They were differentially regulated in keloid samples and had opposite behavior in exposure to hydrocortisone. A key signature of six genes featuring FGF11 not only was highly correlated with significantly dysregulated fibroblast activation but also reflected various levels of immune cell infiltration. FGF11, in particular, revealed the heterogenous immunologic nature of keloid lesions. This study further supported that aberrant fibroblast was one of the main contributing factors and shed some light on investigating immune properties in future studies.The frail, elderly population is at a high risk of postoperative complications. Besides perioperative rehabilitation techniques and management by geriatric teams, the least invasive techniques in anesthesia are required, making regional anesthesia very interesting in terms of benefit-risk ratio. Among them, local anesthesia is a simple, reproducible, inexpensive technique applied to many superficial or deep surgeries, which should make it a gold standard for the frail person. This review provides an update on the current possibilities for various surgeries and exclusion.Epithelial ovarian cancer (EOC) is the most lethal gynecologic cancer. The gold standard therapeutic approach is a combination of surgery plus chemotherapy. Unfortunately, 80% of patients with EOC suffer recurrence within 2-years and the overall response rate for platinum-resistant epithelial ovarian cancer to cytotoxic chemotherapy or poly-(adenosine diphosphate)-ribose polymerase (PARP) inhibitor is modest. New therapies are needed to improve overall survival. The role of immunotherapy has been established in endometrial and cervical cancers, however its effective use in EOC has been limited due to the intrinsic genomics and micro-immune environment associated with EOC. Studies evaluating immunotherapy, largely immune checkpoint inhibitors (ICI), have shown limited activity, yet some patients benefit greatly. Thus, significant efforts must be devoted to finding new strategies for the use of immunotherapy/immunomodulatory drugs (IMiDs). Immunotherapy has a well-tolerated safety profile; however, cost-effectiveness can be an obstacle. The aim of this article is to review the most recent research into the use of IMiDs in patients with platinum-resistant epithelial ovarian cancer.Percutaneous nephrolithotomy is usually considered as safe and effective in the management of renal stones in pediatric population. Urinothorax defined as presence of urine in pleural cavity is a rare complication of percutaneous nephrolithotomy. We present a rare case of slowly developing urinothorax in a 9-year-old boy following PCNL due to migration of DJ stent into the pleural cavity. The case was managed by intracostal tube drainage and repositioning of DJ stent.Staphylococcus aureus infectious endocarditis has a high mortality, major causes of death being cardiac failure, systemic embolism, and sepsis. Pseudoaneurysms, a rare complication of this infection, are not invariably fatal with appropriate treatment. A previously healthy 32-year-old man was found to have multiple cerebral infarctions, and infectious endocarditis with mitral valve vegetation was diagnosed by echocardiography. Because methicillin-resistant Staphylococcus aureus (MRSA) was identified from blood cultures, vancomycin was administered. Massive intracerebral hemorrhage in the left temporo-occipital lobe occurred in the patient on the 3rd day after admission, and the hematoma was completely removed surgically. Another hemorrhage was identified in the right occipital region on the 7th hospital day, which led the patient deep coma. Blood cultures on the 10th day were negative for MRSA; however, imaging studies revealed pseudoaneurysms in the superior mesenteric, hepatic, and left popliteal arteries 3 weeks after admission. No surgical indication was applied to these pseudoaneurysms because the patient remained comatose. On the 78th day after admission, the patient’s blood pressure suddenly dropped and he died. Autopsy demonstrated massive bleeding in the abdominal cavity caused by rupture of the superior mesenteric artery pseudoaneurysm. Our patient’s clinical course was fulminant, his endocarditis being complicated by cerebral infarctions, intracranial hemorrhages, and multiple pseudoaneurysms within 3 weeks of admission. In retrospect, he may have survived if emergency resection of the mitral valve vegetation had been performed on the first or second day of admission; however, the in-hospital mortality rate after such surgery is high.ALK-positive histiocytosis is an emerging histiocytic entity that can involve a single organ or multiple organs. This disease frequently involves the central nervous system, and the importance of immunohistochemical and genetic analyses is emphasized for the accurate diagnosis of this rare entity. However, radiological findings of this disease have not been sufficiently described. Here, we report a case of a 3-year-old boy with ALK-positive histiocytosis with systemic masses that was identified to harbor KIF5B-ALK gene fusion.Intraoperative pulmonary artery injury due to Swan Ganz catheterization is a rare but potentially life-threatening injury which demands rapid recognition and treatment. Subsequent pseudoaneurysm formation can occur if not immediately recognized, and percutaneous embolization is a viable option for treatment in most settings. We report a case of a 59-year-old female who underwent coronary artery bypass surgery and suffered an intraoperative Swan Ganz catheter-related injury which led to life threatening hemorrhage with subsequent pulmonary artery pseudoaneurysm formation that was successfully embolized. This case report is pathognomonic for this injury and discusses risk factors, presentation, and treatment options of this rare but serious injury.Background Giant cell tumors (GCTs) are