8,9-Isopropyl­idenedi­oxy-3-p-tolyl-1,6-dioxa-3-aza­spiro­[4.5]decane-2,10-dione

In the title compound, C17H19NO6, which may serve as a ketone catalyst for the asymmetric epoxidation of olefins, the crystal packing is consolidated by C—H⋯O inter­actions

Gap Anisotropy in Iron-Based Superconductors: A Point-Contact Andreev Reflection Study of BaFe2−x_{2-x}Nix_{x}As2_2 Single Crystals

We report a systematic investigation on c-axis point-contact Andreev reflection (PCAR) in BaFe$_{2-x}$Ni$_x$As$_2$ superconducting single crystals from underdoped to overdoped regions (0.075 $\leq x\leq 0.15$). At optimal doping ($x=0.1$) the PCAR spectrum feature the structures of two superconducting gap and electron-boson coupling mode. In the $s\pm$ scenario, quantitative analysis using a generalized Blonder-Tinkham-Klapwijk (BTK) formalism with two gaps: one isotropic and another angle dependent, suggest a nodeless state in strong-coupling limit with gap minima on the Fermi surfaces. Upon crossing above the optimal doping ($x > 0.1$), the PCAR spectrum show an in-gap sharp narrow peak at low bias, in contrast to the case of underdoped samples ($x < 0.1$), signaling the onset of deepened gap minima or nodes in the superconducting gap. This result provides evidence of the modulation of the gap amplitude with doping concentration, consistent with the calculations for the orbital dependent pair interaction mediated by the antiferromagnetic spin fluctuations.Comment: 5 pages, 4 figure

Solitary Calcified Nodules as the Cause of Carpal Tunnel Syndrome: Two Case Reports and Literature Reviews

Solitary calcified nodule-related carpal tunnel syndrome (CTS) is rare and easy to be misdiagnosed owing to the high incidence of primary CTS. Release of the transverse carpal ligament without removal of the mass leads to persistence of the symptoms and subsequent complications like wasting of the thenar muscles. Here, we report two cases of solitary calcified nodule-related CTS and discuss the role of ultrasound in preventing misdiagnosis. Both patients reported persistent numbness over the lateral side of their palm and weakness of the right wrist with thenar muscle atrophy. One patient had undergone transverse carpal ligament release 2 years previously, and the other had received a local injection of lidocaine at the clinic. Neither patient experienced symptom relief. X-ray revealed a similar finding of nodule lesions in front of the capitate–hamate region. Solitary calcified nodule-related CTS was diagnosed, and the patients underwent nodule removal with/without transverse ligament release. The first patient was a typical case of misdiagnosed solitary calcified nodule-related CTS. The second patient had a definitive clinical sonographic diagnosis before surgery. The accurate diagnosis of secondary CTS is paramount for performing effective surgery. Thus, ultrasonography is an easy, convenient, safe, and effective method in screening for secondary CTS

Neuroprotection of Catalpol for Experimental Acute Focal Ischemic Stroke: Preclinical Evidence and Possible Mechanisms of Antioxidation, Anti-Inflammation, and Antiapoptosis

Neuroprotection is defined as using a therapy that affects the brain tissue in the still-viable ischemic penumbra to salvage or delay the infarction. Catalpol, the main active principle of the root of Radix Rehmanniae, was reported to have pleiotropic neuroprotective effects in neurodegenerative diseases including ischemic stroke. Here, we evaluated the neuroprotective effects of catalpol in experimental acute ischemic stroke. Studies on catalpol in animal models of acute ischemic stroke were identified from 6 databases. Twenty-five studies involving 805 animals were included. Twelve comparisons showed significant effects of catalpol on decreasing infarct size according to 2,3,5-triphenyltetrazolium chloride staining compared with the control (P<0.05). One study reported significant effect of catalpol on reducing infarct size according to magnetic resonance imaging scan compared with the control (P<0.05). Meta-analysis of these studies indicated that catalpol significantly improved the neurological function score according to Zea Longa score, Bederson score, balance beam-walking test, adhesive removal test, bar-grasping score, and corner test compared with the control (P<0.05). In conclusion, catalpol exerted neuroprotective effects for experimental acute focal ischemic stroke, largely through reducing oxidative reactions, inhibiting apoptosis, and repressing inflammatory reactions and autophagy. However, these apparently positive findings should be interpreted with caution because of the methodological flaws

