An Infant-Type Hemispheric Glioma With SOX5::ALK: A Novel Fusion.

Infant-type hemispheric glioma (IHG) is a rare pediatric brain tumor with variable response to chemotherapy and radiotherapy. Molecular insights into IHG can be useful in identifying potentially active targeted therapy. A male fetus was found to have congenital hydrocephalus at the gestational age of 37 weeks. Fetal MRI showed a 2.6 × 2.0-cm tumor located at the frontal horn of the left lateral ventricle, involving the left basal nuclei and thalamus. Tumor biopsy at the age of 2 days revealed an IHG consisting of spindle tumor cells with strong expression of GFAP and ALK. Targeted RNA sequencing detected a novel fusion gene of SOX5::ALK. After initial chemotherapy with cyclophosphamide, carboplatin, and etoposide for 2 cycles, the tumor size progressed markedly and the patient underwent a subtotal resection of brain tumor followed by treatment with lorlatinib, an ALK tyrosine kinase inhibitor with central nervous system (CNS) activity. After 3 months of treatment, reduction of tumor size was observed. After 14 months of treatment, partial response was achieved, and the infant had normal growth and development. In conclusion, we identified a case of congenital IHG with a novel SOX5::ALK fusion that had progressed after chemotherapy and showed partial response and clinical benefit after treatment with the CNS-active ALK inhibitor lorlatinib.

Immune-mediated diseases after vaccinations with AZD1222, BNT-162b2, &/or mRNA-1273: An observational investigation of 78 patients.

BACKGROUND: Immune-mediated diseases (IMDs) after nucleic acid-based vaccines have been sporadically reported since their introduction during the worldwide COVID-19 crisis. Confirming their cause-effect association remains challenging. We analysed the effects of AZD1222 (ChAdOx1 nCoV-19), BNT-162b2, and/or mRNA-1273 on the development &/or deterioration of IMDs in terms of the time of clinical onsets of IMDs after exposure to these vaccines. METHODS: We retrospectively reviewed 78 in-patients in Taipei Veterans General Hospital, who presented with IMDs within 120 days after receiving AZD1222, BNT-162b2, &/or mRNA-1273 vaccinations in Taiwan from May 2021 to April 2022. The duration from inoculation to development of IMD was analysed by two-tailed Kolmogorov-Smirnov (K-S) test for goodness of fit. RESULTS: The average time to new IMDs or flare-up of the diseases following vaccinations was 36 ± 26 days for all 91 events in these 78 patients. The onset time of IMDs after vaccinations was not haphazard as analysed by two-tailed K-S test for overall 91 events (40 new and 51 deteriorating episodes, p < 0.001). The IMDs presenting as non-connective tissue diseases (non-CTDs) have a shorter duration of incubation after vaccinations than those of CTDs (<14.7 days, 95 % confidence interval [CI], 3.0 to 26.4, p = 0.014). Furthermore, systemic vasculitis and type 2 inflammatory diseases were observed exclusively in those receiving AZD1222. CONCLUSION: AZD1222, BNT-162b2, or mRNA-1273 influence the activities of IMDs in ways yet to be explored. High index of suspicion to IMDs after nucleic acid-based vaccine inoculation against COVID-19 may be important for primary care physicians.

Influence of maxillary antrolith on the clinical outcome of implants placed simultaneously with osteotome sinus floor elevation: A retrospective radiographic study.

BACKGROUND: Large antroliths and those located adjacent to the sinus floor can affect clinical interventions and increase the difficulty of implant placement performed simultaneously with osteotome sinus floor elevation surgery. PURPOSE: This retrospective study investigated the clinical outcomes of implants placed simultaneously with osteotome sinus floor elevation subjacent to maxillary antroliths. MATERIAL AND METHODS: Twenty implants inserted subjacent to or intruding into the antrolith after sinus floor elevation were evaluated in 18 patients. Cone-beam computed tomography (CBCT) was used to measure antrolith size and membrane thickness at sites of osteotome sinus floor elevation. Periapical radiographs were used to assess the height of grafted bone. Generalized estimating equation (GEE) analysis was performed to correlate the occurrence of antroliths with patient background characteristics and dental outcomes, based on a sample population of 239, among whom 33 presented antroliths. RESULTS: The 20 implants remained clinically stable over a mean follow-up period of 42.4 months. The mean thickness of the sinus membrane at osteotome sites was 5.4 ± 3.3 mm. None of the cases presented sinus membrane perforation or sinus symptoms following osteotome intervention. The mean gain in the height of grafted sinus bone was 4.0 ± 1.4 mm at the last follow-up. The occurrence of antroliths was higher among females and the elderly (>49 years old). The multivariable GEE analysis showed that the adjusted odds ratio for the occurrence of antroliths with root canal fillings was significantly lower than those without root canal fillings (odds ratio = 0.33; 95% confidence interval = 0.11-0.96). CONCLUSION: Our findings indicate that osteotome sinus floor elevation is a surgical procedure with a risk <17%. Thorough planning based on CBCT and careful management during surgery can eliminate the negative effects of antroliths on implant performance.

