http://ift.tt/2pg0x5n
Δευτέρα 24 Απριλίου 2017
Dynamics of B cell recovery following kidney/bone marrow transplant recipients.
http://ift.tt/2pZhyyi
Biologic treatments for elderly patients with psoriasis
Abstract
The number of elderly patients with psoriasis is increasing in Japan. However, biologic treatment is generally considered to be challenging in elderly patients, due to their increased risk of complications compared with younger patients. Our retrospective study aimed to evaluate the safety profile and efficacy of biologics in senior elderly patients (≥75 years old) with psoriasis. The study involved a cohort of 27 patients aged 75–88 years who were being treated with biologics over a period of more than 1 year. Initial biologics administrated to were adalimumab (five cases) and ustekinumab (22 cases). Eight patients discontinued treatment: two developed cancer; one was transferred to hospital; and five others experienced either bone fracture, interstitial pneumonia, cerebral hemorrhage resulting in death, decrepitude or developed hepatopathy following prophylactic tuberculosis treatment. Efficacy, evaluated by the percentage of patients achieving 75% reduction of Psoriasis Area and Severity Index score, was 76.9% at week 16 (n = 26), 88.0% at week 24 (n = 25) and 90.5% at week 52 (n = 21). Biologic treatments thus show clear efficacy in elderly patients with psoriasis, however, the increased frequency of adverse events requires rigorous patient observation.
http://ift.tt/2oZLfRs
Effect of photoactivation on the reduction of composite resin contamination
Composite resins are predominantly marketed in developing countries in tube form, and the contents of the tube may be used in numerous procedures for different patients. This represents a problem because of the risk of cross-contamination. This study aimed to evaluate contamination in vitro of the internal contents of composite resin tubes in the dental clinics of a higher-education institution, as well as the effect of photoactivation on the level of contamination. Twenty-five tubes containing composite resin were randomly chosen (by lottery). From each tube, two samples of approximately 2 mm of composite resin were removed, and then one sample, but not the other, was photoactivated. These samples were plated on Brain–Heart Infusion (BHI), Sabouraud and MacConkey agars, and the plates were incubated at 37°C for 24–48 h. Colony counting and Gram staining were performed for subsequent microscopic identification of fungi and bacteria. The non-photoactivated composite resin group presented significantly higher microbial contamination in relation to the photoactivated composite resin group. The photoactivation of camphorquinone present in composite resin produces reactive oxygen species, which might promote cell death of contaminant microorganisms. Thus, although the same tube of composite resin may be used for a number of different patients in the dental clinics of developing countries, the photoactivation process potentially reduces the risk of cross-contamination.
http://ift.tt/2oq6bm4
Prediabetes Exhibits Decreased Disposition Index Correlated with Deterioration of Glycemic Parameters in Nonobese Japanese Subjects: A Cross-Sectional Study from Medical Examination
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
http://ift.tt/2pfREZo
A pseudotumour of the thigh: tensor fasciae latae muscle hypertrophy due to an underlying abductor tendon tear
We present a patient with an asymptomatic unilateral swelling of the anterolateral thigh. MRI showed hypertrophy of the tensor fasciae latae muscle due to an underlying gluteus minimus tendon tear.
Abductor tendon tears can present with swelling of the thigh due to secondary tensor fasciae latae muscle hypertrophy.
http://ift.tt/2q0i8ii
Exostosin 1 is expressed in human odontoblasts
Source:Archives of Oral Biology, Volume 80
Author(s): Virve Pääkkönen, Stina Saraniemi, Françoise Bleicher, Zvi Nevo, Leo Tjäderhane
ObjectiveDental pulp is soft connective tissue maintaining the vitality of the tooth, while odontoblasts form the dentin. Our earlier DNA microarray analysis revealed expression of putative tumour suppressor exostosin 1 (EXT-1) in odontoblasts. EXT-1 is essential for heparan sulphate synthesis, which may play a role in the dentin mineralization. Since the absence of the functional EXT-1 causes bone tumours, expression in odontoblasts is interesting. Our aim was to analyse further the EXT-1 expression in human tooth.DesignsDNA microarray and PCR techniques were used to study the EXT-1 expression in mature native human odontoblasts and pulp tissue as well as in newly-differentiated cultured odontoblast-like cells. Immunohistochemistry was performed to study EXT-1 protein in mature human teeth, teeth with incomplete root and developing teeth.ResultsMarkedly higher EXT-1 was observed in mature odontoblasts than in pulp at mRNA level with DNA microarray and PCR techniques. Immunohistochemistry of mature tooth revealed EXT-1 both in odontoblasts and the predentin but not in the dentin. EXT-1 was also observed in the odontoblasts of incomplete root, but the localization of the staining was different. In developing foetal tooth, staining was detected in ameloblasts and the basal lamina.ConclusionsThe detection of EXT-1 in both mature and newly-differentiated cells indicates a role in the odontoblast function, and EXT-1 staining in the predentin indicates a function in the dentin formation. Detection of EXT-1 in developing teeth indicates a role in tooth development.
http://ift.tt/2oGrPOQ
Alternative sweeteners influence the biomass of oral biofilm
Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Fathilah Abdul Razak, Baizatul Amirah Baharuddin, Elisya Farha Mohd. Akbar, Amira Hanim Norizan, Nur Fazilah Ibrahim, Md. Yusoff Musa
ObjectiveCompact-structured oral biofilm accumulates acids that upon prolonged exposure to tooth surface, causes demineralisation of enamel. This study aimed to assess the effect of alternative sweeteners Equal Stevia®, Tropicana Slim®, Pal Sweet® and xylitol on the matrix-forming activity of plaque biofilm at both the early and established stages of formation.MethodsSaliva-coated glass beads (sGB) were used as substratum for the adhesion of a mixed-bacterial suspension of Streptococcus mutans, Streptococcus sanguinis and Streptococcus mitis. Biofilms formed on sGB at 3h and 24h represented the early and established-plaque models. The biofilms were exposed to three doses of the sweeteners (10%), introduced at three intervals to simulate the exposure of dental plaque to sugar during three consecutive food intakes. The treated sGB were (i) examined under the SEM and (ii) collected for turbidity reading. The absorbance indicated the amount of plaque mass produced. Analysis was performed comparative to sucrose as control.ResultsHigher rate of bacterial adherence was determined during the early compared to established phases of formation. Comparative to the sweeteners, sucrose showed a 40% increase in bacterial adherence and produced 70% more plaque-mass. Bacterial counts and SEM micrographs exhibited absence of matrix in all the sweetener-treated biofilms at the early phase of formation. At the established phase, presence of matrix was detected but at significantly lower degree compared to sucrose (p<0.05).ConclusionAlternatives sweeteners promoted the formation of oral biofilm with lighter mass and lower bacterial adherence. Hence, suggesting alternative sweeteners as potential antiplaque agents.
