Viscous fingering and its effect on areal sweep efficiency during waterflooding: an experimental study

Viscous fingering is one of the main challenges that could reduce areal sweep efficiency during waterflooding in oil reservoirs. A series of waterflooding experiments were carried out in a Hele-Shaw cell at ambient temperature during which areal sweep efficiency was estimated and techniques to ease the fingering problem were examined. The onset and propagation of viscous fingers were monitored as a function of both injection rate and injection/production positions. Image processing techniques were utilized to quantitatively investigate the propagation of fingers. The experimental results show that, under specific conditions, increasing the number of finger branches could improve the areal sweep efficiency, whereas growth of a single narrow finger has a negative impact on oil displacement efficiency. According to the obtained results,increasing the injection rate improves the areal sweep efficiency up to a critical rate at which viscous fingers start to grow.The impact of heterogeneity of the medium on distributing the viscous fingers was also investigated by introducing two different arrangements of fractures in the model. The results show that fractures perpendicular to the direction of flow would distribute the displacing water more uniformly, while fractures in the direction of flow would amplify the unfavorable sweep efficiency.

Simulation of the Influence of Surface Wettability on Viscous Fingering Phenomenon in Porous Media

Fingering phenomena are common occurrence in the natural world. It generally takes place when a less viscous fluid displacesa more viscous fluid typically in porous media. Nowadays, such phenomena have extensively been studied due to itsimportance in many industrial fields. In this paper, the effects of surface wettability on finger pattern are studied and simulatednumerically by the Lattice Boltzmann method (LBM). The displacement efficiency is investigated by using two parameters,namely, the breakthrough time and the areal sweep efficiency. The simulation has demonstrated that surface wettability willinfluence the finger pattern no matter the gravity is considered or not, but in the presence of gravity, the finger pattern is muchmore complicated and irregular due to the coexistence and competition of capillary force, viscous force and gravity.

Numerical investigation of viscous fingering in Hele-Shaw cell with spatially periodic variation of depth

Viscous fingering in a modified Hele-Shaw cell is numerically investigated. The cell allows periodic variation of depth in the lateral direction. The wavenumber n of the depth perturbation has great influence on fingering patterns. For n = 1, the fingering pattern due to the interface instability remains the same as that in the conventional Hele- Shaw cell, while the depth variation causes the steady finger to be a little narrower. For n = 2, four different fingering patterns are captured, similar to the available experimental observations in a modified Hele-Shaw cell containing a centered step-like occlusion. It is found that new fingering patterns appear as n further increases, among which, two patterns with spatial oscillation along both edges of the finger are particularly interesting. One is a symmetric oscillatory finger for n = 3, and the other is an asymmetric one for n = 4. The influence of capillary number on fingering patterns is studied for n = 3 and 4. We find that spatial oscillation of the finger nearly ceases at moderate capillary numbers and occurs again as the capillary number increases further. Meanwhile, the wide finger shifts to the narrow one. It is accompanied by a sudden decrease in the finger width which otherwise decreases continuously as the capillary number increases. The wavenumber and the amplitude of depth perturbation have little effect on the finger width.

Numerical Study on Viscous Fingering Using Electric Fields in a Hele-Shaw Cell

We investigate the nonlinear dynamics of amoving interface in aHele-Shaw cell subject to an in-plane applied electric field.We develop a spectrally accurate numerical method for solving a coupled integral equation system.Although the stiffness due to the high order spatial derivatives can be removed using a small scale decomposition technique,the long-time simulation is still expensive since the evolving velocity of the interface drops dramatically as the interface expands.We remove this physically imposed stiffness by employing a rescaling scheme,which accelerates the slow dynamics and reduces the computational cost.Our nonlinear results reveal that positive currents restrain finger ramification and promote the overall stabilization of patterns.On the other hand,negative currents make the interface more unstable and lead to the formation of thin tail structures connecting the fingers and a small inner region.When no fluid is injected,and a negative current is utilized,the interface tends to approach the origin and break up into several drops.We investigate the temporal evolution of the smallest distance between the interface and the origin and find that it obeys an algebraic law(t∗−t)b,where t∗is the estimated pinch-off time.

