NIS-Promoted Chemodivergent and Diastereoselective Synthesis of Pyrrolinyl and Cyclopentenyl Spiropyrazolones via Regulated Cyclization of Alkylidene Pyrazolones with Enamino Esters.

An N-iodosuccinimide-promoted annulation of alkylidene pyrazolones with enamino esters has been explored to construct a spiropyrazolone moiety through a Michael addition/iodination/intramolecular nucleophilic substitution sequence. When the reaction was performed in acetonitrile at 100 °C, it furnished pyrrolinyl spiropyrazolones exclusively in an anti configuration through N-attacking cyclization. When the reaction was performed in dimethyl sulfoxide at 80 °C in the presence of K2HPO4, it afforded cyclopentenyl spiropyrazolones exclusively in the syn configuration through C-attacking cyclization. A plausible mechanism has also been proposed.

When "more for others, less for self" leads to co-benefits: A tri-MRI dyad-hyperscanning study.

Unselfishness is admired, especially when collaborations between groups of various scales are urgently needed. However, its neural mechanisms remain elusive. In a tri-MRI dyad-hyperscanning experiment involving 26 groups, each containing 4 participants as two rotating pairs in a coordination game, we sought to achieve reciprocity, or "winning in turn by the two interacting players," as the precursor to unselfishness. Due to its critical role in social processing, the right temporal-parietal junction (rTPJ) was the seed for both time domain (connectivity) and frequency domain (i.e., coherence) analyses. For the former, negative connectivity between the rTPJ and the mentalizing network areas (e.g., the right inferior parietal lobule, rIPL) was identified, and such connectivity was further negatively correlated with the individual's final gain, supporting our task design that "rewarded" the reciprocal participants. For the latter, cerebral coherences of the rTPJs emerged between the interacting pairs (i.e., within-group interacting pairs), and the coupling between the rTPJ and the right superior temporal gyrus (rSTG) between the players who were not interacting with each other (i.e., within-group noninteracting pairs). These coherences reinforce the hypotheses that the rTPJ-rTPJ coupling tracks the collaboration processes and the rTPJ-rSTG coupling for the emergence of decontextualized shared meaning. Our results underpin two social roles (inferring others' behavior and interpreting social outcomes) subserved by the rTPJ-related network and highlight its interaction with other-self/other-concerning brain areas in reaching co-benefits among unselfish players.

Improved titer and stability of selenium nanoparticles produced by engineered Saccharomyces cerevisiae.

Selenium nanoparticles (SeNPs) have gained significant attention in the fields of medicine and healthcare products due to their various biological activities and low toxicity. In this study, we focused on genetically modifying the Saccharomyces cerevisiae strain YW16 (CICC 1406), which has the ability to efficiently reduce sodium selenite and produce red SeNPs. By overexpressing genes involved in glutathione production, we successfully increased the glutathione titer of the modified strain YJ003 from 41.0 mg/L to 212.0 mg/L. Moreover, we improved the conversion rate of 2.0 g/L sodium selenite from 49.3% to 59.6%. Furthermore, we identified three surface proteins of SeNPs, and found that overexpression of Act1, one of the identified proteins, led to increased stability of SeNPs across different acid-base and temperature conditions. Through a 135-h feed fermentation process using 5.0 g/L sodium selenite, we achieved an impressive conversion rate of 88.7% for sodium selenite, and each gram of SeNPs contained 195.7 mg of selenium. Overall, our findings present an efficient method for yeast to synthesize SeNPs with high stability. These SeNPs hold great potential for applications in nanomedicine or as nutritional supplements to address selenium deficiency.

Central Compartment Atopic Disease and Its Surgical Outcomes: Olfactory Changes and Technical Notes.

