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Cutaneous squamous cell carcinoma (cSCC) comprises 20% of cases of nonmelanoma skin cancers in the United States. In total, 3% to 5% of squamous cell carcinoma (SCC) are metastatic at the time of presentation, associated with significant mortality due to a lack of standardized treatment options. In total, 95% of these tumors are amenable to the initial standard of treatment, which is surgical resection. However, a small percentage of them require systemic therapy as they are either locally advanced to regional lymph nodes or have distant metastasis. The common sites of presentation of cSCC are the scalp and the face with predictable spread to the intra-parotid, upper jugular, and perifacial lymph nodes. In our case report, however, our patient had a large lump lesion on the upper back, an unusual site of presentation of cSCC, with locally advanced metastasis to the left axillary lymph nodes. Subsequently, the tumor marker study revealed a positive SMARCA4 variant (the essential ATPase subunit of the Switch (SWI)/Sucrose Nonfermenting (SNF) chromatin-remodeling complex) that is even rarer in the context of cSCC. Furthermore, abnormalities in SWI/SNF chromatin-remodeling complex subunits have shown promising results as a target therapy for immune checkpoint inhibitor (ICI) therapy. We present an atypical presentation site of locally advanced rare variant SMARCA4-positive cSCC in a patient who received treatment with chemoradiation and systemic therapy with ICI after primary surgical resection. To date, only 2 cases of SMARCA4-positive cSCC were found in the literature with no details of the treatment received. Our case is unique in its atypical site of presentation as well as showing partial response to radiotherapy (RT) and systemic therapy with ICI. [ABSTRACT FROM AUTHOR]

The occurrence of ataxic sensory neuronopathy (ASN) is rare in patients with connective tissue diseases (CTDs). ASN has been described in case reports and case series in patients with CTDs, mostly Sjögren’s syndrome, and most often occurring during middle or old age. ASN in association with systemic lupus erythematosus (SLE) is extremely rare; there has been only one reported case in the literature. In addition, to our knowledge, adolescent onset of symptoms in CTD-associated ASN has not been reported previously. We report the case of a young woman who presented with ASN, characterized by sensory ataxia, with elevated antinuclear antibodies, leukopenia and anemia; she fulfilled the diagnostic criteria for SLE about 7 years after the onset of sensory ataxia. Our case points out that ASN may be the initial presenting feature of SLE. SLE should be included in the differential diagnosis of ASN, especially in patients of young age. [ABSTRACT FROM AUTHOR]

Novel room-temperature-vulcanized silicone rubber/calcium sulfate whisker composites have been prepared. Properties such as viscosity, hardness, tensile strength, elongation at break, and thermal stability were researched and compared. A combination of scanning electronic microscopy studies was used to characterize the structure and reinforcing mechanism of calcium sulfate whisker. Results showed that the addition of 10% calcium sulfate whisker-Y into room-temperature-vulcanized composites improved the tensile strength from 4.2 to 5.0 MPa and elongation at break from 210 to 590%. In addition, some improvement in thermal stability was obtained between 350 and 700°C for room-temperature-vulcanized systems. [ABSTRACT FROM PUBLISHER]

A cell model, together with finite element method (FEM), was employed to analyse the damping capacity of Al/SiC(p) at room temperature. In the model, four different kinds of SiC particulate shape, i.e. circle, rectangle, hexagon and triangle, under different particulate/matrix interface conditions have been respectively considered. Numerical results show that the influence of SiC particle morphology on the damping capacity of the composite is quite different under different matrix/particulate interface conditions: when the interface is ideal, the variation of the damping capacity of Al/SiC(p) at room temperature with the shape of particulates of SiC from high to low is triangle, hexagon, circle and rectangle, in turn, under the condition of the same strain amplitude; when the interface is weak, the order is hexagon, triangle, circle and rectangle. The difference of the damping capacity with different particle shapes was ascribed to the plastic deformation of the cell. Numerical results also show good agreements with the experimental results. [ABSTRACT FROM AUTHOR]

