Comparative Transcriptomic Analyses of Peripheral Blood Mononuclear Cells of COVID-19 Patients without Pneumonia and with Severe Pneumonia in the First Year of Follow-Up.

The multisystemic effects of COVID-19 may continue for a longer time period following the acute phase, depending on the severity of the disease. However, long-term systemic transcriptomic changes associated with COVID-19 disease and the impact of disease severity are not fully understood. We aimed to investigate the impact of COVID-19 and its severity on transcriptomic alterations in peripheral blood mononuclear cells (PBMCs) following 1 year of the disease. PBMCs were isolated from the peripheral blood of healthy control donors who did not have COVID-19 (C; n = 13), from COVID-19 patients without pneumonia (NP; n = 11), and from COVID-19 patients with severe pneumonia (SP; n = 10) after 1-year of follow-up. Following RNA isolation from PBMCs, high-quality RNAs were sequenced after creating a library. Differentially expressed genes (DEGs) and differentially expressed long non-coding RNAs (DElncRNAs) were identified using Benjamini-Hochberg correction and they were analysed for hierarchical clustering and principal component analysis (PCA). Intergroup comparisons (C vs. NP, C vs. SP, and NP vs. SP) of DEGs and DElncRNAs were performed and hub genes were determined. Functional enrichment analyses of DEGs and DElncRNAs were made using Metascape (v3.5.20240101) and the first version of NCPATH. The RNA sequencing analysis revealed 4843 DEGs and 1056 DElncRNAs in "C vs. NP", 1651 DEGs and 577 DElncRNAs in "C vs. SP", and 954 DEGs and 148 DElncRNAs in "NP vs. SP", with 291 DEGs and 70 DElncRNAs shared across all groups, respectively. We identified 14 hub genes from 291 DEGs, with functional enrichment analysis showing upregulated DEGs mainly linked to inflammation and osteoclast differentiation and downregulated DEGs to viral infections and immune responses. The analysis showed that 291 common and 14 hub genes were associated with pneumonia and that these genes could be regulated by the transcription factors JUN and NFκB1 carrying the NFκB binding site. We also revealed unique immune cell signatures across DEG categories indicating that the upregulated DEGs were associated with neutrophils and monocytes, while downregulated DEGs were associated with CD4 memory effector T cells. The comparative transcriptomic analysis of NP and SP groups with 52 gene signatures suggestive of IPF risk showed a lower risk of IPF in the SP group than the NP patients. Our findings suggest that COVID-19 may cause long term pathologies by modulating the expression of various DEGs, DeLncRNAs, and hub genes at the cellular level.

Relationship between nailfold capillaroscopy findings and the etiology and prognosis of interstitial lung disease.

OBJECTIVES: Connective tissue-associated interstitial lung diseases (CTD-ILD) are believed to be caused by microvascular damage. The objective of this study was to assess the nailfold capillaroscopy (NFC) pattern in patients diagnosed with both CTD-ILD and non-CTD-ILD to identify microvascular changes and determine the relation between capillaroscopic parameters, clinical variables, and disease-related measurements. PATIENTS AND METHODS: This cross-sectional study included 95 patients with interstitial lung disease who applied to our Rheumatology and Chest Clinics between September 2021 and July 2023. The patients were divided into two groups based on their diagnosis: non-CTD-ILD (group 1) and CTD-ILD (group 2). Nailfold capillaroscopy was performed. RESULTS: Ninety-five patients, 49 (51% female, mean age 62.31 ± 11.027 years) in group 1 and 46 (69.6% female, mean age 62.09 ± 10.887 years) in group 2, were included in the study. Abnormal capillary morphologies were both detected in the CTD-ILD group and the non-CTD-ILD groups. In patients with a usual interstitial pneumonia (UIP) pattern on chest computed tomography (CT), tortuosity was higher than in patients with non-specific interstitial pneumonia (NSIP) (P = 0.041), and the proportion of tortuosity increased significantly as the duration of the disease increased (P = 0.016). CONCLUSION: Our study highlights capillaroscopic abnormalities alone may not be sufficient to differentiate CTD-ILD (other than systemic sclerosis) from non-CTD-ILD. The presence of NFC abnormalities in non-CTD-ILD may suggest that fibrotic lung disease could potentially play a role in the deterioration of the microvascular structure or abnormal angiogenesis. Our study demonstrated that a multidisciplinary approach, incorporating clinical, morphological, pathological, and serological evaluations, is necessary for interpreting ILD. Key Points • Capillaroscopic abnormalities can also be seen in non-CTD-ILD. • Capillaroscopy findings do not distinguish the non-Ssc etiology of ILD. • Nailfold capillaroscopy may have the potential to serve as a useful tool in predicting prognosis and monitoring the disease progression in patients with idiopathic pulmonary fibrosis (IPF).

Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey.

BACKGROUND: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. METHODS: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The sociodemographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. RESULTS: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 ± 52.6 days, 39.0 ± 52.7 days for radiologic staging, and 74.9 ± 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of patients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. CONCLUSION: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer.

A Postpartum Immigrant with Pulmonary, Pleural, and Intestinal Tuberculosis.

Intestinal tuberculosis is a rare extrapulmonary condition and mainly involves the ileocecal region. Most of the patients with tuberculosis during the postpartum period present with extrapulmonary involvement. The postpartum period has a higher risk of the reactivation of tuberculosis due to changes in the immune system. We present the case of a 22-year-old postpartum immigrant patient, with pulmonary, pleural, and intestinal tuberculosis with intestinal perforation. Due to the nonspecific symptoms of intestinal tuberculosis, clinical suspicion is extremely important.

Elderly idiopathic pulmonary fibrosis patients remain on therapy despite higher incidence of adverse events and dose reductions.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) predominantly affects people over the age of 60 years and its incidence increases with age. Limited data is available on the use of antifibrotics in the elderly IPF population. We aimed to examine the tolerability and safety of antifibrotics (pirfenidone, nintedanib) in elderly patients with IPF in a real-world setting. METHODS: Medical records of 284 elderly (≥75 years) and 446 non-elderly IPF patients (<75 years) were retrospectively analyzed in this multi-center study. Patient characteristics, treatments, adverse events (AEs), tolerability, hospitalizations, exacerbations, and mortality were compared between the elderly and non-elderly group. RESULTS: In the elderly group, the mean age was 79 years and the mean antifibrotic treatment duration was 26.1 months. The most commonly reported AEs were weight loss, loss of appetite and nausea. Elderly IPF patients had a significantly higher incidence of AEs (62.9% vs. 55.1%, p = 0.039) and dose reductions (27.4% vs. 18.1%, p = 0.003) than the non-elderly did, but the rate of discontinuation of antifibrotics was not different between groups (13% vs. 10.8%, p = 0.352). In addition, the severity of the disease, frequency of hospitalizations, exacerbations, and mortality rates were higher in elderly patients. CONCLUSION: The present study showed that elderly IPF patients experienced significantly increased AEs and dose reductions due to antifibrotic use, while the discontinuation rates of the drugs were similar to those of drugs used by non-elderly patients.

Microvascular damage evaluation based on nailfold videocapillarosopy in sarcoidosis.

OBJECTIVES: Microvascular damage is thought to play a role in the pathogenesis of sarcoidosis. We aimed to evaluate the nailfold capillaroscopy (NVC) pattern to detect microvascular changes in patients with sarcoidosis and the relationship of capillaroscopic parameters with clinical variables and disease-related measurements. PATIENTS AND METHODS: Forty-two patients with sarcoidosis and 42 age- and sex-matched patients with systemic sclerosis (SSc) and healthy individuals were included in this cross-sectional case-control study. Patients aged 18-80 years who met the current American Thoracic Society criteria for sarcoidosis were included. NVC was performed by a digital microscope under a magnification of × 200. Capillary density, number of dilated, giant and neoangiogenic capillaries, capillary loop diameter, capillary shape, micro-hemorrhages, and number of avascular areas, were evaluated by an assessor who was blind to the groups allocation. RESULTS: Among the capillaroscopic parameters, neoangiogenesis and dilated capillaries, which can be seen in the pattern of scleroderma, were detected in patients with sarcoidosis but not significantly different from the control group (p = 0.055; p = 0.433, respectively). The rate of tortuosity and crossing capillaries of 50% and above was significantly higher in the sarcoidosis group than in SSc and healthy controls (p < 0.05). In patients with sarcoidosis, the only statistically significant finding was; forced expiratory volume (FEV1) in one second was lower in patients with a crossed capillary rate > 50% than in patients with a crossed capillary rate of less than 50% (FEV1; 87.21 ± 19.3, 102.5 ± 14.8, p = 0.04; respectively). CONCLUSION: Patients with a diagnosis of sarcoidosis have different capillaroscopic patterns. The presence of these nonspecific abnormal patterns may reflect microvascular damage in the pathophysiology of sarcoidosis. Key Points • Microvascular damage may play a role in the pathogenesis of sarcoidosis. • There may be some nonspecific abnormal findings in capillaroscopy findings in sarcoidosis. • Capillaroscopy may be valuable in reflecting sarcoidosis lung injury.

