Rare pelvic peritoneal defect causing small bowel obstruction in a young female with virgin abdomen.

This case report discusses a 46-year-old female with no prior surgical history who presented with severe abdominal pain and generalized tenderness. She was found to have a small bowel obstruction secondary to internal hernia caused by a rare congenital pelvic peritoneal defect in the Pouch of Douglas. She required diagnostic laparoscopy and repair of the pelvic peritoneal defect. Congenital peritoneal defect is an extremely rare cause of small bowel obstruction but should remain a possible differential diagnosis in patients with virgin abdomen presenting with acute abdominal pain.

Relationship between Increased Plasma Levels of Legumain and Properties of Coronary Atherosclerotic Plaque. / Relação entre Níveis Plasmáticos Aumentados de Legumain e Propriedades da Placa Aterosclerótica Coronária.

BACKGROUND: Many clinical studies have confirmed that legumain is closely related to atherosclerosis. Unfortunately, different conclusions have been reached, and analyses and studies on atherosclerotic plaque characteristics in patients with increased plasma levels of legumain are still lacking. OBJECTIVES: This study aimed to investigate the correlation between legumain and coronary atherosclerotic plaque characteristics. METHODS: A total of 81 patients with coronary atherosclerotic heart disease (CHD), including 43 patients with unstable angina (UA) and 38 patients with stable angina (SA), were screened by coronary angiography. Intravascular ultrasound (IVUS) was performed to evaluate the characteristics of coronary atherosclerotic plaques, and plasma legumain levels were also measured. Values of p < 0.05 were considered significant. RESULTS: Legumain concentration was significantly higher in the two CHD subgroups than in the control group (all p<0.001). Legumain concentrations in the UA group were significantly higher than in the SA group (p=0.001). The plaque area, remodeling index (RI), and eccentricity index (EI) in the UA group were significantly higher than those in the SA group (p<0.001, p=0.001, p=0.001, respectively). There was a significant positive correlation between legumain levels and RI and EI in both UA and SA patients (all p<0.05). CONCLUSIONS: High plasma levels of legumain were closely related to the occurrence and severity of CHD, and the lesions tended to be unstable. Legumain is expected to be a potential inflammatory biomarker for the diagnosis of CHD and the early identification of unstable coronary lesions.

FUNDAMENTO: Muitos estudos clínicos confirmaram que a legumain está intimamente relacionada à aterosclerose. Infelizmente, chegaram-se a conclusões diferentes e ainda faltam análises e estudos sobre as características da placa aterosclerótica em pacientes com níveis plasmáticos aumentados de legumain. OBJETIVOS: Este estudo teve como objetivo investigar a correlação entre as características da legumain e da placa aterosclerótica coronariana. MÉTODOS: Um total de 81 pacientes com doença cardíaca aterosclerótica coronariana (DCAC), incluindo 43 pacientes com angina instável (AI) e 38 pacientes com angina estável (AE), foram examinados por angiografia coronária. Foi realizado ultrassom intravascular (IVUS) para avaliar as características das placas ateroscleróticas coronarianas, e os níveis plasmáticos de legumain também foram medidos. Valores de p < 0,05 foram considerados significativos. RESULTADOS: A concentração de legumain foi significativamente maior nos dois subgrupos de doença coronariana do que no grupo controle (todos p<0,001). As concentrações de legumain no grupo AI foram significativamente maiores do que no grupo SA (p=0,001). A área de placa, o índice de remodelamento (IR) e o índice de excentricidade (IE) no grupo AI foram significativamente maiores do que no grupo AE (p<0,001, p=0,001, p=0,001, respectivamente). Houve uma correlação positiva significativa entre os níveis de legumain e IR e IE em pacientes com AI e AE (todos p<0,05). CONCLUSÕES: Níveis plasmáticos elevados de legumain estavam intimamente relacionados com a ocorrência e gravidade da doença coronariana, e as lesões tendiam a ser instáveis. Espera-se que a legumain seja um potencial biomarcador inflamatório para o diagnóstico de doença coronariana e a identificação precoce de lesões coronárias instáveis.

A rare cause of colonic pseudo-obstruction due to light chain amyloidosis.

In this case report, we discuss the rare presentation of a 56-year-old-gentleman with a history of light chain amyloidosis (AL), causing colonic pseudo-obstruction and requiring open subtotal colectomy and end ileostomy. This should remain a differential diagnosis in patients with known light chain AL presenting with nonspecific gastrointestinal symptoms such as constipation and abdominal pain. This prompts early investigation, such as endoscopy and tissue biopsy, and surgical intervention may be warranted.

