Difficulties in establishing a timely diagnosis of pulmonary artery sarcoma misdiagnosed as chronic thrombo-embolic pulmonary disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pulmonary artery sarcomas are rare neoplasms that are often confused with chronic thrombo-embolic disease, as both can have similar clinical and imaging presentation.</p> <p>Case presentation</p> <p>In this report, we present a case of a 50-year-old man initially diagnosed with chronic thrombo-embolic pulmonary disease, but who was later found to have pulmonary artery sarcoma with poor survival prognosis. We review the clinical and imaging characteristics of the two diseases and discuss the difficulties in establishing a timely diagnosis.</p> <p>Conclusion</p> <p>Similar clinical features and imaging presentation of pulmonary artery sarcoma and chronic thrombo-embolic pulmonary disease make definitive diagnosis difficult. This case report also illustrates and emphasizes that in any case with no predisposition factors for embolism, no evidence of deep venous thrombosis and pulmonary emboli, and inadequate relief of symptoms with anticoagulation, an alternative diagnosis of pulmonary artery sarcoma should be considered. If pulmonary artery sarcoma is diagnosed late in the course of the disease, there is usually a poor survival outcome.</p

Multidisciplinary approach to management of hypofibrinogenaemia in pregnancy: A case report

Inherited fibrinogen disorders introduce risk for recurrent abortions, sub-chorionic haematoma, placental abruption and postpartum haemorrhage. This is a case report of a successful pregnancy outcome in a 37-year old woman with hypofibrinogenaemia. She was referred to a coagulation test in the first trimester because of history of preeclampsia and HELLP syndrome in previous pregnancy. Hypofibrinogenaemia was diagnosed with fibrinogen level of 0.7 g/L. During the pregnancy she was regularly monitored for fibrinogen levels and multiple cryoprecipitate concentrates were given. She delivered at 39th gestation week, with elective caesarean section under general anaesthesia. There was one episode of postpartum haemorrhage treated with 2 units of red blood cells, repeated infusions of cryoprecipitate to obtain the level of fibrinogen of 2 g/L. She was discharged on the 6th postpartum day in a good condition. In these disorders levels of fibrinogen should be higher than 1 g/L during pregnancy or 2 g/L in case of caesarean section for successful prenatal and peripartal management

Adsorption, desorption and diffusion of extended objects on a square lattice

Kinetics of the adsorption-desorption process with diffusional relaxation is studied by Monte-Carlo simulations on a square lattice. At each Monte-Carlo step three independent processes proceeding in parallel are attempted: adsorption, desorption and diffusion. The time is measured by the number of adsorption attempts per lattice site and the kinetics of the process is governed by the ratios of desorption to adsorption rate and diffusion to adsorption rate. The process is reversible and after long enough time the system reaches an equilibrium state. For a given desorption/adsorption rate ratio equilibrium coverage is not affected by the diffusion rate, while the diffusion fastens the approach to the equilibrium state. These simulations could also be useful for explanation of the densification process in granular materials. © 2003 Elsevier B.V. All rights reserved

WEGENER GRANULOMATOSIS- CASE REPORT

Wegener granulomatosis is uncommon multisystemic disease, characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and general focal necrotizing vasculitis (Commonly known as „Wegener's triad“). The lungs are involved in 72 per cent of patients and the clinic and radiographic findings indicated bilateral pulmonary nodules of varying size and definition, cavitated in half of the patients, accompanied by the nodular lesion with a rare involvement of the pleura.We described a case of 62-year-old women with pansinusitis, mild azotemia and initial respiratory tract symptoms such as chronic cough and occasional hemoptysis. Due to bilateral nodular infiltrates in lungs on chest radiogram she was initially treated for smear negative pulmonary tuberculosis, but without expected antituberculous response. An additional diagnostic procedure pointed to Morbus Wegener.Two patterns of ANCA positive immunofluorescence are recognized as reliable and valuable diagnostic tools in the absence of histopathology for the diagnosis of Wegener granulomatosis

An innovative, quick and convenient labeling method for the investigation of pharmacological behavior and the metabolism of poly(DL-lactide-co-glycolide) nanospheres

Nanoparticles of poly(DL-lactide-co-glycolide) (PLGA) in the size range 90-150 nm were produced using the physicochemical method with solvent/non-solvent systems. The encapsulation of the ascorbic acid in the polymer matrix was performed by homogenization of the water and organic phases. In vitro degradation and release tests of PLGA nanoparticles with and without encapsulated ascorbic acid were studied for more than 60 days in PBS and it has been determined that PLGA completely degrades within this period, fully releasing all encapsulated ascorbic acid. The cytotoxicity of PLGA and PLGA/ascorbic acid 85/15% nanoparticles was examined with human hepatoma cell lines (HepG2 ECACC), in vitro. The obtained results indicate that neither PLGA nanospheres nor PLGA/ascorbic acid 85/15% nanoparticles significantly affected the viability of the HepG2 cells. The investigation of the distribution and pharmacokinetics of PLGA is crucial for the effective prediction of host responses to PLGA in particular applications. Thus we present a method of labeling PLGA nanospheres and PLGA/ascorbic acid 85/15 wt% nanoparticles by (99m)Tc which binds outside, leaving the cage intact. This enables a quick and convenient investigation of the pharmacological behavior and metabolism of PLGA. The biodistribution of (99m)Tc-labeled PLGA particles with and without encapsulated ascorbic acid after different periods of time of their installation into rats was examined. PLGA nanospheres with encapsulated ascorbic acid exhibit prolonged blood circulation accompanied by time-dependent reduction in the lungs, liver and spleen, and addition in the kidney, stomach and intestine. The samples were characterized by x-ray diffraction, scanning electron microscopy, stereological analysis, transmission electron microscopy, ultraviolet spectroscopy and instant thin layer chromatography

Linking spontaneous and stimulated spine dynamics

Abstract Our brains continuously acquire and store memories through synaptic plasticity. However, spontaneous synaptic changes can also occur and pose a challenge for maintaining stable memories. Despite fluctuations in synapse size, recent studies have shown that key population-level synaptic properties remain stable over time. This raises the question of how local synaptic plasticity affects the global population-level synaptic size distribution and whether individual synapses undergoing plasticity escape the stable distribution to encode specific memories. To address this question, we (i) studied spontaneously evolving spines and (ii) induced synaptic potentiation at selected sites while observing the spine distribution pre- and post-stimulation. We designed a stochastic model to describe how the current size of a synapse affects its future size under baseline and stimulation conditions and how these local effects give rise to population-level synaptic shifts. Our study offers insights into how seemingly spontaneous synaptic fluctuations and local plasticity both contribute to population-level synaptic dynamics

The Fcε‐receptor I pathway is crucial but not exclusive for basophil activation in patients with autoimmune forms of chronic spontaneous urticaria

Ibrutinib, an irreversible and specific Bruton's tyrosine kinase (BTK) inhibitor, leads to complete inhibition of IgE/FcεRI-BTK degranulation of human basophils without affecting the signaling via G-protein coupled receptors (C5a, fMLP) [1;2]. Since autoantibodies in chronic spontaneous urticaria (CSU) either against the IgE/FcεRI complex or IgE play a relevant role in CSU [3;4], ibrutinib could, therefore, be a promising asset in basophil assays [5]. This in-vitro study aimed to differentiate between FcεRI dependent and independent pathways in autoimmune CSU (aiCSU)