Implant Failure and Acetabular Protrusion Post Austin Moore Prosthesis: A Case Report

Implant failure and acetabular protrusion are significant complications following Austin Moore prosthesis insertion, particularly in elderly patients with hip fractures. Total hip arthroplasty (THA) offers superior outcomes compared to hemiarthroplasty (HA) but comes with its own set of challenges. Understanding the risk factors and implications of these complications is crucial for choosing effective management.  In this article, we report a 76-year-old woman who presented with severe left hip pain post-fall, eight years after HA with an Austin Moore prosthesis due to a trochanter fracture. The patient was able to walk with a walker before the fall. Physical examination revealed tenderness and limited range of motion. Radiographic imaging confirmed acetabular protrusion and AMP neck fracture. Conversion to THA using a hybrid system was performed successfully, with the patient exhibiting no post-operative complications. This case report showed that implant failure and acetabular protrusion pose complex challenges, exacerbated by patient demographics, implant design, and bone quality. THA emerges as a preferred option due to its superior outcomes, although conversion from HA is associated with increased risks. Early diagnosis and intervention, as well as a multidisciplinary approach and careful consideration of patient-specific factors, are crucial for optimizing patient outcomes and quality of life

On the contiguous relations of hypergeometric series

AbstractContiguous relations are a fundamental concept within the theory of hypergeometric series and orthogonal polynomials. Their study goes back to Gauss who gave a list of 15 “fundamental” relations for the F12 hypergeometric series. In this paper we will prove some consequences of contiguous relations of F12

Analisis Pengaruh Jarak dan Waktu Terhadap Tingkat Kebisingan di Pemukiman Akibat Sumber dari PLTU dengan Pendekatan Statistik

Kebisingan dari aktivitas putaran blower pada Pembangkit Listrik Tenaga Uap (PLTU) mencapai 115 dB, Tingkat yang membahayakan pendengaran manusia. Oleh karena itu, PLTU harus memberikan peredam kebisingan pada ruangan mesinnya. Studi sebelumnya telah meneliti pengaruh jarak dan waktu terhadap kebisingan akibat operasional mesin pembangkit listrik, Namun belum menggunakan pendekatan Taguchi yang dapat menganalisis interaksi faktor-faktor tersebut secara komprehensif, Sehingga Penelitian ini bertujuan untuk menganalisis pengaruh jarak dan waktu terhadap kebisingan di pemukiman akibat PLTU menggunakan metode Taguchi kemudian dilanjutkan menganalisis menggunakan Regresli linear menggunakan Software Minitab. Data kebisingan diukur dengan variasi jarak dan waktu siang - malam. Hasil analisis menunjukkan bahwa pada jarak 400 meter menunjukan hasil rata-rata sebesar 54,22 dB, Karena aktivitas PLTU cenderung stabil sepanjang hari, perbedaan antara siang dan malam hanya berdampak kecil pada tingkat kebisingan. dimana hasil tersebut sudah dibawah ambang batas yang diizinkan pada tingkat kebisingan di pemukiman sekitar PLTU. Hasil penilitian ini dapat menjadi indikator jarak antara PLTU dengan pemukiman minimal sejauh 400 meter

Giant Bladder stone and rectal prolapse complication in pediatric patient: Case report and literature review

Introduction and importance A giant bladder stone (BS) in the urinary tract system with a rectal prolapse complication is a rare urologic problem; it is even rarer in pediatric patients. In the case of bladder stone formation, a variety of steps result in a variety of stone compositions. This study aims to understand the rare disease course of a one-year-old patient with bladder and urethral stones and a rectal prolapse complication. Case presentation A one-year-old boy presented with an inability to urinate since morning. It was a recurring incident for about a year but never resolved. The patients experienced irregular diarrhea and difficulty eating and drinking. Anal inspection revealed prolapse recti. The laboratory investigation found leukocytosis and anemia with normal blood urea nitrogen and creatinine. Urine tests revealed leukocyturia and hematuria. A plain radiograph of the abdomen showed a round opacity around the pelvic area. Ultrasonography of the abdomen and urinary tract revealed a giant BS and severe bilateral hydronephrosis. Thus, a cystolithotomy procedure was performed, and an additional urethral stone was found. Obtained bladder stones with a size of 30 × 21 × 15mm, with 57 % of uric acid and 33 % of calcium oxalate. A manual reduction of the prolapsed rectum was also performed during surgery. There was no recurrence of the prolapsed rectum after surgery. Clinical discussion BS is very rare in the pediatric population. The development of our case's stone composition starts with pure uric acid, which is later enveloped by calcium oxalate due to its lack of acidic atmosphere. Rectal prolapse occurs due to increased abdominal pressure caused by straining during urination. Conclusion The pathogenesis of BS is multifactorial, with local and systemic factors. Early diagnosis and comprehensive history-taking are essential for BS management decisions. The management of BS depends on its size, composition, and symptoms

Improving mitotic cell counting accuracy and efficiency using phosphohistone‐H3 ( PHH3 ) antibody counterstained with haematoxylin and eosin as part of breast cancer grading