http://ift.tt/2oGypoy
Major Immunodominant Region of Hepatitis B Virus Core Antigen as a Delivery Vector to Improve the Immunogenicity of the Fusion Antigen ROP2-SAG1 Multiepitope from Toxoplasma gondii in Mice
Viral Immunology , Vol. 0, No. 0.
http://ift.tt/2oq9FVA
Modes of Action for Mucosal Vaccine Adjuvants
Viral Immunology , Vol. 0, No. 0.
http://ift.tt/2oGoBLj
Exostosin 1 is expressed in human odontoblasts
Source:Archives of Oral Biology, Volume 80
Author(s): Virve Pääkkönen, Stina Saraniemi, Françoise Bleicher, Zvi Nevo, Leo Tjäderhane
ObjectiveDental pulp is soft connective tissue maintaining the vitality of the tooth, while odontoblasts form the dentin. Our earlier DNA microarray analysis revealed expression of putative tumour suppressor exostosin 1 (EXT-1) in odontoblasts. EXT-1 is essential for heparan sulphate synthesis, which may play a role in the dentin mineralization. Since the absence of the functional EXT-1 causes bone tumours, expression in odontoblasts is interesting. Our aim was to analyse further the EXT-1 expression in human tooth.DesignsDNA microarray and PCR techniques were used to study the EXT-1 expression in mature native human odontoblasts and pulp tissue as well as in newly-differentiated cultured odontoblast-like cells. Immunohistochemistry was performed to study EXT-1 protein in mature human teeth, teeth with incomplete root and developing teeth.ResultsMarkedly higher EXT-1 was observed in mature odontoblasts than in pulp at mRNA level with DNA microarray and PCR techniques. Immunohistochemistry of mature tooth revealed EXT-1 both in odontoblasts and the predentin but not in the dentin. EXT-1 was also observed in the odontoblasts of incomplete root, but the localization of the staining was different. In developing foetal tooth, staining was detected in ameloblasts and the basal lamina.ConclusionsThe detection of EXT-1 in both mature and newly-differentiated cells indicates a role in the odontoblast function, and EXT-1 staining in the predentin indicates a function in the dentin formation. Detection of EXT-1 in developing teeth indicates a role in tooth development.
http://ift.tt/2oGrPOQ
Alternative sweeteners influence the biomass of oral biofilm
Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Fathilah Abdul Razak, Baizatul Amirah Baharuddin, Elisya Farha Mohd. Akbar, Amira Hanim Norizan, Nur Fazilah Ibrahim, Md. Yusoff Musa
ObjectiveCompact-structured oral biofilm accumulates acids that upon prolonged exposure to tooth surface, causes demineralisation of enamel. This study aimed to assess the effect of alternative sweeteners Equal Stevia®, Tropicana Slim®, Pal Sweet® and xylitol on the matrix-forming activity of plaque biofilm at both the early and established stages of formation.MethodsSaliva-coated glass beads (sGB) were used as substratum for the adhesion of a mixed-bacterial suspension of Streptococcus mutans, Streptococcus sanguinis and Streptococcus mitis. Biofilms formed on sGB at 3h and 24h represented the early and established-plaque models. The biofilms were exposed to three doses of the sweeteners (10%), introduced at three intervals to simulate the exposure of dental plaque to sugar during three consecutive food intakes. The treated sGB were (i) examined under the SEM and (ii) collected for turbidity reading. The absorbance indicated the amount of plaque mass produced. Analysis was performed comparative to sucrose as control.ResultsHigher rate of bacterial adherence was determined during the early compared to established phases of formation. Comparative to the sweeteners, sucrose showed a 40% increase in bacterial adherence and produced 70% more plaque-mass. Bacterial counts and SEM micrographs exhibited absence of matrix in all the sweetener-treated biofilms at the early phase of formation. At the established phase, presence of matrix was detected but at significantly lower degree compared to sucrose (p<0.05).ConclusionAlternatives sweeteners promoted the formation of oral biofilm with lighter mass and lower bacterial adherence. Hence, suggesting alternative sweeteners as potential antiplaque agents.
http://ift.tt/2oGypoy
Heterogeneous Prognoses for pT3 Papillary Thyroid Carcinomas and Impact of Delayed Risk Stratification
Thyroid , Vol. 0, No. 0.
http://ift.tt/2oFg3Uc
Assessment and spontaneous healing outcomes of traumatic eardrum perforation with bleeding
This study investigated the influence of the degree of bleeding from the remnant eardrum on the spontaneous healing of human traumatic tympanic membrane perforations (TMPs).
http://ift.tt/2pbRfFl
The effect of submandibular gland preservation during level 1B neck dissection on postoperative xerostomia
Source:Auris Nasus Larynx
Author(s): Jeff D. Markey, William G. Morrel, Steven J. Wang, William R. Ryan
ObjectiveCompare the presence and degree of postoperative xerostomia following preservation or excision of the submandibular gland (SMG) during level IB neck dissection (ND) without adjuvant radiation.MethodsRetrospective review with patient questionnaire administered to patients with pT1-2N0 oral squamous cell carcinoma (SCC) who underwent resection and ND with SMG preservation or SMG excision without postoperative radiation from 2011 to 2015. We analyzed an additional control group that was age and gender-matched and had not undergone oral resection or SMG excision. We compared the scores reported by the three groups from three questionnaires: University of Michigan Xerostomia Quality of Life (XeQoL), Short Form-8 (SF-8), and a xerostomia severity scale (XSS). Dry mouth severity (DMS) was calculated based on XSS scores among those complaining of any xerostomia.ResultsEleven SMG preservation group, 14 SMG excision group and 15 control group patients completed the survey. Complication and recurrence rates were comparable among experimental groups. No differences were identified between the two experimental groups for the XeQoL, SF-8, and XSS questionnaires (p=0.96, 0.87, 0.7). Control patients reported less xerostomia on XeQoL (p=0.046) and XSS (p=0.01) compared to the experimental groups combined with no statistical difference in SF-8 scores (p=0.25). No patients in either group developed regional recurrence in level IB.ConclusionSMG preservation, though technically and oncologically sound, does not appear in this study to reduce xerostomia. Oral resection with ND may result in some degree of xerostomia perception.
http://ift.tt/2pbRY9B
Einseitige supraklavikuläre Schwellung in der Schwangerschaft
Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-105795
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2pcbEu5
What chickens might tell us about the MHC class II system
Aimée Parker | Jim Kaufman
http://ift.tt/2oZddNq
The effect of submandibular gland preservation during level 1B neck dissection on postoperative xerostomia
Compare the presence and degree of postoperative xerostomia following preservation or excision of the submandibular gland (SMG) during level IB neck dissection (ND) without adjuvant radiation.
