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1

Dr., Subuh Parvez Khan, Majid Ahmad Khan Dr., and Fiza Parvez Khan Dr. "Auer Rod-like Inclusions in Multiple Myeloma: First Case Report from the Kashmir Valley." International Journal of Research and Review 6, no. 3 (2019): 178–80. https://doi.org/10.5281/zenodo.3987991.

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Plasma cells are known to have various nuclear and cytoplasmic inclusions. However, Auer rod-like inclusions are rarely found in these types of cells. Here, we report a case of multiple myeloma with Auer rod-like, needle-shaped intracytoplasmic inclusions in plasma cells. To the best of our knowledge, this is the first time to report such a case from Kashmir valley.  
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2

Abdulsalam, Abbas Hashim, and Fatin Mohammed Al-yassin. "Myeloma cells with Auer-rod like inclusions." Turkish Journal of Hematology 29, no. 2 (2012): 206. http://dx.doi.org/10.5505/tjh.2012.72324.

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3

Fekih Salem, Sarra, Wijdene El Borgi, Fatma BenLakhal, et al. "Multiple myeloma with Auer-rod-like inclusions." Annales de Biologie Clinique 79, no. 3 (2021): 253–56. http://dx.doi.org/10.1684/abc.2021.1645.

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4

Oberley, Matthew J., and David T. Yang. "Lymphoproliferative disorder with Auer rod–like inclusions." Blood 124, no. 16 (2014): 2607. http://dx.doi.org/10.1182/blood-2014-07-587683.

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5

Juneja, H. S., S. Rajaraman, J. B. Alperin, and D. F. Bainton. "Auer Rod-Like Inclusions in Prolymphocytic Leukemia." Acta Haematologica 77, no. 2 (1987): 115–19. http://dx.doi.org/10.1159/000205970.

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6

Metzgeroth, G., W. Back, O. Maywald, et al. "Auer rod-like inclusions in multiple myeloma." Annals of Hematology 82, no. 1 (2003): 57–60. http://dx.doi.org/10.1007/s00277-002-0574-0.

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7

Abdulsalam, Abbas Hashim, and Barbara J. Bain. "Auer-rod like inclusions in multiple myeloma." American Journal of Hematology 89, no. 3 (2014): 338. http://dx.doi.org/10.1002/ajh.23648.

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8

Chapuis, Alexandra, Safia Chebrek, Hélène Lefrand, et al. "Auer rod-like inclusions in non blast cells." Annales de biologie clinique 76, no. 1 (2018): 114–17. http://dx.doi.org/10.1684/abc.2017.1302.

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9

Groom, Debra A., Donna Wong, Russell K. Brynes, and Linda K. Macaulay. "Auer Rod-like Inclusions in Circulating Lymphoma Cells." American Journal of Clinical Pathology 96, no. 1 (1991): 111–15. http://dx.doi.org/10.1093/ajcp/96.1.111.

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10

Jakob, Nordberg Nørgaard, Bugge Askeland Frida, Tjønnfjord Geir, and Schjesvold Fredrik. "Neoplastic plasma cells with Auer rod‐like inclusions." eJHaem 1, no. 1 (2020): 6–7. http://dx.doi.org/10.1002/jha2.33.

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11

Tejwani, Narender, Seema Tyagi, and Jasmita Dass. "Multiple Auer Rod Like Inclusions in Multiple Myeloma." Indian Journal of Hematology and Blood Transfusion 33, no. 1 (2016): 121–22. http://dx.doi.org/10.1007/s12288-016-0744-1.

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12

Morgan, Katherine M., and Payal Sojitra. "Auer rod–like inclusions in chronic lymphocytic leukemia." Blood 142, no. 4 (2023): 397. http://dx.doi.org/10.1182/blood.2023020969.

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13

V, Mahesha, Munita Meenu Bal, Neelam Varma, and Vinay Sakhuja. "Auer Rod–like Inclusions in Immunoglobulin A Multiple Myeloma." Archives of Pathology & Laboratory Medicine 129, no. 5 (2005): 706–7. http://dx.doi.org/10.5858/2005-129-0706-ariiia.

