Two Very Rare Cases of Metastatic Thymic Carcinoma with Sjogren's Syndrome: A Case Series.

Thymic tumours are rare thoracic malignancies with thymic carcinoma accounting for approximately 12% of all thymic tumours compared to thymomas which account for approximately 86%. Unlike thymomas, it is very rare for thymic carcinomas to be associated with autoimmune disorders or paraneoplastic syndromes. When these phenomena do occur, the vast majority are myasthenia gravis, pure red cell aplasia, or systemic lupus erythematous. Paraneoplastic Sjogren's syndrome is a rare complication of thymic carcinoma, with only two cases previously reported. Here we present 2 cases of patients with metastatic thymic carcinoma who developed autoimmune phenomena consistent with Sjogren's syndrome without classical symptoms prior to treatment. One patient opted for surveillance of their malignancy, while the other underwent chemoimmunotherapy with favourable results. These case reports describe two distinctive clinical presentations of a rare paraneoplastic phenomenon.

Epidemiology of soccer-related head injury in children 5-14 years in Victoria, Australia.

AIM: Our aim was to use epidemiological data to determine the incidence of soccer-related head injuries in children aged 5-14 years who presented at emergency departments (EDs) or were admitted in hospitals in Victoria, Australia. METHODS: ED presentation and hospital admission de-identified aggregate data were from the Victorian Injury Surveillance Unit. Soccer participation data were compared with the soccer-related head injury data to determine the incidence of this injury among these children. RESULTS: The incidence of ED presentations was 0.17% of children participating in soccer during the study period (financial years 2011-2012 to 2015-2016). The 10-14-years age group presented with more head injuries than the 5-9-years age group. For the admissions data, soccer had a significantly lower (P = 0.0379) incidence of head injury when compared with 'sport as a whole'. CONCLUSIONS: The low incidence of soccer-related head injuries presenting to an ED or admission to hospital is consistent with international findings.

Getting to the point: attempting to improve juror comprehension of capital penalty phase instructions.

This research examined the effects of several versions of capital penalty phase instructions on juror comprehension. Study One documented the impact of California's recently implemented "plain language" instruction. It showed that although the new instruction has clear advantages over the previous version, significant comprehension problems remain. Study Two evaluated several modified instructions designed to enhance comprehension. Participants heard either a standard patterned instruction or one of two alternatives-a psycholinguistically improved instruction, or a "pinpoint" instruction using case-related facts to illustrate key terms-in a simulated death penalty sentencing phase. Persons who heard modified instructions demonstrated higher levels of comprehension on virtually every measure as compared to those in the standard instruction condition.

Beyond 9+0: noncanonical axoneme structures characterize sensory cilia from protists to humans.

The intracellular amastigote stages of parasites such as Leishmania are often referred to as aflagellate. They do, however, possess a short axoneme of cryptic function. Here, our examination of the structure of this axoneme leads to a testable hypothesis of its role in the cell biology of pathogenicity. We show a striking similarity between the microtubule axoneme structure of the Leishmania mexicana parasite infecting a macrophage and vertebrate primary cilia. In both, the 9-fold microtubule doublet symmetry is broken by the incursion of one or more microtubule doublets into the axoneme core, giving rise to an architecture that we term here the 9v (variable) axoneme. Three-dimensional reconstructions revealed that no particular doublet initiated the symmetry break, and moreover it often involved 2 doublets. The tip of the L. mexicana flagellum was frequently intimately associated with the macrophage vacuole membrane. We propose that the main function of the amastigote flagellum is to act as a sensory organelle with important functions in host-parasite interactions and signaling in the intracellular stage of the L. mexicana life cycle.

Functionalized heteroarylpyridazines and pyridazin-3(2H)-one derivatives via palladium-catalyzed cross-coupling methodology.

A general method for the synthesis of functionalized pyridazinylboronic acids/esters is described involving a directed ortho metalation (DoM)--boronation protocol (Schemes 1 and 2). A comprehensive study of the reactivity of the C-B bond in palladium-catalyzed cross-couplings with aryl/heteroaryl halides is presented. Aryl-/heteroarylpyridazines are thereby obtained in synthetically viable yields (typically 40-75%) although in some cases competing protodeboronation has been observed. A series of pyridazin-3(2H)-one derivatives, including 4,6-diaryl/heteroaryl derivatives, have been obtained from the corresponding 3-methoxypyridazines in straightforward procedures (Schemes 3 and 4). Several X-ray crystal structures of aryl-/heteroarylpyridazines and derived pyridazin-3(2H)-one derivatives are reported. These multi-ring systems are of considerable interest in contemporary N-heterocyclic chemistry.

A novel monoclonal antibody for detection of folate receptor alpha in paraffin-embedded tissues.

Folate biochemical pathway components such as FR-alpha are determinants of response to novel antifolate drugs such as pemetrexed. Knowledge of their level of expression in tumors will enable their optimal use by identifying potentially responsive subgroups of patients. In spite of its importance in the diagnosis and treatment of cancer, monoclonal antibodies to FR-alpha suitable for immunohistochemical analysis of formalin-fixed and paraffin-embedded biopsy samples, or that can be used for Western blot analysis, are not available. The aim of this study was thus to generate a monoclonal antibody that could be used to detect specific expression of FR-alpha in paraffin-embedded tissues. A 189 amino acid region of the FR-alpha sequence was expressed as a recombinant fusion protein and used as antigen to generate monoclonal antibodies. Studies by ELISA and Western blot identified specific reactivity of the BN3.2 antibody to the recombinant protein and a single 40 kD protein in whole cell lysates from cell lines known to express FR-alpha. Immunohistochemical analysis of FR-alpha using hybridoma clone BN3.2 in a panel of normal tissues demonstrated expression limited to ovarian epithelia, placental trophoblasts, and proximal kidney tubules. Analysis of a panel of malignant and benign tissues demonstrated limited expression with variable intensities of staining and patterns of both membrane and cytoplasmic reactivity observed between cases. In the majority of malignant ovarian tumors, high intensity staining was observed, predominantly localized to the plasma membrane. Our results show that clone BN3.2 is a sensitive tool for detection of FR-alpha in paraffin-embedded tissues. This preliminary study also supports its use in immunohistochemical studies to determine the role of FR-alpha as a tumor prognostic marker and a possible therapeutic target.