Subungal Mixed Tumor Mimicking Glomus Tumor: A Case Report and Literature Review.

Mixed tumors are well-circumscribed lesions exhibiting epithelial and/or myoepithelial cells and they usually occur in the skin and salivary glands. Soft tissue mixed tumors are extremely rare. Therefore, radiographic findings of soft tissue mixed tumors have very rarely been described in the radiologic literature. Here, we report a rare case of subungual mixed tumor in a 65-year-old female who presented with left 2nd finger pain, describe the radiographic findings, and discuss the differential diagnosis of the tumor.

Molecular Recognition of Pyrophosphate with Extended Bis(Zn(II)-DPA) Derivatives.

A series of pyrophosphate (PPi) receptors were synthesized, and their binding affinities toward both PPi and adenosine triphosphate were evaluated in N-(2-hydroxyethyl)piperazine-N'-ethanesulfonic acid-buffered solution. The presence of two hydrogen bond donors slightly retarded the reaction rate of anionic guest exchange, while four had a significant retardation effect. A macrocyclic receptor, 17, exhibited superior selectivity toward PPi compared with acyclic receptors, presumably due to effective steric interactions. Isothermal titration calorimetry experiments and potentiometric titration experiments revealed the effect of the substituent structure on the degree of anion guest stabilization and the deprotonation of water molecules bound to zinc(II) ions, as well as the guest binding thermodynamics.

Epidemiologic Study of Shoulder Injuries in the PyeongChang 2018 Winter Olympic Games.

BACKGROUND: The purpose of this study is to describe and analyze the shoulder injuries in elite athletes during the 2018 Winter Olympics in Pyeongchang. METHODS: To collect the data of all Olympic athletes who visited venue medical centers, polyclinics, and Olympic-designated hospitals for shoulder injuries during the Olympic Games (February 9 through 25, 2018), we reviewed Olympic electronic medical records and patient information obtained from Olympic medical service teams about athletes who complained of shoulder pain. RESULTS: During the Olympics, a total of 14 athletes visited clinics for shoulder-related symptoms. Five athletes were injured in games and nine were injured in training. The injury was due to overuse in four patients. Ten patients had trauma-related symptoms: one after being hit by an opponent and the other nine after a collision with the ground or an object. There were no patients who complained of symptoms related to pre-existing shoulder conditions. The most common cause of shoulder pain was snow-boarding (one big air and three slopestyle). The most common diagnosis was contusion (n = 6), followed by rotator cuff injuries (n = 3), superior labrum from anterior to posterior lesion (n = 1), sprain (n = 1), acromioclavicular-coracoclavicular injury (n = 1), dislocation (n = 1), and fracture (n = 1). CONCLUSIONS: To the best of our knowledge, this study is the first epidemiologic study of shoulder injury conducted during a huge sports event involving a variety of competitions for elite athletes. If the risk factors of shoulder injury can be established by continuing research in the future, it will be helpful to prevent injury and to prepare safety measures for athletes.

Selenium-Containing Protein From Selenium-Enriched Spirulina platensis Attenuates Cisplatin-Induced Apoptosis in MC3T3-E1 Mouse Preosteoblast by Inhibiting Mitochondrial Dysfunction and ROS-Mediated Oxidative Damage.

Accumulated evidences have verified that cancer chemotherapy may increase the risk of osteoporosis and severely affected the life quality. Osteoclasts hyperactivation was commonly accepted as the major pathogenesis of osteoporosis. However, the role of osteoblasts dysfunction in osteoporosis was little investigated. Our previous study has confirmed that selenium-containing protein from selenium-enriched Spirulina platensis (Se-SP) exhibited enhanced hepatoprotective potential through inhibiting oxidative damage. Herein, the protective effect of Se-SP against cisplatin-induced osteoblasts dysfunction in MC3T3-E1 mouse preosteoblast was investigated, and the underlying mechanism was evaluated. The results indicated that cisplatin dramatically decreased cell viability of preosteoblast by triggering mitochondria-mediated apoptosis pathway. Cisplatin treatment also caused mitochondrial dysfunction and reactive oxide species (ROS)-mediated oxidative damage. However, Se-SP pre-treatment effectively prevented MC3T3-E1 cells from cisplatin-induced mitochondrial dysfunction by balancing Bcl-2 family expression and regulating the opening of mitochondrial permeability transition pore (MPTP), attenuated cisplatin-induced oxidative damage through inhibiting the overproduction of ROS and superoxide anion, and eventually reversed cisplating-induced early and late apoptosis by inhibiting PARP cleavage and caspases activation. Our findings validated that Se-SP as a promising Se species could be a highly effective way in the chemoprevention and chemotherapy of oxidative damage-mediated bone diseases.

