Slow Growing Research Articles

Case Report: An exceptional localisation in the thigh of a giant primary subcutaneous hydatid cyst.

Hydatid disease is a zoonotic disease caused by the larval stage of Echinococcus granulosus and is found globally. Although the liver and lungs are the most prevalent sites of involvement, sub-cutaneous hydatid cysts are rare especially in the primary occurrence. Sub-cutaneous hydatid cysts usually are noticed as slow growing, painless, and mobile masses beneath the overlying skin which is usually normal and are generally found on the trunk and proximal extremities. To the best of our knowledge, very few cases of primary subcutaneous hydatid cysts of the thigh have been documented. We present a case of a 30-year-old woman from a rural setting, who has a large, painless swelling on her thigh. Imaging studies confirmed the presence of a primary subcutaneous hydatid cyst, which is an atypical presentation of the disease. The entire lesion was excised surgically without any evidence of recurrence for a long period postoperatively. This case illustrates the difficulty in establishing a diagnosis and the importance of early surgical management in these cases.

8719 Epidermal Inclusion Cyst Masquerading as Obstructive Craniopharyngioma

Abstract Disclosure: M. Murugesh: None. F. Thelmo: None. J. Watari: None. The most common cause of a sellar mass is notably pituitary adenoma (84.6%), followed by craniopharyngioma (3.2%), cystic nonneoplastic lesion (2.8%), inflammatory lesion (1.1%), meningioma (0.94%). Epidermoid cysts are benign congenital inclusion cysts that can occur anywhere in the body, with about 7% percent occurring in the head and neck region. Very rarely, they can present intracranially, accounting for about 0.3-1.8% of primary tumors. We present a rare case of epidermoid cyst growing as a suprasellar mass causing hypopituitarism.A 58-year-old female presented to the emergency department with dizziness in the setting of an ear infection. CT head showed 2.8 cm complex suprasellar mass, with adjacent 1 cm nodule at the cerebellopontine angle. MRI showed 2.7 x 2.4 x 2.7 cm suprasellar mass along with “a lobular component along the left posterior aspect extending to the cerebellopontine angle which measures about 1.3 cm, causing mass effect on the midbrain, pons, and optic chiasm”. The differential included craniopharyngioma, macroadenoma and meningioma. Notably, she denied any vision changes. She was evaluated by neurosurgery and after extensive multidisciplinary discussion with ENT and ophthalmology, the patient proceeded with endoscopic surgery for mass resection. Intra-operatively, the mass was noted to be densely adherent to the basilar artery, and sub-total resection was performed. Surprisingly on pathology the mass was identified as an epidermoid cyst, as evidenced by debris with cholesterol clefts and no lesional cells. The patient was started empirically on hydrocortisone 50mg three times a day post-resection. Endocrinology was consulted postoperatively with initial concerns of diabetes insipidus in the setting of hypernatremia, however, the patient’s sodium levels normalized. Pituitary panel at this time was concerning for central hypothyroidism (TSH 0.53 and FT4 0.8) and central adrenal insufficiency (ACTH <9 and AM cortisol 0.9). She was ultimately discharged on prednisone 5mg and levothyroxine 75 mcg with outpatient follow-up. While epidermoid cysts are present in the head and neck region about 7% of the time, they rarely occur in intracranial regions, with about 1.5% of intracerebral epidermoid cysts occurring intracranially. They tend to be slow growing and are often found only when they grow large enough to become symptomatic, as seen in our presented case. Our case highlights the importance of recognizing epidermoid cysts as a rare cause of sellar masses. Presentation: 6/1/2024

Comparative overall survival analysis of chordomas of the base of the skull from the Surveillance, Epidemiology, and End Results (SEER) program between 2000 and 2020