Upregulated lncRNA PRNT promotes progression and oxaliplatin resistance of colorectal cancer cells by regulating HIPK2 transcription

BACKGROUND Colorectal cancer(CRC)is the third most common cancer and a significant cause of cancer-related mortality globally.Resistance to chemotherapy,especially during CRC treatment,leads to reduced effectiveness of drugs and poor patient outcomes.Long noncoding RNAs(lncRNAs)have been implicated in various pathophysiological processes of tumor cells,including chemotherapy resistance,yet the roles of many lncRNAs in CRC remain unclear.AIM To identify and analyze the lncRNAs involved in oxaliplatin resistance in CRC and to understand the underlying molecular mechanisms influencing this resistance.METHODS Gene Expression Omnibus datasets GSE42387 and GSE30011 were reanalyzed to identify lncRNAs and mRNAs associated with oxaliplatin resistance.Various bioinformatics tools were employed to elucidate molecular mechanisms.The expression levels of lncRNAs and mRNAs were assessed via quantitative reverse transcription-polymerase chain reaction.Functional assays,including MTT,wound healing,and Transwell,were conducted to investigate the functional implications of lncRNA alterations.Interactions between lncRNAs and trans-cription factors were examined using RIP and luciferase reporter assays,while Western blotting was used to confirm downstream pathways.Additionally,a xenograft mouse model was utilized to study the in vivo effects of lncRNAs on chemotherapy resistance.RESULTS LncRNA prion protein testis specific(PRNT)was found to be upregulated in oxaliplatin-resistant CRC cell lines and negatively correlated with homeodomain interacting protein kinase 2(HIPK2)expression.PRNT was demonstrated to sponge transcription factor zinc finger protein 184(ZNF184),which in turn could regulate HIPK2 expression.Altered expression of PRNT influenced CRC cell sensitivity to oxaliplatin,with overexpression leading to decreased sensitivity and decreased expression reducing resistance.Both RIP and luciferase reporter assays indicated that ZNF184 and HIPK2 are targets of PRNT.The PRNT/ZNF184/HIPK2 axis was implicated in promoting CRC progression and oxaliplatin resistance both in vitro and in vivo.CONCLUSION The study concludes that PRNT is upregulated in oxaliplatin-resistant CRC cells and modulates the expression of HIPK2 by sponging ZNF184.This regulatory mechanism enhances CRC progression and resistance to oxaliplatin,positioning PRNT as a promising therapeutic target for CRC patients undergoing oxaliplatin-based chemotherapy.

Quantitative trait loci identification reveals zinc finger protein CONSTANS-LIKE 4 as the key candidate gene of stigma color in watermelon(Citrullus lanatus)

Stigma color is a critical agronomic trait in watermelon that plays an important role in pollination.However,there are few reports on the regulation of stigma color in watermelon.In this study,a genetic analysis of the F2 population derived from ZXG1553(P1,with orange stigma)and W1-17(P2,with yellow stigma)indicated that stigma color is a quantitative trait and the orange stigma is recessive compared with the yellow stigma.Bulk segregant analysis sequencing(BSA-seq)revealed a 3.75 Mb segment on chromosome 6 that is related to stigma color.Also,a major stable effective QTL Clqsc6.1(QTL stigma color)was detected in two years between cleaved amplified polymorphic sequencing(CAPS)markers Chr06_8338913 and Chr06_9344593 spanning a~1.01 Mb interval that harbors 51 annotated genes.Cla97C06G117020(annotated as zinc finger protein CONSTANS-LIKE 4)was identified as the best candidate gene for the stigma color trait through RNA-seq,quantitative real-time PCR(qRT-PCR),and gene structure alignment analysis among the natural watermelon panel.The expression level of Cla97C06G117020 in the orange stigma accession was lower than in the yellow stigma accessions with a significant difference.A nonsynonymous SNP site of the Cla97C06G117020 coding region that causes amino acid variation was related to the stigma color variation among nine watermelon accessions according to their re-sequencing data.Stigma color formation is often related to carotenoids,and we also found that the expression trend of ClCHYB(annotated asβ-carotene hydroxylase)in the carotenoid metabolic pathway was consistent with Cla97C06G117020,and it was expressed in low amounts in the orange stigma accession.These data indicated that Cla97C06G117020 and ClCHYB may interact to form the stigma color.This study provides a theoretical basis for gene fine mapping and mechanisms for the regulation of stigma color in watermelon.

