Primary endometrial squamous cell carcinoma (PESCC) is a rare malignant tumor. To investigate the clinical and pathological features of PESCC, two cases of PESCC in Fujian Maternal and Child Health Hospital were retrospectively studied and the literatures were reviewed. Both of the two cases were menopausal women aged 57-62 years, clinically presenting with \"vaginal discharge\". Case 1 was a non-keratinising squamous cell carcinoma with high-risk HPV infection. Tumor infiltrated in deep myometrium with multifocal intravascular thrombus and macro metastases to one pelvic lymph node (1/15) and abdominal aortic lymph node (1/1). Lung metastasis occurred 36 months after the surgery. After surgical resection and without postoperative supplemental therapy, the patient remained tumor-free for 110 months to date. Case 2 had a history of breast cancer for 5 years and long-term intake of aromatase inhibitor drugs without HPV infection. It was a keratinized squamous cell carcinoma. Tumor also infiltrated in deep myometrium with multifocal intravascular thrombus and one pelvic lymph node metastasis (1/18), However, no metastasis was seen elsewhere. To date, the patient survived for 16 months without tumor after surgery. Both of the two cases expressed squamous epithelial markers P40, P63, and CK5/6, but neither expressed PAX8 or PR. Case 1 had diffuse expression of P16, wild-type P53, and ER-negative. Case 2 had negative P16, mutant P53, and focal positive ER. PESCC is often associated with HPV infection and low estrogen levels. However, studies in the literatures have found that P16 expression is not always consistent with HPV infection, indicating that PESCC cannot be easily classified as HPV-associated or non-dependent like cervical cancer. There are two main patterns of P16 and P53 expression, P16-positive/P53 wild-type and P16-negative/P53-mutant, but no positive expression of both has been seen so far. It is worth noting that we reported the second case of PESCC with a history of breast cancer, where the patient had been taking the oral aromatase inhibitor drug (exemestane) for a long period of time to reduce the estrogen level, indicating the low estrogen level may be also a key factor in the pathogenesis of PESCC.

UNASSIGNED: Although tuberculosis (TB) of the central nervous system is quite common, tuberculous pyogenic ventriculitis is not only rare; it is a devastating disease in an immunocompetent patient if left untreated.
UNASSIGNED: We present the case of a 43-year-old man who underwent successful treatment for tuberculous pyogenic ventriculitis that presented with meningeal syndrome and loss of consciousness.
UNASSIGNED: Tuberculous pyogenic ventriculitis is a rare manifestation of intracranial tuberculous infection. Despite advances in imaging techniques, the diagnosis of intraventricular TB is essentially biological.

Primary breast lymphoma (PBL) is a rare malignant lymphoid neoplasm limited to the breast, accounting for about 0.15% of all malignant breast tumors and 1.7% to 2.2% of extra-nodal lymphomas. PBL must be distinguished from conventional breast carcinomas due to different therapeutic approaches. A 25-year-old female presented with a left breast mass. Histopathology and immunohistochemical tests confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL). She had no similar lesions elsewhere in the body. She received 1 cycle of R-CHOP chemotherapy but absconded from the treatment and succumbed afterward while at home. Recent developments in DLBCL treatment have greatly improved patient outcomes by incorporating targeted medicines like rituximab, increased chemotherapy regimens, new drugs, and individualized treatment techniques. PBL appears to have a worse prognosis; thus, delay or abscondment from treatment is of serious concern when it comes to improving the prognosis of patients with PBL.

Of all primary bladder cancers, primary adenocarcinoma is an uncommon tumor. When considering all tumor origin areas, secondary bladder involvement from carcinoma, whether by direct extension or metastasis, is actually more prevalent than primary adenocarcinoma, despite its rarity. The most common source of subsequent bladder tumors is endometrial, lung, colon, prostate, breast, or other organ adenocarcinomas. Primary bladder adenocarcinoma is thought to result from urothelial metaplasia, which is frequently linked to persistent irritation or inflammation. Bladder exstrophy, recurrent urinary tract infections, long-term irritation from calculi or foreign bodies, and history of schistosomiasis are risk factors. A portion of these malignancies are associated with urachal remnants, where the tumor originates at the dome of bladder. Here we present a case of primary adenocarcinoma in a 44-year-old female patient that originated from the dome of urinary bladder.