Chordomas of the skull base are rare, slow growing, locally invasive cancers with limited long-term survival analysis reported in the literature. We seek to provide comparative survival analysis of patients on a long-term (20-year) basis using population-level data. The Surveillance, Epidemiology, and End Results (SEER) program was queried for cases of chordoma relegated to the base of the skull, diagnosed between 2000 and 2020. Demographic, disease, and treatment information were analyzed using Cox proportional hazards and log-rank comparisons. 630 patients with chordoma of the skull base were identified. Age ≤ 49 years at diagnosis was associated with increased five-, 10-, and 20-year overall survival (hazard ratio (HR) = 0.39, 0.33, and 0.30, respectively; p < 0.001 for all). Treatment with surgery and adjuvant radiotherapy was associated with increased five-, 10-, and 20-year survival (HR = 0.71, 0.79, and 0.79, respectively; p < 0.001 for all). On univariate analysis, widowed patients had decreased survival (20-year overall survival = 34.8% [15.3%-34.8%] compared to married patients (74.4% [68.1%-80.8%]. Surgery remains the primary treatment associated with increased survival among patients with chordoma of the skull base, with adjuvant radiotherapy serving a complimentary role. Demographic factors such as marital status are also associated with changes in survival.

Traumatic Fibroma : A Case Report

Fibroma is a benign fibrous tissue growth that develops as reactive hyperplasia to trauma or local irritation. It is usually characterized by slow growing, painless, firm, nodular mass merging with the colour of surrounding tissue. It is mainly seen in the region of buccal mucosa, along the plane of occlusion of maxillary and mandibular teeth, tongue, gingiva and hard palate. On clinical examination it resembles pyogenic granuloma, peripheral giant cell granuloma.

Historic ocean acidification of Loch Sween revealed by correlative geochemical imaging and high-resolution boron isotope analysis of Boreolithothamniom cf. soriferum

Ocean Acidification (OA) arises from the increase in atmospheric carbon dioxide concentration following the industrial revolution. The ecological and socio-economic consequences of OA were first identified around 10–15 years ago but remain poorly understood. This is particularly true in coastal regions where local processes can have dramatic consequences on pH trends through time, obscuring and compounding the long-term effects from rising atmospheric CO2. Here we explore the possibility of generating long records of coastal ocean pH using the skeletons of widely distributed coralline algae (CA). The skeletons of these slow growing (<1 mm/year) taxa often contain micron-scale heterogeneities, making sampling for high-resolution climate reconstructions using bulk sampling techniques difficult. Here we use laser ablation coupled to inductively coupled plasma mass spectrometers to generate high-resolution 2D images of the element/calcium ratios and boron isotope composition (δ11B) of a sample of Boreolithothamniom cf. soriferum from Loch Sween in Scotland, UK where we have been monitoring temperature since 2004 and pH during 2014. By carefully correlating the geochemical images with a scanning electron microscopy image we can segment them to remove the marginal portions of the skeleton, isolating the central growth axis to generate an age model and growth rate. The δ11B-pH is significantly elevated above the seawater pH in Loch Sween (8.4 to 8.9 vs. 7.9 to 8.1) consistent with other CA that show internal pH elevation. On a seasonal scale, internal pH is negatively correlated with temperature and also exhibits a long-term decline. By removing this temperature effect, internal pH can be correlated to seawater pH during the 2014 monitoring period allowing us to reconstruct a seawater acidification trend from 2004 to 2018 of -0.018 pH units per year, 10x higher than open ocean trends but consistent with contemporaneous monitoring efforts of UK coastal waters. Reconstructed aqueous CO2 suggests that prior to ∼2008 Loch Sween was a sink of CO2 but after this date, particularly during the early summer, it was a substantial CO2 source. Comparison of reconstructed aqueous CO2 with a record of calcification rate of our sample of Boreolithothamniom cf. soriferum suggests this acidification and associated rise in local seawater pCO2 may have freed this sample from carbon limitation leading to a recent increase in calcification.