Relação entre Níveis Plasmáticos Aumentados de Legumain e Propriedades da Placa Aterosclerótica Coronária / Relationship between Increased Plasma Levels of Legumain and Properties of Coronary Atherosclerotic Plaque

Resumo Fundamento Muitos estudos clínicos confirmaram que a legumain está intimamente relacionada à aterosclerose. Infelizmente, chegaram-se a conclusões diferentes e ainda faltam análises e estudos sobre as características da placa aterosclerótica em pacientes com níveis plasmáticos aumentados de legumain. Objetivos Este estudo teve como objetivo investigar a correlação entre as características da legumain e da placa aterosclerótica coronariana. Métodos Um total de 81 pacientes com doença cardíaca aterosclerótica coronariana (DCAC), incluindo 43 pacientes com angina instável (AI) e 38 pacientes com angina estável (AE), foram examinados por angiografia coronária. Foi realizado ultrassom intravascular (IVUS) para avaliar as características das placas ateroscleróticas coronarianas, e os níveis plasmáticos de legumain também foram medidos. Valores de p < 0,05 foram considerados significativos. Resultados A concentração de legumain foi significativamente maior nos dois subgrupos de doença coronariana do que no grupo controle (todos p<0,001). As concentrações de legumain no grupo AI foram significativamente maiores do que no grupo SA (p=0,001). A área de placa, o índice de remodelamento (IR) e o índice de excentricidade (IE) no grupo AI foram significativamente maiores do que no grupo AE (p<0,001, p=0,001, p=0,001, respectivamente). Houve uma correlação positiva significativa entre os níveis de legumain e IR e IE em pacientes com AI e AE (todos p<0,05). Conclusões Níveis plasmáticos elevados de legumain estavam intimamente relacionados com a ocorrência e gravidade da doença coronariana, e as lesões tendiam a ser instáveis. Espera-se que a legumain seja um potencial biomarcador inflamatório para o diagnóstico de doença coronariana e a identificação precoce de lesões coronárias instáveis.

Abstract Background Many clinical studies have confirmed that legumain is closely related to atherosclerosis. Unfortunately, different conclusions have been reached, and analyses and studies on atherosclerotic plaque characteristics in patients with increased plasma levels of legumain are still lacking. Objectives This study aimed to investigate the correlation between legumain and coronary atherosclerotic plaque characteristics. Methods A total of 81 patients with coronary atherosclerotic heart disease (CHD), including 43 patients with unstable angina (UA) and 38 patients with stable angina (SA), were screened by coronary angiography. Intravascular ultrasound (IVUS) was performed to evaluate the characteristics of coronary atherosclerotic plaques, and plasma legumain levels were also measured. Values of p < 0.05 were considered significant. Results Legumain concentration was significantly higher in the two CHD subgroups than in the control group (all p<0.001). Legumain concentrations in the UA group were significantly higher than in the SA group (p=0.001). The plaque area, remodeling index (RI), and eccentricity index (EI) in the UA group were significantly higher than those in the SA group (p<0.001, p=0.001, p=0.001, respectively). There was a significant positive correlation between legumain levels and RI and EI in both UA and SA patients (all p<0.05). Conclusions High plasma levels of legumain were closely related to the occurrence and severity of CHD, and the lesions tended to be unstable. Legumain is expected to be a potential inflammatory biomarker for the diagnosis of CHD and the early identification of unstable coronary lesions.

The Concentration of Non-structural Carbohydrates, N, and P in Quercus variabilis Does Not Decline Toward Its Northernmost Distribution Range Along a 1500 km Transect in China.

Understanding the mechanisms that determine plant distribution range is crucial for predicting climate-driven range shifts. Compared to altitudinal gradients, less attention has been paid to the mechanisms that determine latitudinal range limit. To test whether intrinsic resource limitation contributes to latitudinal range limits of woody species, we investigated the latitudinal variation in non-structural carbohydrates (NSC; i.e., total soluble sugar plus starch) and nutrients (nitrogen and phosphorus) in mature and juvenile Chinese cork oak (Quercus variabilis Blume) along a 1500 km north-south transect in China. During the growing season and dormant season, leaves, branches, and fine roots were collected from both mature and juvenile oaks in seven sites along the transect. Tissue concentration of NSCs, N, and P did not decrease with increasing latitude irrespective of sampling season and ontogenetic stage. Furthermore, higher levels of NSCs and N in tissues of juveniles relative to mature trees were found during the dormant season. Partial correlation analysis also revealed that during the dormant season, soluble sugar, NSC, the ratio of soluble sugar to starch, and tissue nitrogen concentration were correlated positively with latitude but negatively with precipitation and mean temperature of dormant season. Our results suggest that carbon or nutrient availability may not be the driving factors of the latitudinal range limit of the studied species. Further studies should be carried out at the community or ecosystem level with multiple species to additionally test the roles of factors such as regeneration, competition, and disturbance in determining a species' northern distribution limit.