Maintaining a stable and uniform heat transfer from steel shell to mould is important to produce high quality casting billet. In the present paper, a large amount of measured data of heat flux and temperature for round billet continuous casting mould from a plant trial has been analysed to shed light on the variability and non-uniformity of mould heat transfer around the perimeter. The results show that the variability and non-uniformity of heat extraction from the steel through the mould is affected slightly by operational parameters, such as pouring temperature, casting speed, meniscus, electromagnetic stirring current, but strongly by the steel carbon content and mould powder type. The installation of the mould in caster machine determines the magnitude of non-uniformity of heat transfer to a great extent. The relative root mean square (rRMS) of mould heat flux, presenting the variability and non-uniformity of mould heat transfer around the perimeter in transverse section, has wider range of variation and higher mean value compared with that of temperature. When the abnormality of heat transfer happens, such as deposit, the non-uniformity of mould heat transfer is also studied. [ABSTRACT FROM AUTHOR]

A thermocouple based thermal monitoring system, employing a specially designed heat flux sensor to measure temperature and heat flux simultaneously, has been developed for the mould of a round billet caster. Based on the measured data, mould temperature and heat flux distributions are analszed for a wide range of casting conditions. The results show that the heat flux profiles along the mould length and around the mould circumference are frequently variable, especially in the area 70–110 mm below the meniscus where heat flux is much higher and more sensitive to operational parameters such as pouring temperature, casting speed, carbon content and mould powder. The local temperature and heat flux responses are also studied in abnormal heat transfer conditions, i.e.scale. Finally, through analysing the fluctuations of heat flux measurements, an optimised thermocouple layout is proposed. The experimental and analytical results lay the foundation for an intelligent mould with online detection of defects, adjustment of operational parameters, optimisation of the monitoring system and even prediction of abnormal heat transfer. [ABSTRACT FROM AUTHOR]

Purpose: To determine the most accurate criterion for predicting malignancy of small cervical lymph nodes with gray-scale ultrasound (GSUS) and power Doppler ultrasound (PDUS).Material and Methods: Findings of 69 pathologically verified cervical nodes (38 benign, 31 malignant) in 57 patients without wide echogenic hilum on GSUS that measured less than 10 mm in minimal axial diameter were prospectively studied. Minimal and maximal axial diameters, ratios of minimal to maximal axial diameters, and presence or absence of calcification or necrosis of the nodes were assessed. On PDUS, vascularity in the node was classified into 4 pattern groups. A logistic model was used to evaluate the significant factors for predicting malignancy.Results: The logistic model revealed that the minimal axial diameter and vascularity patterns were the only significant factors for malignancy. Using the minimal axial diameter, a node larger than 8 mm showed the highest accuracy (73%) with 45% sensitivity and 93% specificity. Of the vascularity patterns, spotted or peripheral pattern had the highest accuracy (80%) with 61% sensitivity and 93% specificity. A combined criterion of the minimal axial diameter larger than 8 mm and spotted or peripheral pattern increased the accuracy to 82% and sensitivity to 77% but specificity decreased to 86%.Conclusion: A combined criterion of minimal axial diameter and vascular patterns was most accurate for diagnosing occult metastatic lymph nodes in the neck. [ABSTRACT FROM AUTHOR]

Purpose: To test the effect of digital compression of CT images on the detection of small linear or spotted high attenuation lesions such as coronary artery calcification (CAC).Material and Methods: Fifty cases with and 50 without CAC were randomly selected from a population that had undergone spiral CT of the thorax for screening lung cancer. CT image data were compressed using JPEG (Joint Photographic Experts Group) or wavelet algorithms at ratios of 10:1, 20:1 or 40:1. Five radiologists reviewed the uncompressed and compressed images on a cathode-ray-tube. Observer performance was evaluated with receiver operating characteristic analysis.Results: CT images compressed at a ratio as high as 20:1 were acceptable for primary diagnosis of CAC. There was no significant difference in the detection accuracy for CAC between JPEG and wavelet algorithms at the compression ratios up to 20:1. CT images were more vulnerable to image blurring on the wavelet compression at relatively lower ratios, and "blocking" artifacts occurred on the JPEG compression at relatively higher ratios.Conclusion: JPEG and wavelet algorithms allow compression of CT images without compromising their diagnostic value at ratios up to 20:1 in detecting small linear or spotted high attenuation lesions such as CAC, and there was no difference between the two algorithms in diagnostic accuracy. [ABSTRACT FROM AUTHOR]