Broiler flocks in production systems with slower-growing breeds and reduced stocking density receive fewer antibiotic treatments and have lower mortality

In the Netherlands, the number of broiler production systems with higher welfare standards, using slower-growing broilers and decreased stocking densities, has increased over the last decade. This study aimed to investigate the effect of this change on antibiotic treatments, mortality, and footpad lesions. Data from national monitoring databases from 2013 to 2021 were used, resulting in 113,380 included flocks from 917 farms. Flocks were divided into conventional (CONV), medium-growing (MED), and slow-growing (SLOW), based on breed and slaughter age (median age: CONV 42 d; MED 50 d; SLOW 56 d). Generalized mixed-effect models were created to compare antibiotic treatments in and after the first week, total on-farm mortality, and footpad lesion scores between these 3 production systems. Year, quarter, flock size, thinning, number of houses, and regional density of poultry farms were included as fixed effects. Random effects were farm and veterinary practice in all models, with an additional random slaughterhouse effect to describe footpad lesions. Probability of treatment in the first week of age in CONV flocks overall years (7.2%, 95% CI [5.9, 8.7]) was higher than in MED (2.0%, 95% CI [1.6, 2.5]) and SLOW flocks (1.3%, 95% CI [1.0, 1.7]). Treatment probability after the first week was similarly higher in CONV flocks (14.7%, 95% CI [12.1, 17.6]) than in MED (3.2%, 95% CI [2.5, 4.0]) and SLOW flocks (2.2%, 95% CI [1.7, 2.9]). CONV flocks had a higher mean mortality (3.2%, 95% CI [3.0, 3.4]) than MED (2.0%, 95% CI [1.9, 2.1]) and SLOW flocks (1.9%, 95% CI [1.8, 2.0]). Regarding footpad lesions, CONV flocks had the highest mean scores (range 0-200) over all years, whereas SLOW flocks had the lowest scores (CONV: 46.1, 95% CI [42.1, 50.6]; MED: 21.3, 95% CI [18.9, 24.0]; SLOW: 13.2, 95% CI [11.5, 15.1]). This analysis of data from flocks over a 9-yr period indicates that switching from conventional to alternative production systems with higher welfare standards could positively affect broiler health and antibiotic use.

Intraosseous schwannoma mimicking periapical radiolucency of mandible

Intraosseous schwannoma is a rare entity with less than 1% reported cases. Having predilection for posterior mandible, they are clinically slow growing and asymptomatic until they manifest as intra or extra oral swelling with or without nerve paraesthesia. 38-year-old female patient reported with chief complaint of swelling in lower left back teeth region gradually increasing to current size in last three months. With history of recent extraction, and well-defined, uniformly radiolucent lesion having sclerotic margins and buccal cortical breach, a provisional diagnosis of residual cyst of 36 was considered. However, incisional biopsy revealed it to be schwannoma, thereby changing the course of management. Absence of conclusive clinical signs and symptoms and non-specific radiographic features make intraosseous schwannoma a challenging diagnosis. It is therefore important that careful attention be paid to adjoining radiographic structures and possible nerve involvement.

Precise quantification of skeletal muscle fibers reveals the physiological basis for growth rate discrepancies in broilers1