Therapeutic targeting of cellular prion protein: toward the development of dual mechanism anti-prion compounds

PrPSc,a misfolded,aggregation-prone isoform of the cellular prion protein(PrPC),is the infectious prion agent responsible for fatal neurodegenerative diseases of humans and other mammals.PrPSccan adopt different pathogenic conformations(prion strains),which can be resistant to potential drugs,or acquire drug resistance,posing challenges for the development of effective therapies.Since PrPCis the obligate precursor of any prion strain and serves as the mediator of prion neurotoxicity,it represents an attractive therapeutic target fo r prion diseases.In this minireview,we briefly outline the approaches to target PrPCand discuss our recent identification of Zn(Ⅱ)-Bn PyP,a PrPC-targeting porphyrin with an unprecedented bimodal mechanism of action.We argue that in-depth understanding of the molecular mechanism by which Zn(Ⅱ)-Bn PyP targets PrPCmay lead toward the development of a new class of dual mechanism anti-prion compounds.

ZNF554 Inhibits Endometrial Cancer Progression via Regulating RBM5 and Inactivating WNT/β-Catenin Signaling Pathway

Objective:Uterine corpus endometrial carcinoma(UCEC),a kind of gynecologic malignancy,poses a significant risk to women’s health.The precise mechanism underlying the development of UCEC remains elusive.Zinc finger protein 554(ZNF554),a member of the Krüppel-associated box domain zinc finger protein superfamily,was reported to be dysregulated in various illnesses,including malignant tumors.This study aimed to examine the involvement of ZNF554 in the development of UCEC.Methods:The expression of ZNF554 in UCEC tissues and cell lines were examined by qRT-PCR and Western blot assay.Cells with stably overexpressed or knocked-down ZNF554 were established through lentivirus infection.CCK-8,wound healing,and Transwell invasion assays were employed to assess cell proliferation,migration,and invasion.Propidium iodide(PI)staining combined with fluorescence-activated cell sorting(FACS)flow cytometer was utilized to detect cell cycle distribution.qRT-PCR and Western blotting were conducted to examine relative mRNA and protein levels.Chromatin immunoprecipitation assay and luciferase reporter assay were used to explore the regulatory role of ZNF554 in RNA binding motif 5(RBM5).Results:The expression of ZNF554 was found to be reduced in both UCEC samples and cell lines.Decreased expression of ZNF554 was associated with higher tumor stage,decreased overall survival,and reduced disease-free survival in UCEC.ZNF554 overexpression suppressed cell proliferation,migration,and invasion,while also inducing cell cycle arrest.In contrast,a decrease in ZNF554 expression resulted in the opposite effect.Mechanistically,ZNF554 transcriptionally regulated RBM5,leading to the deactivation of the Wingless(WNT)/β-catenin signaling pathway.Moreover,the findings from rescue studies demonstrated that the inhibition of RBM5 negated the impact of ZNF554 overexpression onβ-catenin and p-glycogen synthase kinase-3β(p-GSK-3β).Similarly,the deliberate activation of RBM5 reduced the increase inβ-catenin and p-GSK-3βcaused by the suppression of ZNF554.In vitro experiments showed that ZNF554 overexpression-induced decreases in cell proliferation and migration were counteracted by RBM5 knockdown.Additionally,when RBM5 was overexpressed,it hindered the improvements in cell proliferation and migration caused by reducing the ZNF554 levels.Conclusion:ZNF554 functions as a tumor suppressor in UCEC.Furthermore,ZNF554 regulates UCEC progression through the RBM5/WNT/β-catenin signaling pathway.ZNF554 shows a promise as both a prognostic biomarker and a therapeutic target for UCEC.