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14

Engelman, Astrid, Delphine Manzoni, Jean-Claude Bordet, and Liliana Vila. "Auer rod-like inclusions in a monoclonal B lymphocytosis." Annales de Biologie Clinique 77, no. 4 (2019): 461–63. http://dx.doi.org/10.1684/abc.2019.1467.

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15

Zhao, Yantian, and Juan Lv. "Auer Rod-Like Inclusions in B-Cell Prolymphocytic Leukemia." Turkish Journal of Hematology 36, no. 4 (2019): 280–81. http://dx.doi.org/10.4274/tjh.galenos.2018.2018.0192.

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16

Sylvia, Mary T., Sajini E. Jacob, and Debdatta Basu. "Multiple myeloma with crystalline and Auer rod-like inclusions." British Journal of Haematology 179, no. 1 (2017): 8. http://dx.doi.org/10.1111/bjh.14832.

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17

Noujaim, Jonathan Christopher, та Giovanni D’Angelo. "Auer rod-like inclusions in κ light chain myeloma". Blood 122, № 17 (2013): 2932. http://dx.doi.org/10.1182/blood-2013-06-504647.

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18

Lemež, Petr. "Auer-Rod-Like Inclusions in Cells of B-Lymphocytic Lineage." Acta Haematologica 80, no. 3 (1988): 177–78. http://dx.doi.org/10.1159/000205630.

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19

Dunphy, Cherie H., David Chung, and Frank R. Dunphy. "Auer rod-like inclusions in adult common acute lymphoblastic leukemia." Human Pathology 25, no. 2 (1994): 211–14. http://dx.doi.org/10.1016/0046-8177(94)90281-x.

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20

Ho, Wai Khoon, and Daniela Zantomio. "Auer rod-like inclusions in plasma cells in multiple myeloma." Journal of Clinical Pathology 67, no. 6 (2014): 547–48. http://dx.doi.org/10.1136/jclinpath-2014-202195.

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21

Oh, Sung-hee, and Chan Jeoung Park. "Auer rod-like crystal inclusions in plasma cells of multiple myeloma." Korean Journal of Hematology 45, no. 4 (2010): 222. http://dx.doi.org/10.5045/kjh.2010.45.4.222.

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22

Zhu, Jianfeng, Chunyan Zhang, Wei Guo, Feng Li, Shanhua Zou, and Baishen Pan. "Auer rod-like inclusions in the cytoplasm of splenic lymphoma cells." Leukemia & Lymphoma 55, no. 11 (2014): 2663–64. http://dx.doi.org/10.3109/10428194.2014.896006.

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23

Hristov, Alexandra C., Andrew Saladino, Victor E. Nava, and Christopher D. Gocke. "Auer rod–like inclusions in a low-grade B-cell leukemia." Annals of Diagnostic Pathology 14, no. 4 (2010): 292–95. http://dx.doi.org/10.1016/j.anndiagpath.2009.07.005.

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24

Dass, Jasmita, and Jyoti Kotwal. "Plasma cells with Auer rod-like inclusions in a patient with myeloma." Blood Research 53, no. 1 (2018): 7. http://dx.doi.org/10.5045/br.2018.53.1.7.

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25

Pujani, M., M. Pujani, S. Sharma, and P. Malhan. "Auer rod-like inclusions in reactive plasmacytosis seen with acute myeloid leukemia." Journal of Postgraduate Medicine 55, no. 3 (2009): 197. http://dx.doi.org/10.4103/0022-3859.57403.

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26

Morin, Jérome, and Lucile Baseggio. "Auer-rod like inclusions associated to azurophilic granules in plasma cells neoplasm." Annales de Biologie Clinique 79, no. 3 (2021): 258–59. http://dx.doi.org/10.1684/abc.2021.1644.

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27

Mansukhani, Dia, Balkrishna Padate, Kalyani Bapat, Nazreen Desai, and Shanaz Khodaiji. "Auer Rod-Like Inclusions in Light Chain Myeloma: A Rare Morphological Feature." Indian Journal of Hematology and Blood Transfusion 36, no. 1 (2019): 225–26. http://dx.doi.org/10.1007/s12288-019-01157-y.

