27 research outputs found
Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis
Introduction: This study aimed to cross-culturally adapt a
Malay version of Knee Injury and Osteoarthritis Outcome
Score (KOOS) and to evaluate its psychometric properties in
patients with knee osteoarthritis (OA).
Materials and Methods: The English version KOOS was
translated into a Malay version using forward and backward
translation process, followed by face validity and content
validity. Two hundred and twenty-six knee OA patients
attending the Outpatient and Orthopaedic Clinics, Universiti
Sains Malaysia Hospital, completed the Malay version
KOOS. Construct validity using confirmatory factor analysis
and internal reliability assessment were performed.
Results: The results showed that the original five-factor
model with 42 items failed to achieve acceptable values of
the goodness of fit indices, indicating poor model fit. A new
five-factor model of 26 items demonstrated acceptable level
of goodness of fit (comparative fit index= 0.929, incremental
fit index= 0.930, Tucker Lewis fit index= 0.920, root mean
square error of approximation= 0.073 and Chisquared/
degree of freedom= 2.183) indices to signify a
model fit. The Cronbach’s alpha value for the new model
ranged from 0.776 to 0.946. The composite reliability values
of each construct ranged between 0.819 and 0.921,
indicating satisfactory to high level of convergent validity.
Conclusion: The five-factor model with 26 items in the
Malay version of KOOS questionnaire demonstrated a good
degree of goodness of fit and was found to be valid, reliable
and simple as an assessment tool for symptoms, pain,
activity of daily living, sports and recreational activity and
quality of life for Malaysian adults suffering from knee
osteoarthritis
Histological and immunohistochemical features of the spleen in persistent polyclonal B-cell lymphocytosis closely mimic splenic B-cell lymphoma
Persistent polyclonal B-cell lymphocytosis (PPBL) is rare and intriguing hematological disorder predominantly reported in young to middle- aged smoking women. It is characterized by persistent moderate polyclonal B-cell lymphocytosis with circulating hallmark binucleated lymphocytes and elevated polyclonal serum IgM. Most patients have benign clinical course on long-term follow-up. Some pathologic features of PPBL may resemble malignant lymphoma, including morphology as well as frequent cytogenetic and molecular abnormalities. Significant symptomatic splenomegaly requiring splenectomy is very unusual for this disorder; therefore there is a lack of descriptions of the morphologic features of the spleen in the literature. We present here one of the first detailed descriptions of the morphologic and immunohistochemical features of the spleen from a young female with PPBL who developed massive splenomegaly during 6-year follow up. Splenectomy was performed for symptomatic relief and suspicion of malignant process. The morphological and immunohistochemical features of the spleen closely mimicked involvement by B-cell lymphoma, however there was no monotypic surface light chain restriction seen by flow cytometry and no clonal rearrangement of IgH gene was detected by molecular analysis. Evaluating a splenectomy sample in cases like this may present a diagnostic challenge to pathologists. Therefore, correlation with B cell clonality studies (by flow cytometry and molecular analysis), clinical findings and peripheral blood morphology searching for characteristic binucleated lymphocytes is essential to avoid misdiagnosing this benign process as B-cell lymphoma. We also present here a literature review on pathogenesis of PPBL
Clear cell variant of diffuse large B-cell lymphoma: a case report
<p>Abstract</p> <p>Introduction</p> <p>Diffuse large B-cell lymphoma is a diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or exceeding the normal macrophage nuclei. We report a case of a clear cell variant of diffuse large B-cell lymphoma involving a lymph node in the neck, which was clinically suspected of being metastatic carcinoma.</p> <p>Case presentation</p> <p>A 39-year-old Caucasian ethnic Albanian man from Kosovo presented with a rapidly enlarging lymph node in his neck, but he also disclosed B symptoms and fatigue. A cytological aspirate of the lymph node revealed pleomorphic features. Our patient underwent a cervical lymph node biopsy (large excision). The mass was homogeneously fish-flesh, pale white tissue replacing almost the whole structure of the lymph node. The lymph node biopsy showed a partial alveolar growth pattern, which raised clinical suspicion that it was an epithelial neoplasm. With regard to morphological and phenotypic features, we discovered large nodules in diffuse areas, comprising large cells with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In these areas, there was high mitotic activity, and in some areas there were macrophages with tangible bodies. Staining for cytokeratins was negative. These areas had the following phenotypes: cluster designation marker 20 (CD20) positive, B-cell lymphoma (Bcl)-2-positive, Bcl-6<sup>-</sup>, CD5<sup>-</sup>, CD3<sup>-</sup>, CD21<sup>+ </sup>(in alveolar patterns), prostate-specific antigen-negative, human melanoma black marker 45-negative, melanoma marker-negative, cytokeratin-7-negative and multiple myeloma marker 1-positive in about 30% of cells, and exhibited a high proliferation index marker (Ki-67, 80%).</p> <p>Conclusion</p> <p>According to the immunohistochemical findings, we concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of activated cell type, post-germinal center cell origin. Our patient is undergoing R-CHOP chemotherapy treatment.</p
The polycomb group proteins, BMI-1 and EZH2, are tumour-associated antigens