Nursing of a patient with multiple primary cancers: A case report and review of literature

BACKGROUND Although the occurrence of multiple primary cancers(MPC)is not exceedingly common,it is not rare in clinical practice.In recent years,there has been a notable increase in its incidence.The frequent confusion between MPC and tumor metastasis or recurrence often leads to delays in diagnosis and treatment.This study aimed to enhance understanding of MPC,improve diagnostic accuracy,guide precise clinical treatment,and implement a case management nursing model(CMNM)to facilitate quick patient recovery.CASE SUMMARY A 61-year-old female patient presented with persistent upper abdominal pain lasting over 2 months.Gastroscopy revealed the presence of both gastric and duodenal cancers.Following a thorough evaluation,the patient underwent pancreaticoduodenectomy,cholecystectomy,and total gastrectomy.Post-surgery,an individualized case management nursing approach was applied,leading to a successful recovery.Three months after the surgery,follow-up examinations showed no signs of recurrence.CONCLUSION The CMNM effectively promoted rapid patient recovery,enhanced the quality of orthopedic nursing services,and accelerated postoperative recovery,ultimately leading to increased patient satisfaction with nursing care.

Line Patterns Segmentation in Blurred Images Using Contrast Enhancement and Local Entropy Thresholding

Finger vein extraction and recognition hold significance in various applications due to the unique and reliable nature of finger vein patterns. While recently finger vein recognition has gained popularity, there are still challenges associated with extracting and processing finger vein patterns related to image quality, positioning and alignment, skin conditions, security concerns and processing techniques applied. In this paper, a method for robust segmentation of line patterns in strongly blurred images is presented and evaluated in vessel network extraction from infrared images of human fingers. In a four-step process: local normalization of brightness, image enhancement, segmentation and cleaning were involved. A novel image enhancement method was used to re-establish the line patterns from the brightness sum of the independent close-form solutions of the adopted optimization criterion derived in small windows. In the proposed method, the computational resources were reduced significantly compared to the solution derived when the whole image was processed. In the enhanced image, where the concave structures have been sufficiently emphasized, accurate detection of line patterns was obtained by local entropy thresholding. Typical segmentation errors appearing in the binary image were removed using morphological dilation with a line structuring element and morphological filtering with a majority filter to eliminate isolated blobs. The proposed method performs accurate detection of the vessel network in human finger infrared images, as the experimental results show, applied both in real and artificial images and can readily be applied in many image enhancement and segmentation applications.

Analysis of the Effect of Intensive Nursing Care on Improving Sleep Quality During the Perioperative Period of Severed Finger Reimplantation

Objective:To investigate the clinical effect of perioperative intensive nursing on patients who underwent severed finger reimplantation and its influence on sleep quality.Methods:62 patients who underwent severed finger reimplantation between January 2023 and December 2023 were included.They were divided into two groups:the observation group(n=31)and the control group(n=31).The control group received basic nursing interventions,while the observation group received intensive nursing care.The comparison parameters included visual analog pain score(VAS),incidence of vascular crises,length of hospitalization,Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Score(HAM-D),Hamilton Anxiety Score(HAM-A),and patient satisfaction.Results:Postoperative VAS score,incidence of vascular crisis,hospitalization time,PSQI score,and HAM-A and HAM-D scores of the observation group were lower than those of the control group(P<0.05).Meanwhile,the patient satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Perioperative intensive nursing care for patients undergoing severed finger reimplantation demonstrates significant benefits.It reduces postoperative pain,lowers the incidence of vascular crises,shortens hospitalization durations,enhances sleep quality,alleviates negative emotions,and improves nursing satisfaction.These findings underscore the importance and applicability of such care practices.