Skeletal muscle is composed of multinucleated muscle fibers, which play a crucial role in determining the quality of meat products in livestock. Quantifying the total number of muscle fibers (TNM) is essential for understanding muscle composition, yet remains challenging in poultry, particularly due to the size of the livestock that complicates the preparation of tissue sections for analysis and renders the counting process laborious. Our previous study developed an automatic muscle fiber quantification tool powered by deep learning, named MyoV, which has addressed this bottleneck. This study aimed to employ the tool for the accurate quantification of the TNM in the pectoral muscles of slow-growing (SL), medium-growing (ML), and fast-growing (FL) broilers. Results showed that FL exhibited higher growth performance compared to ML and SL from embryonic to rearing stages. Processing of whole slide images of pectoral muscle revealed significantly higher TNM in FL and ML than in SL (P < 0.01). The TNM of FL, ML and SL were 693,568.00 ± 54,169.80, 652,122.00 ± 65,822.60 and 539,778.57±40,722.94 at 7 days of age (D7), respectively. And the TNM at D35 were 663,014.93±58,801.11, 645,784.76±80,204.34 and 507,280.29±98,092.16 of FL, ML and SL. Differences in cross-sectional area (CSA) of muscle fibers among the three groups were consistent with TNM results. Correlation analysis showed a correlation coefficient of 0.73-0.89 between body weight (BW) and TNM and a correlation coefficient of 0.78-0.87 between BW and CSA. These findings directly indicate that the number of muscle fibers in broilers is an important foundation for their rapid growth and development. This study precisely quantifies the muscle fiber number of important skeletal muscle in poultry for the first time, providing the direct evidence for the physiological basis of rapid development in broilers and offering important data support for further in-depth researches on muscle fiber development.

Characteristics and Outcomes of Occult Infections in Presumed Aseptic Nonunions: A Retrospective Cohort Study.

To determine (1) the rate of positive cultures in presumed aseptic nonunions, (2) the rate and microbial spectrum of positive cultures that represented occult infection, and (3) rates of nonunion healing. Retrospective cohort study. Tertiary referral center. Adult patients with a presumed aseptic nonunion treated with single-stage revision between 2002 and 2022. The rate of positive cultures compared for 2 protocols: old: 1-2 samples cultured 7 days versus new: 5 samples cultured 14 days. The rate of positive cultures meeting occult infection criteria with the new protocol (≥2 samples with phenotypically indistinguishable microorganisms, or ≥1 sample with a high virulent microorganism). Nonunion healing rates between protocols and between groups based on culture results with the new protocol. One hundred seventy-nine patients were included. The rate of positive cultures was 14% (n = 15/105) with the old protocol and 51% (n = 38/74) with the new protocol (P < 0.001). With the new protocol, the rate of positive cultures meeting occult infection criteria was 19% (n = 14/74), and coagulase-negative staphylococci (48%) and Cutibacterium acnes (38%) were the most common microorganisms. Nonunion healing rates after the primary revision did not differ between protocols (old: 82% vs. new: 86%, P = 0.41) and groups based on culture result (sterile: 86% vs. occultly infected: 93%, P = 0.66). The final overall nonunion healing rate was 97%. Occult infections were identified in 1 in 5 presumed aseptic nonunions using a standardized protocol with 5 intraoperative samples cultured 14 days and were predominantly caused by slow growing, gram-positive microorganisms. The local spectrum and antimicrobial sensitivity of occult infections should be considered when developing empiric antimicrobial protocols. Patients with presumed aseptic nonunions can expect high healing rates, regardless of the culture result. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Transcriptome analysis of large yellow croaker (Larimichthys crocea) at different growth rates.

The unsynchronized growth of the large yellow croaker (Larimichthys crocea), which impacts growth efficiency, poses a challenge for aquaculture practitioners. In our study, juvenile stocks of large yellow croaker were sorted by size after being cultured in offshore cages for 4 months. Subsequently, individuals from both the fast-growing (FG) and slow-growing (SG) groups were sampled for analysis. High-throughput RNA-Seq was employed to identify genes and pathways that are differentially expressed during varying growth rates, which could suggest potential physiological mechanisms that influence growth rate. Our transcriptome analysis identified 382 differentially expressed genes (DEGs), comprising 145 upregulated and 237 downregulated genes in comparison to the SG group. GO and KEGG enrichment analyses indicated that these DEGs are predominantly involved in signal transduction and biochemical metabolic pathways. Quantitative PCR (qPCR) results demonstrated that cat, fasn, idh1, pgd, fgf19, igf2, and fads2 exhibited higher expression levels, whereas gadd45b and gadd45g showed lower expression compared to the slow-growing group. In conclusion, the differential growth rates of large yellow croaker are intricately associated with cellular proliferation, metabolic rates of the organism, and immune regulation. These findings offer novel insights into the molecular mechanisms and regulatory aspects of growth in large yellow croaker and enhance our understanding of growth-related genes.

