Repairing of recurrent leg ulcer induced by hydroxyurea with posterior tibial artery perforator propeller flap: Case report.

INTRODUCTION AND IMPORTANCE: Hydroxyurea is a cytotoxic drug commonly used to treat various myeloproliferative disorders. However, prolonged oral administration of this drug may trigger skin side effects and ulcers. There are few clinical reports on treating leg ulcers caused by hydroxyurea and even fewer clinical reports on managing recurrent ulcers after treatment. CASE PRESENTATION: An 87-year-old woman with essential thrombocythemia presented with a painful skin ulcer on her left calf. After failed outpatient treatment, she opted for hospitalisation for free skin grafting. Four months later, ulcers reappeared at the transplant site, leading to her readmission to the hospital. The diagnosis revealed that the leg ulcers were caused by hydroxyurea. Despite this, she persisted with hydroxyurea treatment and subsequently underwent posterior tibial artery perforator flap surgery. During the two-year follow-up, a new ulcer developed on the medial condyle of her other calf. However, no new ulcers or local pain were observed in the area where perforator flap grafting was performed. CLINICAL DISCUSSION: Leg ulcers caused by hydroxyurea are rare clinically and can easily be misdiagnosed. There is currently minimal research on ulcer recurrence after treatment. Posterior tibial perforator flaps may more effectively promote the healing of recurrent ulcers. CONCLUSION: Compared to conservative treatment and skin grafting surgery, the posterior tibial artery perforator flap offers a dependable blood supply and enhances the likelihood of wound healing. It can be considered an option, particularly for recurrent and refractory ulcers, even without discontinuing medication.

Estimating intrafraction tumor motion during fiducial-based liver stereotactic radiotherapy via an iterative closest point (ICP) algorithm.

BACKGROUND: Tumor motion may compromise the accuracy of liver stereotactic radiotherapy. In order to carry out a precise planning, estimating liver tumor motion during radiotherapy has received a lot of attention. Previous approach may have difficult to deal with image data corrupted by noise. The iterative closest point (ICP) algorithm is widely used for estimating the rigid registration of three-dimensional point sets when these data were dense or corrupted. In the light of this, our study estimated the three-dimensional (3D) rigid motion of liver tumors during stereotactic liver radiotherapy using reconstructed 3D coordinates of fiducials based on the ICP algorithm. METHODS: Four hundred ninety-five pairs of orthogonal kilovoltage (KV) images from the CyberKnife stereo imaging system for 12 patients were used in this study. For each pair of images, the 3D coordinates of fiducial markers inside the liver were calculated via geometric derivations. The 3D coordinates were used to calculate the real-time translational and rotational motion of liver tumors around three axes via an ICP algorithm. The residual error was also investigated both with and without rotational correction. RESULTS: The translational shifts of liver tumors in left-right (LR), anterior-posterior (AP),and superior-inferior (SI) directions were 2.92 ± 1.98 mm, 5.54 ± 3.12 mm, and 16.22 ± 5.86 mm, respectively; the rotational angles in left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions were 3.95° ± 3.08°, 4.93° ± 2.90°, and 4.09° ± 1.99°, respectively. Rotational correction decreased 3D fiducial displacement from 1.19 ± 0.35 mm to 0.65 ± 0.24 mm (P<0.001). CONCLUSIONS: The maximum translational movement occurred in the SI direction. Rotational correction decreased fiducial displacements and increased tumor tracking accuracy.

Roles of microRNA-206 in osteosarcoma pathogenesis and progression.

BACKGROUND AND AIMS: MicroRNA-206 has proven to be down-regulated in many human malignancies in correlation with tumour progression. Our study aimed to characterize miR-206 contributions to initiation and malignant progression of human osteosarcoma. METHODS: MiR-206 expression was detected in human osteosarcoma cell line MG63, human normal osteoblastic cell line hFOB 1.19, and paired osteosarcoma and normal adjacent tissues from 65 patients using quantitative RT-PCR. Relationships of miR-206 levels to clinicopathological characteristics were also investigated. Moreover, miR-206 mimics and negative control siRNA were transfected into MG63 cells to observe effects on cell viability, apoptosis, invasion and migration. RESULTS: We found that miR-206 was down-regulated in the osteosarcoma cell line MG63 and primary tumor samples, and decreased miR-206 expression was significantly associated with advanced clinical stage, T classification, metastasis and poor histological differentiation. Additionally, transfection of miR-206 mimics could reduce MG- 63 cell viability, promote cell apoptosis, and inhibit cell invasion and migration. CONCLUSIONS: These findings indicate that miR-206 may have a key role in osteosarcoma pathogenesis and development. It could serve as a useful biomarker for prediction of osteosarcoma progression, and provide a potential target for gene therapy.

