital or acquired. TNis ultimately a response to physical or chemical trauma that leads to formation of nodes along the hair shaft. Here, we reported a case of TNof the beard, diagnosed clinically and through trichoscopy. Patient was advised to shave his beard hair and to avoid brushing completely. On follow-up, the patient was symptomatically better. Based on this, TNof the beard was confirmed.</p>

LOW-PRESSURE PNEUMOPERITONEUM WITH ABDOMINAL ELEVATION IN LAPAROSCOPIC RADICAL PROSTATECTOMY IN ELDERLY PATIENTS WITH A LOCALIZED FORM OF PROSTATE CANCER

Рак предстательной железы является актуальной проблемой у мужчин старших возрастных групп, при этом сопутствующий преморбидный фон данной категории пациентов зачастую приводит к развитию послеоперационных осложнений при применении стандартного оперативного метода. В статье приведены результаты применения пневмоперитонеума низкого давления с лифтингом передней брюшной стенки при лапароскопической радикальной простатэктомии у пациентов пожилого возраста с локализованной формой рака предстательной железы. Убедительно показано, что использование этой методики позволяет обеспечить удовлетворительное операционное поле, получить стабильные показатели операционного мониторинга и при этом уменьшить длительность самого оперативного пособия, а также уменьшить длительность госпитализации и частоту встречаемости послеоперационных осложнений. Prostate cancer is an actual problem among males of older age groups, while the concomitant pre-morbid background of this category of patients often leads to the development of postoperative complications using the standard surgical method. The article presents the results of using low-pressure pneumoperitoneum with anterior abdominal wall lifting for laparoscopic radical prostatectomy in elderly patients with a localized form of prostate cancer. Convincingly shown that the use of low-pressure techniques pneumoperitoneum with lifting anterior abdominal wall ensures satisfactory operating field, obtains stable indicators of operational monitoring and allow to reduce the duration of the operation, as well as reduce the duration of hospitalization and incidence of postoperative complications.

Prevalence of Dental Fluorosis among Southern Jordanian Population

Introduction. Jordan is one of the Middle Eastern countries that is classified as a poor water resource country. People in Jordan consume any available water. In the south of Jordan, water resources are limited. The drinking water contains high levels of fluoride, which in turn leads to augmented danger of both skeletal and dental fluorosis. Aims. This study is focused on evaluating the pervasiveness of dental fluorosis among patients of Karak City and assessing the degree and distribution of fluorosis. Materials and Methods. This research focuses on 2,512 patients ranging from 12 to 52 years old seeking dental treatment in the Dental Department at “Prince Ali ben Al Houssin Hospital” in Karak City. Dental fluorosis status was assessed by using Modified Dean’s Fluorosis Index.” The data collected were subjected to statistical analysis. Results. The dental fluorosis prevalence within our sample was 39.9% in Karak City. Females were more influenced than males, and fluorosis was detected more often in those who drank tap water and was more common in a very mild and localized form. Conclusion. Fluorosis necessitates constant observation, and future study in terms of the intake in Jordan is recommended in terms of all sources. It would not be too soon to note that the supply of drinking water needs to be changed in South Jordan.

ZEB1 as an additional predictor of tumor progression in Ewingʼs sarcoma. Results of a morphological study on a population of children and adolescents

Relevance. Ewingʼs sarcoma (ES) is a classic representative of the extensive family of ES tumors, which occupies one of the leading positions among the malignant pathology of the musculoskeletal system in children and adolescents. This group is characterized by an extremely large variety of morphological, immunohistochemical, and molecular genetic characters among its representatives. The absence of specific pathognomonic markers for ES, as well as the presence of wide variability of clinical manifestations complicates the differential diagnosis. Materials and methods. The study included patients of childhood and adolescence with a localized and generalized form of ES/PNEТ of various localizations undergoing treatment in the conditions of the Department of Pediatric Oncology of the Federal State Budgetary Research Center for Oncology from 2009 to 2019. As the material, the tissue of the primary tumor of ES/PNEТ from paraffin blocks was used, obtained from 67 patients during the primary biopsy, as well as after the surgical stage as part of a combined or complex treatment. The expression of ZEB1 was determined immunohistochemically.Results. The highest average level of expression of ZEB1 protein was observed in group 4 with a generalized form of ES (surgical material) and amounted to 60.8 ± 2.2 %, the minimum level was detected in group 2 with a localized form of ES (surgical material) and amounted to 29.2 ± 3.0 %. Between groups 2 (localized form) and 4 (generalized form) statistically significant differences were noted (p = 0.026).Conclusion. As a result of an immunohistochemical study, the ZEB1 protein showed its prognostic significance when comparing groups with a localized and generalized form of ES (p = 0.026). The predominance of the expression level of ZEB1 protein in the group with the generalized form statistically significantly increased the chances of metastasis by 3.6 times (95 % CI 1.13-11.8).