Appendicular schwannoma: Case report of a rare differential of a right iliac fossa mass

Schwannomas are slow growing, mostly benign tumors arising from the Schwann cells of the nerve sheath. They usually arise from the nerves of the head-and-neck region. They are rare in the gastrointestinal tract. The stomach is the most common site for gastrointestinal schwannomas. Appendicular schwannomas are even a rarer entity that may present as a right iliac fossa mass. The final diagnosis is by histopathology and immunohistochemistry. Treatment is essentially surgical. Such entities may present as diagnostic dilemmas presenting as the not-so-common cause of iliac fossa mass and hence deserve reporting and discussion. We report our experience of treating a case of appendicular schwannoma in a 70-year-old lady with a short discussion on its characteristics and management.

O-039 Con - the faster the better

Abstract Late o’clock: Are slow growing embryos clinically usable? Con - the faster the better Reproductive medicine and, within it, embryology, have experienced milestones in the understanding of pre-implantation embryonic development over the last quarter of a century. The development of blastocyst culture media for embryo culture even after embryonic genome activation and the possibility of continuous monitoring of embryonic morphokinetics throughout the pre-implantation period have been major contributors. The development of molecular genetic techniques has also played an important role. The introduction of new cryopreservation techniques has also improved the success rate of the clinical use of surplus embryos, including slow-growing embryos not otherwise selected for fresh cycle transfer. Two questions are most frequently encountered in clinical embryology today: which embryo in a cohort has the best chance of resulting in a live-born child, and how slow and morphologically suboptimal can an embryo be to still be considered clinically useful? In particular, the latter question does not have an easy answer, as embryos demonstrate varying pace of development. A further problem arises if there are no optimal embryos available in the cohort and this answer has to be given on day 2, 3 or 5, as this is when the embryo transfer is scheduled to take place. Some studies suggest that longer timing of any stage of embryonic development from pronuclear fading onwards means that the embryo is late in development due to certain abnormalities and is likely to be energetically depleted by the activation of its repair mechanisms. Such embryos not only have a lower implantation potential compared to fast embryos, but also diverge in time from the optimal receptivity of the endometrium. Additional testing and/or storage of slow-growing embryos brings the question of their clinical usability to the time of frozen embryo replacement cycles and quiets the couple's expectation of a “successful” completion of the stimulated cycle. Whether embryos are to be selected for fresh ET or FER, the “the faster - the better” principle is likely to be applied. In daily clinical practice, decisions on the use of slow-growing and/or morphologically sub-optimal embryos and the timing of embryo transfer are made on an individual basis, taking into account various medical as well as non-medical (e.g. economic, logistical) factors. These may also include portraying a positive image of the centre's performance. However, patients expect infertility specialists to make realistic assessments not only of the viability of slow growing embryos, but also of the outcome of the transfer of them. The assessment must be based not only on medical and ethical but also on rational grounds.

Transcriptomic signatures and genomic regions associated with growth in the flatfish Senegalese sole