Intraosseous epidermoid cyst discovered in the distal phalanx of a thumb: a case report.

Intraosseous epidermoid cyst is considered a rare benign inclusion cyst found mainly in the skull and phalanges. Once the cyst is differentiated from other similar lesions, the cyst can be treated with simple curettage, seldom requiring additional managements. We experienced this rare case that had been treated successfully without complication.

Primary cutaneous nocardiosis caused by Nocardia nova in a kidney transplant recipient.

Nocardia nova is a rare aetiological pathogen for cutaneous nocardiosis. To the best of our knowledge, this is the first case of N. nova primary cutaneous infection in a kidney transplant recipient. Identification was performed using 16S rRNA and secA1 gene sequence analyses. The patient was not treated successfully by antibiotics alone. Surgical debridement was required for successful treatment.

Relationship between the extent of labral lesions and the frequency of glenohumeral dislocation in shoulder instability.

PURPOSE: This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability. METHODS: Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups. RESULTS: The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels. CONCLUSION: The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.

Fracture-dissociation of ceramic liner.

The use of BIOLOX delta ceramic (CeramTec AG, Plochingen, Germany) has been increasing. This ceramic prevents cracking by restraining the phase transformation due to the insertion of nano-sized, yttria-stabilized tetragonal zirconia into the alumina matrix. This restrains the progress of cracking through the formation of platelet-like crystal or whiskers due to the addition of an oxide additive. We observed a case of BIOLOX delta ceramic liner (CeramTec AG) rim fracture 4 months postoperatively. Radiographs showed that the ceramic liner was subluxated from the acetabular cup. Scratches on the acetabular cup and femoral neck were seen, and the fracture was visible on the rim of the liner. Under electron microscope, metal particle coatings from the ceramic liner were identified. The ceramic liner, fracture fragments, and adjacent tissues were removed and replaced with a ceramic liner and femoral head of the same size and design. We believe the mechanism of the fracture-dissociation of the ceramic liner in this case is similar to a case of separation of the ceramic liner from the polyethylene shell in a sandwich-type ceramic-ceramic joint. To prevent ceramic liner fracture-dissociation, the diameter of the femoral neck needs to be decreased in a new design, while the diameter of the femoral head needs to be increased to ensure an increase in range of motion.

Morphological changes of collagen fibrils in the subsynovial connective tissue in carpal tunnel syndrome.

BACKGROUND: Pathologic changes occur commonly in the subsynovial connective tissue in patients with carpal tunnel syndrome. The purposes of this study were to investigate the ultrastructural changes of the subsynovial connective tissue in these patients and compare them with the findings in cadaver controls. METHODS: The diameter and density of collagen fibrils were measured by transmission electron microscopy in specimens of subsynovial connective tissue from ten patients with idiopathic carpal tunnel syndrome and from ten fresh-frozen cadavers of individuals without known symptoms of carpal tunnel syndrome. RESULTS: We noted deformed collagen fibrils with a spiraled appearance in the specimens from the patients. We also observed phagocytosis of elastin fibrils in all of those specimens. These changes were noted only rarely in the cadaver controls. The mean diameter (and standard deviation) of the collagen fibrils was 45.5 +/- 8.0 nm in the control group and 54.8 +/- 15.2 nm in the patient group (p < 0.05). The mean number of collagen fibrils per 0.04 microm2 (density) was 201.38 +/- 48.88 in the control group and 157.08 +/- 54.38 in the patient group (p < 0.05). CONCLUSIONS: These ultrastructural findings suggest that subsynovial collagen in patients with carpal tunnel syndrome is structurally different from that in individuals without carpal tunnel syndrome, but the processes resulting in that abnormal morphology remain to be elucidated.