http://ift.tt/2pYl2kG
Assessment and spontaneous healing outcomes of traumatic eardrum perforation with bleeding
Source:American Journal of Otolaryngology
Author(s): Zhong-hai Jin, Zi-Han Lou, Zheng-Cai Lou
ObjectiveThis study investigated the influence of the degree of bleeding from the remnant eardrum on the spontaneous healing of human traumatic tympanic membrane perforations (TMPs).Study designA case series with chart review.SettingA tertiary university hospital.Materials and methodsThe clinical records of traumatic TMP patients who met the case selection criteria were retrieved and categorized into two groups based on the documented degree of bleeding from the remnant eardrum: with and without bleeding. The demographic data and spontaneous healing outcomes (i.e., healing rate and duration) of these two TMP types were analyzed using the chi-squared test or t-test.ResultsOne-hundred and eighty-eight cases met the inclusion criteria and were analyzed. Of these, 58.5% had perforations without bleeding and the remaining 41.5% had perforations with bleeding. The overall closure rate at the end of the 3-month follow-up period was 90.9% for perforations without bleeding and 96.2% for perforations with bleeding; the difference was not statistically significant (P>0.05). However, the average closure time differed significantly between the two groups (P<0.05): 29.4±3.7days for perforations without bleeding and 20.6±9.2days for perforations with bleeding. The closure rate was significantly different between the groups (62 vs. 15.6%, P<0.01) within 2weeks for medium-sized perforations. In total, 11 (39.3%) large-sized perforations achieved complete closure in the group with bleeding, while none of the large-sized perforations closed in the group without bleeding within 2weeks. The closure rate of medium-sized perforations was not significantly different (79.2 vs. 92%, P>0.05) between the groups without and with bleeding within 4weeks, while the closure rate of large-sized perforations was significantly different between the groups without and with bleeding (27.2 vs. 75%, P=0.0).ConclusionThis study shows that traumatic TMPs with bleeding significantly shortened the closure time compared to TMPs without bleeding. This finding indicates a significant correlation between the prognosis of traumatic TMPs and the degree of eardrum bleeding: severe bleeding from and a hematoma in the remnant eardrum appear to be good signs.
http://ift.tt/2pf89oA
The Impact of Oral Promethazine on Human Whole-Body Motion Perceptual Thresholds
Abstract
Despite the widespread treatment of motion sickness symptoms using drugs and the involvement of the vestibular system in motion sickness, little is known about the effects of anti-motion sickness drugs on vestibular perception. In particular, the impact of oral promethazine, widely used for treating motion sickness, on vestibular perceptual thresholds has not previously been quantified. We examined whether promethazine (25 mg) alters vestibular perceptual thresholds in a counterbalanced, double-blind, within-subject study. Thresholds were determined using a direction recognition task (left vs. right) for whole-body yaw rotation, y-translation (interaural), and roll tilt passive, self-motions. Roll tilt thresholds were 31 % higher after ingestion of promethazine (P = 0.005). There were no statistically significant changes in yaw rotation and y-translation thresholds. This worsening of precision could have functional implications, e.g., during driving, bicycling, and piloting tasks. Differing results from some past studies of promethazine on the vestibulo-ocular reflex emphasize the need to study motion perception in addition to motor responses.
http://ift.tt/2psW28s
Systemic mastocytosis with KIT V560G mutation presenting as recurrent episodes of vascular collapse: response to disodium cromoglycate and disease outcome
Mastocytosis are rare diseases characterized by an accumulation of clonal mast cells (MCs) in one or multiple organs or tissues. Patients with systemic mastocytosis (SM), whose MCs frequently arbor the activat...
http://ift.tt/2paTEzU
The Impact of Oral Promethazine on Human Whole-Body Motion Perceptual Thresholds
Abstract
Despite the widespread treatment of motion sickness symptoms using drugs and the involvement of the vestibular system in motion sickness, little is known about the effects of anti-motion sickness drugs on vestibular perception. In particular, the impact of oral promethazine, widely used for treating motion sickness, on vestibular perceptual thresholds has not previously been quantified. We examined whether promethazine (25 mg) alters vestibular perceptual thresholds in a counterbalanced, double-blind, within-subject study. Thresholds were determined using a direction recognition task (left vs. right) for whole-body yaw rotation, y-translation (interaural), and roll tilt passive, self-motions. Roll tilt thresholds were 31 % higher after ingestion of promethazine (P = 0.005). There were no statistically significant changes in yaw rotation and y-translation thresholds. This worsening of precision could have functional implications, e.g., during driving, bicycling, and piloting tasks. Differing results from some past studies of promethazine on the vestibulo-ocular reflex emphasize the need to study motion perception in addition to motor responses.
http://ift.tt/2psW28s
Human β-defensin-3 Induces IL-8 Release and Apoptosis in Airway Smooth Muscle Cells
Abstract
Background
Human airway smooth muscle cells (ASMCs) may have a pro-inflammatory role through the release of inflammatory mediators. Increasing evidence indicates that human β-defensins (HBDs) are related to pathogenesis of asthma.
Objectives
To examine the plasma level of HBD-1, -2 and -3 in asthmatic patients and the expression of their mouse orthologs in the lung tissue of a mouse model of chronic severe asthma. Further to investigate the effect of HBD-3 on the release of the pro-inflammatory cytokine IL-8 and to explore the mechanisms.
Methods
The plasma levels of HBD-1, -2 and -3 from 34 healthy controls and 25 asthmatic patients were determined by ELISA. The expression of mouse β-defensins MBD-1, -3 and -14 in the lung tissue of asthmatic mice was detected by Western blot. The ASMCs were cultured with HBD-3 for 24h, and then the supernatant level of IL-8 was evaluated by ELISA and the cell viability was examined by WST-1 assay. The signaling pathway was investigated with blocking antibodies or pharmacological inhibitors.
Results
The plasma levels of HBD-1 and -3 were elevated in asthmatic patients, and the expression of MBD-14, the mouse ortholog for HBD-3, was increased in asthmatic mice. HBD-3 induced IL-8 production in a CCR6 receptor-specific manner and was dependent on multiple signaling pathways. Moreover, HBD-3 induced cell apoptosis concurrently, which was dependent on the ERK1/2 MAPK pathway. Mitochondrial ROS regulated both HBD-3-induced IL-8 production and cell apoptosis.
Conclusions & Clinical Relevance
These observations provide clear evidence of an important new mechanism for the promotion of airway inflammation and tissue remodeling with potential relevance for the treatment of asthma.
This article is protected by copyright. All rights reserved.
http://ift.tt/2pYhvpw
Genetic Variation at the Th2 Immune Gene IL13 is Associated with IgE-mediated Paediatric Food Allergy
Abstract
Background
Food allergies pose a considerable worldwide public health burden with incidence as high as one in ten in 12-month old infants. Few food allergy genetic risk variants have yet been identified. The Th2 immune gene IL13 is a highly plausible genetic candidate as it is central to the initiation of IgE-class switching in B cells.
