A Review of Type 1 and Type 2 Intraductal Papillary Neoplasms of the Bile Duct

Intraductal papillary neoplasm of the bile duct(IPNB)is a heterogeneous disease similar to intraductal papillary mucinous neoplasm of the pancreas.These lesions have been recognized as one of the three major precancerous lesions in the biliary tract since 2010.In 2018,Japanese and Korean pathologists reached a consensus,classifying IPNBs into type l and type 2 IPNBs.IPNBs are more prevalent in male patients in East Asia and are closely related to diseases such as cholelithiasis and schistosomiasis.From a molecular genetic perspective,IPNBs exhibit early genetic variations,and different molecular pathways may be involved in the tumorigenesis of type 1 and type 2 IPNBs.The histological subtypes of IPNBs include gastric,intestinal,pancreaticobiliary,or oncocytic subtypes,but type 1 IPNBs typically exhibit more regular and well-organized histological features than type 2 IPNBs and are more commonly found in the intrahepatic bile ducts with abundant mucin.Due to the rarity of these lesions and the absence of specific clinical and laboratory features,imaging is crucial for the preoperative diagnosis of IPNB,with local bile duct dilation and growth along the bile ducts being the main imaging features.Surgical resection remains the optimal treatment for IPNBs,but negative bile duct margins and the removal of lymph nodes in the hepatic hilum significantly improve the postoperative survival rates for patients with IPNBs.

Varying of up-conversion nanoparticles luminescence from the muscle tissue depth during the compression

The current work is focused on the study of optical clearing of skeletal muscles under local compression.The experiments were performed on in vitro bovine skeletal muscle.The time dependence of optical clearing was studied by monitoring the luminescence intensity of NaYF_(4)∶Er,Yb upconverting particles located under tissue layers.This study shows the possibility to use upconverting nanoparticles(UCNPs)both for studying the dynamics of the optical clearing of biological tissue under compression and to detect moments of cell wall damage under excessive pressure.The advantage of using UCNPs is the presence of several bands in their luminescence spectra,located both at close wavelengths and far apart.

Cartilage and facial muscle tissue engineering and regeneration： a mini review

Cartilage and facial muscle tissue provide basic yet vital functions for homeostasis throughout the body, making human survival and function highly dependent upon these somatic components. When cartilage and facial muscle tissues are harmed or completely destroyed due to disease, trauma, or any other degenerative process, homeostasis and basic body functions consequently become negatively affected. Although most cartilage and cells can regenerate themselves after any form of the aforementioned degenerative disease or trauma, the highly specific characteristics of facial muscles and the specific structures of the cells and tissues required for the proper function cannot be exactly replicated by the body itself. Thus, some form of cartilage and bone tissue engineering is necessary for proper regeneration and function. The use of progenitor cells for this purpose would be very beneficial due to their highly adaptable capabilities, as well as their ability to utilize a high diffusion rate, making them ideal for the specific nature and functions of cartilage and facial muscle tissue. Going along with this, once the progenitor cells are obtained, applying them to a scaffold within the oral cavity in the affected location allows them to adapt to the environment and create cartilage or facial muscle tissue that is specific to the form and function of the area. The principal function of the cartilage and tissue is vascularization, which requires a specific form that allows them to aid the proper flow of bodily functions related to the oral cavity such as oxygen flow and removal of waste. Facial muscle is also very thin, making its reproduction much more possible. Taking all these into consideration, this review aims to highlight and expand upon the primary benefits of the cartilage and facial muscle tissue engineering and regeneration, focusing on how these processes are performed outside of and within the body.