Smoking Cessation Success and Affecting Factors in Geriatric Patients.

Background: There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey. Methods: Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given. Results: Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women. Conclusion: Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging.

Characteristics and outcomes of COVID-19 patients with IPF: A multi-center retrospective study.

BACKGROUND: There are few data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) infection in patients with idiopathic pulmonary fibrosis (IPF). The objective of this study is to describe the characteristics and outcomes of IPF patients confirmed COVID-19 infection. METHODS: In this retrospective, multi-center, cohort study, patients from 4 hospital medical records with known IPF and a COVID-19 diagnosis were identified. Demographic and clinical outcome data were abstracted through a review of electronic medical records. RESULTS: Records for 46 patients with IPF and COVID-19 were abstracted. The mean age was 65±10 years. The most common symptom was dyspnea, followed by fever and cough. Ground-glass opacities (n = 35, 83.3%) and consolidations (n = 11, 26.1%) were the main imaging features of the disease in thorax computed tomography (CT). Twenty-four patients (52.1%) required hospitalization. Among the hospitalized patients, 16 (66.6%) were admitted to the intensive care unit (ICU), and 10 (41.6%) underwent invasive mechanical ventilation. Thirteen patients (28.2%) died of COVID-19 complications. Mortality rate was significantly associated with lower DLCO/VA, long term oxygen therapy and consolidation finding on CT of thorax (p<0.05). On multivariable analysis, neither factor was associated with hospitalization or mortality. CONCLUSIONS: IPF patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, ICU requirement, and mortality rate. Measures to minimize the risk of COVID-19 infection remain key to protect IPF patients.

Primary Antibody Deficiencies With Pulmonary Complications: A Single-Center Experience.

Background Primary immunodeficiencies are a heterogeneous group of genetic diseases caused by one or more abnormalities in the immune system. Although pulmonary complications are common in patients with primary immunodeficiency diseases, these complications contribute significantly to morbidity and mortality. Aim The aim of our study was to evaluate the distribution of the features of pulmonary radiological involvement and demographic findings in this patient group. Materials and methods The files of patients who were treated and followed up with the diagnosis of primary immunodeficiency between 2014 and 2021 were analyzed retrospectively. Demographic data, symptoms, additional diseases, and computed tomography findings of the patients were recorded. Results The mean age of 32 cases was 37.34±13.54 (20-69) and the age of diagnosis was 28.90±15.75 (1-62). Twenty of the cases were male and 10 were female. The most common symptom was diarrhea with 53.1% and cough with 34.4%. The most common radiological finding is bronchiectasis in 75% of cases. Twenty-one (65.6%) of the cases had recurrent pneumonia before diagnosis and no pneumonia was observed after intravenous immunoglobulin replacement therapy. Three of the cases (9.4%) died during the follow-up. Conclusions Primary immunodeficiency should be considered in patients with bronchiectasis and a history of recurrent pneumonia, and further investigations should be performed. Early diagnosis of patients with primary immunodeficiency is very important for the early detection and treatment of malignancy and the interstitial lung disease that may develop.

COVID-19: vaccination vs. hospitalization.

OBJECTIVE: Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. SETTING: Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. METHODS: We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. RESULTS: We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. CONCLUSION: Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.

Masculinity, femininity, and angry drivers: Masculinity and femininity as moderators between driver anger and anger expression style among young drivers.

Driver anger and its expression are among the most studied topics in traffic safety literature. However, the function of gender roles, i.e., masculinity and femininity, in driving anger experience and expression has remained mainly unexplored. The present study investigates the association between driving anger and gender roles on the expression of anger among young drivers. Three hundred seventy-nine young drivers filled a questionnaire including the Driving Anger Scale, Bem Sex Roles Inventory, Driving Anger Expression Inventory, and demographic information. Moderated regression analyses showed that masculine gender role and anger provoked by other road users' discourtesy were positively and femininity negatively related to verbal aggression while driving. Anger related to police presence, slow driving, and masculine gender role were positively related to gesture-based and vehicle-based expression of driver aggression. Hostility and feminine gender role were negatively related to the gesture-based expression of driver aggression, while anger related to witnessing illegal driving and feminine gender role were negatively related to the vehicle-based expression of aggression. The interaction effects between masculinity and hostility, masculinity and slow driving, and femininity and illegal driving were also found on the gesture-based expression of driver aggression. The effects of interaction between masculinity and slow driving and femininity and illegal driving were also found on the vehicle-based expression of driver aggression. Slow driving and femininity had a positive relationship to the adaptive expression of anger in driving. The results suggest that masculinity and femininity moderate the relationship between driving anger and the expression of driving anger among young drivers.