Background: Central compartment atopic disease (CCAD) is a recent, novel phenotype of chronic rhinosinusitis. Only a few studies have assessed olfactory function in patients with CCAD. Objectives: We aimed to investigate olfactory function changes after functional endoscopic sinus surgery (FESS) in patients with CCAD and proposed some surgical techniques to enhance the postoperative olfactory outcomes in such patients. Design: A retrospective cohort study. Methods: We collected data from 23 patients (8 men and 15 women) with CCAD who underwent FESS performed by a surgeon in Taiwan, between June 2018 and December 2021. The demographic data, olfactory function, and serum and tissue eosinophil percentages of the included patients were analyzed. The Top International Biotech Smell Identification Test (TIBSIT; Top International Biotech, Taipei, Taiwan) was used to assess olfactory function. Results: Of the 23 patients, most (95%) showed a positive reaction to aeroallergens, and 2 patients (8.7%) had asthma. Ten patients (43.5%) had peripheral eosinophilia, and 9 (39%) had eosinophilic nasal polyps. Moreover, the patients presented with variable olfactory dysfunction; the mean preoperative TIBSIT (pr-TIBSIT) score was 12.8 ± 2.3 (range: 0-43), whereas the mean postoperative TIBSIT (po-TIBSIT) score was 29.2 ± 1.9 (range: 16-44). The po-TIBSIT score was significantly better than the pre-TIBSIT score (paired t test, P < .0001). The improvement in olfactory function was not significantly correlated with the patients' age, serum eosinophil percentages, and nasal polyp eosinophil counts. Conclusion: Our findings indicate that CCAD is significantly associated with olfactory dysfunction and that FESS can effectively improve olfactory function. To optimize postoperative olfactory outcomes, precise removal of polyps from the olfactory cleft without damaging the neuroepithelium is recommended. Our study provides valuable insights into the management of CCAD patients undergoing FESS and can guide surgical decision-making to achieve optimal olfactory function outcomes.

Preoperative pancreatic CT value is related to pancreatic fistula after pancreaticoduodenectomy: a retrospective study.

Background: Pancreatic fistula (PF) is the main complication in patients undergoing pancreaticoduodenectomy. Computed tomography (CT) value can reflect pancreatic tissue characteristics which is related to PF. This study was designed to study the relationship between the preoperative CT value and pancreatic fistula. Methods: We retrospectively reviewed the clinical and medical data of patients undergoing pancreaticoduodenectomy from 2017 to 2021. The pancreatic CT value and the CT value ratios of the pancreas and abdominal aorta (PCT/ACT) were measured and compared between the PF group and non-PF group. The values in different PF severity groups were compared using variance analysis. A cut-off value was selected by receiver operating characteristic (ROC) curve. Single-factor and multiple-factor analysis were performed to evaluate Correlation between PF and CT. Results: One hundred and twenty-seven cases were included in this study. The PCT/ACT in the PF group was significantly lower than that in the non-PF group (P<0.001), and the PCT/ACT value was correlatively lower in the severe PF group than in the mild PF group (P=0.008). A cutoff value of 0.99 was selected by ROC curves analysis. Further multifactor analysis identified PCT/ACT <0.99 to be an independent preoperative predictor [odds ratio (OR): 11.3, P<0.01]. Conclusions: The preoperative pancreatic CT value can indirectly reflect the histological condition of the pancreas and thus may related to postoperative PF after pancreaticoduodenectomy and provide useful information for surgeons in deciding upon the pancreaticojejunostomy method.

Potential factors affecting success rate and long term outcome in single balloon enteroscopy-assisted therapeutic endoscopic retrograde cholangiopancreatography in patients with pancreaticojejunal anastomotic stenosis: a retrospective study.