The Effects of Amino Acid Nutritional Deficiency on the Expression of Protein Metabolism-Related Genes in the Mammary Gland and Muscle Tissues of Lactating Mice

The mammary gland tissue exhibits a series of responses that are different from those of muscle and other peripheral tissues under amino acid deficiency. So, this present study was designed to investigate the effects of amino acid nutritional deficiency on the expression of protein metabolism-related genes in the mammary gland and muscle tissues of lactating mice. A total of 60 postpartum, lactating Kunming white mice were selected and randomly divided into 5 groups;each group contained 12 mice. Group A was the control group. The mice in group A were maintained on a normal diet after the initiation of lactation. Group B (starved) was given normal saline via intragastric administration. Group C (energy) was given glucose solution via intragastric administration. Groups D and E received a sodium caseinate solution via intragastric administration, which provided 0.5 g protein/d and 1.5 g protein/d, respectively. The results showed the following. 1) When the mice were exposed to nutritional stress caused by dietary amino acid deficiency, the β-casein mRNA expression level was increased in the mammary gland tissue. The increase in β-casein expression was the most significant in the energy-supplemented group, followed by the starved group (P P 14k and C2 (P P P < 0.05). 5) The phosphorylation level of p70S6K was elevated in the muscle tissues collected from the treatment groups. However, the magnitude of the increase was far smaller compared to that in the mammary gland tissues.

Three‑dimensional Modeling and Simulation of Muscle Tissue Puncture Process

Needle biopsy is an essential part of modern clinical medicine.The puncture accuracy and sampling success rate of puncture surgery can be effectively improved through virtual surgery.There are few three-dimensional puncture(3D)models,which have little significance for surgical guidance under complicated conditions and restrict the development of virtual surgery.In this paper,a 3D simulation of the muscle tissue puncture process is studied.Firstly,the mechanical properties of muscle tissue are measured.The Mooney-Rivlin(M-R)model is selected by considering the fitting accuracy and calculation speed.Subsequently,an accurate 3D dynamic puncture model is established.The failure criterion is used to define the breaking characteristics of the muscle,and the bilinear cohesion model defines the breaking process.Experiments with different puncture speeds are carried out through the built in vitro puncture platform.The experimental results are compared with the simulation results.The experimental and simulated reaction force curves are highly consistent,which verifies the accuracy of the model.Finally,the model under different parameters is studied.The simulation results of varying puncture depths and puncture speeds are analyzed.The 3D puncture model can provide more accurate model support for virtual surgery and help improve the success rate of puncture surgery.

Diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms

Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors derived from the neuroendocrine cell system,which that have increased in incidence and prevalence in recent years.Despite improvements in radiological and metabolic imaging,endoscopy still plays a pivotal role in the number of GEPNENs.Tumor detection,characterization,and staging are essential in management and treatment planning.Upper and lower gastrointestinal(GI)endoscopy is essential for correct localization of the primary tumor site of GI NENs.Endoscopic ultrasonography(EUS)has an important role in the imaging and tissue acquisition of pancreatic NENs and locoregional staging of GI neuroendocrine tumors.Correct staging and histological diagnosis have important prognostic implications.Endoscopic operating techniques allow the removal of small GI NENs in the early stage of mucosal or submucosal invasion of the intestinal wall.Preoperative EUS-guided techniques may help the surgeon locate small and deep tumors,thus avoiding formal pancreatic resections in favor of parenchymal-sparing surgery.Finally,locoregional ablative treatments have been proposed in recent studies with promising results in selected patients.

Fostering tissue engineering and regenerative medicine to treat musculoskeletal disorders in bone and muscle

The musculoskeletal system,which is vital for movement,support,and protection,can be impaired by disorders such as osteoporosis,osteoarthritis,and muscular dystrophy.This review focuses on the advances in tissue engineering and regenerative medicine,specifically aimed at alleviating these disorders.It explores the roles of cell therapy,particularly Mesenchymal Stem Cells(MSCs)and Adipose-Derived Stem Cells(ADSCs),biomaterials,and biomolecules/external stimulations in fostering bone and muscle regeneration.The current research underscores the potential of MSCs and ADSCs despite the persistent challenges of cell scarcity,inconsistent outcomes,and safety concerns.Moreover,integrating exogenous materials such as scaffolds and external stimuli like electrical stimulation and growth factors shows promise in enhancing musculoskeletal regeneration.This review emphasizes the need for comprehensive studies and adopting innovative techniques together to refine and advance these multi-therapeutic strategies,ultimately benefiting patients with musculoskeletal disorders.