Shared Memory Semi-Implicit Solver for Hydrodynamical Instability Processes

The Advection-Diffusion Reaction (ADR) equation appears in many problems in nature. This constitutes a general model that is useful in various scenarios, from porous media to atmospheric processes. Particularly, it is used at the interface between two fluids where different types of instabilities due to surface mobility may appear. Together with the ADR equation, the Darcy-Brinkman model describes the phenomena known as fingering that appear in different contexts. The study of this type of system gains in complexity when the number of chemical species dissolved in both fluids increases. With more solutes, the increasing complexity of this phenomenon generally requires much computational power. To face the need for more computational resources, we build a solver tool based on an Alternating Direction Implicit (ADI) scheme that can be run in Central Processing Unit (CPU) and Graphic Processing Unit (GPU) architectures on any notebook. The implementation is done using the MATLAB platform to compare both versions. It is shown that using the GPU version strongly saves both resources and calculation times.

Intron-retained alternatively spliced VIN3-LIKE 2 gene from Chimonanthus praecox promotes flowering in transgenic Arabidopsis

Vernalization is a process of acquiring or accelerating the flowering ability by prolonged cold exposure.VERNALIZATION INSENSITIVE3(VIN3)is induced by chilling and is extremely important for the vernalization response in Arabidopsis thaliana.However,the issue of the induction of the VIN3-LIKE genes in wintersweet(Chimonanthus praecox)has been largely neglected.In the present study,we explored the molecular regulation of the PHD type finger protein-encoding gene CpVIL2 in relation to the growth and development of wintersweet in Arabidopsis.In wintersweet,quantitative real-time PCR(qRT-PCR)analysis showed that the relative expression of CpVIL2-As2i(intron-retained alternatively spliced in the second intron)was extremely higher in the pistils than in the other tissues.And the relative CpVIL2-As2i expression in flower buds(FBs)treated at 8°C was higher than that of FBs in December,2016 under natural conditions,which was not detected in non-flowering FBs at 16°C.In Arabidopsis,the expression patterns of the CpVIL2-As2i gene were detected at first in CpVIL2-As2i pro::GUS(β-glucuronidase)lines,with predominantly higher expression in flowers and inflorescence.Meanwhile,the hormone-induced expression profiles of the CpVIL2-As2i promoter were confirmed using exogenous induction by abscisic acid(ABA)and indole acetic acid(IAA)phytohormones,where the GUS enzyme activity obviously decreased compared with that of control.In comparison with Arabidopsis/Col-0,early flowering was detected in ectopic 35S::CpVIL2-As2i lines.Overall,these results demonstrated the function of the CpVIL2-As2i gene,at the same time,provided us with new insights into the molecular mechanisms of early flowering and complex regulatory networks of vernalization in wintersweet.

Diagnostic value of methylated branched chain amino acid transaminase 1/IKAROS family zinc finger 1 for colorectal cancer