BACKGROUND: Total hip arthroplasty (THA) has transformed patient lives, yet evolving expectations and the number of postoperative foot angle changes have underscored the need for precise component positioning. The objective of this study was to use three-dimensional (3D) preoperative planning to evaluate stem alignment and orientation for three THA systems using two different stem fit algorithms. It was hypothesized that the different stem alignments would yield similar changes in stem orientation and placement within the canal for all three systems.
METHODS: This study introduced a novel 3D preoperative planning tool, comparing two different surgical stem fit philosophies within the canal: \"canal fit\" (CF) and \"anatomical fit\" (AF). We virtually implanted ten subjects with three different THA implant systems using both philosophies, evaluating 60 total fits within the canals. The \"canal fit\" philosophy aimed to minimize cortical bone removal. In contrast, the \"anatomical fit\" philosophy prioritized aligning the implanted head with the anatomical head center.
RESULTS: Detailed analyses revealed that AF led to fixation occurring mainly on the medial aspect of the stem, while CF exhibited a more even distribution between medial and lateral sides. The AF philosophy achieved significantly closer placement of the implanted head to the anatomical center (2.0 to 2.1 mm) compared to the CF philosophy (3.0 to 6.0 mm) (P < 0.01). The AF resulted in neutral stem orientation (0°) across all stems, whereas the CF exhibited greater malrotation (2.0 to 7.0°) (P < 0.02). The AF required more bone removal (0.13 to 0.46 cm³) than the CF (0.02 to 0.06 cm³) (P < 0.01).
CONCLUSIONS: The findings underscore the importance of 3D planning, emphasizing its potential to improve stem version alignment in THA. The results from this study may advocate 3D preoperative planning with robotic surgery to plan stem placement within the canal while maintaining anatomical femoral head restoration.

BACKGROUND: Revision total knee arthroplasty (rTKA) remains underexplored regarding patient-reported outcome measures (PROMs), particularly in terms of time to reach Minimal Clinically Important Difference (MCID). This study addresses this gap by comparing the time to achieve MCID between primary TKA (pTKA) and rTKA patients, providing valuable insights into their recovery trajectories.
METHODS: A total of 8,266 TKAs (7,618 pTKA and 648 rTKA) were retrospectively studied in a multi-institutional arthroplasty registry. Patients who completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical, PROMIS Physical Function Short Form 10a (PF-10a), and Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form (KOOS-PS) questionnaires were identified by Current Procedural Terminology (CPT) codes. Survival curves with and without interval-censoring were utilized to evaluate the time to achieve MCID.
RESULTS: Comparing the time to achieve MCID, rTKAs were significantly faster than pTKA for PROMIS Global Physical (3.5 versus 3.7 months, P = 0.004) and KOOS-PS (3.3 versus 4.2 months, P < 0.001), but similar for PROMIS PF-10a (4.4 versus 4.8 months, P = 0.057). Interval-censoring also showed similar trends with earlier times to achieve MCID for rTKAs for PROMIS Global Physical (0.6 to 0.61 versus 0.97 to 0.97 months, P = 0.009) and KOOS-PS (0.97 to 0.97 versus 1.47 to 1.47 months, P < 0.001), but not for PROMIS PF-10a (2.43 to 2.54 versus 1.90 to 1.91 months, P = 0.92).
CONCLUSIONS: The present study revealed that the time to achieve MCID was faster in patients undergoing rTKA compared to those undergoing pTKA. These findings allow surgeons to reassure preoperative revision TKA patients that their recovery to a minimal clinically important difference postoperatively may be quicker than expected, especially when compared to their initial recovery after primary TKA.

BACKGROUND: Hypothermia is defined as a body core temperature below 35 °C and can be caused by internal or external stress. Primary hypothermia is caused by excessive exposure to low environmental temperature without any medical conditions prior to that. Secondary hypothermia is caused by alteration in thermoregulation by disease, trauma, surgery, drugs, or infections. The aim of the research is to investigate core temperature values in rats subjected to specific water temperatures at five different time points. It focuses on distinguishing between primary and secondary hypothermia in these rats.
METHODS: The total 21 Wistar rats were divided into three experimental groups as: Control group rats exposed only to hypothermic condition (n = 7); Alcohol + hypothermia (n = 7); and Benzodiazepines + hypothermia (n = 7). The temperature spots analyzed in the study were: normal core temperature, core temperature during injection of 0,3 ketamine, temperature of immersion and the temperature at the onset of hypothermia and temperature at the time of death.
RESULTS: In our study the comparative analysis of body temperatures at various time points following submersion in water revealed significant differences among the study groups treated with either alcohol or benzodiazepines and the control group. Notable differences were observed in baseline temperature, post-anesthesia induction temperature, and immediate post-submersion temperature. Specifically, significant differences were discovered among the alcohol and benzodiazepine groups (p < 0.001) and ranging from the alcohol and control groups (p < 0.001). The analysis of survival times following induced hypothermia revealed a statistically significant difference among the three experimental groups (p = 0.04), though subsequent post-hoc comparisons did not demonstrate significant differences in mean survival times.
CONCLUSIONS: There is a difference in survival time between primary and secondary hypothermia groups, depending on consumption and intoxication with alcohol or benzodiazepines. The analysis of survival times following induced hypothermia showed a statistically significant difference among the groups.

