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* Context.--Associations between granulomatous lobular mastitis (GLM) and Corynebacterium kroppenstedtii have been reported since 2002, but large-scale studies to assess the actual prevalence of this bacterium in GLM have not been performed. Objective.--To assess the prevalence of C kroppenstedtii in GLM using real-time polymerase chain reaction and Sanger sequencing. Design.--We analyzed formalin-fixed, paraffin-embedded tissues from 67 cases of GLM by sequential DNA amplification and sequencing to assess the rate of C kroppenstedtii detection in GLM. A retrospective analysis including patient demographics, history of pregnancy and lactation, clinical signs and symptoms, radiographic findings, histologic pattern, Gram stain results, and microbial cultures was performed on 67 cases of GLM. In addition, 10 cases of nongranulomatous breast abscess were included as controls. Results.--C kroppenstedtii 16S rRNA SYBR real-time polymerase chain reaction was positive on formalin-fixed, paraffin-embedded tissues from 46 of 67 (68.7%) GLM cases, while all control cases were negative. Among the positive cases, the majority showed features of cystic neutrophilic granulomatous mastitis. Conclusions.--C kroppenstedtii was highly prevalent in GLM cases and was not found to be associated with nongranulomatous breast abscess in our study (P < .001)., Granulomatous lobular mastitis (GLM) is an uncommon benign, inflammatory disease of the breast first described in 1972 by Kessler and Wolloch (1) that characteristically affects women of childbearing age with [...]

Recent updates in the classification of myeloid neoplasms (MNs) recognize the poor prognostic impact of TP53 mutations, with particular emphasis on the TP53 allele status. Studies on the effect of TP53 allele status exclusively in therapy-related MNs (t-MNs) are lacking. We compared the clinicopathologic and survival characteristics of t-MNs with single-hit (SH) and multi-hit (MH) TP53 mutations. A total of 71 TP53-mutated t-MNs were included, including 56 (78.9%) MH and 15 (21.1%) SH. Both groups showed comparable genetic profiles with an excess of high-risk karyotypes and a paucity of other co-mutated genes. TP53 was the sole detectable mutation in 73.3% of SH and 75.0% of MH cases. The overall survival (OS) of SH TP53-mutated t-MNs was not significantly different from MH cases (median survival: 233 vs.273 days, p = 0.70). Our findings suggest that t-MNs with SH TP53 mutations share the poor prognostic and biologic profile of their MH counterparts. [ABSTRACT FROM AUTHOR]

Context.--Acute invasive fungal rhinosinusitis (AIFRS) is an aggressive form of fungal sinusitis, which remains a significant cause of morbidity and mortality. Early diagnosis and intervention are keys to improving patient outcomes. Intraoperative consultation has shown promise in facilitating early surgical intervention, but the accuracy of frozen section has not been clarified in this setting. Objectives.--To assess the accuracy of frozen-section diagnosis in patients with clinically suspected AIFRS. Design.--All cases of clinically suspected AIFRS during a 10-year period (2009-2019) were retrospectively reviewed. The frozen-section results were compared with the final permanent sections as well as the tissue fungal culture results, following which the accuracy of frozen section was determined. Results.--Forty-eight patients with 133 frozen-section evaluations for AIFRS were included in the study. Thirty of 48 patients and 61 of 133 specimens were positive for AIFRS on final pathology. Of 30 positive patients, 27 (90%) had at least 1 specimen diagnosed as positive during intraoperative consultation; among the 61 positive specimens, 54 (88.5%) were diagnosed as positive during intraoperative consultation. Of 72 negative specimens, all were interpreted as negative on frozen section. Thus, frozen sections had a sensitivity of 88.5% (95% CI, 0.78-0.97), specificity of 100% (95% CI, 0.94-1), positive predictive value of 100% (95% CI, 0.92-1), and negative predictive value of 90.6% (95% CI, 0.82-0.97). Conclusions.--This study represents the largest series assessing the diagnostic accuracy of frozen section analysis in AIFRS. These findings are useful in frozen section-informed intraoperative decision making. (Arch Pathol Lab Med. 2021;145:648-656; doi: 10.5858/arpa.2019-0696-OA, Acute invasive fungal rhinosinusitis (AIFRS) is a potentially lethal and rapidly progressive disease. It primarily affects immunocompromised or diabetic patients, in whom organisms that are ubiquitous but usually harmless can [...]

