Late-Onset Melorheostosis: A Case Report.

Melorheostosis is a rare benign bone pathology involving bone dysplasia and hyperostosis. The disease can be recognized with a characteristic radiographic feature of radiopaque lesions dripping along a long bone's diaphysis. The aberrant bone formation and development manifests mainly as pain, edema, and paresthesia of the affected limb. Severe cases may report limb deformity as well as limited range of motion. Until now, there have been approximately 300 cases reported about melorheostosis worldwide and its diverse clinical picture and age distribution. In Vietnam, there is only one known case of melorheostosis discovered incidentally via radiography. The scarcity of cases presents a challenge within the medical community in recognizing and diagnosing the condition, and a delayed diagnosis can lead to severe contracture and compromised limb motility. In this article, we reported an 82-year-old case of polyostotic melorheostosis with late onset and predominant edema, affecting the sternum, the ribs, and multiple bones of the right extremities and presented our clinical approach for a geriatric patient with chronic limb edema. Our case is distinctive in terms of anatomical location as well as the predominant 20-year non-pitting edema. A prompt diagnosis was made upon the classic dripping candle wax radiographic features emphasizing the role of plain X-ray in establishing the diagnosis without extraneous utilization of other modalities and invasive procedures. Exclusion of other causes of chronic edema such as lymphadenopathy, malignancy as well as parasitic infection is of clinical importance.

Cluster formation and relaxation in particle rafts under uniform radial expansion.

Particle rafts floating at an air-liquid interface exhibit a variety of behaviors when interfacial flow is introduced. Motivated by previous experimental observations, the failure pattern of particle rafts under uniform radial expansion is reported in this paper. The expansion process is specifically designed to expand the system affinely in the radial direction and to keep the velocity gradient constant throughout. A strong resemblance to the results of particle rafts under uniform uniaxial expansion is found. The size of the cluster emerging as the rafts are pulled apart scales inversely with the pulling velocity. This is a result of two competing velocities: the interparticle separation speed provided by the flow and a size-dependent relaxation speed for clustering. A model, generalized from a one-dimensional linear (in)stability calculation, is in agreement with the failure morphology found for this radially expanded system. Nonlinear relaxation and particle rearrangement are observed after the initial clustering occurs. This is a feature unique to a two-dimensional system. With its easily accessible particle dynamics at the microscopic level, this system provides insights into the morphology controlled by two competing mechanisms in two or higher dimensions and across different scales.

Denatured collagen inhibits neuroblastoma tumor-sphere migration and growth via the LOX/LOXL2 - FAK signaling pathway.

A complex interplay exists within the tumor microenvironment and extracellular matrix, which could contribute to solid tumor progression. Collagen, a major component of the extracellular matrix, may correlate with cancer prognosis. While thermal ablation has shown promise as a minimally invasive treatment of solid tumors, its impact on collagen is still unknown. In this study, we demonstrate that thermal ablation, but not cryo-ablation, induces irreversible collagen denaturation in a neuroblastoma sphere model. Prolonged collagen denaturation resulted in a significant reduction in sphere stiffness, migration, and proliferation, and an increase in apoptosis. Mechanistic analysis revealed that collagen denaturation inhibited collagen cross-linking, reduced extracellular LOX/LOXL2 expression, and resulted in decreased phosphorylation of FAK. Downstream of FAK, we observed reduced epithelial to mesenchymal transition, attenuated CDC42 expression, and decreased migration. Collectively, these results suggest that denatured collagen presents a novel target for modulating the tumor microenvironment and treating solid cancers via the LOX1/LOXL2-FAK signaling pathway.

Rifts in rafts.

A particle raft floating on an expanding liquid substrate provides a macroscopic analog for studying material failure. The time scales in this system allow both particle-relaxation dynamics and rift formation to be resolved. In our experiments, a raft, an aggregate of particles, is stretched uniaxially by the expansion of the air-liquid interface on which it floats. Its failure morphology changes continuously with pulling velocity. This can be understood as a competition between two velocity scales: the speed of re-aggregation, in which particles relax towards a low-energy configuration determined by viscous and capillary forces, and the difference of velocity between neighboring particles caused by the expanding liquid surface area. This competition selects the cluster length, i.e., the distance between adjacent rifts. A model based on this competition is consistent with the experimental failure patterns.

Case Report: Epidural Abscess Following Obstetric Epidural Anesthesia in Vietnam.

Epidural abscess after obstetric epidural anesthesia occurs infrequently and may result in severe morbidity. We report a clinical case of an epidural abscess in Vietnam. A 31-year-old woman who was in labor was admitted to our hospital and given epidural anesthesia indicated to relieve labor pain. After three hours of anesthesia, cesarean section was indicated for the patient due to signs of fetal failure, the epidural catheter was then used to relieve pain for the first 48 hours postoperatively. On post-partum day 5 she presented with high fever of 39-40°C, fatigue, stimulation, dyspnea, and lumbar pain. The patient then suffered from sepsis and lower limb paralysis. She was diagnosed with epidural abscess based on the MRI of the lumbar spine. The abscess was treated by surgery for draining and appropriate antibiotics with a satisfactory outcome as she completely recovered her motor function and stable health status.