Effects of high‑grain diet feeding on fatty acid profiles in milk,blood,muscle,and adipose tissue,and transcriptional expression of lipid‑related genes in muscle and adipose tissue of dairy cows

Background High-grain(HG)diets affect lipid metabolism in the liver and mammary tissue of dairy cows,but its effects on muscle and adipose tissue have not been wide evaluated.Thus,the aim of this study is to clarify this issue.Methods Twelve Holstein cows were randomly divided into two groups:conventional diet group(CON,n=6)and the HG diet group(n=6).On day 7 of week 4,rumen fluid was sampled to measure pH,milk was sampled to meas-ure components,and blood was sampled to measure biochemical parameters and fatty acid composition.After the experiment,cows were slaughtered to collect muscle and adipose tissue for fatty acid composition and transcriptome analysis.Results HG feeding decreased the ruminal pH,milk’s fat content and long-chain fatty acid proportion(P<0.05)and increased the proportion of short-and medium-chain fatty acids in the milk(P<0.05)as compared with CON diets.The concentrations of blood cholesterol,low-density lipoprotein,and polyunsaturated fatty acids in the HG cows were lower than those in CON cows(P<0.05).In muscle tissue,HG feeding tended to increase the triacylglycerol(TG)concentration(P<0.10).Transcriptome analysis revealed changes in the biosynthesis of the unsaturated fatty acids pathway,the regulation of lipolysis in the adipocytes pathway,and the PPAR signalling pathway.In adipose tissue,HG feeding increased the concentration of TG and decreased the concentration of C18:1 cis9(P<0.05).At the transcrip-tome level,the fatty acid biosynthesis pathway,linoleic acid metabolism pathway,and PPAR signalling pathway were activated.Conclusion HG feeding leads to subacute rumen acidosis and a decreased milk fat content.The fatty acid profiles in the milk and plasma of dairy cows were changed by HG feeding.In muscle and adipose tissue,HG feeding increased TG concentration and up-regulated the expression of genes related to adipogenesis,while down-regulated the expression of genes related to lipid transport.These results complement our knowledge of the fatty acid composi-tion of muscle and adipose tissue in dairy cows and expand our understanding of the mechanisms by which HG diets affect lipid metabolism in muscle and adipose tissue.

A"messenger zone hypothesis"based on the visual three-dimensional spatial distribution of motoneurons innervating deep limb muscles

Coordinated contraction of skeletal muscles relies on selective connections between the muscles and multiple classes of the spinal motoneuro ns.Howeve r,current research on the spatial location of the spinal motoneurons innervating differe nt muscles is limited.In this study,we investigated the spatial distribution and relative position of different motoneurons that control the deep muscles of the mouse hindlimbs,which were innervated by the obturator nerve,femoral nerve,inferior gluteal nerve,deep pe roneal nerve,and tibial nerve.Locations were visualized by combining a multiplex retrograde tracking technique compatible with three-dimensional imaging of solvent-cleared o rgans(3DISCO)and 3-D imaging technology based on lightsheet fluorescence microscopy(LSFM).Additionally,we propose the hypothesis that"messenger zones"exist as interlaced areas between the motoneuron pools that dominate the synergistic or antagonist muscle groups.We hypothesize that these interlaced neurons may participate in muscle coordination as messenger neurons.Analysis revealed the precise mutual positional relationships among the many motoneurons that innervate different deep muscles of the mouse.Not only do these findings update and supplement our knowledge regarding the overall spatial layout of spinal motoneurons that control mouse limb muscles,but they also provide insights into the mechanisms through which muscle activity is coordinated and the architecture of motor circuits.