Comparison of flap outcomes between single- and multiple-perforator-based free anterolateral thigh flap in head and neck reconstruction.

INTRODUCTION: The number of perforators required for safe perfusion remains under debate. This study aimed to determine whether a single- or multiple-perforator-based anterolateral thigh flap yields better flap outcomes in head and neck reconstruction. PATIENTS AND METHODS: Between August 2012 and July 2016, 180 men and 4 women with a mean age of 52.8 ± 9.8 years underwent head and neck anterolateral thigh flap reconstruction for oncologic defect in 181 cases, plate exposure in two cases, and trismus release in one case. The flap was patched for inner or external lining, folded for through-through defect, or tubed for cervical esophageal reconstruction. Of 184 flaps, 136 (73.9%) were based on multiple perforators (range, 2-5 perforators), whereas 48 (26.1%) were based on a single perforator. The demographics, operative findings, and flap outcomes were compared. RESULTS: The prevalence of systemic diseases between groups was comparable. The mean flap size in the single-perforator group was smaller (92.8 ± 36.8 vs. 140.5 ± 99.9 cm2 , P < .0001). Twenty-one flaps (11.4%) required emergency take-back and 13 (61.9%) were successfully salvaged. Eight flaps failed, yielding a 95.7% flap survival rate. The single-perforator group had a significantly higher rate of emergency take-back for vascular compromise (8/48 (16.7%) vs. 8/136 (5.9%), P = .035), a decreased salvage success rate (2/8 (25.0%) vs. 11/13 (84.6%), P = .018), and a corresponding lower flap survival rate (42/48 (87.5%) vs. 134/136 (98.5%), P = .004). CONCLUSION: Whenever possible, we recommend including multiple cutaneous perforators in anterolateral thigh flaps to yield better flap outcomes in head and neck reconstruction.

Locked Thumb Metacarpophalangeal Joint Caused by Entrapment of the Sesamoid Bone: A Report of 2 Cases.

Locked thumb metacarpophalangeal joint caused by entrapment of the sesamoid bone is an uncommon entity. The intact volar plate, strong ligamentous attachment between the sesamoid bone and the joint, and altered axis of inserted muscle all contribute to failure of closed reduction. The patient's history, clinical presentation, and plain radiographic findings are all important clues to diagnosing this rare disease. We describe 2 patients with a similar mechanism of injury, where the sesamoid bones were displaced into the thumb metacarpophalangeal joint causing lock thumb. The anatomy, pathophysiology, and surgical management of the patients are also described and discussed. Both patients were successfully treated with meticulous open reduction.

Pilot-scale study on the acid-catalyzed steam explosion of rice straw using a continuous pretreatment system.

A continuous acid-catalyzed steam explosion pretreatment process and system to produce cellulosic ethanol was developed at the pilot-scale. The effects of the following parameters on the pretreatment efficiency of rice straw feedstocks were investigated: the acid concentration, the reaction temperature, the residence time, the feedstock size, the explosion pressure and the screw speed. The optimal presteaming horizontal reactor conditions for the pretreatment process are as follows: 1.7 rpm and 100-110 °C with an acid concentration of 1.3% (w/w). An acid-catalyzed steam explosion is then performed in the vertical reactor at 185 °C for 2 min. Approximately 73% of the total saccharification yield was obtained after the rice straw was pretreated under optimal conditions and subsequent enzymatic hydrolysis at a combined severity factor of 0.4-0.7. Moreover, good long-term stability and durability of the pretreatment system under continuous operation was observed.

Ischemic postconditioning protects liver from ischemia-reperfusion injury by modulating mitochondrial permeability transition.