Corticosteroid use in COVID-19 pneumonia.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has a 1-2% fatality rate, where no specific treatment has yet been defined. Although corticosteroids are recommended for selected COVID-19 patients without acute respiratory distress syndrome (ARDS) and septic shock, there is no consensus regarding patient subgroups, dose, and duration. In this study, it was aimed to examine the contribution of corticosteroid treatment to the management of COVID-19 pneumonia without ARDS, septic shock both in acute and recovery setting. MATERIALS AND METHODS: The study population was divided into two as those who used corticosteroids during the recovery phase (who did not develop sufficient radiological or clinical improvement) and those who did so during the activation phase (non-ARDS/septic shock condition, clinical, laboratory or radiological progression). RESULT: We identified 47 patients, 26 of which were males, and mean age was 60.5 ± 16.5 years. Seventeen patients were found to receive corticosteroids during the recovery phase and the rest (n= 30) during the activation period. After corticosteroid therapy, we found reduction of increased pre-treatment levels of D-dimer, ferritin, fibrinogen, CRP, increment of decreased pre-treatment lymphocyte count and saturation. Complete symptomatic improvement was detected in 6.9% and 17.6% of the patients in the activation phase and recovery phase, respectively. Complete radiological improvement was found in 11.5% and 35.3% of the patients in the activation phase and recovery phase, respectively. While corticosteroid treatment was initiated on day 4.2 ± 2.6 and continued for a mean of 5.9 ± 2.8 days in the activation group, it was started on day 8.1 ± 11.3 and administered for 7.8 ± 3.8 days in the recovery group. In both groups, methylprednisolone was given at a median dose of 40 mg/day. CONCLUSIONS: Short-term low-dose corticosteroid therapy may improve clinical, radiological, laboratory outcomes in the management of COVID-19 pneumonia during the activation period without ARDS and non-septic shock and during recovery period with no satisfactory response. Further randomized controlled studies will be useful in demonstrating its efficacy.

May mepolizumab used in asthma correct subfertility?

INTRODUCTION: Asthma is one of the most common chronic airway disease among reproductive period of women. Chronic inflammation in asthma, eosinophilia, high steroid treatment and uncontrolled asthma may cause infertility by affecting the reproductive organs, menstrual cycle and quality of life. Some patients with severe asthma have frequent exacerbations associated with persistent eosinophilic inflammation despite continuous treatment with high-dose inhaled glucocorticoids with or without oral glucocorticoids. Mepolizumab (anti-IL-5) is a succesful option of treatment. CASES: First case; 25-year-old female patient has been diagnosed having asthma and rhinitis for 5 years. Even she had desired pregnancy for 3 years, she was unable to have a baby, and had been diagnosed having primary infertility. Second case; 36 years old female had rhinitis for 6 years and asthma for 4 years Although she used the same contraception method (withdrawal,condom) for years, she did not get pregnant until receiving the second dose of mepolizumab treatment. RESULT: Two women were treated with mepolizumab for eosinophilic severe asthma and they got pregnant. CONCLUSION: Unexplained infertility in people with severe eosinophilic asthma may be corrected by mepolizumab treatment. However, there is not enough data regarding the use of mepolizumab during pregnancy.

The Assessment of Impact of the COVID-19 Pandemic on Patients Receiving Orthodontic Treatment.