Background: Mitotic count in breast cancer is an important prognostic marker. Unfortunately, substantial inter‐ and intraobserver variation exists when pathologists manually count mitotic figures. To alleviate this problem, we developed a new technique incorporating both haematoxylin and eosin (H&E) and phosphorylated histone H3 (PHH3), a marker highly specific to mitotic figures, and compared it to visual scoring of mitotic figures using H&E only. Methods: Two full‐face sections from 97 cases were cut, one stained with H&E only, and the other was stained with PHH3 and counterstained with H&E (PHH3–H&E). Counting mitoses using PHH3–H&E was compared to traditional mitoses scoring using H&E in terms of reproducibility, scoring time, and the ability to detect mitosis hotspots. We assessed the agreement between manual and image analysis‐assisted scoring of mitotic figures using H&E and PHH3–H&E‐stained cells. The diagnostic performance of PHH3 in detecting mitotic figures in terms of sensitivity and specificity was measured. Finally, PHH3 replaced the mitosis score in a multivariate analysis to assess its significance. Results: Pathologists detected significantly higher mitotic figures using the PHH3–H&E (median ± SD, 20 ± 33) compared with H&E alone (median ± SD, 16 ± 25), P < 0.001. The concordance between pathologists in identifying mitotic figures was highest when using the dual PHH3–H&E technique; in addition, it highlighted mitotic figures at low power, allowing better agreement on choosing the hotspot area (k = 0.842) in comparison with standard H&E (k = 0.625). A better agreement between image analysis‐assisted software and the human eye was observed for PHH3‐stained mitotic figures. When the mitosis score was replaced with PHH3 in a Cox regression model with other grade components, PHH3 was an independent predictor of survival (hazard ratio [HR] 5.66, 95% confidence interval [CI] 1.92–16.69; P = 0.002), and even showed a more significant association with breast cancer‐specific survival (BCSS) than mitosis (HR 3.63, 95% CI 1.49–8.86; P = 0.005) and Ki67 (P = 0.27). Conclusion: Using PHH3–H&E‐stained slides can reliably be used in routine scoring of mitotic figures and integrating both techniques will compensate for each other's limitations and improve diagnostic accuracy, quality, and precision

The molecular mechanisms underlying reduced E-cadherin expression in invasive ductal carcinoma of the breast: high throughput analysis of large cohorts

E-cadherin is a tumor suppressor gene in invasive lobular breast cancer. However, a proportion of high-grade ductal carcinoma shows reduced/loss of E-cadherin. In this study, we assessed the underlying mechanisms and molecular implications of E-cadherin loss in invasive ductal carcinoma. This study used large, well-characterized cohorts of early-stage breast cancer-evaluated E-cadherin expression via various platforms including immunohistochemistry, microarray analysis using Illumina HT-12 v3, copy number analysis using Affymetrix SNP 6.0 arrays, and next-generation sequencing for differential gene expression. Our results showed 27% of high-grade invasive ductal carcinoma showed reduced/loss of E-cadherin membranous expression. CDH1 copy number loss was in 21% of invasive ductal carcinoma, which also showed low CDH1 mRNA expression (p = 0.003). CDH1 copy number was associated with copy number loss of TP53, ATM, BRCA1, and BRCA2 (p < 0.001). Seventy-nine percent of invasive ductal carcinoma with reduced CDH1 mRNA expression showed elevated expression of E-cadherin transcription suppressors TWIST2, ZEB2, NFKB1, LLGL2, CTNNB1 (p < 0.01). Reduced/loss E-cadherin expression was associated with differential expression of 2143 genes including those regulating Wnt (FZD2, GNG5, HLTF, WNT2, and CER1) and PIK3-AKT (FGFR2, GNF5, GNGT1, IFNA17, and IGF1) signaling pathways. Interestingly, key genes differentially expressed between invasive lobular carcinoma and invasive ductal tumors did not show association with E-cadherin loss in invasive ductal carcinoma. We conclude that E-cadherin loss in invasive ductal carcinoma is likely a consequence of genomic instability occurring during carcinogenesis. Potential novel regulators controlling E-cadherin expression in invasive ductal carcinoma warrant further investigation

Quantitative expression of oestrogen receptor in breast cancer: Clinical and molecular significance

BackgroundOestrogen receptor (ER) positive breast cancer (BC) patients are eligible for endocrine therapy (ET), regardless of ER immunohistochemical expression level. There is a wide spectrum of ER expression and the response to ET is not uniform. This study aimed to assess the clinical and molecular consequences of ER heterogeneity with respect to ET-response.MethodsER expression, categorised by percentage and staining intensity in a large BC cohort (n = 7559) was correlated with clinicopathological parameters and patient ET response. The Cancer Genome Atlas Data BC cohort (n = 1047) was stratified by ER expression and transcriptomic analysis completed to better understand the molecular basis of ER heterogeneity.ResultsThe quantitative proportional increase in ER expression was positively associated with favourable prognostic parameters. Tumours with 1–9% ER expression were characteristically similar to ER-negative (<1%) tumours. Maximum ET-response was observed in tumours with 100% ER expression, with responses significantly different to tumours exhibiting ER at < 100% and significantly decreased survival rates were observed in tumours with 50% and 10% of ER expression. The Histochemical-score (H-score), which considers both staining intensity and percentage, added significant prognostic value over ER percentage alone with significant outcome differences observed at H-scores of 30, 100 and 200. There was a positive correlation between ER expression and ESR1 mRNA expression and expression of ER-regulated genes. Pathway analysis identified differential expression in key cancer-related pathways in different ER-positive groups.ConclusionET-response is statistically proportionally related to ER expression with significant differences observed at 10%, 50% and 100%. The H-score adds prognostic and predictive information