Automated body composition analysis system based on chest CT for evaluating content of muscle and adipose

Objective To establish a body composition analysis system based on chest CT,and to observe its value for evaluating content of chest muscle and adipose.Methods T7—T8 layer CT images of 108 pneumonia patients were collected(segmented dataset),and chest CT data of 984 patients were screened from the COVID 19-CT dataset(10 cases were randomly selected as whole test dataset,the remaining 974 cases were selected as layer selection dataset).T7—T8 layer was classified based on convolutional neural network(CNN)derived networks,including ResNet,ResNeXt,MobileNet,ShuffleNet,DenseNet,EfficientNet and ConvNeXt,then the accuracy,precision,recall and specificity were used to evaluate the performance of layer selection dataset.The skeletal muscle(SM),subcutaneous adipose tissue(SAT),intermuscular adipose tissue(IMAT)and visceral adipose tissue(VAT)were segmented using classical fully CNN(FCN)derived network,including FCN,SegNet,UNet,Attention UNet,UNET++,nnUNet,UNeXt and CMUNeXt,then Dice similarity coefficient(DSC),intersection over union(IoU)and 95 Hausdorff distance(HD)were used to evaluate the performance of segmented dataset.The automatic body composition analysis system was constructed based on optimal layer selection network and segmentation network,the mean absolute error(MAE),root mean squared error(RMSE)and standard deviation(SD)of MAE were used to evaluate the performance of automatic system for testing the whole test dataset.Results The accuracy,precision,recall and specificity of DenseNet network for automatically classifying T7—T8 layer from chest CT images was 95.06%,84.83%,92.27%and 95.78%,respectively,which were all higher than those of the other layer selection networks.In segmentation of SM,SAT,IMAT and overall,DSC and IoU of UNet++network were all higher,while 95HD of UNet++network were all lower than those of the other segmentation networks.Using DenseNet as the layer selection network and UNet++as the segmentation network,MAE of the automatic body composition analysis system for predicting SM,SAT,IMAT,VAT and MAE was 27.09,6.95,6.65 and 3.35 cm 2,respectively.Conclusion The body composition analysis system based on chest CT could be used to assess content of chest muscle and adipose.Among them,the UNet++network had better segmentation performance in adipose tissue than SM.

Direct-writing Process and in vivo Evaluation of Prevascularized Composite Constructs for Muscle Tissue Engineering Application

Tissue engineered skeletal muscle is expected to treat muscle defects caused by trauma and disease.However,designing and manufacturing thick and complex tissue engineered skeletal muscle requires vascularization to ensure its internal cell viability and nutrient supply in vitro.In this article,we developed a set of Direct-Writing(DW)bio-printing procedure to manufacture a prevascularized composite construct with Human Umbilical Vein Endothelial Cell(HUVEC)and C2C12 cells for muscle tissue engineering application.We put the cells into the construct during the DW process to obtain the prevascularization and intend to promote its vascularization in vivo later.The constructs with cells or without cells were implanted respectively into nude mice back for 3 weeks,after which the mice healthily live for all the time and all the implants are tightly bonded to the host.From immunohistochemical analysis,CD31-positive blood vessels existed in the implanted samples with cells are more substantial than those without cells,but the implanted samples with HUVEC and C2C12 cells have much more number of small blood vessels distributing evenly.Moreover,the implants with cells,especially that with HUVEC and C2C12 cells,are able to get better fusion with the host skin and subcutaneous tissues.Histological analysis demonstrates that our DW-based constructs have the potential to be getting to vascularize the tissue engineered muscle.

