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Recalcitrant distal humeral non-union following previous Leiomyosarcoma excision treated with retainment of a radiated non-angiogenic segment augmented with 20 cm free fibula composite graft: A case report

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World Journal of Orthopedics 2019年第4期10卷 212-218页

作者： Martin Gathen Grayson Norris simon kay Peter V Giannoudis Department of Orthopedics and Trauma Surgery University Hospital of Bonn Academic Department of Trauma and Orthopaedics School of Medicine University of Leeds Plastic and Reconstructive Surgery School of Medicine University of Leeds

BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle *** radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up pathological fractures are common complications that can be accompanied by Implant failure and defect situations that are most challenging in their *** SUMMARY We present a case of a 52-year-old female suffering from a pathological fracture of the humeral shaft 10 yr after resection of a Leiomyosarcoma and postoperative radiotherapy. She developed implant failure after retrograde nailing and another failure after revision to double plate fixation. In a two-stage revision, the implants were removed and the huge segmental defect created after debridement was bridged by a compound osteosynthesis with nancy nails and bone cement for formation of the induced membrane. Due to the previous radiotherapy treatment,20 cm of the humeral shaft were declared devascularized but were left in situ as a scaffold. In the second stage, a vascularized fibula graft was used in combination with a double plate fixation and autologous spongiosa grafts for final *** This combinatory treatment approach led to a successful clinical outcome and can be considered in similar challenging cases.

关键词： Humerus Fibular graft Bone tumor Osseous defect Implant failure Leiomyosarcoma Case report

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Atypical hematological manifestation of celiac disease:A case report of aplastic anemia in a 2-year-old child and review of the literature

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Pediatric Investigation 2021年第2期5卷 159-162页

作者： Thea von Graffenried Mattia Rizzi Michel Russo Andreas Nydegger simon kayemba-kay’s Pediatric Gastroenterology Unit Department of PediatricsUniversity of LausanneCentre Hospitalier Universitaire VaudoisLausanneSwitzerland Hemato-Oncology Unit Department of PediatricsUniversity of LausanneSwitzerland Department of Pediatrics Centre Hospitalier du Valais RomandSionSwitzerland Department of Pediatrics Centre Hospitalier des Pays de MorlaixFrance

Introduction Celiac disease typically presents with symptoms of malabsorption,but extraintestinal manifestations are increasingly *** anemia as the mode of celiac disease presentation is extremely rare in *** presentation We report a 2-year-old boy who presented with loose stools,loss of appetite,and bicytopenia with severe aregenerative normocytic ***,including bone marrow aspirate and biopsy,revealed aplastic *** for malabsorption showed increased plasma concentrations of anti-transglutaminase and anti-gliadin antibodies.A duodenal biopsy confirmed the histologic features of celiac *** child received a packed red cell transfusion and was started on a gluten-free diet,with a very good prognosis and normalization of both his blood and histological *** the best of our knowledge,our report is the sixth pediatric case in the *** Screening for celiac disease should be performed in children with unexplained hematological abnormalities such as aplastic anemia with or without gastrointestinal symptoms.

关键词： Aplastic anemia Celiac disease Child Gluten-free diet

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Regenerative biomarkers for Duchenne muscular dystrophy

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Neural Regeneration Research 2019年第8期14卷 1317-1320页

作者： simon Guiraud kay E.Davies MDUK Oxford Neuromuscular Centre Department of PhysiologyAnatomy and Genetics

Skeletal muscle has an extraordinary capacity to regenerate after injury and trauma. The muscle repair mechanism is a complex process orchestrated by multiple steps. In neuromuscular disorders such as Duchenne muscular dystrophy (DMD), the pathological consequences of the lack of dystrophin and the loss of the dystrophin-associated protein complex are dramatic, with a progressive cascade of events, such as continual influx of inflammation, repeated cycles of degeneration and impaired regeneration. Thus, muscle regeneration is a hallmark of the disease and careful monitoring of regenerative processes with robust markers should provide useful information to the field. Since decades, several indices of regeneration such as centronucleation and fibre size have been commonly used. In the present review, we discuss the impaired regenerative process in DMD, the common and new indices of regeneration and their associated methodologies. We notably highlight the regenerative marker embryonic myosin as a robust indicator of muscle regeneration. We also describe new quantitative methodologies offering the possibility of using a panel of translational regenerative biomarkers to obtain a more complete view of the regeneration processes. Upregulation of utrophin, an autosomal and functional paralogue of dystrophin, is one of the most promising therapeutic strategies as it targets the primary cause of the disease and is applicable to all DMD patients regardless their genetic defects. As utrophin is a regeneration associated protein increased in dystrophic muscle, we discuss the correlation of utrophin levels after drug treatment with regeneration markers. The recent advances in technologies and complementary markers of muscle regeneration described in this review, provide an unprecedented opportunity to develop more robust utrophin DMD based strategies for all DMD patients.