Background: Pancreaticojejunal anastomotic stenosis (PJS) after pancreaticoduodenectomy (PD) is difficult to treat. Single-balloon enteroscope-assisted endoscopic retrograde pancreatography (SBE-assisted ERP) is a safe way to treat PJS with the strength of minimally invasion and repeatability, but since its technical difficulty and few patient number, data on long-term outcomes remain limited. The optimal treatment is still unknown. We aim to study the safety, effectiveness, and long-term outcome of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERP in patients with PJS in this study. Methods: The clinical information of patients undergoing SBE-assisted therapeutic ERP from March 2016 to March 2021 were retrospectively analyzed. All patients were diagnosed as PJS and without any contraindication for therapeutic endoscopy. Treatment details, postoperative complications, factors influencing technical success rate were evaluated. Long-term outcomes results were obtained by clinical or telephone follow-up. Results: Sixteen patients with median age of 51 years were included in this study, surgical reconstruction methods including PD with Whipple reconstruction, PD with Child reconstruction, pylorus-preserving pancreaticoduodenectomy (PpPD) with Whipple reconstruction. Eight patients were successfully treated. No serious complications happened. Risk factors for the failure of pancreaticojejunal anastomotic site identification include the digestive tract reconstruction sequence, pancreaticojejunostomy method, pancreatic duct tube implantation, pancreatic duct width before surgery, and pancreatic fistula during perioperative period. The median follow-up time was 77.2 months, the mean indwelling time of the stent was 62.3 months [interquartile range (IQR), 6.8-153.7 months]. Two of eight patients developed recurrent PJS. The variation in body mass index (BMI) was +2.46 in the non-recurrence group compared to -1.09 in the recurrence group and -2.12 in the endoscopic retrograde cholangiopancreatography (ERCP) treatment failure group. Conclusions: ERP intervention should be carried out early once PJS occurs in order to increase success rate. BMI is a crucial indicator which can reflex PJS rehabilitation degree during follow-up. In order to reduce PJS recurrence rate, a wider pancreatic stent and a longer stent indwelling time are recommended.

Description and genomic characterization of Jiella flava sp. nov., isolated from Acrostichum aureum.

Two endophytic bacteria, designated strains CQZ9-1T and MQZ9-1, were isolated from semi-mangrove plant Acrostichum aureum collected from Maowei Sea Mangrove Nature Reserve in Guangxi Zhuang Autonomous Region, PR China. The two strains possessed almost identical 16S rRNA gene sequences (99.7 %). The average nucleotide identity (ANI), average amino acid identity (AAI) and the digital DNA-DNA hybridization (dDDH) values between the two strains were 100 %, indicating that they represented the same species. The 16S rRNA gene sequence similarities between strains CQZ9-1T, MQZ9-1 and the most closely related type strains, Jiella mangrovi KSK16Y-1T, Jiella sonneratiae MQZ13P-4T and Jiella endophytica CBS 5Q-3T were 98.0-98.1, 97.3-97.4 and 97.3-97.4 %, respectively. The results of phylogenetic analyses based on 16S rRNA gene sequences and genome sequences indicated that CQZ9-1T and MQZ9-1 formed a distinct lineage with J. endophytica CBS5Q-3T, Jiella pacifica 40Bstr34T, J. mangrovi KSK16Y-1T, J. sonneratiae MQZ13P-4T, Jiella aquimaris JCM 30119T and J. aquimaris 22II-16-19i. The draft genomes of strains CQZ9-1T and MQZ9-1 were 4  162  933 bp and 4  164  266 bp in size, respectively, and their DNA G+C contents were both 63.8 %. Comparative genome analysis of the two strains and the type strains of related species revealed ANI, AAI and dDDH values below the cut-off levels of 95-96, 95.5 and 70 %, respectively. The ubiquinone detected in CQZ9-1T was Q-10. The major cellular fatty acid of strains CQZ9-1T and MQZ9-1 was found to be C18:1ω7c. Combined data from phenotypic, phylogenetic and chemotaxonomic studies indicated that CQZ9-1T and MQZ9-1 represent a novel species of the genus Jiella, for which the name Jiella flava sp. nov. is proposed. The type strain is CQZ9-1T (= CGMCC 1.18725T = JCM 34331T).

