Thepatientisa63- year-old woman who presented to her dermatologist for the removal of two nevi near her mouth. Histologic examination revealed melanocytic nevi showing maturation with dermal descent. Within the dermis...Thepatientisa63- year-old woman who presented to her dermatologist for the removal of two nevi near her mouth. Histologic examination revealed melanocytic nevi showing maturation with dermal descent. Within the dermis, adjacent to these nevoid cells, were multiple large hair follicles that were surrounded by dense fibrosis. The fibrous sheaths contained thickened,dense collagen bundles and were well circumscribed, resembling perifollicular fibromas. Further discussion with the patient and the dermatologist revealed that the patient had “ plucked” hair from these nevi. We, therefore, believe that the perifollicular fibrosis that we observed is secondary to trauma. We present this case to remind all that posttraumatic events can simulate perifollicular fibromas and that the erroneous diagnosis of such could lead to the erroneous diagnosis of Birt- Hoggs Dubé syndrome.展开更多
Preclinical modelling studies are beginning to aid development of therapies targeted against key regulators of pancreatic cancer progression. Pancreatic cancer is an aggressive, stromally-rich tumor, from which few pe...Preclinical modelling studies are beginning to aid development of therapies targeted against key regulators of pancreatic cancer progression. Pancreatic cancer is an aggressive, stromally-rich tumor, from which few people survive. Within the tumor microenvironment cellular and extracellular components exist, shielding tumor cells from immune cell clearance, and chemotherapy, enhancing progression of the disease. The cellular component of this microenvironment consists mainly of stellate cells and inflammatory cells. New findings suggest that manipulation of the cellular component of the tumor microenvironment is possible to promote immune cell killing of tumor cells. Here we explore possible immunogenic therapeutic strategies. Additionally extracellular stromal elements play a key role in protecting tumor cells from chemotherapies targeted at the pancreas. We describe the experimental findings and the pitfalls associated with translation of stromally targeted therapies to clinical trial. Finally, we discuss the key inflammatory signal transducers activated subsequent to driver mutations in oncogenic Kras in pancreatic cancer. We present the preclinical findings that have led to successful early trials of STAT3 inhibitors in pancreatic adenocarcinoma.展开更多
Importance:Staphylococcus lugdunensis(S.lugdunensis)is a coagulase-negative staphylococcus(CoNS),found commonly as skin flora in humans.While most species of CoNS are clinically benign,S.lugdunensis can exhibit a simi...Importance:Staphylococcus lugdunensis(S.lugdunensis)is a coagulase-negative staphylococcus(CoNS),found commonly as skin flora in humans.While most species of CoNS are clinically benign,S.lugdunensis can exhibit a similar virulence to that ofS.aureus.However,there is scant data concerningS.lugdunensis infection in the pediatric population.Objective:To ascertain localS.lugdunensis infection rates and sensitivity patterns in the pediatric population.Methods:A retrospective analysis was undertaken of allS.lugdunensis isolates across a 6-year period from 2015 to 2020.Data were collected from electronic patient notes and laboratory records.Matrix-assisted laser desorption ionization and time of flight mass spectrometry were used to identify isolates.Results:Ninety-six isolates ofS.lugdunensis were identified from 86 patients.Of these,34 isolates were treated as an infection.Twenty-three(67.6%)were found to have skin as the primary source of infection.While the observed number was small,central nervous system(CNS)sources ofS.lugdunensis infection appear to be a significant source:all three isolates cultured from cerebrospinal fluid were clinically managed as infection.All three were associated with ventriculoperitoneal(VP)shunt infection.No cases ofS.lugdunensis infective endocarditis were identified.About 18.6%ofS.lugdunensis isolates were resistant to flucloxacillin.Interpretation:S.lugdunensis is an uncommon but significant cause of infection in the pediatric population and appears to be a rising cause of CNS infection,particularly when associated with VP shunts.Flucloxacillin is recommended locally as the first choice of antibiotic.展开更多
文摘Thepatientisa63- year-old woman who presented to her dermatologist for the removal of two nevi near her mouth. Histologic examination revealed melanocytic nevi showing maturation with dermal descent. Within the dermis, adjacent to these nevoid cells, were multiple large hair follicles that were surrounded by dense fibrosis. The fibrous sheaths contained thickened,dense collagen bundles and were well circumscribed, resembling perifollicular fibromas. Further discussion with the patient and the dermatologist revealed that the patient had “ plucked” hair from these nevi. We, therefore, believe that the perifollicular fibrosis that we observed is secondary to trauma. We present this case to remind all that posttraumatic events can simulate perifollicular fibromas and that the erroneous diagnosis of such could lead to the erroneous diagnosis of Birt- Hoggs Dubé syndrome.
文摘Preclinical modelling studies are beginning to aid development of therapies targeted against key regulators of pancreatic cancer progression. Pancreatic cancer is an aggressive, stromally-rich tumor, from which few people survive. Within the tumor microenvironment cellular and extracellular components exist, shielding tumor cells from immune cell clearance, and chemotherapy, enhancing progression of the disease. The cellular component of this microenvironment consists mainly of stellate cells and inflammatory cells. New findings suggest that manipulation of the cellular component of the tumor microenvironment is possible to promote immune cell killing of tumor cells. Here we explore possible immunogenic therapeutic strategies. Additionally extracellular stromal elements play a key role in protecting tumor cells from chemotherapies targeted at the pancreas. We describe the experimental findings and the pitfalls associated with translation of stromally targeted therapies to clinical trial. Finally, we discuss the key inflammatory signal transducers activated subsequent to driver mutations in oncogenic Kras in pancreatic cancer. We present the preclinical findings that have led to successful early trials of STAT3 inhibitors in pancreatic adenocarcinoma.
文摘Importance:Staphylococcus lugdunensis(S.lugdunensis)is a coagulase-negative staphylococcus(CoNS),found commonly as skin flora in humans.While most species of CoNS are clinically benign,S.lugdunensis can exhibit a similar virulence to that ofS.aureus.However,there is scant data concerningS.lugdunensis infection in the pediatric population.Objective:To ascertain localS.lugdunensis infection rates and sensitivity patterns in the pediatric population.Methods:A retrospective analysis was undertaken of allS.lugdunensis isolates across a 6-year period from 2015 to 2020.Data were collected from electronic patient notes and laboratory records.Matrix-assisted laser desorption ionization and time of flight mass spectrometry were used to identify isolates.Results:Ninety-six isolates ofS.lugdunensis were identified from 86 patients.Of these,34 isolates were treated as an infection.Twenty-three(67.6%)were found to have skin as the primary source of infection.While the observed number was small,central nervous system(CNS)sources ofS.lugdunensis infection appear to be a significant source:all three isolates cultured from cerebrospinal fluid were clinically managed as infection.All three were associated with ventriculoperitoneal(VP)shunt infection.No cases ofS.lugdunensis infective endocarditis were identified.About 18.6%ofS.lugdunensis isolates were resistant to flucloxacillin.Interpretation:S.lugdunensis is an uncommon but significant cause of infection in the pediatric population and appears to be a rising cause of CNS infection,particularly when associated with VP shunts.Flucloxacillin is recommended locally as the first choice of antibiotic.