Growth performance is a complex genetic trait that interacts with several environmental variables and life-history attributes, most notably sex and reproduction. Thus, unveiling the genetic architecture of growth remains as a major challenge particularly in flatfish in which sexual dimorphism seems to be a common feature. In this study, we investigated the gene expression profiles and genomic windows associated with growth in the Senegalese sole (Solea senegalensis), which exhibits a female-biased size dimorphism. For this purpose, three fast-growing (FG) and two slow-growing (SG) genetic families were selected according to their breeding values for weight at harvest. Principal component analysis (PCA) using 17 morphometric traits showed that main variation (92.5%) was explained by size and shape. While phenotypic variation clearly separated the FG and SG groups, some differences associated with sex were still observable. Females exhibited greater weight, higher ventral body heights and less elliptical body shapes than males supporting sexual dimorphism both in size and shape. RNA-seq analysis identified 693, 12645 and 1059 differentially expressed transcripts (DETs) between FG and SG in muscle, liver, and brain, respectively. It should be noted a major effect of sex in muscle and liver with 7428 and 15715 DETs, respectively. In these two tissues, >50% of DETs for growth were also co-regulated by sex. Functional analysis using DETs for growth and sex unveiled intricate interactions between vitellogenesis, reproductive status, and growth-related transcriptional networks, particularly in muscle and liver tissues. Main transcriptional enriched pathways associated with growth were closely related to energy provision, cell cycle and signaling. Analysis of sex-specific and growth×sex interacting DETs between males and females highlighted lipid metabolism, macrophagy regulation, cell cycle, DNA and RNA metabolism, ribosome biogenesis, energy provision and maintainance of cellular homeostasis as the most relevant pathways driving sexual dimorphism. A variants analysis using RNA pool-seq data identified eleven genomic windows associated with growth distributed across the genome. Main gene candidates (pptc7, taz, abcd1, tfe3, nfix, ptcd2, prkaa1), whose expression was highly modified by growth, were involved in mitochondrial homeostasis, regulation of mitochondrial activity, energy production and regulation of musculoskeletal system. All these data improve our understanding of the intricate genetic architecture governing growth in sole.

Verruciformes Xanthom an der linken Wange bei einer 56-jährigen Patientin – Diagnostik, Therapie und Nachsorge

The oral verruciform xanthoma (OVX) is a rare, benign lesion that occurs predominantly in the masticatory region of the oral cavity. The OVX is small, slow growing, and mostly free of clinical symptoms. The exact pathogenesis is unknown, and a viral etiology such as from a human papillomavirus (HPV) infection has not been proven. Although primarily observed in healthy individuals, there have been cases in patients with autoimmune diseases and with chronic graft-versus-host disease (GvHD). The treatment of choice is complete excision of the lesion. This case report showcases a successful surgical removal of an oral verruciform xanthoma on the left buccal mucosa in a 56-year-old patient with GvHD 14 years after allo-genic stem cell transplantation due to a Non-Hodgkin lymphoma.

Genetic diversity and population structure of a rare flowering tree endemic to Appalachia, Stewartia ovata.

Stewartia ovata (cav.) Weatherby, commonly known as mountain stewartia, is an understory tree native to the southeastern United States (U.S.). This relatively rare species occurs in isolated populations in Virginia, Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Alabama, and Mississippi. As a species, S. ovata has largely been overlooked, and limited information is available regarding its ecology, which presents obstacles to conservation efforts. Stewartia ovata has vibrant, large white flowers that bloom in summer with a variety of filament colors, suggesting potential horticultural traits prized by ornamental industry. However, S. ovata is relatively slow growing and, due to long seed dormancy, propagation is challenging with limited success rates. This has created a need to assess the present genetic diversity in S. ovata populations to inform potential conservation and restoration of the species. Here, we employ a genotyping-by-sequencing (GBS) approach to characterize the spatial distribution and genetic diversity of S. ovata in the southern Appalachia region of the eastern United States. A total of 4475 single nucleotide polymorphisms (SNPs) were identified across 147 individuals from 11 collection sites. Our results indicate low genetic diversity (He = 0.216), the presence of population structure (K = 2), limited differentiation (F ST = 0.039), and high gene flow (Nm = 6.16) between our subpopulations. Principal component analysis corroborated the findings of STRUCTURE, confirming the presence of two distinct S. ovata subpopulations. One subpopulation mainly contains genotypes from the Cumberland Plateau, Tennessee, while the other consists of genotypes present in the Great Smoky Mountain ranges in Tennessee, North Carolina, and portions of Nantahala, Chattahoochee-Oconee national forests in Georgia, highlighting that elevation likely plays a major role in its distribution. Our results further suggested low inbreeding coefficient (F IS = 0.070), which is expected with an outcrossing tree species. This research further provides necessary insight into extant subpopulations and has generated valuable resources needed for conservation efforts of S. ovata.

