Durable disease regression with copanlisib treatment in PI3K-mutated metastasizing ameloblastoma: A case report.

Ameloblastoma is a rare tumor arising from odontogenic cells that is benign, yet locally aggressive. Metastasizing ameloblastoma (METAM) is an ultra-rare ameloblastoma variant in which both primary and secondary tumors have histological features of benign ameloblastoma. This is a case report of a patient who presented with a jaw mass and subsequent lung metastases, later diagnosed as METAM.

Debriefing Among Hospice Professionals During a Pandemic.

Although the hospice industry cannot afford to lose professionals to compassion fatigue and burnout, work challenges related to the COVID-19 pandemic potentially place hospice professionals at an increased risk. Reflective debriefing has been recommended to provide emotional support to battle job dissatisfaction, compassion fatigue, and burnout. The purpose of this study was to provide reflective debriefing sessions to hospice professionals and identify common themes reported about their professional and personal experiences during the COVID-19 pandemic.

Autologous regulatory T-cell transfer in refractory ulcerative colitis with concomitant primary sclerosing cholangitis.

Objective: Ulcerative colitis (UC) is a chronic, debilitating immune-mediated disease driven by disturbed mucosal homeostasis, with an excess of intestinal effector T cells and an insufficient expansion of mucosal regulatory T cells (Tregs). We here report on the successful adoptive transfer of autologous, ex vivo expanded Tregs in a patient with refractory UC and associated primary sclerosing cholangitis (PSC), for which effective therapy is currently not available.

Design: The patient received a single infusion of 1×10 autologous, ex vivo expanded, polyclonal Tregs per kilogram of body weight, and the clinical, biochemical, endoscopic and histological responses were assessed 4 and 12 weeks after adoptive Treg transfer.

Key performance indicators for pre hospital emergency Anaesthesia - a suggested approach for implementation.

Background: Pre-hospital Emergency Anaesthesia (PHEA) is regarded as one of the highest risk interventions that pre-hospital providers perform. AAGBI guidance from 2017 suggests the use of Key Performance Indicators (KPIs) to audit PHEA quality. The aim of this study was to develop KPIs for use in our service and evaluate their impact.

Countertransference and Projective Identification Revisited and Applied to the Practice of Group Analytic Supervision.

Countertransference and projective identification are two concepts that are very useful when describing the dynamics of atmospheric processes and also more explicit issues in supervision groups. Researching both aspects of interpersonal relationship helps the group analyst to better identify and understand the emotional reactions in the group experience. However, it is important to see the different approaches of these two concepts.

Evidence-based practice in Behçet's disease: identifying areas of unmet need for 2014.

Background: Behçet's Disease (BD) is characterized by a relapsing-remitting course, with symptoms of varying severity across almost all organ systems. There is a diverse array of therapeutic options with no universally accepted treatment regime, and it is thus important that clinical practice is evidence-based. We reviewed all currently available literature describing management of BD, and investigated whether evidence-based practice is possible for all disease manifestations, and assessed the range of therapeutic options tested.

Myeloid angiogenic cells act as alternative M2 macrophages and modulate angiogenesis through interleukin-8.

Endothelial progenitor cells (EPCs) promote angiogenesis, and clinical trials have shown such cell therapy to be feasible for treating ischemic disease. However, clinical outcomes have been contradictory owing to the diverse range of EPC types used. We recently characterized two EPC subtypes, and identified outgrowth endothelial cells as the only EPC type with true progenitor and endothelial characteristics.

Soluble CD26 / dipeptidyl peptidase IV enhances human lymphocyte proliferation in vitro independent of dipeptidyl peptidase enzyme activity and adenosine deaminase binding.

Human CD26 has dipeptidyl peptidase-4 (DPP IV) enzyme activity and binds to adenosine deaminase (ADA). CD26 is costimulatory for lymphocytes and has a circulating soluble form (sCD26). DPP IV enzyme inhibition is a new successful type 2 diabetes therapy.

Innovative management of lupus erythematosus.

This article focuses on the management of discoid lupus erythematosus, subacute cutaneous lupus erythematosus, and systemic lupus erythematosus when the usual therapeutic arsenal such as oral antimalarial drugs and topical/oral steroids fail or provide insufficient treatment efficacy. Many of the treatments listed are the same or similar to each other because of similarities in the pathogenesis of various subtypes of cutaneous lupus. The clinical challenge is to determine the indications for topical versus systemic therapy, and to also identify the scenarios when combined therapy is necessary.

Y-box protein-1 is actively secreted through a non-classical pathway and acts as an extracellular mitogen.

Y-box protein (YB)-1 of the cold-shock protein family functions in gene transcription and RNA processing. Extracellular functions have not been reported, but the YB-1 staining pattern in inflammatory glomerular diseases, without adherence to cell boundaries, suggests an extracellular occurrence. Here, we show the secretion of YB-1 by mesangial and monocytic cells after inflammatory challenges.

A case-series of 29 patients with lichen planopilaris: the Cleveland Clinic Foundation experience on evaluation, diagnosis, and treatment.

Background: Lichen planopilaris results in scaling, atrophy, and permanent alopecia with scarring and is thought to be autoimmune in origin.

Objective: To evaluate the clinical findings of patients with LPP so as to aid in the evaluation and diagnosis of the disease and to review the current effective therapies.

Methods: We reviewed the medical records of 29 patients with LPP that were seen in the Department of Dermatology at The Cleveland Clinic Foundation between 1992 and 2003.