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28

Fekih-Mrissa, Najiba, Sawsen Bouzidi, AmanAllah Nasr, et al. "A case of iga-kappa multiple myeloma with intracytoplasmic Auer rod-like inclusions." Journal of Applied Hematology 10, no. 3 (2019): 106. http://dx.doi.org/10.4103/joah.joah_43_19.

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29

Enko, Dietmar, and Gernot Kriegshäuser. "Light Chain Myeloma with Highly Atypical Plasma Cells and Extensive Auer Rod-Like Inclusions." Turkish Journal of Hematology 36, no. 1 (2019): 61–62. http://dx.doi.org/10.4274/tjh.galenos.2018.2018.0197.

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30

Naharro, Elena Frye, and Michael A. Linden. "Auer rod–like inclusions in B-cell lymphoma mimicking therapy-related acute myeloid leukemia." Blood 144, no. 26 (2024): 2793. https://doi.org/10.1182/blood.2024025759.

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31

Sojitra, Payal, Moon-woo Nam, Reeba Omman, and Milind M. Velankar. "Auer rod-like inclusions in monoclonal B-cell lymphoproliferative disorder: A potential diagnostic pitfall." Pathology International 67, no. 2 (2016): 113–15. http://dx.doi.org/10.1111/pin.12492.

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32

Gupta, Anurag, G. Krishna Reddy, Nagaraju Nalla, and Manu Goyal. "Lymphoblasts with Auer rod - like inclusions in a case of paediatric B lymphoblastic leukemia." Pediatric Blood & Cancer 64, no. 7 (2016): e26392. http://dx.doi.org/10.1002/pbc.26392.

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33

Pradhan, Sarita. "Auer Rod-Like Inclusions in Reactive Plasma Cells in a Case of Acute Myeloid Leukemia." Turkish Journal of Hematology 33, no. 4 (2016): 351–52. http://dx.doi.org/10.4274/tjh.2015.0399.

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34

Yabushita, Tomohiro, Kazuyuki Ueno, Satoshi Yoshioka, and Takayuki Ishikawa. "Auer-rod-like Inclusions in the Mature Neutrophils of a T-acute Lymphoblastic Leukemia Patient." Internal Medicine 57, no. 20 (2018): 3057–58. http://dx.doi.org/10.2169/internalmedicine.0756-18.

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35

Keutgens, A., J. Foguenne, A. Gothot, and Fr Tassin. "Atypical plasma cells with coexpression of myeloid markers and bundles of Auer rod-like inclusions." International Journal of Laboratory Hematology 37, no. 4 (2014): e85-e86. http://dx.doi.org/10.1111/ijlh.12322.

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36

Pradhan, Sarita. "Reply: “Auer Rod-Like Inclusions in Reactive Plasma Cells in a Case of Acute Myeloid Leukemia”." Turkish Journal of Hematology 33, no. 4 (2016): 368. http://dx.doi.org/10.4274/tjh.2016.0172.

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37

Niu, C., T. Tran, A. Gamayo, X. Zhao, S. Rezk, and E. Brem. "Recurrent Plasma Cell Myeloma with Intracytoplasmic Auer Rod-like Inclusions after Autologous Hematopoietic Stem Cells Transplantation." American Journal of Clinical Pathology 162, Supplement_1 (2024): S91—S92. http://dx.doi.org/10.1093/ajcp/aqae129.204.