Preoperative CA125 as a risk factor for symptom recurrence of adenomyosis after ultrasound-guided high-intensity focused ultrasound ablation surgery.

OBJECTIVES: To investigate the relationship between preoperative CA125 and symptom recurrence in adenomyosis after ultrasound-guided high-intensity focused ultrasound ablation surgery (FUAS). METHODS: A total of 502 adenomyosis patients after FUAS in Affiliated Nanchong Central Hospital of North Sichuan Medical College from June 2017 to March 2021 were reviewed. Factors associated with symptom recurrence of adenomyosis were analyzed by binary logistic regression model. ROC was used to determine the optimal cutpoint. Magnitude of preoperative CA125 relating to timing of symptom recurrence was measured by cox regression and Kaplan-Meier (K-M) curves. Besides, multiple liner regression model was used to identify the impacting factors for preoperative CA125. RESULTS: Multiple binary logistic analysis showed preoperative CA125 was related to symptom recurrence (OR = 1.002, 95%: 1.000～1.004, p = 0.043). The ROC of preoperative CA125 for recurrence validated 35 U/ml had a high sensitivity (82.5%). Preoperative CA125 was related to timing of symptom recurrence (HR = 2.255, 95%: 1.387-3.667, p = 0.001). K-M curves showed medium recurrence time in preoperative CA125 level >35 U/ml group (38.5 months) was shorter than that in CA125 level ≤35 U/ml group (44.5 months) (p = 0.001). Multiple liner regression analyses showed uterus volume and adenomyotic lesions volume positively correlated to preoperative CA125 level, while age negatively correlated to preoperative CA125 level. CONCLUSION: The higher level of preoperative CA125 was related to an earlier onset of symptom recurrence after FUAS.

Protective effects of camellia and olive oils against cognitive impairment via gut microbiota-brain communication in rats.

Food intake influences neurofunction via the gut microbiota-brain axis. Monounsaturated fatty acid (MUFA) consumption is highly associated with neuroprotection; the mechanism behind the effects of olive oil and camellia oil on gut microbiota remains unclear. In this study, the objective was to compare the neuroprotective role of oleic acid-rich camellia oil and olive oil against AlCl3-induced mild cognitive impairment (MCI) in rats. Morris water maze tests revealed that learning and memory capacities improved in AlCl3-induced rats subjected to camellia oil administration better than olive oil treatment. Moreover, the results showed that the camellia oil- and olive oil-treated AlCl3-induced rat groups had significantly reduced oxidative stress and inflammatory cytokines. Notably, Spearman correlation analysis indicated that the inflammatory cytokines negatively correlated with the microbial strains (Bacteroides pectinophilus_group and Blautia) in response to camellia oil administration. Furthermore, Ruminococcaceae_UCG014 abundance was significantly enhanced by camellia oil intake, which was highly positively associated with antioxidant activity expression. In conclusion, the novel data suggest that the outcomes of camellia oil consumption were superior to those of olive oil intake as camellia oil may have a beneficial effect on MCI protection and improvement through the gut microbiota-brain communication.

Distinct cerebral coherence in task-based fMRI hyperscanning: cooperation versus competition.

This study features an functional magnetic resonance imaging (fMRI) hyperscanning experiment from 2 sites, 305 km apart. The experiment contains 2 conditions: the dyad collaborated to win and then split the reward in the cooperation condition, whereas the winner took all the reward in the competition condition, thereby resulting in dynamic strategic interactions. To calculate the cerebral coherence in such jittered event-related fMRI tasks, we first iteratively estimated the feedback-related blood oxygenation level-dependent responses of each trial, using 8 finite impulse response functions (16 s) and then concatenated the beta volume series. With the right temporal-parietal junction (rTPJ) as the seed, the interpersonal connected brain areas were separately identified: the right superior temporal gyrus (rSTG) (cooperation) and the left precuneus (lPrecuneus) (competition), both peaking at the designated frequency bin (1/16 s = 0.0625 Hz), but not in permuted pairs. In addition, the extended coherence analyses on shorter and longer concatenated volumes verified that only in the optimal trial frequency did the rTPJ-rSTG and rTPJ-lPrecuneus couplings peak. In sum, our approach both showcases a flexible analysis method that widens the applicability of interpersonal coherence in the rapid event-related fMRI hyperscanning and reveals a context-based inter-brain coupling between interacting pairs during cooperation and during competition.

