Unicentric Portocaval Castleman Disease in an Adolescent: Challenges in Diagnosis and Management.

Castleman disease is an unusual, benign disorder of unknown etiology, characterized by the proliferation of the lymphoid tissue. It can have a unicentric or multicentric presentation, depending on the number of lymph nodes involved. On clinical examination and imaging, it can imitate a malignancy and the diagnosis can only be confirmed on histopathological examination. Retroperitoneal location and presentation in the pediatric age group are extremely rare. We report a case of an adolescent girl with a unicentric lymph nodal mass in the portocaval space which was completely excised.

(E)-4-(1,3-Benzodioxol-5-yl)but-3-en-2-one.

In the title compound, C(11)H(10)O(3), the benzodioxole ring adopts a flattened [puckering parameters: q(2) = 0.107 (2) Å, ϕ(2) = 160 (1)°] envelope conformation with the methylene C atom as the flap. The crystal packing features chains, parallel to the c axis, composed of dimers connected by weak C-H-O hydrogen bonds and extending in layers in the bc plane.

A comparative evaluation of cyclic fatigue resistance of FlexiCON (Edge Endo) files in rotary versus reciprocating motion at various curvatures - An in vitro study.

AIM: The aim of the study to compare the cyclic fatigue resistance of FlexiCON (Edge Endo) files in rotary versus reciprocating motion in coronal, middle, and apical curvature of the simulated artificial canal. MATERIALS AND METHODS: A total number of 36 new files, 25 mm length of ISO size 25 at the tip and a taper of 0.06, were used for the study and divided into two groups of 18 files each. Group I: FlexiCON X3, was used in a rotary motion and Group II: FlexiCON X1 was used in a reciprocating motion. Cyclic fatigue testing was conducted in a custom-made device that allowed for a reproducible simulation of a curved canal. The canal system, which comprised two adjustable stainless steel blocks, had a 60° angle of curvature and 3 mm width. The groups were further divided into three subgroups with six files in each, representing apical curvature (Group Ia/IIa), middle curvature (Group Ib/IIb), and Coronal curvature (Group Ic/IIc). Using X-Smart plus motor, files were used in rotary and reciprocating mode and the number of cycles to failure was recorded. STATISTICAL ANALYSIS: Data were analyzed using ANOVA and Post hoc followed by Dunnett's test and unpaired t-test using Statistical Package for the Social Sciences 16 version. RESULTS: FlexiCON X1 reciprocating files showed the maximum cyclic fatigue resistance at coronal curvature (1936.50 ± 1.09) followed by middle (1514.50 ± 1.07) and apical curvature (1487.50 ± 6.75), while FlexiCON X3 rotary files showed the maximum cyclic fatigue at the middle curvature (1106.00 ± 4.21), followed by coronal (920.00 ± 1.16) and apical curvature (757.00 ± 5.34). The statistical analysis revealed a statistically significant difference (P = 0.001) between the two groups. CONCLUSION: FlexiCON X1 reciprocating files showed better cyclic fatigue resistance at coronal, middle, and apical curvature compared to FlexiCON X3 rotary files.

Endothelial cell loss and central corneal thickness in patients with and without diabetes after manual small incision cataract surgery.

PURPOSE: Cataract surgery is known to change the corneal endothelial cell density and morphology. In patients with diabetes, this change is more pronounced. This prospective cohort study was conducted to assess and compare the endothelial cell loss and change in central corneal thickness (CCT) after manual small incision cataract surgery (SICS) in patients with diabetes versus age-matched patients without diabetes. METHODS: Consecutive patients with diabetes (153) in the age group 40-70 years and age-matched patients without diabetes (163) undergoing manual SICS were enrolled. Preoperative and 1 week, 6 weeks, and 3 months postsurgery assessments of corneal endothelial loss and change in CCT were done using specular microscopy and ultrasound pachymetry. RESULTS: There was a steady drop in the endothelial density in both the groups postoperatively, with the percentage of endothelial loss at 6 weeks and 3 months being 9.26 ± 9.55 and 19.24 ± 11.57, respectively, in patients with diabetes and 7.67 ± 9.2 and 16.58 ± 12.9, respectively, in controls. The percentage of loss between 6 weeks and 3 months was found to be of significant difference (P < 0.023). In both the groups, an initial increase in CCT till the second postoperative week was followed by a reduction of CCT in the subsequent follow-up (sixth week) and a further reduction in the last follow-up (3 months). The change in CCT between the second and sixth weeks was significantly higher in the diabetic group (P = 0.045). CONCLUSIONS: The diabetic endothelium was found to be under greater metabolic stress and had less functional reserve after manual SICS than the normal corneal endothelium.

Stereoselective synthesis of complex polycyclic aziridines: use of the Brønsted acid-catalyzed aza-Darzens reaction to prepare an orthogonally protected mitomycin C intermediate with maximal convergency.

A concise synthesis of a highly functionalized intermediate lacking only C10 of the mitomycin backbone is described. The key to this development is the Brønsted acid-catalyzed aza-Darzens reaction used to forge the cis-aziridine. Additionally an oxidative ketalization fortuitously occurs during the quinone-enamine coupling step, leading to an orthogonally protected hydroquinone.