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Abstract Introduction/Objective Plasma cell myeloma (PCM) is a bone marrow based neoplastic disorder of plasma cells (PCs). The detection of intracytoplasmic Auer rod-like inclusions (ARLI) is rare in PCM. The correlation between the ARLI and the diagnosis, recurrence, prognosis of PCM remains unknown. Methods/Case Report Retrospective comparison of pathological findings between two separate bone marrow biopsies of a recurrent kappa-restricted, IgA-positive PCM with intracytoplasmic ARLI before and after autologous hematopoietic stem cell transplantation (HSCT) with a 7-year observation. A detailed review of all the published cases of PCM with intracytoplasmic ARLI. Results (if a Case Study enter NA) The neoplastic PCs exhibited anaplastic features in the original diagnosis but became relatively mature in the recurrence after the autologous HSCT. The intracytoplasmic ARLI were found in both cases and tended to increase in the recurrence. The patient’s renal function was within normal range at the first diagnosis and during the recurrence. To the best of our knowledge, about 41 cases have been published since the first description of ARLI in 1940 including 16 females (age of onset: 38 to 72 years, mean: 57.7 y), and 25 males (age of onset: 34 to 79 years, mean: 58.2 y). The lysosomal origin of ARLI with the predominance in kappa-restricted, IgG- producing PCM and possible correlation with adult Fanconi syndrome were described. Only 7 kappa-restricted, IgA- producing PCM with ARLI were among them. Conclusion Our case is the first recurrent kappa-restricted IgA PCM with ARLI after autologous HSCT. The morphologies of the neoplastic PCs have changed from anaplastic to relatively mature and more have ARLI in the recurrence. However, the correlation with the adult Fanconi syndrome is not observed in our case. The average age at diagnosis is similar between male and female and might be younger than the average age (69 years) at diagnosis for all PCM.
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38

HÜTTER, G., D. NOWAK, I. W. BLAU, and E. THIEL. "Auer rod-like intracytoplasmic inclusions in multiple myeloma. A case report and review of the literature." International Journal of Laboratory Hematology 31, no. 2 (2009): 236–40. http://dx.doi.org/10.1111/j.1751-553x.2007.01023.x.

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39

Gao, Zhanxi, Fang Cui, Mei Liu, Yukai Guo, Yuhong Hu, and Min Shi. "Auer rod-like inclusions in the cytoplasm of B-cell lymphoma cells with bone marrow infiltration." Experimental Hematology 77 (September 2019): 6–11. http://dx.doi.org/10.1016/j.exphem.2019.08.003.

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40

Takahashi, Toru, Munehiro Suzukawa, Masaru Akiyama, and Katsuhiro Hatao. "Auer rod-like cytoplasmic inclusion bodies in nodal marginal zone lymphoma cells." International Journal of Hematology 89, no. 2 (2009): 133–34. http://dx.doi.org/10.1007/s12185-009-0264-y.

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41

Harankhedkar, Shivangi, and Ruchi Gupta. "MPO-negative inclusions and Auer rod–like structures in a case of acute myeloid leukemia with t(8;21)." Blood 130, no. 16 (2017): 1869. http://dx.doi.org/10.1182/blood-2017-05-780817.

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42

Gajendra, Smeeta. "Comment: In Response to “Auer Rod-Like Inclusions in Reactive Plasma Cells in a Case of Acute Myeloid Leukemia”." Turkish Journal of Hematology 33, no. 4 (2016): 367. http://dx.doi.org/10.4274/tjh.2016.0139.

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43

Kahng, Jimin, Jeana Kim, Suk Joon Shin, and Kyungja Han. "A Case of IgA kappa Light Chain Deposition Disease and Combined Adult Fanconi Syndrome with Auer rod-like Intracytoplasmic Inclusions in Plasma Cells and Proximal Renal Tubular Cells." Annals of Laboratory Medicine 27, no. 4 (2007): 248–52. http://dx.doi.org/10.3343/kjlm.2007.27.4.248.

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44

Al-Janadi, Anas, Karng S. Log, Prashanth Peddi, and Brian Olsen. "IgM Myeloma: Report of Two Cases of a Rare Entity with Unusual Immunophenotype." Blood 114, no. 22 (2009): 4901. http://dx.doi.org/10.1182/blood.v114.22.4901.4901.