Insulin action in muscle and adipose tissue in type 2 diabetes:The significance of blood flow

Under normal metabolic conditions insulin stimulates microvascular perfusion(capillary recruitment) of skeletal muscle and subcutaneous adipose tissue and thus increases blood flow mainly after meal ingestion or physical exercise.This helps the delivery of insulinitself but also that of substrates and of other signalling molecules to multiple tissues beds and facilitates glucose disposal and lipid kinetics.This effect is impaired in insulin resistance and type 2 diabetes early in the development of metabolic dysregulation and reflects early-onset endothelial dysfunction.Failure of insulin to increase muscle and adipose tissue blood flow results in decreased glucose handling.In fat depots,a blunted postprandial blood flow response will result in an insufficient suppression of lipolysis and an increased spill over of fatty acids in the circulation,leading to a more pronounced insulin resistant state in skeletal muscle.This defect in blood flow response is apparent even in the prediabetic state,implying that it is a facet of insulin resistance and exists long before overt hyperglycaemia develops.The following review intends to summarize the contribution of blood flow impairment to the development of the atherogenic dysglycemia and dyslipidaemia.

Vitamin A regulates intramuscular adipose tissue and muscle development:promoting high-quality beef production

During growth in cattle,the development of intramuscular adipose tissue and muscle is dependent upon cell hyperplasia(increased number of adipocytes)and hypertrophy(increased size of adipocytes).Based on the results of previous studies,other adipose tissue depots(e.g.,perirenal and subcutaneous)develop from the fetal stage primarily as brown adipose tissue.The hyperplastic stage of intramuscular adipose is considered to develop from late pregnancy,but there is no evidence indicating that intramuscular adipose tissue develops initially as brown adipose tissue.Hyperplastic growth of intramuscular adipose continues well into postweaning and is dependent on the timing of the transition to grain-based diets;thereafter,the late-stage development of intramuscular adipose tissue is dominated by hypertrophy.For muscle development,hyperplasia of myoblasts lasts from early(following development of somites in the embryo)to middle pregnancy,after which growth of muscle is the result of hypertrophy of myofibers.Vitamin A is a fat-soluble compound that is required for the normal immunologic function,vision,cellular proliferation,and differentiation.Here we review the roles of vitamin A in intramuscular adipose tissue and muscle development in cattle.Vitamin A regulates both hyperplasia and hypertrophy in in vitro experiments.Vitamin A supplementation at the early stage and restriction at fattening stage generate opposite effects in the beef cattle.Appropriate vitamin A supplementation and restriction strategy increase intramuscular adipose tissue development(i.e.,marbling or intramuscular fat)in some in vivo trials.Besides,hyperplasia and hypertrophy of myoblasts/myotubes were affected by vitamin A treatment in in vitro trials.Additionally,some studies reported an interaction between the alcohol dehydrogenase-1C(ADH1C)genotype and vitamin A feed restriction for the development of marbling and/or intramuscular adipose tissue,which was dependent on the timing and level of vitamin A restriction.Therefore,the feed strategy of vitamin A has the visible impact on the marbling and muscle development in the cattle,which will be helpful to promote the quality of the beef.

Homocysteine-induced Enhanced Expression of Tissue Factor in Human Vascular Smooth Muscle Cells

The homocysteine （Hcy）-induced tissue factor （TF） expression in human vascular smooth muscle cells （VSMCs） and the effect of Hcy on the activity of nuclear factor-kappaB （NF-кB） and the expression of inducible nitric oxide synthase （iNOS） were investigated. Human umbilical artery VSMCs were cultured by tissue explanting method, identified by α-actin immunohistochemistry, and incubated with different concentrations of Hcy/PTDC （NF-кB inhibitor）. Semi-quantitative RT-PCR was performed to detect the expression of TF mRNA in VSMCs. Flow cytometry was used to assay the expression of TF protein on the surface of VSMCs and the expression of iNOS in VSMCs. Western blot was carried out to detect the expression of NF-кB protein in nuclei. The results showed that Hcy could induce VSMCs expressing TF mRNA significantly after the VSMCs were incubated with Hcy at concentrations of 10, 100, 500 μmol/L respectively. There was low expression level of TF protein on the surface of the resting VSMCs and Hcy could also induce VSMCs expressing TF pro- tein on the cell surface in different concentrations. Additionally, Hcy could rapidly induce the activation of NF-кB and this effect could be significantly inhibited by PDTC. Hcy alone could not induce the expression of iNOS in VSMCs. It was concluded that Hcy could significantly induce the expression of TF in VSMCs and enhance the activation of NF-ΚB, subsequently mediate TF gene expression and protein synthesis. NF-кB-mediated expression of TF in VSMCs might be the important mechanism of atherosclerosis and thrombosis induced by Hcy.