Objective
Here we sought to investigate whether genetic polymorphisms at IL13 are associated with the development of challenge-proven IgE-mediated food allergy.
Method
We genotyped nine IL13 'tag' single nucleotide polymorphisms (tag-SNPs) in 367 challenge-proven food allergic cases, 199 food sensitised-tolerant cases and 156 non-food allergic controls from the HealthNuts study. 12-month old infants were phenotyped using open oral food challenges. SNPs were tested using Cochran-Mantel-Haenszel test adjusted for ancestry strata. A replication study was conducted in an independent, co-located sample of four paediatric cohorts consisting of 203 food allergic cases and 330 non-food allergic controls. Replication sample phenotypes were defined by clinical history of reactivity, 95% PPV or challenge and IL13 genotyping was performed.
Results
IL13 rs1295686 was associated with challenge-proven food allergy in the discovery sample (P=0.003; OR=1.75; CI=1.20-2.53). This association was also detected in the replication sample (P=0.03, OR=1.37, CI=1.03-1.82) and further supported by a meta-analysis (P=0.0006, OR=1.50). However, we cannot rule out an association with food sensitisation. Carriage of the rs1295686 variant A allele was also associated with elevated total plasma IgE.
Conclusions
We show for the first time, in two independent cohorts, that IL13 polymorphism rs1295686 (in complete linkage disequilibrium with functional variant rs20541) is associated with challenge-proven food allergy.
This article is protected by copyright. All rights reserved.
http://ift.tt/2pdtnTY
Phase 1/2 Study Exploring the Safety, Tolerability, and Efficacy of INCAGN01876 Combined With Immune Therapies in Advanced or Metastatic Malignancies
Conditions: Advanced Malignancies; Metastatic Malignancies
Interventions: Drug: INCAGN01876; Drug: Nivolumab; Drug: Ipilimumab
Sponsor: Incyte Corporation
Recruiting - verified April 2017
http://ift.tt/2pWOJmu
Interventions: Drug: INCAGN01876; Drug: Nivolumab; Drug: Ipilimumab
Sponsor: Incyte Corporation
Recruiting - verified April 2017
http://ift.tt/2pWOJmu
A New Treatment for Zenker's Diverticulum-submucosal Tunneling Endoscopic Septum Division
Condition: Zenker Diverticulum
Intervention: Procedure: Submucosal tunneling endoscopic septum division
Sponsors: Shanghai Zhongshan Hospital; Winthrop University Hospital
Not yet recruiting - verified April 2017
http://ift.tt/2pdm2Ul
Intervention: Procedure: Submucosal tunneling endoscopic septum division
Sponsors: Shanghai Zhongshan Hospital; Winthrop University Hospital
Not yet recruiting - verified April 2017
http://ift.tt/2pdm2Ul
Cetuximab in Combination With Paclitaxel Plus Cisplatin Versus Paclitaxel Plus Cisplatin Alone for the First-line Treatment of Recurrent and/or Metastatic Esophageal Squamous Cell Carcinoma
Conditions: Esophageal Cancer, Squamous Cell; Cetuximab Effect; Chemotherapy Effect
Interventions: Drug: cetuximab; Drug: cisplatin plus paclitaxel
Sponsor: Peking University
Recruiting - verified April 2017
http://ift.tt/2pWwDkq
Interventions: Drug: cetuximab; Drug: cisplatin plus paclitaxel
Sponsor: Peking University
Recruiting - verified April 2017
http://ift.tt/2pWwDkq
Bildgebung der Nasennebenhöhlen und der Frontobasis
Zusammenfassung
Die Erkrankungen der Schädelbasis und Nasennebenhöhlen stellen aufgrund der anatomischen Gegebenheiten besondere Anforderungen an die radiologische Diagnostik. Die Schnittbildverfahren stellen hier die primär eingesetzten Modalitäten dar. Hilfestellung bei der Auswahl der Verfahren geben die neuen Leitlinien der Fachgesellschaften. Im vorliegenden Artikel wird eine Übersicht über die radiologischen Verfahren und ihren bestmöglichen Einsatz anhand von Fallbeispielen aus der Praxis gegeben. Dabei wird deutlich, dass häufig eine Kombination aus Computertomographie (CT) und Magnetresonanztomographie (MRT) erforderlich ist. Die Verwendung der CT zur Navigation ist tägliche Routine. Gelegentlich sind weiterführende Verfahren wie die Angiographie oder Myelographie indiziert, insbesondere wenn eine präoperative Gefäßdiagnostik oder Embolisation erfolgen soll. Insgesamt ist die Beurteilung der Diagnostik komplex, erfordert Erfahrung und sowohl Kenntnisse der Krankheitsbilder als auch der diagnostischen Verfahren und somit die enge Zusammenarbeit der Fachgebiete Hals-Nasen-Ohren-Heilkunde und Radiologie.
http://ift.tt/2oD9K4A
Molecular fingerprinting of complex grass allergoids: size assessments reveal new insights in epitope repertoires and functional capacities
Subcutaneous allergen immunotherapy (SCIT) is a well-documented treatment for allergic disease which involves injections of native allergen or modified (allergoid) extracts. The use of allergoid vaccines is a ...
http://ift.tt/2p9IKdH
Divergent Schwannoma-Like Phenotype in a Pleomorphic Adenoma
Abstract
The schwannoma-like pleomorphic adenoma is a rare histopathological variant of the pleomorphic adenoma. Five previous reports with seven cases exist in English language literature. These tumors present in the parotid gland most commonly. Intraparotid schwannomas of the facial nerve and schwannomas with glandular differentiation have also been reported. A 60-year-old male presented with an asymptomatic swelling over the left angle of the mandible. The swelling had been present for about 12 years with a recent increase in size. CT imaging showed a hyperdense circumscribed mass of the superficial lobe of the parotid. The working diagnosis was that of a benign tumor of salivary gland or soft tissue origin. The mass was excised with careful preservation of the facial nerve. The 3.5 cm mass was submitted for histopathological examination. The well-circumscribed, encapsulated mass showed a predominant sheet-like proliferation of Antoni type A-like tissue, Foci of glandular differentiation with duct-like structures were also seen. Cytological atypia or mitotic activity were not seen. Nuclei of lesional cells diffusely and strongly expressed reactivity to p63. The final diagnosis was a schwannoma-like pleomorphic adenoma. No recurrence has been reported in the 15 months since the removal. Facial nerve function is unimpaired with a House Brackmann facial nerve function score of one. The potential for misdiagnosis in fine needle aspirate and incisional biopsies is real in cases of schwannoma-like pleomorphic adenoma. The diagnostic pitfalls include the schwannoma and leiomyoma. Schwannomas with glandular differentiation have also been reported and therefore a misdiagnosis may potentially occur in excised specimens. Careful application of immunohistochemistry may help in the differentiation of these lesions.