The membrane-associated form of cyclin D1 enhances cellular invasion

The essential G1-cyclin, CCND1, is a collaborative nuclear oncogene that is frequently overexpressed in cancer. D-type cyclins bind and activate CDK4 and CDK6 thereby contributing to G1–S cell-cycle progression. In addition to the nucleus, herein cyclin D1 was also located in the cytoplasmic membrane. In contrast with the nuclear-localized form of cyclin D1 (cyclin D1NL), the cytoplasmic membrane-localized form of cyclin D1 (cyclin D1MEM) induced transwell migration and the velocity of cellular migration. The cyclin D1MEM was sufficient to induce G1–S cell-cycle progression, cellular proliferation, and colony formation. The cyclin D1MEM was sufficient to induce phosphorylation of the serine threonine kinase Akt (Ser473) and augmented extranuclear localized 17β-estradiol dendrimer conjugate (EDC)-mediated phosphorylation of Akt (Ser473). These studies suggest distinct subcellular compartments of cell cycle proteins may convey distinct functions.

Laryngeal Amyloidosis: A Case Report

Introduction: laryngeal amyloidosis is an uncommon localized form of amyloidosis. The clinical symptomatology is not specific, and the diagnosis should be evoked in a persistent dysphonia.Case report: A 45-year-old patient who had consulted for dysphonia lasting for 2 years. The nasofibroscopy showed an infiltrative lesion of the vocal cords. The laryngeal biopsy was performed and revealed laryngeal amyloidosis. Search for other locations were negative.Conclusion: dysphonia is the most common symptom of laryngeal amyloidosis. Monitoring is extended because of the risk of recurrence and systemic dissemination.

Rare Localization of a Giant Cell Tumor of the Synovial Sheaths of the Hand: Thenar Lodge with Compression of the Median Nerve

The synovial sheath cell tumor (TCGGS) represents the localized form of hemo pigmented villonodular synovitis, which remains a rare tumor in our practice. It occurs mainly in young adults with a predominance of women. It mainly affects the fingers of the hand, its location at the level of the thenar compartment is very rare. Clinically, it has a local expression, which can be summarized as a swelling characterized by slow growth and which may be accompanied by signs of compression at a late stage. An anatomo-pathological examination remains the key element in diagnosis and prognosis. Treatment is based on surgery with complete tumor removal. We report the case of TCGGS of the thenar compartment with compression of the median nerve.

Chubby Infant – Should One Worry? An Infant with Primary lymphedema – Mini Review and Case Report

Lymphedema is a localized form of tissue swelling, characterized by a progressive accumulation of a tissue fluid in the interstitial compartment as a result of the lymphatic system dysfunction. It is a rare disease in the pediatric population and in the majority of cases it is a consequence of an abnormal formation of the lymphatic system, which is called primary lymphedema. Although its epidemiology is not precise, it is assumed that 1:100 000 children suffer from primary lymphedema. The diagnosis can be made by a proper clinical examination after ruling out secondary causes of lymphedema, particularly in cases with a more asymmetric swelling of the extremities. In this very article we present a case report of an 8-months-old infant with primary lymphedema, who had presented swelling of the extremities from birth and yet no pathology was suspected before. The purpose of this article is to draw attention to the fact that a baby with excessive subcutaneous tissue is not always a healthy, chubby infant with considerable amount of fat tissue.