We used SEREX technology to identify novel tumour-associated antigens in patients with primary hepatocellular carcinoma and found serological responses to the polycomb group (PcG) protein BMI-1, which is overexpressed in a range of different tumour types. Further studies identified T-cell responses to both BMI-1 and another PcG protein, EZH2, in cancer patients and at relatively lower levels in some normal donors. We next identified several CD8+ T-cell epitopes derived from BMI-1 and EZH2 and demonstrated that EZH2-derived peptides elicited more significant interferon-γ (IFN-γ) release than BMI-1-derived peptides. That CD8+ T cells were responsible for the observed responses was confirmed for EZH2 by both IFN-γ capture assays and tetramer staining using an HLA-A0201-restricted, EZH2-derived YMSCSFLFNL (aa 666–674) epitope. The ability of YMSCSFLFNL (aa 666–674) to stimulate the in vitro expansion of specific T cells from peripheral blood lymphocytes was greatly enhanced when the CD25+ T-cell population was depleted. EZH2-specific cytotoxic T lymphocyte clones specific for two HLA-A0201 epitopes were generated and found to recognise endogenously processed EZH2 in both HLA-matched fibroblasts and tumour cell lines. Given the widespread overexpression of PcG proteins in cancer and their critical role in oncogenesis, these data suggest that they may be useful targets for cancer immunotherapy
Consistent truncations of supergravity and 1/2-BPS RG flows in 4d SCFTs
With the purpose of holographically describing flows from a large family of
four dimensional and conformal field theories, we
discuss truncations of seven dimensional supergravity to five dimensions. We
write explicitly the reduced gauged supergravity and find BPS equations for
simple configurations. Lifting these flows to eleven dimensions or Massive IIA
supergravity, we present string duals to RG flows from strongly coupled
conformal theories when deformed by marginal and/or relevant operators. We
further discuss observables common to infinite families of and
QFTs in this context.Comment: 28 pages plus appendixes. JHEP versio
The Aguablanca Ni–(Cu) sulfide deposit, SW Spain: geologic and geochemical controls and the relationship with a midcrustal layered mafic complex
The Aguablanca Ni–(Cu) sulfide deposit is
hosted by a breccia pipe within a gabbro–diorite pluton.
The deposit probably formed due to the disruption of a
partially crystallized layered mafic complex at about 12–
19 km depth and the subsequent emplacement of melts and
breccias at shallow levels (<2 km). The ore-hosting breccias
are interpreted as fragments of an ultramafic cumulate,
which were transported to the near surface along with a
molten sulfide melt. Phlogopite Ar–Ar ages are 341–
332 Ma in the breccia pipe, and 338–334 Ma in the layered
mafic complex, and are similar to recently reported U–Pb
ages of the host Aguablanca Stock and other nearby calcalkaline
metaluminous intrusions (ca. 350–330 Ma). Ore
deposition resulted from the combination of two critical
factors, the emplacement of a layered mafic complex deep
in the continental crust and the development of small
dilational structures along transcrustal strike-slip faults that
triggered the forceful intrusion of magmas to shallow
levels. The emplacement of basaltic magmas in the lower
middle crust was accompanied by major interaction with
the host rocks, immiscibility of a sulfide melt, and the
formation of a magma chamber with ultramafic cumulates
and sulfide melt at the bottom and a vertically zoned mafic
to intermediate magmas above. Dismembered bodies of
mafic/ultramafic rocks thought to be parts of the complex
crop out about 50 km southwest of the deposit in a
tectonically uplifted block (Cortegana Igneous Complex,
Aracena Massif). Reactivation of Variscan structures that
merged at the depth of the mafic complex led to sequential
extraction of melts, cumulates, and sulfide magma. Lithogeochemistry
and Sr and Nd isotope data of the Aguablanca
Stock reflect the mixing from two distinct reservoirs, i.e.,
an evolved siliciclastic middle-upper continental crust and a
primitive tholeiitic melt. Crustal contamination in the deep
magma chamber was so intense that orthopyroxene
replaced olivine as the main mineral phase controlling the early fractional crystallization of the melt. Geochemical
evidence includes enrichment in SiO2 and incompatible
elements, and Sr and Nd isotope compositions (87Sr/86Sri
0.708–0.710; 143Nd/144Ndi 0.512–0.513). However, rocks
of the Cortegana Igneous Complex have low initial
87Sr/86Sr and high initial 143Nd/144Nd values suggesting
contamination by lower crustal rocks. Comparison of the
geochemical and geological features of igneous rocks in the
Aguablanca deposit and the Cortegana Igneous Complex
indicates that, although probably part of the same magmatic
system, they are rather different and the rocks of the
Cortegana Igneous Complex were not the direct source of
the Aguablanca deposit. Crust–magma interaction was a
complex process, and the generation of orebodies was
controlled by local but highly variable factors. The model
for the formation of the Aguablanca deposit presented in
this study implies that dense sulfide melts can effectively
travel long distances through the continental crust and that
dilational zones within compressional belts can effectively
focus such melt transport into shallow environments
HOTAIR and its surrogate DNA methylation signature indicate carboplatin resistance in ovarian cancer
Shoulder Impingement, An Uncommon Complication of Distal Clavicle Fracture Treated Arthroscopically: A Case Report
Jellyfish Envenomation Resulting In Vascular Insufficiency And Neurogenic Injury of Upper Limb
Following a week after a jellyfish sting, a young man presented with regional cyanosis and threat of distal gangrene secondary to vascular spasm in the forearm. The patient also suffered from transient paresis and numbness of the affected upper limb. Contrasted imaging revealed unopacified vessels in the distal forearm and worsening swelling warranted emergency surgical fasciotomy for
impending compartment syndrome. This case highlights the occurrence of jellyfish envenomation and the need for early treatment