http://ift.tt/2onjRhN
Divergent Schwannoma-Like Phenotype in a Pleomorphic Adenoma
Abstract
The schwannoma-like pleomorphic adenoma is a rare histopathological variant of the pleomorphic adenoma. Five previous reports with seven cases exist in English language literature. These tumors present in the parotid gland most commonly. Intraparotid schwannomas of the facial nerve and schwannomas with glandular differentiation have also been reported. A 60-year-old male presented with an asymptomatic swelling over the left angle of the mandible. The swelling had been present for about 12 years with a recent increase in size. CT imaging showed a hyperdense circumscribed mass of the superficial lobe of the parotid. The working diagnosis was that of a benign tumor of salivary gland or soft tissue origin. The mass was excised with careful preservation of the facial nerve. The 3.5 cm mass was submitted for histopathological examination. The well-circumscribed, encapsulated mass showed a predominant sheet-like proliferation of Antoni type A-like tissue, Foci of glandular differentiation with duct-like structures were also seen. Cytological atypia or mitotic activity were not seen. Nuclei of lesional cells diffusely and strongly expressed reactivity to p63. The final diagnosis was a schwannoma-like pleomorphic adenoma. No recurrence has been reported in the 15 months since the removal. Facial nerve function is unimpaired with a House Brackmann facial nerve function score of one. The potential for misdiagnosis in fine needle aspirate and incisional biopsies is real in cases of schwannoma-like pleomorphic adenoma. The diagnostic pitfalls include the schwannoma and leiomyoma. Schwannomas with glandular differentiation have also been reported and therefore a misdiagnosis may potentially occur in excised specimens. Careful application of immunohistochemistry may help in the differentiation of these lesions.
http://ift.tt/2onjRhN
Leptin and NGF in saliva of patients with diabetes mellitus type 2: a pilot study
Abstract
Aims
This study aimed to measure salivary levels of leptin and NGF in patients with type 2 diabetes (T2D) and to compare with healthy subjects. In addition, markers previously evaluated in diabetes, including insulin, HGF and MCP-1, and markers of inflammation (IL-1b, IL-6, IL-8, TNF-α), were also measured in saliva in order to evaluate possible relationship of these markers with the new analytes evaluated in the study.
Methods
Unstimulated whole saliva was collected by passive drooling from a total of 65 individuals (34 controls and 31 with T2D) and used for leptin, NGF, HGF, MCP-1, insulin, IL-1b, IL-6, IL-8, and TNF-α determination.
Results
Salivary leptin was 2.1 higher in DM than in healthy controls (P<0.001), while no statistically significant differences were detected between the two groups in salivary concentrations of NGF. Salivary IL-6, TNF-α, insulin and MCP-1 were higher in DM in comparison with controls (P<0.05 in all cases). Leptin showed positive significant correlations with MCP-1, IL-6, TNF-α, and insulin, while NGF positively correlated with HGF, MCP-1, IL-1 β, IL-6, and TNF-α
Conclusions
This pilot study indicates that salivary leptin is increased in patients with T2D being positively correlated with insulin and por-inflammatory cytokines and should be further explored as a non-invasive biomarker of diabetes mellitus. In addition salivary NGF was positively correlated with pro-inflammatory cytokines and further studies should be performed to evaluate if it could be useful to detect diabetic neuropathy in T2D patients.
This article is protected by copyright. All rights reserved.
http://ift.tt/2pXvhIW
The prognostic value of B7-H6 protein expression in human oral squamous cell carcinoma
Abstract
Objectives
To investigate the expression and prognostic value of B7-H6 protein in oral squamous cell carcinoma tissues.
Materials and Methods
A total of 50 oral squamous cell carcinoma samples, 10 oral leukoplakia samples and 17 normal controls were included in the analysis. The expression of B7-H6 in oral squamous cell carcinoma, oral leukoplakia and normal controls was evaluated by immunohistochemical assay.
Results
The B7-H6 protein expression was significantly higher in oral squamous cell carcinoma tissues than that in normal oral mucosa. Furthermore, a significant relationship was found between the expression of B7-H6 and differentiation, but not with age, sex, tumor size, lymph metastasis, clinical stage or recurrence. Further, the survival curves showed that B7-H6 was an independent prognostic factor of overall survival and disease-free survival in oral squamous cell carcinoma. Moreover, multivariate survival analysis by COX proportional hazards regression model revealed that the recurrence, differentiation and expression of B7-H6 were related to the prognosis. Lastly, we verified the prognostic value of B7-H6 in oral squamous cell carcinoma.
Conclusions
B7-H6 may represent a new prognostic marker for oral squamous cell carcinoma.
This article is protected by copyright. All rights reserved.
http://ift.tt/2p9MI6p
Divergent Schwannoma-Like Phenotype in a Pleomorphic Adenoma
Abstract
The schwannoma-like pleomorphic adenoma is a rare histopathological variant of the pleomorphic adenoma. Five previous reports with seven cases exist in English language literature. These tumors present in the parotid gland most commonly. Intraparotid schwannomas of the facial nerve and schwannomas with glandular differentiation have also been reported. A 60-year-old male presented with an asymptomatic swelling over the left angle of the mandible. The swelling had been present for about 12 years with a recent increase in size. CT imaging showed a hyperdense circumscribed mass of the superficial lobe of the parotid. The working diagnosis was that of a benign tumor of salivary gland or soft tissue origin. The mass was excised with careful preservation of the facial nerve. The 3.5 cm mass was submitted for histopathological examination. The well-circumscribed, encapsulated mass showed a predominant sheet-like proliferation of Antoni type A-like tissue, Foci of glandular differentiation with duct-like structures were also seen. Cytological atypia or mitotic activity were not seen. Nuclei of lesional cells diffusely and strongly expressed reactivity to p63. The final diagnosis was a schwannoma-like pleomorphic adenoma. No recurrence has been reported in the 15 months since the removal. Facial nerve function is unimpaired with a House Brackmann facial nerve function score of one. The potential for misdiagnosis in fine needle aspirate and incisional biopsies is real in cases of schwannoma-like pleomorphic adenoma. The diagnostic pitfalls include the schwannoma and leiomyoma. Schwannomas with glandular differentiation have also been reported and therefore a misdiagnosis may potentially occur in excised specimens. Careful application of immunohistochemistry may help in the differentiation of these lesions.
http://ift.tt/2onjRhN
The expression of Helicobacter pylori tfs plasticity zone cluster is regulated by pH and adherence, and its composition is associated with differential gastric IL-8 secretion
Abstract
Background
Helicobacter pylori virulence is associated with different clinical outcomes. The existence of an intact dupA gene from tfs4b cluster has been suggested as a predictor for duodenal ulcer development. However, the role of tfs plasticity zone clusters in the development of ulcers remains unclear. We studied several H. pylori strains to characterize the gene arrangement of tfs3 and tfs4 clusters and their impact in the inflammatory response by infected gastric cells.