Meckel\'s cave is a dural recess in the posteromedial portion of the middle cranial fossa, serving as a conduit for the trigeminal nerve and hosting various pathologies. The radiological diagnosis of Meckel\'s cave pathologies is often challenging, especially when they are atypical and rarely encountered. Here, we discuss the case of a 41-year-old woman who presented with right hemifacial pain, numbness, and binocular diplopia. Imaging features suggested a T2 hypointense, T1 hyperintense, and nonenhancing mass in the right Meckel\'s cave. Intraoperatively, an extra-axial black mass was observed, suggestive of melanoma, which was radically excised. Further postoperative workup and biopsy revealed it was a primary central nervous system (CNS) malignant melanoma, an exceedingly rare condition. Due to the rarity of the disease, a consensus regarding treatment regimens is lacking. This case report underscores the significance of considering uncommon diagnoses when faced with unusual radiological findings and emphasizes the importance of aggressive surgical resection and the evolving landscape of adjuvant treatments for primary CNS melanomas.

UNASSIGNED: Angiomatoid fibrous histiocytoma (AFH) is a clinically rare, low-grade malignant soft tissue tumor that occasionally metastasizes. It accounts for 0.3% of all soft tissue tumors and most frequently occurs in the extremities, followed by the trunk, and the head and neck. Primary angiomatoid fibrous histiocytoma (PAFH) of the pulmonary bronchus is rare. In this paper, the clinical and imaging data of a case of PAFH of the pulmonary bronchus are reported, and the literature is reviewed.
UNASSIGNED: A 57-year-old female patient presented with a six-month history of cough without apparent cause, characterized by paroxysmal dry cough, chest tightness, and shortness of breath, which worsened with activity. She did not experience fever, chills, chest pain, hemoptysis, or night sweats. Laboratory tests revealed an elevated C-reactive protein and ferritin levels, while tumor markers such as AFP, CEA, CA199, CA125, CA50, and T-SPOT were negative. A chest CT scan showed bronchial obstruction, atelectasis, and a soft tissue density in the right middle lobe of the lung. The enhanced scan demonstrated uneven enhancement of endobronchial nodules. An 18F-FDG PET/CT scan revealed a nodular soft tissue density shadow in the right lung bronchus with uneven density, clear boundaries, and increased 18F-FDG uptake, with a maximum standard uptake value (SUVmax) of 11.2. Bronchoscopy revealed a nodular or polypoid mass that was yellow and tough. Based on imaging findings, the preoperative diagnosis favored lung cancer. However, the postoperative pathological diagnosis confirmed primary angiomatoid fibrous histiocytoma (PAFH) of the pulmonary bronchus.
UNASSIGNED: The incidence of primary angiomatoid fibrous histiocytoma (PAFH) is very low, and its clinical manifestations and imaging findings lack specificity, with the final diagnosis relying on pathology. PET/CT imaging has a certain value in the diagnosis of PAFH and holds significant application value in preoperative staging, postoperative efficacy evaluation, and follow-up monitoring. In conclusion, this case report further expands the spectrum of lung and bronchial tumors.

Cognitive impairment represents one of the core features of schizophrenia, involves both neurocognition and social cognition domains, and has a significant negative impact on real-world functioning. The present review provides a framework for the conceptualization and characterization of \"primary\" and \"secondary\" cognitive impairment in schizophrenia. In this conceptualization, primary cognitive impairment can be defined as a consequence of the neurobiological alterations that underlie psychopathological manifestations of the disorder, while secondary cognitive impairment can be defined as the results of a source issue that has a negative impact on cognitive performance. Sources of secondary cognitive impairment are frequent in people with schizophrenia and include several different factors, such as positive and negative symptoms, depressive symptoms, autistic symptoms, pharmacotherapy, substance abuse, metabolic syndrome, social deprivation, and sleep disorders. It can be hypothesized that secondary cognitive impairment may be improved by effectively resolving the source issue, while primary cognitive impairment may benefit from dedicated treatment. Further research is required to confirm this hypothesis, to better characterize the distinction between primary and secondary cognitive impairment in a clinical and in a neurobiological perspective, and to evaluate the impact of systematically assessing and treating secondary cognitive impairment.