关键词： DMD regeneration biomarkers utrophin embryonic myosin methodologies muscle repair degeneration

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Diploidy in evolutionary algorithms for dynamic optimization problems A best-chromosome-wins dominance mechanism

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International Journal of Intelligent Computing and Cybernetics 2015年第4期8卷 312-329页

作者： Boris Shabash kay C.Wiese School of Computing Science Simon Fraser UniversityBurnabyCanada

Purpose–In this work,the authors show the performance of the proposed diploid scheme(a representation where each individual contains two genotypes)with respect to two dynamic optimization problems,while addressing drawbacks the authors have identified in previous works which compare diploid evolutionary algorithms(EAs)to standard *** paper aims to discuss this ***/methodology/approach–In the proposed diploid representation of EA,each individual possesses two copies of the *** order to convert this pair of genotypes to a single phenotype,each genotype is individually evaluated in relation to the fitness function and the best genotype is presented as the *** order to provide a fair and objective comparison,the authors make sure to compare populations which contain the same amount of genetic information,where the only difference is the arrangement and interpretation of the *** two representations are compared using two shifting fitness functions which change at regular intervals to displace the global optimum to a new ***–For small fitness landscapes the haploid(standard)and diploid algorithms perform comparably and are able to find the global optimum very ***,as the search space increases,rediscovering the global optimum becomes more difficult and the diploid algorithm outperforms the haploid algorithm with respect to how fast it relocates the new *** both algorithms use the same amount of genetic information,it is only fair to conclude it is the unique arrangement of the diploid algorithm that allows it to explore the search space ***/value–The diploid representation presented here is novel in that instead of adopting a dominance scheme for each allele(value)in the vector of values that is the genotype,dominance is adopted across the entire genotype in relation to its *** a result,this representation can be extended across any alphabet,for any optimization function.

关键词： Evolutionary computation Genetic algorithms Diploidy Dynamic optimization

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A study of different annealing schedules in SARNA-predict A permutation based SA algorithm for RNA folding

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International Journal of Intelligent Computing and Cybernetics 2015年第2期8卷 152-171页

作者： Herbert H.Tsang kay C.Wiese Applied Research Lab Trinity Western UniversityLangleyCanada School of Computing Science Simon Fraser UniversitySurreyCanada

Purpose–The purpose of this paper is to present a study of the effect of different types of annealing schedules for a ribonucleic acid(RNA)secondary structure prediction algorithm based on simulated annealing(SA).Design/methodology/approach–An RNA folding algorithm was implemented that assembles the final structure from potential substructures(helixes).Structures are encoded as a permutation of *** SA searches this space of *** and annealing schedules were studied and fine-tuned to optimize algorithm ***–In comparing with mfold,the SA algorithm shows comparable results(in terms of F-measure)even with a less sophisticated thermodynamic *** terms of average specificity,the SA algorithm has provided surpassing *** limitations/implications–Most of the underlying thermodynamic models are too simplistic and incomplete to accurately model the free energy for larger *** is the largest limitation of free energy-based RNA folding algorithms in *** implications–The algorithm offers a different approach that can be used in practice to fold RNA sequences ***/value–The algorithm is one of only two SA-based RNA folding *** authors use a very different encoding,based on permutation of candidate *** in depth study of annealing schedules and other parameters makes the algorithm a strong *** benefit is that new thermodynamic models can be incorporated with relative ease(which is not the case for algorithms based on dynamic programming).

关键词： Annealing schedule Simulated annealing RNA secondary structure prediction Ribonucleic acid RNA folding Permutation

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