Methods
The genome of 14 H. pylori strains isolated from Western patients, pediatric (n=10) and adult (n=4), was fully sequenced using the Illumina platform MiSeq, in addition to eight pediatric strains previously sequenced. These strains were used to infect human gastric cells, and the secreted interleukin-8 (IL-8) was quantified by ELISA. The expression of virB2, dupA, virB8, virB10, and virB6 was assessed by quantitative PCR in adherent and nonadherent fractions of H. pylori during in vitro co-infection, at different pH values.
Results
We have found that cagA-positive H. pylori strains harboring a complete tfs plasticity zone cluster significantly induce increased production of IL-8 from gastric cells. We have also found that the region spanning from virB2 to virB10 genes constitutes an operon, whose expression is increased in the adherent fraction of bacteria during infection, as well as in both adherent and nonadherent fractions at acidic conditions.
Conclusions
A complete tfs plasticity zone cluster is a virulence factor that may be important for the colonization of H. pylori and to the development of severe outcomes of the infection with cagA-positive strains.
http://ift.tt/2q6BXkD
Reduced infectivity of waterborne viable but nonculturable Helicobacter pylori strain SS1 in mice
Abstract
Background
Helicobacter pylori infection has been consistently associated with lack of access to clean water and proper sanitation, but no studies have demonstrated that the transmission of viable but nonculturable (VBNC) H. pylori can occur from drinking contaminated water. In this study, we used a laboratory mouse model to test whether waterborne VBNCH. pylori could cause gastric infection.
Materials and Methods
We performed five mouse experiments to assess the infectivity of VBNCH. pylori in various exposure scenarios. VBNC viability was examined using Live/Dead staining and Biolog phenotype metabolism arrays. High doses of VBNCH. pylori in water were chosen to test the "worst-case" scenario for different periods of time. One experiment also investigated the infectious capabilities of VBNC SS1 using gavage. Further, immunocompromised mice were exposed to examine infectivity among potentially vulnerable groups. After exposure, mice were euthanized and their stomachs were examined for H. pylori infection using culture and PCR methodology.
Results
VBNC cells were membrane intact and retained metabolic activity. Mice exposed to VBNCH. pylori via drinking water and gavage were not infected, despite the various exposure scenarios (immunocompromised, high doses) that might have permitted infection with VBNCH. pylori. The positive controls exposed to viable, culturable H. pylori did become infected.
Conclusions
While other studies that have used viable, culturable SS1 via gavage or drinking water exposures to successfully infect mice, in our study, waterborne VBNC SS1 failed to colonize mice under all test conditions. Future studies could examine different H. pylori strains in similar exposure scenarios to compare the relative infectivity of the VBNC vs the viable, culturable state, which would help inform future risk assessments of H. pylori in water.
http://ift.tt/2q6C2or
Ten-Year Follow-Up after Bilateral Submacular Neovascular Membrane Removal in a Case of Autosomal Recessive Bestrophinopathy
Herein, we report the case of an 8-year-old girl who presented in December 2000 with a submacular neovascular membrane in the right eye, with a clinical diagnosis of Best disease. At that time, she underwent pars plana vitrectomy (PPV) with removal of the subretinal choroidal neovascularization (CNV). Her vision improved from 20/200 to 20/25. Four years later, a new CNV developed in the other eye. Initially, she underwent unsuccessful photodynamic therapy. As her vision worsened, she underwent a second, this time successful, PPV with membrane removal in the left eye, with vision improving to 20/30. Ten years later, she returned complaining of vision loss over the last year. Her vision was 20/200 OU, and optical coherence tomography demonstrated very large intraretinal cystoid spaces resembling bilateral macular schisis. Four ranibizumab injections as well as dorzolamide eye drops were tried, both without success. Finally, she underwent PPV with internal limiting membrane peeling and gas-fluid exchange in the left eye. One month later, the macula appeared flat and vision had improved to 20/60. The same procedure was performed 1 year later for the right eye, with vision improving to 20/80. One year later, mild cystic spaces developed again in both eyes, although much smaller than previously observed. Her vision remained stable.
Case Rep Ophthalmol 2017;8:265–270
http://ift.tt/2p9kyZ9
Cystic tumour of the atrioventricular node: treatment dilemma
An asymptomatic 18-year-old black woman was found to have an incidental finding of third-degree atrioventricular (AV) block on a routine ECG. 2-Dimensional transthoracic echocardiography showed a heterogeneous mass in the region of the peri-membranous septum in the AV node area. A cardiac MRI showed a well-defined cystic mass arising from the right side of the interatrial septal wall. An MRI compatible permanent pacemaker was implanted with plans to monitor the tumour with non-invasive imaging. Cystic tumour of the AV node is a rare primary cardiac tumour. It is known as the smallest and most common primary cardiac tumour that can cause sudden death. All previous six cases of living patients with cystic tumour of the AV node reported in the literature were females and symptomatic. We present a rare case of a patient with cystic tumour of the AV node, and we highlight the treatment dilemmas for this condition.
http://ift.tt/2p92ApO
Intraductal oncocytic papillary neoplasm: a benign hepatic cystic neoplasm
A 61-year-old Asian man presented with severe right upper quadrant pain which had been worsening for several months. Laboratory results indicated elevated aspartate aminotransferase and alanine aminotransferase. The subsequent ultrasound, CT and MRI showed a large cystic mass with solid components and severe intrahepatic and extrahepatic biliary ductal dilatation. The mass was resected and pathology showed a well-demarcated mucinous cystic lesion with polygonal cells containing ovoid nuclei and abundant pink oncocytic cytoplasm. These findings are characteristic of intraductal oncocytic papillary neoplasm (IOPN), a rare subtype of intraductal papillary neoplasm of the liver. IOPN occurs most frequently in the Asian regions endemic to clonorchiasis and hepatolithiasis; however, cases have been reported in the Western world as well. Patients with IOPN are male or female and typically middle-aged. Treatment is typically resection. Prognosis is favourable and recurrence is rare. The 5-year survival rate is upwards of 80%.
http://ift.tt/2pX3gRE
Mechanical CPR in a child: can one size fit all?