Computed tomography angiographic findings following gradual occlusion of the dorsal sagittal sinus for definitive excision of a caudal calvarial multilobular tumour of bone in a dog

AbstractMultilobular tumour of bone is a rare, slow growing, locally aggressive malignancy in dogs. Surgical resection of the primary tumour is currently the recommended treatment for local disease control. Wide or definitive extent excision to obtain a histologically complete excision is ideal when possible; however, wide excision can be challenging for caudally located calvarial tumours in which the excision will include removal of the confluence of the two transverse sinuses and dorsal sagittal sinus. Acute sacrifice to the dorsal sagittal sinus has the potential for fatal cerebral oedema. To manage this risk, gradual occlusion of the dorsal sagittal sinus before wide excision of caudally located multilobular tumour of bones has been successfully reported in two patients. The current case report documents another successfully managed case with this technique, and includes the computed tomography angiographic findings during the gradual occlusion process.

Characteristics Of Pleomorphic Adenoma at Oral and Maxillofacial Surgery Department Dr. Hasan Sadikin General Hospital Bandung Period 2017-2022

Introduction: Pleomorphic adenoma (benign mixed tumors) is the most common neoplasm affecting both major and minor salivary glands, slow growing, asymptomatic, and unilateral. The most affected location of the tumor is major salivary glands namely parotid glands and in minor salivary glands, it manifests in the intraoral, namely the palate region. This study aims to obtain information about the characteristics of patients with pleomorphic adenoma at the Oral and Maxillofacial Surgery Department of Hasan Sadikin General Hospital Bandung. Methods: This study is a retrospective descriptive analysis method based on the medical data record of a patient who was diagnosed with pleomorphic adenoma and undergoing treatment at Oral and Maxillofacial Surgery Department of Hasan Sadikin General Hospital Bandung period 2017 to 2022. The data obtained include age, gender, patient domicile, tumor predilection location, supporting examination, and definitive treatment. Results: The total participants in this study were 27 patients, with women 8 (70%), range at the age of 31-50 years old (30%). The majority of patients were from Bandung City (56%). Most of the lesion were found in major salivary glands was at parotid gland with 3 patient (10%) and in minor salivary was at the palate region with 18 patients (77%). Most common supporting examination used in this study were fine needle aspiration biopsy (FNAB), panoramic x-ray, and CT scan, with definitive treatment received by the respondent were surgical excision. Conclusion: Pleomorphic adenomas are often occurred in women during third decade of life. The majority of the lesion occurred in minor salivary gland at the palate region. Surgical excision is most definitive treatment were performed. Keywords: Patient characteristics, pleomorphic Adenoma, salivary gland

Effects of gut bacterial community on differential growth of sea cucumber (Apostichopus japonicus): Molecular mechanisms based on host-gut microbiome co-metabolism

Gut microbiome and their metabolites are increasingly recognized for their pivotal role in regulating the health and growth of the host. The mechanism by which the host-gut microbiome co-metabolism affects the growth rate of sea cucumber (Apostichopus japonicus) remains unclear. In this study, the intestinal wall tissues of fast-growing (FG) and slow-growing (SG) A. japonicus were collected from the full-sib family for 16S amplicon sequencing, metagenomics, metabolomics, and transcriptomics analyses. The results showed a marked variation in the gut bacterial community of A. japonicus with different growth rates. Compared with SG group, FG A. japonicus had a higher abundance of Bacteroidetes. Many of these bacteria were associated with the degradation of polysaccharides, which could potentially affect growth performance. The abundance of Proteobacteria, however, was found to be higher in SG A. japonicus, thereby increasing the potential risk of disease. The metabolome results were further supported by the predicated KEGG functions of the gut microbiomes, lots of metabolites related to the metabolism and biosynthesis of fructose 6-phosphate, arachidonic acid, oleic acid, and dihydroxyacetone phosphate were upregulated in the FG A. japonicus. Furthermore, the genes (IGF1, HK, PK, PCK1) were significantly upregulated in the FG A. japonicus, which were mainly enriched in the metabolic pathways of lipids, amino acids, and carbohydrates. Gut bacterial community via their unique metabolic pathways, which in turn affected the metabolic phenotypes of the organism and eventually led to differences in growth performance of A. japonicus. These findings might help understand the molecular mechanisms of growth gap in sea cucumber, thereby increasing the mariculture production.