BACKGROUND The diagnostic value of combined methylated branched chain amino acid transaminase 1(BCAT1)/IKAROS family zinc finger 1(IKZF1)in plasma for colorectal cancer(CRC)has been explored since 2015.Recently,several related studies have published their results and showed its diagnostic efficacy.AIM To analyze the diagnostic value of methylated BCAT1/IKZF1 in plasma for screening and postoperative follow-up of CRC.METHODS The candidate studies were identified by searching the PubMed,Embase,Cochrane Library,CNKI,and Wanfang databases from May 31,2003 to June 1,2023.Sensitivity,specificity,and diagnostic accuracy were calculated by merging ratios or means.RESULTS Twelve eligible studies were included in the analysis,involving 6561 participants.The sensitivity of methylated BCAT1/IKZF1 in plasma for CRC diagnosis was 60%[95%confidence interval(CI)53-67]and specificity was 92%(95%CI:90-94).The positive and negative likelihood ratios were 8.0(95%CI:5.8-11.0)and 0.43(95%CI:0.36-0.52),respectively.Diagnostic odds ratio was 19(95%CI:11-30)and area under the curve was 0.88(95%CI:0.85-0.91).The sensitivity and specificity for CRC screening were 64%(95%CI:59-69)and 92%(95%CI:91-93),respectively.The sensitivity and specificity for recurrence detection during follow-up were 54%CONCLUSION The detection of methylated BCAT1/IKZF1 in plasma,as a non-invasive detection method of circulating tumor DNA,has potential CRC diagnosis,but the clinical application prospect needs to be further explored.

介导植物干旱应答的RING finger类型泛素连接酶的研究进展

干旱是影响植物生长和农作物产量的重要环境因素。泛素连接酶E3是蛋白质泛素化修饰的关键酶之一,对于植物生长发育和干旱胁迫应答具有重要的调控作用。RING finger类型泛素连接酶是其成员最多的一种类型。本文主要概述了植物对干旱胁迫的响应机制及植物中的RING finger类型E3,并详细综述了RING finger类型E3介导植物干旱胁迫应答的研究进展,可以供大家参考。

Investigation of Experimental Devices for Finger Active and Passive Tactile Friction Analysis

Complicated tribological behavior occurs when human fingers touch and perceive the surfaces of objects.In this process,people use their exploration style with different conditions,such as contact load,sliding speed,sliding direction,and angle of orientation between fingers and object surface consciously or unconsciously.This work addressed interlaboratory experimental devices for finger active and passive tactile friction analysis,showing two types of finger movement.In active sliding experiment,the participant slid their finger freely against the object surface,requiring the subject to control the motion conditions themselves.For passive sliding experiments,these motion conditions were adjusted by the device.Several analysis parameters,such as contact force,vibration acceleration signals,vibration magnitude,and fingerprint deformation were recorded simultaneously.Noticeable friction differences were observed when comparing active sliding and passive sliding.For passive sliding,stick-slip behavior occurred when sliding in the distal direction,evidenced by observing the friction force and the related deformation of the fingerprint ridges.The employed devices showed good repeatability and high reliability,which enriched the design of the experimental platform and provided guidance to the standardization research in the field of tactile friction.

Sensitivity and specificity of hearing tests for screening hearing loss in older adults

Objectives: The study aimed to determine the most appropriate hearing screening test to identify disabling hearing loss for adults aged 65 years or older.Methods: This study included 577 older adults. Four hearing screening tests were considered in the study, including the Hearing Handicap Inventory for Elderly Screening(HHIE-s), three single question tests, the whisper test, and the finger rub test. The sensitivity and specificity of these tests referenced to the hearing threshold of disabling hearing loss were estimated.Results: Among all tests, only the single self-perception question(0.7064 for sensitivity;0.7225 for specificity) and whisper test(0.7833 for sensitivity;0.7708 for specificity) could obtain both sensitivity and specificity higher than 70% for adults aged ≥65 years.Conclusion: Overall, we suggest using the whisper test to identify disabling hearing loss(>40 dB HL at the better ear) for adults aged 65 years or older. However, if the conditions do not permit, the single selfperception question is also acceptable. Moreover, HHIE-s might not be a good test to detect disabling hearing loss for adults aged 80 years or older.