Improved citation status of World Journal Gastroenterology in 2004: Analysis of all reference citations by WJG and citations of WJG articles by other SCI journals during 1998-2004.

AIM: To determine the citation status in 2004 and the citation trend of WJG by analyzing all articles cited by WJG and all WJG articles cited by SCI journals during 1998-2004. METHODS: The total number of published articles and reference citations in WJG, authors' self-citations, WJG's self-citations, citations of WJG articles by SCI journals and inappropriate citations in WJG during 1998-2004 were statistically analyzed. Data on self-citations of the articles published between 1998 and August 2004 (Issues 1-16) were from ISI SCI-E, and data on self-citations of articles published after August 2004 (Issues 17-24) were from the WJG Editorial Office. Data on citations of WJG articles by other journals between 1998 and August 2004 were from ISI SCI-E. RESULTS: Annual number of published articles: WJG published 179, 144, 211, 174, 236, 634 and 830 articles, respectively, in 1998, 1999, 2000, 2001, 2002, 2003 and 2004. The number in 2004 increased by 594, compared to that in 2002, giving an increased rate of 251.7%. Annual references cited by WJG were 2 123, 2 125, 6 244, 8 883, 11 442, 23 218 and 25 971, respectively, in 1998-2004. The average number was 31.3 per WJG article in 2004, which was less than that (48.5) in 2002, giving a reduction rate of 35.5%. Authors of WJG cited 125, 126, 343, 210, 354, 310 and 470 of their own published articles, respectively, in 1998-2004. The average number of authors' self-citations was 0.57 per WJG article in 2004, which was decreased by 0.93 or 62.0%, compared with that in 2002. Annual numbers of journal's self-citations: Authors of WJG articles cited 5, 7, 373, 733, 1474, 1947 and 1412 of WJG articles, respectively, in 1998-2004. The average number of journal's self-citations was 1.70 per WJG article in 2004, which decreased by 4.55 or 72.8%. No WJG article was cited in 1998 by other SCI journals. However, the number of citations steadily increased afterwards, with 16, 18, 39, 85, 372 and 580, respectively, in 1999-2004. The average number of citations by other SCI journals was 0.11, 0.09, 0.22, 0.36, 0.59 and 1.06 per WJG article, respectively, 1999-2004 (January-August). There was an increase by 582%, when comparing the citation numbers between 2004 and 2002. Annual WJG self-citation rates and citation rates of WJG articles by other SCI journals: WJG self-citation rates were 30.43%, 95.40%, 95.07%, 94.55%, 83.96% and 67.47%, respectively, in 1999-2004 (January-August). Compared with 2002, the self-citation rate in 2004 decreased by 26.87%. The citation rates of WJG articles by other SCI journals were 69.57%, 4.60%, 4.93%, 5.45%, 16.04%, and 32.53%, respectively, in 1999-2004 (January-August). Compared with 2002, the citation rate in 2004 decreased by 26.87%. There were 8, 19, 218, 274, 461, 698 and 574 inappropriate citations, respectively, in 1998-2004. The average inappropriate citation in 2004 was 0.69 per article, which represents a decrease of 1.26, compared with that in 2002. Inappropriate citations were mostly those with the differences between the two sides of the hyphens of 5-9, and the proportions of inappropriate citations within the three subsections of the differences between the two sides of the hyphens (5-9, 10-19, and >=20) were approximately 7:2:1. In addition, inappropriate citations mostly occurred with frequencies of 1-3 in the articles, and the proportion of inappropriate citations within the two frequency subsections (1-3 and >3) have been approximately 4:1 since 1999. CONCLUSIONS: In 2004, the average number of reference citations, authors' self-citations and journal's self-citations were 31.3, 0.57 and 1.70 per article, respectively, which represents a decrease in the numbers by 35.5%. 62.0%, and 72.8% respectively compared to the corresponding numbers in 2002. WJG self-citation rate was 67.47% in 2004 (January-August), which was a decrease by 26.87%, compared with 2002. The citation rate of WJG articles by other SCI journals was 32.53% in 2004 (January-August), an increase of 26.87%, compared to 2002. There were 574 inappropriate citations in 2004, with an average of 0.69 per article, which represents a decrease of 1.26, compared with that in 2002. These figures demonstrate that the overall citation status of WJG is improving.