Growth mechanism and magnon excitation in NiO nanowalls

The nanosized effects of short-range multimagnon excitation behavior and short-circuit diffusion in NiO nanowalls synthesized using the Ni grid thermal treatment method were observed. The energy dispersive spectroscopy mapping technique was used to characterize the growth mechanism, and confocal Raman scattering was used to probe the antiferromagnetic exchange energy J2 between next-nearest-neighboring Ni ions in NiO nanowalls at various growth temperatures below the Neel temperature. This study shows that short spin correlation leads to an exponential dependence of the growth temperatures and the existence of nickel vacancies during the magnon excitation. Four-magnon configurations were determined from the scattering factor, revealing a lowest state and monotonic change with the growth temperature

Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

BACKGROUND: The treatment of trigger finger so far has heavily relied on clinicians’ evaluations for the severity of patients’ symptoms and the functionality of affected fingers. However, there is still a lack of pathological evidence supporting the criteria of clinical evaluations. This study’s aim was to correlate clinical classification and pathological changes for trigger finger based on the tissue abnormality observed from microscopic images. METHODS: Tissue samples were acquired, and microscopic images were randomly selected and then graded by three pathologists and two physicians, respectively. Moreover, the acquired images were automatically analyzed to derive two quantitative parameters, the size ratio of the abnormal tissue region and the number ratio of the abnormal nuclei, which can reflect tissue abnormality caused by trigger finger. A self-developed image analysis system was used to avoid human subjectivity during the quantification process. Finally, correlations between the quantitative image parameters, pathological grading, and clinical severity classification were assessed. RESULTS: One-way ANOVA tests revealed significant correlations between the image quantification and pathological grading as well as between the image quantification and clinical severity classification. The Cohen’s kappa coefficient test also depicted good consistency between pathological grading and clinical severity classification. CONCLUSIONS: The criteria of clinical classification were found to be highly associated with the pathological changes of affected tissues. The correlations serve as explicit evidence supporting clinicians in making a treatment strategy of trigger finger. In addition, our proposed computer-aided image analysis system was considered to be a promising and objective approach to determining trigger finger severity at the microscopic level

Dedifferentiated liposarcoma can induce a leukemoid reaction

SummaryLiposarcoma is one of the most common malignant soft tissue neoplasms in adults; however, few reports of liposarcoma had been described the expression of leukocytosis and granulocyte-colony stimulating factor (G-CSF). In this report, we present the rare case of a patient who had de-differentiated liposarcoma and elevated G-CSF levels that resulted in a leukemoid reaction. The patient was a 65-year-old man who had been lame for one month due to right thigh swelling. His body temperature was slightly elevated at 38°C and leukocytosis with an elevated white blood cell (WBC) count (41500/μL) was noted. The findings of computed tomography of the lower extremities indicated the presence of a malignancy. Therefore, an incision biopsy was performed. Based on the finding of magnetic resonance imaging (MRI) and the biopsy pathology report, we diagnosed the patient with liposarcoma. Moreover, the preoperative serum G-CSF level was elevated (261.8 pg/mL). An en bloc excision including the entire biopsy pathway was performed 5 days after admission. After en bloc excision of the tumor, WBC count, C-reactive protein (CRP) level, and G-CSF expression decreased. The final pathologic report confirmed the diagnosis of de-differentiated liposarcoma. No local recurrence or distant metastasis was detected in the follow-up image study, and the patient has remained asymptomatic 2 years after surgery. The case described here is a rare type of liposarcoma that produces G-CSF, which in turn, induces leukocytosis. Liposarcoma with elevated G-CSF levels resulting in a leukemoid reaction may indicate a poorly differentiated cell type and may be associated with a poor prognosis; however, en bloc excision of the tumor remains the primary treatment for this type of tumor. Moreover, the WBC count and G-CSF serum level can be as the tools monitoring the tumor recurrence