7. Language disorders and autism.

Early diagnosis of language disorders and autism is important, and early intervention for autism and some language disorders makes a difference. Developmental surveillance of children to detect these disorders should be a routine part of medical practice. The persistence and pervasiveness of communication and socialising deficits differentiate children with autism from those with specific developmental language disorders.

Glycation and glycoxidation of low-density lipoproteins by glucose and low-molecular mass aldehydes. Formation of modified and oxidized particles.

Patients with diabetes mellitus suffer from an increased incidence of complications including cardiovascular disease and cataracts; the mechanisms responsible for this are not fully understood. One characteristic of such complications is an accumulation of advanced glycation end-products formed by the adduction of glucose or species derived from glucose, such as low-molecular mass aldehydes, to proteins. These reactions can be nonoxidative (glycation) or oxidative (glycoxidation) and result in the conversion of low-density lipoproteins (LDL) to a form that is recognized by the scavenger receptors of macrophages.

Comparative time-courses of copper-ion-mediated protein and lipid oxidation in low-density lipoprotein.

Free radicals damage both lipids and proteins and evidence has accumulated for the presence of both oxidised lipids and proteins in aged tissue samples as well as those from a variety of pathologies including atherosclerosis, diabetes, and Parkinson's disease. Oxidation of the protein and lipid moieties of low-density lipoprotein is of particular interest due to its potential role in the unregulated uptake of lipids and cholesterol by macrophages; this may contribute to the initial stage of foam cell formation in atherosclerosis. In the study reported here, we examined the comparative time-courses of lipid and protein oxidation during copper-ion-mediated oxidation of low-density lipoprotein.

Clinical study of mitral valve repair: short-term and long-term outcomes.

Background: In recent years, mitral valve reconstructive techniques have become an increasingly preferential alternative to replacement. The purpose of this study was to evaluate short-term and long-term outcomes associated with mitral valve repair.

Methods: This study involved 99 patients who had mitral valve repair for mitral regurgitation from January 1990 to June 1996.

Effects of carbamazepine on cortical excitatory and inhibitory phenomena: a study with paired transcranial magnetic stimulation.

The effect of a single dose of oral carbamazepine on cortical facilitatory and inhibitory phenomena was investigated in 13 healthy human subjects by focal transcranial magnetic stimulation. Paired stimulation was performed via a figure-of-eight shaped magnetic coil using two Magstim-200 stimulators and a Bistim-interface at interstimulus intervals of 3, 10, and 17 ms. In addition, the silent period evoked by single focal transcranial stimuli during sustained voluntary muscle contraction was investigated without and with carbamazepine.

Pure stimulus-sensitive truncal myoclonus of propriospinal origin.

The clinical and electrophysiological features of stimulus-sensitive truncal myoclonus are described in a 49-year-old woman. Touching the skin of the back and abdomen would evoke jerks in both ipsilateral and contralateral axial muscles; there was no spontaneous jerking. Multichannel EMG recordings showed bilateral short-latency muscle bursts at truncal recording sites both rostral and caudal to stimulus sites.

Determination of the solution structure of a platelet-adhesion peptide of von Willebrand factor.

Two-dimensional nuclear magnetic resonance (NMR) spectroscopy in combination with distance geometry (DG) and dynamical simulated annealing (DSA) calculations have been used to determine the tertiary solution structure of a synthetic 29-residue fragment of von Willebrand factor (vWF). This fragment (D514-E542) represents an adhesion site on vWF for its platelet receptor, the glycoprotein Ib-IX complex (GP Ib-IX). The NMR data yielded 109 interproton distance measurements and two chi 1 dihedral angle constraints for use in DG and DSA calculations.

Morbidity and mortality of coronary bypass grafting in patients 70 years of age and older.

The hospital mortality and major factors contributing to hospital morbidity and postoperative length of stay were examined in 597 consecutive patients 70 years of age and older who underwent isolated coronary artery bypass grafting (CABG) between January, 1978, and December, 1983. The mean age of the patients was 73 years, and 66% were men. Unstable angina was present in 59% of patients, left main coronary disease in 13%, and moderate or severe left ventricular dysfunction in 10%.

Heparin dose for accurate anticoagulation in cardiac surgery.

A simplified technique relating individual heparin dose to desired anticoagulant effect was used in 152 patients during cardiac surgery. Activated clotting time (act) was measured by semi-automated technique (Hemochron) before and after heparin, 200 U/kg I.V.

Transient cerebral ischemic attacks associated with worn porcine heterograft prosthesis. Case report.

Details are reviewed of a case of transient cerebral ischemic attacks which probably resulted from thromboembolism from a Hancock porcine heterograft prosthesis. Cause of the embolism probably was thrombus formation on the worn cloth covering of the supporting valve stent. Technical and antomic factors which assure precise seating of the prosthesis in the mitral anulus without contacting the ventricular wall appear to be important in preventing this complication.

Hypoplastic left heart syndrome. Experience with an operation to establish functionally normal circulation.

A new operation to establish functionally normal circulation was performed in five neonates with hypoplastic left heart syndrome. With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the patent ductus arteriosus was ligated. The atrial septum was excised and the atrium was repartitioned with a pericardial baffle so that pulmonary veins were in continuity with the tricuspid valve and right ventricle.

Experimental bypass of the left ventricle.

Bypass of the left ventricle was accomplished in dogs and the entire circulation was supported temporarily by only the right ventricle. The atrial septum was excised, and the atrium was repartitioned so that the pulmonary veins were in continuity with the right ventricle and the venae cavae were connected through the atrium. Anastomosis of the superior vena cava to the right pulmonary artery brought systemic venous return directly to the lungs.