Cushing Syndrome Caused by Pituitary and Adrenal Hybrid Tumor: A Rare Case Report

Introduction: Cushing syndrome is a rare endocrine disorder caused by a variety of underlying etiologies. It can be due to exogenous or endogenous high cortisone levels (ACTH-dependent or ACTH-independent). We herein report a case of ACTHdependent Cushing syndrome caused by pituitary and adrenal hybrid adenoma. Case report: A 42-year-old female presented with a complaint of hematemesis. She had hirsutism, central obesity and violaceous striae on her abdomen and thigh. On detailed clinical examination and relevant investigation, we found that the cause of hematemesis was esophagitis with necrotic gastric ulcer due to Cushing syndrome caused by the pituitary and adrenal hybrid adenoma. Discussion: Cushing syndrome is a rare endocrine disorder characterized by increased exogenous or endogenous serum cortisol levels, which lead to various clinical presentations. Early identification of the disease and its cause is critical. The entire clinical presentation must be considered for correct diagnosis, which is generally delayed due to the overlapping symptoms of the disease with various specialities. Conclusion: Diagnosis and management of Cushing’s syndrome continues to present considerable challenges and necessitates referral to higher centers. Its diverse presentation warrants a complete clinical, physical, radiological and endocrine examination

Evidence for topological defects in a photoinduced phase transition

Upon excitation with an intense ultrafast laser pulse, a symmetry-broken ground state can undergo a non-equilibrium phase transition through pathways dissimilar from those in thermal equilibrium. Determining the mechanism underlying these photo-induced phase transitions (PIPTs) has been a long-standing issue in the study of condensed matter systems. To this end, we investigate the light-induced melting of a unidirectional charge density wave (CDW) material, LaTe$_3$. Using a suite of time-resolved probes, we independently track the amplitude and phase dynamics of the CDW. We find that a quick ($\sim\,$1$\,$ps) recovery of the CDW amplitude is followed by a slower reestablishment of phase coherence. This longer timescale is dictated by the presence of topological defects: long-range order (LRO) is inhibited and is only restored when the defects annihilate. Our results provide a framework for understanding other PIPTs by identifying the generation of defects as a governing mechanism

Lineage-specific dynamic and pre-established enhancer–promoter contacts cooperate in terminal differentiation

Chromosome conformation is an important feature of metazoan gene regulation; however, enhancer–promoter contact remodeling during cellular differentiation remains poorly understood. To address this, genome-wide promoter capture Hi-C (CHi-C) was performed during epidermal differentiation. Two classes of enhancer–promoter contacts associated with differentiation-induced genes were identified. The first class ('gained') increased in contact strength during differentiation in concert with enhancer acquisition of the H3K27ac activation mark. The second class ('stable') were pre-established in undifferentiated cells, with enhancers constitutively marked by H3K27ac. The stable class was associated with the canonical conformation regulator cohesin, whereas the gained class was not, implying distinct mechanisms of contact formation and regulation. Analysis of stable enhancers identified a new, essential role for a constitutively expressed, lineage-restricted ETS-family transcription factor, EHF, in epidermal differentiation. Furthermore, neither class of contacts was observed in pluripotent cells, suggesting that lineage-specific chromatin structure is established in tissue progenitor cells and is further remodeled in terminal differentiation

Myocarditis with Unidigital Gangrene in Scrub Typhus Patient – Rare Case

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, an obligate intracellularbacterium. The disease is of greatest public health importance in rural areas of Asia and the Western Pacific Islands. Theclinical manifestations range from subclinical disease to organ failure. The chief target of organism is the vascular endotheliumof various organs. There is inflammation in and around the blood vessels that causes endothelial damage resulting invascular leakage and organ dysfunction. Case report: A 70-year-old female patient, farmer by occupation, presented tous with features of acute febrile illness and shortness of breath and was diagnosed as scrub typhus with myocarditis. Shesubsequently developed gangrene of right little finger. The patient was investigated for infectious and noninfectious causesof vasculitis leading to gangrene. We established that the cause for gangrene was scrub typhus as evidenced by presence ofeschar and positive serology. Conclusion: We report for the first time a case of scrub typhus complicated by both myocarditisand gangrene. Both myocarditis and unidigital gangrene are unusual complications of scrub typhus. Hence, scrub typhusshould be ruled out in patients who present with these complications

Investigation of Magnesium Silicate as an Effective Gate Dielectric for AlGaN/GaN Metal Oxide High Electron Mobility Transistors (MOSHEMT)

In this study, a 6 nm layer of Magnesium Silicate (Mg-Silicate) was deposited on AlGaN/GaN heterostructure by sputtering of multiple stacks of MgO and SiO$_{2}$, followed by rapid thermal annealing in a nitrogen (N$_{2}$) environment. The X-ray photoelectron spectroscopy (XPS) analysis confirmed the stoichiometric Mg-Silicate (MgSiO$_{3}$) after being annealed at a temperature of 850 $^\circ$C for 70 seconds. Atomic force microscopy (AFM) was employed to measure the root mean square (RMS) roughness (2.20 nm) of the Mg-Silicate. A significant reduction in reverse leakage current, by a factor of three orders of magnitude, was noted for the Mg-Silicate/AlGaN/GaN metal-oxide-semiconductor (MOS) diode in comparison to the Schottky diode. The dielectric constant of Mg-Silicate($\mathcal{E}_{Mg-Silicate}$) and the interface density of states (D$_{it}$) with AlGaN were approximated at $\sim$ 6.6 and 2.0 $\times$ 10$^{13}$ cm$^{-2}$eV$^{-1}$ respectively, utilizing capacitance-voltage (CV) characteristics

The Role of Ellis‐Van Creveld 2(EVC2) in Mice During Cranial Bone Development

EvC syndrome is a type of autosomal‐recessive chondrodysplasia. Previous case studies in patients suggest abnormal craniofacial development, in addition to dwarfism and tooth abnormalities. To investigate how craniofacial development is affected in EvC patients, surface models were generated from micro‐CT scans of control mice, Evc2 global mutant mice and Evc2 neural crest‐specific mutant mice. The anatomic landmarks were placed on the surface model to assess the morphological abnormalities in the Evc2 mutants. Through analyzing the linear and angular measurements between landmarks, we identified a smaller overall skull, shorter nasal bone, shorter frontal bone, and shorter cranial base in the Evc2 global mutants. By comparing neural crest‐specific Evc2 mutants with control mice, we demonstrated that the abnormalities within the mid‐facial regions are not accounted for by the Evc2 mutation within these regions. Additionally, we also identified disproportionate length to width ratios in the Evc2 mutants at all levels from anterior to posterior of the skull. Overall, this study demonstrates a more comprehensive analysis on the craniofacial morphological abnormalities in EvC syndrome and provides the developmental insight to appreciate the impact of Evc2 mutation within the neural crest cells on multiple aspects of skull deformities. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 301:46–55, 2018. © 2017 Wiley Periodicals, Inc.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141635/1/ar23692_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141635/2/ar23692.pd