This case report describes the successful resuscitation of an 11-year-old boy who suffered out-of-hospital cardiac arrest (OHCA) using mechanical cardiopulmonary resuscitation (CPR) by adapting the Lund University Cardiopulmonary Assist System (LUCAS)2 Device by rolling a blanket under the patient's back to increase his chest height, thus allowing the LUCAS device to administer compliant CPR.
http://ift.tt/2p9uaDj
Unusual presentation for a tailgut cyst
A 67-year-old man with a slow-growing, asymptomatic perianal lesion was presented to the colorectal clinic. Physical examination and radiological investigation were suggestive of an externally prolapsing colonic polyp. However, intraoperative findings of a cystic lesion containing a thick brown substance questioned the initial diagnosis. After complete surgical resection of the encapsulated lesion, histological examination revealed a tailgut cyst (cystic hamartoma). These uncommon lesions originate from an embryological remnant of the hindgut. They are generally benign but may have extremely rare malignant potential which warrants complete surgical resection. Throughout the literature, they are described to present with various symptoms and may be found in several anatomical locations, most commonly within the retrorectal space. In very rare instances, with only two other documented cases, they can be found externally at the anorectal junction. Although very rare, an anal tailgut cyst should be taken into account in differential diagnosis.
http://ift.tt/2pX319o
Severe vincristine-induced polyneuropathy in a teenager with anaplastic medulloblastoma and undiagnosed Charcot-Marie-Tooth disease
Severe neuropathy is a known adverse effect of vincristine in patients with Charcot-Marie-Tooth disease (CMT). We present the case of a 16-year-old girl with anaplastic medulloblastoma treated with gross total resection and high-dose craniospinal radiation with adjuvant vincristine chemotherapy who developed acute-onset severe quadriplegia and vocal cord paralysis. Vincristine and radiation therapy were discontinued. Although her neuropathy slowly improved over several weeks, she developed metastatic extraneural medulloblastoma and died 5 months after diagnosis. Subsequent genetic testing revealed previously asymptomatic and undiagnosed CMT1A. Our case highlights the importance of early recognition of acute vincristine neurotoxicity that should raise suspicion of an underlying hereditary neuropathy.
http://ift.tt/2p9m0e1
International inter-rater agreement in scoring acne severity utilizing cloud-based image sharing of mobile phone photographs
Abstract
Background
Cloud-based image sharing technology allows facilitated sharing of images. Cloud-based image sharing technology has not been well-studied for acne assessments or treatment preferences, among international evaluators. We evaluated inter-rater variability of acne grading and treatment recommendations among an international group of dermatologists that assessed photographs.
Methods
This is a prospective, single visit photographic study to assess inter-rater agreement of acne photographs shared through an integrated mobile device, cloud-based, and HIPAA-compliant platform. Inter-rater agreements for global acne assessment and acne lesion counts were evaluated by the Kendall's coefficient of concordance while correlations between treatment recommendations and acne severity were calculated by Spearman's rank correlation coefficient.
Results
There was good agreement for the evaluation of inflammatory lesions (KCC = 0.62, P < 0.0001), noninflammatory lesions (KCC = 0.62, P < 0.0001), and the global acne grading system score (KCC = 0.69, P < 0.0001). Topical retinoid, oral antibiotic, and isotretinoin treatment preferences correlated with photographic based acne severity.
Conclusions
Our study supports the use of mobile phone based photography and cloud-based image sharing for acne assessment. Cloud-based sharing may facilitate acne care and research among international collaborators.
http://ift.tt/2pcT5HX
Transient Esotropia in the Child: Case Report and Review of the Literature
The aim of this report is to investigate the possible causes of acute acquired onset of transient esotropia (AATE) in children and to help to differentiate ophthalmoplegic migraine (OM) from accommodative spasm (AS). A case of an 8-year-old Caucasian female affected by AATE and diplopia is described. The day before AATE onset, the patient complained of slight headache without nausea and vomiting, with spontaneous resolution. AATE diagnosis is challenging. The most likely ophthalmological causes of AATE are AS and OM. In these cases it is important to evaluate the presence of both a familial history of recurrent headaches and an AATE associated with migraine, ptosis, nausea, and vomiting. A full ophthalmological evaluation and a thorough refractive examination in cycloplegia are mandatory to exclude ophthalmological causes.
Case Rep Ophthalmol 2017;8:259–264
http://ift.tt/2oCVWXA
Forsaken Foregut: Case Report of Simultaneous Black Esophagus and Ischemic Cholangiopathy
Black esophagus or acute esophageal necrosis rarely occurs after severe hemodynamic compromise or low-flow states. Other contributing factors may include corrosive injury from gastric contents and diminished mucosal repair mechanisms. Ischemic cholangitis, another rare clinical entity, is also usually the result of a significant vascular and/or hypotensive insult to the biliary tree. We describe the first case of combined acute esophageal necrosis and ischemic cholangiopathy in a 62-year-old male who completely recovered from the esophageal injury but developed progressive liver failure from ischemic cholangiopathy.
http://ift.tt/2pcdrBe
A retrospective study: Acute rheumatic fever and post-streptococcal reactive arthritis in Japan
Publication date: Available online 22 April 2017
Source:Allergology International
Author(s): Satoshi Sato, Yoji Uejima, Eisuke Suganuma, Tadamasa Takano, Yutaka Kawano
BackgroundAcute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSRA) are immune-mediated consequences of group A streptococcal pharyngitis. ARF has declined in developed nations. No prevalence survey of PSRA has been conducted. This study evaluated the incidence and characteristics of ARF and PSRA in Japanese children.MethodsFrom 2010 to 2015, ARF and PSRA were evaluated using clinical data retrospectively collected by chart review from 528 hospitals.ResultsFrom 323 hospitals (61% response rate), 44 cases of ARF and 21 cases of PSRA were reported. Patients with ARF and/or PSRA were mainly from large cities in Japan. The mean age of ARF occurrence was 8.5 years, and the ratio of female/male patients was 16:28. Major manifestations in the acute phase included carditis, 27 cases (61.4%); polyarthritis, 22 cases (50%); erythema marginatum, 7 cases (15.9%); Sydenham chorea, 3 cases (6.8%); and subcutaneous nodules, 1 case (2.3%). Twenty-one (58.3%) patients had migratory arthritis. During the follow-up period, 6 patients (13.6%) showed mild carditis. For PRSA, the mean age was 8.2 years, and the ratio of female/male patients was 12:9. Six (28.6%) patients had monoarthritis, and 4 (19%) patients had migratory arthritis. No patient had carditis.ConclusionsAlthough ARF and PSRA are rare in the Japanese pediatric population, substantial numbers of patients with both conditions were identified in this study. We observed a high incidence of arthritis and carditis in ARF patients. No PSRA case was complicated with carditis. General pediatricians need to have updated information about ARF and PSRA, even in industrialized countries.
http://ift.tt/2pWYR18
The role of macrophages in the pathogenesis of mycosis fungoides
Summary
Background
Macrophages are classified into classically activated (M1) and alternatively activated (M2) macrophages. Decrease in macrophage number in tumour tissue with treatment has been reported.
Aim
The aim of this study was to determine whether treatment has an effect on the number of dermal M1 and M2 macrophages in patients with mycosis fungoides (MF).
Methods
In total, 21 patients (8 women, 13 men; age range 42–73 years) were included in this study. We determined markers for dermal M1 (inducible nitric oxide synthase and CD68) and M2 (markers: CD163 and CD206) macrophages using double immunohistochemistry to reduce the error rate, and then counted the cells.