Yam (Dioscorea spp.) is an important tuber crop consumed globally. However, stable yam production faces challenges from a variety of diseases caused by fungi, nematodes, viruses, and bacteria. Prominent diseases such as anthracnose, leaf spot, yam wilt, dry rot, and crazy root syndrome, currently pose serious threats to yam yields. These diseases not only result in quality degradation but also cause great economic losses. This review summarizes the damages, symptoms, causal agents, and epidemic factors of major yam diseases. It also outlines a comprehensive disease control strategy that includes the use of resistant varieties, proper crop rotation, sanitation measures, and the application of agrochemicals and biocontrol agents. Additionally, this review addresses future perspectives on risk factors and knowledge gaps, aiming to serve as a reference for in-depth research into advanced disease monitoring and control technologies for yams. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndromes (MDS) are age-related myeloid neoplasms with Increased risk of progression to acute myeloid leukemia (AML). The mechanisms of transformation of MDS to AML are poorly understood, especially in relation to the aging microenvironment. We previously established an mDia1/miR-146a double knockout (DKO) mouse model phenocopying MDS. These mice develop age-related pancytopenia with oversecretion of proinflammatory cytokines. Here, we found that most of the DKO mice underwent leukemic transformation at 12-14 months of age. These mice showed myeloblast replacement of fibrotic bone marrow and widespread leukemic infiltration. Strikingly, depletion of IL-6 in these mice largely rescued the leukemic transformation and markedly extended survival. Single-cell RNA sequencing analyses revealed that DKO leukemic mice had increased monocytic blasts that were reduced with IL-6 knockout. We further revealed that the levels of surface and soluble IL-6 receptor (IL-6R) in the bone marrow were significantly increased in high-risk MDS patients. Similarly, IL-6R was also highly expressed in older DKO mice. Blocking of IL-6 signaling significantly ameliorated AML progression in the DKO model and clonogenicity of CD34-positive cells from MDS patients. Our study establishes a mouse model of progression of age-related MDS to AML and indicates the clinical significance of targeting IL-6 signaling in treating high-risk MDS., Introduction Myelodysplastic syndromes (MDS) are age-related clonal myeloid neoplasms characterized by ineffective hematopoiesis. Patients with high-risk MDS have a significantly increased incidence of progression into acute myeloid leukemia (AML). The [...]

Objectives Because of its low frequency in adult populations and clinical and laboratory overlap with hemophagocytic lymphohistiocytosis and other T-cell lymphomas, T-cell/natural killer (NK) cell systemic, chronic, active Epstein-Barr virus (EBV) (T/NK sCAEBV) infection remains underdiagnosed, preventing critical, prompt therapeutic interventions. Methods We report a 5-case series that included 2 adult patients with T/NK sCAEBV and 3 additional adult patients with T/NK lymphomas with concomitant systemic EBV infection to review these entities' overlapping diagnostic and clinical features. Results Approximately 95% of the world population has been infected with EBV during their lifetime, and infection is usually asymptomatic, with symptomatic cases eventually resolving spontaneously. A small subset of immunocompetent patients develops CAEBV, a life-threatening complication resulting from EBV-infected T-cell or NK cell neoplastic lymphocytes. The sites of end-organ damage in T/NK sCAEBV demonstrate pathologic findings such as reactive lymphoid proliferations, making the diagnosis difficult to establish, with the only curative option being an allogeneic hematopoietic stem cell transplant. Conclusions This diagnosis is most prevalent in Asia, with few cases reported in Western countries. Adult age is an independent risk factor for poor outcomes, and most cases are diagnosed in pediatric populations. [ABSTRACT FROM AUTHOR]

In this paper, we assess and compare a conventional cycloidal drive and its involute-tooth kinematical equivalent via finite element (FE) and dynamical multi-body analysis. The analysis of the stiffer conventional cycloidal configuration reveals multiple points of contacts, although some of these have little contribution to the torque transmission. Significant non-torque loads are self-induced, with contact forces constantly changing in magnitude and orientation, consistently with the contact characteristics of the cycloid. In the involute alternative, the stress concentration was more localized to two or three points of contact, according to the involute contact ratio, leading to increased stresses. The contact forces remained constant relative to the tangential direction, as per the constant involute pressure angle, contributing to desirable torque loads. The torque ripple was found to have two components, one at the tooth engagement frequency ( f z ) and one at the high-speed shaft rotation frequency ( f n ), the former being more pronounced in the conventional cycloidal case, while the latter being larger for the cycloidal drive with involute teeth. Moreover, both analytical calculations and the multi-body dynamics simulations suggest that the involute-tooth design is more efficient compared to the conventional cycloidal-tooth design. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: There are different methods for treatment of the long bone fractures, including femoral diaphyseal fractures, ranging from closed intramedullary nail, open intramedullary nail to flexible nail, plating, and external fixator in open type 3 B and 3C fractures. The aim of this study was to compare the functional outcome of open versus closed techniques in treating femoral diaphyseal fractures in skeletally mature adults. METHODOLOGY: A simple observational study was conducted at the Department of Orthopedics, Allied Hospital Faisalabad, from January 2018 to January 2020 with a total of 60 skeletally mature patients with mean age 38.4+1.2 who fulfilled the inclusion criteria were operated, and five patients lost in follow-up. Group A consisted of 27 patients (18 males and 9 females) who were operated with closed interlocking technique. Group B consisted of 28 patients (12 males and 16 females) who were operated with open technique. Both groups were followed prospectively for two years to evaluate the outcome. T-test was used for statistical analysis. RESULTS: The rate of union in group A was better than in group B. Patients in group A had a reunion 1.99±0.86 weeks earlier than group B a significant difference between the two groups with p<0.001. Nonunion occurred in 02(7.40%) patients of group A and 03(10.71%) patients of group B. Only 01 (3.7%) patient from group A and 02 (7.40%) patient of group B suffered from deep infections. CONCLUSION: Closed interlocking for femoral diaphyseal fractures provides earlier reunion of the bone and should be considered the treatment of choice. In case of lack of technical availabilities, open interlocking should be considered as a suitable option. [ABSTRACT FROM AUTHOR]