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Abstract Abstract 4901 Introduction Plasma cell myeloma is characterized by clonal proliferation of plasma cells and serum and/or urine paraprotein, most commonly IgG, IgA or light chain only. IgM, IgD, IgE and non-secretory variants are infrequent. IgM myeloma comprises less than 0.5% of myelomas. These should not be confused with B-cell non-Hodgkin lymphoma showing plasmacytoid differentiation and an IgM paraprotein, particularly lymphoplasmacytic lymphoma. Two cases are reported herein. Case 1 A 57 year old female with known MGUS, type II diabetes, rheumatoid arthritis, underwent total thyroidectomy for papillary thyroid carcinoma. Two months later she required excision of a cervical lymph node, identified by radioactive iodine scanning, revealing metastatic papillary thyroid carcinoma. However, during pre-operative evaluation, cytopenias were noted (hemoglobin 7.8 g/dL, platelets 86 × 109L), and renal insufficiency (creatinine 2.1 mg/dL). Subsequent laboratory findings included a serum IgM kappa paraprotein of 6158 mg/dL, normal IgA, decreased IgG of 423 mg/dL, elevated beta-2 microglobulin (7.7 mg/L), elevated serum viscosity (3 cp), mildly decreased serum calcium (8.2 mg/dL). A skeletal survey was negative. Pathologic findings: Peripheral blood showed pancytopenia, marked RBC rouleaux, and occasional atypical plasmacytoid cells (5%). Bone marrow biopsy sections revealed marked hypercellularity with a predominance of plasmacytoid cells. By immunohistochemistry (IHC), these were CD138+, CD117+. MUM1+, weak cytoplasmic kappa+, weak CD79a+, CD45-, CD19-, CD20-, PAX 5-, CD5-, CD10-, CD23-, CD56-, cyclin D1-. Flow cytometry (FC) of peripheral blood also revealed abnormal cells, of comparable phenotype (CD45-, CD19-, CD20-, CD38+, CD138+, CD56-), though CD117 and cytoplasmic light chain expression were not evident. Clinical course: Management included plasma exchange for serum hyperviscosity, pulse steroids and thalidomide. Despite these interventions, her condition worsened, including a progressive decline in renal function, requiring hemodialysis. Eventually she declined further treatment, and expired two months after diagnosis. Case 2 An 83 year old male patient presented with fatigue, dyspnea, diffuse pain, paresthesias involving hands and feet of two weeks duration. Past history was remarkable for COPD, lower extremity DVT, and hyperlipidemia. Physical examination revealed no lymphadenopathy or organomegaly. Laboratory studies revealed pancytopenia, IgM kappa paraprotein of 4664 mg/dL, normal serum IgG, diminished IgA, elevated serum creatinin (1.7 mg/dL), normal serum calcium, elevated beta-2 microglobulin (4.9 mg/L) and elevated serum viscosity (3.4 cp). A skeletal survey was negative. Pathologic findings: Peripheral blood revealed pancytopenia with marked RBC rouleaux. Marrow aspirate smears showed abundant abnormal plasma cells, many showing numerous, azurophilic, crystalline cytoplasmic inclusions, Auer rod-like. Bone marrow biopsy was hypercellular and heavily infiltrated by abnormal plasma cells. By IHC, these were CD138+, MUM1+, cyclin D1+, CD56+, cytoplasmic kappa+, CD20+ (sub-set), weak CD117+. FC of marrow aspirate yielded comparable results (CD56 co-expression, bright CD38+ and CD138+, CD19-, CD20-, CD45-). Conventional cytogenetics revealed a normal male karyotype. Interphase FISH revealed t(11; 14), trisomies 11, 13, 14 and 17, with 13q14 and 17p13 deletions. Clinical course: The patient rapidly deteriorated, and expired shortly after hospital admission. Conclusion We describe two cases of IgM myeloma. The diagnosis in each case was supported by morphology and immunophenotype and, in one case, by interphase FISH. These add to our limited knowledge regarding the biology of this disorder. Recently, it has been suggested that such cases are of relatively uniform immunophenotype, in particular lacking either CD56 or CD117 expression (Feyler S et al, BJH 140, 547-551, 10/2007). Our cases show that the spectrum of immunophenotypic findings in IgM myeloma is broader than has been suggested. In addition, one of the two cases showed Auer-rod like crystalline cytoplasmic inclusions in malignant plasma cells, also a rare finding in this setting. Disclosures No relevant conflicts of interest to declare.
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45

AlMozain, Nour, and Tarek Owaidah. "Plasma cell myeloma with Auer rode like inclusions." Hematology/Oncology and Stem Cell Therapy 11, no. 2 (2018): 112–13. http://dx.doi.org/10.1016/j.hemonc.2018.03.007.