BACKGROUND: We tested the effectiveness of ischemic postconditioning (iPoC) in mitigating ischemia-reperfusion (I/R) injury of liver and the mechanism involves inhibiting the opening of the mitochondrial permeability transition pore (mPTP). METHODS: iPoC, performed by three cycles of 1 min I/R of the liver, was tested on a partial liver I/R model on rats. The serum alanine transaminase levels, terminal deoxynucleotidyl transferase dUTP nick-end labeling staining, cytochrome c release, the formation of 4-hydroxy-2-nonnenal-modified proteins, and mitochondrial membrane potential (Δψm) were measured. Atractyloside (ATR) and NIM811, which modify the opening of mPTP, were administered in selected groups. RESULTS: iPoC, and NIM811, diminished the elevation of serum alanine transaminase level after I/R injury (174.0±28.3 U/L for iPoC; 94.3±25.4 U/L for control+NIM811) when compared with others (416.3±16.7 U/L for control, 557.0±86.7 U/L for iPoC+ATR, P<0.05). The expressions of cytosolic cytochrome c after I/R injury were decreased in iPoC and control+NIM811 groups when compared with others. After I/R, the apoptosis and the 4-hydroxy-2-nonnenal-modified proteins were attenuated in iPoC group when compared (apoptotic counts/50 HPF: 723.3±98.7 for iPoC, 1274±201.2 for control, 1057.6±39 for iPoC+ATR, P<0.05). The Δψm measured by flow cytometry was better preserved in iPoC and NIM811 groups. CONCLUSIONS: iPoC attenuated cell deaths after I/R injury of liver. The protective effects were negated by the addition of ATR--a mPTP opener--and mimicked by injection of NIM811--a mPTP opening inhibitor. The study indicated iPoC conferred protection by modulating mPTP.

When Pinocchio acts like a human, a wooden hand becomes embodied. Action co-representation for non-biological agents.

Action observation automatically activates corresponding motor representations in the observer, which is essential in coordinating actions with others. It is assumed that this co-representation system is activated by biological agents only. However, we often identify with biological agents, whereas this is not the case for non-biological agents. The present study investigated whether action co-representation depends on the perceived animacy of the non-biological interaction partner. Before performing a joint Simon task with either an animated image of a human or a wooden hand, participants either watched a video fragment of a biological agent, or of a non-biological agent, Pinocchio, to increase perceived animacy of this agent. Whereas participants who watched the 'biological' agent showed a Simon effect only when co-acting with a biological agent, participants who watched 'non-biological' agent (i.e. Pinocchio) showed a Simon effect only when co-acting with a non-biological agent. The present findings provide evidence for the assumption that motor simulation strongly depends on higher order processes.

Action co-representation is tuned to other humans.

The present study attempts to explore the process by which knowledge of another's intentional behavior in a joint-action scenario is represented through the action observation and execution network-also known as the common coding system. Participants (n = 18) were instructed to perform the complementary social Simon task under the implemented belief of interaction with either an unseen human (biological agent) or a computer program, where in fact, all response sequences from either "partner" were generated by computer. Results provide behavioral and neurophysiological evidence (P3 and S-LRP) that the believed intentionality of another person's actions is sufficient to facilitate a strong-enough agency-dependent social Simon effect to modulate action planning and anticipation. We suggest that the co-representation of human action may be an evolved biologically tuned default of the human motor system.

Does the human motor system simulate Pinocchio's actions? Coacting with a human hand versus a wooden hand in a dyadic interaction.

Corepresenting actions performed by conspecifics is essential to understanding their goals, inferring their mental states, and cooperating with them. It has recently been demonstrated that joint-action effects in a Simon task provide a good index for corepresentation. In the present study, we investigated whether corepresentation is restricted to biological agents or also occurs for nonbiological events. Participants performed a Simon task either with an image of a human hand or with a wooden analogue. The Simon-like effect emerged only when participants coacted with a biological agent. The lack of the joint-action effect when participants interacted with a wooden hand indicates that the human corepresentation system is biologically tuned.

A common coding framework in self-other interaction: evidence from joint action task.

Many of our actions are influenced by the social context. Traditional approach attributes the influence of the social context to arousal state changes in a socially promotive way. The ideomotor approach, which postulates common coding between perceived events and intended actions, uses a conceptual scheme of ideomotor compatibility to explain self-other interaction. In this study, we recorded reaction times (RTs) and event-related potentials in a Go/NoGo task with stimulus-response (S-R) compatibility arrangement to examine how the social context affects self-other interaction. Although the social facilitation theory predicted that RTs would be faster when acting together with audience rather than acting alone, the ideomotor theory predicted S-R compatibility effects only for the joint condition. The results revealed S-R compatibility on the RTs, lateralized readiness potential of the Go trials, and P3 of the NoGo trials in the joint condition, which were in line with the predictions of the ideomotor theory. Owing to the anticipation of other's actions, self and other's actions are internally and unintentionally coded at the representational level and their functional equivalency can be realized through a common coding framework between perception and action systems. Social facilitation theory was not supported, because we found no significant data differences depending on the setting.