Biometric Finger Vein Recognition Using Evolutionary Algorithm with Deep Learning

In recent years,the demand for biometric-based human recog-nition methods has drastically increased to meet the privacy and security requirements.Palm prints,palm veins,finger veins,fingerprints,hand veins and other anatomic and behavioral features are utilized in the development of different biometric recognition techniques.Amongst the available biometric recognition techniques,Finger Vein Recognition(FVR)is a general technique that analyzes the patterns of finger veins to authenticate the individuals.Deep Learning(DL)-based techniques have gained immense attention in the recent years,since it accomplishes excellent outcomes in various challenging domains such as computer vision,speech detection and Natural Language Processing(NLP).This technique is a natural fit to overcome the ever-increasing biomet-ric detection problems and cell phone authentication issues in airport security techniques.The current study presents an Automated Biometric Finger Vein Recognition using Evolutionary Algorithm with Deep Learning(ABFVR-EADL)model.The presented ABFVR-EADL model aims to accomplish bio-metric recognition using the patterns of the finger veins.Initially,the presented ABFVR-EADL model employs the histogram equalization technique to pre-process the input images.For feature extraction,the Salp Swarm Algorithm(SSA)with Densely-connected Networks(DenseNet-201)model is exploited,showing the proposed method’s novelty.Finally,the Deep-Stacked Denoising Autoencoder(DSAE)is utilized for biometric recognition.The proposed ABFVR-EADL method was experimentally validated using the benchmark databases,and the outcomes confirmed the productive performance of the proposed ABFVR-EADL model over other DL models.

Multiple flexor tendon ruptures due to osteochondroma of the hamate:A case report

BACKGROUND Closed rupture of the little and ring finger flexor tendons caused by the hamate is mostly associated with a fracture or nonunion of the hamate hook.Only one case of a closed rupture of the finger flexor tendon caused by osteochondroma in the hamate has been reported.Here,we present a case study to highlight the possibility of hamate osteochondroma as a rare cause of finger closed flexor tendon rupture based on our clinical experience and literature review.CASE SUMMARY A 48-year-old man who had been a rice-field farmer for 7–8 h a day for the past 30 years visited our clinic due to the loss of right little finger and ring finger flexion involving both the proximal and distal interphalangeal joints.The patient was diagnosed with a complete rupture of the ring and little finger flexors because of the hamate and was pathologically diagnosed with an osteochondroma.Exploratory surgery was performed,and a complete rupture of the ring and little finger flexors due to an osteophyte-like lesion of the hamate was observed,which was pathologically diagnosed as an osteochondroma.CONCLUSION One should consider that osteochondroma in the hamate may be the cause of closed tendon ruptures.

Iatrogenic flexor tendon rupture caused by misdiagnosing sarcoidosis-related flexor tendon contracture as tenosynovitis: A case report

BACKGROUND Sarcoidosis is a multisystem disease characterized by granuloma formation in various organs.Sarcoidosis-related flexor tendon contractures are uncommon in clinical settings.This contracture is similar to stenosing tenosynovitis and po-tentially leads to misdiagnosis and mistreatment.Herein,we report a rare case of sarcoidosis-related finger flexor tendon contracture that was misdiagnosed as tenosynovitis.A 44-year-old woman presented to our department with flexion contracture of the right ring and middle fingers.The patient was misdiagnosed with tenosynovitis and underwent acupotomy release of the A1 pulley of the middle finger in an-other hospital that resulted in iatrogenic rupture of both the superficial and profundus flexors.Radiological presentation showed multiple sarcoid involve-ments in the pulmonary locations and ipsilateral forearm.A diagnosis of sar-coidosis was made based on the presence of non-caseating granulomas with tubercles consisting of Langhans giant cells with lymphocyte infiltration on biopsy,and the patient underwent surgical repair for the contracture.After 2 mo,the patient experienced another spontaneous rupture of the repaired middle finger tendon and underwent surgical re-repair.Satisfactory results were achieved at the 10 mo follow-up after reoperation.CONCLUSION Sarcoidosis-related finger contractures are rare;thus,caution should be exercised when dealing with such patients to avoid incorrect treatment.