Recurrent Tolosa-Hunt syndrome.

The Tolosa-Hunt syndrome (THS) is caused by granulomatous inflammation in the cavernous sinus, superior orbital fissure, or orbit characterized by painful ophthalmoplegia. Here, we report a case of recurrent THS in a 48-year-old female, who initially showed a poor response to low-dose steroids. Each episode involved different cranial nerves and painful ophthalmoplegia. Neuroimaging showed enhancement in the right cavernous sinus. The patient was treated with glucocorticoid pulse therapy and azathioprine. THS was previously considered to be responsive to glucocorticoids. This report demonstrates a case of THS with poor response to steroids and unique presentation of frequent recurrence with different cranial nerve involvement.

Regiodivergent Synthesis of 4,5'- and 4,4'-Imidazolinyl Spiropyrazolones from 4-Alkylidene Pyrazolones and Amidines.

The solvent-free reaction of 4-alkylidene pyrazolones with amidines can furnish 4,5'-imidazolinyl spiropyrazolones in good to excellent yields when promoted by N-iodosuccinimide under solvent-free ball-milling conditions, whereas it almost exclusively affords 4,4'-imidazolinyl spiropyrazolones if mediated by N-bromosuccinimide in heated toluene. On the basis of this switchable cyclization strategy, a powerful metal-free method for regioselective and diastereoselective synthesis of structurally diverse 4,5'- and 4,4'-imidazolinyl spiropyrazolones has been successfully developed.

Ursolic acid restores sensitivity to gemcitabine through the RAGE/NF-κB/MDR1 axis in pancreatic cancer cells and in a mouse xenograft model.

Gemcitabine (GEM) is a first-line drug for pancreatic cancer therapy, but GEM resistance is easily developed in patients. Growing evidence suggests that cancer chemoprevention and suppression are highly associated with dietary phytochemical and microbiota composition. Ursolic acid (UA) has anti-inflammatory and anticancer effects; however, its role in improving cancer drug resistance in vivo remains unclear. In this study, the aim was to explore the role of UA in managing drug resistance-associated molecular mechanisms and the influence of gut microbiota. The in vitro results showed that receptor for advanced glycation end products (RAGE), nuclear factor kappa B p65 (NF-κB/p65), and multidrug resistance protein 1 (MDR1) protein levels were significantly increased in GEM-resistant pancreatic cancer cells (named MIA PaCa-2 GEMR) compared to MIA PaCa-2 cells. Downregulation of RAGE, pP65, and MDR1 protein expression not only was observed following UA treatment but also was seen in MIA PaCa-2 GEMR cells after transfection with a RAGE siRNA. Remarkably, the enhanced effects of UA coupled with GEM administration dramatically suppressed the RAGE/NF-κB/MDR1 cascade and consequently inhibited subcutaneous tumor growth. Moreover, UA could increase alpha diversity and regulate the composition of gut microbiota, especially in Ruminiclostridium 6. Taken together, these results provide the first direct evidence of MDR1 attenuation and chemosensitivity enhancement through inhibition of the RAGE/NF-κB signaling pathway in vitro and in vivo, implying that UA may be used as an adjuvant for the treatment of pancreatic cancer in the future.

A brain network that supports consensus-seeking and conflict-resolving of college couples' shopping interaction.

