Solitary Bone Plasmacytoma of the Skull Base With an Unusual Presentation

Solitary bone plasmacytoma (SBP) is a rare hematological malignancy that usually occurs in the spine and rarely in the skull. It rarely presents in the skull base, but presenting symptoms are associated with cranial nerve involvement depending on the site of the disease. We present the case of a 61-year-old man with an unusual presentation of hoarseness secondary to vocal fold palsy. Imaging showed a large bony lesion in the temporo-occipital region with involvement of the jugular foramen. Further detailed diagnostic procedures confirmed SBP of the skull base. Radiotherapy was given with an uneventful recovery of vocal fold function. Skull base plasmacytoma can be considered as a differential diagnosis of causes of unilateral vocal fold palsy. Early therapeutic management may improve vocal fold function.

Validation of Fespixon in Postoperative Scar Cosmesis Using Quantitative Digital Photography Analysis

BACKGROUND

Unsightly scarring after surgery remains a dilemma. One of the challenges is the lack of objective scar assessment tools.

OBJECTIVES

This study aimed to evaluate the efficacy of a novel medicine, Fespixon, for prevention and/or alleviation of post-skin incision scar. The second aim was to demonstrate the practicality of our digital analysis system to see if it would serve as a sensitive tool for scar-improving assessment.

METHODS

A prospective, placebo-controlled trial involving patients with postoperative transverse scars was conducted. Each patient received a topical formulation of Fespixon on the left scar, and placebo cream on the right scar. In addition to the subjective mVSS and VAS scores, we utilized digital photography for monthly scar analysis, with CIELab and hue serving as the colorimetric, and contrast, correlation, homogeneity, and entropy as texture information.

RESULTS

Forty-six participants (mean age, 52 years) were enrolled in the trial. All the parameters of subjective assessment showed superior results for the Fespixon-treated side, with significant differences in pigmentation, vascularity, pliability, height, itchiness, and patient satisfaction (p = 0.043, 0.013, 0.026, 0.002, 0.039, 0.012, respectively). The trends of color and texture showed increased relative difference ratios, with significant differences in most of the eigenvalues towards the Fespixon-treated side, including the CIELab-L (p = 0.000), Hue-R, B, G (p = 0.034, 0.001, 0.011), contrast (p = 0.000), homogeneity (p = 0.000), correlation (p = 0.011), and entropy (p = 0.000).

CONCLUSIONS

We validated the efficacy of Fespixon in postoperative scar healing applications from not only subjective assessments but also with objective quantitative analyses. The results also indicated that our digital photographic quantitative analysis system is an ideal tool for quantification of scar appearance.

Repetitive Transcranial Magnetic Stimulation, a Novel Therapeutic Strategy for Refractory Paradoxical Vocal Fold Motion Disorder

Paradoxical vocal fold motion disorder (PVFMD) is a condition involving the inappropriate narrowing of the larynx with symptoms of laryngeal tightness and dyspnea. A 23-year-old woman was diagnosed with PVFMD by imaging, revealing dynamically constricted, supraglottic tissue, an abnormal adduction of the vocal cords with a characteristic "posterior chink" observed. After diagnosis, laryngeal control retraining protocols and biofeedback therapy were initiated. To treat persistent symptoms, interventions such as vocal fold botulinum toxin (BoNT) injections were performed with slight improvements. Ultimately, psychiatry performed 10 repetitive transcranial magnetic stimulations (rTMS) with a right-sided, low-frequency approach to treat the patient's underlying major depressive disorder and comorbid anxious distress. Afterward, the patient's symptoms were successfully reduced with an improvement in Dyspnea Severity Index. Although most patients with PVFMD were relieved with laryngeal control therapy, some are refractory and lack the literature on the best treatment. In this case, we followed the multidisciplinary approach and individualized our novel therapeutic strategies including especially rTMS, which successfully reduced symptoms. This is the first reported case of refractory PVFMD to be treated with novel interventions, and rTMS might play a role in PVFMD mitigation.

Clinical Relevance of Urine Flow Rate and Exposure to Polycyclic Aromatic Hydrocarbons

Background: Polycyclic aromatic hydrocarbon (PAH) metabolites have received increasing attention because several of these organic substances are highly carcinogenic or mutagenic. Exposure to PAHs is associated with many harmful health effects; however, we are not aware of any study that has explored the exposure to PAHs and urinary conditions in the general population. The present work aimed to investigate the correlation among PAH and urine flow rate (UFR). Method: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2009–2012 were used in our study. A total of 4172 participants and a total of nine PAH metabolites were examined. The UFR was measured as the amount of urine excreted in a period of time (mL/h). Several covariates were adjusted in linear regression models. Result: After adjusting for variables, the PAH metabolites in urine showed a significant correlation with UFR. Dose-dependent associations between PAH metabolites in the urine and UFR were also found. Higher quartiles of PAH metabolites in urine exhibited higher regression coefficients. Conclusion: Our study highlighted that PAH metabolites in urine had a strong association with decreased UFR in the US adult population. These findings support the possibility that PAH exposure is related to bladder dysfunction. Further prospective studies are warranted.