locally aggressive but rarely malignant bone neoplasms that uncommonly involve the skull. In this report, we describe a tumor of the sphenoid sinus. Gefitinib-based PROTAC 3 Case presentation A 51-year-old female was presented with headache, and bilateral decreased visual acuity, CT scan, and brain MRI revealed an infra-sellar enhancing tumor expanding to the sellar and supra-sellar region which proved to be a GCT. the patient had received 03 months of preoperative denosumab-based treatment and imaging follow-up showed regression in size and morphology modifications of tumor tissue. Conclusion This is one of few reports to describe the appearance of sphenoid bone GCT, and the first report to highlight the effects of short-term denosumab treatment in GCTb in such a location.Carotid webs are known to cause acute ischemic stroke in younger adults and have a high recurrence rate. Herein, we report a case of a symptomatic carotid web in a 51-year-old man who was transferred to our hospital after developing consciousness disturbance and left hemiparesis. He was diagnosed with right middle cerebral artery occlusion and underwent mechanical thrombectomy. Because his carotid web was the likely embolic source, we performed carotid artery stenting using a dual-layer stent to crimp the vessel wall and secure closure of the web pocket. Follow-up angiography was performed at 3 weeks after stenting, and endothelialization on the web pocket was confirmed. The high scaffolding effect of the dual layer stent may promote the endothelialization on the carotid web.Pediatric chordomas are rarely described in the literature with most cases being managed surgically followed by adjuvant radiotherapy for local control. We present a case of an 18-year-old female with thoracic chordoma causing significant mass effect resulting in tracheal deviation, esophageal compression, and splaying of the great vessels. Ultrasound-guided anterior left transcervical percutaneous biopsy of the neck with surgical pathology immunohistochemistry confirmed the presence of chordoma. The patient underwent extensive palliative debulking followed by radiation therapy leading to clinical improvement. This case demonstrated that an ultrasound-guided percutaneous biopsy is an essential procedure in the diagnosis and treatment of chordoma, which led to successful treatment when followed by surgery and radiation.Thermal ablation by microwave ablation (MWA) or radiofrequency ablation (RFA) is a frequently used technique for hepatic lesion treatment due to its low rate of complications. Surgery, transarterial chemoembolization (TACE), and yttrium-90 (Y-90) transarterial radioembolization (TARE) are other ways to treat hepatic lesions. Thoracobiliary fistula (TBF) is a rare side effect of thermal ablation. Other side effects include vascular injury, damage to the biliary system, and infection. We present the case of a 62-year-old male patient who has a history of lymphoma and was diagnosed with a hepaticellular carcinoma lesion on follow-up CT in segment VII, which appeared in close relation to the right diaphragm. The patient had been through several interventional procedures, including Y-90 therapy, TACE, and MWA with thermal impact, which resulted in a biloma forming and ramping up the progression of pleurobiliary fistula, which is confirmed by HIDA scan, this case highlights the significance of monitoring patients after thermal ablation, particularly in cases of large justa-diaphragmatic tumors, to detect any diaphragmatic or biliary tree injuries.An internal hernia is a protrusion of a visceral organ through a peritoneal or mesenteric opening within the abdominal or pelvic cavities. Internal hernias may present with a wide range of symptoms from mild digestive pain to acute abdomen. Internal hernias have a high morbidity and mortality rate often due to delayed diagnosis and progression of bowel obstruction to bowel ischemia or infarction. High clinical suspicion, cross-sectional imaging, and early surgical intervention are important to prevent life-threatening complications. Here, we report an internal hernia of the cecum through the foramen of Winslow and into the lesser sac with classic CT findings. The patient underwent a successful exploratory laparotomy and resection.Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy characterized by a genetic predisposition to small arteries of the brain. It is produced by a mutation in the NOTCH3 gene and concerns adults. The symptomatology is diversified including migraines with or without aura, subcortical ischemic events, and cognitive impairment. The diagnosis of CADASIL is suspected by neuroimaging and confirmed by genetic testing. Treatment of the disease remains preventive. We report a case of CADASIL manifesting as status migrainosus with persistent aura.Widespread issues in respirator availability and fit have been rendered acutely apparent by the COVID-19 pandemic. This study sought to determine whether personalized 3D printed respirators provide adequate filtration and function for healthcare workers through a Randomized Controlled Trial (RCT). Fifty healthcare workers recruited within NHS Lothian, Scotland, underwent 3D facial scanning or 3D photographic reconstruction to produce 3D printed personalized respirators. The primary outcome measure was quantitative fit-testing to FFP3 standard. Secondary measures included respirator comfort, wearing experience, and function instrument (R-COMFI) for tolerability, Modified Rhyme Test (MRT) for intelligibility, and viral decontamination on respirator material. Of the 50 participants, 44 passed the fit test with the customized respirator, not significantly different from the 38 with the control (p = 0.21). The customized respirator had significantly improved comfort over the control respirator in both simulated clinical conditions (p less then 0.