One of the typical campus scenes is the social interaction between college couples, and the lesson couples must keep learning is to adapt to each other. This fMRI study investigated the shopping interactions of 30 college couples, one lying inside and the other outside the scanner, beholding the same item from two connected PCs, making preference ratings and subsequent buy/not-buy decisions. The behavioral results showed the clear modulation of significant others' preferences onto one's own decisions, and the contrast of the "shop-together vs. shop-alone", and the "congruent (both liked or disliked the item, 68%) vs. incongruent (one liked but the other disliked, and vice versa)" together trials, both revealed bilateral temporal parietal junction (TPJ) among other reward-related regions, likely reflecting mentalizing during preference harmony. Moreover, when contrasting "own-high/other-low vs. own-low/other-high" incongruent trials, left anterior inferior parietal lobule (l-aIPL) was parametrically mapped, and the "yield (e.g., own-high/not-buy) vs. insist (e.g., own-low/not-buy)" modulation further revealed left lateral-IPL (l-lIPL), together with left TPJ forming a local social decision network that was further constrained by the mediation analysis among left TPJ-lIPL-aIPL. In sum, these results exemplify, via the two-person fMRI, the neural substrate of shopping interactions between couples.

Calculations of energy deposition and ionization in the 2019 novel coronavirus by electron beam irradiation.

Using Monte Carlo methods, this study investigates energy deposition of energetic electrons and ionization in the 2019 novel coronavirus by electron irradiation, which are important characteristic quantities related with biological damage formation. The inelastic scattering of low-energy electrons (<10 keV) was calculated by dielectric theory. The optical energy-loss functions of viral proteins and RNA were derived from an empirical method in the energy-loss range <40 eV and the calculation of optical parameters of the biomolecules. The densities and distributions of energy deposition and ionization were calculated from the stopping power and inelastic cross-sections in the electron-cascade simulation. Electrons with primary energies of approximately 1-3 keV produced significant energy deposition and ionization in the target coronavirus. More energetic electrons were less effective due to the larger electron range and fewer scattering events in the coronavirus.

Camellia oil alleviates the progression of Alzheimer's disease in aluminum chloride-treated rats.

Alzheimer's disease (AD), the most common type of dementia, is associated with oxidative stress, inflammation, and gut microbiota (GM) imbalance. Recent studies have demonstrated that camellia oil has antioxidant and anti-inflammatory activity and modulates the immune system and GM. However, the effect of camellia oil in alleviating AD pathogenesis remains unclear. An SD rat model of cognitive decline was established by the daily oral administration of aluminum chloride. The results revealed that the aluminum chloride-treated group exhibited deteriorated memory capacity and increased expression of AD-related proteins, whereas these features were mitigated in camellia oil-treated groups. Treatment with camellia oil increased antioxidant enzyme levels and decreased MDA levels. Additionally, camellia oil modulated the expression of cytokines by inhibiting RAGE/NF-κB signaling and microglial activation. Interestingly, autophagy-related proteins were increased in the camellia oil-treated groups. Moreover, camellia oil increased the abundance of probiotics in the GM. Camellia oil can reverse AD brain pathology by alleviating deficits in memory, increasing learning capacity, increasing antioxidant activity, modulating the expression of immune-related cytokines, enhancing autophagy and improving the composition of GM in aluminum chloride-treated rats, implying that AD pathogenesis may be mitigated by treatment with camellia oil through the microbiome-gut-brain axis.

An Evaluation System of Fundus Photograph-Based Intelligent Diagnostic Technology for Diabetic Retinopathy and Applicability for Research.