Results
The number of dermal M1 cells was significantly lower pretreatment compared with post-treatment (P < 0.01). The numbers of dermal M2 cells were also numerically decreased by treatment. These results did not change significantly after exclusion of the patients who had recurrence (n = 2). There were no statistically significant differences between groups classified by stage, lesion type or treatment outcome.
Conclusion
Macrophage numbers are decreased in MF after treatment of tumour tissue.
http://ift.tt/2q6m7q3
The watch-pat in pediatrics sleep disordered breathing: Pilot study on children with negative nocturnal pulse oximetry
Source:International Journal of Pediatric Otorhinolaryngology, Volume 97
Author(s): Agostino Serra, Salvatore Cocuzza, Luigi Maiolino, Alessandro Abramo, Giacomo Spinato, Giovanni Tonoli, Maurizio Amadori, Doriano Politi, Giancarlo Tirelli, Roberto Spinato, Paola Di Mauro
ObjectivesThe main purpose of this study was to determine the efficacy of Watch-PAT in Pediatric Sleep Disordered Breathing (PSDB) diagnosis in children with symptoms suggestive of PSDB, in which the nocturnal pulse oximetry was negative according to the Brouilette criteria.MethodsWe enrolled 28 patients aged between 5 and 12 years (mean age: 7.75 ± 1.69), who underwent the registration with Watch-PAT, that utilizes the Peripheral Arterial Tone (PAT), AHI, RDI, body position, snoring, pulse oximetry and actigraphy.ResultsRecording Watch-PAT was indicative of PSDB in 10/28 (35.7%) patients; when it was placed the threshold of AHI > 1 the number of positive patients for PSDB increased to 17/28 (60.7%). Exists a positive correlation between pat-RDI (rho = 0.798, p = 0.005) and the snoring > 40% of the time (rho = 0.656, p < 0.001) were correlated with the pat-AHI values.ConclusionThe recording Watch-PAT appears to permit the defection of a certain number of SDB that might escape to the clinical evaluation and pulse oximetry only.
http://ift.tt/2oXBYcG
Malignant middle cerebral artery infarction
Description
A 55-year-old man with hypertension was referred from a rural hospital. Two days before, he had developed a cardioembolic ischaemic stroke, which resulted in left-sided hemiparesis and hemianaesthesia. On the day of referral, he developed repeated vomiting and severe headache, followed by progressive obtundation and coma. There was papilloedema. Both planter reflexes were extensors. A non-contrast CT brain scan was done (figure 1). The initial CT brain scan was not available for comparison. The patient was outside the international guidelines on timing of decompressive hemicraniectomy (DCH) for ischaemic stroke and was extremely unwell. After a few hours, he died from 'malignant middle cerebral artery (MCA) infarction'.
Figure 1
Axial non-contrast CT brain scan of the patient 2 days after developing right-sided middle cerebral artery embolic occlusion. Note that almost the entire right cerebral hemisphere is swollen and has compressed the left hemisphere. The midline structures...
http://ift.tt/2okTuc5
Migration of clips to the colon after laparoscopic partial nephrectomy
A 78-year-old man was treated with laparoscopic partial nephrectomy for a 4 cm tumour in the lower pole of the left kidney. The patient was discharged 2 days postoperatively. Preoperatively there was no sign of metastasis; the pathology indicated complete removal of the tumour, a renal cell carcinoma. 53 days postoperatively the patient had acute onset of rectal bleeding. A colonoscopy revealed necrosis and three clips on the wall of the colon corresponding to where the descending colon passes over the left kidney. The patient was treated conservatively. Clip migration has been reported previously, but to our knowledge we present the first case of clip migration to the colon after laparoscopic partial nephrectomy. Suggestions to avoid the presented complication are made.
http://ift.tt/2p8rKoh
Diabetes mellitus and acquired haemophilia: new association?
Diabetes mellitus encompasses a group of highly prevalent carbohydrate metabolic disorders with an increasing incidence. Some subtypes are thought to be associated with other immune-mediated diseases. Acquired haemophilia on the other hand is a quite rare autoimmune disease that is thought to be secondary to the emergence of inhibiting anticoagulation factor VIII antibodies (inhibitors) in patients with previously normal haemostatic function. More recently, numerous different diseases have been associated with acquired haemophilia namely immune-mediated diseases, drugs and solid and haematologic neoplasms. The authors report on a case of a patient with new onset acquired haemophilia arising in the setting of diabetic ketoacidosis.
http://ift.tt/2okUNbe
A tenebrous tale: malignant melanoma of the oesophagus
A 57-year-old man presented with a 4-month history of worsening symptoms of oesophageal obstruction. The physical examination was unremarkable. An oesophagogastroduodenoscopy revealed an exophytic tumour in the distal oesophagus. A biopsy demonstrated malignant melanoma. Staging of the melanoma showed disseminated lymph node and bony-spine metastases. He had no prior history of cutaneous or ocular melanoma. Following full multidisciplinary team input, he was palliated with a metal mesh stent and immunotherapy. He died 3 months later following community management.
http://ift.tt/2okWuFB
De Novo PTEN Mutation in a Young Boy with Cutaneous Vasculitis
Phosphatase and tensin homolog (PTEN) is the protein encoded by the PTEN gene (10q23.3). PTEN mutations are related to a variety of rare diseases referred to collectively as PTEN hamartoma tumor syndromes (PHTS), which include Cowden Syndrome, Bannayan-Riley-Ruvalcaba syndrome, Proteus Syndrome, and Proteus-like syndrome. These diseases are associated with an increased risk of malignancy and for this reason an accurate and early diagnosis is essential in order to institute cancer surveillance. PTEN is a regulator of growth and homeostasis in immune system cells, although there are limited data describing immune dysregulation caused by PTEN mutations. We describe a case of PHTS syndrome caused by a de novo mutation in PTEN detected using a targeted next generation sequencing (NGS) gene panel which was instigated for workup of cutaneous vasculitis. We highlight the diagnostic utility of this approach and that mutations in PTEN may be associated with immune-dysregulatory features such as vasculitis in young children.
http://ift.tt/2q5C3J1
The antimicrobial peptide hBD2 promotes itch through Toll-like receptor 4 signaling in mice
Source:Journal of Allergy and Clinical Immunology
Author(s): Jing Feng, Jialie Luo, Madison R. Mack, Pu Yang, Feng Zhang, Guan Wang, Xuan Gong, Tao Cai, Zhinan Mei, Brian S. Kim, Shijin Yin, Hongzhen Hu
Teaser
The psoriasis biomarker hBD2 produces a robust scratching response in a TLR4-dependent manner in mice. TRPV1 is a downstream mediator of hBD2-induced itch. These findings suggest that hBD2 might act as an endogenous pruritogen in psoriatic itch.http://ift.tt/2pVriKj
Εγγραφή σε:
Αναρτήσεις (Atom)