'You can keep your hat on: a giant forehead trichilemmal cyst

Description

A 70-year-old man was referred to plastic surgery with a progressively enlarging lesion to his forehead. A small nodule had been present since 30 years. The patient had presented to his general practitioner at the time and had been reassured that this was a sebaceous cyst which warranted no further attention. As the lesion continued to grow over the intervening years, the patient did not seek any further medical attention and concealed the lesion under a cap.

On examination, he had a 5x6x6 cm pedunculated, fleshy exophytic tumour on his central forehead (figure 1A), with further nodules each measuring 2–3 cm diameter dotted across his scalp.

Figure 1

(A) Anterior view of the pedunculated forehead lesion. (B) Axial CT showing no intracranial component or bony erosion.

CT showed a heterogeneous midline scalp lesion abutting the outer table of the skull but with...

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Traumatic pneumocephaly: trapped air from where?

Traumatic pneumocephaly is literally defined as 'air in the head' after trauma. While this phenomenon has been well described in the literature, our case report is unique in describing diffuse pneumocephalus in the subaponeurotic space, subdural space, subarachnoid space, brain and ventricles without a break in the cranial vault: a 26-year-old man fell from a =9 meter scaffolding in a water tower. Following an arduous and delayed extrication, the patient was unresponsive with loss of pulse requiring intubation, cardiopulmonary resuscitation and release of tension pneumothorax with bilateral thoracostomy tubes. Examination remained poor with a Glasgow Coma Scale of 3. Immediate exploratory laparotomy was performed for a small right retroperitoneal haematoma on Focused Assessment with Sonography for Trauma. Postoperative imaging revealed diffuse pneumocephaly without facial fractures. This case presentation explores unusual causes of fistulous connections with the atmosphere that may lead to air trapped in and around the cranial vault.

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What is the cause of this fever? Malaria with concomitant pneumonia

A 43-year-old Hispanic woman presented to the clinic complaining of fever, chills and cough for 14 days. The patient reported a recent trip to Asia 12 days prior to presenting symptoms. Given her physical examination findings, she was treated empirically for community acquired pneumonia. Since her symptoms worsened despite the antibiotic, she was referred to the Emergency Department for further evaluation. The patient was ultimately diagnosed with pneumonia and malaria. When evaluating patients with history of recent travel, it is important to consider communicable diseases that are endemic to the areas visited, as well as multiple disease aetiologies for complicated and refractory cases.

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Tension pneumothorax and pneumoperitoneum after double-lumen endotracheal intubation

Description

A 75-year-old woman with a history of hypertension was admitted to our hospital for video-assisted thoracic surgery of the right caudal lung lobe because of a pT4N0M0 adenocarcinoma. After uneventful induction of anaesthesia, a difficult intubation was encountered due to a short stature and limited mobility of the neck. After multiple attempts a 35 French double-lumen tube was placed over a gum-elastic bougie with help of a video laryngoscope. To confirm correct placement a bronchoscopy was performed; however, the carina could not be visualised and the tube was repositioned several times.

Suddenly a swelling of the abdomen and subcutaneous emphysema in the neck were noticed, ventilation pressures increased, and the patient developed bradycardia. A tension pneumothorax was suspected and bilateral needle thoracentesis was performed. The double-lumen tube was replaced by a size 6.5 single-lumen tube. Bilateral thorax drains were placed and the patient was admitted to the intensive care....

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Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers doi: 10.3390/cancers9120160

Authors: Constantinos Yeles Efstathios-Iason Vlachavas Olga Papadodima Eleftherios Pilalis Constantinos Vorgias Alexandros Georgakilas Aristotelis Chatziioannou

Ionizing radiation-induced bystander effects (RIBE) encompass a number of effects with potential for a plethora of damages in adjacent non-irradiated tissue. The cascade of molecular events is initiated in response to the exposure to ionizing radiation (IR), something that may occur during diagnostic or therapeutic medical applications. In order to better investigate these complex response mechanisms, we employed a unified framework integrating statistical microarray analysis, signal normalization, and translational bioinformatics functional analysis techniques. This approach was applied to several microarray datasets from Gene Expression Omnibus (GEO) related to RIBE. The analysis produced lists of differentially expressed genes, contrasting bystander and irradiated samples versus sham-irradiated controls. Furthermore, comparative molecular analysis through BioInfoMiner, which integrates advanced statistical enrichment and prioritization methodologies, revealed discrete biological processes, at the cellular level. For example, the negative regulation of growth, cellular response to Zn2+-Cd2+, and Wnt and NIK/NF-kappaB signaling, thus refining the description of the phenotypic landscape of RIBE. Our results provide a more solid understanding of RIBE cell-specific response patterns, especially in the case of high-LET radiations, like α-particles and carbon-ions.

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Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers doi: 10.3390/cancers9120160

Authors: Constantinos Yeles Efstathios-Iason Vlachavas Olga Papadodima Eleftherios Pilalis Constantinos Vorgias Alexandros Georgakilas Aristotelis Chatziioannou

Ionizing radiation-induced bystander effects (RIBE) encompass a number of effects with potential for a plethora of damages in adjacent non-irradiated tissue. The cascade of molecular events is initiated in response to the exposure to ionizing radiation (IR), something that may occur during diagnostic or therapeutic medical applications. In order to better investigate these complex response mechanisms, we employed a unified framework integrating statistical microarray analysis, signal normalization, and translational bioinformatics functional analysis techniques. This approach was applied to several microarray datasets from Gene Expression Omnibus (GEO) related to RIBE. The analysis produced lists of differentially expressed genes, contrasting bystander and irradiated samples versus sham-irradiated controls. Furthermore, comparative molecular analysis through BioInfoMiner, which integrates advanced statistical enrichment and prioritization methodologies, revealed discrete biological processes, at the cellular level. For example, the negative regulation of growth, cellular response to Zn2+-Cd2+, and Wnt and NIK/NF-kappaB signaling, thus refining the description of the phenotypic landscape of RIBE. Our results provide a more solid understanding of RIBE cell-specific response patterns, especially in the case of high-LET radiations, like α-particles and carbon-ions.

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Optimization of the prescription isodose line for Gamma Knife radiosurgery using the shot within shot technique

This work explores how the choice of prescription isodose line (IDL) affects the dose gradient, target coverage, and treatment time for Gamma Knife radiosurgery when a smaller shot is encompassed within a larg...

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