Berberine Inhibits Gluconeogenesis in Skeletal Muscles and Adipose Tissues in Streptozotocin-induced Diabetic Rats via LKB1-AMPK-TORC2 Signaling Pathway

The effect and potential molecular mechanisms of berberine on gluconeogenesis in skeletal muscles and adipose tissues were investigated.After adaptive feeding for one week,8 rats were randomly selected as the normal group and fed on a standard diet.The remaining 32 rats were fed on a high-fat diet and given an intravenous injection of streptozotocin(STZ)for 2 weeks to induce the diabetic models.The diabetic rat models were confirmed by oral glucose tolerance test(OGTT)and randomly divided into 4 groups(n=8 each),which were all fed on a high-fat diet.Berberine(3 g/kg per day)or metformin(183 mg/kg per day)was intragastrically administered to the diabetic rats for 12 weeks,serving as berberine group and metformin group respectively.5-aminoimidazole-4-carboxamide1-β-D-ribofuranoside[AICAR,an agonist of AMP-activated protein kinase(AMPK),0.5 mg/kg per day]was subcutaneously injected to the diabetic rats for 12 weeks,serving as AICAR group.The remaining 8 diabetic rats served as the model group,which was given a 0.5%carboxyl methylcellulose solution by oral gavage.Fasting serum insulin(FINS),OGTT as well as lipid parameters were tested by commercial kit.The protein levels of liver kinase B1(LKB1),AMPK,phosphorylated AMP-activated protein kinase(p-AMPK),transducer of regulated CREB activity 2(TORC2),phosphorylated transducer of regulated CREB activity 2(p-TORC2),phosphoenolpyruvate carboxykinase(PEPCK),and glucose-6-phosphatase(G6Pase)in skeletal muscles and adipose tissues were examined by Western blotting.The results showed that berberine significantly decreased the body weight,plasma glucose,insulin levels,and homeostatic model assessment for insulin resistance(HOMA-IR)of diabetic rats compared with those in the model group.Meanwhile,the serum total triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)levels were markedly decreased and high-density lipoprotein cholesterol(HDL-C)level was significantly increased after the treatment with berberine.In addition,we found that berberine significantly increased the expression of p-AMPK and LKB1,while decreasing the p-TORC2 levels in skeletal muscles and adipose tissues.Moreover,the expression of PEPCK and G6Pase was significantly down-regulated after the treatment with berberine compared to the model group.It was suggested that the mechanism by which berberine inhibited peripheral tissue gluconeogenesis may be attributed to the activation of the LKB1-AMPK-TORC2 signaling pathway.

Gene Expression Profile of Human Skeletal Muscle and Adipose Tissue of Chinese Han Patients with Type 2 Diabetes Mellitus

Objective To study the differential patterns of gene expression in skeletal muscle and adipose tissue between type 2 diabetes mellitus （T2DM） patients and healthy subjects using DNA microarray analysis, Methods T2DM patiens were divided into female group, young male group and old male group. DNA microarray analysis and quantitative real-time PCR were carried out to anaIyze the relation between gene expressions and T2DM. Results The mRNA expression of 298, 578, and 350 genes was changed in the skeletal muscle of diabetes mellitus patients compared with control subjects. The 1320, 1143, and 2847 genes were modified in adipose tissue of the three groups. Among the genes surveyed, the change of 25 and 39 gene transcripts in skeletal muscle and adipose tissue was ≥2 folds, These differentially expressed genes were classified into 15 categories according to their functions. Conclusion New genes are found and T2DM can be prevented or cured.