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46

Alkhayat, Adnan. "Plasma cell leukemia with a multiple auer rod-like." Journal of Applied Hematology 9, no. 1 (2018): 37. http://dx.doi.org/10.4103/joah.joah_7_18.

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47

Biscari, P., and F. Bisi. "Membrane-mediated interactions of rod-like inclusions." European Physical Journal E 7, no. 4 (2002): 381–86. http://dx.doi.org/10.1140/epje/i2001-10103-x.

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48

Pueschel, Curt M. "Rod-shaped virus-like particles in the endoplasmic reticulum ofAudouinella saviana(Acrochaetiales, Rhodophyta)." Canadian Journal of Botany 73, no. 12 (1995): 1974–80. http://dx.doi.org/10.1139/b95-211.

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Rod-shaped particles, approximately 30 nm in width and 1000 nm or more in length, were found in cells of the red alga Audouinella saviana (Meneghini) Woelkerling. Parallel in orientation and hexagonally packed, these inclusions were located within dilated cisternae of rough endoplasmic reticulum. The rods consisted of an electron-dense central element surrounded by a thick-walled tube that appeared to be composed of repeating granular subunits. Although uninfected controls of the same species were not available, the morphology and substructure of the inclusions, the absence of such inclusions in other species of Audouinella, and the apparent connection of these particles with cellular abnormalities and necrosis suggest that these inclusions may be viral in nature. Among the unusual and possibly cytopathic features of cells containing particles were ropy, fibrillar structures free in the cytoplasm, corrugated mitochondrial cristae, amorphous mitochondrial inclusions, highly convoluted photosynthetic membranes, and loss of integrity of the nuclear envelope. This is the first report of the presence of possible rod-shaped virus-like particles in red algae. Key words: Acrochaetiales, Audouinella saviana, Rhodophyta, ultrastructure, virus-like particles.
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49

LAVROV, N. A., and E. E. PAVLOVSKAIA. "ELASTIC WAVE SCATTERING ON A SYSTEM OF ROD-LIKE INCLUSIONS." Journal of Sound and Vibration 248, no. 2 (2001): 329–50. http://dx.doi.org/10.1006/jsvi.2001.3790.

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50

Guo, Shuo, Andrey Vladimirovich Karasev, Anders Tilliander, and Pär Göran Jönsson. "Evaluation of Sulfide Inclusions before and after Deformation of Steel by Using the Electrolytic Extraction Method." Metals 11, no. 4 (2021): 543. http://dx.doi.org/10.3390/met11040543.

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The characteristics of elongated MnS have a critical effect on fatigue anisotropy and all mechanical anisotropies. A comparative investigation of nonmetallic inclusions in both stainless steels and tool steels has been carried out in this study. The inclusion characteristics were investigated using electrolytic extraction (EE) followed by scanning electron microscopy combined with energy-dispersive spectroscopy (SEM-EDS). Overall, three types of MnS inclusions (type I (regular), type II (irregular) and type III (Rod)) were found in tool steels in as-cast samples, which had not been heat-treated. Furthermore, three types of MnS inclusions (Rod-like sulfide (RS), Plate-like sulfide (PS) and Oxysulfide (OS)) were found in samples taken after rolling. Based on the breakability of the elongated MnS, three types of inclusions, Type UU, UB and BB, where U represents the undamaged or unbroken edge of an inclusion and B represents the fragment or broken edge of an inclusion, were studied in both stainless steels and tool steels both before and after additional heat treatment. The effect of heat treatment and dissolving the metal layer during the EE process is also discussed. The results show that both processes have a limited effect on the breakability of inclusions in steels with carbon contents <0.42 mass%.
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