INTRODUCTION: In April 2018, the US Food and Drug Administration (FDA) approved the world's first artificial intelligence (AI) medical device for detecting diabetic retinopathy (DR), the IDx-DR. However, there is a lack of evaluation systems for DR intelligent diagnostic technology. METHODS: Five hundred color fundus photographs of diabetic patients were selected. DR severity varied from grade 0 to 4, with 100 photographs for each grade. Following that, these were diagnosed by both ophthalmologists and the intelligent technology, the results of which were compared by applying the evaluation system. The system includes primary, intermediate, and advanced evaluations, of which the intermediate evaluation incorporated two methods. Main evaluation indicators were sensitivity, specificity, and kappa value. RESULTS: The AI technology diagnosed 93 photographs with no DR, 107 with mild non-proliferative DR (NPDR), 107 with moderate NPDR, 108 with severe NPDR, and 85 with proliferative DR (PDR). The sensitivity, specificity, and kappa value of the AI diagnoses in the primary evaluation were 98.8%, 88.0%, and 0.89, respectively. According to method 1 of the intermediate evaluation, the sensitivity of AI diagnosis was 98.0%, specificity 97.0%, and the kappa value 0.95. In method 2 of the intermediate evaluation, the sensitivity of AI diagnosis was 95.5%, the specificity 99.3%, and kappa value 0.95. In the advanced evaluation, the kappa value of the intelligent diagnosis was 0.86. CONCLUSIONS: This article proposes an evaluation system for color fundus photograph-based intelligent diagnostic technology of DR and demonstrates an application of this system in a clinical setting. The results from this evaluation system serve as the basis for the selection of scenarios in which DR intelligent diagnostic technology can be applied.

Influence of prostate size on the perioperative and postoperative outcome of transurethral plasmakinetic enucleation of the prostate: Results of 892 patients with 3 years of follow-up.

To explore the influence of prostate size on the outcome of Plasmakinetic enucleation of the prostate (PkEP) for the treatment of benign prostate hyperplasia (BPH), The data of 892 patients with symptomatic BPH who underwent PkEP were retrospectively reviewed. Among them, 199 (22.31%) had the prostate size smaller than 40 g (Group 1), 409 (45.85%) between 40 and 79 g (Group 2), 197 (22.09%) between 80 and 120 g (Group 3), and 87 (9.75%) larger than 120 g (Group 4). Perioperative variables, perioperative and postoperative complications were recorded. Patients were followed up for 36 months postoperatively. The efficiency of the surgery increased as the prostate size increased. Greater decreases in hemoglobin were noted in groups with larger prostates, while the duration of catheterization after the operation was similar across all groups. During the 3-year follow-up, the postoperative improvement in International Prostate Symptom Score (IPSS), Quality of Life (QOL), maximal flow rate (Qmax) and post-void residual urine volume (PVR), as well as longterm complications including urethral stricture and bladder-neck contracture were comparable across the 4 groups. These findings revealed that PkEP is more efficient for large prostate and can treat all prostates regardless of the size with equivalent symptom relief and micturition improvement.

Extramedullary hematopoiesis involving the thyroid: A rare cytologic finding in otherwise healthy patients and review of literature.

BACKGROUND/PURPOSE: The thyroid gland is an uncommon site for the presence of extramedullary hematopoiesis (EMH). We report the cases of four Taiwanese women with hematopoietic elements on the smears of thyroid fine needle aspiration (FNA) samples and compare the findings with those of previously reported cases. METHODS: We retrieved the data of cases in which thyroid FNA performed between January 2000 and December 2016. The clinical manifestations, laboratory data, and image findings of cases with thyroid EMH were reported. A review of English literature was performed, and the reported cases were compared with our series. RESULTS: During the study period, 63,361 specimens of thyroid FNAs were identified. Four specimens contained hematopoietic elements from four women. Ultrasound study revealed calcifications in three patients. A review of English literature yielded 18 reports of thyroid EMH involving 29 patients. Twenty-six patients were women, and three were men. Nodule calcifications were found in 13 patients. Four patients had primary myelofibrosis, and one had chronic anemia. None had a thyroid malignancy. CONCLUSION: Four patients were noted to have bone marrow elements on the smears among 63,361 thyroid FNA samples. These four Taiwanese women presented with nodular goiter and foci of hematopoietic elements by thyroid FNA without any chronic disease of hematopoietic tissue or any evidence of a thyroid malignancy.