Engineering skeletal muscle tissue in bioreactor systems

Objective To give a concise review of the current state of the art in tissue engineering （TE） related to skeletal muscle and kinds of bioreactor environment.Data sources The review was based on data obtained from the published articles and guidelines.Study selection A total of 106 articles were selected from several hundred original articles or reviews.The content of selected articles is in accordance with our purpose and the authors are authorized scientists in the study of engineered muscle tissue in bioreactor.Results Skeletal muscle TE is a promising interdisciplinary field which aims at the reconstruction of skeletal muscle loss.Although numerous studies have indicated that engineering skeletal muscle tissue may be of great importance in medicine in the near future,this technique still represents a limited degree of success.Since tissue-engineered muscle constructs require an adequate connection to the vascular system for efficient transport of oxygen,carbon dioxide,nutrients and waste products.Moreover,functional and clinically applicable muscle constructs depend on adequate neuromuscular junctions with neural calls.Third,in order to engineer muscle tissue successfully,it may be beneficial to mimic the in vivo environment of muscle through association with adequate stimuli from bioreactors.Conclusion Vascular system and bioreactors are necessary for development and maintenance of engineered muscle in order to provide circulation within the construct.

Muscle and adipose tissue biopsy in older adults with type 2 diabetes

We describe a method for obtaining skeletal muscle and subcutaneous adipose tissue in a single percutaneous needle biopsy procedure. Biopsies were performed in a double-blind randomized, sham-exercise controlled clinical trial of power training in 103 older adults with type 2 diabetes. In total 110 biopsies (73.3%) were performed in the first 50 participants at 3 time points. Muscle samples were obtained in 102/110 biopsies (92.7%);adipose samples were obtained in 72/110 biopsies (65.5%);both tissue types were obtained in 65/110 biopsies (59.1%). The average weight of muscle samples was 131±92 mg and the median weight of adipose samples was 51 mg (range 3 to 412 mg). No adverse effects of biopsies were reported other than mild transient pain or light-headedness. This is one of the first reports of both adipose and muscle tissue obtained during the same biopsy, and the first to describe in detail sampling technique, yield and safety.

Disseminated soft tissue diffuse large B-cell lymphoma involving multiple abdominal wall muscles:A case report

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common subtype of non�Hodgkin lymphoma,and patients with DLBCL typically present rapidly growing masses.Lymphoma involving muscle is rare and accounts for only 5%;furthermore,multiple muscles and soft tissue involvement of DLBCL is unusual.Due to unusual clinical manifestation,accurate diagnosis could be delayed.CASE SUMMARY A 61-year-old man complained of swelling,pain and erythematous changes in the lower abdomen.Initially,soft tissue infection was suspected,however,skin lesion did not respond to antibiotics.18Fluoro-2-deoxy-D-glucose(18F-FDG)positron emission tomography-computed tomography demonstrated FDG uptake not only in the skin and subcutaneous tissue of the abdomen but also in the abdominal wall muscles,peritoneum,perineum,penis and testis.DLBCL was confirmed by biopsy of the abdominal wall muscle and subcutaneous tissue.After intensive treatment including chemotherapy with rituximab,cyclophosphamide,doxorubicin,vincristine and prednisolone,central nervous system prophylaxis(intrathecal injection of methotrexate,cytarabine and hydrocortisone)and orchiectomy,he underwent peripheral blood stem cell mobilization for an autologous hematopoietic stem cell transplantation.Despite intensive treatment,the disease progressed rapidly and the patient showed poor outcome(overall survival,9 mo;disease free survival,3 mo).CONCLUSION The first clinical manifestation of soft tissue DLBCL involving multiple muscles was similar to the infection of the soft tissue.

Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome

BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.