Extramedullary Anaplastic Plasmacytoma of the Bladder: A Case Report and Current Literature Review

Extramedullary plasmacytoma (EMP) can be found in any organ as a primary tumor or as part of multiple myeloma (MM). It mostly affects the head and neck region, upper respiratory tract and gastrointestinal tract. Bladder is one of the organs in which EMP is rarely seen. In this case, we reported a patient with a history of MM developed recurrence in the form of plasmacytomas in the bone and the bladder without bone marrow involvement after bone marrow transplantation. This recurrence has been reported as anaplastic plasmacytoma (AP) which is a rare variant of plasmacytoma. It is important to make a differential diagnosis of this subtype, which is very similar immunohistochemically with plasmablastic lymphoma (PBL) and responds poorly to treatment. This distinction is often made clinically. In this case, the pathological diagnosis of tumor in the urinary bladder was accepted as AP due to the absence of HIV and EBV infections and the presence of MM history. Immunotherapy was started for the patient who responded poorly to chemotherapy, but the recurrence of mass in the bladder was observed. Our case report is important in terms of its rare presentation in the bladder and aggressive character

Lymphocyte-to-monocyte ratio is a valuable marker to predict prostate cancer in patients with prostate specific antigen between 4 and 10 ng/dl

Objective: To evaluate the diagnostic value of serum inflammation markers derived from complete blood count in diagnosis of prostate cancer (PCa). Methods: We retrospectively analyzed the data of 621 patients who underwent prostate biopsy between March 2013 and April 2018. Age, prostate specific antigen (PSA), free PSA, platelet count, neutrophil count, lymphocyte count, monocyte count, prostate volume (PV) and pathology result of the patients were recorded. Patients were grouped as benign prostatic hyperplasia (BPH), prostatitis and PCa. Patients were also grouped according to PSA values, as PSA 10 ng/dl. Results: The mean lymphocyte-to-monocyte ratio (LMR) value of the patients with PCa was significantly lower in the entire cohort (p = 0.047). In the PSA 4-10 ng/dl range, LMR value wassignificantly lower in patients with PCa than those with BPH or prostatitis (p = 0.012). In this PSA range, free/total PSA ratio and LMR were significant factors to predict PCa. The cut-off values of LMR, free/total PSA were 3.05 and 0.15 respectively. The sensitivities, spesificities, positive predictive values (PPV) and negative predictive values using LMR cut-off, free/total PSA cut-off and their combination were assessed. Specificity and PPV of the combination group were higher (97.2%, 83.3% respectively) compared to free/total PSA cut-off group (91.6%, 76.6%) and LMR cut-off group (67.8%, 43.7%). Conclusions: LMR is a useful tool at detecting PCa especially in patients with PSA value between 4 and 10 ng/dl. The combination of free/total PSA ratio and LMR improves the diagnostic accuracy more than the use of free/total PSA ratio alone

Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging

Objective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors. Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging co evaluate the presence of any WMHs. Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively). Conclusion: MVP is found CO be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might nor be involved in the evolution of WMHs in migrain

Oxidative steam reforming of glycerol to synthesis gas in a microchannel reactor

Oxidative steam reforming (OSR) of glycerol to synthesis gas (syngas) was studied in a microchannel reactor that involved a thin layer of Rh/Al2O3 catalyst coated to the inner wall of a rectangular channel. The effects of reaction temperature (550-700 °C), molar inlet ratios of carbon-to-oxygen (C/O = 0.75, 1.125; C and O: moles of carbon and oxygen atoms at the inlet, respectively) and steam-to-carbon (S/C = 3-5) and microchannel reactor configuration on product distribution and syngas composition were investigated. In all experiments, complete, coke-free conversion of glycerol to gaseous carbon containing species was observed. The only exception was seen at 550 °C and C/O = 1.125 that led to 93% glycerol conversion and solid carbon deposition, the latter being verified by XPS and Raman spectroscopy analyses. Decrease in C/O from 1.125 to 0.75 promoted oxidation of H2, CO, CH4, C2H4, C2H6 and other carbon containing species on the catalyst surface, with the magnitude of promotion being increased notably with temperature. Despite O2-enriched feeding, Rh remained at metallic state as revealed by XPS characterization of the spent samples. Lowering C/O also elevated yields of CO2 and steam, the latter which drived water-gas shift (WGS), an important side reaction that affected product distribution on Rh/Al2O3 in favor of H2. Yields of C1-C2 hydrocarbons decreased at higher temperatures and at lower C/O and S/C ratios due to their consumption via total oxidation and steam reforming routes, respectively. Microchannel reactor packed with particulate form of catalyst gave yields of CO2 and H2 lower and yields of CO and C1-C2 hydrocarbons higher than those obtained in the coated configuration under identical conditions. These findings seemed to correlate with the extents of oxidation reactions and WGS, which were believed to vary mainly with different heat transport characteristics of the reactor schemes. H2/CO ratios close to the ideal value of 1 for Fischer-Tropsch synthesis were obtained at 700 °C, S/C = 3-4 and C/O = 1.125

Association of oxidative stress with clinical characteristics in patients with rheumatoid arthritis

BackgroundFew studies examining the association between oxidative stress and clinical parameters or disease activity in patients with rheumatoid arthritis (RA) are available. Therefore, the objective of this study was to test whether oxidative stress has any association with clinical parameters and disease activity in patients with RA