Field Performance of Quercus bicolor Established as Repeatedly Air-Root-Pruned Container and Bareroot Planting Stock

Benefits of repeated air-root-pruning of seedlings when stepping up to progressively larger containers include excellent lateral root distribution immediately below the root collar and an exceptionally fibrous root ball. To evaluate long-term field performance of repeatedly air-root-pruned container stock, three plantings of swamp white oak (Quercus bicolor Willd.) 10 to 13 years old were located that also included bareroot planting stock. Initial and final stem diameter and height and above-ground green weights were determined on randomly selected trees at each site. On a site with a sandy, excessively drained, high pH soil, trees (age 10) from container stock were 1.5 times taller, 2.3 times larger in dbh, and 2.8 times greater in green weight than trees from bareroot stock which averaged only 2.9 m tall, 3.9 cm dbh, and 16.3 kg green weight. On a site with high clay, poor internal drainage, and frequent flooding, trees (age 12) from container stock were 1.4 times taller, 1.8 times larger in dbh, and 4.1 times greater in green weight than trees from bareroot stock which averaged 4 m tall, 7.3 cm dbh, and 28 kg green weight. On an upland site with deep loess soils, there was a trend for trees (age 13) from container stock to be only slightly larger than trees from bareroot stock with each stock type averaging 9.6 m tall, 20 cm dbh, and 177 kg green weight. Repeated air-root pruning produced lateral roots immediately below the root collar that resulted in large container stock with large well-balanced root systems that were competitive on harsh or less than ideal oak sites. Although the process is relatively labor intensive, propagation of repeatedly air-root-pruned container stock is readily adaptable internationally to locally available sources of organic matter and open-bottom containers.

Biomarkers in nonalcoholic fatty liver disease-the emperor has no clothes?

Fatty liver is present in over ten percentage of the world population and it is a growing public health problem.Nonalcoholic fatty liver disease(NAFLD) is not a single disease,but encompasses a spectrum of diseases of different etiologies.It is difficult to find highly specific and sensitive diagnostic biomarkers when a disease is very complex.Therefore,we should aim to find relevant prognostic markers rather than accurate diagnostic markers which will help to minimize the frequency of liver biopsies to evaluate disease progression.There are several biomarker panels commercially available,however,there is no clear evidence that more sophisticated panels are better compared to simple criteria such as,presence of diabetes over five years,metabolic syndrome,obesity,obstructive sleep apnea,aspartate transaminase/alanine transaminase(ALT) ratio > 0.8 or ferritin levels > 1.5 times normal in patients with over six month history of raised ALT and/or ultrasonological evidence of fat in the liver.Currently the biomarker panels are not a replacement for a liver biopsy.However the need and benefit of liver biopsy in NAFLD is questionable because there is no convincing evidence that biopsy and detailed staging of NAFLD improves the management of NAFLD and benefits the patient.After all there is no evidence based treatment for NAFLD other than management of lifestyle and components of "metabolic syndrome".

Fibrosing cholestatic hepatitis following cytotoxic chemotherapy for small-cell lung cancer

Fibrosing cholestatic hepatitis(FCH) is a variant of viral hepatitis reported in hepatitis B virus or hepatitis C virus infected liver,renal or bone transplantation recipients and in leukemia and lymphoma patients after conventional cytotoxic chemotherapy.FCH constitutes a well-described form of fulminant hepatitis having extensive fibrosis and severe cholestasis as its most characteristic pathological findings.Here,we report a case of a 49-year-old patient diagnosed with small-cell lung cancer who developed this condition following conventional chemotherapy-induced immunosuppression.This is the first reported case in the literature of FCH after conventional chemotherapy for a solid tumor.In addition to a detailed report of the case,a physiopathological examination of this potentially life-threatening condition and its treatment options are discussed.

Recurrent hepatitis C after liver transplant

End stage liver disease from hepatitis C is the most common indication for liver transplantation in many parts of the world accounting for up to 40% of liver transplants. Antiviral therapy either before or after liver transplantation is challenging due to side effects and lower efficacy in patients with cirrhosis and liver transplant recipients, as well as from drug interactions with immunosuppressants. Factors that may affect recurrent hepatitis C include donor age, immunosuppression, IL28 B genotype, cytomegalovirus infection, and metabolic syndrome. Older donor age has persistently been shown to have the greatest impact on recurrent hepatitis C. After liver transplantation, distinguishing recurrent hepatitis C from acute cellular rejection may be difficult, although the development of molecular markers may help in making the correct diagnosis. The advent of interferon free regimens with direct acting antiviral agents that include NS3/4A protease inhibitors, NS5 B polymerase inhibitors and NS5 A inhibitors holds great promise in improving outcomes for liver transplant candidates and recipients.