Differential research of inflammatory and related mediators in BPH, histological prostatitis and PCa

Prostate cancer (PCa) is one of the most common male malignancies in the world. It was aimed to investigate differential expression of inflammatory and related factors in benign prostatic hyperplasia (BPH), prostate cancer (PCa), histological prostatitis (HP) and explore the role of Inducible nitric oxide synthase (iNOS), (VEGF) Vascular endothelial growth factor, androgen receptor (AR) and IL-2, IL-8 and TNF-α in the occurrence and development of prostate cancer. RT-PCR was used to detect the mRNA expression level of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α in BPH, PCa and BPH+HP. Western blotting and immunohistochemical staining were used to detect the protein levels of various proteins in three diseases. The results showed the mRNA and protein levels of iNOS, VEGF and IL-2, IL-8 and TNF-α were significantly increased in PCa and BPH+HP groups compared with BPH group (p < .05), while the AR was significantly lower than those in PCa and BPH+HP groups (p < .05). There was no significant difference in the mRNA and protein levels of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α between PCa and BPH+HP groups (p > .05). iNOS, VEGF, AR and IL-2, IL-8 and TNF-α are involved in the malignant transformation of prostate tissue and play an important role in the development and progression of Prostate cancer (PCa).

Correlation of inflammatory mediators in prostatic secretion with chronic prostatitis and chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common clinical syndrome, and the mechanisms underlying the relationship between CP/CPPS and ED are still unclear. This study aimed to investigate the differential expression of 40 inflammatory mediators in patients with CP/CPPS and to demonstrate whether these mediators related to the severity of erectile function. Eighty cases of patients with CP/CPPS were selected, including 40 cases of IIIA and 40 cases of IIIB, with 20 cases of healthy men as controls. After collecting their expressed prostatic secretion, cytokines levels in EPS were determined by ELISA using ELISA kits. The IIEF-5 questionnaire was used to evaluate erectile function. IIEF-5 scores were significantly lower in the IIIA and IIIB groups than those in the control group. The expression of IL-8, IL-1β and ICAM-1 was markedly higher in the IIIA and IIIB groups than in the control group. The expression of IL-8, IL-1β and ICAM-1 in the IIIA group was higher than that in the IIIB group. The expression of IL-8, IL-1β and ICAM-1 was negatively correlated with IIEF-5 scores in both IIIA and IIIB patients. In conclusion, IL-8, IL-1β and ICAM-1 are possible indicators for the clinical diagnosis of CP/CPPS and evaluation of erectile function on patients with CP/CPPS.

Limits on spin-independent couplings of WIMP dark matter with a p-type point-contact germanium detector

We report new limits on a spin-independent weakly interacting massive particle (WIMP)-nucleon interaction cross section using 39.5 kg days of data taken with a p-type point-contact germanium detector of 840 g fiducial mass at the Kuo-Sheng Reactor Neutrino Laboratory. Crucial to this study is the understanding of the selection procedures and, in particular, the bulk-surface events differentiation at the sub-keV range. The signal-retaining and background-rejecting efficiencies were measured with calibration gamma sources and a novel n-type point-contact germanium detector. Part of the parameter space in the cross section versus WIMP-mass implied by various experiments is probed and excluded.

[A case-control study on relationship between hepatitis C infection and primary liver cancer]

All the cases and controls emerged from a cohort study held in the past years. They were male, more than 20 years of age at the time of their enrollment into the cohort study, with serum specimens taken and kept at -20 degrees C. Every death of primary liver cancer (PLC), occurred since then, as a 'case' (78 in total), was compared with no more than 4 matched controls chosen from cohort members who were still alive until the last follow-up. ELISA technique was used to test anti-HCV antibodies in the stored serum specimens of the cases and controls. The Results showed that anti-HCV prevalence rates were 33.3% (26/78) of the cases and 15.3% (40/262) of their matched controls, respectively (chi 2 = 11.86, P < 0.01, ORMH = 3.0, PAR% = 23.40%). The results suggest that HCV infection is another important factor in the aetiology of PLC in Guangxi, China. Because the serum specimens tested were drawn years before the occurrence of PLC deaths, our conclusion need not worry about the sequential problem, which occurs in most of other kinds of case-control studies.