A case of trichoblastoma of the auricular cavity and review of the literature

Trichoblastoma（TB） is a rare germ cell skin adnexal tumor of the hair, and it is a rare follicular tumor of the skin that differentiates from the hair germ epithelium and is often regarded as a benign skin tumorHowever, it is poorly confined and has a local infiltrative growth pattern. tb occurs in the head and neck region, especially in the face, and presents clinically as a slow growing, well-defined and elevated nodule. TB is routinely treated surgically. Due to the lack of universally accepted treatment guidelines or protocols, the recurrence rate after surgery is high, which makes clinical cure more difficult. In this study, a 65-year-old female patient was found to have a swelling with recurrent rupture and pus flow from the right external auditory canal opening and the auricular cavity. After initial misdiagnosis as otitis externa, she was treated with conventional anti-infective therapy, but her symptoms did not resolve and gradually worsened before coming to our hospital. The condition presented in this case is relativelyrare,therepre,timely and accurate diagnosis and treatment are crucial for prognosis improvement of such diseases.

Unraveling molecular advancements in chordoma tumorigenesis and treatment response: a review of scientific discoveries and clinical implications.

Chordomas are tumors thought to originate from notochordal remnants that occur in midline structures from the cloves of the skull base to the sacrum. In adults, the most common location is the sacrum, followed by the clivus and then mobile spine, while in children a clival origin is most common. Most chordomas are slow growing. Clinical presentation of chordomas tend to occur late, with local invasion and large size often complicating surgical intervention. Radiation therapy with protons has been proven to be an effective adjuvant therapy. Unfortunately, few adjuvant systemic treatments have demonstrated significant effectiveness, and chordomas tend to recur despite intensive multimodal care. However, insight into the molecular underpinnings of chordomas may guide novel therapeutic approaches including selection for immune and molecular therapies, individualized prognostication of outcomes, and real-time noninvasive assessment of disease burden and evolution. At the genomic level, elevated levels of brachyury stemming from duplications and mutations resulting in altered transcriptional regulation may introduce druggable targets for new surgical adjuncts. Transcriptome and epigenome profiling have revealed promoter- and enhancer-dependent mechanisms of protein regulation, which may influence therapeutic response and long-term disease history. Continued scientific and clinical advancements may offer further opportunities for treatment of chordomas. Single-cell transcriptome profiling has further provided insight into the heterogeneous molecular pathways contributing to chordoma propagation. New technologies such as spatial transcriptomics and emerging biochemical analytes such as cell-free DNA have further augmented the surgeon-clinician's armamentarium by facilitating detailed characterization of intra- and intertumoral biology while also demonstrating promise for point-of-care tumor quantitation and assessment. Recent and ongoing clinical trials highlight accelerating interest to translate laboratory breakthroughs in chordoma biology and immunology into clinical care. In this review, the authors dissect the landmark studies exploring the molecular pathogenesis of chordoma. Incorporating this into an outline of ongoing clinical trials and discussion of emerging technologies, the authors aimed to summarize recent advancements in understanding chordoma pathogenesis and how neurosurgical care of chordomas may be augmented by improvements in adjunctive treatments.