Unique pattern of fibrosing cholestatic hepatitis after liver transplantation

To explore the pathological features and thedifferential diagnosis of recurrent HBV after livertransplantation.Methods: One case of liver transplantation for HBVcirrhosis was subjected to liver biopsises on time post-operatively.Results: 25 days after liver transplantation, serologicHBsAg, HBeAg and HBV-DNA of the patient becamenegative, but HBsAg was positive again on day 58 af-ter liver transplantation. Histopathological examina-tion showed balloon-like changes of hepatocytes withfragmental necrosis, fibrosis in the portal areas andaround the portal veins, cholestasis in some hepato-cytes and canaliculi, and positive HBsAg and HBcAgwith immunohistochemical staining. Clinically hepaticenzyme levels progressively increased, maintained forsome time, and decreased rapidly at last. Stubborn hy-poproteinemia was associated with the aggregation ofgeneral condition of the patient.Conclusions: Fibrosing cholestatic hepatitis (FCH) is aspecial type in recurrent infection of HBV after livertransplantation. It has a serious clinical process andspecific pathological changes different from those ofthe usual HBV.

Celiac disease and microscopic colitis:A report of 4 cases

Celiac disease (CD) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people at all ages.However,it can be associated also to other immunopathological disorders,and may be associated with abnormal histology in segments of the gut other than the small bowel including colonic inflammation.While guidelines for endoscopic investigation of the jejunum are well defined,no indication is defined for colonic investigation.We describe four cases of concurrent CD and microscopic colitis (MC) diagnosed at our department over a 10-year period and analyzed the main features and outcomes of CD in this setting.The symptoms of these patients were improved initially by a gluten-free diet before the onset of MC symptoms.Two of the patients were siblings and had an atypical form of CD.The other two patients with CD and MC also presented with fibrosing alveolitis and were anti-Saccharomyces cerevisiae antibody positive.The co-existence of immune-mediated small bowel and colonic inflammatory and pulmonary diseases are not well-known,and no systematic approach has been used to identify the lifelong patterns of these immune-based diseases.Patients can develop,or present with CD at any stage in life,which can co-exist with other gastrointestinal diseases of (auto-) immune origin.In addition,the fa-milial co-existence and prevalence of MC in patients with a prior diagnosis of CD are unclear.Clinicians managing celiac disease should be aware of these associations and understand when to consider colon investigation.

Pulmonary Artery Bypass for Fibrosing Mediastinitis

This is a very unusual case with unexpected findings. In spite of sophisticated investigation tests such as MRI and pul?monary angiogram, it may be very difficult to identify the nature of pulmonary artery stenosis or occlusion.

Use of the Scar Acceleration Method/Método de Aceleração Cicatricial—MAC®—in the Treatment of Capsular Contracture: Case Report

Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MACò method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300 s), violet (60 s) and blue (120 s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MACò method showed improvement in signs and symptoms—the sensation of prosthesis stiffness in the lower and medial region, local temperature, and pain in the right breast. The patient was followed up after treatment and currently, she has no complaints. There was also no need for surgical intervention. In the present case report, the MACò method proved to be effective. Further research is suggested with a cohort of patients with capsular contracture, with randomization and evaluation of a larger number of patients with the referred method.

Frontal fibrosing alopecia update

Frontal fibrosing alopecia(FFA) is a recently described form of primary cicatricial alopecia, characterized by progressive recession of the frontotemporal hairline and eyebrow loss, occurring predominantly in postmenopausal women. The incidence of FFA has increased significantly during the last decade and we may be facing an epidemic of the disease. Because this condition causes permanent hair loss, prompt diagnosis and treatment are essential for obtaining optimal outcome. This article reviews existing knowledge on epidemiology, etiopathogenesis, clinico-histological features, diagnosis,and treatment modalities of FFA.