OBJECTIVE: The aim of this study was to determine the difficulties experienced by patients receiving orthodontic treatment during the COVID-19 pandemic and to evaluate the problems experienced by orthodontic patients, along with their attitudes toward these problems. METHODS: A cross-sectional survey study including a total of 502 patients (291 female; 211 male) receiving orthodontic treatment at a public or private clinic was conducted via a web-based questionnaire. RESULTS: Of all participants, 70.1% (352) were between the ages of 12 and 18 and 77.1% (387) were treated in a public clinic. According to the results, 97.3% (372) of the patients in the public clinic and 71.1% (79) of the patients in the private clinics had not been able to continue their treatment for 2 months or longer. Most of the participants were concerned about extended treatment duration (349, 69.5%) during this period. While the most common problems in patients with fixed appliances were soft tissue irritation (230, 52.5%), bracket failure (142, 32.4%), gingival swelling (88, 20.1%), and pain (88, 20.1%); there were issues of new spaces between teeth (41, 64.1%), pain (37, 57.8%), and gingival swelling (29, 45.3%) among patients with removable appliances. CONCLUSION: Most patient appointments were delayed during the COVID-19 pandemic. Patients experienced various problems with their treatment, and as a result, concerns about extended treatment duration increased. Therefore, orthodontists should pay more attention to teleorthodontics during the pandemic process.

Effectiveness of Behavioral and Pharmacological Smoking Cessation Treatment in Patients with Failed Attempt at Quitting with E-cigarettes.

OBJECTIVE: The tobacco industry has introduced electronic cigarettes (e-cigarettes) as a less harmful substitute to cigarettes and as an aid to smoking cessation. This study aimed to evaluate the success of evidence-based pharmacological treatments and behavioral/cognitive training in patients who failed to quit smoking with e-cigarettes. MATERIAL AND METHODS: A total of 109 consecutive patients with failed attempts at smoking cessation by e-cigarettes were admitted. A questionnaire was administered to evaluate the demographic characteristics and smoking habits. Nicotine dependence scores of the smokers were obtained using the Fagerström addiction test. Appropriate pharmacological therapy and behavioral/cognitive training were given to each patient who failed to quit smoking with e-cigarettes. RESULTS: The mean age of the participants was 35.2±10.4 years, and 89 (81.7%) were men. Education level was high school or university for 92 (84.4%) patients; only 17 (15.6%) graduated from middle school. The mean number of cigarettes smoked per day was 25.8±10.8, and the mean nicotine dependence score was 6.7±1.9. Only 6 (5.5%) individuals quit smoking temporarily after using e-cigarettes, with a mean restarting time of 3.3±2.0 months in all 6 patients. The smoking cessation rate in our study was 43.1% (47 patients) with medical treatment. The remaining individuals were unable to quit smoking with pharmacological treatment, and the mean restarting time for these patients was 10.4±2.2 months. CONCLUSION: It has been shown that the success rate of smoking cessation increases with pharmacological treatment and behavioral/cognitive training in individuals who failed to quit smoking with e-cigarettes.

Use of cyclic strain bioreactor for the upregulation of key tenocyte gene expression on Poly(glycerol-sebacate) (PGS) sheets.

The inadequate donor source and the difficulty of using natural grafts in tendon repair and regeneration has led researchers to develop biodegradable and biocompatible synthetic based tissue equivalents. Poly(glycerol sebacate) (PGS) is a surface-erodible bioelastomer and has been increasingly investigated in a variety of biomedical applications. In this study, PGS elastomeric sheets were prepared by using a facile microwave method and used as elastomeric platform for the first time under mechanical stimulation to induct the tenocyte gene expression. It is revealed that elastomeric PGS sheets promote progenitor tendon cell structure by increasing proliferation and gene expression with regard to tendon extracellular matrix components. Human tenocytes were seeded onto poly(glycerol-sebacate) sheets and were cultured two days prior to transfer to dynamic culture in a bioreactor system. Cell culture studies were carried out for 12 days under 0%, 3% and 6% strain at 0.33 Hz. The PGS-cell constructs were examined by using Scanning Electron Microscopy (SEM), cell viability via live/dead staining using confocal microscopy, and GAG/DNA analysis. In addition, gene expression was examined using real-time polymerase chain reaction (RT-PCR). Tenocytes cultured upon PGS scaffolds under 6% cyclic strain exhibited tendon-like gene expression profile compared to 3% and 0% strain groups. The results of this study show that PGS is a suitable material in promoting tendon tissue formation under dynamic conditions.

A rare tumor of the diaphragm: pleomorphic rhabdomyosarcoma.

We present the case of an extremely rare tumor of the diaphragm. The patient was a middle-aged woman with a 1-month history of dyspnea, fatigue, and cough. Chest roentgenogram and computed tomography scan of the thorax revealed a mass located at the dome of the right diaphragm. Pathologic examination of the biopsy specimen revealed pleomorphic rhabdomyosarcoma.