Defense pattern of Chinese cork oak across latitudinal gradients: influences of ontogeny, herbivory, climate and soil nutrients.

Knowledge of latitudinal patterns in plant defense and herbivory is crucial for understanding the mechanisms that govern ecosystem functioning and for predicting their responses to climate change. Using a widely distributed species in East Asia, Quercus variabilis, we aim to reveal defense patterns of trees with respect to ontogeny along latitudinal gradients. Six leaf chemical (total phenolics and total condensed tannin concentrations) and physical (cellulose, hemicellulose, lignin and dry mass concentration) defensive traits as well as leaf herbivory (% leaf area loss) were investigated in natural Chinese cork oak (Q. variabilis) forests across two ontogenetic stages (juvenile and mature trees) along a ~14°-latitudinal gradient. Our results showed that juveniles had higher herbivory values and a higher concentration of leaf chemical defense substances compared with mature trees across the latitudinal gradient. In addition, chemical defense and herbivory in both ontogenetic stages decreased with increasing latitude, which supports the latitudinal herbivory-defense hypothesis and optimal defense theory. The identified trade-offs between chemical and physical defense were primarily determined by environmental variation associated with the latitudinal gradient, with the climatic factors (annual precipitation, minimum temperature of the coldest month) largely contributing to the latitudinal defense pattern in both juvenile and mature oak trees.

Mechanical Coupling Error Suppression Technology for an Improved Decoupled Dual-Mass Micro-Gyroscope.

This paper presents technology for the suppression of the mechanical coupling errors for an improved decoupled dual-mass micro-gyroscope (DDMG). The improved micro-gyroscope structure decreases the moment arm of the drive decoupled torque, which benefits the suppression of the non-ideal decoupled error. Quadrature correction electrodes are added to eliminate the residual quadrature error. The structure principle and the quadrature error suppression means of the DDMG are described in detail. ANSYS software is used to simulate the micro-gyroscope structure to verify the mechanical coupling error suppression effect. Compared with the former structure, simulation results demonstrate that the rotational displacements of the sense frame in the improved structure are substantially suppressed in the drive mode. The improved DDMG structure chip is fabricated by the deep dry silicon on glass (DDSOG) process. The feedback control circuits with quadrature control loops are designed to suppress the residual mechanical coupling error. Finally, the system performance of the DDMG prototype is tested. Compared with the former DDMG, the quadrature error in the improved dual-mass micro-gyroscope is decreased 9.66-fold, and the offset error is decreased 6.36-fold. Compared with the open loop sense, the feedback control circuits with quadrature control loop decrease the bias drift by 20.59-fold and the scale factor non-linearity by 2.81-fold in the ±400°/s range.

Dual-axis rotational coronary angiography can reduce peak skin dose and scattered dose: a phantom study.

The purpose of this study was to evaluate peak skin dose received by the patient and scattered dose to the operator during dual-axis rotational coronary angiography (DARCA), and to compare with those of standard coronary angiography (SA). An anthropomorphic phantom was used to simulate a patient undergoing diagnostic coronary angiography. Cine imaging was applied on the phantom for 2 s, 3 s, and 5 s in SA projections to mimic clinical situations with normal vessels, and uncomplicated and complicated coronary lesions. DARCA was performed in two curved trajectories around the phantom. During both SA and DARCA, peak skin dose was measured with thermoluminescent dosimeter arrays and scattered dose with a dosimeter at predefined height (approximately at the level of left eye) at the operator's location. Compared to SA, DARCA was found lower in both peak skin dose (range: 44%-82%, p < 0.001) and scattered dose (range: 40%-70%, p < 0.001). The maximal reductions were observed in the set mimicking complicated lesion examinations (82% reduction for peak skin dose, p < 0.001; 70% reduction for scattered dose, p < 0.001). DARCA reduces both peak skin dose and scattered dose in comparison to SA. The benefi t of radiation dose reduction could be especially signifi cant in complicated lesion examinations due to large reduction in X-ray exposure time. The use of DARCA could, therefore, be recommended in clinical practice to minimize radiation dose.